Parenting with migraine: Understanding effective treatment for children and teens

In the beginning

Think back to when you first started having migraines.  Think how long it took you to understand what was happening, how to find the right medical treatment, and to manage your headaches effectively.

As a parent with migraines, it is possible that one or more of your children may also suffer from migraine headaches.  It may feel like you’re back at square one, trying to figure out what is happening to your child, how to get the right medical treatment, and how to help your child manage their migraines effectively.

Migraine in children and teens

Most people with migraines begin to have them before they are 20 years old.  Migraines usually begin earlier in boys than in girls.  Up to age seven, boys have migraines as often, or slightly more often, than girls.  Once girls begin their menstrual periods they have more migraines than boys.

The Migraine Research Foundation asked parents what concerned them most about their children’s migraine headaches. Their top worry was how to get the best treatment for their child.  In addition, over half of the parents were very concerned about how migraines would affect their child’s school and social activities. This worry is not unwarranted. The Migraine Action organization in the United Kingdom estimates that children in the UK with migraine lose 2.75 million school days per year. 

Try to look at the big picture

Health care providers, patients, and families can try to look at illness from different points of view: the biological, the psychological and the social. For children and teens, most experts stress the importance of considering how all three, the body, the mind, and the social environment, all play a role in migraine and migraine management.

Biological

Medications that are often used to treat migraines in adults may have value in children and teens as well.For example, triptan medications that can be effective with adults are sometimes also used with children. For children the decision to use these medicines by the health care provider is considered to be “off-label” because no formal clinical studies have proven them safe and effective for people under age 18.  Off-label use means that the medication is used for something other than what the U.S. Food and Drug Administration has specifically approved.

Medical treatment used for children and teens with migraines fall into the same three categories as the medications for adults: (1) those used to prevent a migraine from starting; (2) those used to stop a migraine early; and (3) those which provide relief of pain and other symptoms during a headache episode.  Just as with adults, each type of medication is most effective when used with other self-management strategies, such as dietary and lifestyle changes, exercise and relaxation therapy.

Psychological

From a psychological perspective, many of the same lifestyle factors that help adults manage migraines can also help children and teens.  Learning to identify and avoid the “triggers” that can set off a migraine is just as important for children and teens.  Triggers may vary from person to person. Common migraine triggers include:

  • Stress – related to school, social, and family problems
  • Menstruation – normal hormonal changes caused by the menstrual cycle
  • Changes in eating patterns – skipping meals can cause migraines
  • Caffeine – children get caffeine in soft drinks, iced tea, and chocolate
  • Lack of sleep – reduces energy and increases stress
  • Weather changes – changes in barometric pressure may trigger migraines
  • Travel – motion can trigger a migraine
  • Foods and additives -children and teens commonly eat foods or food additives that may be triggers, like aged cheeses, pizza, luncheon meats, hot dogs containing nitrates, or MSG, a seasoning found in many snack foods

Children can be taught how their body responds to stress, and how to use stress-reduction skills. Life style changes including getting enough sleep and maintaining good nutrition and regular eating patterns. Like headache management programs for adults, when children know how to recognize and avoid triggers, how to manage stress, and how to think differently about headaches, they can manage them more effectively.  Learning these skills at home will help with their migraine management along with their medical treatment and medication.

Some children and teens with more severe or frequent headaches may benefit from group or peer-to-peer support.  A migraine support group may be hard to find, but sharing experiences with peers can be rewarding and reassuring as groups are an excellent place for children and teens to obtain support and knowledge to help them cope with their challenges.

As a parent, it is important to help your child learn how to gradually manage their own health care and to become advocates for themselves. They can learn what questions to ask, how to follow medical recommendations, and how to communicate well with health professionals. As they grow older they can then begin to take a more active role in their medical treatment and self-care.

Social

It is important to stay aware of what is happening in your child’s social life.  Social stress may contribute to the onset of headaches. Social stressors, big or small, may include parental conflict, financial stresses, illness and other losses, physical moves, pressure from peers, and school expectations.,

Summary

In many ways, understanding and managing migraines in children is similar to what you did as an adult.  The key difference is to learn how to shift the focus to a child’s point of view and lifestyle.  It is also important to find medical providers who have experience managing migraine in children and teenagers.

 

References

Migraine facts and figures. Migraine Action. Retrieved December 9, 2011 from
http://www.migraine.org.uk/index.php?sectionid=1029