There is nothing more distressing than watching your child suffering from a migraine attack and feeling helpless, unsure of what to do. Many treatments are not approved or not suitable for children, so we have to make do with the tips and tricks that might help manage your child's migraine or relieve symptoms of an attack.
The following FAQs were put together by parents from our support group for parents of kids with migraine.
FAQ – Kids and Migraine
I think my child is having a migraine attack for the first time. What should I do ?
You can give your child their normal pain medication such as ibuprofen or paracetamol. They may be sensitive to light and want to go into a dark room or have a sleep. Keep them hydrated. Many will wake feeling better. Some may still feel unwell the next day. Consider making an appointment with your GP the next day.
Can a child take any medications for a migraine attack and who can prescribe them ?
Yes there are medications that can be given to a child for migraine. These may be prescribed by your GP but more complex cases will usually be referred to a specialist – a paediatric neurologist. Medications fit into 3 main categories:
- Pain relief. This is your usual over the counter medications such as ibuprofen or paracetamol. In some cases something stronger maybe prescribed by a neurologist.
- Abortive medications. These medications can be successful to slow or abort a migraine. They must be taken at first onset of the migraine and need to be prescribed by a doctor. Examples that may be suitable for your child include Rizatriptan or Sumatriptan.
- Preventative medications. These are usually prescribed by a specialist for chronic cases who get a lot of frequent migraine attacks. There are different types and can be a little trial and error to see which one works best for your child. Your specialist can advise if this is appropriate for your child.
How do I know when my child should take an abortive ?
Abortives (triptans) need to be taken at first onset of the migraine attack to be successful in either aborting or reducing the severity of the migraine.
It can be hard to tell when a migraine attack is starting, and even harder for young children. Some people get aura before their migraine attack. These are usually changes in vision such as zig zags or bright lights. Others may get tingling of arms or legs, feel dizzy, or nauseated. Getting irritable is common too. It’s important to ask your child some questions to learn about their migraine and help them learn symptoms.
Not everyone gets aura, so for those people it’s harder to tell first onset. Pain maybe their only indicator. Depending on the frequency of attacks or age of your child it may take some time for them to learn when a migraine attack is coming on.
Abortives should not be used frequently. If your doctor prescribes this for your child please discuss with them medication limits – the maximum number they should have in a week or month.
Are they any medications kids shouldn’t take ?
Yes. Many adults use aspirin for migraine but this isn’t suitable for children. There are also some new migraine CGRP medications being used by adults that are not yet approved for use in children in Australia. Please discuss your child's medication needs with their doctor or specialist. Always follow the dose provided by your doctor as the dosage may differ for a child.
Some teenagers maybe able to use aspirin – please discuss this with your doctor.
Are there other ways to help rather than medications ?
Yes there are. There are many different things you can try to help such as these tips. Examples include an ice pack on their head or back of neck to help relieve pain, or just sleeping it off.
Pain can also be treated with the Cefaly – a tens machine for use on headaches (do not use a normal tens machine). Some patients find visiting a physiotherapist helps, or seeing a specially trained Watson Headache Physiotherapist.
Others use sports drinks or Hydrolyte – while hydration won’t necessarily help a migraine in progress it may help reduce the severity. Some people find a low inflammatory diet can help too.
There are also some vitamins supplements that can help with migraine such as magnesium and some B group vitamins. Please discuss this with your doctor. You can ask if the Bioceuticals Migraine Care supplement would be suitable for your child.
Working out their triggers and then avoiding them is also very helpful.
Should my child see a specialist ? If so what information should I take to the appointment ?
If your child is having severe or frequent migraine attacks many GPs will refer you onto a paediatric neurologist. Your GP maybe happy to start your child on an abortive or even a preventative while you are waiting to see the paediatric neurologist. The more information you can take to the neurologist appointment the better they can help you. Details may include frequency and duration of attacks, symptoms, any known triggers, any medications previously trialled. If you keep a migraine diary you may like to take it to the appointment, along with any recent test results that may have been carried out.
What things could trigger my child's migraine ?
There are a number of things that may trigger your child's migraine. Some people have one or two triggers only, while others may have a lot. Triggers may include things like
- Exercise
- Poor sleep
- Hot weather
- Changing weather conditions including humidity or drop in barometric pressure
- Drop in blood sugar – not eating enough or frequently enough
- Bright lights
- Strong smells such as perfumes or deodorants
- Loud noises such as music or alarms
- Foods such as chocolate, citrus, MSG or caffeine
- Dehydration
- Stress
- Blocked sinuses / head cold
How do I find out what my child's triggers are?
Sometimes looking through a list of triggers and thinking about what your child did before they had their migraine attack you will be able to work out what triggered it. Other times it can be harder. Some people find keeping a migraine diary helps them determine triggers.
What is a migraine diary?
A migraine diary is a record that may help you determine triggers or you can take to your doctor to show frequency of migraine attacks. Some like to use an app like Migraine Buddy while others find it easier to record into a diary or notebook. It’s up to you to record what you like. You may want to just record attack duration, frequency or days off school. You can include medication doses or change in medications. You may want to use it to determine triggers. In this case you may keep a record of food, water, exercise. sleep or activities.
Are their different types of migraine?
Yes there are different types of migraine. These include Migraine with Aura, Migraine without Aura, Vestibular Migraine (affects vision and balance), Hemiplegic Migraine (a rare type with muscle weakness) and Abdominal migraine.
What is abdominal migraine and how do I help ?
Abdominal migraine is most commonly found in children, although it can continue into adulthood in some cases. The pain is in the abdomen (usually around the belly buttom) rather than in their head. The triggers are often the same as other head migraine attack, and treatments are also the same. You may find a fibre supplement helps your child during an abdominal migraine. It is best to seek medical advice if you think your child is having abdominal migraine.
What do I do if my child gets a migraine at school ?
If your child uses abortives or pain killers it is important they can access this at school quickly if required. Please discuss this with your school. You may find an action plan written by your GP or neurologist (or even a letter from yourself) detailing medications and dosage is appropriate. You could also have other details included – for example you may want to be notified to collect your child if they take an abortive or you may want them to wait in a dark quiet room.
My child is getting weird or new symptoms. What do I do ?
Migraine is not just a headache. It can have other symptoms such as vomiting, visual disturbances, dizziness, loss of feeling in arms or legs and even loss of speech. If you child is developing new symptoms please let your doctor know.
If your child is experiencing more frequent or severe migraine symptoms please let your doctor know. Many neurologists will want to review your child every 6-12 months to monitor their condition, and adjust medications if required.
Should I ever take my child to emergency or call an ambulance?
If your child is showing first time symptoms such as loss of movement down one side of the body you should call an ambulance. The symptoms of hemiplegic migraine and stroke can be very similar.
If your child is in severe migraine pain some parents do take them to hospital emergency. What will happen in emergency will depend on what your child's symptoms are, which hospital you take them to, how busy it is when you arrive and which doctor you see. If your child needs to visit emergency often then you could discuss with your neurologist and get an emergency action plan written up that you take into the emergency room with you.
My child finds exercise is a trigger. What do I do?
Many people who find exercise as a trigger find it is the rapid increase of heart rate. For example they maybe able to walk or even jog a little but not do a fast sprint. If you find your child is getting frequent exercise induced migraines you may need to slow down or pace their exercise. Some exercise is good – some people find the fitter they are the more their body might be able to handle before their heart rate increases. Increase in exercise should be taken slowly. You can discuss with your child's doctor and review medication.
Where can I learn more about migraine?
You can learn more about migraine by reading the information on this website on the basics of migraine.
You may also like to join some of the Migraine Australia chats on Facebook - including Migraine Family and Friends support group (for parents or carers) and the Migraine Warriors Australia Support Group
You can also ask your gp or neurologist any questions you may have about migraine.