Coping With Migraines at School

For the nearly 10% of kids age 5 to 15 years and 30% of teenagers 15 to 19 who have migraines, school can present a unique challenge. As a parent, you can help by working closely with your child and his or her school to develop a three-part approach that includes identifying and avoiding triggers, early symptom identification, and a clear action plan.

Here's how to do it, as well as some strategies to help prevent migraines at school.

Avoid Triggers

The first step to ensuring your child isn't too negatively affected by his or her migraines is to identify and control any triggers that may lead to an episode.

In order to accurately identify what makes your child vulnerable to a migraine, try keeping a headache diary for two or three months that tracks various conditions, times, foods, environmental changes, stressful situations, and locations that may be migraine triggers. If you have a teen with migraines, ask him or her to fill out the diary and look for patterns.

Once you've identified your child's triggers, you can work to control and/or avoid them, thereby (hopefully) reducing migraine frequency. Share your findings with school personnel too, as well as your child.

Identify Early Symptoms

Not all kids who have migraines experience pre-migraine symptoms, known as the prodrome or premonitory phase, but it seems that many kids have at least one. These symptoms can begin hours and up to one day before the head pain occurs.

It's important to help your child learn to identify his or her prodrome symptoms, if applicable, and to recognize the signs of an impending migraine. That said, don't let normal body sensations be misread as signs of developing migraines.

Common warning signs that your child may be in the prodrome phase include:

• Stiff neck
• Fatigue and yawning
• Euphoria
• Changes in bowel movements or urination
• Ringing in the ears
• Food cravings
• Social withdrawal
• Low or irritable mood
• Difficulty concentrating
• Paleness
• Dark shadows under the eyes

For kids who have migraine with aura, a less common type than migraine without aura, the aura can sometimes occur before the headache phase, though it's usually present at the same time as the head pain. Auras last anywhere from five minutes to an hour. Aura symptoms are typically visual but can be sensory, language-related, retinal, motor, and neurological, and may include:

• Bright spots or flashes of light or color affecting the eyes
• Tingling in the hands, feet, or face that's often followed by numbness

If you're not sure if your child has aura symptoms, ask him or her about any unusual visual changes just before or during the migraine. A migraine diary can help track your child's prodrome and/or aura symptoms and migraine patterns too, another great reason to start one.

Create an Action Plan

Above all, establish good communication with your school and create an action plan for your child.

Meet With School Staff

Have a meeting with your child's teacher and other school staff at the start of each school year to make sure that they understand migraines. Give the school a written list of your child's prodrome warning signs to help them recognize an oncoming migraine, as well as a description of the typical symptoms your son or daughter experiences.

Bring a Doctor's Note

It's also a good idea to give the school a letter from your child's primary care physician explaining the migraine diagnosis and the necessity of quick treatment, as well as what medications or preventative steps he or she recommends for your child's migraines at school.

Follow Protocol and Work With the School

Find out what steps the school would like your child to follow if a migraine strikes. For example, if your child begins to notice prodrome symptoms at school, where should he or she go for help? You'll need to be able to tell your child who will be helping him or her, whether it's the classroom teacher, an office secretary, or a school nurse.

Explain to the teacher that in the event of prodromal symptoms, your child may need to take certain steps to help prevent a migraine from occurring. Ask the teacher how your child should go about taking steps such as:

• Grabbing a quick snack
• Getting a drink of water
• Going to a quiet place, turning off the lights, and catching a quick catnap
• Performing yoga or breathing and relaxation techniques to quell stress

Set Up Medication Procedures

If you and your child's doctor decide that medication may be needed at school, you'll need to make sure any permission forms are completed and that there's a supply of medications on hand. These medications must be submitted with clearly written instructions about what symptoms should prompt administration and how the medication should be given (amount and frequency).

Explain When the School Should Contact You

Let the school administrators know what symptoms and situations should prompt them to contact you immediately, such as:

• A migraine that doesn't improve after two hours, despite treatment
• Symptoms that vary considerably from the typical symptoms your child experiences with a migraine
• Extreme symptoms, such as visual changes, vomiting, slurred speech, fever, weakness, or paralysis
• An increasing frequency of migraines
• A need for a fresh supply of medicine

Strategies to Stave off Migraines at School

To help your child avoid common migraine triggers and control migraines in school, try implementing these approaches:

• Be sure that your child gets adequate sleep every night. According to the National Sleep Foundation, school-aged children 6 to 13 years old need 9 to 11 hours of sleep nightly, whereas teens 14 to 17 years old age need 8 to 10 hours nightly. Sadly, most kids, whatever their age, don't get enough sleep. Not only can this trigger a migraine, but it makes it harder for your child to pay attention and do well at school too.
• Maintain a consistent daily routine and sleep schedule. This includes on the weekends too.
• Get ready for school in a calm way. Because some experts believe that stress can either bring on or complicate the treatment of migraines, plan ahead to cut down on the morning frenzy. Consider taking time the night before to lay out clothes, pack backpacks, etc.
• Have your child eat a healthy breakfast every day. Skipping meals can increase the likelihood of a migraine.
• Make sure your child has access to snacks and a healthy lunch during the school day. If you and your pediatrician decide that a daily or occasional snack is important for your child's well-being, but the school doesn't provide a time for snacks, bring the matter to the attention of school administrators so that your son or daughter can have a quick mid-morning and/or mid-afternoon bite.
• Understand your child's food triggers. This is especially important if your son or daughter will be eating a school-provided lunch or if other children might be bringing in snacks or a birthday treat to share in class. Encourage your child to watch out for foods that commonly induce his or her migraines, such as aged cheese, processed foods, cured meats, nuts, chocolate, raisins, yeast-containing baked goods, and foods containing monosodium glutamate (MSG).
• Ensure that your child is well-hydrated. Getting adequate fluids throughout the day can help prevent migraines. Speak with the teacher about keeping a water bottle at your child's desk so that he or she can take regular sips.
• Avoid caffeine. Caffeine can be a trigger for some people, and since children are smaller and harder-hit by a dose than adults would be, discourage your child from drinking caffeinated beverages.
• Check into fluorescent lighting. If your child's classroom is lit by fluorescent lights and he or she is sensitive to the flickering, you may need to talk to the school about using alternative lighting.
• Establish some downtime in your child's daily schedule. Since stress is a major migraine trigger, it may be helpful to keep your child's stress level low (a good idea, regardless). With that in mind, try not to over-schedule his or her after-school activities.

A Word From Verywell

With some advanced planning, there's a lot that you can do to minimize the challenges your child or teen faces due to migraines. Keeping communication open with your child's school and giving your son or daughter a sense of how to recognize and prevent developing migraines, and what to do if one strikes, will lay the foundation for an enjoyable and successful school year.