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Migraines at School

Coping with Migraines at School

By Rosalyn Carson-DeWitt, MD

Updated March 05, 2009

(LifeWire) - For the 5% of grade-school-aged children and 20% of teenagers who have migraine headaches, school can present a unique challenge. Migraine symptoms can be especially unsettling when they occur away from home. Children may find it embarrassing to ask the teacher for help and may worry that classroom peers will make fun of them.

You can be most helpful by working closely with your child and the school to develop a three-part plan that includes trigger avoidance, early symptom identification and a clear action plan.

Avoid Triggers

The first step involves identifying and controlling any specific factors that may lead to a migraine in your child. In order to accurately identify what kinds of things make your child vulnerable to a migraine headache, consider keeping a journal that tracks various conditions that are often considered migraine triggers. Once you've identified your child's triggers, you can work to control them, hopefully thereby reducing migraine frequency.

The following steps can be helpful for a variety of common migraine triggers. Once you've identified the specific triggers for your son or daughter, you can focus on the most appropriate measures by making sure that your child:

  • Gets adequate sleep every night -- According to the National Sleep Foundation, children ages 5 to 12 need 10 to 11 hours of sleep nightly, whereas teenagers need 8½ to 9¼ hours nightly.
  • Maintains a consistent sleep schedule -- Although it's tempting to let children stay up later on weekends, it's actually better to keep them on their usual bedtime routine.
  • Gets ready for school in a calm way every morning -- The effects of stress in regard to migraine headaches hasn't been completely clarified. Some experts think stress can trigger migraines; others consider it an aggravating factor that can make migraines more difficult to treat. 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.
  • Eats a healthy breakfast every day -- Skipping meals can increase the likelihood of a migraine.
  • 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 mid-afternoon snack.
  • Understands about 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 most commonly induce migraines, such as aged cheese, processed foods, cured meats, nuts, chocolate, raisins, yeast-containing baked goods and foods containing monosodium glutamate (MSG).
  • Stays 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.
  • Avoids 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.
  • Isn't sensitive to fluorescent lighting -- If the classroom is lit by fluorescent lights and your child is sensitive to the flickering, you may need to talk to the school about using alternative lighting.
  • Has some daily down time --Since it may be helpful to keep your child's stress level low, try not  to over-schedule the after-school activities.
  • Keeps a consistent daily schedule -- This will help avoid stress around homework completion and insure consistency regarding sleeping and eating.

Identify Early Symptoms

It's important to help children learn to identify their pre-headache symptoms and recognize the signs of an impending migraine headache. However, the tricky thing is not to let you or your child become hypersensitive to normal body sensations, misreading them as signs of incipient migraines.

Many parents find it valuable to work closely with their children, helping them notice common warning signs, such as stiff neck, fatigue, yawning, frequent urination, dizziness, ringing in the ears, low or irritable mood, difficulty concentrating, bright spots or flashes of light or color affecting the eyes, or tingling or numbness in the hands, feet or face. You may want to keep a migraine diary to help track your child's pre-headache symptoms and migraine patterns.

Also make sure your son or daughter knows what to do if warning symptoms occur at school.

Create an Action Plan

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

Find out what steps the school would like your child to follow if a migraine strikes. For example, if your child begins to notice pre-headache symptoms at school, what then? Where would the child go for help? You'll need to be able to tell your child who will be helping them, whether it will be the classroom teacher, an office secretary or a school nurse.

Explain to the teacher that in the event of pre-headache 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 such things as:

Ask your pediatrician to help you decide whether any medications should be given at school. If so, 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). Make sure you check back with the school during the year to maintain the school's supply of your child's medicines.

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

  • A headache 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, or weakness or paralysis
  • Increasing frequency of migraines
  • Need for a fresh supply of medicine

With some advanced planning, there's a lot parents can do to minimize the challenges their children and teens face due to migraine headaches. Giving your son or daughter a sense of how to recognize and avert incipient migraines, and what to do if one strikes, will lay the foundation for an enjoyable and successful school year.

Sources: "Adolescent Sleep Needs and Patterns." Sleepfoundation.org. 28 Dec. 2006. National Sleep Foundation. 28 Mar. 2008 <http://www.sleepfoundation.org/atf/cf/{F6BF2668-A1B4-4FE8-8D1A-A5D39340D9CB}/sleep_and_teens_report1.pdf>.

Haslam, R.H.A. "Headaches." Nelson Textbook of Pediatrics. 17th ed. Ed. John Noble. Philadelphia: Saunders Elsevier, 2004. 2012-2014.

"Migraine Headache in Children and Adolescents." Familydoctor.org. June 2006. American Academy of Family Physicians. 28 Mar 2008 <http://familydoctor.org/online/famdocen/home/children/parents/common/common/757.html>.

"Parenting Corner Q&A: Chronic Health Conditions. ." AAP.org. Oct. 2007. American Academy of Pediatrics. 28 Mar. 2008 <http://www.aap.org/publiced/BR_Chronic_School.htm>.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content.  Rosalyn Carson-DeWitt, MD, works as a medical writer, editor and consultant in Durham, NC. She served as editor-in-chief for two multi-volume MacMillan encyclopedias: "The Encyclopedia of Drugs, Alcohol, and Addictive Behavior" and "Drugs, Alcohol and Tobacco: Learning About Addictive Behavior." She worked on the 18th edition of the "Merck Manual of Diagnosis and Therapy," and has written thousands of print and online articles for healthcare providers and consumers.
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