According to the Spanish Association of Pediatric Emergency Services, hiccup crises (sometimes described as the baby being 'frozen') are “events that occur after a scare, fall, blow, or reprimand. The baby suddenly stops breathing and becomes purple or pale, eventually usually starting to cry. Recovery is complete and quick, occurring in less than a minute, but they may be a bit sleepy.” My daughter experienced such an event 3 or 4 times when she was a baby, and if you don't know what's happening, it's really scary because you think the baby is choking, and you feel responsible for reversing the situation.

It is generally seen in healthy babies (approximately) from six months to six years, but by the age of 4/5, they are likely to have outgrown this condition; some sources indicate that 5 to 7 percent of children in this age group experience this condition. To expand on this information a bit more, although this condition is an acute event, it is not an epileptic event and does not carry significant health risks, as the affected baby regains consciousness and breath within a few seconds.

A common view about the intention behind this condition is that children do not do this intentionally; in fact, we are dealing with very young individuals with an immature brain, and they lose control over expressing their emotions in every situation. Let’s not forget that they have many more years to lose their innocence, in summary: the idea that they want to disturb us is quite questionable.

Understanding Hiccup Crises

The cause of this condition may be experiencing a sadness or “fear”; for example, being scolded by a parent or being disturbed by a big sibling. With careful observation, we can predict the onset of a hiccup crisis by approaching the baby, speaking gently to them, or even (if it hasn’t started yet) holding them… However, these events start and end, and no one (or at least I think so) wants to watch their baby start crying strongly, turn red, then purple, and even stop breathing.

From a medical perspective, hiccup crises are a reflex response of the organism to a very intense emotion. They usually occur after anger, frustration, fear, pain, or a fall. This condition is not a “trick” or a voluntary behavior; it is the result of how an immature nervous system reacts. Therefore, they are considered harmless and self-limiting events that disappear without leaving a lasting effect as the child grows.

It is observed that hiccups tend to recur in similar situations in many children: temper tantrums, boundary disputes, unexpected blows, vaccination shots, or frightening moments. Additionally, family history is quite common; that is, it is seen that one of the parents or siblings experienced similar events in childhood, suggesting that there may be a hereditary component.

Two types of hiccup crises are described: pale (pallor) and blue (cyanosis); both involve apnea and loss of consciousness (which can last up to a minute, quite a long time for those who are unfamiliar). In severe cases, seizures may occur, but these seizures do not leave any damage: but beware! A seizure lasting more than 60 minutes should be checked by a pediatrician, even if it has ended. Furthermore, experts generally state that any seizure lasting more than a minute requires urgent evaluation and that any prolonged seizure requires immediate medical intervention.

Experts explain that in both blue and pale hiccup crises, the child may faint for a certain period. Observing this condition can be quite striking, but the event usually lasts less than a minute, and the child heals on their own. In some cases, iron deficiency anemia has been associated with it; when the pediatrician identifies and corrects this deficiency, the frequency of hiccups may decrease, but this relationship does not always exist.

Types of Hiccup Crises and How to Recognize Them

Experts define two main types of hiccup crises, and it will be useful to describe them more clearly:

  1. Blue hiccup crisis
    It usually occurs after intense crying, great anger, significant frustration, or fear. The typical sequence is as follows:
    • The child cries forcefully and suddenly stops breathing to take a breath.
    • The face turns purple or blue (cyanosis), sometimes including the lips.
    • They may become a bit stiff and sometimes may faint for a certain period.
    • After this brief event, they regain their breath and start crying or remain sleepy for a while.

    This type of hiccup crisis is strongly associated with intense emotions such as anger or frustration.

  2. Pale hiccup crisis
    It is less common and usually associated with sudden fear or pain (for example, a strong blow or an unexpected fall). It typically develops as follows:
    • There may be a small whimper or short cry, or they may not cry at all.
    • Suddenly, the child stops breathing.
    • The face and body become very pale, as if “blood has been lost”.
    • They may experience a state of unawareness for a while, and the body remains limp.
    • Afterwards, without remembering what happened, they spontaneously regain consciousness.

In both types, some children may experience brief seizure-like movements (tremors of the arms or legs). When these movements last only a few seconds and occur alongside a typical hiccup crisis, they are not associated with epilepsy or brain damage. However, if the crisis lasts longer or does not match the classic sequence, it is important to consult a pediatrician.

Hiccup crises are seen in healthy children aged 6 months to 6 years and occur most frequently between 6 and 18 months, gradually disappearing as the nervous system matures. It is rare to see them in the neonatal period, but very early cases can also follow a similarly benign course; therefore, pediatricians evaluate these events with clinical examination and additional tests if necessary to differentiate them from other serious pathologies.

Never Do This During a Hiccup Crisis

  • Lose your calm, shout, or call out to the baby.
  • Shake or jolt them.
  • Put fingers in their mouth, as there is no choking situation.
  • Try to stop it after the event has started.
  • Keep them away from objects they could hit and injure themselves with.

In addition to these, experts emphasize that if the hiccup crisis follows a typical pattern and the child spontaneously recovers within a few seconds, resuscitation maneuvers (mouth-to-mouth) should not be performed. Such interventions can increase anxiety in the surroundings and sometimes make it difficult to observe the event calmly.

Considering the age, I would not scold a child of that age (based on my own experience), but there are many recommendations circulating that babies “express themselves”; clearly, I think we lack patience for them to mature in managing their emotions in other ways. Definitely, screaming uncontrollably in response to what is happening and then scolding seems to me more indicative of the immaturity of the adult rather than the baby.

Pediatricians also recommend not systematically giving in to all tantrums for fear of hiccup crises arising. It is understandable that parents want to avoid experiencing such an impressive event again at all costs, but always giving in out of fear can make it difficult to set clear and consistent boundaries, which is fundamental for the child's emotional development. It is important to maintain respectful discipline with love and calmness, remembering that the hiccup crisis is not voluntary and that the child has no control over it.

My Baby Had a Hiccup Crisis, What Should I Do?

You can resolve your questions by talking to a pediatrician, but remember that “they do not heal”; theoretically, they cannot be prevented, but in practice, some symptoms give us the opportunity to predict them in advance, and (this is important) hiccup crises usually occur more frequently in the evening, at a time when the baby is tired, so one solution is to create an environment that may affect him.

If your child is having a hiccup crisis at that moment, the general recommendations from experts are:

  • Keep them in a lying position, preferably on a safe surface (in a crib, on a wide couch, or on the floor with a blanket) to reduce the risk of falling.
  • Remove any hard or sharp objects around them to prevent injury.
  • Observe their breathing and skin color, stay calm, and remember that in most cases, they will spontaneously breathe within a few seconds.
  • If they fainted, you can gently check their mouth to see if there is an object that could pose a choking risk, but this is usually not the case in typical hiccup crises.

Remember that even if they are a baby, you can speak to them gently and tell them that you will help them get through these events. If the child is under 5 months old or is having a seizure (especially if this seizure lasts more than a minute), consult a doctor. Additionally, the following situations are recommended for urgent consultation:

  • If the event lasts more than a few minutes and there is no clear improvement.
  • If the child does not return to their normal state after the event or remains very disoriented.
  • If the event is not associated with crying, fear, a blow, or intense emotion, meaning it occurs without a clear trigger.
  • If you observe prolonged abnormal movements of the arms and legs, this suggests they may be having a different seizure.

The pediatrician will evaluate the medical history during the examination and may request tests to rule out iron deficiency anemia or other causes that could increase hiccups if deemed necessary. In very unusual or complex cases, additional tests or follow-up by a pediatric neurologist may be considered, but this is unusual in typical cases.

The sequence is as follows: apnea + change in skin color + crying, then everything returns to normal; if your child is having a hiccup crisis, there is no need to worry too much, but understanding (and perhaps preventing) this situation is beneficial for everyone's peace of mind. I did the same.

Things that seem to help reduce the frequency of events are:

  • Ensuring that the child is not overly tired or hungry, as fatigue and hunger increase tantrums and crying.
  • Establishing regular sleep and feeding routines supports their emotional stability.
  • When setting boundaries or scolding if necessary, do so in a calm tone of voice, without yelling or threatening.
  • Not overly dramatizing the event in front of the child, thus not creating extra fear or associating the hiccup crisis with great attention.

For families who experience hiccup crises with great anxiety, it may also be helpful to talk to a mental health professional (child psychologist or psychiatrist) to manage your emotions and better accompany your child in these situations.

Clear information, professional support when needed, and plenty of calm will ensure that these events remain a very impressive but temporary anecdote in your child's story, without any impact on their health or neurological development.