If your child is having a seizure, the most important thing you can do is keep them safe, stay calm, and time it. Most childhood seizures stop on their own within one to three minutes. Your job is not to stop the seizure but to protect your child from injury while it runs its course. If the seizure lasts longer than 5 minutes, call 911.
What to Do During the Seizure
As soon as you realize your child is seizing, check the time or start a timer on your phone. This single step matters more than almost anything else you do, because the duration of the seizure determines whether you need emergency help. While the seizure is happening, gently lower your child to the floor if they aren’t already there. Move furniture, sharp objects, or anything hard away from them. Place something soft under their head, like a folded jacket or small pillow.
Turn your child onto their side. This keeps their airway clear so that saliva or vomit doesn’t block their breathing. Loosen any tight clothing around their neck. Stay with them the entire time.
Do not put anything in your child’s mouth. Children cannot swallow their tongues during a seizure, and placing objects between their teeth risks breaking teeth, injuring the jaw, or causing choking. Do not try to hold your child down or restrain their movements. Restraining a seizing child does not shorten the seizure and can cause muscle or joint injuries. Let the seizure happen while you keep the space around them safe.
When to Call 911
Call 911 if any of the following apply:
- The seizure lasts longer than 5 minutes.
- Your child has a second seizure shortly after the first one.
- Your child has trouble breathing or does not wake up after the seizure stops.
- Your child was injured during the seizure.
- The seizure happened in water.
- This is your child’s first seizure ever.
A seizure lasting 5 minutes or longer is a medical emergency. At that duration, the brain becomes increasingly resistant to stopping on its own, and the risk of neurological injury rises the longer it continues. Emergency responders have medications that can end a prolonged seizure safely.
If your child has a known seizure disorder and their doctor has prescribed a rescue medication, you may be instructed to give it after 5 minutes of continuous seizure activity. Every child with a rescue medication should have a written health care plan that spells out exactly when and how to administer it. Follow that plan, and still call 911 if the seizure does not stop.
What to Expect After the Seizure Stops
When the seizure ends, your child will enter a recovery phase that can look alarming even though it’s normal. They may be confused, exhausted, or unable to speak clearly. Some children fall into a deep sleep. Others are agitated, emotional, or disoriented. Headaches, muscle soreness, and nausea are all common. Younger children may cry without being able to explain why.
Keep your child on their side until they are fully awake and responsive. Speak to them calmly and let them know where they are and what happened. Don’t offer food or water until they’re alert enough to swallow safely. Some children recover within a few minutes, while others take 30 minutes or longer to feel like themselves again. Loss of bladder control during or after a seizure is not unusual, so handle it matter-of-factly to avoid embarrassment.
Febrile Seizures: When Fever Is the Trigger
Febrile seizures are the most common type of seizure in young children, typically occurring between 6 months and 5 years of age. They’re triggered by a rapid rise in body temperature, often from a common illness like an ear infection or a virus. Watching your child convulse because of a fever is terrifying, but febrile seizures are generally not harmful and do not cause brain damage.
A simple febrile seizure lasts under 15 minutes, affects the whole body (rather than just one side), and happens only once within a 24-hour period. These typically don’t require any treatment beyond managing the underlying fever and following standard seizure first aid. A complex febrile seizure lasts longer than 15 minutes, involves jerking on just one side of the body, or occurs more than once in 24 hours. Complex febrile seizures warrant medical evaluation, and a neurologist may need to review what happened.
After a febrile seizure, your child’s doctor will focus on identifying what’s causing the fever rather than the seizure itself. For a well-appearing child with a normal neurological exam, brain imaging and blood tests are usually not necessary.
What to Write Down for the Doctor
Whether your child ends up in the emergency room or at a follow-up appointment, the details you recorded during and after the seizure are invaluable. Doctors rely on your observations because they almost never witness the seizure themselves. Here’s what to note, either during the event or immediately after:
- Duration: How long the seizure lasted from start to finish.
- What it looked like: Stiffening, jerking, eye rolling, lip smacking, chewing motions, or going completely limp.
- Where it started: Did movements begin in one hand, one side of the face, or the whole body at once? Did they spread from one area to another?
- Awareness: Did your child seem conscious or completely unresponsive? Could they hear you?
- Skin changes: Did their lips or face turn blue? Did they sweat?
- Breathing: Was breathing irregular, noisy, or paused?
- Bladder or bowel control: Did they lose control?
- Recovery: How long before your child could respond to their name, recognize you, and speak normally?
If you can safely take a short video on your phone while still keeping your child protected, do it. Video gives neurologists more diagnostic information than any written description. Even 10 to 15 seconds of footage can help identify the seizure type.
After a First Seizure
A first seizure in a child always warrants a medical evaluation, even if it was brief and your child recovered quickly. The doctor will want to understand whether this was an isolated event, a febrile seizure, or the beginning of a seizure disorder like epilepsy. That evaluation usually involves a detailed history, a physical exam, and sometimes an EEG (a test that measures electrical activity in the brain).
One seizure does not mean your child has epilepsy. Many children have a single seizure and never have another. But understanding what happened and whether your child is at risk for future seizures allows you to prepare, whether that means having a rescue medication plan, informing your child’s school, or simply knowing what to do if it happens again.