Breath holding spells & being sick during sleep training

There are two less common reactions you need to be prepared for when sleep training the first is blue breath holding spells which are caused by an involuntary reflex that is part of the crying mechanism. Breath-holding spells are common, with one type or the other occurring in around 1 in 20 children. They usually start between 6 and 18 months of age, and affect both boys and girls equally.

Breath holding spells can really frighten parents. There are two types of breath holding spells. Blue breath holding spells in response to upset, anger, fear or sudden shock or pain and these are the ones that may occur during sleep training if they cry a lot. Reflex anoxic seizures can be triggered by an unexpected fright, pain or fall with a minor head injury. The breath holding is not caused by the injury but by the sudden fright or pain.

It can appear alarming as the child seems to stop breathing and can change going blue or a deathly pale grey with a temporary loss of consciousness. The last for less than a minute, don’t harm the child and they recover spontaneously. When they lose consciousness their autonomic nervous system takes over and they start to breathe again automatically so stay calm.
Although blue breath-holding spells and reflex anoxic seizures can be scary to witness, they don’t harm the child and don’t cause neurological problems, such as brain damage or epilepsy. The management is the same for both types of breath holding spells. Blue breath holding is what may happen during controlled crying.

Blue breath holding spells:

*Usually occur when the child is very upset and cries vigorously
*The child turns blue and stops breathing after a series of sobs where they breathe out
*Breathing resumes after gasping or taking an inward breath
*The child may become stiff or floppy while unconscious

Reflex anoxic seizures:

Usually occur when the child has a sudden, unexpected fright or pain – the trigger may not always be obvious
*The child may or may not cry or sob first
*They can go a deathly pale grey colour and collapse, losing consciousness
*They often go stiff rather than floppy, and then gasp as they come round when their colour returns

What to do if your child has a breath-holding spell

*Stay calm – it should pass in less than a minute
*Lie them on their side – don’t pick them up
*Keep an eye on them until the spell ends
*Make sure they can’t hit their head, arms or legs on anything – if they start to jerk, gently cushion their head, arms or legs to prevent injury
*Avoid shaking or hitting them
*Avoid putting anything in their mouth – including your fingers
*Avoid splashing them with water
*Avoid mouth-to-mouth resuscitation

You don’t need to try to help your child breathe or help their heart beat.
They start to breathe on their own, and their heart rate returns to a normal rhythm on its own after the episode or seizure has finished – this is usually in less than a minute. Afterwards, they may cry or scream. Reassure your child and make sure they get plenty of rest after having a blue breath-holding spell or reflex anoxic seizure. Act as if nothing has happened and avoid making a fuss – don’t punish or reward them. Carry on with the training as planned.
Although blue breath-holding spells and reflex anoxic seizures can be scary to witness, they don’t harm the child and don’t cause neurological problems, such as brain damage or epilepsy.
In some cases, blue breath-holding spells and reflex anoxic seizures may be linked to iron deficiency anaemia so if they happen regularly it is worth seeing you GP to have their iron levels checked.

Vomiting due to crying during sleep training

This is an area that can be emotive and strong views are held, it can feel very shocking and alarming if your child I sick whilst you are doing sleep training . However quite a few children do vomit it they cry a lot or are upset. Children can be upset for all sorts of reasons but not getting what they want is a common one. It is always important to check your child is not unwell or has reflux or any other condition which is why they may be vomiting. When doing any form of sleep training your baby or child should be fit and well.
If they are sick be mindful of how you respond to it as we know that behaviour that is noticed increases. If you pay a lot of attention to it and make a fuss or give in, some babies and children quickly learn to vomit whenever they are upset or don’t get what they want. If they are sick you change them and settle them with clean sheets with the minimum of fuss or comment. If they do gag or vomit at bedtime do protect the sheet with an extra layer of sheet so you can quickly change them, you might want to put newspaper on the floor to protect it. They may be sick a few times but once their tummy is empty they will not vomit again, continue with the sleep training and you will find the vomiting stops very quickly once they realise you are staying firm.
In the daytime work at trying to make the cot fun by spending a short time a few times a day playing games in and around the cot, such as peek a boo through the bars, hiding a favourite toy in the cot for them to find it and other fun games your baby or child enjoys.