(NEW YORK) -- When 3-year-old Rozalynn Cevetto has at least two things wrong -- she is hungry, tired, hurt or just not getting her way -- she looks as if she is going to cry but never takes the "big breath."
The first breath-holding incident occurred when Rozalynn was only 14 months old.
"She would start crying, but then appear to take a big breath, but really, she was just sitting there with her mouth agape until she passed out from not breathing," said her mother, Sarah Cevetto, 31, a mother of four from Niles, Ohio.
"It was frightening, at first," she said. "Her eyes would roll back, her lips would turn blue and her face would get really tight."
Cevetto herself was a breath holder when she was little, as was her father. In the 1980s, doctors treated her with medication for seizures, diagnosing her as an epileptic.
But Rozalynn's doctors tell her to just wait, the toddler will outgrow it.
"Breath-holding spells are pretty common in the toddler set," said Ari Brown, an Austin, Texas, pediatrician and author of the book, Toddler 411. "However, they are not harmful in healthy children because if the child actually holds his breath until he passes out, the body's natural mechanism to breathe -- just like when you are sleeping -- kicks in and overrides the child's forced breath-holding."
Even so, many parents and some child psychologists worry that the incidents are not physiological but behavioral, and worry that a child will take advantage of their parents' terror and learn to be manipulative.
"Bottom line," said Brown. "Don't let your toddler's breath-holding hold your parenting discipline strategy hostage."
Brown estimated "1 in 100 or 1,000, but not 1 in 20,000" children are breath-holders.
The only time these attacks deserve a medical evaluation is if they occur on a regular basis or happen more frequently. A small number of children actually have an iron deficiency that can cause the incidents.
According to the Baby Center, one of the largest online resources for childbirth and parenting, breath-holding spells usually happen in response to pain, fear, frustration, anger or surprise.
Sometimes trauma can trigger an attack. It can happen rarely or up to several times a day. Sometimes, a child will turn blue and behave as if having a seizure. Most outgrow breath-holding by the time they are 8.
"While these spells sometimes occur with tantrums, they're not willful," according to Baby Center. "Your child is not holding her breath on purpose."
Copyright 2012 ABC News Radio