Help! Breath Holding

Hi,
I have a 12 month dcg set to start in 2 weeks so i sent mom a touch base email yesterday about this and that. They are a lovely family from what i can tell, but in her reply she mentioned the following:

' one thing to be aware of that has come up in the last month is that she seems to be breath holding while crying to the point where she faints for 5 seconds. it seems to happen when she's tired, and less than once a week....taken her to doctor and they are going to run a few tests just to be sure, but they weren't too concerned...we blow gently on her face and that sometimes seems to get her to take a breath. '

Has anyone dealt with this at all? I've heard of older children being angry and holding their breath, but a baby doing this, I'm not familiar with. I've read online that it's not very common and is involuntary. Child goes limp/ turns blue until they breathe again. .... Sounds like oxygen deprivation which scares me quite a bit. Would you be able to deal with this? When one faints, do they always automatically start breathing again? This actually has me very concerned now and i'm not sure i'm able to deal with this happening, even if it's just a few times per month. What if she's standing having an episode and then falls while fainting? Am i being too worried? Would you take her on and wait and see?
if fatigue is a factor i can only see that getting worse at daycare - and then if she experiences this at nap time when crying, how would i know? I do check on child every time they cry for the first little while, but eventually i hope they can self-soothe and i wouldn't necessarily check on every cry.

Would you be comfortable?

Update - I just received another email from mom that so far her daughter has not turned blue... she writes: 'she doesn't turn blue and she hasn't fallen from an upright position yet. She's usually on the floor or being held by one of us (because if it's going to happen it's going to happen while she's crying hard). Her eyes roll and it's literally only 5 seconds if that. It was frightening the first time for us, but the doctor's response (after listening to her heart etc) was to say "Some kids do this, she'll grow out of it". She's been left with grandparents and a babysitter a few times and they have never experienced it. It's been four times in the last six weeks so not often at all.
They are going to run a few tests just to be absolutely sure, but it's been three weeks and after leaving two messages they haven't gotten back to us yet. I will let you know ‎if anything else develops."

uggh... hard to know what to do

I personally would not feel comfortable simply from a liability standpoint.

Nope, no way would I take that on.

I just rec'd another email this morning which I attached to original post... thanks so much for your input. child is healthy otherwise, but this is alarming I find

My cousins 1 yr old does this. A lot. It was a few times a week for a while. She did it twice while visiting my brother, once because the dog walked up close to her. Another time my brother picked her up (she knows him well).

There really is nothing to do about it. It is a random thing some kids do, if it is brief and they resume breathing on their own there really is nothing to do.

My nephew did this twice when closer to 2 yrs. His home daycare provider took his toy away (to tidy up) and he flipped out. Next thing she knew he face planted, was blue in the face and wasn't breathing for a couple seconds. She panicked (of course) and called my brother. He picked him up immediately and rushed him to the emergency room. The doctors ran a bunch of tests just to rule out anything and in the end they were told it is a fairly 'normal' childhood thing. The doctor's 2 nephews were prone to doing it on a regular basis. My brother and sister-in-law rushed out and bought wine and chocolates and flowers and brought it to the home daycare provider. She was understanding and all was well until my nephew started school this year. My nephew did it once more at home but that was it.

Some kids just get upset and lose it. Some hold their breath (forget to breath?).

I don't know that I would be too concerned. Maybe just let them know you will proceed on a trial basis and should it be something that you can't handle they will need to move on. It is ok to let them know that in these cases you may not be able to hold the child as you have numerous children to be caring for. The main factor here will be how often this child decides to do this and under what circumstances. Once a week is not a big deal in the grand scheme of things...multiple times a day when the child isn't getting their way is an issue.

Thanks everyone for your opinion - my son is in paramedic school and he said could be vaso-vagal response when someone's vagal nerve (which runs from our brain down neck) becomes too stimulated (from crying) it can cause fainting. Even someone exerting a lot of pressure to pass a BM can faint because of it!
I'll see how it goes and if she doesn't turn blue and gets over it quick, I may be able to handle it.
Luckily, I have an out in my contract.

I have a little one who went through this. While it did happen at home, it never once happened at daycare. It eventually decreased and seems to have gone away now. Certainly a concern at the time though. Ended up being a complete non issue at daycare. I would discuss should she faint & have a really hard fall resulting in her head being struck, that she be checked out & kept home for 24hrs.

I did hear about it in a first aid class and they said to just blow gently on the child's face and to stay calm as they get over it quickly also the grow out of it

I think in a situation like this you have to look at this as a professional caregiver aka BUSINESS PERSPECTIVE, not a parent, or someone who has heard of it before etc.

Number 1, this is an undiagnosed condition. All people are doing on here are speculating which makes sense, but a child without any kind of formal diagnosis means that anything could happen and that it is entirely possible that the next time the child stops breathing, it could be a much more severe issue.

Number 2, there is a difference between holding breath and stopping breathing. One is voluntary and one isn't and the difference in cause and the implications are significant.

Number 3, What if? That is the question...so many what ifs in the profession that we just have to try to be prepared for, but knowingly walking into a situation like this of a child who is either holding breath, which is behavioural and likely very difficult to correct, or stopping breathing which is medical and much more unpredictable, at least while no formal diagnosis has been made anyway, seems like a huge unnecessary risk to the child and provider to me. Although many of us have child and infant first aid and CPR, has anyone actually performed this on a child? How do you know when it is time to be concerned? How do you know when it goes from no big deal, to an emergency? The only people with extensive enough training and the qualifications to make that call are Dr's and paediatric nurses. Yes others may have some basic training in an emergency, but as I said have you ever had to perform life-saving techniques on a child? My background is healthcare, acute and emergency healthcare and even I wouldn't take this on. It isn't about me, it is about the child and their family. if something tragic were to happen with this child, it would be on the provider. You would have to have the parents sign a waiver of liability but I think a parent would be a fool to do that given the unpredictability of the repercussions of a child who stops breathing. Now granted this is a pessimistic perspective, but I am not about to trivialise this as a "no big deal" situation when it comes to caring for other peoples children. Our own children is a whole other thing. Our liability Insurance probably wouldn't even cover us when it came down to it and a parent sued. Look at the other people over the years on this site who have been sued for simply doing their job. This has to many risk factors for the child's well-being and my personal well being too. Providers have terminated and not signed on families for far less and situations which fall under the category of normal behaviour.

An additional huge factor here is that we work alone. We do not have another staff member to pay closer attention to a high need child who at any given moment could hit the deck or stop breathing. We do not have specialized training to deal with every eventuality when it comes to these things, and for a child who has breathing issues, this really does just seem like a no-brainer to me that a single home daycare provider with no resources, no formal training for the majority, especially in this area, and no support staff is at increased liability for a child like this. This isn't a child with a disability, this is a child with an undiagnosed medical issue who STOPS BREATHING! Unless someone can guarantee that I am not liable for any negative outcome and who can offer me a written formal diagnosis I wouldn't have even thought twice about saying no. Even with those things though, it wouldn't have taken long for me to swallow my pride and listen to my gut telling me that there are safer childcare setting for a child with these types of needs. Just my Opinion!

It's no big deal to me. But to each their own. it has to be what you are comfortable with. I've had many kids do this. It happens when they are upset and start crying so I always knew when it was coming. I'd either run out the front door or blow in their face and they came too. Or if they passed out they came to 5 sec later. In all of my yrs of experiences I've seen it a lot so I guess it's normal to me. Some kids just freak out and are stubborn and they forget to breath. In all my cases it wasn't a big deal it was short lived and all grew out of it.

I had to blow twice on 2 different kids and I stayed calm and just blow into their face and counted the seconds till they cried normally ....so for me the main thing was staying CALM and the children only did it ONLY once each in the years I had them ,one 15 years ago in a big daycare where I worked and one 3 years ago here at my home daycare

Hi, after much thought about this, I decided not to take on this child, as I wasn't able to sleep! I'm so glad to have gotten all your different opinions - some people comfortable, some not. The parents of the child say it's absolutely no big deal, but it just didn't sit right for me and at the end of the day, I need to be comfortable with all these children, especially medically. I can put up with a lot, but not an unknown risk.
I sent a note last nite, and of course received very frustrated note back which I understand. I will be updating my contract to state that if anything changes with the child's medical condition, or anything out of the ordinary during the holding stage, to please let me know immediately (she notified me of this 6 weeks after first episode).
Just when I think I've got the contract all done...
I do feel very bad and question myself why i'm making a big deal, but that's just the way it is. Thanks to everyone! I feel relieved.
I gave back deposit, and am back to advertising....