You’ve seen it or heard about it: a child is throwing a tantrum, holding his breath, and his parents are ignoring him, because that’s what they’ve been told to do. Or sometimes something different happens, like the child falls and hurts himself, and goes almost catatonic. Parents worry, but the pediatrician usually tells them “It’s normal. He’ll grow out of it.” If they are sent to a neuro specialist, the specialist usually tells them the same thing. The same WRONG thing.
Dr. Dorothy Kelly, et al, did extensive research on breathholding and came up with a few important facts. One is that sometimes the pediatrician and neuro specialist are right: some children hold their breath until they pass out and automatically start breathing again. Our brains have trigger points, one of which is oxygen/carbon dioxide levels. When our brains note that we’ve accumulated too little oxygen or too much CO2, we are stimulated to breathe.
But there is another side to the coin. Dr. Kelly, et al, reported that sometimes the pediatrician and the neuro specialist are wrong: some children do not start breathing again.
The children who do not start breathing again, or those whose breathholding is “involuntary,” can die. “Involuntary” means that some physical or emotional shock triggers the spell, rather than a conscious decision on the part of the child. One possible explanation for this is a dysfunctional autonomic nervous system. The autonomic nervous system is dysfunctional, and will not respond and force breathing at the normal trigger point for CO2/O2 levels.
These children or infants may have several or many episodes during which they involuntarily hold their breaths, finally gasp, then start breathing again. However, at some point, they will fail to re-start the breathing process. Finally, they cannot be resuscitated, even with extreme measures.
How do you know which group your breathholder falls into? You don’t, unless you find the right doctor, until the child dies or survives into adulthood. There are several very sad sites on the web where you can read about parents and children who were given the wrong advice. [http://www.angelfire.com/il3/formax/]
You don’t have to be one of the unfortunates who spend the rest of their lives regretting not having known more or done more to keep their children healthy. You can take precautions if your child is a breathholder. You can realize that breathholding can be a behavior, or it can be a symptom. You can remember the words “involuntary breathholding” and “autonomic dysfunction” and “vagally mediated.” Then you can use those words when speaking with your pediatrician about these symptoms, and insist on a referral to a neuro specialist who is familiar with involuntary breathholding and autonomic dysfunction.
Don’t worry about “giving in” and paying too much attention to the child’s emotional needs; after all, you are responsible for those, too. We have too many amateur psychrinks who want us to believe that psychological causes underlie almost all child behavior. We have to remember that although our children can be superb manipulators, most of them lack the subtlety to formulate an involved scenario for manipulation purposes, at least until they get older and have a wider experience to draw on. Most of our kids are straightforward, extremely literal thinkers, and do not enjoy discomfort. It’s up to the adults to ferret out the causes of what we call “behavior” and to respond appropriately.
Some physicians use “BHS” to indicate breathholding spells. Southwest SIDS Institute issued a statement that “vagally mediated BHS which occur in approximately 1 out of every 100 infants and young children are associated with increased morbidity and mortality. Sudden asystole or severe bradycardia (slowing of the heart), seizure activity, and even death may occur.” Dr. Kelly cited the use of metaclopromide and/or Donnatol, and the occasional addition of Tegretol, to control vagally induced breathholding spells [involuntary breathholding].
Preventable deaths of children are among the most tragic events a family may experience, and the most important factor in most of these events is the information at parent has or doesn’t have at the time it’s needed. With the advances in medicine and the internet availability as a quick research tool, you can keep up with the latest research, the most current information, and take the kind of preventative measures that will enable you and your children to experience long and happy lives.