BHS (Breath Holding Spells)



BHS (breath-holding spells) also called as Expiratory Apnea are episodes wherein the kid halts breath and becomes unconscious for short spans of time shortly ensuing a terrifying, emotionally distressing or an agonizing experience.

BHS is known to affect five percent of children in good health. They generally start in the initial year of life, peaking by the age of 2, subsiding by 4 years of age in fifty percent infants and by 8years in 83% of infants.

BHS could take one of the two below stated forms, namely:

The cyanotic form of BHS:

The most prevalent and initiated in subconscious manner by young kids mostly as a part of a temper tantrum or as a retort to being scolded or other disconcerting events. These episodes become quite recurrent at about two years of age and are uncommon among children past 5 years of age. Usually, the crying starts (at times without essentially being sentient about it), followed by breathing out and halting breath. Soon the skin starts turning blue and the child loses orientation and becomes unconscious.  A momentary seizure might take place. Some seconds later the breathing starts and the skin colour turns to normal and consciousness is regained. The episode could be possibly interrupted when one places a cold piece of cloth over the kid’s face at the time the spell starts.

BHS could be a petrifying event for the parent. Some consider that the child holds his/her breath purposefully, but mostly they are unintentional and spontaneous in nature. These happen when the kid is wakeful and is actively breathing. These spells could pursue from anywhere between two to twenty seconds, but could prolong more than a minute.

Mostly one’s doctor would offer information regarding BHS and assure that it is not detrimental to the child. After BHS has been diagnosed, it is crucial not to make dramatic changes in the manner of treating or attending to the kid except for the two exemptions. Firstly, one needn’t be overly nervous or tensed about the kid either before or after BHS. Secondly, one must not totally give in to the kid’s demands on all occasions, in an attempt to stop him from ever getting upset.

Holding breath spellThe doctor might also examine the child for anemia and prescribe iron supplements for lowering the regularity of BHS. Though medication is occasionally advantageous to kids with BHS, however those with severe and recurrent BHS might find this beneficial.

When BHS takes place, the child should be laid down on his/her back and safeguard them from any head injury and aspiration till the time recovery happens. If needed, the child’s mouth and airways needs to be cleared in order to avert choking. The parent needs to follow these instructions in a calm and unruffled manner and avoid overreacting to the episode. An EKG test is also at times conducted for such kids to diagnose any hidden heart ailment. One needs to delve into one’s family history and inform one’s doctor or caregiver about BHS.

Cyanotic breath-holding spells respond to intake of iron supplements in spite of the kid not having iron-deficit anemia, and for treating obstructive sleep apnea.

The pallid form of BHS:

These unanticipated and uncontrollable spells lead to the child turning extremely pale rather than the bluish or purplish tone. It classically occurs after a hurtful experience like after a fall or head injury or being abruptly shocked. This leads to the brain sending signal through the vagus nerve that swiftly lowers the heart rate leading to lost consciousness both of which are transitory in nature. Paleness, limpness and at times seizure and incontinence might ensue. The heart beat slowing down during the time. After the spell passes by matters return to normal.

An atypical form of BHS related to a rare genetic condition known as familial dysautonomia or Riley Day Syndrome are unintentional spells occurring among infants that are already gravely ill.

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