Brief Answer: Breath holding spells or Cyanotic spells Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day Being a Parent myself and Pediatric Surgeon I understand your concern and apprehension. It could possibly be 1. Breath holding spells 2. Cyanotic spells Breath holding spells are reflexive events typically initiated by a provocative events that cause anger, frustration or pain causing child to cry. Crying stops at dull expiration and there is reduced oxygen in body and this leads to reduced level of oxygenated hemoglobin in blood. This causes bluish discolouration of lips causing cyanosis. Diagnosis of this is based on typical history and sequence of crying , bluish discolouration and later pale appearance with or without brief loss of consciousness. This condition is usually self limiting and just require reassurance to parents. At the same time breath holding spells needs to be differentiated from other disorder that can cause cyanosis and require further management as they are serious. They need to be differentiated from 1. Seizure 2. Cyanotic spells of Cyanotic heart disease. The child will require further investigation like EEG and 2 D Echocardiography to rule out these abnormality in consultation with your Pediatrician. If these reports are normal then it's likely Breath holding spells. Do get back to me if you need any further assistance, will be glad to assist you. Take care Best Regards Dr Deepak Kishore MBBS, MS, MCH Consultant Pediatric Surgeon

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