How do you parent a daughter with migraine? If you don’t have migraines yourself, you might wish that you understood better what she was going through. On the other hand, you may know all too well. Migraine tends to run in families, so if you are a mother with migraine you may have a daughter who develops migraine headaches in adolescence. Dr. Elizabeth Loder, a professor at Harvard Medical School, notes that if one parent has migraine, chances are 50% that the children will, too. If your daughter suffers from migraines, she will need three things from you: emotional support and caring, answers to her questions, and good health care decisions made for her.
Emotional support and caring
For children, migraines are not just painful. They can also be scary and confusing. Your daughter may be unable to do all the things that she wants to do, like attend school and play, and may become angry. Young children have a hard time describing symptoms, especially those related to migraine, like nausea, vomiting, and sensitivity to light and sound. They may become irritable, and not understand why. Some don’t even mention their symptoms because they think everyone must have them. If your daughter could possibly have migraines, experts recommend that she keep a “headache diary” to track her symptoms. This works best if her doctor suggests specific things to watch for. These include:
- Time and date of each attack
- Location and description of the headache
- Description of any symptoms before the attack
- All food and drink consumed in the 12 hours before the attacks
- Information about the previous night’s sleep, such when she went to sleep and woke, and the quality of her sleep
- If it applies to her, where she is in her menstrual cycle
- Activities she participated in before the attacks
- All medications she took and their effects
This information helps her doctor understand the problem and can help avoid future attacks.
Answers to her questions
Your daughter will have many questions. Some will be factual, while others require emotional support. She may ask, “Why me?” To help her, you’ll need to learn about migraine. Migraine is more common in girls than was previously recognized. In girls, it usually begins sometime after her first menstrual period and is often affected by hormonal changes in her monthly cycle. Migraine in children differs from adult migraine. Adult migraine typically involves pain on one side of the head. In children and adolescents, migraine sometimes involves pain on both sides of the head. Generally, children have much shorter attacks than adults, and some children do not have headaches at all. An example of headache-free migraine is abdominal migraine, characterized by stomach pain, nausea, and vomiting, but no headache. Symptoms may alternate with migraine headaches. As the child grows older, abdominal migraine usually shifts to a typical migraine,or can continue with episodes of abdominal pain.
A well-informed parent can be a big help. Not only will you have answers for your daughter’s questions, you will be better prepared to make decisions about her treatment.
Good health care decisions
If your daughter has severe recurring headaches, or symptoms similar to those described above, take her to a doctor. Before you go, have her explain to you what happens in her attacks and how long she has been having them. When children report severe headaches parents tend to focus on life-threatening causes, such as injury or infection of the brain, or a brain tumor. There is no simple test for migraine, but tests can rule out other potential causes. Once you know that the problem is not life-threatening, and migraine is not, the next step will be to decide on treatment strategies. Even if they are not life-threatening, repeated headaches are often disabling. Children with headaches miss twice as many schooldays as those who do not, and they are three times as likely to have emotional and behavioral problems. Once your doctor identifies migraine as the problem, you can:
- Determine what “triggers” your daughter’s migraines
- Seek guidance for a treatment plan for when attacks occur
- If her headaches are frequent, and disabling, discuss preventive measures, including medications as well as non-drug therapies
Knowing what triggers her migraines can help your daughter avoid attacks before they happen. A headache diary is especially helpful in identifying migraine triggers. In the past, the best “medicine” for migraine was sleep. Now there are medications that can “abort” the attack if taken when the headache begins. Medical treatments for migraine include a range of medications and non-drug therapies, like stress management or relaxation therapy. Some drugs have significant side effects. Your doctor will explain the options, but you will make most of the decisions.
Migraine is treatable and manageable, but medical treatment alone is not enough. Any therapy is more likely to succeed if your daughter has strong family support. Discussing your daughter’s migraine with her brothers and sisters may be helpful, so they can understand when a migraine attack occurs. Your family’s support will help her learn to manage her condition, so that she, not her migraines, will be in charge.
American Council for Headache Education. (n.d.). Migraine variants in children. Retrieved June 23, 2008 from http://www.achenet.org/education/