Parents have been holding their breath waiting for me to tell them what to do for their young children who seem to be having what we call breath-holding spells, especially when they get angry. Well, I dont want anyone to get blue in the face over this topic, so heres some information. Breath-holding is a fairly common behavior in most toddlers. About 5% of healthy, breath-holding toddlers will get so upset they exhale forcefully and then decide not to breathe to the point they may turn blue or pale. They literally fall to the ground limp, sometimes with some shaking of the arms and legs, which is what we call an official breath-holding spell. Though these are extremely scary to watch, they resolve spontaneously and within 30-60 seconds a child will catch her breath and begin to cry. They do not indicate a serious seizure disorder or brain damage. Breath-holding spells are rare before 6 months of age, peak at the age of two, and then disappear by age 5. After children recover from their first breath-holding spell, and they will, it is good to speak with your childs doctor, or have your child seen, to reassure you that this is a typical spell and not a problem with your childs brain or heart. Sometimes being anemic due to low iron stores can contribute to the problem. The most important thing you can do if your child has these spells is figure out what provokes them and avoid that trigger, or at least try to distract your child by calling them over to look at something interesting. Once you know it is a breath-holding spell and that the outcome is going to be fine, you should stay relaxed, give your child a hug when they come out of it, and go about your business. If you are frightened, dont let them know it or theyll do this more and more frequently when they begin to get upset to get their way or seek your attention. Hopefully, tips like this will allow you to breathe more easily the next time your child has a breath-holding spell. Lewis First, M.D., is chief of Pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch "First with Kids" weekly on WOKO 98.9FM and on WCAX-TV Channel 3. Visit the First with Kids archives at www.vermontchildrens.org.