What to Expect the First Year (99 page)

“Recently my baby has started holding his breath when he's crying. Today he held it so long, he actually passed out. Could this be dangerous?”

With all those nights of checking on your baby's breathing behind you—you might have thought you'd be able to breathe easily now. And after you read this, you actually should be able to. In fact, even a baby who turns blue and passes out during a breath-holding session recovers quickly and completely.

Breath-holding spells that are triggered by crying—which, as you well know, can be triggered in babies by a variety of factors, from being mad, to being frustrated, to being in pain—are common and harmless. The crying, instead of letting up, becomes more and more hysterical, at which point baby begins to hyperventilate, then finally stops breathing. Sometimes, only the lips turn blue—scary enough, but considered mild by breath-holding standards. Less frequently (but even once is enough for a terrified parent who's standing by watching), a baby turns blue all over and then loses consciousness. While he's unconscious, his body may stiffen or even twitch. Fortunately, breathing resumes and consciousness returns in less than a minute as automatic respiratory mechanisms click into place and breathing resumes (the respiratory system's version of autopilot)—long before any harm is done to baby (the same may not be said of your nerves). You may be able to stop a breath-holding episode sooner by blowing on your baby's face or sprinkling water on it—either may trigger auto-breathing.

About 1 in 5 babies holds his breath during a crying spell. Some have only occasional episodes, others may have one or two a day or more. Breath holding tends to run in families (so check with your parents to see if either of you had episodes when you were tots) and is most common between 6 months and
4 years, though it can occasionally begin earlier or continue later.

While you're waiting for it to run its developmental course (don't hold your breath), try to head off some of the crying spells that can result in breath-holding spells:

• Avoid the triggers. You know the drill by now: A baby who is overtired or overstimulated is always more prone to major meltdowns (and less able to handle anger, frustration, and pain) than a well-rested one. Keep your little fellow mellow, and you'll avert some of the meltdowns that lead to breath holding.

• Keep routines routine. Regular nap-times, regular mealtimes and snack times, and plenty of unwinding as needed will help prevent fits of temper.

• Choose your battles. Too many no's can lead to too much frustration for baby. When you need to say no, try to offer an acceptable substitute.

• Get your soothe on. Try to calm baby before hysteria sets in, using music, toys, or other diversions. Or just offer quiet comfort—a cuddle, some gentle rocking, a hushed “shh.”

• Stay as calm as you can. If you're worried about crying escalating to the point of breath holding, your first impulse when baby starts howling is (understandably) to panic. But the calmer you stay, the faster your little one is likely to regain his calm. Even if the breath holding has begun, being the calm in your baby's storm can help it pass more quickly—and return less often. After all, as your little one begins to use breath holding as a parent-button pusher (and he will), not playing into his mini-manipulations will pay off. (What's the point of making a scene if nobody seems to notice?)

• Don't cave after a spell. On the subject of mommy-and-daddy manipulation, if your baby knows he can get what he wants by holding his breath, he will repeat, repeat, repeat.

Some research suggests that breath-holding spells can be a sign of iron deficiency, so check with the doctor to see if your little one's iron supplies could be low, especially if breath holding doesn't seem to be triggered by a tantrum or other fit of frustration. In fact, giving an iron supplement can sometimes help ease breath holding even when no deficiency is detected.

While passing out during a breath-holding episode triggered by crying isn't considered worrisome, check with the doctor if you need more reassurance (who wouldn't?). Certainly, any loss of consciousness that's not related to a crying spell definitely should be evaluated.

“My baby used to love to watch me turn on the vacuum cleaner, but now he's suddenly terrified of it—and anything else that makes a loud noise.”

That's because he's wising up. When your baby was younger, loud noises didn't frighten him—even if they sometimes startled him—because he wasn't sophisticated enough to connect loud with potentially dangerous, and potentially dangerous with scary. As his understanding of the world grows—and with it his ability to sort out (in his still evolving baby brain) what's a legitimate threat and what isn't—his fears grow, too. In other words, while being afraid of a vacuum cleaner may seem the definition of irrational to you, it actually represents a thinking baby's thought process. Temperament may also play a role in fearful reactions—a
little one who's “high sensitivity” may be especially bothered by loud noises, especially sudden ones.

There are any number of things in a baby's everyday life that, though harmlessly humdrum to you, can trigger terror in him: sounds (such as the roar of a vacuum cleaner, the whir of a blender, the barking of a dog, the whine of a siren, the ring of the doorbell, the flushing of a toilet, the gurgle of water draining from the bathtub), having a shirt pulled over his head, being lifted high in the air (especially if he's begun to climb, pull up, or otherwise develop depth perception), being plunked down in a bath, the motion of a wind-up or mechanical toy, and much more.

Probably all babies experience fears at some point, though some overcome them so quickly, their parents are never aware of them. Little ones who live in an especially busy, noisy environment that's always buzzing with activity (say, one where there are older siblings and multiple pets) may be less fear prone—or they may be more likely to experience fears earlier, as well as get rid of them earlier. Temperament also plays a role, of course, as it does in most behaviors.

Sooner or later, your little one will leave his baby fears behind (though an early fear of the vacuum cleaner may be sucked up by a somewhat more sophisticated fear—say, of monsters). Until then, you can help your baby cope with everyday fears in these ways:

Don't force facing fears.
Making your baby come nose to nozzle with the vacuum cleaner won't help him overcome his fear, but it could dial up its intensity. A fear of household appliances you've turned on and off for years without incident may seem unreasonable to you, but with your baby's limited scope of experience, it's very legitimate to him. He needs to confront the noisy beast on his own terms and in his own time, when he feels it's safe.

Don't make fun.
Yes, most everything your baby does is adorable—even his cowering at the sound of the vacuum cleaner's high-pitched hum. But try not to poke fun at his fears, laughing at them (again, as cute as they may be) or calling them silly. Remember, they're real—not silly—to him.

Do accept and sympathize.
By accepting and respecting your baby's fears as real, and offering comfort for them as needed, you'll help him overcome them faster. If he wails when you switch on the vacuum cleaner (or flush the toilet, or turn on the blender), be quick to pick him up and give him a great big reassuring hug. But don't overdo the comfort and sympathy—otherwise you may reinforce the idea that there is something to fear.

Do build confidence and skills.
While it's important for your baby's budding self-esteem to validate his fears, your ultimate goal is to help him conquer them. You can do that by giving him “safe” opportunities to become gradually familiar with the things he fears, to learn what they do and how they work, and to gain some sense of control over them (knowledge is, after all, power—even over a powerful vacuum cleaner). Let him touch or study the vacuum when it's turned off and unplugged—he's probably as fascinated with the machine as he is afraid of it.

Help him take baby steps toward vanquishing his vacuum fears. After he's become comfortable playing with the dust-sucking beast when it's off, try holding him securely in one arm while you vacuum with the other. (If that's out of his comfort zone, too, back off and try again another day.) Then show him how to turn the machine on himself, with a little help from you if the switch is tricky. If it's the toilet's flush he fears, have him throw a sheet or two of toilet paper into the toilet, then hold him while you flush it down together (happily waving bye-bye to the t.p. can make the process seem less menacing). If it's the draining tub, let him watch the water drain when he is safely out of it, wrapped securely in a towel and in your arms. If dogs are his demon, try petting one while your baby watches from a distance and from a safe spot—say, in a pair of friendly arms. When he's finally willing to approach a dog in your arms, encourage your baby (while you hold him) to “make nice doggie” to a dog you know is gentle and won't suddenly snap.