How to Recognize and Treat Migraines in Children

Migraines can be difficult to deal with at any age, but migraines in children can be even more difficult to spot and treat. Migraines cause severe headaches and other symptoms like nausea, vomiting, sensitivity to noises or movements, and a visual experience like flickering lights.  Childhood migraines are common, up to 10% of children and 28% of teenagers experience migraines. 

Spotting a migraine in children can be difficult. For one thing, it can be hard for kids to describe what they’re feeling. Young children who don’t talk well yet may appear fussy or irritable. Older children might be able to say they have a headache but still not know how to explain things like sensitivity to light or sound, head pounding, or dizziness.

To help bridge that communication gap, here’s more information on how to recognize migraines in children and a few things you can do to keep childhood migraines under control.

What causes migraines in children?

Experts don’t know exactly what causes migraines. But there’s evidence that migraines in children are linked to:

• Genetics: Scientists think genetics play a big part in who gets migraines. If one parent has migraines, children have a 50% chance of getting migraines, too. If both parents have migraines, that number increases to 75%.  

• Sex hormones: Exposure to sex hormones may affect whether children develop migraines. Before puberty, males and females experience migraines at about the same rate. After puberty, females are more likely to experience migraines, and this trend continues throughout adulthood. Experts think fluctuations in estrogen and progesterone levels are responsible for this difference.

• Trigger exposure: Many things can trigger migraines in kids, including stress, sleep changes, missed meals, and dehydration. Weather changes — especially storms that cause barometric pressure changes — can also trigger migraines in children. Some children also have food triggers 

Migraines aren’t the same as regular headaches. And migraines in children aren’t a one-time event either. Most children who experience a migraine will have episodes on and off throughout childhood. 

What do migraine symptoms in kids look like?

It can be hard to know when a child has a migraine. They might not be able to explain what they’re feeling. Younger children may act uncomfortable or irritable. If migraines run in your family, you can be on the lookout for signs of migraines in kids.

Look for typical symptoms of migraine in children

Migraine symptoms in kids are not always the same as those in adults. Experts classify headaches as childhood migraines when kids have at least 5 headaches in 1 year along with 2 of these 4 headache features:

• Pain on one side of the head

• A throbbing feeling (like the beating of a drum)

• A headache that gets worse with activity or that limits activity

• Nausea, vomiting, or worsening headache with light or sound exposure 

Here are some other key differences in childhood migraines: 

• The pain often occurs on both sides of the head instead of just one side (which is common in adults).

• Children can have an upset stomach or vomiting without a headache.

• They can look pale.

• They may feel lightheaded or dizzy.

• Very young children may be unsteady or keep their head tilted.

Like adults, some children with migraines experience an aura. These are visual or physical signs — like flashing lights or tingling sensations — that signal that a migraine is about to start. 

Look for a pattern that brings on migraines in your child

Kids with migraines will have symptoms again and again. But they will seem normal between these episodes. While migraines can be unpredictable, sometimes migraines in kids follow a pattern. 

Keep a diary of when your child develops migraines. Write down the date and time symptoms start and end. Keep note of which migraine symptoms your child develops and how they describe the headache. 

If your child can tell you, ask if they had any exposure to known migraine triggers. It’s also important to note if your child was sick or active when the migraine came on. 

A migraine diary can help you and your child figure out when a migraine is coming on. It will also help you figure out which triggers to avoid. If some triggers are unavoidable, you can also be prepared with migraine medication if your child develops migraine symptoms. 

Help kids describe their symptoms

Children may not be able to describe their symptoms well. You can let them use their own words or make kid-friendly suggestions:

• To describe a throbbing or pulsatile headache: “Does it feel like your head is beating like a drum?” 

• To describe a sharp pain: “Do you feel like something is poking you?” 

Look for symptoms that can be migraine clues

Kids are not little adults. They may have very different symptoms when experiencing childhood migraines. These conditions are called “migraine variants” and include:

• Cyclic vomiting: In some children, migraines begin with cyclic vomiting. In this condition, children experience episodes of intense vomiting. A child might vomit five or six times per hour, refuse to eat, and look pale during an episode. After several hours, the symptoms end and the child is fine — with no other known cause. In cyclic vomiting, the symptoms repeat every few weeks or so. It’s not always clear if children with cyclic vomiting also have headaches during their episodes. 

• Abdominal migraine: These children have stomach pain and vomiting without a headache. Unlike cyclic vomiting, these episodes don’t happen at regular intervals. And the vomiting doesn’t tend to be as intense.

• Colic: There may be a connection between infantile colic and migraines. Infantile colic is a condition of young infants in which a baby has unexplainable bouts of crying that last for hours. Some evidence shows that adults with migraines were more likely to have experienced colic as infants.

• Motion sickness: Similarly, research suggests that children who develop motion sickness (like getting car sick or sea sick) are more likely to develop migraines than those who don’t.

How do you treat migraines in children at home?

Migraines do go away on their own. But your child may be miserable until the migraine goes away. Fortunately, there are things you can do to make your child more comfortable during a migraine. Acting quickly can help shorten the migraine and make it less severe.

Encourage fluids

Dehydration can trigger a migraine. One study showed that people who hydrate more on a daily basis get migraines less often. And when they do get migraines, they tend to be less severe.  

So give your child lots of fluids when a migraine headache starts. If your child has vomiting with their migraine, they may need medication to fight off the nausea so they’re able to drink. 

Encourage sleep 

Sleep helps with migraine for people of all ages. So don’t be surprised if your child wants to go to bed when they get a migraine. Kids with migraines may need extra sleep as they start to recover.

Find a quiet space

Loud sounds, strong smells, and bright lights may all seem more intense when a child gets a migraine. Move your child to a quiet, dark space when they begin to have a migraine headache.

Try biofeedback

Research shows that relaxation techniques, like deep-breathing exercises, can reduce migraine symptoms. And some researchers have been working on developing smartphone apps that help kids practice these relaxation techniques. 

Are there medications to treat migraines in children?

There are both over-the-counter (OTC) and prescription medications that children can take to make a migraine go away. Evidence shows that migraines are easiest to break if they’re treated quickly. Medication should be taken as soon as the migraine starts — within 1 hour for best results.

Over-the-counter treatments

OTC treatments can help relieve a migraine. But your child shouldn’t use them more than 2 or 3 times in 1 week. Using them too often can lead to rebound headaches. If your child needs to take a medication for migraine more often than that, talk to their provider about starting a preventive medication instead. 

Some OTC options for migraines in children include:

• Ibuprofen (Motrin or Advil): This is the first-choice treatment for migraines in children. It’s safe for children 6 months and older. To treat a migraine, the dose can be repeated after 6 hours, if needed.

• Acetaminophen (Tylenol): This can also help treat a migraine. It has the advantage of not bothering a sensitive stomach, so it can be especially helpful in a child who has migraines with vomiting.

• Naproxen (Aleve): This is effective for older children and teens with migraine, and its effects can last up to 12 hours. It’s very similar to ibuprofen, so these two medications should never be taken together. 

Prescription medications

Triptan medications work to stop a migraine that has already started. They can be combined with naproxen or ibuprofen for a stronger effect if needed. 

Most triptans come in different strengths and forms, including tablets, dissolvable tablets (melts), or nasal sprays. Melts and nasal sprays make it easier to give medicines for children who can’t swallow a pill. And they can help if a child has nausea or vomiting as part of their migraine. 

Triptans that are approved to treat migraines in kids include: 

• Almotriptan

• Rizatriptan 

• Sumatriptan

• Zolmitriptan 

If your child needs to take triptan medication more than nine times per month, talk to their provider about taking a medication to prevent migraines before they start.

Can you prevent migraines in children?

There are things you can do to help lower the chances of your child experiencing a migraine. These things won’t stop migraines in children, but they may help lower how often migraines occur.

Keep a regular sleep/wake schedule

Waking up and going to bed at the same time every day may prevent migraines. Staying up late or sleeping in can throw off a child’s sleep cycle and trigger a migraine. Children with migraines should stick to a regular bedtime and wake-up time every day — even on weekends and holidays.

Encourage activity

Keeping your child active is good for their health and teaches them healthy skills for life. But if your child experiences migraines, regular activity can also lower their risk of having a migraine episode.  

Keep regular mealtimes

Skipped meals and dehydration can trigger a migraine in children. Make sure your child sticks to scheduled meal times whenever possible, especially if skipping a meal is a known trigger for their migraines.

Avoid triggers 

Some foods can trigger migraines in kids. Examples include aged cheese, dried fruits, cured meats, and chocolate. Exposure to caffeine and tobacco smoke can also trigger migraines. Try to make sure your child avoids these triggers whenever possible.

Are there medications that prevent migraines in children?

There are different OTC and prescription medications to prevent migraines. These are usually taken every day to be most effective. Although research shows that these medications can reduce how often migraines occur, none of them can prevent migraines altogether.

Over-the-counter preventives

These choices are available without a prescription. Before your child starts taking a daily medication or supplement, speak with their provider to make sure it’s safe: 

• Magnesium: A daily magnesium supplement has been shown to be useful for preventing migraines.

• Vitamin supplementation: Folic acid along with vitamins B6 and B12, can reduce the frequency of migraines in some people. Vitamin B2 (riboflavin) is also sometimes effective in adults and might be helpful in children.

Prescription preventives

None of these medications work perfectly to prevent migraines, and all of them can come with side effects. Researchers have found that these medications work only slightly better than a placebo (or sugar pill). Talk to your child’s provider to get more information about these options: 

• Amitriptyline 

• Topiramate

• Propranolol 

• Cyproheptadine

When should you be concerned about your child’s migraine?

Bad headaches can be scary for parents. So when should migraines in children be a cause for concern? 

See their healthcare provider right away if your child has migraines and you notice any of these symptoms:

• Headaches that awaken your child from sleep at night or happen first thing in the morning

• Headaches that are rapidly getting more frequent or severe

• Headache with a fever and a stiff neck

• Headaches that happen with a bowel movement or exercise

• A sudden, very severe headache — especially with changes in vision, confusion, or vomiting

Why trust our experts?

Written by:

Brian Clista, MD

Dr. Clista is a board-certified pediatrician who works in private practice in Pittsburgh, Pennsylvania. He previously served as a National Health Service Corporation Scholar in the inner city of Pittsburgh for 11 years.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Our editorial standards

Meet our experts