Breath-Holding Spells
What causes breath-holding spells in young children?
Breath-holding spells are an involuntary reflex in children aged about 6 months to 3 years, triggered by upset, frustration, pain or fright. Blue spells follow hard crying; pale spells follow a shock or knock. They run in families and are linked to iron deficiency. Almost always harmless, most children outgrow them — but a doctor should confirm the diagnosis and rule out seizures.
One moment your toddler is crying hard — the next they go silent, stiffen, and their lips turn blue. It is one of the most frightening things a parent can witness, and almost always far less dangerous than it looks.
In short
Breath-holding spells happen when a young child — usually between 6 months and 3 years — gets a sudden trigger like pain, fright, frustration or anger, cries hard, and then involuntarily stops breathing on the out-breath. They are reflexive, not deliberate — your child is not doing it on purpose and cannot control it. The two common types are blue (cyanotic) spells, set off by upset or frustration, and pale (pallid) spells, set off by sudden pain or a fright. They are common, almost always harmless, and most children grow out of them by school age.What actually causes them
A spell is an exaggerated reflex in a still-maturing nervous system — not a behaviour your child has chosen.- Blue (cyanotic) spells — triggered by anger, frustration or hard crying. The child cries vigorously, breathes out, and then holds the breath out; oxygen briefly dips and the lips and face go bluish. This is the most common type.
- Pale (pallid) spells — triggered by a sudden shock, fright or minor knock to the head. The heart rate briefly slows (a vagal reflex), the child goes pale and limp, and may faint momentarily.
- Underlying contributors — these spells run in families, so there is often a genetic tendency. Iron deficiency (with or without anaemia) is a well-recognised factor, and correcting it can reduce how often spells happen — which is why a doctor may check iron levels.
During a spell a child may briefly lose consciousness, stiffen, or have a few jerks. This is alarming but usually passes within under a minute, after which the child recovers and breathes normally again.
When to see a doctor
Spells themselves are usually benign, but a doctor should confirm that — and rule out look-alikes. Seek a prompt medical review if: the spells started before 6 months or continue beyond 6 years, the episodes are very frequent, recovery is slow or your child seems unwell or drowsy afterwards, or there is any doubt about whether it was a spell or a seizure. Breathing that stops on its own and recovers quickly after a clear trigger is reassuring; unexplained or prolonged episodes always deserve a clinician's eyes.The Pinnacle way
A clinical AbilityScore® and any diagnosis are formed only at a Pinnacle Blooms Network centre, under qualified clinician care — never from an article or an app. If frequent spells sit alongside any worry about how your child is developing, calming or connecting, a structured developmental check brings clarity and peace of mind. Explore [how we support emotional regulation](/), understand what the AbilityScore is and how it is established, and learn about behaviour and emotional therapy.Trusted sources
American Academy of Pediatrics (HealthyChildren.org) guidance on breath-holding spells; NICE clinical knowledge on paediatric breath-holding and iron status.Next step — Frightened by a recent spell, or noticing them often? [Book a gentle developmental check with a Pinnacle clinician](/) for reassurance and a clear plan.
This is general information, not a diagnosis — a clinical AbilityScore® and any diagnosis are formed only at a Pinnacle Blooms Network centre under qualified clinician care.
What to watch
Watch whether spells follow a clear trigger (crying, fright, a knock) and whether your child recovers quickly and fully within a minute. Note any spells before 6 months or after 6 years, very frequent episodes, slow recovery, drowsiness afterwards, or doubt about whether it was a spell or a seizure — and share these with your doctor.
Try this at home
During a spell, stay calm and keep your child safe — lay them flat on their side, clear the area, and do not shake, splash water or put anything in their mouth. Most spells end on their own in under a minute. Afterwards, comfort your child normally and avoid giving in to the trigger out of fear, as that can unintentionally reinforce the pattern.
Trusted sources
Developed by SETU Consortium · Pinnacle Blooms Network · Last reviewed 2026-06-10 · reviewed every 365 days
This is general information, not a diagnosis. A clinical AbilityScore® and any diagnosis are formed only at a Pinnacle Blooms Network centre, under qualified clinician care.
Frequently asked
Are breath-holding spells dangerous?
They look terrifying but are almost always harmless. The breathing stops only briefly and recovers on its own, usually within under a minute, with no lasting harm. A doctor should still confirm the diagnosis and rule out other causes such as seizures.
Is my child holding their breath on purpose?
No. Breath-holding spells are an involuntary reflex in a still-maturing nervous system, not a deliberate tantrum behaviour. Your child cannot start or stop a spell at will, even though one may begin during crying or frustration.
Can iron deficiency cause breath-holding spells?
Iron deficiency, with or without anaemia, is a well-recognised contributor, and correcting it can reduce how often spells occur. This is why a doctor may check your child's iron levels and recommend supplementation if needed.
When will my child grow out of breath-holding spells?
Most children outgrow them by around school age. Spells typically start between 6 months and 3 years; if they begin before 6 months, continue beyond 6 years, or are very frequent, see a doctor to confirm what is happening.