Effectiveness of Oral Iron Supplement on Breath-holding Spells in Children

Objective: To evaluate the effectiveness of iron therapy in breath-holding spells. Material and Methods: This was a prospective interventional study, which was conducted in the Department of Pediatrics, Lady Reading Hospital, Peshawar, from September 2010 to October 2011. A total of 43 children between the ages of 8 and 54 months, with breath holding spells (BHS) were included. Relevant data was recorded on specifically designed questionnaire. All patients were treated by an oral iron preparation for 12 weeks. Haemoglobin, mean corpuscular volume (MCV) and frequency of BHS were recorded at baseline and every 4 weeks for effectiveness of iron therapy. Results: Twenty seven (62.8%) patients were male and 16 (37.2%) were female with male to female ratio of 1.6:1. Mean age at presentation was 21 months while age regarding onset of spells ranged between 3 to 28 months with mean age of 9.7 months. The cyanotic type of spell was detected in 34 (79.1%) children and the pallid type in 9 (20.9%) children. A positive family history of Breath-Holding (BH) was identified in 13(30.2%) children. There was a statistically significant fall in the frequency of breath holding spells with 12 weeks of iron therapy. At start of therapy, 25 patients were having more than 10 episodes per week while no patient was having such episodes at 12 weeks of therapy (p-value=0.000). Conclusion: Iron therapy is effective in the treatment of BHS.