Eleven-year-old Camden Jordan of Carmel says his migraines feel like a “headache times 100.”
Nine-year-old Mya Burow of Fishers says hers are “really, really miserable.” “You cannot think at all,” she says. “You keep saying things, like, ‘Go away! Go away!’ It HURTS.'”
It’s the kind of suffering no parent wants to watch their child endure. But how can you tell if your child’s headaches are actually migraines – and what can you do to help them escape the cycle of pain?
Five classic symptoms
In order to diagnose a headache as a migraine in a child, doctors look for at least two of these signs:
-Throbbing or pulsing pain
-Moderate to severe intensity
-Sensitivity to light and/or sound
-Pain that worsens with activity
-Nausea or vomiting
St. Vincent pediatric neurologist Dr. Lisa McGuire says your child’s behavior is a good indicator of how intense their pain is. “What I tell people is, if it’s a migraine, you’re not going to sit there and play video games or watch TV. Generally with a migraine you see light or sound sensitivity, children will prefer to lie down or be still because movement makes it worse, and you’ll see nausea or vomiting, or both.”
Like adults, children may also experience an aura with migraines, which can create visual disturbances. “Sometimes kids will describe flashing lights, black dots or partial loss of vision,” says McGuire.
Treatment option #1: One headache at a time
If a child’s migraines are occurring four times per month or less, Dr. McGuire recommends avoiding a daily preventive medication, focusing instead on finding the best abortive medication to stop them once they start.
That’s the treatment pattern Mya Burow has followed. Her mother, Andrea Burow, says she helps Mya recognize symptoms early, so she can get to a comfortable place before she starts vomiting.
Medications can help Mya relax and fall asleep faster, but they don’t really manage her pain. Andrea says it’s hard when Mya’s migraines spoil important moments. “Last year she was a flower girl in a wedding,” recalls Andrea. “We made it through the day, but then she couldn’t make it to the reception. Those are the things you don’t want to miss in life.”
Treatment option #2: Preventative medications
For children whose migraines occur more than four times per month, physicians often recommend a daily, preventive medication. Camden Jordan’s family ultimately decided on a daily medication, since his migraines were so frequently getting in the way of school and sports. “It is absolutely disruptive,” says his mother, Jennifer Jordan. “He would come home from school and have a headache and just want to lie in bed and not do homework. That was kind of becoming a big deal.” Camden also takes Excedrin Migraine as soon as possible after a headache begins, and drinks Gatorade, since dehydration can be a trigger. Even with these tools, he often has to just let the migraine run its course. “If he throws up, he lays down and falls asleep, and when he wakes up it’s gone”, explains Jennifer. “If he doesn’t throw up, it lasts longer.”
Treatment option #3: Natural methods
A variety of natural methods have also been found effective in preventing and treating childhood migraines. Physicians often recommend keeping food and activity diaries to identify triggers, and resting in a darkened, quiet room after a migraine begins. The Burows say Mya seemed to benefit from cranial massage (which can address secondary muscle tension prompted by migraines), and the Jordans say Cam is doing better after they eliminated chocolate and hot dogs from his diet.
Dr. McGuire also says, based on results of a recent study, she began recommending some of her patients take 3 milligrams of melatonin about 30 minutes before bedtime. “I tell most of my migraine patients the hour before bed at night not to watch TV or look at a screen, because there is some evidence that screen light tricks your brain into thinking it’s day and suppresses melatonin,” says Dr. McGuire.
Empowerment: The best medicine
For most children, there is no perfect solution to migraines. That’s why Dr. McGuire says it is critical for parents to empower their kids and celebrate all successes. Make sure they know you believe they are in pain, and are proud of what they are doing to improve their migraines. “It’s important to let them know they are part of the treatment plan. It helps them feel better faster, and causes fewer other issues.”