Materiały źródłowe

• #1 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Breath-holding spells commonly affect up to 5% of all infants. While they are benign, they might be a frightening experience for children and, consequently, for their caregivers. Breath-holding spells occur in children with benign neurological examination findings and children who meet age-appropriate developmental milestones. Typically breath-holding spells do not affect the subsequent neurological development of a child. […] These episodes can be reduced by distracting the child and avoiding the triggers. While benign, knowing these spells’ pathophysiology and differential diagnosis is essential so other pathological conditions may be ruled out. This activity reviews the evaluation of breath-holding episodes and the role of the interprofessional team in managing this condition and educating the parents.

• #2 Baby Breath Holding: Causes, Diagnosis, Treatment, and Outlook

  https://www.healthline.com/health/parenting/baby-holding-breath

  Breath holding affects 0.1% to 4.6% of otherwise healthy young children. It typically starts occurring between 6 and 18 months of age. […] Theres no known medication that will stop a baby from holding their breath. […] In some cases, breath holding may be related to iron deficiency anemia. In these cases, an iron supplement may help decrease the frequency of breath holding. […] If breath holding increases in frequency or interferes with daily activities, your childs doctor may refer them to a neurologist (brain specialist) and cardiologist (heart specialist). These healthcare professionals can rule out an underlying medical condition.

• #3 Breath-Holding Spells (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/spells.html

  A breath holding spell is when a child holds their breath, usually after being angry, frustrated, startled, or in pain. Sometimes the breath holding leads to the child passing out. […] Kids outgrow the spells without any treatment. […] Treating the anemia may help reduce the number of spells. […] If this is your child’s first breath-holding spell, get medical care. Although the spells aren’t harmful, it’s good to get your child checked out. […] Your doctor can work with you on ways to try to limit your child’s spells. […] If you are very worried about the spells, talking to a mental health professional can help you find ways to cope.

• #4 What Are Breath-Holding Spells in Kids? | Children’s Hospital Colorado

  https://www.childrenscolorado.org/just-ask-childrens/articles/breath-holding-spells/

  Everything You Need to Know About Breath-Holding Spells […] Watching your child have a breath-holding spell can be scary and overwhelming. These spells occur in about 5% of healthy children, and about 20% to 33% of children with breath-holding spells have a family history of them. Our Associate Clinic Medical Director of the Child Health Clinic, Elizabeth Kudron, MD, MPH, shares what happens during these spells, how to keep your child safe, when to call your child’s doctor and more. […] A breath-holding spell is when your child or baby holds their breath for long enough that they temporarily stop breathing, which sometimes causes them to pass out. You might notice a child get blue lips or face right before passing out during a breath-holding spell. These incidents are almost always triggered by an upsetting event, such as being angry that parents or caregivers set limits, being scared, falling or being in pain due to a mild injury. Most spells only last 10 to 60 seconds.

• #5 Breath-holding in babies and children

  https://www.nhs.uk/conditions/breath-holding-in-babies-and-children/

  Breath-holding is when a baby or child stops breathing for up to 1 minute and may faint. It can happen when a child is frightened, upset, angry, or has a sudden shock or pain. It’s usually harmless but can be scary for parents, particularly when it happens for the first time. […] Breath-holding is usually harmless and your child should grow out of it by the age of 4 or 5. […] There’s no specific treatment for breath-holding. It should eventually stop by the time your child is 4 or 5 years old. […] Medicines are rarely used to treat breath-holding. […] Breath-holding is sometimes related to iron deficiency anaemia. […] Your child’s blood iron levels may be checked. They may need iron supplements if their iron levels are low.

• #6 What Are Breath-Holding Spells in Kids? | Children’s Hospital Colorado

  https://www.childrenscolorado.org/just-ask-childrens/articles/breath-holding-spells/

  Even though a breath-holding spell can be overwhelming and might cause worry, you can focus on comforting your child immediately after a spell. Then, you can return to your regular activities. Remember that they didn’t have a breath-holding spell on purpose. It’s OK to feel scared, but it’s important to reassure your child that they are safe. […] Although breath-holding spells are often frightening for caregivers, they do not cause brain damage or any other harm, and your child will outgrow them. […] You should talk to your child’s doctor if you think that your child had a breath-holding spell. Some children with breath-holding spells may have low iron or blood levels (anemia). Your child’s doctor may want to run additional tests and can help determine if your child has breath-holding spells or another diagnosis, such as seizures which can sometimes appear similar to a breath-holding spell.

• #7 Breath-Holding Spells – Child Neurology Foundation

  https://www.childneurologyfoundation.org/disorder/breath-holding-spells/

  The use of antiseizure medications is almost never recommended for breath-holding spells. This is true even in cases where the child shows brief convulsive movements during a spell. In rare cases, a breath-holding spell may evolve into an actual epileptic seizure. Still, this typically does not warrant the use of an antiseizure medication. […] No long-term neurological or health issues occur as a consequence of having breath-holding spells in childhood. […] There is not an increased risk of having epileptic seizures associated with breath-holding spells. This is true even if the child shows convulsive movements during the spell. […] Overall, outlook is excellent for both types of breath-holding spells.

• #8 What Are Breath-Holding Spells in Kids? | Children’s Hospital Colorado

  https://www.childrenscolorado.org/just-ask-childrens/articles/breath-holding-spells/

  It is important to know that this is something a child can’t control, and you can’t prevent them from occurring. They will only occur when your child is awake and do not occur during sleep. […] You can help keep your child safe when they have a breath-holding spell by following these steps: Help your child lie flat on their side during a spell. Stay with them until the spell ends and they start breathing again. Make sure there isn’t anything around your child that they could hit their heads, arms or legs on. Do not put anything in your child’s mouth because it could make them choke or vomit. Try to remain calm. The spell should last less than 1 minute. Call 911 if your child is not breathing for more than 1 minute, as this could indicate something else is going on that might require immediate medical attention, such as choking or a seizure.

• #9 Breath holding

  https://www.rch.org.au/kidsinfo/fact_sheets/Breath_holding/?hc_location=ufi

  Breath holding is common, especially in children aged six months to six years old. […] No treatment is needed and your child will start breathing and recover by themselves. […] It is unlikely your child is holding his breath on purpose, even if it looks like hes holding his breath as part of a tantrum. […] Your doctor may want to check your child’s iron levels and may start an iron supplement to try and reduce the frequency of spells.

• #10 Breath-Holding Spells

  https://mentalhealth.networkofcare.org/lake/HealthLibrary/Article?docType=na&articleId=hw31827

  Breath-holding spells are usually not serious and don’t cause lasting damage. With time, they go away on their own. […] Most children don’t need treatment for breath-holding spells. Spells will go away as your child gets older. If your doctor thinks that a medical condition is causing the spells, your child may need treatment. […] To decrease the chance of more spells, make sure that your child gets plenty of rest, and try to help your child feel secure. Be sure to tell your child’s doctor if your child starts to have spells more often or if they seem worse or different than before. […] If you have trouble dealing with your child’s spells or find yourself getting angry, talk with your doctor or a counselor. Try to keep in mind that your child isn’t having spells on purpose. […] After the spell, reassure your child. Don’t punish your child for having the spell.

• #11 Breath-Holding Spells in Toddlers | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/breath-holding-spells-toddlers

  Young children, when faced with an upsetting situation or sudden pain, can hold their breath, causing them to turn bluish or pale, and pass out. Although this is alarming to parents, breath-holding spells are generally not harmful. Children who experience these episodes typically recover quickly with no lasting effects. […] If this is the first time your child has experienced one of these spells, contact your primary care provider. There may be a correlation of breath-holding spells with iron-deficiency anemia, so your child’s primary care provider may check the blood count. It is also important to rule out other more serious conditions that in rare cases may mimic breath holding spell. […] The parents best response to a breath-holding spell is to remain calm, recognize that your child isn’t doing it on purpose, and offer reassurance. Discuss the problem with your child’s primary care provider.

• #12 What Are Breath-Holding Spells in Kids? | Children’s Hospital Colorado

  https://www.childrenscolorado.org/just-ask-childrens/articles/breath-holding-spells/

  It is important to know that this is something a child can’t control, and you can’t prevent them from occurring. They will only occur when your child is awake and do not occur during sleep. […] You can help keep your child safe when they have a breath-holding spell by following these steps: Help your child lie flat on their side during a spell. Stay with them until the spell ends and they start breathing again. Make sure there isn’t anything around your child that they could hit their heads, arms or legs on. Do not put anything in your child’s mouth because it could make them choke or vomit. Try to remain calm. The spell should last less than 1 minute. Call 911 if your child is not breathing for more than 1 minute, as this could indicate something else is going on that might require immediate medical attention, such as choking or a seizure.

• #13 Breath Holding Spells: Do This When Your Upset Child Hoods Breath

  https://www.webmd.com/children/children-breath-holding

  If your child has one breath-holding spell, theyll likely have more. Some children have them several times a day, while others may have just one in a year. […] There are no drugs or other treatments for these spells. Some studies suggest that anemia, or low levels of red blood cells, may be a culprit and that iron supplements may help. But more research is needed. Your doctor may order blood work to determine iron levels. […] The best thing to do is let your child lie on their side while they’re out. That helps the blood flow to their brain and gives them a chance to recover more quickly. […] Your childs doctor may teach you how to spot triggers that cause the spells, so you may prevent them. Sometimes, blowing hard on your babys face can interrupt a breath-holding spell. But this wont work for every baby, and it may not work for older children. […] If temper tantrums set off breath-holding attacks, your doctor may help you figure out a new way to set limits for your child. Take care not to give in to your child just to avoid a spell. This can lead to behavior problems that may last even after they’re outgrown their breath-holding spells.

• #14 Breath holding spell Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/breath-holding-spell

  Some children have breath-holding spells. This is an involuntary stop in breathing that is not in the child’s control. […] No treatment is usually needed. But iron drops or pills may be given if your child has an iron deficiency. […] During a spell, make sure your child is in a safe place where they will not fall or be hurt. […] Place a cold cloth on your child’s forehead during a spell to help shorten the episode. […] After the spell, try to be calm. Avoid giving too much attention to the child, as this can reinforce the behaviors that led to the spell. […] Avoid situations that cause your child’s temper tantrums. This can help reduce the number of spells. […] Ignore breath-holding spells that do not cause your child to faint. Ignore the spell in the same way you ignore temper tantrums.

• #15 Breath-holding spell – UF Health

  https://ufhealth.org/conditions-and-treatments/breath-holding-spell

  No treatment is usually needed. But iron drops or pills may be given if your child has an iron deficiency. […] During a spell, make sure your child is in a safe place where they will not fall or be hurt. […] Place a cold cloth on your child’s forehead during a spell to help shorten the episode. […] After the spell, try to be calm. Avoid giving too much attention to the child, as this can reinforce the behaviors that led to the spell. […] Avoid situations that cause your child’s temper tantrums. This can help reduce the number of spells. […] Ignore breath-holding spells that do not cause your child to faint. Ignore the spell in the same way you ignore temper tantrums.

• #16 Iron supplementation for the treatment of breath-holding attacks in children | Cochrane

  https://www.cochrane.org/CD008132/BEHAV_iron-supplementation-for-the-treatment-of-breath-holding-attacks-in-children

  Iron may reduce the frequency and severity of breath-holding attacks (or spells) in children but more research is needed to determine the extent of this effect. […] Iron supplementation, which is generally well tolerated orally, may reduce the frequency and severity of breath-holding attacks, particularly if the child is anaemic. […] Iron supplementation (at 5 mg/kg/day of elemental iron for 16 weeks) appears to be useful in reducing the frequency and severity of breath-holding attacks. […] Iron may still be of assistance in children who are not anaemic or who have low, normal haemoglobin levels. […] Further high-quality randomised control trials of iron supplementation to treat breath-holding attacks in children are required. […] Iron supplementation has been claimed to reduce the frequency or severity, or both, of breath-holding attacks in children. […] In these trials, iron supplementation significantly reduced the frequency of breath-holding attacks in children (OR 76.48; 95% CI 15.65 to 373.72; P 0.00001).

• #17 What Are Breath-Holding Spells in Kids? | Children’s Hospital Colorado

  https://www.childrenscolorado.org/just-ask-childrens/articles/breath-holding-spells/

  It is important to know that this is something a child can’t control, and you can’t prevent them from occurring. They will only occur when your child is awake and do not occur during sleep. […] You can help keep your child safe when they have a breath-holding spell by following these steps: Help your child lie flat on their side during a spell. Stay with them until the spell ends and they start breathing again. Make sure there isn’t anything around your child that they could hit their heads, arms or legs on. Do not put anything in your child’s mouth because it could make them choke or vomit. Try to remain calm. The spell should last less than 1 minute. Call 911 if your child is not breathing for more than 1 minute, as this could indicate something else is going on that might require immediate medical attention, such as choking or a seizure.

• #18 Breath holding spell Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/breath-holding-spell

  Some children have breath-holding spells. This is an involuntary stop in breathing that is not in the child’s control. […] No treatment is usually needed. But iron drops or pills may be given if your child has an iron deficiency. […] During a spell, make sure your child is in a safe place where they will not fall or be hurt. […] Place a cold cloth on your child’s forehead during a spell to help shorten the episode. […] After the spell, try to be calm. Avoid giving too much attention to the child, as this can reinforce the behaviors that led to the spell. […] Avoid situations that cause your child’s temper tantrums. This can help reduce the number of spells. […] Ignore breath-holding spells that do not cause your child to faint. Ignore the spell in the same way you ignore temper tantrums.

• #19 Breath-Holding Spells

  https://mentalhealth.networkofcare.org/lake/HealthLibrary/Article?docType=na&articleId=hw31827

  Breath-holding spells are usually not serious and don’t cause lasting damage. With time, they go away on their own. […] Most children don’t need treatment for breath-holding spells. Spells will go away as your child gets older. If your doctor thinks that a medical condition is causing the spells, your child may need treatment. […] To decrease the chance of more spells, make sure that your child gets plenty of rest, and try to help your child feel secure. Be sure to tell your child’s doctor if your child starts to have spells more often or if they seem worse or different than before. […] If you have trouble dealing with your child’s spells or find yourself getting angry, talk with your doctor or a counselor. Try to keep in mind that your child isn’t having spells on purpose. […] After the spell, reassure your child. Don’t punish your child for having the spell.

• #20 Breath-holding spells in children | Raising Children Network

  https://raisingchildren.net.au/babies/behaviour/common-concerns/breath-holding

  Breath-holding spells usually end within 30-60 seconds, when children stop holding their breath and start to cry or scream. […] Seek medical attention the first time your child has a breath-holding incident. Your health professional will check to make sure that your child doesn’t have a more serious condition. […] You can’t prevent breath-holding, but you might be able to prevent the events leading up to breath-holding. […] If your child’s breath-holding is triggered by tantrums because you said no to something, try to avoid giving in and saying yes. It’s important to give your child clear boundaries and guide them towards positive behaviour.

• #21 Breath-holding spells factsheet | The Sydney Children’s Hospitals Network

  https://www.schn.health.nsw.gov.au/breath-holding-spells-factsheet

  Breath-holding spells are common in young children. They do not usually need to be diagnosed by a doctor. […] There is no treatment for breath-holding spells. […] Parents and carers can make sure their child is safe during a breath-holding spell by staying calm and comforting your child, laying your child on their side, making sure nothing is blocking your child’s mouth or nose, and making sure there is nothing around your child that could hurt them if they fall or lose consciousness. […] Comfort your child after the spell without focusing on or rewarding it. While children do not hold their breath on purpose, rewarding them after a spell can teach them to associate breath-holding with comfort. This can lead to future issues. […] If you are concerned about your child’s ability to manage big feelings and breath-holding spells, speak to your local doctor.

• #22 Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6696822/

  Breath-holding spells are frightening and stressful to parents. Confident reassurance and frank explanation are cornerstones of treatment. Advice regarding the handling of frustration, anger and discipline is appropriate. Parents should be counseled to reduce sources of conflict, such as coercion in eating, premature bowel and bladder training, and excessive parental demands. Parents should be advised to be tolerant and consistent in discipline. […] It has been shown that iron supplementation in children with breath-holding spells and concomitant iron deficiency anemia or iron deficiency is effective in decreasing the frequency and severity of the breath-holding spells. Furthermore, the autonomic nervous system dysregulation in children with breath-holding spells can be improved by iron supplementation. A Cochrane review of two randomized and quasi-randomized controlled trials comparing iron supplementation with placebo or no therapy in 84 children with recurrent breath-holding spells showed that iron supplementation significantly reduced the frequency of breath-holding spells (odds ratio: 76.48; 95% confidence interval: 15.65 to 372.72; p 0.00001).

• #23

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ad1702

  Home treatment usually is all that is needed for breath-holding spells. You can make breath-holding spells less likely by helping your child get plenty of rest, feel secure, and manage their frustration. […] Talk to your doctor if: Spells become more frequent or more severe or change their pattern. […] Make sure all your child’s caregivers understand the cause of breath-holding spells and how to manage them.

• #24 Breath-Holding Spells

  https://mentalhealth.networkofcare.org/lake/HealthLibrary/Article?docType=na&articleId=hw31827

  Breath-holding spells are usually not serious and don’t cause lasting damage. With time, they go away on their own. […] Most children don’t need treatment for breath-holding spells. Spells will go away as your child gets older. If your doctor thinks that a medical condition is causing the spells, your child may need treatment. […] To decrease the chance of more spells, make sure that your child gets plenty of rest, and try to help your child feel secure. Be sure to tell your child’s doctor if your child starts to have spells more often or if they seem worse or different than before. […] If you have trouble dealing with your child’s spells or find yourself getting angry, talk with your doctor or a counselor. Try to keep in mind that your child isn’t having spells on purpose. […] After the spell, reassure your child. Don’t punish your child for having the spell.

• #25 Breath Holding Spells: Do This When Your Upset Child Hoods Breath

  https://www.webmd.com/children/children-breath-holding

  If your child has one breath-holding spell, theyll likely have more. Some children have them several times a day, while others may have just one in a year. […] There are no drugs or other treatments for these spells. Some studies suggest that anemia, or low levels of red blood cells, may be a culprit and that iron supplements may help. But more research is needed. Your doctor may order blood work to determine iron levels. […] The best thing to do is let your child lie on their side while they’re out. That helps the blood flow to their brain and gives them a chance to recover more quickly. […] Your childs doctor may teach you how to spot triggers that cause the spells, so you may prevent them. Sometimes, blowing hard on your babys face can interrupt a breath-holding spell. But this wont work for every baby, and it may not work for older children. […] If temper tantrums set off breath-holding attacks, your doctor may help you figure out a new way to set limits for your child. Take care not to give in to your child just to avoid a spell. This can lead to behavior problems that may last even after they’re outgrown their breath-holding spells.

• #26 Breath Holding Spells: Do This When Your Upset Child Hoods Breath

  https://www.webmd.com/children/children-breath-holding

  If your child has one breath-holding spell, theyll likely have more. Some children have them several times a day, while others may have just one in a year. […] There are no drugs or other treatments for these spells. Some studies suggest that anemia, or low levels of red blood cells, may be a culprit and that iron supplements may help. But more research is needed. Your doctor may order blood work to determine iron levels. […] The best thing to do is let your child lie on their side while they’re out. That helps the blood flow to their brain and gives them a chance to recover more quickly. […] Your childs doctor may teach you how to spot triggers that cause the spells, so you may prevent them. Sometimes, blowing hard on your babys face can interrupt a breath-holding spell. But this wont work for every baby, and it may not work for older children. […] If temper tantrums set off breath-holding attacks, your doctor may help you figure out a new way to set limits for your child. Take care not to give in to your child just to avoid a spell. This can lead to behavior problems that may last even after they’re outgrown their breath-holding spells.

• #27 Breath Holding Spells

  https://www.pediatriconcall.com/articles/developmental-pediatrics/breath-holding-spells/breath-holding-spells-patient-education

  Parents can also be taught how to prevent a spell. Some children can be distracted from their breath-holding if intervened before they become blue by distracting them or making them look at something interesting. The parents should be cautioned against running and picking up the child every time he cries to decrease an undue number of attacks. […] A behavior modification program may help if a child has frequent tantrums. Parents should be reassured that long term prognosis is very good. […] Pharmacological treatment is usually not required. Anticonvulsants have no role in breath-holding spells. Atropine sulfate may be tried in children with frequent pallid spells. Though there are reports of iron therapy in breath-holding spells (as these children usually have iron deficiency anemia), its usefulness is still not completely documented.

• #28 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Since breath-holding spells do not have any long-term effects, parents should be advised to minimize their attention to the episodes to keep the child from developing behavioral problems. However, it can be stressful for parents to see their child having breath-holding spells; working with a professional counselor may help parents cope. […] In one randomized control study, psychoeducational therapy the anxiety and depression levels of the mother as well as showed a reduction in the number of breath-holding spells. Thus, reassurance and behavior intervention remains the gold standard of treatment. […] Several studies suggest that there may be an association between iron deficiency anemia and breath-holding spells. Iron supplementation can decrease the frequency of breath-holding spells, with a starting dose of 3 to 6 mg/kg/d. Iron treatment can be given even if the child does not have iron deficiency since it may decrease the frequency of spells.

• #29 Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6696822/

  Breath-holding spells are frightening and stressful to parents. Confident reassurance and frank explanation are cornerstones of treatment. Advice regarding the handling of frustration, anger and discipline is appropriate. Parents should be counseled to reduce sources of conflict, such as coercion in eating, premature bowel and bladder training, and excessive parental demands. Parents should be advised to be tolerant and consistent in discipline. […] It has been shown that iron supplementation in children with breath-holding spells and concomitant iron deficiency anemia or iron deficiency is effective in decreasing the frequency and severity of the breath-holding spells. Furthermore, the autonomic nervous system dysregulation in children with breath-holding spells can be improved by iron supplementation. A Cochrane review of two randomized and quasi-randomized controlled trials comparing iron supplementation with placebo or no therapy in 84 children with recurrent breath-holding spells showed that iron supplementation significantly reduced the frequency of breath-holding spells (odds ratio: 76.48; 95% confidence interval: 15.65 to 372.72; p 0.00001).

• #30 Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6696822/

  Breath-holding spells are frightening and stressful to parents. Confident reassurance and frank explanation are cornerstones of treatment. Advice regarding the handling of frustration, anger and discipline is appropriate. Parents should be counseled to reduce sources of conflict, such as coercion in eating, premature bowel and bladder training, and excessive parental demands. Parents should be advised to be tolerant and consistent in discipline. […] It has been shown that iron supplementation in children with breath-holding spells and concomitant iron deficiency anemia or iron deficiency is effective in decreasing the frequency and severity of the breath-holding spells. Furthermore, the autonomic nervous system dysregulation in children with breath-holding spells can be improved by iron supplementation. A Cochrane review of two randomized and quasi-randomized controlled trials comparing iron supplementation with placebo or no therapy in 84 children with recurrent breath-holding spells showed that iron supplementation significantly reduced the frequency of breath-holding spells (odds ratio: 76.48; 95% confidence interval: 15.65 to 372.72; p 0.00001).

• #31 Iron supplementation for the treatment of breath-holding attacks in children | Cochrane

  https://www.cochrane.org/CD008132/BEHAV_iron-supplementation-for-the-treatment-of-breath-holding-attacks-in-children

  Iron may reduce the frequency and severity of breath-holding attacks (or spells) in children but more research is needed to determine the extent of this effect. […] Iron supplementation, which is generally well tolerated orally, may reduce the frequency and severity of breath-holding attacks, particularly if the child is anaemic. […] Iron supplementation (at 5 mg/kg/day of elemental iron for 16 weeks) appears to be useful in reducing the frequency and severity of breath-holding attacks. […] Iron may still be of assistance in children who are not anaemic or who have low, normal haemoglobin levels. […] Further high-quality randomised control trials of iron supplementation to treat breath-holding attacks in children are required. […] Iron supplementation has been claimed to reduce the frequency or severity, or both, of breath-holding attacks in children. […] In these trials, iron supplementation significantly reduced the frequency of breath-holding attacks in children (OR 76.48; 95% CI 15.65 to 373.72; P 0.00001).

• #32 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Since breath-holding spells do not have any long-term effects, parents should be advised to minimize their attention to the episodes to keep the child from developing behavioral problems. However, it can be stressful for parents to see their child having breath-holding spells; working with a professional counselor may help parents cope. […] In one randomized control study, psychoeducational therapy the anxiety and depression levels of the mother as well as showed a reduction in the number of breath-holding spells. Thus, reassurance and behavior intervention remains the gold standard of treatment. […] Several studies suggest that there may be an association between iron deficiency anemia and breath-holding spells. Iron supplementation can decrease the frequency of breath-holding spells, with a starting dose of 3 to 6 mg/kg/d. Iron treatment can be given even if the child does not have iron deficiency since it may decrease the frequency of spells.

• #33 Breath-Holding Spells | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18619

  Breath-holding spells are a common problem in the pediatric population, with a frequency of up to 5% of children. Most breath-holding spells occur before the child turns 18 months old and generally resolve by age 6. […] Since breath-holding spells do not have any long-term effects, parents should be advised to minimize their attention to the episodes to keep the child from developing behavioral problems. However, it can be stressful for parents to see their child having breath-holding spells; working with a professional counselor may help parents cope. […] Several studies suggest that there may be an association between iron deficiency anemia and breath-holding spells. Iron supplementation can decrease the frequency of breath-holding spells, with a starting dose of 3 to 6 mg/kg/d. Iron treatment can be given even if the child does not have iron deficiency since it may decrease the frequency of spells.

• #34 Iron supplementation for the treatment of breath-holding attacks in children | Cochrane

  https://www.cochrane.org/CD008132/BEHAV_iron-supplementation-for-the-treatment-of-breath-holding-attacks-in-children

  Iron may reduce the frequency and severity of breath-holding attacks (or spells) in children but more research is needed to determine the extent of this effect. […] Iron supplementation, which is generally well tolerated orally, may reduce the frequency and severity of breath-holding attacks, particularly if the child is anaemic. […] Iron supplementation (at 5 mg/kg/day of elemental iron for 16 weeks) appears to be useful in reducing the frequency and severity of breath-holding attacks. […] Iron may still be of assistance in children who are not anaemic or who have low, normal haemoglobin levels. […] Further high-quality randomised control trials of iron supplementation to treat breath-holding attacks in children are required. […] Iron supplementation has been claimed to reduce the frequency or severity, or both, of breath-holding attacks in children. […] In these trials, iron supplementation significantly reduced the frequency of breath-holding attacks in children (OR 76.48; 95% CI 15.65 to 373.72; P 0.00001).

• #35 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Since breath-holding spells do not have any long-term effects, parents should be advised to minimize their attention to the episodes to keep the child from developing behavioral problems. However, it can be stressful for parents to see their child having breath-holding spells; working with a professional counselor may help parents cope. […] In one randomized control study, psychoeducational therapy the anxiety and depression levels of the mother as well as showed a reduction in the number of breath-holding spells. Thus, reassurance and behavior intervention remains the gold standard of treatment. […] Several studies suggest that there may be an association between iron deficiency anemia and breath-holding spells. Iron supplementation can decrease the frequency of breath-holding spells, with a starting dose of 3 to 6 mg/kg/d. Iron treatment can be given even if the child does not have iron deficiency since it may decrease the frequency of spells.

• #36 Breath holding spells: Types, causes, and prevention

  https://www.medicalnewstoday.com/articles/breath-holding-spells

  Breath holding spells do not indicate a health issue and do not harm the child. However, they can be distressing to witness. […] Doctors do not recommend treatments for breath holding spells as most children outgrow the condition. However, according to a 2019 study, some children may benefit from taking iron supplements even if they are not diagnosed with iron deficiency anemia. Caregivers should talk with a doctor before giving a child supplements. […] A child that regularly has breath holding spells should have a checkup with a healthcare professional to rule out medical conditions. […] Caregivers may benefit from counseling to give reassurance and help them manage a child’s breath holding episodes.

• #37 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Increasing evidence shows piracetam or levetiracetam can reduce the instances of breath-holding spells. In randomized controlled trials piracetam (40mg/kg/d), significantly decreased breath-holding spells compared to placebo. A recent head-to-head comparison in a randomized control trial between levetiracetam and piracetam showed better efficacy of levetiracetam, though more studies are needed. Another study showed that combining iron and levetiracetam was more efficacious than levetiracetam alone in controlling breath-holding spells. […] Breath-holding spells are not harmful and do not result in brain damage. Neurologic development outcome, if already normal, will remain normal. Most children will no longer have the episodes by age 6. […] Treating breath-holding spells can require a collaborative approach, including collaboration with the following specialties: Child and adult psychiatry for behavioral interventions aimed at parents and children. Pediatric cardiology if LQTS is suspected. Pediatric neurology if seizure or other neurological disorder is suspected. Genetics if an underlying genetic disease is suspected based on physical exam or family history.

• #38 Breath-Holding Spells | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18619

  Increasing evidence shows piracetam or levetiracetam can reduce the instances of breath-holding spells. In randomized controlled trials, piracetam significantly decreased breath-holding spells compared to placebo. A recent head-to-head comparison in a randomized control trial between levetiracetam and piracetam showed better efficacy of levetiracetam, though more studies are needed. Another study showed that combining iron and levetiracetam was more efficacious than levetiracetam alone in controlling breath-holding spells. […] Breath-holding spells are not harmful and do not result in brain damage. Neurologic development outcome, if already normal, will remain normal. Most children will no longer have the episodes by age 6.

• #39 Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6696822/

  Cardiac pacemaker implantation should be considered for children with pallid breath-holding spells associated with severe bradycardia that is associated with cardioinhibition during breath-holding spells and that is refractory to medical treatment. The procedure should also be considered in children with cyanotic breath-holding spells associated with prolonged asystole. […] Episodes of unconsciousness and convulsions associated with breath-holding spells that are of short duration are usually innocuous and should be treated by proper positioning to insure a patent airway and to prevent aspiration. Anticonvulsants are not indicated in children with this type of breath-holding spells. […] Preliminary studies showed that piracetam (2-oxo-1-pyrrolidine) (40 to 50 mg/kg/day in two divided doses), a cyclic derivative of gamma-aminobutyric acid (GABA), is effective in reducing the frequency of breath-holding spells.

• #40 Breath-Holding Spells – MD Searchlight

  https://mdsearchlight.com/child-health/breath-holding-spells/

  For example, some studies have found a link between iron deficiency anaemia and breath-holding spells in children. As a result, iron supplements can help reduce the frequency of these episodes. They can be given even if the child doesnt have an iron deficiency, as it may still lessen the occurrence of spells. […] Theres growing evidence that certain medications, like piracetam or levetiracetam, can help to decrease the frequency of breath-holding spells. In scientifically controlled trials, piracetam significantly reduced these spells as compared to a placebo. However, more studies are needed to determine which medication is more effective. Another study suggested that a combination of iron and levetiracetam was more successful in controlling breath-holding spells than using levetiracetam alone.

• #41 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Increasing evidence shows piracetam or levetiracetam can reduce the instances of breath-holding spells. In randomized controlled trials piracetam (40mg/kg/d), significantly decreased breath-holding spells compared to placebo. A recent head-to-head comparison in a randomized control trial between levetiracetam and piracetam showed better efficacy of levetiracetam, though more studies are needed. Another study showed that combining iron and levetiracetam was more efficacious than levetiracetam alone in controlling breath-holding spells. […] Breath-holding spells are not harmful and do not result in brain damage. Neurologic development outcome, if already normal, will remain normal. Most children will no longer have the episodes by age 6. […] Treating breath-holding spells can require a collaborative approach, including collaboration with the following specialties: Child and adult psychiatry for behavioral interventions aimed at parents and children. Pediatric cardiology if LQTS is suspected. Pediatric neurology if seizure or other neurological disorder is suspected. Genetics if an underlying genetic disease is suspected based on physical exam or family history.

• #42 Breath-Holding Spells | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18619

  Increasing evidence shows piracetam or levetiracetam can reduce the instances of breath-holding spells. In randomized controlled trials, piracetam significantly decreased breath-holding spells compared to placebo. A recent head-to-head comparison in a randomized control trial between levetiracetam and piracetam showed better efficacy of levetiracetam, though more studies are needed. Another study showed that combining iron and levetiracetam was more efficacious than levetiracetam alone in controlling breath-holding spells. […] Breath-holding spells are not harmful and do not result in brain damage. Neurologic development outcome, if already normal, will remain normal. Most children will no longer have the episodes by age 6.

• #43 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Increasing evidence shows piracetam or levetiracetam can reduce the instances of breath-holding spells. In randomized controlled trials piracetam (40mg/kg/d), significantly decreased breath-holding spells compared to placebo. A recent head-to-head comparison in a randomized control trial between levetiracetam and piracetam showed better efficacy of levetiracetam, though more studies are needed. Another study showed that combining iron and levetiracetam was more efficacious than levetiracetam alone in controlling breath-holding spells. […] Breath-holding spells are not harmful and do not result in brain damage. Neurologic development outcome, if already normal, will remain normal. Most children will no longer have the episodes by age 6. […] Treating breath-holding spells can require a collaborative approach, including collaboration with the following specialties: Child and adult psychiatry for behavioral interventions aimed at parents and children. Pediatric cardiology if LQTS is suspected. Pediatric neurology if seizure or other neurological disorder is suspected. Genetics if an underlying genetic disease is suspected based on physical exam or family history.

• #44 Breath-Holding Spells – Child Neurology Foundation

  https://www.childneurologyfoundation.org/disorder/breath-holding-spells/

  The use of antiseizure medications is almost never recommended for breath-holding spells. This is true even in cases where the child shows brief convulsive movements during a spell. In rare cases, a breath-holding spell may evolve into an actual epileptic seizure. Still, this typically does not warrant the use of an antiseizure medication. […] No long-term neurological or health issues occur as a consequence of having breath-holding spells in childhood. […] There is not an increased risk of having epileptic seizures associated with breath-holding spells. This is true even if the child shows convulsive movements during the spell. […] Overall, outlook is excellent for both types of breath-holding spells.

• #45 Breath-holding spells: Scary but not serious

  https://www.contemporarypediatrics.com/view/breath-holding-spells-scary-not-serious

  Breath-holding spells represent an interplay among the central nervous system respiratory control center, the autonomic nervous system, and cardiopulmonary mechanics. […] The most important aspect of treatment, then, is to reassure the family that the episodes are harmless. Parents need to know that the episodes are involuntary and that the child will begin breathing spontaneously without parental action. […] A therapeutic trial of iron is appropriate in children who have breath-holding spells. We suggest 6 mg/kg/day for at least three months. Most physicians believe that anti-convulsants are not beneficial. Because of the apparent association of breath-holding spells with autonomic dysregulation, however, atropine may be helpful. It should be used only for severe and frequent pallid attacks in consultation with a neurologist or cardiologist. […] The accompanying parent guide offers further comfort about the benign nature of these spells.

• #46 Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6696822/

  In children with pallid breath-holding spells, the use of atropine may be considered to block the vagal reflex if the attacks are frequent and severe and when there is evidence that the attack is secondary to cardiac asystole as indicated by a positive ocular compression test. […] Glycopyrrolate, a synthetic quaternary ammonium compound, has an anticholinergic property that is longer-acting than atropine. The medication has been used with success in the treatment of children with pallid breath-holding spells. The use of glycopyrrolate may be considered in those cases with severe, frequent pallid breath-holding spells associated with bradycardia. […] Fluoxetine has also been used with success in the treatment of children with pallid breath-holding spells based on case reports. Additional information is necessary before the use of fluoxetine can be considered in the treatment of children with severe and frequent pallid breath-holding spells.

• #47 Breath-holding spells | MedLink Neurology

  https://www.medlink.com/articles/breath-holding-spells

  Because anemia or iron deficiency may be a factor contributing to breath-holding spells, use of an oral iron preparation is appropriate, with the goal of ameliorating or ending the spells. […] A retrospective study demonstrated successful treatment of pallid breath-holding spells with fluoxetine. […] In rare cases of severe breath-holding, treatment with atropine sulfate, methonitrate, or scopolamine has been attempted, although this is not dramatically helpful in most circumstances. […] Villain and colleagues chose to implant a pacemaker in children with severe breath-holding spells. […] Kelly and colleagues implanted permanent ventricular demand pacemakers in 10 pediatric patients with breath-holding spells and associated bradycardia and concluded this intervention to be safe, efficacious, and warranted in these patients.

• #48 Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6696822/

  Calik et al. successfully treated a 12-month-old male infant with a 3-month history of breath-holding spells, on average, 5 attacks per week with oral melatonin at a dose of 0.08 mg/kg once a day. The medication resulted in a significant improvement in the breath-holding spells. Based on their experience, the authors suggested the use of melatonin in the treatment of children with breath-holding spells. Further studies need to be done to confirm or refute their findings before melatonin can be considered in the treatment of children with frequent and severe breath-holding spells. […] Successful treatment of severe and frequent breath-holding spells with theophylline has also been described. Further studies are needed to confirm or refute the usefulness of theophylline in the treatment of severe and frequent breath-holding spells.

• #49 Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6696822/

  Cardiac pacemaker implantation should be considered for children with pallid breath-holding spells associated with severe bradycardia that is associated with cardioinhibition during breath-holding spells and that is refractory to medical treatment. The procedure should also be considered in children with cyanotic breath-holding spells associated with prolonged asystole. […] Episodes of unconsciousness and convulsions associated with breath-holding spells that are of short duration are usually innocuous and should be treated by proper positioning to insure a patent airway and to prevent aspiration. Anticonvulsants are not indicated in children with this type of breath-holding spells. […] Preliminary studies showed that piracetam (2-oxo-1-pyrrolidine) (40 to 50 mg/kg/day in two divided doses), a cyclic derivative of gamma-aminobutyric acid (GABA), is effective in reducing the frequency of breath-holding spells.

• #50 Breath-Holding Spells – Child Neurology Foundation

  https://www.childneurologyfoundation.org/disorder/breath-holding-spells/

  Breath-holding spells are short spells of time during which a child stops breathing. They are commonly mistaken for seizures. […] No treatment is needed for isolated, rare, or infrequent events. […] It is important to reassure and counsel parents. They should understand the benign nature of these spells. Parents may avoid disciplining their child for fear of provoking an event. Decreasing parents emotional reaction to the spells allows for age-appropriate discipline. […] Oral iron supplementation tends to improve spells. This helps especially if the child is iron deficient. Iron is usually given for between 1 and 4 months. […] Extremely severe cases sometimes require a heart pacemaker. A pacemaker is an electrical device used to stimulate or steady the heartbeat. It requires surgery to implant. A pacemaker is used when the spells involve:

• #51 Breath-holding spells | MedLink Neurology

  https://www.medlink.com/articles/breath-holding-spells

  Because anemia or iron deficiency may be a factor contributing to breath-holding spells, use of an oral iron preparation is appropriate, with the goal of ameliorating or ending the spells. […] A retrospective study demonstrated successful treatment of pallid breath-holding spells with fluoxetine. […] In rare cases of severe breath-holding, treatment with atropine sulfate, methonitrate, or scopolamine has been attempted, although this is not dramatically helpful in most circumstances. […] Villain and colleagues chose to implant a pacemaker in children with severe breath-holding spells. […] Kelly and colleagues implanted permanent ventricular demand pacemakers in 10 pediatric patients with breath-holding spells and associated bradycardia and concluded this intervention to be safe, efficacious, and warranted in these patients.

• #52 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Since breath-holding spells do not have any long-term effects, parents should be advised to minimize their attention to the episodes to keep the child from developing behavioral problems. However, it can be stressful for parents to see their child having breath-holding spells; working with a professional counselor may help parents cope. […] In one randomized control study, psychoeducational therapy the anxiety and depression levels of the mother as well as showed a reduction in the number of breath-holding spells. Thus, reassurance and behavior intervention remains the gold standard of treatment. […] Several studies suggest that there may be an association between iron deficiency anemia and breath-holding spells. Iron supplementation can decrease the frequency of breath-holding spells, with a starting dose of 3 to 6 mg/kg/d. Iron treatment can be given even if the child does not have iron deficiency since it may decrease the frequency of spells.

• #53 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Parents should be educated on handling the events and receive reassurance that breath-holding spells have no long-term effects. Given some parental stress levels associated with these episodes, parents may also benefit from a counselor if these episodes create stress and affect family dynamics. In addition, parents should receive assistance to cope with the stress and should be educated about discipline techniques.

• #54 Breath-Holding Spells – MD Searchlight

  https://mdsearchlight.com/child-health/breath-holding-spells/

  Treatment Options for Breath-Holding Spells: Although breath-holding spells in children can be alarming for parents, they dont have long-term effects. So parents are often advised to not overly react to these episodes in order to avoid the child developing behavioural issues. Yet, given the distressing nature of these incidents, it can be helpful for parents to work with a professional counsellor to learn the best ways to cope. […] In fact, a study found that therapy aimed at teaching and guiding (psychoeducational therapy) reduced mothers anxiety and depression levels and also resulted in fewer breath-holding spells with the child. Its safe to say that reassurance and behavioural intervention remain the main treatment methods. Keep in mind that while other treatments may work, their benefits and risks must be carefully considered, especially because breath-holding spells usually improve on their own over time.

• #55 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Since breath-holding spells do not have any long-term effects, parents should be advised to minimize their attention to the episodes to keep the child from developing behavioral problems. However, it can be stressful for parents to see their child having breath-holding spells; working with a professional counselor may help parents cope. […] In one randomized control study, psychoeducational therapy the anxiety and depression levels of the mother as well as showed a reduction in the number of breath-holding spells. Thus, reassurance and behavior intervention remains the gold standard of treatment. […] Several studies suggest that there may be an association between iron deficiency anemia and breath-holding spells. Iron supplementation can decrease the frequency of breath-holding spells, with a starting dose of 3 to 6 mg/kg/d. Iron treatment can be given even if the child does not have iron deficiency since it may decrease the frequency of spells.

• #56 Breath-Holding Spells – MD Searchlight

  https://mdsearchlight.com/child-health/breath-holding-spells/

  Treatment Options for Breath-Holding Spells: Although breath-holding spells in children can be alarming for parents, they dont have long-term effects. So parents are often advised to not overly react to these episodes in order to avoid the child developing behavioural issues. Yet, given the distressing nature of these incidents, it can be helpful for parents to work with a professional counsellor to learn the best ways to cope. […] In fact, a study found that therapy aimed at teaching and guiding (psychoeducational therapy) reduced mothers anxiety and depression levels and also resulted in fewer breath-holding spells with the child. Its safe to say that reassurance and behavioural intervention remain the main treatment methods. Keep in mind that while other treatments may work, their benefits and risks must be carefully considered, especially because breath-holding spells usually improve on their own over time.

• #57 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Increasing evidence shows piracetam or levetiracetam can reduce the instances of breath-holding spells. In randomized controlled trials piracetam (40mg/kg/d), significantly decreased breath-holding spells compared to placebo. A recent head-to-head comparison in a randomized control trial between levetiracetam and piracetam showed better efficacy of levetiracetam, though more studies are needed. Another study showed that combining iron and levetiracetam was more efficacious than levetiracetam alone in controlling breath-holding spells. […] Breath-holding spells are not harmful and do not result in brain damage. Neurologic development outcome, if already normal, will remain normal. Most children will no longer have the episodes by age 6. […] Treating breath-holding spells can require a collaborative approach, including collaboration with the following specialties: Child and adult psychiatry for behavioral interventions aimed at parents and children. Pediatric cardiology if LQTS is suspected. Pediatric neurology if seizure or other neurological disorder is suspected. Genetics if an underlying genetic disease is suspected based on physical exam or family history.

• #58 Breath-Holding Spells (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/spells.html

  A breath holding spell is when a child holds their breath, usually after being angry, frustrated, startled, or in pain. Sometimes the breath holding leads to the child passing out. […] Kids outgrow the spells without any treatment. […] Treating the anemia may help reduce the number of spells. […] If this is your child’s first breath-holding spell, get medical care. Although the spells aren’t harmful, it’s good to get your child checked out. […] Your doctor can work with you on ways to try to limit your child’s spells. […] If you are very worried about the spells, talking to a mental health professional can help you find ways to cope.

• #59 Breath-Holding Spells in Toddlers | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/breath-holding-spells-toddlers

  Young children, when faced with an upsetting situation or sudden pain, can hold their breath, causing them to turn bluish or pale, and pass out. Although this is alarming to parents, breath-holding spells are generally not harmful. Children who experience these episodes typically recover quickly with no lasting effects. […] If this is the first time your child has experienced one of these spells, contact your primary care provider. There may be a correlation of breath-holding spells with iron-deficiency anemia, so your child’s primary care provider may check the blood count. It is also important to rule out other more serious conditions that in rare cases may mimic breath holding spell. […] The parents best response to a breath-holding spell is to remain calm, recognize that your child isn’t doing it on purpose, and offer reassurance. Discuss the problem with your child’s primary care provider.

• #60

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ad1702

  Home treatment usually is all that is needed for breath-holding spells. You can make breath-holding spells less likely by helping your child get plenty of rest, feel secure, and manage their frustration. […] Talk to your doctor if: Spells become more frequent or more severe or change their pattern. […] Make sure all your child’s caregivers understand the cause of breath-holding spells and how to manage them.

• #61 Breath-Holding Spells in Toddlers | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/breath-holding-spells-toddlers

  Young children, when faced with an upsetting situation or sudden pain, can hold their breath, causing them to turn bluish or pale, and pass out. Although this is alarming to parents, breath-holding spells are generally not harmful. Children who experience these episodes typically recover quickly with no lasting effects. […] If this is the first time your child has experienced one of these spells, contact your primary care provider. There may be a correlation of breath-holding spells with iron-deficiency anemia, so your child’s primary care provider may check the blood count. It is also important to rule out other more serious conditions that in rare cases may mimic breath holding spell. […] The parents best response to a breath-holding spell is to remain calm, recognize that your child isn’t doing it on purpose, and offer reassurance. Discuss the problem with your child’s primary care provider.

• #62 Children with breath-holding spells undergo unnecessary diagnostic interventions | Faculty of Medicine, Lund University

  https://www.medicine.lu.se/article/children-breath-holding-spells-undergo-unnecessary-diagnostic-interventions

  Breath-holding spells are common in young children and are benign. Yet children often undergo unnecessary diagnostic interventions when seeking medical care. […] A team of researchers at Lund University, Sweden has now proposed guidelines to reduce the number of emergency and unplanned medical visits and to provide more equitable and structured care for children with breath-holding spells. […] While breath-holding spells are a familiar concept in healthcare, there are no diagnostic criteria or guidelines on how to assess these children when they seek medical care. This leads to uncertainty about how to investigate and take care of the patients, and also what might be an appropriate follow-up. […] This is why we need clear diagnostic criteria, to standardise assessment and treatment. […] The new guidelines will make it clearer when children need an ECG and when they should have a blood test to check their blood count and iron status.

• #63 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Increasing evidence shows piracetam or levetiracetam can reduce the instances of breath-holding spells. In randomized controlled trials piracetam (40mg/kg/d), significantly decreased breath-holding spells compared to placebo. A recent head-to-head comparison in a randomized control trial between levetiracetam and piracetam showed better efficacy of levetiracetam, though more studies are needed. Another study showed that combining iron and levetiracetam was more efficacious than levetiracetam alone in controlling breath-holding spells. […] Breath-holding spells are not harmful and do not result in brain damage. Neurologic development outcome, if already normal, will remain normal. Most children will no longer have the episodes by age 6. […] Treating breath-holding spells can require a collaborative approach, including collaboration with the following specialties: Child and adult psychiatry for behavioral interventions aimed at parents and children. Pediatric cardiology if LQTS is suspected. Pediatric neurology if seizure or other neurological disorder is suspected. Genetics if an underlying genetic disease is suspected based on physical exam or family history.

• #64 Breath-Holding Spells – Child Neurology Foundation

  https://www.childneurologyfoundation.org/disorder/breath-holding-spells/

  The use of antiseizure medications is almost never recommended for breath-holding spells. This is true even in cases where the child shows brief convulsive movements during a spell. In rare cases, a breath-holding spell may evolve into an actual epileptic seizure. Still, this typically does not warrant the use of an antiseizure medication. […] No long-term neurological or health issues occur as a consequence of having breath-holding spells in childhood. […] There is not an increased risk of having epileptic seizures associated with breath-holding spells. This is true even if the child shows convulsive movements during the spell. […] Overall, outlook is excellent for both types of breath-holding spells.

• #65 Breath-Holding Spells | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18619

  Increasing evidence shows piracetam or levetiracetam can reduce the instances of breath-holding spells. In randomized controlled trials, piracetam significantly decreased breath-holding spells compared to placebo. A recent head-to-head comparison in a randomized control trial between levetiracetam and piracetam showed better efficacy of levetiracetam, though more studies are needed. Another study showed that combining iron and levetiracetam was more efficacious than levetiracetam alone in controlling breath-holding spells. […] Breath-holding spells are not harmful and do not result in brain damage. Neurologic development outcome, if already normal, will remain normal. Most children will no longer have the episodes by age 6.

• #66 Breath-Holding Spells

  https://www.parenting.org/article/Pages/breath-holding-spells.aspx

  When BHS occur, caregivers should lay the child on his or her back and guard against head injury and aspiration until recovery occurs. If necessary, the oral airway should be cleared. These preventive maneuvers should be done, and the overall approach to the child should be marked by neutral emotions. Although medication is rarely beneficial for children with cyanotic BHS, children with severe and frequent pallid BHS may benefit from medication that slows parasympathetic activity. […] Generally, however, the scientific literature provides a very optimistic prognosis. Long-term negative effects for cyanotic BHS have not been reported. Long-term effects for pallid BHS are isolated to an increased risk for faintness episodes (e.g., at the sight of blood) in adolescence and adulthood.

• #67 Breath-Holding Spells (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/spells.html

  A breath holding spell is when a child holds their breath, usually after being angry, frustrated, startled, or in pain. Sometimes the breath holding leads to the child passing out. […] Kids outgrow the spells without any treatment. […] Treating the anemia may help reduce the number of spells. […] If this is your child’s first breath-holding spell, get medical care. Although the spells aren’t harmful, it’s good to get your child checked out. […] Your doctor can work with you on ways to try to limit your child’s spells. […] If you are very worried about the spells, talking to a mental health professional can help you find ways to cope.

• #68 Breath-holding in babies and children

  https://www.nhs.uk/conditions/breath-holding-in-babies-and-children/

  Breath-holding is when a baby or child stops breathing for up to 1 minute and may faint. It can happen when a child is frightened, upset, angry, or has a sudden shock or pain. It’s usually harmless but can be scary for parents, particularly when it happens for the first time. […] Breath-holding is usually harmless and your child should grow out of it by the age of 4 or 5. […] There’s no specific treatment for breath-holding. It should eventually stop by the time your child is 4 or 5 years old. […] Medicines are rarely used to treat breath-holding. […] Breath-holding is sometimes related to iron deficiency anaemia. […] Your child’s blood iron levels may be checked. They may need iron supplements if their iron levels are low.

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