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When Your Child Has Migraine Headaches

Migraines are a type of severe headache. Having a migraine headache can be very painful. But there are things you can do to help your child feel better. And you may be able to help your child prevent migraines.

The four stages of migraine headaches

Mother holding cloth to sick child's forehead.

Migraines often progress through four stages. Your child may or may not have all four stages. And the stages may not be the same every time a migraine occurs. The four basic stages of migraine headaches are:

  • Prodrome. In this early stage, your child may feel tired, uneasy, or moody. It may be hours or days before the headache pain begins.

  • Aura. Up to an hour before a migraine, your child may experience an aura (odd smells, sights, or sounds). This may include flashing lights, blind spots, other vision problems, confusion, or trouble speaking.

  • Headache. Your child has pain in one or both sides of the head. Your child may feel nauseated and have a strong sensitivity to light, sound, and odors. Vomiting and/or diarrhea may also occur. This stage can last anywhere from a few hours to a few days.

  • Postdrome or recovery. For up to a day after the headache ends, your child may feel tired, achy, and “wiped out.”

What causes migraine headaches?

It is not clear why migraines occur. If a family member has migraines, your child may be more likely to have them. Many people find that their migraines are set off by a “trigger.” Common migraine triggers include:

  • Chemicals in certain foods and drinks, such as aged cheeses, luncheon meats, chocolate, coffee, sodas, and sausages or hot dogs

  • Chemicals in the air, such as tobacco smoke, perfume, glue, paint, or cleaning products

  • Dehydration (not enough fluid in the body)

  • Not enough sleep

  • Hormonal changes in the body during puberty

  • Environmental factors, such as bright or flashing lights, hot sun, or air pressure changes

What are the symptoms of migraine headaches?

Your child may have some or all of the following symptoms:

  • Pain, often severe, occurring in a specific area of the head (such as behind one eye)

  • Aura (odd smells, sights, or sounds)

  • Nausea and/or vomiting, or diarrhea

  • Sensitivity to light or sound

  • Feeling drowsy

How are migraine headaches diagnosed?

To diagnose migraine headaches, the healthcare provider will:

  • Ask about your child’s symptoms and any other health issues your child may have. You may also be asked if a family member has a history of migraine headaches.

  • Examine your child.

  • Ask you and your child to keep a “headache diary” for a short period. This means writing down what time of day your child gets headaches, where the pain is felt, how often the headaches happen, and how bad the headaches are. You may also be asked to write down things that make the headache better or worse. The diary can help the healthcare provider learn more about the headaches and determine the best treatment.

How are migraine headaches prevented and treated?

The goal is to try to stop a migraine headache in its early stages.

  • Work with your child to learn his or her triggers. Then, you can talk about ways to avoid these triggers when possible.

  • Have a nonsteriodal anti-inflammatory drug (NSAID), such as ibuprofen, available to your child at all times. This includes during school and after-school activities. If your child feels the prodrome or aura stage of migraine, he or she should take the NSAID right away. (Be sure your child follows the dosage instructions given by the healthcare provider. A higher than usual dose may be required for migraine pain.) If your child is older than 7 and has frequent migraines, the healthcare provider may recommend a prescription pain medication.

If your child’s headache pain has already started:

  • Give the child a dose of an NSAID if he or she has not already taken one.

  • Have him or her lie down in a dark, quiet room.

  • Apply a cold compress over your child’s face and eyes (if your child wishes). 

  • Have your child stay quiet and still (or sleep) until the pain goes away.

What are the long-term concerns?

As your child gets older, the frequency of migraine may change. The likelihood of lifelong migraine may also increase if one parent has lifelong migraines.

Call your child’s healthcare provider right away if your child has any of the following

  • Fever and stiff neck with a headache

  • In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

  • In a child 3 to 36 months, a rectal temperature of 102°F (39.0°C) or higher

  • In a child of any age who has a temperature of 103°F (39.4°C) or higher

  • A fever that lasts more than 24 hours in a child under 2 years old, or for 3 days in a child 2 years or older

  • A seizure caused by the fever

  • Headache pain that does not respond to NSAIDs

  • Headache pain that seems different or much worse than previous episodes

  • Headache upon awakening or in the middle of the night

  • Dizziness, clumsiness, slurred speech, or other changes with a headache

  • Migraines that happen more than once a week or suddenly increase in frequency

 

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