“Breathing spasms” are more often a sign of an immature nervous system that is common and normally seen in infants. These may last for an hour or so but should resolve on their own. Other causes of irregular breathing after crying may include breath-holding spells, laryngomalacia, and gastroesophageal reflux (GERD). It is always best to seek consult with your pediatrician to rule out any serious causes.
New parents are often anxious and deeply troubled when their babies start to breathe strangely after a bout of crying. Some are fearful that it may be related to sudden infant death syndrome, while others may think of it as a breathing problem that may become worse.
In a couple of online forums, mothers would describe these events as “sobbing spasms,” “stutter breath,” and “prolonged hiccups.” Babies and young children are often seen “gasping,” trying to catch their breath, uncomfortable-looking, and as if they are about to panic.
There are several reasons why an infant may act this way — and yes, it can also simply be due to normal behavior! Let’s dig deep into this unsettling situation and discover what may be causing these “breathing spasms” in your child.
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Immature nervous system
Think back to the last time you’ve cried uncontrollably and hysterically — after you’ve let all your feelings out and the crying ended, you find yourself trying to catch your breath. It’s the same thing for infants.
Although they probably have not cried as long as you did, crying does take a lot of their energy, so they encounter some trouble as they return to their normal breathing pattern.
While it takes just a few seconds for adults and older kids to adjust their breathing, newborns and infants need some extra time to get back to their normal breathing patterns. Their nervous system is still immature and developing, even after birth.
Because of this, they seem to have trouble breathing, or breathe in spasms, as they recover from crying.
Some babies need 30 to 60 minutes, while others may breathe this way for up to a few hours.
Since situations like this may be nerve-wracking, it’s important to list down and read up on other conditions that may either cause this behavior, or become associated with it. When you’re in doubt, it’s always best to seek help from a healthcare professional.
Young children 6 months to 2 years of age can develop breath-holding spells. These are long episodes of crying that are triggered by pain or emotions.
Too much crying means less time to breathe, and at some point, babies lose consciousness from the lack of air. This is very brief and not harmful, as there is a very low risk of any long-term effects.
It’s important to note that breath-holding spells are not intentional: all children, whether infants or not, aren’t aware of this and could not control themselves.
There are two main types of breath-holding spells. In the first (and more common) one, babies turn bluish in the face, while in the second, babies become pale-looking.
In this type of breath-holding spell, infants may suddenly stop breathing while they exhale, become bluish (called cyanosis), either limp or rigid, then lose consciousness for a few seconds.
Cyanotic breath-holding spells more commonly come from short and loud cries and usually last for less than a minute.
In this type of breath-holding spell, common causes include fear and pain. Cries aren’t as loud as in the cyanotic type. Infants may suddenly gasp, then briefly lose consciousness, before quickly recovering.
In both types of breath-holding spells, some infants may experience arching of the back or jerking movements if they remain unconscious for at least 45 seconds.
If you suspect your child has experienced a breath-holding spell, it may be wise to schedule an appointment with a doctor to rule out other, more serious conditions.
Some breath-holding spells may be related to iron deficiency anemia. Studies show that giving iron supplements (at the appropriate dose, of course) may lessen the number of breath-holding episodes. Ask your doctor if your child may need iron supplementation.
The larynx is an organ composed of cartilages and tissues. It assists us in breathing and protecting the passages where air passes through. It also contains our vocal cords, which are important body tissues that we use to speak.
In laryngomalacia, the cartilages forming the upper part of the larynx are weak and immature, causing it to collapse into the passageway when infants inhale air. This produces a high-pitched sound, called inspiratory stridor, heard only during inhalation.
Some infants with this condition have worse symptoms when excited, stressed, during feeding, or while crying.
Laryngomalacia may be present at birth and may resolve by 12 to 18 months old.
Most cases are only mild to moderate — of all babies with this condition, only 1 percent are severe enough to consider hospitalization and surgical treatment.
Infant reflux and GERD
Between the esophagus and the stomach lies a band of muscle that helps keep food from coming out of the stomach, back through the esophagus, and out the mouth (as vomit).
This is called the lower esophageal sphincter (LES). In infants, the LES may not be fully developed. Add that to the constant position of lying on their backs (infants lying on their tummy are prone to SIDS) and meals consisting of milk (or soft foods), and you have a recipe for infant reflux.
At least half of all infants have experienced reflux. Most cases develop from 4 to 6 months of age, are mild, and resolve on their own without any treatment. This is called “silent reflux”.
On the other hand, there are situations where reflux may not be normal. Signs that may indicate gastrointestinal reflux disease (GERD) include the following:
- Vomiting or forceful spit-up that leads to crying and irritability.
- Refusal to feed.
- Arching of the back.
- Choking or persistent coughing.
However, some infants have severe symptoms and may need certain medications. Your doctor may provide a more accurate assessment and prescribe any needed medicines.
It’s more likely that your child may not have any of the above conditions. After a complete history and physical examination, your doctor may diagnose your child with brief resolved unexplained event (BRUE).
This condition applies to children less than one-year-old who have at least 2 episodes of certain events, which include irregular breathing. In BRUE, these events happen quickly, but come and go on their own.
I’m worried about SIDS. How do I know that my child’s “breathing spasms” isn’t a sign of SIDS?
Although sudden infant death syndrome (SIDS) is quite rare and not fully explained, studies have shown that the following situations or signs are some of the risk factors for the condition:
– Babies sleeping on their stomach.
– Soft sleeping surfaces.
– Placing soft linens, blankets, or toys beside the infant while sleeping.
– Exposure to smoke, or mothers who smoke while pregnant.
– Premature babies.
– Babies born with low birth weight.
As of now, there isn’t any significant information pointing out a connection to irregular breathing.
What happens after my child is diagnosed to have BRUE?
Infants with BRUE may be classified as low-risk or high-risk. Depending on this classification, your doctor may request for further tests. Low-risk infants typically need only a few tests, such as an ECG and nasal swab for pertussis.
My child was diagnosed with laryngomalacia. Will they ever outgrow this condition?
Yes! In mild and moderate cases, laryngomalacia resolves before they turn 2 years old. For severe cases, it is best to speak with your doctor as the prognosis may be different for each child.
I was told that my child’s breathing spasms are normal. Just to be safe, which new signs or symptoms would need another hospital visit?
Some of the signs to watch out for include facial cyanosis (bluish discoloration in the face) that doesn’t go away, jerking or convulsive movements that won’t go away, rolling of the eyes, fever episodes, irritability, or a weak-looking child.
If your child has no spontaneous breathing after one minute, or doesn’t have any pulse at any period of time, start CPR, immediately call for help, and transfer your child to the nearest hospital as soon as possible.
“Breathing spasms” are quite worrisome, especially for first-time parents, but it’s most likely due to an immature nervous system. Irregular breathing after crying may also be due to breath-holding spells, laryngomalacia, or gastroesophageal reflux (GERD).
When there are no other possible conditions to explain this, your doctor may consider your child as a case of brief resolved unexplained event (BRUE), which may or may not need further tests and evaluation.