The Difference between a Pallid Attack and a Cyanotic Attack

If your child has breath holding spells, you might feel like the only parent in the world who has ever experienced such a horror. But actually, they are fairly common. In fact, as many as one-fourth of all healthy children have a breath holding episode at some point in their young lives. Even so, they can be quite alarming.

Not every breath holding spell is the same. There are two major types of breath holding spells. The good news is that neither one of them constitutes a medical emergency.

Cyanotic Attacks

The cyanotic attack is the most common type of breath holding spell. This occurs in response to an emotional trigger. Your child may be angry, upset, hurt or frustrated. He begins to cry, but stops suddenly when he exhales and fails to inhale. If he holds his breath long enough, he may turn blue, hence the name “cyanotic.”

In many cases, a cyanotic attack resolves on its own after a few seconds. Sometimes, however, the child passes out. But when that occurs, his reflexes take over and he begins to breathe again. Occasionally, children who experience a cyanotic attack have a mild seizure after losing consciousness, but this is not a sign of a seizure disorder. There is also no increased risk of seizure disorder or other neurological problems later in life.

Pallid Attacks

Pallid attacks are much less common than cyanotic attacks. They usually occur when the child is startled or injured. There is no crying involved, the child simply stops breathing. He turns pale, goes limp, and faints. Once again, when he loses consciousness, he begins to breathe again on his own.

Pallid attacks present no immediate danger beyond the risk of injury when fainting. Nor do they cause an increased risk of severe health problems later in life. Those who have pallid attacks as children, however, may have an increased incidence of fainting, known as syncope, later in life.

Handling Breath Holding Attacks

With both cyanotic and pallid attacks, it’s important that parents do not overreact. This could scare the child, or it could teach him that throwing tantrums and/or holding his breath is a good way to get attention or whatever else they want. Just make sure he is okay, and make an appointment with his pediatrician if it is his first attack or there is any reason for concern.

Cyanotic attacks are pretty easy to predict once you’ve seen your child have one. If you see one coming on, you could clap your hands to startle the child into breathing again. Placing a cold washcloth on his face may also cause him to start breathing.

Breath holding spells are rarely cause for concern. Children tend to grow out of them by the time they start school. But if you’re worried, a trip to the pediatrician can rule out more serious problems.

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