What are BHS

What are breath-holding spells?

Breath-holding spells are brief periods when young children stop breathing for up to 1 minute. These spells often cause a child to pass out (lose consciousness). Breath-holding spells usually occur when a young child is angry, frustrated, in pain, or afraid. But the spell is a reflex. Children don't have breath-holding spells on purpose.
There are two types of breath-holding spells:

• A cyanotic spell is caused by a change in the child's usual breathing pattern, usually in response to feeling angry or frustrated. It's the most common type.
• A pallid spell is caused by a slowing of the child's heart rate, usually in response to pain.

Some children may have both types of spells at one time or another.
Breath-holding spells can occur in children between 6 months and 6 years of age. They are most common from 1 to 3 years of age. Some children have them every day, and some have them only once in a while.
Breath-holding spells are usually not serious and don't cause lasting damage. With time, they go away on their own.

What causes breath-holding spells?

Breath-holding spells are usually caused by either a change in the child's breathing or a slowing of the heart rate. These reactions may be brought on by pain or by strong emotions.
In some children, breath-holding spells may be related to iron deficiency anemia, a condition in which the body doesn't produce a normal number of red blood cells.

What are the symptoms?

A breath-holding spell may cause:

• Fainting. It usually lasts for less than a minute.
• Twitching muscles, a stiff body, or a seizure.
• Changes in breathing and heartbeat.
• In a cyanotic spell: The child may breathe too fast or too hard. When the child breathes out, there may be a long pause before the child takes another breath.
• In a pallid spell: The heartbeat may slow down.
• Changes in skin color.
• In a cyanotic spell: The skin may turn red or blue-purple, especially around the lips.
• In a pallid spell: The skin may be pale and sweaty.
• Crying.
• In a cyanotic spell: There may be a short burst of intense crying.
• In a pallid spell: There may be a single cry or no cry at all.

How are breath-holding spells diagnosed?

Doctors can usually diagnose breath-holding spells based on what happens during a spell. The doctor will examine your child and ask you to describe the spells. It may help for you to keep a record of what happens during each spell.
If your doctor thinks that your child has a seizure disorder or another condition, such as iron deficiency anemia, your child may need other tests.

How are they treated?

Most children don't need treatment for breath-holding spells. Spells will go away as your child gets older. If your doctor thinks that a medical condition is causing the spells, your child may need treatment.
To decrease the chance of more spells, make sure that your child gets plenty of rest, and try to help your child feel secure. Be sure to tell your child's doctor if your child starts to have spells more often or if they seem worse or different than before.
Breath-holding spells can be frustrating for parents. If you have trouble dealing with your child's spells or find yourself getting angry, talk with your doctor or a counselor. Try to keep in mind that your child isn't having spells on purpose.

What should you do when your child has a breath-holding spell?

To protect your child during a spell, lay your child on the floor and keep his or her arms, legs, and head from hitting anything hard or sharp.
Your child may stop breathing for up to 1 minute (60 seconds) during a spell. If your child doesn't wake up quickly and start breathing again, call 911 or other emergency services. The 911 operator may tell you to give your child rescue breaths while you wait for help to arrive.
After the spell, reassure your child. Don't punish him or her for having the spell.
For videos, or our personal experience with BHSs, see Living life with BHS & RAS.
Please see this website for more information:
http://www.webmd.com/parenting/tc/breath-holding-spells-frequently-asked-questions

What is RAS or Reflex Anoxic Seizures?

Reflex Anoxic Seizures (Syncope in the Young)
Syncope (pronounced sin-co-pee) is a medical term for a ‘blackout’ or a ‘common faint’ that is caused by a sudden lack of blood supply to the brain. This is very common, and occurs in roughly half of all individuals during their lives. There are many causes of syncope; the most common is vasovagal syncope, also known as neurocardiogenic syncope or reflex syncope.
With some children who suffer from a syncope condition, any unexpected stimulus, such as pain, shock
or fright, causes the heart and breathing to stop; the eyes to roll up into the head; the complexion to become white, often blue around the mouth and under the eyes; the jaw to clench and the body to stiffen; and sometimes the arms and legs to jerk.
After what seems like hours, but is probably less than 30 seconds, the body relaxes and the heart starts beating (sometimes very slowly at first). The sufferer is unconscious. One or two minutes later the person may regain consciousness but can appear to be unconscious for over an hour. Upon recovery the person may be very emotional and then fall into a deep sleep for two to three hours. He or she looks extremely pale with dark circles under the eyes. Episodes may occur several times per day/week/month, they also appear to come in batches.
Because of the symptoms, syncope is often unfortunately misdiagnosed as temper tantrums, cyanotic breath-holding (prolonged expiratory apnea), or epilepsy. Therefore, one of the aims of STARS is to bring about both professional and public awareness of syncope conditions.
Living with syncope:
"I just wanted to wrap her up in a blanket and sit and play jigsaws all day, knowing that she was unlikely to have an attack if she didn't move" - (Parent).
Such a response to caring for a child with a syncope condition is natural; however parents need to balance the understandable need to protect their child from harm against the long-term problems caused by this attitude. Excluding children from everyday activities and risks can stunt their normal emotional and psychological development. Discipline and limit-setting are particularly difficult for families of these children, but they remain essential for the child's healthy development.
What to do in brief:
Make sure the individual is lying flat in a safe environment ensuring nothing is blocking their airways.
Talk reassuringly (it is know that the individual can sometimes hear but is unable to answer) and comfort upon recovery.
Although it should not be necessary to call a doctor, if the person has had a particularly nasty bump it may be wise to seek medical advice.
Please see this website for more information:
http://www.stars-us.org/