Children who have breath-holding bouts are often intelligent and easily frustrated. In a case of severe frustration a child may take a deep breath and hold it, making his face first red and then blue if the breath is held for long enough. A severe bout may end in a short period of unconsciousness, but because the breath is held on purpose breathing will continue automatically as soon as consciousness is lost. Brain damage from lack of oxygen or a convulsion is very unlikely to occur. Parents can help to prevent a bout of breath-holding by avoiding confrontational or frustrating situations; they should also handle a bout sensitively rather than with punishment. Mouth-breathing, as opposed to breathing through the nose, can start if the nasal passages are blocked completely or partly by enlarged adenoids. The more enlarged the adenoids, the more likely the child is to breathe through his mouth during the day as well as at night. Snoring, bad breath, impaired senses of taste and smell, an altered resonance to the voice, ear trouble and an irritating cough may also be indicative of enlarged adenoids. When the adenoids return to normal, or if they are removed by an operation, many children carry on mouth-breathing, a habit that can be difficult to stop.
Dirt-eating can be normal behaviour in inquisitive babies and toddlers exploring their surroundings. Emotionally disturbed or mentally retarded children may also do it. A danger of dirt-eating is if flakes of lead-containing paint from old houses or other poisonous materials are eaten over a long period. Persistent dirt-eating could be a sign of boredom, unhappi-ness or an underlying emotional problem.