It is the single most terrifying thing a parent can witness. One second, your toddler is screaming because you cut their toast the "wrong" way or they tripped over a rug, and the next, the sound just… stops. Their mouth stays wide open in a silent wail. Their face turns a haunting shade of blue or a ghostly pale. Then, they go limp. They’re out cold.
When a baby stops breathing while crying and passes out, your brain immediately goes to the darkest places imaginable. SIDS. Seizures. Heart failure. You’re probably scrambling for your phone to dial 911 while your heart hammers against your ribs. But then, as quickly as it started, they gasp, wake up, and look at you like nothing happened—or maybe they fall into a deep sleep for an hour.
This phenomenon is known medically as a breath-holding spell. It isn't a "behavioral" choice. Your baby isn't being "manipulative" or "stubborn." It’s an involuntary reflex. Honestly, it’s one of those glitches in the human nervous system that seems designed specifically to give parents gray hairs.
What’s actually happening in the body?
To understand why a baby stops breathing while crying and passes out, we have to look at the autonomic nervous system. This is the system that handles things you don't think about, like your heartbeat and digestion. In some kids, usually between the ages of 6 months and 6 years, this system overreacts to a sudden stimulus.
There are two main flavors of these spells. The first is the Cyanotic spell. This is the "blue" one. It usually happens when a child is frustrated or angry. They exhale so hard during a cry that they basically empty their lungs and then just... forget to take the next breath. Their blood oxygen drops, they turn blue around the lips, and they lose consciousness.
The second type is the Pallid spell. These are less common and, frankly, even scarier-looking. These are the "pale" spells. They usually follow a sudden fright or a minor injury, like bumping a knee. The heart rate slows down drastically because the vagus nerve overreacts. The child turns white as a sheet and faints.
It feels like forever. In reality? Most of these episodes last less than sixty seconds. According to the American Academy of Pediatrics (AAP), breath-holding spells occur in about 5% of healthy children. It’s a significant number, yet we don't talk about it nearly enough in prenatal classes or pediatrician checkups until it actually happens.
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The Irony of Iron Deficiency
Here is a weird fact that most parents find surprising: there is a documented link between breath-holding spells and iron-deficiency anemia.
Dr. Joseph DiMario and other researchers have highlighted through various clinical studies that many children who frequently have these episodes are low on iron. We don’t fully know why. It might be that iron plays a role in how neurotransmitters regulate the involuntary breathing reflex. Some parents find that after their pediatrician prescribes an iron supplement, the spells almost entirely vanish. It isn't a "cure" for everyone, but it’s a massive clue that this is a physiological issue, not a "naughty child" issue.
If your child is having these spells, ask for a simple blood test. A CBC (Complete Blood Count) or a ferritin test can tell you if their iron stores are depleted. It's a much easier fix than the neurological testing most parents fear they’ll need.
Distinguishing Spells from Seizures
The biggest fear is usually epilepsy. It’s a logical jump. A child goes limp or stiff, stops breathing, and passes out—that looks like a seizure.
However, there are distinct differences. A breath-holding spell is almost always "provoked." There is a trigger. A fall, a "no" from a parent, a loud noise. Seizures are usually unprovoked; they just happen out of nowhere, even during sleep. Also, children who have a breath-holding spell typically recover their mental clarity very fast. They might be tired, but they know who you are. After a tonic-clonic seizure, there is usually a "postictal" phase where the person is profoundly confused or disoriented for a long time.
That said, some kids do have a few jerky movements while they are passed out during a spell. This is called a "reflex anoxic seizure." It’s still part of the breath-holding spell and usually isn't a sign of underlying epilepsy, but it is definitely something to mention to your doctor.
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The "Do Nothing" Protocol
This sounds impossible. When your baby stops breathing while crying and passes out, every instinct tells you to shake them, blow in their face, or start CPR.
Don't.
Blowing in their face might actually prolong the reflex. Shaking them is dangerous. If you start CPR on a child whose heart is still beating (which it usually is during these spells), you can cause more harm than good.
The best thing you can do is lay them flat on their side on the floor. Being flat helps blood flow back to the brain. Keep the area clear. If they have food in their mouth, gently sweep it out so they don't choke when they finally gasp for air. Then, you just wait. You count the seconds. You realize that their brain is smarter than the reflex—the moment they pass out, the reflex "resets," and the body automatically takes a breath.
Dealing with the "Aftermath" Tantrum
The hardest part for parents of "blue" spell-takers is what happens next. If the spell was triggered by you saying "no" to a cookie, and then the child passes out, you are going to feel a massive urge to give them the cookie the moment they wake up.
Resist it.
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If a child learns that passing out results in getting what they want, they won't "fake" the spell (they can't), but the emotional outbursts that lead to the spells might become more frequent. You have to stay calm. Once the child is awake and okay, go back to normal. If the "no" was for a cookie, it stays a "no" for a cookie. This is incredibly difficult when you're shaking from the adrenaline of seeing your kid turn blue, but it’s vital for their emotional development.
When should you actually worry?
While breath-holding spells are benign in the vast majority of cases, they aren't always just a "quirk."
If a spell happens for the first time before 6 months of age, that’s a red flag. If the child doesn't wake up within a minute, or if they seem to have spells that aren't triggered by anything at all, you need a full workup. Doctors might want an EKG (Electrocardiogram) to rule out Long QT syndrome, which is a heart rhythm issue that can look like a breath-holding spell.
Basically, the first time it happens, you go to the doctor. Every time. You want that peace of mind. You want the professional to say, "Yes, this is a breath-holding spell," rather than guessing yourself.
Actionable Next Steps for Parents
If you are currently dealing with this, here is your roadmap for staying sane and keeping your child safe.
- Log the episodes. Keep a note on your phone. Record the date, the trigger (was it a fall or a tantrum?), how long they were out, and what color they turned. This data is gold for your pediatrician.
- Request an iron panel. Don't just buy vitamins over the counter; get the bloodwork done first to see if there is an actual deficiency.
- Inform the caregivers. Your babysitter, your mother-in-law, and the daycare workers need to know this happens. If they don't know, they will panic and call an ambulance, which results in a very expensive and stressful hospital bill for a benign event.
- Check the heart. Ask your doctor if an EKG is warranted just to be 100% sure the heart rhythm is normal. Most of the time it is, but it's a quick, non-invasive test.
- Stay "boring" during a spell. When it happens, don't scream. Don't crowd them. Lay them down, stay close, and wait for the "reset." The more calm the environment is when they wake up, the faster they will settle back down.
Breath-holding spells are a brutal test of parental nerves. It feels like a life-or-death crisis every single time. But as scary as it is to see your baby stop breathing while crying and pass out, remember that their body is designed to take over and fix the problem. They will breathe again. They will wake up. And eventually, they will grow out of it.