Kid's Health topics

Headaches and Migraines in Children

Hellooooo!!

Easter has come and gone now and I hope you all had your fill of chocolate because I certainly did. I don’t even LIKE chocolate… I do this to myself every year (*face palm*), then I spend the next 3 months running of calories that weren’t even worth it!

So as you guys are probably aware, I had a complete shocker of an Easter break.  Grief came as a king tide this year and the tide stayed in a long time.   All I was hoping for was a little bit of quiet, relaxation time (as things have been so hectic) but then I had the 2nd anniversary of mum’s death, my beloved golden retriever puppy (who really wasn’t a puppy at all – she was to turn 18 years old in June), Georgie suddenly and unexpectedly died on Easter Sunday, then mum’s birthday and the 11th anniversary of my brother-in-law’s passing all in the one week.  I honestly felt like someone had come with an axe and chopped me off at the knees.  I took a week off everything (work, blogging etc) to try to pick up the pieces, and I really appreciate how understanding everyone has been about it all.

So you guys have all seen the posts on Facebook of the comfort food I have indulged in this last week in an attempt to fill the hole in my heart… It sort of worked… but I’m back to it this week and can hopefully build up some momentum to do some exciting and fun posts for you in coming weeks and generate some positive vibes!

My Comfort Food Menu this last week has included:

  1. Fish tacos with fresh salsa and home made chilli aioli
  2. Southern Style (Air) Fried Chicken (served with homemade slaw and tangy carrot and potato mash)
  3. Roti Canai (or the breakfast variation I invented – “Brioche Canai” –> don’t call me crazy – it was TOTES DELISH!  You HAVE to try it!)
  4. Cracking roast pork belly with the crackliest crackling EVER! Served with sides of wilted baby spinach, a golden potato bake and apple sauce
  5. Roasted pork tenderloins with a miso and mushroom cream served with sides of baked parmesan cauliflower steaks (with crispy home grown sage), tangy potato and carrot mash and roasted baby Truss tomatoes on-the-vine

Please leave me a comment (below or on my Facebook page) if you want a recipe and which one you are after!

Some of you might have also noticed that my Instagram profile ” @DrMeggsieCooks ” was the featured Instacook in the Sunday Mail this weekend!!  It was so unexpected and I was so stoked after a really rough week that something so nice could have happened.

Also planning to run a competition to celebrate passing 1000+ followers!!!!!!!!!!!!!  WOOT WOOT!!!!!!!!!  Haven’t figured out what it will be yet – but for a prize I thought about a nice bottle of French champagne (but then some don’t drink, and would worry that the bottle might smash in the post)… or some yummy chocolates (but then would worry about them melting)….  Maybe a Coles/Myer voucher or something (a bit boring, but easy to post and then you can by whatever you want!)…  Please leave me a comment to LET ME KNOW IF YOU HAVE ANY IDEAS!!!

 

So let me get back to what I do best here – blogging!!  I came up with this topic last week when I was driving home from work at about 9pm.  I always try to do topics that are common and widely applicable to as many parents as possible… and I have no idea why I hadn’t thought about headaches as a topic before (*face palm*) – invariably because of my “mummy brain.”

 

HEADACHES AND MIGRAINE IN CHILDREN

Headaches are really common in children and we see this problem frequently as general paediatricians. Of the children who get referred to us, over 90% of these have chronic (that is, long standing) headache.  This is not to say that 90% of kids have persistent headaches, but more I suppose a reflection on the fact that by the time they get referred to a specialist, most of the simple methods to control pain have been tried, and parents/kids/GPs are looking for something further to help.

Specifically today I wanted to talk about migraines – but to do that I need to give you a bit of background about headaches generally…

So when a child presents with chronic headaches, the easy and common thing for parents to do is PANIC!! But you shouldn’t.  Brain tumours (let’s face it – that’s what you were thinking of weren’t you!?) that obstruct the flow of CSF (cerebrospinal fluid – or the fluid that sits around your brain and spinal cord to cushion it) are uncommon.

 

CAUSES OF HEADACHE

As you would totes be aware already, there are HEAPS of things that could potentially cause a headache:

  • Lack of sleep or sudden changes in sleep patterns
  • Skipping meals/being hungry
  • Dehydration
  • Stress
  • Too much screen time
  • Vision/sight problems
  • Certain medications (ie as a potential side effect)
  • Strong odours
  • Caffeine or caffeine withdrawal
  • For older girls – menstruation/hormone changes
  • Certain foods such as cheese, nuts, chocolate, ice cream, fatty or fried food, lunch meats, hot dogs, yoghurt, aspartame, MSG and then for adults, alcohol)

So given that headaches are so common in kids, most parents want to know what the RED FLAGS signs are – or, when do you need to be worried about a headache in your child? This is what I generally advise:

  1. Sudden onset or severe headache
  2. Increasing frequency or severity of headache
  3. Weakness in the arms or legs
  4. Headache that wakes a child from sleep
  5. Early morning headache associated with vomiting

Differential diagnosis “What are the things it could be?”

  • Chronic headache
  • Raised intracranial pressure
  • Benign intracranial hypertension
  • Migraine

I would have to write another blog about each of these conditions (let me know if you want to know about them – I can definitely blog about them at some later stage), but today I wanted to focus on MIGRAINES.

 

What might your doctor do to investigate and differentiate between these diagnoses?

First thing’s first – your doctor will take a thorough history from you about your child’s headaches.

They’ll ask things like (but not limited to):

  • How often do they occur?
  • Where is it most painful?
  • What time of day do they happen?
  • How long do they last? How quickly do they come on?
  • What makes it worse (aggravating factors)? Better (relieving factors)?
  • What other symptoms happen with the headache (eg vomiting, nausea, sensitivity to light/sound etc)?
  • How much sleep has been had/not had?
  • What kind of foods does the child usually eat on an average day?  Has there been any changes to this of late?
  • Is there anything stressful going on in the child’s environment recently?  For example – at home, moving house, death of a pet/family member, family conflict or parental separation or at school, bullying, change of usual teacher, friendship troubles etc.

They will then do a full examination, to see if they can find signs that might point towards a cause.  And then, they might order some investigations (eg blood tests, scans etc).

 

How do you know if it is a migraine?

Migraines are headaches that typically last anywhere between 4-72 hours that mostly occur with nausea and vomiting as well as an over-sensitivity to light or sound. The pain of a migraine headache is throbbing in nature and worsens with normal activity.

Sometimes migraines are associated with auras. Auras are warning symptoms that can occur before the migraine occurs. They are commonly reported as visual disturbances such as flashing lights, or changes in smell or perception.

Treatment of migraine

There are a couple of “arms” to migraine treatment – firstly, aimed at RELIEVING the headache itself and the symptoms that go with it and then PREVENTING it from happening. Usually, the earlier you get onto treatment, the more effective it is.

  1. Pain relief – things like paracetamol and ibuprofen (not aspirin in children under 12 years of age)
  2. Medication to treat nausea and vomiting
  3. Other specific migraine treatments that are not strictly “pain killers” but act to stop the migraine
  4. Preventative treatment – for children who suffer from frequent migraines

It is also important to AVOID TRIGGERS for your child’s headaches. Examples might be:

    • Getting glasses to reduce eye strain if they are needed
    • Getting adequate sleep
    • Avoiding/minimising stress
    • Ensuring adequate hydration

So I hope this post has helped you to teach you a little about dealing with your little one’s (or not-so-little-ones as the case may be) headaches and has been useful in helping you to understand what migraines are and how we manage them.

Will be back on Friday with an AWESOME (slightly cheating) laksa recipe…

Until next week, keep your suggestions and comments coming about ideas of competitions/prizes you might like to see and what recipes you’d like me to share.

As always, help me out by hitting “Share” on our FB page to reach as many people as we can.  Back Friday!!

 

xxDr Megs

 

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