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Periodic Breathing Spasms in Young Infant
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Periodic Breathing Spasms in Young Infant

Our son is 4 months old. Occassionally he has scary episodes of a breathing problem that always seems to be triggered by crying.

It happens when he becomes very upset and cries loudly for 5 minutes or more. All of a sudden be will suck in his breath for about 3-5 seconds and have a panicked look on his face. Then he relaxes and breathes normally. This will happen every 30-60 seconds....and then maybe every couple of minutes. These attacks will last for hours even while he sleeps that night, and by the morning he is 100% better.

The attacks are also accompanied by an intermittent hiccuping noise or a type of "stridor" which is also gone by morning.

Can anyone share their insights? My doctor feels reflux might be causing the airway to spasm to keep acid from being aspirated, but after 3 weeks of treating my son with Zantac and the usual reflux comfort measures, he is still having attacks.

It seems to be directly related to the crying and/or being extremely upset. Can crying in an infant cause spasms such as this that last for hours (8 or more)? What kind of specialist should we see for this....or will he just outgrow it?

We are so worried. I have a small video clip of him doing it.....if there is a doctor who would be willing to look at it. Thanks.
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Avatar_n_tn
see a pediatric pulmonary dr. my baby also has funny breathing while she sleeps along with excessive sweating. the dr ordered a sleep study which found mild obstructive sleep apnea. this could be caused by reflux or large tonsils/adnoids.

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Avatar_f_tn
We had the same situation when our child was 2 mos upto now. She does not do it so often and is more calm after crying. A neurologists did an EEG- normal. Said it was a king od breath holding spell. But I do not agree with this 100 %. It looked back then scary...She is now 3 and only gets hiccups if she cries for long...
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Avatar_f_tn
My son is now 2 years old.  He started this same thing when he was 3 months old.  The 1st time he did this week took him immediately to the emergency room.  Of course, nothing was found.  Over the next several months we had many test ran.  EEG, upper GI, Monitered over night in the hospital while have these "episodes", E-rays,,I even recorded my son doing this,,,everything was normal.....the final diagnosis was silent reflux.  I do think that he has/had silent reflux-which is when the baby doesn't actually throw up but tries to prevent it from coming us (which is what was suppose to cause these episodes, but I am not convinced that this is the main cause.  Ace is much better now-the episodes are less common; however, from time to time he still does this-especially if he gets hurt.  It still bothers me when it happens but it doesn't appear to bother him and most of the time when I get him to calm down enought and take a few deep breaths it seems to stop so it is much easit to deal with now that he is older-and again, it is much less common. Maybe 1 every several months or so.
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555858_tn?1331991981
It's now 2012 and I wanted to post an update here since so many people have asked me about my son because their child is experiencing the same thing. Hopefully, this information will be helpful to you all!

First, let me say two things. My son outgrew the breathing spasms or "apnea of crying" as it is sometimes called. Then we had another baby boy with the same issue. He also outgrew it.

Secondly, it doesn't appear to be life-threatening, so this should give you all some peace about it.

My theory is that any child who is experiencing these spasms should be checked out thoroughly so that parents can discover what the TRIGGER is. Something is setting off the involuntary closing up and relaxing of the throat. Find out what that is!

Here is my full story:

Our son, who is 3 1/2 now, experienced his first "apnea of crying" or "sobbing spasm" when he was about 8 weeks old. He was sleeping in his swing and I noticed a definite pattern of (1) a sharp and sudden intake of breath (2) holding the breath for anywhere from 5 to 10 seconds (3) release or deflating of breath. All of this was involuntary, and happening beyond his control. This was definitely not a case of a child getting upset or crying and deliberately holding his breath. The best way I could describe them was "breathing spasms" or "involuntary gasping."

We rushed him to our pediatrician that night and the doctor said it looked like a hiccup, but was definitely something different. Oxygen levels were fine. The doctor had no answer so we just went home. The spasms continued throughout that night, even as my infant son slept. In the morning, they were gone completely.

This same scenario repeated itself throughout his infancy - nine out of ten of the episodes being triggered by sobbing or intense crying. As time passed, they began to shorten in duration and severity. By the time he was 2, they were gone for good and we've seen no repeats (again, he is now over 3 years old).

The best answer I ever got from a medical professional was from my friend, a speech pathologist. She said his throat structures were all normal, but that what was happening during an attack was something like a "Laryngospasm" where the throat/windpipe briefly and involuntarily closes up. The triggers for such spasms are varied, just as people experience headaches for a variety of reasons. Our job was to find the trigger.

Then the plot thickened. We had another baby last year and he ALSO has experienced these same spasms, however they were much milder and went away by the time he was 12 months old.

My personal theory about these sobbing spasms (esp. in infants and children) is that in an otherwise "healthy" child they are most likely triggered by:

1. Allergies (i.e. a very common allergic symptom is to have the throat swell, close up or spasm)
2. Exertion (i.e. similar to asthma but not actually a diagnosed condition - this would be classified as Intermittent Asthma, which is usually outgrown)
3. Intense Crying (this is a known phenomenon and happens to many of us - we get hiccups or spasms of the diaphragm after sobbing. In some people, perhaps this reflex is highly sensitive or exaggerated)

And there might be a combination of the above triggers.

And in almost every case....it's not life threatening. I think a parent would need to be very concerned only if an underlying condition was diagnosed such as chronic asthma or other respiratory disorders, structural abnormalities in the throat or lungs, or a severe allergy.

In our children's case I noticed something VERY interesting in hindsight. Both of our little boys had a serious milk protein allergy from birth (this is different from lactose intolerance). They were so sensitive that if I ate a little dairy and then breastfed them, they would have a reaction (usually extreme fussiness, gas and vomiting). Fortunately, both of my sons outgrew this allergy. AND around the same time they outgrew the milk allergy....the spasms stopped! This to me is no coincidence, esp. as I've seen it happen twice now.

In summary, in the case of my two youngest (I actually have 4 children but the first two never experienced this or the allergies), I feel that both were suffering from a moderate food allergy which put them at risk for these throat spasms. In other words, they did not have episodes of spasms every time some dairy got in their system. Instead, it was bouts of crying that triggered the episodes. But I'm pretty sure it was the pre-existing allergy which made them susceptible.

My theory bears itself out in what I've continued to observe. My two little boys may cry and sob and get very upset, but it no longer triggers the throat spasms, just the normal little "hiccups" we all get for a little while after.

Finally.....there is an article on the web called "The sobbing spasm or the apnea of crying: a review and a proposal for care" but I can't access it because it's in Spanish! If someone can get a hold of the English text, please let me know. It would be helpful to all of us who are concerned about this issue!

Thanks
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Avatar_f_tn
thank you so much for this...I was seaching for this and your message put my mind at ease - two years later :-)
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