Q&A: Children’s migraine
By: Steph Weatherley, Information and Support Services Advisor, The Migraine Trust
In this blog, we answer common questions we get asked about children’s migraine via The Migraine Trust helpline.
My child has been diagnosed with abdominal migraine, what is this?
Abdominal migraine is thought to affect around four percent of children. The main symptoms of abdominal migraine include:
- regular attacks of moderate to severe stomach pain that last from 2-72 hours (for most people the symptoms should resolve between attacks)
- feeling sick and vomiting during attacks
- loss of appetite and paleness
- no headache during attacks
- feeling normal between attacks.
Some children experience other migraine symptoms with the stomach pain such as sensitivity to light, sound and smell, fatigue and headache. For a lot of children with migraine (of any type) being sick can stop the attack and many children feel better after they’ve been sick.
Most children who experience abdominal migraine grow out of it by their teens, but often go on to develop migraine headaches. It can often be mistaken for other conditions, and isn’t very well known or understood. Unfortunately, we don’t know why some people get abdominal migraine.
What are the triggers for children’s migraine?
It can help to be aware of any triggers that may make migraine symptoms worse. When you have migraine, your brain is sensitive to change and can be sensitive to certain factors which can make things worse. Routine and balance in activities are really important, and a headache diary is a good way of seeing what may be impacting the migraine attacks.
Some common triggers in children include:
- disturbed sleep, or sleeping too much. Setting a regular wake-up routine can be helpful.
- dehydration – a lot of children, particularly when at school or out and about may not drink enough, which can trigger migraine attacks.
- food – skipping meals, going too long between eating or eating too many unhealthy snacks can all have a negative impact on migraine. It can be helpful to eat regularly, and have healthy snacks available throughout the day. In terms of certain foods triggering migraine, this varies from person to person and the best way to identify any potential causes is to keep a note in the diary and see if there are any links.
- stress – is often a big trigger for migraine, and finding ways to manage any stresses can be helpful. A lot of children find relaxation activities, and being able to talk about how they’re feeling can help.
- exercise – can often be protective, but some children find if they start suddenly or aren’t prepared for exercise it can trigger an attack. It’s important to start gently and make sure they drink plenty before, during and after any exercise.
What treatments can my child have?
There are different treatments available for children with migraine, and the most suitable one will depend on their medical history, age and symptoms. Most people find that paracetamol or ibuprofen can help relieve migraine symptoms in children. It’s important it’s taken at the right time, usually when the pain comes on so that it is effective. If it is taken too early or too late it can be less effective. Some people find that syrups or tablets that dissolve in water are easier and more effective for their child to take, a pharmacist or the GP should be able to advise.
If your child is having severe attacks or they’re not responding to over the counter treatments, doctors will usually suggest trying a migraine-specific treatment, such as triptans. Doctors are often cautious about prescribing these, and some of them are only licensed for children over 12. However, some, such as sumatriptan, can be taken by younger children (https://bnfc.nice.org.uk/drug/sumatriptan.html).
For persistent headache, the doctor may suggest preventive treatment. These are medicines taken daily with the aim of building up in the system and reducing how often and how bad the migraine attacks are. There are different treatments available and the one they suggest will depend on your child’s symptoms, age and medical history. It takes a few weeks for these to start working, and it can take up to three months to see the full benefit.
My child has a migraine diagnosis, what support can we get at school?
Migraine is protected under the law as such if a child’s migraine recurs over a period of a year, and negatively impacts on their ability to carry out their normal day-to-day activities, they may be classed as ‘disabled’ under the Equality Act 2010. Your child’s doctor can advise whether they are likely to be classed as disabled.
This puts an obligation on schools to make reasonable adjustments for a disabled child to ensure that they are not put at a major disadvantage. The Children and Families Act 2014 also puts the duty on maintained schools and academies to support children who have medical conditions in school. Support required will be dependent on a child’s need, how migraine affects the individual, school policy etc. There are many common adjustments that schools can make to support a child with migraine such as:
- support to catch up on work missed
- materials to work at home if possible
- extra time in examinations including tests
- examinations taken in an alternative room if light is a trigger
- adjustments to attendance policies
- time off for medical appointments
- reduced timetable
- adjust seating position to near a window to access natural light or dim the lights above their desk
- administration of medicines.
If your child does not have an individual healthcare plan it may be necessary to discuss developing a plan that identifies their needs and to make suitable tailored adjustments for them. Your child’s doctor can write to the school about their condition and recommend suitable adjustments.
You can also ask to see the school’s policy on supporting pupils with medical conditions to see what support may be available. We have a good toolkit for support in school as well which can be found here.
If you have further questions about your migraine or are in need of support, you can speak to us via our free helpline on 0808 802 0066 or via our online contact form.