Q&A: My son holds his breath sometimes until he passes out. Should I be worried?

While it is important for any child with symptoms that involve turning blue and/or passing out to be evaluated by a doctor for seizures and/or other causes, the sequence of events you have described fits the classic description of cyanotic breath-holding spells. Just as the name implies, cyanotic breath-holding spells typically involve children (usually between the ages 6 months and 6 years) becoming angry or upset, holding their breath, turning blue, and actually passing out. This sort of response—often the result of something as simple as being scolded or a relatively minor injury—is much more extreme than a typical toddler tantrum and is understandably quite scary for parents (and even pediatricians) to witness.

The good news is that breath holding spells are not true seizures, often require no treatment, and most children outgrow them by the average age of 4. That said, it's very important if your child actually stops breathing during his spells to make sure that there's nothing in his mouth that he could choke on and that he is in a safe place until the spell is over. Interestingly, children who are also iron deficient or anemic may experience fewer episodes when given iron supplements, so be sure to ask your doctor about this as an underlying cause and a possible treatment. Otherwise, the real parental challenge involves figuring out how to continue disciplining your child without triggering breath holding spells, and how to maintain your calm when they do occur.