By: Caitlin Haxel, MD, FAAP
& Juan Villafane, MD, FAAP
Passing out or fainting―also known by the medical term syncope―is common among young people, especially teenagers.
As many as
1 in 4 healthy children and adolescents have fainted at some point. Has your child?
Although the experience can be frightening, it's
usually not caused by anything serious. Most young people recover quickly after fainting, typically in less than one minute.
What causes a healthy child to faint?
Most often, fainting happens in otherwise healthy children when there is a temporary drop in the flow of oxygen-rich blood to the brain (blood pressure). Usually, the child recovers quickly. This is called
simple fainting.
Triggers for simple fainting can include:
Not drinking enough fluids―especially during
hot weather or in overheated spaces. Dehydration is the most common cause of fainting in children. Not drinking enough fluids also reduces blood volume and lowers blood pressure.
Standing still for a long time in one place. This can cause the blood to pool in the legs because of gravity or standing up quickly.
Overheating―especially in overcrowded environments.
Strong emotions in response to pain, blood, or something shocking or scary. This can cause the part of the brain that controls blood pressure, breathing rate, and heart rate to suddenly switch gears and get out of sync.
Hyperventilating or breathing too fast. This can happen due to anxiety or fear, because it causes rapid changes in our blood supply to the brain.
Breath-holding spells. These are common in young children during
temper tantrums or when they are in pain.
Breath-holding spells generally are not serious, and most children outgrow them by 6 years of age.
Certain movements, such as coughing, swallowing, weight lifting, going to the bathroom, or even hair-grooming may stretch or press on sensitive nerve endings. This trigger is rare and usually affects teens; with the vast majority outgrowing it.
What are some warning signs and symptoms before fainting?
About 5 to 10 seconds before fainting, there are a number of warning signs including:
Dizziness or lightheadedness
Nausea
A surge of warmth and sweating, or sudden cold feeling
Blurry or spotty vision
"Ringing" in the ears
Pale or ashy appearance
Faster heart rate (called tachycardia)
If my child has fainted before, should I tell her teachers and coaches?
Yes. They can help watch for signs and help her to the floor if it happens again and help avoid risks like having her stand at the end of a row in crowded bleachers.
Can fainting be a sign of a more serious medical condition?
In some cases, fainting can be a sign of an underlying health problem or condition, such as:
Internal bleeding. A blow to the head (such as a
concussion) or belly.
Diabetes. Sudden drops in blood sugar can cause fainting. The brain needs sugar for energy.
Diabetes also can cause increased urination that leads to dehydration. If a child with diabetes faints, it is considered a diabetic emergency.
Use this form from "Helping the Student with Diabetes Succeed: A Guide for School Personnel" to prepare a hypoglycemia emergency care plan.
Eating disorders.
Anorexia and bulimia can cause fainting from dehydration, low blood sugar, and changes in blood pressure or circulation caused by starvation, vomiting, or over exercising.
Heart issues.
Irregular heartbeats (cardiac arrythmia) or structural problems (heart or valve) can cause fainting. Fainting that happens during exercise always needs medical follow-up.
Migraines. Fainting is a symptom of certain types of
migraine headaches.
Alcohol and drug use. Alcohol makes blood vessels dilate or widen which can cause the blood pressure to drop. Some
illegal drugs, like methamphetamines, affect heart function and can lead to fainting.
Pregnancy. Changes to the circulatory system in pregnancy can affect blood pressure and increase the body's need for fluids.
Postural orthostasis tachycardia syndrome (POTS). This condition affects an estimated
1 in 100 teens who get a rapid heartbeat and lightheadedness or fainting when standing, especially after lying down. Episodes often start after viral illness, trauma, or major surgery.
Addison's Disease/adrenal insufficiency. Children with this condition don't produce enough hormones, such as cortisol, that help control the response to stress, blood pressure, and blood sugar levels.
How is more serious fainting diagnosed and treated?
For child who faints on several occasions, or if there are signs of a more serious medical condition, your pediatrician may refer your child to a
pediatric cardiologist. While there, your child may receive various kinds of heart tests. See
Common Types of Cardiac Testing.
Red flag symptoms of possible heart issues with fainting:
Fainting during exercise
Abnormal or especially fast heartbeats, particularly if they occur prior to fainting
Family history of
sudden cardiac death. Your pediatrician may ask about any close relatives who died from unintentional injuries or
drowning, which may have involved cardiac-related fainting.
Can I prevent my child from fainting?
Your pediatrician can recommend ways to help prevent simple fainting.
Here are some ideas:
Stay hydrated and eat well. Make sure your child drinks plenty of water or other
healthy beverages each day. Limit caffeine and avoid skipping meals.
Monitor blood pressure. If your child's blood pressure is low or normal, your pediatrician may suggest a change in his or her diet. .
Take breaks from the heat. Avoid standing for long periods in warm environments, such as practice fields in the sun or crowded places. Limit time in hot showers, saunas, hot tubs, and Jacuzzis.
Help your child learn to recognize the early signs of fainting. When his symptoms start, remind him to put his head between his legs or lay down.
Are there medications to help prevent fainting?
Medications may be prescribed in certain cases. Some types of steroids, beta blockers, and anti-arrhythmic drugs and selective serotonin reuptake inhibitor (SSRI) anti-depressants may help some patients. More research is needed to determine the effectiveness of these medications in children and teens.
Remember:
Most children and teens who faint recover quickly and without any lasting harm. Knowing how to help prevent fainting spells, like getting plenty of fluids, can help avoid the scary experience of passing out.
Any time your child does faint, be sure to tell your pediatrician.
Additional Information:
About Dr. Haxel:
Caitlin Haxel, MD, FAAP, is a pediatric cardiology fellow focusing on advanced imaging and fetal cardiology at the Children's Hospital Colorado in Aurora, Colorado. She completed her medical education at State University of New York in Brooklyn, New York followed by her pediatric residency and pediatric cardiology fellowship at New York Presbyterian-Morgan Stanley Children's Hospital at Columbia University Medical Center in New York, NY. Within the American Academy of Pediatrics, Dr. Haxel is a member of the Section on Cardiology and Cardiac Surgery Publications and Communications Committee.
About Dr. Villafane:
Juan Villafane, MD, FAAP, is a pediatric cardiologist. Within the American Academy of Pediatrics, Dr. Villafane is a member of the Section on Cardiology and Cardiac Surgery Publications and Communications Committee.