Children and teens can have many different types of headaches. One of the most common, affecting about 10 percent of children and teens, are migraines.

How can you tell if it’s a migraine?

Migraine headaches are more painful than “normal headaches.” Most of the time, a child or teen with a migraine won’t want to do normal activities, even fun ones like playing or hanging out with friends.

They might describe the pain as pounding, like their heart is beating in their head or they’re being hit in the head. Younger kids might describe them differently, such as a basketball bouncing in their head or (my personal favorite) “like a t-rex is chewing on my brain.”

Migraines in children can be different than migraines in adults.

For example, most adults with a migraine have pain on only one side of their head. Children are more likely to have migraines on both sides of their head. For a headache to be classified as a migraine your child might either feel sick to their stomach or throw up and/or that both lights and sounds are really intense and painful.

Some children might have all these symptoms. Usually, a child with a migraine will want to go lie down, often in a dark and quiet place, and will try to go to sleep. Sleep often helps migraines go away.

Looking for Triggers

Many children with migraines have triggers that start them. Some common ones include:

· Strong smells, such as bleach, tobacco smoke, and perfumes

· Big weather changes, like storms or temperature swings

· Allergies

· Hormone changes

· Poor health habits, such as too much screen time for entertainment, not getting enough sleep, skipping meals, not drinking enough water, and drinking too much caffeine

· Struggling with strong emotions due to stress, anxiety, depression, or anger, which are one of the most common triggers of migraines

How to Help Your Child

Start by helping your child improve their health habits. Just improving these habits reduces your child’s risk for getting any headache, including migraines. You can find more information in our Headache Hygiene 101 article.

When your child gets a migraine, there are things you can do to help them feel better.

If their migraine isn’t too bad, sometimes just letting them have a short rest in a calm and quiet place can help. Your child might like having a hot pack or a cold pack to put on their head or neck.

Younger kids might want to cuddle or be comforted. Some children and teens become frightened when they get a migraine. Encourage them to stay calm and be reassuring. If they panic, scream, or sob, the migraine pain can get worse instead of better.

If you choose to give your child medicine like Motrin or Tylenol, give it to them as soon as they know that they are getting a bad headache. The faster a medication is given, the better it works.

However, it is important not to use pain relivers too often. If you give pain relievers for headaches more than about two days each week, you can accidentally cause a rebound headache.

Do not give children under the age of 12 pain relievers that contain aspirin, such as Excedrin Migraine or some types of BC powders.

When to be Concerned

It is very rare for a migraine to be caused by a brain tumor or stroke in children. While there are reasons we might want to get a picture of your child’s brain, most children do not need to have a CT or MRI scan for migraines.

You should seek emergency care if your child or teen:

· Is experiencing “the worst headache of their life”

· Feels that their headache hurts more when they lie down

· Has trouble seeing or has double vision

· Becomes confused, weak on one side, or has a personality change

· Has a seizure

· Is woken up by severe pain from a headache that started while they were asleep, and the headache isn’t getting better

Other signs that your child or teen might be struggling with migraines can include a sudden decline in their athletic or school performance or avoiding activities they once enjoyed. As there are other reasons that these signs could be occurring, talk to their pediatrician about your concerns.

Getting help for your child:

If your child or teen is struggling with headaches, there are treatments that can help.

Their pediatrician might recommend an evaluation by a pediatric headache specialist. Learn more about the WVU Medicine Children’s Neurology Department and conditions we treat at our website.

References: · Pediatric migraine. American Headache Society. (n.d.). · Treatment of migraine in children: AMF. American Migraine Foundation. (2022, December 12).