Title: Migraine headaches in children

What are migraine headaches? — Migraine headaches or “migraines” are a kind of headache that can happen in adults and children. Migraines often start off mild and then get worse.

What are the symptoms of migraines in children? — The symptoms of migraines are different based on the child’s age:

●In toddlers, symptoms include suddenly getting very pale, being less active than normal, and vomiting.
●In young children, migraines can cause nausea, vomiting, and belly pain, and make children sensitive to light and noise. The headache can affect the whole head or just parts of the head. For example, it might affect just the forehead or just the sides of the head.
●In teens, the symptoms tend to be more like the symptoms adults get. The headache usually starts off slowly and affects only one side of the head. But in about one-third of teens, both sides of the head are affected.
No matter what age, most children feel better if they lie down in a quiet, dark room while they are having a migraine.

Some children have something called an “aura” before a migraine starts. An aura is a weird symptom or feeling that warns the child that a migraine is coming. Each child’s aura is different, but in most cases auras affect a child’s vision. As part of an aura a child might see flashing lights, bright spots, zig-zag lines, or lose part of his or her vision. Another child might have numbness and tingling of the lips, lower face, and fingers of one hand. The aura usually lasts a few minutes and goes away when the headache starts.

Some teenage girls get migraines every month, around the time their menstrual periods begin. These are called “menstrual migraines.”

Should my child see a doctor or nurse? — Take your child to the doctor right away (without giving any medicine) if he or she has a headache that:

●Starts after a head injury
●Wakes him or her up from sleeping
●Is sudden and severe and happens with other symptoms, such as:
•Neck pain or stiffness
•Double vision or changes in vision
•Loss of balance
•Fever of 100.4°F (38°C) or higher
You should also take your child to see a doctor or nurse if he or she has a headache and:

●Gets headaches more than once a month
●Is younger than 3 years old
Are there tests my child should have? — Probably not. Your child’s doctor or nurse will probably be able to tell what is causing your child’s headaches by doing an exam and by learning about his or her symptoms. But if your child’s doctor or nurse thinks your child has a serious problem, he or she might order an imaging test such as an MRI or a CT scan. Imaging tests create pictures of the inside of the body.

What can I do to help when my child has a migraine? — When your child’s migraine starts:

●Have your child rest in a quiet dark room with a cool cloth on his or her forehead.
●Encourage him or her to sleep.
●Give your child only the medicine or medicines that you have talked to your doctor about.
How are migraines treated in children? — There are lots of prescription and non-prescription medicines that can ease the pain of migraines. There are also prescription medicines that can help prevent migraines from happening in the first place. The right medicine for your child will depend on how often he or she gets migraines and how severe they are. If your child gets migraines often, work with his or her doctor to find a treatment that helps.

If your child has headaches often, do not try to manage them on your own with non-prescription pain medicines. Giving non-prescription pain medicines too often can cause more headaches later.

Is there anything I can do to keep my child from getting a migraine? — Maybe. In some cases, migraines can be “triggered” or set off by certain foods or things that children do. Some possible headache triggers are:

●Skipping meals
●Not drinking enough fluids
●Having too little or too much caffeine
●Sleeping too much or too little
●Certain foods containing nitrates, such as bologna or hot dogs
If you can figure out what is triggering your child’s headaches, you might be able to help your child avoid those triggers. To find possible triggers, keep a headache diary for your child. In the diary, write down every time your child has a headache along with the following information:

●The times it started and ended
●Where in the head the headache was, for example left side, right side, both sides or behind the eyes
●How the headache felt, for example, “pounding” or “sharp”
●What your child ate and did before the headache started
●How bad the headache was – Using the FACES pain scale can help 
●What you did to try to help, for example having your child rest in a dark room
●What, if any, medicine you gave, including the name of the medicine and how much you gave
●Any other symptoms your child had with the headache, for example numbness in his or her lips
After you have been keeping a diary for a while, check to see if there are any foods or events that seem to bring on a headache. Then, try avoiding those triggers to see if headaches happen less. Share the diary with your child’s doctor or nurse. It can help him or her understand your child’s headaches and choose the best treatment for your child.

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