Coping with migraines in children

Last autumn I wrote about my experiences with migraines as an adult. However, small boy has also been suffering with classic childhood migraines since he was about 4 and a half.

Before I go further, I want to be absolutely clear that I’m not a medical professional and our experiences shouldn’t guide you in responding to your own child’s symptoms.

If you need more official type information about migraines and headaches in children, I can recommend this NHS Fact Sheet. But, if in doubt, see a doctor.

The first time

The first time small boy had a migraine, it was tea time midway though the half term holiday after this first six weeks in reception at school. He sat down at the table, looked at us and at his dinner, then told us he had a sore head and his tummy hurt. We thought he must just be really hungry and encouraged him to eat his favourite broccoli first. Within a minute, he’d brought back up that first mouthful of broccoli and we rushed him to the downstairs bathroom. He was really sick and a very sad shade of pale grey. Once his tummy had settled, he had an early night and slept for 13 hours. The next day he was fine, it didn’t seem to be a tummy bug. We decided that he must have been dehydrated and the headache from not drinking enough had made his nauseous. We didn’t think any more of it and didn’t even look up what might have been going on.

Classic progression

Then, two weeks later, I got a call from afterschool club. Small boy was grey and complaining of a sore head and tummy. I went and fetched him and the experience of that first headache repeated itself; pain, vomiting, lots of sleep. This time though he was sick again in the morning and we thought he’d caught a sickness bug from school.

Then…. nothing more for six months. In the spring, just before lockdown, he had another awful headache and sickness. This time, I called the doctor and we quickly had a telephone appointment. The doctor was pretty decisive in her diagnosis. She said it was an absolute classic presentation of a childhood migraine, he was a little young starting to have them, but he should grow out of them at puberty. Great, just the 8 years or so to live with them then.

The progression that small boy experiences is totally classic; headache (not one-sided), painful stomach ache, vomiting, sleep and then he’s fine. From start to end is typically 2-4 hours, nothing like the days of pain that adults can experience.

What next?

Small boy has continued to have migraines roughly every six months ever since. He’s now heading for eight and he knows exactly what he’s feeling as soon as it starts. Each year, at school, we’ve explained to the teacher what to watch out for and each year they’ve reacted to the first migraine as though there’s no ongoing condition. The result of that, has been a rushed phone call a couple of hours after he first tells the teacher he’s feeling bad and then being sick in the car on the way home. This last week, he had the second one with his current teacher and she knew straight away that he needed to come home.

Causes

We haven’t been able to figure out what’s triggering small boy’s migraines. He’s really good about drinking enough and no two cases have involved any of the same unusual foods in the two or three days before. We think that maybe there’s a relationship between really rich meats – once it was after ostrich burgers and once after some really nice pate. But that’s not always the case at all. He’s also had them when he’s just had the same normal meals for the days before, no unusual activities. Another factor might be tiredness, and growing, but that’s really hard to track.

Coping

When I have a migraine, I take sumatryptan which is a magical medication; it completely sorts me out and has me back to normal within a couple of hours at most.

However, children can’t take tryptans.

So, we just have to let the migraine’s development guide us. When he’s in pain, we sit in a quiet, dark room and snuggle close. When he’s ready to be sick, we just soothe him through that. There’s absolutely no point giving pain relief because his gastric processes shut down, so it wouldn’t get into his gut to be absorbed and anyway, it irritates his stomach and just makes him vomit sooner. Once he’s stopped being sick, he needs sleep. So depending on the time of day, he might go for an early night, or he might just cuddle on the sofa and end up sleeping on my knee for as long as he needs. When he wakes up, he has little sips of water to make sure his tummy is ready for something and then some dry crackers until he decides he wants a meal – that might be the next day.

That’s all you can do with childhood migraines really, let them play out with comfort and support for your child, patience and as little fuss as possible if there’s a mess – no one wants to feel even worse when they’re sick by worrying about things like that.

If you have to take your child anywhere in the car, like fetching them home from school, be prepared with a bag or bucket and an old towel.

Variations

There’s been a bit of variety in the last few migraines though. Last autumn, he had one where he was much more sick than usual; vomiting every 10 minutes for an hour and a half. But then he slept from 5pm for two hours, waking up fine and hungry and avoiding bedtime at 7pm. Then, about a month ago, we were at my parents’ house and he had a migraine with no sickness, just pain, sleep, better.

More concerning is that he’s just had another one just four weeks since the last. This is the only time since those first two that they’ve come less than 5 months apart. Not only that, but after the less severe previous one, this seems to have been the worst in terms of pain. Maybe he’s getting older and more aware, so maybe more emotionally affected by the pain. He was absolutely distraught with this most recent one though, just sobbing with his head in his hands, whimpering that he just wanted the pain to stop.

We’re going to be really careful now. If he has another one anytime soon, we’ll be taking him to the doctors. An increase in headaches in children is always something to get checked out.

In fact, I would strongly recommend that if you suspect you child has suffered from a migraine, take them to your doctor. It should absolutely be on their medical records and checked that nothing else is going on.

How about you?

Do you or your children have experience of migraines in childhood? Please let me know how they were for you and how you coped.