Migraine headaches can begin at any age. It’s estimated that about 10% of children between 5-15 years old and up to 28% of teens experience migraines.

“I think migraine in little kids is often underdiagnosed because, as a society, we generally don’t recognize that 5, 6, 7, 8-year-olds can experience these types of painful episodes,” says Dr. Pilar Bradshaw. “Sometimes, kids have a migraine in association with certain triggers.”

What is the difference between a migraine and a headache?
Migraine pain is usually more severe than a typical headache. It often includes throbbing on one side of the head that often worsens with activity. Migraine headaches also tend to occur with other symptoms, such as nausea, vomiting, vision problems (e.g., seeing spots or flashing lights), light and sound sensitivity, and tingling.

If your child exhibits neurological symptoms before, during or after a migraine episode, including double vision, changes in speech or balance or difficulty using their hands, see your doctor immediately. These are not symptoms of a migraine.

Migraines often develop in stages:

  • Premonitory or warning phase: tiredness, stiff neck, mood changes (can last up to 24 hours)
  • Aura phase: seeing spots, squiggly lines, dizziness, weakness, numbness and/or confusion. These symptoms, which don’t happen with all types of migraines, may last up to an hour.
  • Attack phase: severe, throbbing or pulsating pain with nausea, vomiting and light sensitivity
  • Postdrome phase: may include extreme tiredness and sluggishness, post-migraine

Risk factors and triggers
It’s not known what causes migraine, although a combination of genetic and environmental factors likely plays a role:

  • Genetics: According to the American Academy of Pediatrics, migraines tend to run in families. If one parent has them, there is roughly a 50% chance that a child will, too. If both parents experience migraines, the chance a child will have them is closer to 90%.
  • Gender: Before puberty, boys have more migraines than girls. That flips in the teen years and by age 17, as many as 8% of boys and 23% of girls have had a migraine.
  • Stress and sleep: Too much stress and irregular sleep schedules—getting too much or too little sleep–can also trigger migraines.
  • Foods and fluids: Skipping meals, eating certain foods—including aged cheeses and meats, chocolate and citrus fruits—as well as consuming additives, such as red and yellow food dyes, monosodium glutamate (MSG) and aspartame can set off migraines. Dehydration is also a trigger.

“I encourage you to keep a diary of your child’s migraines, so that when you visit your pediatrician, you have an accurate record of what’s been happening, so your doctor can get a better idea of how often and how severe the headaches have been,” says Dr. Bradshaw.

When keeping a diary, include the following information:

  • When the headache started
  • Where the pain was located
  • Severity of the pain
  • How long the headache lasted
  • Any other symptoms
  • If medications were effective

You may also want to keep track of how much sleep your child had, as well as meals, fluids, exercise, stress and weather changes.

Treating migraine
For some children, sleep alone is an effective treatment for migraines. Treating migraines can be challenging for kids who require something more, because most FDA-approved drugs to prevent migraines are not recommended for kids under age 12.

“However, there are some things you can try, like over-the-counter medications,” Dr. Bradshaw says. “Ibuprofen, Advil or Motrin given immediately at the onset of a mild to moderate migraine can help ease the severity. It’s also helpful to immediately hydrate your child with plenty of water.”

If your child is experiencing headaches or migraines, talk with your pediatrician. Together, you can work on the best course of treatment for your child.