Breath Holding Spells: Practical Parenting Advice From Someone Who’s Lived It
I was standing in the Trader Joe’s checkout line, my cart half-full of bruised bananas and chocolate oat milk, when my two-year-old Lila screwed up her face and went dead silent. She’d been grabbing for the neon blueberry puffs stacked by the register, and I’d just told her no—we already had an unopened box at home. In three seconds, her whole face went from pink to deep purple, her little body went rigid, and the older woman behind me gasped loud enough for everyone within three feet to hear. I didn’t panic this time. I just nudged her back from the sharp edge of the cart, knelt down to her level, and waited. That’s the biggest thing I’ve learned about breath holding spells: most of the time, all you really need to do is wait, the right way.
The first time Lila had a spell, I called 911. She was 18 months old, had snuck into the kitchen and grabbed my sharp kitchen scissors off the counter, and I’d pulled them out of her hand before she could cut anything. She cried for half a second, then went silent, and collapsed on the floor. I was screaming her name, my hands were shaking, and by the time the operator picked up, she woke up and blinked at me like nothing had happened. We went to the pediatrician the next day, and she told me it was a common breath holding spell—something that happens to about 1 in 5 toddlers, when their underdeveloped nervous system gets overwhelmed by frustration or pain and forgets how to regulate breathing automatically. It’s not misbehavior, she said. It’s a reflex.
That didn’t stop the unsolicited advice from rolling in. A mom at playgroup told me I was too soft, that I just needed to let her “snap out of it” and be firmer. My neighbor told me I should just give her what she wanted before she hurt herself. I tried both, and both were wrong. Blowing hard in her face to jolt her into breathing, which a cousin suggested, just scared her so bad the next spell lasted 10 seconds longer. Giving in once—after that first terrifying 911 call, I let her hold the blunt craft scissors for five minutes just to calm both of us down—meant she had another spell two days later when I said no to ice cream for breakfast. Even though it’s not intentional manipulation, kids quickly connect the dots: this big scary reaction gets me what I want, so I’ll do it again.
What stuck, after months of trial and error, are small, concrete things that don’t take any extra effort or fancy parenting tricks. First, I always check for safety first, and that’s it. If we’re near stairs, or a parking lot, or a hard edge of furniture, I gently move her to a soft, clear spot. I don’t grab her or shake her or yell “breathe!” at the top of my lungs—all that just spikes my own stress, which she picks up on, and makes her more rigid. Instead, I keep my voice soft, and I say the same thing every time: “I’m here. Your body will remember how to breathe soon.” I count seconds under my breath, because I know 99% of spells end in less than a minute, and that keeps me from spiraling into panic.
After it’s over, I don’t make a big fuss. If she passes out, when she wakes up I just check for bumps, give her a quick hug if she wants it, and move on. If she doesn’t pass out, once she’s breathing regularly again, I name her feeling so she starts to learn what she’s feeling, but I don’t back down on the original rule. That day at Trader Joe’s, after it was over, she gasped for air and started crying soft little sobs, and I said “I know you were so mad you couldn’t get the puffs right now. We have a whole box at home, and we can have some as soon as we get there. Let’s go pay now.” No extra attention, no negotiation, no big lecture.
I also started doing a few small pre-emptive things that cut the number of spells almost in half in a month. I noticed 8 out of 10 of Lila’s spells happened when she was tired or hungry, so I stopped scheduling errands and playdates right before nap time, and I always keep a pack of plain crackers in my diaper bag for when we run late. Before we walk into any store where she usually asks for treats, I tell her exactly what to expect: “Today we’re buying milk and apples. We aren’t getting any candy or puffs because we have those at home. Your job is to help me put the apples in the bag, okay?” Giving her a small, specific job gives her something to focus on instead of fixating on the thing she can’t have.
My pediatrician did give me one clear rule for when to worry, and I pass that on too: call a doctor if a spell lasts longer than a minute, if your kid doesn’t wake up within two minutes of passing out, if they have weakness or stiffness on one side after, or if they’re still having spells after they turn 5. I never had to use that, but it’s good to have it clear in your head so you don’t brush off something that actually needs checking.
Lila just turned three last month. She hasn’t had a full spell in almost five months. The last one was at the playground, when a little boy grabbed her favorite purple shovel out of her hand. I walked over, stood between her and the edge of the climbing structure, said my line, and she started breathing again before 30 seconds passed. Now when she’s mad, she yells “I so angry!” and stomps her feet, which is way easier to deal with. I still get that little jolt of panic when I see another parent staring wide-eyed at a breath-holding kid at the store, and I want to go over and tell them it’s going to be okay. It’s scary, there’s no way around that. But it’s just a phase most kids grow out of, and you don’t have to do anything fancy to get through it. The small, calm, consistent things are the ones that work.
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