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Hi again,

My son had another episode the next day where this happened to him and he was rushed to the hospital and stayed for 5 days.His Oxygen was very low, he had an ear infection in the right ear and pneumonia in his right lung, he also is very congested b/c he has a cold. The Doctors say is could be this Breath Holding Spell or he could be having Seizures.We still do not know what happened but we are scheduled for an EEG and a MRI in 2 weeks. They did several tests in the hospital but we are waiting for those 2 tests. Should I be very concerned or ask for them to do some other types of tests on him? I am very nervous and scared that something is going to happen to my son and not know what to do or what to ask the Doctors. Can you please give me some advice on what to do? Just so you know, when he had the 2nd episode he was not crying, he was playing and it sounded like he was choking and then just stopped breathing and turned blue and went limp and was not moving with his eyes opened. My son also had an episode in the hospital and the doctors were able to see what happened and placed him in an Oxygen tent (which he was in for 4 days). Please any advice?
Followup To

Question -
When my  13th month old cries he turns blue(lips & face) and he stops breathing. Is this normal? We just had an incident a few minutes ago and it was very scary. My son was crying and he turned blue stopped breathing and his eyes were not moving. We were running to the car and he stopped and was fine. Can you help me understand why he does this? And is there anything we can do to make this stop? It is very scary.

Answer -
Hi, Alexis,

This is a standard breath holding spell and won't hurt him at all.  Here is a handout I give to my patients.  Hope it helps.

Good luck, Dr. Olson


Breath-Holding Spells
What is a breath-holding spell?
A breath-holding spell is when your child holds his breath when he is suddenly injured, frustrated, angry, or frightened.  Breath-holding spells begin between the ages of 6 months and 2 years.  They occur only while the child is awake.
During a breath-holding spell:
  Your child may make 1 or 2 cries and then hold his breath in expiration until he becomes blue around the lips and passes out.  
  Your child may stiffen and may have a few twitches or muscle jerks.  
  Your child will breathe normally again and become fully alert in less than 1 minute.  
What is the cause?
An abnormal reflex allows 5% of normal children to hold their breath long enough to pass out.  Most children do not do this deliberately.  
Holding the breath (when frustrated) and becoming bluish without passing out is such a common reaction in young infants that it is not considered abnormal.  
How long does it last?
Breath-holding spells usually occur from 1 or 2 times a day to 1 or 2 times a month.  Children usually stop having breath-holding spells by the time they are 4 or 5 years old.  
Breath-holding spells are not dangerous, and they don't lead to epilepsy or brain damage.  
How can I take care of my child?
  Treatment during attacks of breath-holding
These attacks are harmless and always stop by themselves.  Time the length of a few attacks, using a watch with a second hand.  
During an attack, do not hold your child upright.  Instead, he should lie flat.  This position will increase blood flow to the brain and may prevent some of the muscle jerking.  Put a cold wet washcloth on your child's forehead until he starts breathing again.  Don't start resuscitation or call a rescue squad--it's not necessary.  Also, don't put anything in your child's mouth because it could make him choke or vomit.  
  Treatment after attacks of breath-holding
Give your child a brief hug and go about your business.  A relaxed attitude is best.  If you are frightened, don't let your child know it.  If your child had a temper tantrum because he wanted his way, don't give in to him after the attack.  
  Prevention of injuries
The main injury risk of a breath-holding spell is a head injury.  If your child starts to have an attack while standing near a hard surface, go to him quickly and help lower him to the floor.
What can I do to help prevent breath-holding spells?
Most attacks from falling down or a sudden fright can't be prevented.  Neither can most attacks that are triggered by anger.  However, some children can be distracted from their breath-holding if you intervene before they become blue.  Tell your child to come to you for a hug or to look at something interesting.  Ask him if he wants a drink of juice.
If your child is having attacks every day, he probably has learned to trigger some of the attacks himself.  This can happen when parents run to the child and pick him up every time he starts to cry, or when they give him his way as soon as the attack is over.  Avoid these responses and your child won't have an undue number of attacks.  
When should I call my child's health care provider?
Call during office hours if:
  More than one spell occurs each week.  
  The attacks change.  
  You have other concerns or questions.  
Caution:  Call a rescue squad (911) if your child has a different kind of attack during which he stops breathing for more than 1 minute or turns white (not blue).

Answer
Hi, Alexis,

The second episode was unlikely a breath-holding spell.  Did he choke on something, a small toy, etc. and has a pneumonia because of that?  Does he have a small object blocking his airway, causing the lung with the "pneumonia" to collapse?  

Just some thoughts.  Sounds like your doctors are on the right track.  Hope he does well, Dr. Olson

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David Olson, MD

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I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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