Definition

• Your child is having a migraine headache
• It is like previous migraines

Health Information

Symptoms

• Severe, very painful headaches. The pain is usually described as throbbing or pounding.
• Pain usually only on one side of the head.
• The pain is very severe and keeps your child from doing any normal activities.
• Lights and sound make them worse. Most children want to lie down in a dark, quiet room.
• Vomiting or nausea is present in 80%.

Cause

• Migraines run in families (genetic).
• Also called vascular headaches because of changes in the blood vessels.

Pain Scale

• Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
• Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
• Severe: The pain is very bad. It keeps your child from doing all normal activities.

Care Advice

1. Overview:
   • The sooner a migraine headache is treated, the more likely the treatment will work.
   • Often the most helpful treatment is going to sleep.
   • Here is some care advice that should help.
2. Migraine Medicine:
   • If your child’s doctor has prescribed a medicine for migraines, use it as directed.
   • Give it as soon as the migraine starts.
   • If not, ibuprofen is the best over-the-counter drug for migraines. Give ibuprofen now.
   • Repeat ibuprofen in 6 hours if needed.
3. Cold Pack:
   • Put a cold pack on the spot that hurts the most. You can also use a cold wet washcloth.
   • Do this for 20 minutes.
4. Fluids:
   • Drink lots of fluids as soon as you think a migraine is coming on.
   • Reason: Being short on fluids is the most common trigger for a migraine attack.
5. Sleep:
   • Have your child lie down in a dark, quiet place.
   • Try to fall asleep.
   • People with a migraine often wake up from sleep with their migraine gone.
6. Prevention of Migraine Attacks:
   • Drink lots of fluids. Reason: Mild dehydration is the most common trigger for migraines.
   • Don’t skip meals.
   • Get enough sleep each night.
7. What to Expect:
   • With treatment, migraine headaches usually go away in 2 to 6 hours.
   • Most people with migraines get 3 or 4 attacks per year.
8. Return to School:
   • Children with a true migraine headache are not able to stay in school.
   • Children with migraine headaches also commonly get muscle tension headaches. For those, they should take a pain medicine and go to school.

Call Your Doctor If

• Headache becomes much worse than past migraines
• Headache lasts longer than past migraines
• You think your child needs to be seen

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

 #AAP