The Breath-Holding Child

QUESTION: It's frightening and distressing, and most important; I just don't
know what to do about it. My 3 and a half year old, when he gets mad, will
just hold his breath until he passes out. He actually turns blue! Do you
know what this condition comes from and what I can do about it?
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ANSWER: A breath-holding child can be a most alarming experience for a
parent, but while your heart is racing away, the child is doing little damage
to itself. These attacks are benign and don't evolve into more serious
conditions. They are limited to young children, begin between the ages of 6
and 18 months and are over by 5 or 6 years of age. Typically they start from
an event as minor as a fright or minor bump, or even just frustration, and
the child cries vigorously for several moments. Then, suddenly, they gasp,
stop breathing, becoming blue (cyanotic) from lack of oxygen, become rigid and
then lose consciousness. Then normal breathing resumes, and when the child
returns to consciousness the episode is over. In severe cases, there may
even be a seizure, but less severe cases may last for a minute or less. There
may be a family history of this problem about 25% of the time, but a careful
examination by a physician is in order to be sure that this is merely a
breath-holding disorder, rather than epileptic seizures or a condition known
as pallid infantile syncope. Treatment is almost totally in your hands, and
the manner in which you react to these episodes. If you can maintain your
cool, strengthened by the reassurance that there are no terrible results from
the terrifying sequence of events, than you can address the whims of your
child with firm, quiet determination. If you allow your fear to overcome your
good counsel, the child will take over, using the threat of breath-holding to
manipulate you. When you are convinced that breath-holding attacks are
harmless, you will regain control and be able to deal effectively with these
attacks, which are self-limited.