Fort Worth, TX,
11:00 AM

The Facts About Fainting in Children

When I saw my 13-year-old passed out on the living room floor after doing nothing but getting up off the couch, my heart rate soared. He came to and we went to his pediatrician. Turns out, it’s not uncommon for pre-teens and teens to experience fainting.

By Ashley Antle

As the mother of three boys, I’ve seen the inside of an urgent care center and emergency room a time or two. I’ve learned not to panic at the first sight of blood. But when I saw my 13-year-old passed out on the living room floor after doing nothing but getting up off the couch, my heart rate soared. I was terrified. My mind raced with questions.

Is he breathing? Is he having a seizure? Do I call an ambulance? Is something wrong with his heart?

Fortunately, the fainting spell didn’t last long. A few seconds in and he came to. One minute he was out, the next minute he was fine, albeit a little confused as to why he was on the floor. Of course, off to his pediatrician we went.

An exam showed no signs of anything other than a little fluid in one of his ears. His bloodwork was normal and everything checked out from a neurological standpoint. The diagnosis was narrowed down to a few possibilities — dehydration, orthostatic hypotension or just a random case of syncope.

Unbeknownst to me, it’s not uncommon for pre-teens and teens to experience syncope. That’s the medical term for fainting. Determined to learn more, I talked to a few physicians at Cook Children’s Medical Center — a pediatrician, a pediatric cardiologist and a pediatric neurologist. They helped me understand what to look for if it happens again, and the signs that indicate it could be something more serious than a random case of syncope.

“Fainting is a lot more common than people think,” said Diane Arnaout, M.D., a pediatrician at Cook Children’s Pediatrics Forest Park.

About 20% of all children will experience at least one fainting episode during adolescence, according to a study published in Paediatrics & Child Health.

“Thankfully, most of the causes are benign,” Dr. Arnaout said. “It’s so scary, and we tend to think the worst when fainting happens. But a thorough visit with your primary care doctor should be able to assess whether it’s caused by common or more scary causes.”

What can cause children to faint?

The most common form of syncope is called vasovagal syncope. It’s caused by a sudden drop in heart rate and blood pressure. Several things can trigger it, like fear, emotional stress, the sight of blood, dehydration, getting overheated or standing for too long with your legs locked. Some kids faint when having their hair combed or styled because of sensitive nerves in their scalp. Yes, that’s really a thing. It’s called hair grooming syncope.

Fainting can also be the result of orthostatic hypotension. That’s when you stand up from a sitting or lying position and your blood pressure bottoms out. The next thing you know, you’re passed out on the floor. Dehydration can lead to orthostatic hypotension, especially in teens who tend to be under-hydrated.

“The most common reason for kids to faint is relative dehydration,” said Deborah Schutte, M.D., a pediatric cardiologist at Cook Children’s. “They’re not getting enough fluids. Another common thing is that they don’t drink much until late in the day, right before athletic practice and games, or after they get home from school. I always encourage them to start their day with a glass of water and continue to drink throughout the day.”

What to do if your child faints

The first thing you should do if your child faints is checking their airway. Make sure they are breathing and have a pulse, but don’t try to pick them up or raise their head.

“If it’s a ‘simple faint’ they should be breathing comfortably with a regular pulse and should arouse within a couple of minutes,” Dr. Schutte said. “If the child does not arouse, or there are concerns related to breathing or pulse, call 911.”

Other red flags include a sensation of a fast or irregular heartbeat before fainting, a history of congenital heart disease, fainting during exercise or recurring episodes. If your child experiences any of these, it would be wise to consult a cardiologist.

Watch for how quickly your kid rebounds, especially when it comes to their neurological status. If they are like mine — out one minute and back to normal the next — it probably doesn’t warrant emergency care but, rather, a visit with their pediatrician.

“Any episodes where a child has altered mental status and they’re not coming back to baseline quickly, or if there are signs of seizure during the event such as stiffening or jerking movements, those issues should be checked out by a neurologist,” said Rachelle Herring, M.D., a pediatric neurologist at Cook Children’s.

Also, know that kids can have a stroke, and any stroke-related symptoms warrant a call to 911. To remember the signs of stroke, think BE FAST.

Balance - Is there a sudden loss of balance or coordination?

Eyes - Is there blurred or lost vision?

Face - Is one side of the face drooping or numb?

Arm - Is there weakness, numbness or loss of movement in the arms, legs or one side of the body?

Speech - Is speech slurred?

Time - If you or someone you know is experiencing any of these symptoms, call 911 immediately.

As unsettling as the incident with my son was, I feel better knowing it’s not completely out of the ordinary for someone his age. I’m paying closer attention to how much water he’s drinking throughout the day, and I’m now armed with the vital information I need to better, and more calmly, assess the situation if it ever happens again.