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Family Forum / Parenting / Mothers / January 2005Breath holding Spells
Anyones else child have these? I keep getting told it's very common and 1:20 kids do it but I am yet to meet anybody in my vast circle of parents whose child also does what Seth (3) does. I think I'm being fibbed too. And stuff I read on line isn't very helpful for tips because they all assume it's a behavioural thing and the child is having a tantrum and purposely holds their breath as a manipulative technique, and it's not like that for Seth at all, he rarely has tantrums. His is always when he cries, that crying can be triggered by being hurt, being scared, being told off, having a fight with a sibling...anything, but it's always crying from distress not a 'give me what I want' tantrum. I feel these online advisory sites are a little harsh, most of the advice is don't give in to them, leave them alone and let them go for it etc. When clearly he is distressed by not being able to catch a breath and you can see in his face if he could he would, it's not a malicious behaviour, it seems out of his control. I can't imagine anything more cruel than to ignore the poor baby when he's so distressed and scared by what's happening to him. A typical episode for him starts with him crying, you get maybe one or two 'cries' out of him then the noise stops, his mouth is open, face screwed up in distress, he is like mid cry but there is no noise. Then his lips and around his eyes start going blue while the rest of his face goes pale, he looses the ability to stand (usually one of us is with him by this time and eases him to the floor but occasionally it's happened outside and he's fallen) and falls to the floor. Then his legs start to kick and his arms flail, his eyes tend to roll back and he'll loose control of his bladder then go limp and pass out. He's out maybe 30 seconds (which is an eternity if your watching it, even though it doesn't sound like a long time)then he comes to and is very drowsy, he'll often fall asleep or curl up on the couch quietly soon an episode. I haven't had him examined but I have talked to our paediatrician about him and she said, although scary it's pretty normal and he'll grow out of it by 5. Granted he's only 3 and has a couple more years left yet until he's five, but it doesn't seem to be getting any better. He'll have one about once a fortnight, but lately he's been having one every day. It just couldn't be good for you. I'm wondering if I should take him in for a blood test and ask for an EEG. Any opinions, experiences? Andrea <snip> > His is always when he cries, that crying can be triggered by being hurt, > being scared, being told off, having a fight with a sibling...anything, > but it's always crying from distress not a 'give me what I want' tantrum. > I feel these online advisory sites are a little harsh, most of Maybe it is not voluntary. I'm no doctor, but a) EEG won't necessarily tell you anything. b) It is a very weird feeling when you black out. c) shock, now emphasised by fear can do that. Seth needs to be reassured that a) he's ok - he is not weird or anything - it happens to some people. b) it's ok to be unhappy / hurt when things don't go the way you expect. Also maybe some way for him to show coping with what's happening is too hard for him. c) if his ears or head get that funny feeling to sit down straight away. d) to have something sweet after like sugar water or some chocolate - that restores the blood sugar quickest. A warm drink is also good. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Also having seen the looks of worry on people's faces when I've come around after fainting (rolled eyes, locked jaws the lot) is scary especially after the weird buzzing feeling. I did it so much from the age of about 4 to 12 that I was excused from ever attending school assembly. It is mostly over now. {{{}}} Marc > Maybe it is not voluntary. No it's not. I'm no doctor, but > a) EEG won't necessarily tell you anything. Sorry I meant ECG, and from what I can tell this helps rule out cardiac problems such as long Q-T syndrome (which is what preturnaturals, from m.k.b, husband died of a few years ago). I've finally just come across a good paper on it, medically angled and not by some parenting know-it-all guru like Dr Green which has pretty much set my mind to get him assessed because he's fitting the seizure picture as much as the breath holding picture so being borderline I'd like a better assessment. http://www.postgradmed.com/issues/2002/05_02/jennette.htm > b) It is a very weird feeling when you black out. Yes I know, I faint a lot myself. > Seth needs to be reassured that > a) he's ok - he is not weird or anything - it happens to some people. Yes he is, this has been going on a while now, the first few were very scary and I treated him like some fragile baby, snuggling him all day long, but he has so many now the kids call me as soon as they see it starting and we just give him room, assure him he's ok when he comes too and make him a little bed on the couch. > b) it's ok to be unhappy / hurt when things don't go the way you expect. Well this isn't really why they are happening, it's not an emotional response it's a physical one. They don't happen because he's unhappy with the way life has gone for him, it's a physical response to crying, like hiccuping. > Also maybe some way for him to show coping with what's happening is too hard > for him. I don't think so, because the event that led to the crying is often pretty insignificant, it's the actual crying his body can't seem to handle. Today it was a fight with Lydia who broke his puzzle, happens all the time, she's a complete pain, but today it caused him to cry, and once that crying starts then the involuntary breath holding starts. He has good verbal skills too, he can and does easily verbalize frustrations so I think it's more a physical thing. > c) if his ears or head get that funny feeling to sit down straight away. I don't think you really get what goes on, but that's ok :-) It's not something you can reason with or make suggestions to him at the time, he's not breathing, his body is fighting for air, suggesting he sit down won't even register, his body is beyond that. > d) to have something sweet after like sugar water or some chocolate - that > restores the blood sugar quickest. A warm drink is also good. It's not really a blood glucose thing, it's a lack of oxygenated blood to the brain, plus I don't really want to get into the habit of rewarding his fainting spells with a treat. We try to down play it as much as possible. Thanks for your suggestions though :-) > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ > Also having seen the looks of worry on people's faces when I've come around > after fainting (rolled eyes, locked jaws the lot) is scary especially after > the weird buzzing feeling. I don't really get any buzzy feeling myself, my head just starts to feel very heavy and large, I feel nauseated, sound disappears and everything goes grey then black then goodnight nurse. Peter tells me I usually am out with my eyes open too which would be quite freaky to look at. I don't feel 'buzzy' when I come too though, but I am usually profusely sweaty, and still often feeling a little nauseous. I guess fainting feels as different to different people as much as the things that trigger it. Interesting though as the paper above does say BHS is more common with Adult family members who are prone to fainting even though I didn't do what he does as a child I do faint at the drop of a hat so it could have a genetic link. > I did it so much from the age of about 4 to 12 that I was excused from ever > attending school assembly. It is mostly over now. Your school assemblies must of been really sucky lol. I fainted at my wedding which is one of the few times it was unprovoked, just passed out cold right in the middle of the ceremony. But usually my fainting is caused by either hurting myself (bang on head, twisting ankle and such) not eating enough, low BP or my anaemia. Andrea <snip> > http://www.postgradmed.com/issues/2002/05_02/jennette.htm I'll look at that. >> b) it's ok to be unhappy / hurt when things don't go the way you expect. > > Well this isn't really why they are happening, it's not an emotional > response it's a physical one. They don't happen because he's unhappy with > the way life has gone for him, it's a physical response to crying, like > hiccuping. Yes I understand that. >> Also maybe some way for him to show coping with what's happening is too >> hard for him. [quoted text clipped - 13 lines] > not breathing, his body is fighting for air, suggesting he sit down won't > even register, his body is beyond that. No, I'm not suggesting to do it at the time. But if talking about it at other times. At 3 he may not 'get it', but eventually it will take hold and he'll be able to keep himself safer. >> d) to have something sweet after like sugar water or some chocolate - >> that restores the blood sugar quickest. A warm drink is also good. > > It's not really a blood glucose thing, it's a lack of oxygenated blood to > the brain, plus I don't really want to get into the habit of rewarding his > fainting spells with a treat. We try to down play it as much as possible. Just from my experience after an episode like that, that a bit of sugar or warm drink sets my equilibrium back to normal. I get the not rewarding - that's way a small glass of sugar water is the best. > Thanks for your suggestions though :-) >> [quoted text clipped - 10 lines] > still often feeling a little nauseous. I guess fainting feels as different > to different people as much as the things that trigger it. Buzzy, sounds swirl, brain races and then out. Very sweaty after, tingly tongue, sore jaw. > Interesting though as the paper above does say BHS is more common with > Adult family members who are prone to fainting even though I didn't do > what he does as a child I do faint at the drop of a hat so it could have a > genetic link. > Your school assemblies must of been really sucky lol. I fainted at my > wedding which is one of the few times it was unprovoked, just passed out eeep > cold right in the middle of the ceremony. But usually my fainting is > caused by either hurting myself (bang on head, twisting ankle and such) > not eating enough, low BP or my anaemia. Physical pain, shortage of fresh air (that's way assemblies sucked), emotional shock, too much Riesling wine, lol. It's ok. Marc <snip> >> http://www.postgradmed.com/issues/2002/05_02/jennette.htm > I'll look at that. That's very interesting. My sister has been diagnosed with a syncope condition. Marc > <snip> >>> http://www.postgradmed.com/issues/2002/05_02/jennette.htm [quoted text clipped - 3 lines] > condition. > Marc I have a syncope condition as well >> <snip> >>>> http://www.postgradmed.com/issues/2002/05_02/jennette.htm [quoted text clipped - 5 lines] > >I have a syncope condition as well Could you please enlighten me as to what that means Jen? I'm not familiar with that term. -- X http://www.americanheart.org/presenter.jhtml?identifier=4749 There you go. Marc >>> <snip> >>>>> http://www.postgradmed.com/issues/2002/05_02/jennette.htm [quoted text clipped - 11 lines] > -- > X <snip> >> <snip> >>>> http://www.postgradmed.com/issues/2002/05_02/jennette.htm [quoted text clipped - 5 lines] > > I have a syncope condition as well Jen, out of interest how long did it take to get diagnosed? My sister's was only dxed after a near-fatal car accident in her mid-30s. Marc >> Maybe it is not voluntary. > [quoted text clipped - 12 lines] > assessment. > http://www.postgradmed.com/issues/2002/05_02/jennette.htm I was going to suggest having him seen by a neurologist. It almost sounds like he's having some kind of seizure. I used to work with a lot of epileptics and that drowsiness always followed one of their seizures. That and the fact that its increasing in frequency suggest, like you said, that the problem is increasing not decreasing. I just read most of the article and looking at that table they presented it almost seems like a combination of BHS and Generalized Seizures. /shrugs I'm only going on the info you've given, my experience and the article and I'm no doctor so everything I've said should be taken with probably more than just one grain of salt. You're his mother. You know your child. I would have him examined by both a neurologist and a cardiologist. {{{{{{Andrea}}}}}} It must be terrifying to watch your baby go through this and not know what's going on or how to help him. It does sound like you're helping him cope with its aftermath and not letting him dwell on it which is good. Keep us updated and be sure to take care of yourself too. Angela > I just read most of the article > and looking at that table they presented it almost seems like a combination > of BHS and Generalized Seizures. /shrugs That's what I concluded too, like the loss of bladder control (which has only started recently as the episodes have gotten more severe and frequent), and his didn't start in infancy, I think it started around 18 months. After the first one or two I posted about it here so I'll have to google myself to find out when his first episodes were. I'll make an appointment for him for next week when the kids are back at school and ask for some referrals I think. I actually noticed Lydia doing a mild one today too, I didn't see what happened I just looked up and there she was all pale and mid cry not drawing breath, as soon as I went up to her she started making noise so she might be on the same track. Andrea I'm wondering if I should take > him in for a blood test and ask for an EEG. Any opinions, experiences? > > Andrea I certainly would, and a consult with a neurologist. It could be anything up to a petit mal occurrence and he MIGHT outgrow it, but in the meantime his brain is being deprived of oxygen during these spells and that can't be a good thing for his development. gloria p > I'm wondering if I should take > [quoted text clipped - 10 lines] > > gloria p I think I've been overly erring on the side they were benign because everyone keeps telling me it's so common, even our paed when I brought it up reassured me that it was not harmful to them. But I'm starting to think it's not that common at all, or certainly not what he's doing. Whenever I bring up my concerns I get an anecdote back of how their neighbours kid was like that, or their nephew was a breath holder...everyone seems to know one yet I can't find one actual 'parent' who can share my experience blow by blow. I'm starting to think this breath holding via tantrum is some sort of parenting urban legend and most people actually have no idea what a true breath holding spell looks like. Andrea > A typical episode for him starts with him crying, you get maybe one or > two 'cries' out of him then the noise stops, his mouth is open, face [quoted text clipped - 15 lines] > day. It just couldn't be good for you. I'm wondering if I should take > him in for a blood test and ask for an EEG. Any opinions, experiences? I agree with Angela here, Andrea. My 11yo sister has had 3 or 4 episodes like this. Everything is the same except she isn't crying so it is hard to pick up on right away. She twitches rather than flails. Hers appears to be triggered by pain, mostly, though they can't limit it to that. She has been through test upon test for months and months and they have found nothing. One episode happened when she was at the orthopedic doctor's office. She was sitting, her eyes rolled back and were twitching, her head was slightly jerking sideways, she was limp and her breathing would pause. The doctor was there and took her and laid her on the table and checked her vitals and such. He said he is no specialist in the area but he can tell us 100% that she was having a siezure. I would really talk to the ped about this and get some testing done just to rule out the main major causes. On a side note: My brother has Long QT and it was found sort of by fluke in that he passed out quite violently one morning (and I watched it happen- YIKES) and the doctor couldn't pinpoint the cause and sent him in for an EKG. The hospital called my mom and had her rush to his school and bring him to the hospital. If she couldn't do it within a certain time frame, they were going to send an ambulance to pick him up! They don't think the passing out had anything to do with the Long QT but it *can* be related. Fortunately, his case is a bit different than the ones you see on the news with teenagers falling lifeless on the court, never able to be revived. His heart rate gets NORMAL when his heart is stressed. He is more at risk on an every day basis than when exercising. However, the risk he does have is slim provided he does not take certain meds and such. It is a very scary thing you are describing, Andrea. I know that I, at least, would be relieved if the major tests came back clear. The scary thing about those episodes is that it is possible for one to be just a bit more stressful on the heart than the usual one and it could, possibly, be fatal. (((Andrea and Seth))) -Kara. > On a side note: > My brother has Long QT and it was found sort of by fluke in that he passed > out quite violently one morning (and I watched it happen- YIKES) and the > doctor couldn't pinpoint the cause and sent him in for an EKG. Well I'd never even heard of it until Preternatural from MKB said that was what her husband died of. She mentioned it way back when Seth first started the passing out, as it's often the only sign...other than just right out dying. Something I'd like to rule out for sure if we can. Is there anything you can do for it once you know about it, does your brother have to be on medication, watch his diet/activity/stress? Does he have regular cardio scans? Andrea > Well I'd never even heard of it until Preternatural from MKB said that > was what her husband died of. She mentioned it way back when Seth first [quoted text clipped - 3 lines] > brother have to be on medication, watch his diet/activity/stress? Does > he have regular cardio scans? My understanding is that drugs are usually involved (beta blockers as the first line) and nutrition can potentially be helpful (high potassium, maybe?) and there are some other possibilities if necessary. Here's a website that might be of some use: http://www.qtsyndrome.ch/ I definitely would have him checked carefully if I were you. I would want some more serious issues ruled out, even if there was a good chance it was benign. Seems to me the more serious things it could be are things you need to know about. I wouldn't be comfortable just watching and waiting. I too only know *of* folks who've had a breath-holding kid, but the descriptions I've heard don't sound like what Seth is doing. His situation sounds potentially more serious to me that what I've heard others describe. Best wishes, Ericka > http://www.qtsyndrome.ch/ Thanks Ericka and Kara for the links, that's definitely something I'd like to rule out. Andrea > Is there anything you can do for it once you know about it, does your > brother have to be on medication, watch his diet/activity/stress? Does > he have regular cardio scans? There are several different forms of treatment based on his performance with the stress-test. Depending on the severity, there are several forms of medications that can be taken if necessary. However, the most common form of treatment that I have seen is forbidding the child/adult from partaking in high intensity activities. For example, there is a very athletic girl the year below me in highschool who collapsed after running in a cross-country meet. She was diagnosed with Long QT as were 2 of her siblings after they tested the whole family. They were all swimmers and runners and are not allowed to do either any more. While most would see this as gut wrenching for an athletic family, they got extremely involved in the leadership aspects of the teams as managers and team captains and the coaches were great about making them part of the team. They also took up golfing as well and got involved in other school activities. To ensure that you have a long, happy life though, these are small sacrafices to be made. Additionally, the most invasive form of "treatment" is the installation of a pace-maker which we have seen done before. My brother will need to have regular EKGs done to be sure that the condition has not worsened or changed forms. He must carry a card in his car, wallet, and everywhere he goes that lists medications he can NOT take. All of his trainers at school have been made aware as have his coaches and such. FWIW, he is on an athletic scholarship and competing on a collegiate level right now. He is very lucky that his form of LongQT is not nearly as life threatening. They tested the whole family as well because certain forms can be genetic but his, fortunately, was not. I really hope that Seth does not have Long QT but if, g*d forbid, he does, I think it is extremely important to get it diagnosed sooner rather than later so that you are able to make yourself aware and educated in order to make the proper adjustments. Good luck, Andrea. -Kara. > On a side note: > My brother has Long QT and it was found sort of by fluke in that he passed > out quite violently one morning (and I watched it happen- YIKES) and the > doctor couldn't pinpoint the cause and sent him in for an EKG. eeeek Kara! That sounds awful to have to watch that happen! What is QT? I'm reading and not the definition here. A > eeeek Kara! That sounds awful to have to watch that happen! It was frightening because I have seen people faint before- but he literally FLEW backwards and was in the air and landed on the corner of the dresses. It was incredibly violent. All I wanted to do was go in and ask him if I could use the toilet before he went in to take his shower in the morning. We were standing in the doorway and I asked if he would wait a second and he passed out. My dad came and got him to come back to it. They waited about 20 mins and he went to get in the shower again and passed out in the bathroom- fortunately my dad caught him that time. His school tried to kick him off of the team because of it- not for their sake but because they worried about his well-being. His cardiologist had to called his trainer and explain it all for him. > What is QT? I'm reading and not the definition here. Your heart beats in a P, Q, R, S, T pattern where R is the peak of each beat. P is the signal for the atrium of your heart to contract. Q is where the atrium begins to relax and the ventricle starts to contract. R is the peak of the ventricular contraction which continues to through S and finishes at T. At T, both the atrium and the ventricle relax. The QT is the time period between the Q and T waves which is also the length of the ventricular contraction. Those who suffer from Long QT syndrome have much longer ventricular contraction periods than the average person. For most people with Long QT, intense physical activity and certain medications make the time period become even LONGER. When the ventricular contraction becomes too long, the body can not pump blood properly and it can be fatal. I don't know if that made ANY sense at all but I am just reiterating what I learned last semester in Biology. Hey- maybe I *did* get something out of that class!! Hope this helps! -Kara. Anni, I meant to add this to the end of that last post but I forgot! Here is a website that explains it in more detail: http://tinyurl.com/563l2. -Kara. holy sh.t! I've heard of it being done as attention seeking etc... but for the kid to pass out and end up like Seth does can NOT be normal poor wee mite and poor parents!!!!!!! > holy sh.t! > I've heard of it being done as attention seeking etc... I've heard of it too but you know what, not in my 16 years of parenting have I actually ever met a kid who did it, or a parent of a kid who did it or even seen it in 10 years involvement in early childhood centres, never. I'm beginning to think it's a parenting urban legend....'I know a kid who' scenario. According to that site I posted the link too only 4.5% of kids have the severe breath holding spells that lead to blacking out like Seth, which leads me to believe there's a lot of embellishment going on with some parenting stories ;-) Andrea > Anyones else child have these? I keep getting told it's very common and > 1:20 kids do it but I am yet to meet anybody in my vast circle of parents [quoted text clipped - 32 lines] > couldn't be good for you. I'm wondering if I should take him in for a > blood test and ask for an EEG. Any opinions, experiences? That sounds horrible and not the norm that they often talk about.... the fact that he passes out should trigger the paed off right there as I'm pretty sure that children that hold their breath because they are having a tantrum can't/rarely hold it until they pass out (I could be wrong... I just cant remember atm) (okay, I just looked up a site and it says in very rare cases the child will faint... it also says that if they faint and fall you should contact you doctor and "In rare cases, when the pediatrician feels the behavior indicates an emotional disturbance, you may be referred to a mental health professional." This site also said that you must contact the doctor if they child faints because there is usually same underlying problem) I'd pushed to get him checked as it really doesn't sound like the normal 'tantrum' behaviour. good luck.  SignatureLeanne -------------------------------- There is a time for departure even when there is no certain place to go... http://uk.pg.photos.yahoo.com/ph/lstacherski/album?.dir=/1b24&.src=ph&.tok=ph_0B GCBvVMFF54J >>Anyones else child have these? I keep getting told it's very common and >>1:20 kids do it but I am yet to meet anybody in my vast circle of parents [quoted text clipped - 37 lines] > pretty sure that children that hold their breath because they are having a > tantrum can't/rarely hold it until they pass out Well she didn't seem concerned, I mean she was concerned but she reassured me it was fine and wasn't harming him in anyway. I think there is a misconception about what a real breath holding spell is. The stories of kids that do it on purpose while having a tantrum I think are a different kettle of fish, and most likely not the sort of breath holding spell that paediatricians call breath holding spells. And even then they seem to catagorise them into two sorts, mild and severe, the severe ones being when they pass out during them, the mild being where they eventually take a breath before they get to that stage. Neither one is a voluntary action though or done by a child throwing a tantrum, they are a physical response to crying. Andrea >> That sounds horrible and not the norm that they often talk about.... >> the fact that he passes out should trigger the paed off right there as [quoted text clipped - 3 lines] > Well she didn't seem concerned, I mean she was concerned but she > reassured me it was fine and wasn't harming him in anyway. The two parents I know who had kids who did this *did* have kids who would occasionally hold their breath long enough to pass out. > I think there is a misconception about what a real breath holding spell > is. The stories of kids that do it on purpose while having a tantrum I [quoted text clipped - 5 lines] > Neither one is a voluntary action though or done by a child throwing a > tantrum, they are a physical response to crying. Yeah, the ones I heard of would hold their breath during a tantrum, but it really didn't sound like how you describe Seth doing it. Both sets of parents didn't question for a moment that the breath holding was benign. I'm trying hard to remember the details of how they described it, and can't quite get it, but I know that when they did describe it to me, it seemed sensible to me that this was "just" breath holding and nothing to worry much about. I don't get that same feeling hearing your description. Both of the kids in question were very volatile, stubborn kids (great kids, but you know what I mean). Both grew out of it before school age. I don't know squat about this aside from what I heard from those friends, but the things that stand out in your story for me were the fear, the loss of bladder control, and the fatigue afterwards. I don't recall the other parents mentioning those. Best wishes, Ericka "Breath-holding spells (BHS) are dramatic, involuntary episodes that occur in otherwise healthy children. These episodes are often frightening to parents and worrisome to physicians. Because they can mimic serious or even life-threatening conditions, these generally benign spells require careful evaluation. In this article, Dr Jennette reviews how to differentiate conditions that require treatment from harmless breath-holding episodes that a child will outgrow." http://www.postgradmed.com/issues/2002/05_02/jennette.htm SignatureLeanne -------------------------------- There is a time for departure even when there is no certain place to go... http://uk.pg.photos.yahoo.com/ph/lstacherski/album?.dir=/1b24&.src=ph&.tok=ph_0B GCBvVMFF54J > "Breath-holding spells (BHS) are dramatic, involuntary episodes that occur > in otherwise healthy children. These episodes are often frightening to [quoted text clipped - 5 lines] > > http://www.postgradmed.com/issues/2002/05_02/jennette.htm Thanks, that was the link I found myself last night, it was quite helpful. Andrea My older dd used to do this. Outgrew it. I personally don't think she was doing it on purpose (my mom told me I did it too) It appeared to me when she was doing this it was just bad control of her breath and she'd breathe in and just pass out. She'd come to quickly and cry. Anni |
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