Breath holding spells, or apnea, are neurological episodes of infancy and childhood. The incidence is 0.1%-4.6%, mostly within 2 years of age, and the frequency of seizures varies, gradually decreasing after 3-5 years of age, and rarely seen after 6 years of age. Most episodes of breath-holding have obvious triggers, such as unfulfilled demands, fright, pain, or anger, and are characterized by emotional outbursts, forceful crying, sudden cessation of crying after one or two or several cries, breath-holding, and temporary absence of breathing, while the face is red or slightly bruised and the eyes stare blankly for half a minute to one minute. In some cases, the child may hold his or her breath for 2-3 minutes or even longer, with increased bruising, body jerking, loss of consciousness, or even twitching of the limbs, then the muscles relax, breathing resumes, and the face returns to normal, but some babies are tired and need to sleep for a while after the seizure. A few breath-holding episodes can appear pale type, which is caused by vagus-mediated cardiac depression. The number of episodes is variable, and in severe cases can be several times a day (triggered by the presence of stimuli). The number of episodes decreases with age. The seizures often stop at the age of 5-6 years. It is common in children who are overindulged, willful or neurotic. About 30% have a family history. Pathogenesis During seizures, hypercapnia and cerebral hypoxia due to breath-holding, and vasoconstriction or secondary respiratory spasms during crying, slowing of the heartbeat causing decreased cardiac output, and finally syncope and convulsions. The pathogenesis may be due to a variety of causes: it is currently believed that the central nervous system is immature and poorly regulated; others include the action of the vagus nerve causing heart rate slowing and respiratory depression, dysregulation of the peripheral vascular response; in pulmonary dynamics, reflex regulation of inappropriate stimuli causing expiratory asphyxia and hypoxemia; and iron deficiency making the child’s behavior irritable. A correct and detailed history, describing the circumstances and course of the seizure, asking about the age of seizure onset, frequency (daily, weekly or monthly), precipitating factors, environment, face color during the seizure, presence of tonicity or clonus in the limbs, mental reaction after the seizure, and family history, combined with EEG, can make a clear diagnosis. Pediatric breath-holding seizures need to be differentiated from pediatric epilepsy. Breath-holding seizures are often preceded by obvious triggers and start with sudden breath-holding and apnea, followed by cyanosis, loss of consciousness and convulsions. The disease generally does not require medication, and parents need not panic. They should immediately carry the child to bed, lie on his or her side or flat, keep him or her quiet, unbutton the collar, keep the airway open; clean the mouth of foreign bodies or vomit, avoid shaking the child, and reduce or avoid all adverse stimuli. Parents see this phenomenon is extremely fearful, lest the breath hold time is too long and accidents, so everything is obedient to the child, to meet their requirements, over time, it will breed the child this habit, when encountered again similar events, they will often “repeat” to win the sympathy of parents. The key to corrective action lies in correct parenting, attention to the living environment arrangements, lifting the factors that cause mental tension and conflict, and trying to avoid sudden and unexpected stimuli. Family members should be kind to the child, so that he feels the warmth of the family; but also patient education, so that he consciously strict requirements for themselves. If you overemphasize not to frustrate their emotions, often unprincipled to meet the child’s desires, the future can cause abnormalities in character. On the contrary, if overly strict requirements are put forward, it is easy to cause frequent episodes of breath-holding, which is not good for health. If there is iron deficiency anemia then iron supplements should be given in a timely manner.