Helping Children with Migraines
A migraine headache is a neurological disorder that involves intense headaches, often accompanied by nausea, vomiting, and sensitivity to light and sound. Migraines affect 10–25% of children, making them one of the top five childhood health concerns.1 These painful headaches can cause significant disruption to daily activities and a child’s quality of life—negatively affecting them physically, socially, and in school. While the exact cause of migraines is still unknown, studies consistently show that the two most common triggers for migraines in children are insufficient sleep and emotional stress.2 Dietary factors also play a role, but particular food triggers may not be as common as expected. There may also be nutritional deficiencies responsible for migraine severity, although more research is needed. The good news is that modifying behavioural and lifestyle habits can significantly reduce the occurrence of childhood migraines. These migraines can be managed better if they are diagnosed early and treated.
FOCUS ON MORE ZZZ’S
Sleep deprivation is one of the most common causes of migraine headaches in children and adolescents. Insufficient total sleep time, daytime sleepiness, difficulty falling asleep, and night waking are all associated with migraine headaches. Snoring and sleep apnea are common in children who experience migraine headaches, so a sleep study may be needed as part of a treatment plan. Research shows that improving sleep quality by implementing healthier sleep habits can reduce migraine frequency.2 Ensuring children maintain a regular sleep schedule (even on weekends), get to bed on time, avoid caffeinated beverages, and limit late-night screen time can help improve the amount and quality of their sleep. According to the National Sleep Foundation, the recommended sleep times are 9–12 hours for children (6–12 years) and 8–10 hours for teenagers (13–18 years).3 Prioritizing adequate sleep for children is an important consideration for growth and development, as well as migraine reduction.
Stress at home and school is linked to migraines in children and adolescents.2 Ensuring safe, supportive surroundings for children at home and academically reduces the risk of mental-emotional stress. Migraines in children occur more commonly with school schedule changes, with more migraines occurring at the start of an academic year. Screening for concerns such as bullying, learning difficulties, and other interpersonal challenges can help show where more support is needed. Keeping open, non-judgmental communication with children can help bring about conversations around mental-emotional needs. There is also a high correlation between mood disturbances and migraines in children, including mood swings, anxiety, depression, and difficulties with attention.1 Strong evidence exists for cognitive behavioural therapy (CBT) to help reduce headache frequency in children; offering children the opportunity to learn coping strategies for stress and pain management through CBT can improve both migraines and any mood-related symptoms. Additional relaxation techniques such as deep breathing exercises, guided imagery, and progressive muscle relaxation are also beneficial for migraine reduction.4
Evaluating the role of diet in pediatric migraines is complex because multiple triggers and variables can modify an individual’s pain threshold. While the research is still inconclusive on specific food triggers for migraine headaches in children, one dietary habit does stand out as a common concern; prolonged fasting or skipping meals has been identified as a clear predictor of migraine onset, so this habit should be avoided.2 Unless other obvious dietary triggers have been identified, maintaining a balanced diet with regular meal timing should be the goal, rather than randomly limiting certain foods. The one exception may be to screen for celiac disease, as this condition is found in a high number of children with migraines—following a gluten-free diet generally resolves migraines for those that do test positive.5
DON’T FORGET VITAMIN D!
Even though research on supplement use for migraines in children is less studied than in adults, it has been found that a deficiency of vitamin D in children is associated with migraine headaches. Studies show that migraine frequency, severity, and duration are improved with adequate vitamin D supplementation.6 Like any vitamin, more is not better, and high levels of vitamin D can be toxic (so testing is advised). Vitamin D levels can be checked by a medical or naturopathic doctor to target optimal dosing.
Migraines are a complicated health issue with several contributing factors. In pediatrics, sleep and stress management are key and should be the foundation of any treatment plan. If symptoms still aren’t improving, tracking migraine patterns alongside diet, sleep, stress, mood, and menstrual cycles (if applicable) may help identify more specific triggers. Increased frequency or severity of headaches, visual disturbances, numbness, weakness, fever with a headache, or any altered level of consciousness requires immediate medical evaluation.
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