There are so many different factors to consider when facing most of the common parenting issues.
The Nurse Judy approach is a combination of many years of medical experience, a desire to treat things as naturally as possible, a large dollop of common sense.
are very common in children and adolescents. In one study, 56% of boys
and 74% of girls between the ages of 12 and 17 reported having had a
headache within the past month. By age 15, 5% of all children and
adolescents have had migraines
and 15% have had tension headaches. Does your child tend to head off to
a quiet, dark room when there is too much going on? It could be
headaches are more common in children once they reach 9 or 10, some
children as young as 2-3 can articulate that their head hurts.
tension and cluster are called primary headaches because they are
neurological disorders not caused by an underlying medical condition.
There is no specific medical test for migraines, so diagnosis is usually
based on symptoms. Some of the classic symptoms include:
moderate to severe throbbing pain for 24-72 hours. Often this is on one
side of the head. (for those of you who enjoy knowing its etymology,
the word migraine comes from the Greek hemicranios, meaning half a
*nausea (they may or may not actually vomit)
*Sensitivity to light, noise or odor
15-20% of migraine sufferers experience visual disturbances about 15
minutes before the headache sets in. This is known as an aura.
drawing up at the bottom was drawn by one of my favorite people,
Rachel, when she was seven years old in an attempt to describe to her
doctor what an aura felt like.
don't always manifest as headaches. Some children also have abdominal
migraines. If your child is having frequent tummy aches and or
complaints about nausea, ask them if they have any visual symptoms.
have a big genetic component. There is often a strong family history. A
pediatric neurologist at UCSF says, "If you're having trouble finding
the family history, the paternal grandmother is often the link. Because
migraine genes are expressed more often in women than in men, dad might
pass on the genes to a child without knowing it."
There are also current studies to see if there is a connection between colic in a baby and migraines later on.
headaches result from another medical condition. These conditions can
range from a relatively harmless illness like sinusitis or the flu to
more serious conditions. Strep throat is often accompanied by a
headache. Simple cold/allergies are also common culprits. As miserable
as these headaches are, most parents and practitioners are less
concerned if there is an obvious cause like a virus.
Mystery headaches are somewhat more alarming. A red flag that you should contact a doctor about a headache would be one:
*that wakes the patient out of a deep sleep
*appears suddenly and is more severe and different from past headaches
*comes along with weakness or numbness or tingling
*makes it difficult to think or remember things
*follows a recent head injury (within 2 weeks)
that are associated with vomiting are also worth checking out (if the
entire family has the flu and is having similar symptoms, I am much less
there is a headache that is coming more than once a week or with any
kind of frequency that has you alarmed, it is worth getting checked
out. It is always worth starting with your primary doctor, but they may
want to do a referral to a headache specialist.
first step is for the neurologist to make sure that there isn't
something serious going on. Once the scary stuff has been ruled out,
they can be an essential part of your team helping to manage chronic
headaches moving forward. Headache specialists can help you identify the
triggers and explore many non-medical options. The folks at UCSF are on
the cutting edge of managing migraines. They are exploring things like
CoQ10 and Riboflavin rather than jumping to medication options (you need
to see them to discuss dosages.) In fact they are currently looking for
teens for a study seeing if melatonin might play an important role in
treatment. If you have a teen 12-17 who might be interested in taking
part in this check out this link:
patient will need to only go in for one visit. The rest of the data
will be gathered remotely. The participants will also be given a Fitbit
that they get to keep!
your child is having headaches, start keeping a journal to see if you
can identify the causes. The information that will be most useful to the
doctor is the frequency of the headaches and the tracking of the
treatment. What did you try? Did it help?
you think of other things to add to the journal look at this list of
some common triggers and see if any obvious one come to mind:
*Irregular sleep habits
*Not getting regular exercise
*Change in weather
*Foods with additives/nitrates
*Red wine (hey this info is for you grown ups too)
*Lighting changes e.g., bright fluorescent
daughter Lauren had very frequent headaches. Our cousin Avi lovingly
nagged and nagged her to see if a gluten free diet would help. He was
relentless. She finally gave in and agreed to give it a shot. To her
delight (and horror) it made a huge difference. She has been gluten free
(and headache free) for years. When she gets an accidental exposure to
gluten the headaches come roaring back. There is no ignoring the
get migraines when I drink a certain type of red wines. A glass of
Syrah will trigger a headache that knocks me flat. Every step ricochets
from my feet up through my head. Not fun. My learning curve on this was
almost comical. I couldn't imagine that I was really reacting to only
one type of wine and it took about 3 or 4 miserable experiences until I
stopped all experiments and simply don't drink any Syrah.
If you or your child are suffering from headaches be a sleuth!
was a recent study that showed in some cases regular exercise was just
as effective as medication in preventing and reducing headaches.
Some people have also had success with alternative therapies such as gentle chiropractics and or acupuncture.
I will close with some last words of wisdom from the wonderful Dr Gelfand
*Get regular sleep
*Stay well hydrated with non caffeinated beverages
*DON'T skip breakfast
*Get regular exercise.
* Chocolate is innocent!! It is no longer on the list of frequent triggers,
was very fortunate that Dr Amy Gelfand allowed me to "pick her brain"
so to speak about this important topic. Dr. Gelfand is a child
neurologist at the UCSF Headache Center. She specializes in diagnosing
and treating children who suffer from a variety of headache disorders,
as well as children with childhood periodic syndromes such as abdominal
migraine that are felt to be precursors to migraine headache later in