An Overview of Pediatric Migraines: Symptoms, Prevention, and Treatment

Although most people associate migraines with adults, migraines also can affect children and teenagers. Figuring out an effective treatment plan early on can help improve the quality of life for a child with migraines and help prevent these headaches from following them into adulthood.

This article will discuss the causes, symptoms, and treatment methods for pediatric migraines, as well as how to prevent them.

What Are Pediatric Migraines?

Migraines typically are considered moderate-to-severe headaches lasting from two to 48 hours and occurring two to four times each month. Pediatric migraines are migraine headaches that occur in people under the age of 18. People of any age, even infants, can get migraines, but they are more common as children get older.

About 3% of preschool-aged children, 4%–11% of elementary school–aged children, and 8%–15% of high school adolescents experience migraines.

Migraines are primary headaches (not caused by a different medical condition) that are more common in boys prior to puberty and girls after puberty.

Pediatric migraines can be treated with medication and lifestyle changes, but many children who suffer from pediatric migraines will experience them as adults too.

Because migraines can present with a variety of symptoms in addition to headache, especially stomach problems, they can be difficult to diagnose, particularly in younger children.

Healthcare professionals divide pediatric migraines into two classes. They are:

• Mild pediatric migraines: Lasting for one or two hours and eased by staying in a calm, quiet environment
• Moderate-to-severe pediatric migraines: Lasting two to six hours, often requiring treatment, and causing a child to miss out on their normal activities

Causes of Pediatric Migraines

Healthcare professionals believe that migraines are rooted in the neurological system, occurring in the brain and nerves, as well as the blood vessels.

Research is still underway on the precise causes of migraines. However, researchers believe that migraines occur when a person’s pain networks in the head are activated or triggered. Triggers include stress, skipping meals, sleeping too much or not enough, or changes in weather.

Once these networks are activated, they cause inflammation of the blood vessels in the brain. This can lead to pain and other symptoms.

Migraines have a strong genetic component and can run in families. In fact, 60%–70% of people who experience migraines have at least one immediate family member who also gets migraines.

Pediatric Migraine Symptoms

The primary symptom of migraines is a severe headache, but migraines can present with a host of other symptoms, especially in children. The symptoms of migraines in children often vary by age and include:

• Pounding or throbbing head pain
• Pale skin
• Being irritable or moody
• Sensitivity to light and sound
• Loss of appetite
• Nausea or vomiting

Infants and Toddlers

Babies younger than a year old may have episodes of head banging when they have a migraine. This might be their only visible symptom.

Toddlers who have migraines experience:

• Irritability, rocking, and crying
• Vomiting and abdominal pain
• The need to seek out a dark room
• General appearance of being unwell

School-Aged Children and Teenagers

School-aged children and teenagers are able to articulate that their head hurts. They might say that their pain is in their forehead, temples, or eyes.

In children, migraines often occur on both sides of the head, unlike migraines in older individuals that are usually concentrated on one side of the head.

Teenagers with migraines generally experience more severe headaches than younger children. They may have a throbbing headache on one side, similar to migraine in adults.

Triggers

Migraines can be triggered by physical and environmental factors, including:

• Stress
• Lack of sleep or too much sleep
• Certain foods
• Skipping meals
• Changes in weather or climate, including barometric pressure
• Hormonal changes, including menstruation
• Certain medications, including birth control pills, asthma treatments, and stimulants
• Changes in regular routine
• Caffeine

Diagnosis and Treatment of Pediatric Migraines

Pediatric migraines are often underdiagnosed.

If your child frequently complains of headaches, you should talk to your pediatrician about the possibility of migraines, especially if there is a family history of them.

Healthcare professionals might order tests to rule out other causes of headache, but the diagnosis of pediatric migraines usually is made based on symptoms alone. Imaging tests are seldom needed, and there’s no definitive test for pediatric migraines.

Once your child is diagnosed, your doctor will talk to you about treatment options, including medications. As with migraines in adults, it’s important to treat the symptoms of pediatric migraines early on. After your child takes medications, they should rest in a quiet, dark room.

The treatment options for pediatric migraines include:

• Nonsteroidal anti-inflammatory medications (NSAIDs): These include over-the-counter pain relievers like Advil or Motrin (ibuprofen) and Aleve (naproxen sodium).
• Triptans: Prescription migraine medications, if pain relievers aren't enough, can be used in children over age 6. Triptans interrupt the progression of a migraine.

Children and teenagers should not use medication to treat migraines more than twice a week.

Prevention of Pediatric Migraines

In order to lessen the reliance on medication, it’s important to prevent pediatric migraines. Preventing migraines can also make medical treatment more effective when it is required.

To prevent pediatric migraines:

• Know your triggers. Pediatric migraines can be triggered by certain foods, overstimulation, stress, and other factors. Track your child’s symptoms to identify triggers and possibly avoid them in the future. 
• Focus on mental health. Pediatric migraines can be brought on by stress. Cognitive behavioral therapy has been shown to help kids better manage stress, thus reducing the frequency of their migraines.
• Healthy diet and exercise. Kids should stay well-hydrated by drinking plenty of water and avoiding drinks containing caffeine or added sugar. Meals should be eaten at regular times, and sugary, fatty, and processed foods should be avoided. Also make sure your child is getting enough physical activity by encouraging exercise, like bike riding or swimming.
• Get plenty of sleep. Children with migraines should get eight to 10 hours of sleep every night. They should go to bed and wake up at the same time each day.

A Word From Verywell

Pediatric migraines can take a toll on children and parents. Watching your child suffer, especially when they’re too young to communicate their symptoms, can be heartbreaking.

Healthcare professionals are learning more about pediatric migraines, including treatment and prevention techniques. Talk to your pediatrician or healthcare provider about how to effectively treat your child’s migraines and ways to prevent them before they start.

Frequently Asked Questions

How do I know if my child has a moderate or severe pediatric migraine? 

It can be hard for young children to express their level of pain. Generally, a pediatric migraine is considered mild if it lasts for less than two hours, and moderate to severe if it lasts two to six hours. More severe migraines will leave children in lots of pain, seeking a quiet, dark room, and avoiding daily activities. Some children may experience nausea or vomiting.

How frequent are pediatric migraines?

Pediatric migraines can occur two to four times per month. Migraines occur in about 3% of preschool-aged children, 4%–11% of elementary school-aged children, and 8%–15% of high school-aged children. Migraines are more common in boys prior to puberty and in girls after puberty.

What are the current recommendations for pediatric migraine prevention?

Many migraine triggers, such as changes in weather and hormonal changes, cannot be prevented. However, there are some preventive steps parents and children can take to help avoid migraines, including managing their physical and mental health, eating regular meals that include plenty of vegetables and protein, and avoiding sugars and processed foods.

Children should also get plenty of exercise and sleep. Cognitive behavioral therapy, which teaches children how to better manage stress and emotions, will help some children with pediatric migraines.