There are two types of involuntary breath holding disorders as follows ~
Blue Breath Holding Spells
These episodes are caused by an involuntary reflex that is part of the crying mechanism
This is the most common type of breath holding disorder and often occurs during vigorous crying or sobbing that’s triggered by pain, frustration, anger or fear.
The child usually cries vigorously for less than 15 seconds and then becomes silent, their breath held on the outward breath, unable to take an inward breath (inhale).
The child turns blue, particularly around the lips, they become floppy or stiff and then lose consciousness, milder attacks without losing consciousness are also common.
They will remain in an unconscious state for less than a minute before regaining consciousness and breathing normally again, they may appear tired for a while afterwards.
Reflex Anoxic Seizures
These episodes are caused by an involuntary slowing of the heart rate, to the extent the heart may actually stop beating from 5 ~ 30 seconds (hence they become so pale)
These are often triggered by a sudden unexpected fright or pain, such as a fall, the child will often open their mouth as if they are going to cry but make no sound before turning a deathly pale grey colour and losing consciousness and often wet themselves during one of these involuntary episodes.
They will become either limp or more often stiff, with their eyes rolling upwards, and their fingers may become clawed due to lack of oxygen to the muscles, their body may also jerk.
The seizure will usually last for less than a minute, after the child regains consciousness, they may appear sleepy and confused for a few hours (only minutes in some cases).