Why Do Toddlers Have Breath Holding Spells? Practical Advice For Parents and Caregivers
I’m in the cereal aisle at the grocery store, leaning down to grab the honey-oats my 7-year-old swears are the only acceptable breakfast, when my 2-year-old Mia lets out a sharp yell. She’d spotted the pink unicorn cereal with the glitter prize inside, and I’d told her we’d get it next trip, after she finished the half-eaten box of puffs we had at home. Next thing I know, her face screws up, her little fists clench at her sides, she sucks in a huge breath… and doesn’t breathe out.
I’d never seen anything like it. Her lips started turning pale, then blue, and I panicked. I grabbed her shoulders, shook her gently, and begged her to breathe, my voice way louder than I meant it to be. After what felt like a full minute, she gasped, body jerking, and started wailing. I grabbed the pink unicorn box off the shelf, threw it in my cart, and got us out of there as fast as I could, my face hot from all the stares other shoppers were giving me.
It happened again two weeks later at playgroup, when a little boy took the blue shovel Mia had been digging with. This time, I knew what was coming, but I still felt that twist of panic and embarrassment. I kept thinking the other parents were judging me for having a kid that threw such extreme tantrums. I thought Mia was just being manipulative, that I’d caved once and now she was using this big scary trick to get what she wanted. That night, I called the pediatrician and got an appointment first thing the next week.
She checked Mia over, asked me a dozen questions about when the spells happened and how long they lasted, then told me something that took a huge weight off my chest: this wasn’t misbehavior. It’s a reflex, common in kids between 6 months and 4 years old, caused by an immature nervous system. When kids get so overwhelmed by frustration, fear, or even pain that their brain can’t process it fast enough, the automatic signal to keep breathing glitches. About one in 10 kids experience breath holding spells, she said, and almost all outgrow them completely by the time they’re 5.
Over the next few months, I tried what she suggested, and worked out a routine that’s made everything way easier. The first and most important thing I learned is to not panic. I used to run over, grab Mia, and make a huge fuss out of what was happening, which just ramped up both our stress levels. Now, the second I see her hold that breath, I first steady her if she’s standing, and gently sit her on the floor or a soft couch if she looks wobbly, to keep her from falling and hitting her head. I move anything hard or sharp out of the way, just in case. Then I stay low, keep my voice calm, and say one simple thing: “I know you’re really mad. I’m here, you can breathe.” I don’t repeat it over and over. I just wait.
The next thing that made a big difference is not giving in to whatever she was crying about just to end the spell. The doctor explained that while spells aren’t intentional at first, if you always give the child what they want right after, they’ll quickly learn that the spell gets them what they’re after, and they happen more often. After my appointment, I tested this: Mia had a spell when I wouldn’t let her climb on the kitchen counter to grab the cookie jar. I sat her on the tile next to me, waited out the 30 second spell, and when she started crying after, I said “I know you want a cookie before dinner, that makes you so mad. Cookies are for after we eat. Let’s go play with your playdough while we wait.” I didn’t give her the cookie, I just stuck to the rule. After a month of this, the spells went from a couple times a week to once every couple of weeks.
Mia’s daycare teacher told me she does something similar: when a spell happens, she moves Mia to a soft spot on the rug away from the other kids, waits it out, and once it’s over, they go back to whatever activity they were doing like nothing happened. She doesn’t make a big deal out of it in front of the class, which keeps Mia from getting extra attention that could encourage it.
Most spells are totally harmless, but it’s good to know when to check in with a doctor. If a spell lasts longer than a minute, if your kid is sleepy or confused for more than 10 minutes after it ends, or if you’re having more than five spells a week, give your pediatrician a call. Mine also checked Mia’s iron levels, because low iron can make spells more common for some kids, and that’s an easy fix if it comes up.
Mia is two and a half now. She still has a spell every once in a while, usually when she’s tired and can’t put her big feelings into words. Last week at the park, an older kid cut her off in line for the slide, and she sucked in that familiar breath. I felt that old split second jolt of panic, just an old habit. But I just walked over, moved a sharp stray rock out of the way, knelt down, and waited. Twenty seconds later, she gasped, then cried into my shoulder. I wiped her face, said that was really unfair, and walked her back to the line. Five minutes later she was sliding down whooping, like nothing had happened.
I don’t know when she’ll outgrow these completely. It’s still a little awkward when it happens in front of people who haven’t seen it before, and I still get that little twist of fear every time. But I don’t lie awake worrying anymore, and I don’t buy overpriced sugary cereal I don’t want just to avoid it. It’s just one of those messy, unexpected parts of raising a toddler that no one warns you about. For now, that’s enough.
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