Key points to remember

• A migraine is a condition that can cause a headache with throbbing pain and other symptoms like feeling sick, vomiting, dizziness and sensitivity to light, sound and smell.
• Migraine headaches can be very painful, but they are not life-threatening.
• There is no cure for migraines – treatments aim to stop symptoms and prevent future headaches.
• Different things cause migraines in different people. Help your child avoid any known causes of migraines, if possible.
• Treating your child’s migraine headache early can stop it from getting worse.
• Doctors may recommend supplements or medicine if your child has frequent migraine attacks.
• Call an ambulance (000) immediately if your child gets a sudden and severe headache with symptoms like fainting, sudden confusion, tingling or weakness in the face and arms.

What is a migraine?

A migraine is a condition that can cause a headache with throbbing pain and other symptoms like feeling sick (nausea), vomiting, dizziness and sensitivity to light, sound and smell. The term ‘migraine’ refers to the condition, while ‘migraine attack’ refers to the symptoms during an episode.

Migraines tend to run in the family, and about half of children who get migraines will continue to have them when they are adults. Some children have migraine attacks now and then, while others have them more than once a week.

While they can be painful and disruptive, migraines are not life-threatening. Unfortunately, there is no cure for migraines, but treatments aim to stop symptoms and prevent future headaches.

What causes migraines in children and young people?

Many things can cause migraine attacks in children and young people, including:

• tiredness
• bright lights, including phone, tablet and television screens
• loud noises
• relaxing after physical or mental stress, such as after exercise or school tests
• muscle tightness over a long time
• smoking or breathing in second-hand tobacco smoke
• missing meals
• drinking alcohol
• caffeine in coffee, energy drinks and some medicines
• menstruation
• oral contraceptives (the Pill)
• hot weather.

For a few children, certain foods can trigger migraine attacks, such as:

• food with the amino acid ‘tyramine,’ including aged cheese, smoked fish, chicken livers, figs and some beans
• chocolate
• nuts or peanut butter
• fruit – especially avocado, banana and citrus fruits
• onion
• dairy products like milk, yoghurt and cheese
• baked goods
• meats with nitrates like bacon, hot dogs, salami and other cured meats
• foods containing monosodium glutamate (MSG)
• processed, fermented, pickled, or marinated food.

Signs and symptoms of migraines in children

Toddlers and young children may have a migraine attack with nausea or vomiting, and they may go pale quickly.

Older children and teenagers have more adult-like migraines with a headache as their main symptom.

Migraine attacks usually include a headache, which often lasts 6 to 12 hours but can last from 2 to 72 hours. Regardless of your child's age, migraine symptoms usually go away with sleep.

A migraine headache may be:

• severe
• dull or throbbing
• all over the head, or worse on the sides of the head – particularly in young children
• on one side of the head – particularly in older children.

Your child may also:

• lose their appetite, feel sick or vomit
• feel tired
• have stomach pain.

There are different types of migraine based on symptoms. Some children have migraine attacks with rare features like dizziness or fainting (basilar migraine), tingling or weakness around the face and arms (hemiplegic migraine), or sudden confusion and disorientation (acute confusional migraine).

It is important to note that these symptoms can also be signs of a more serious condition such as stroke. Call an ambulance (000) immediately if your child has a headache and develops any of these symptoms.

Migraine warning signs

Some children get warning signs known as a ‘prodrome’ hours or days before a migraine attack. These signs can make them yawn and feel sick, tired, and sensitive to light and/or sound.

Visual or sensory changes just before a migraine attack are called a ‘migraine aura.’ Examples of these changes include seeing spots or zig-zag lines, tingling lips or losing some vision. This experience can be distressing to children and lasts for a few minutes, usually stopping when the headache begins.

After the headache has gone away, some children get ‘postdrome’ symptoms like fatigue, difficulty concentrating and neck stiffness.

When to see a doctor

If your child gets many headaches or their headaches are very painful, it is best to speak with a doctor.

There are no specific tests to confirm migraines. Doctors can usually diagnose after examining your child and hearing about their headache symptoms and history. In a very small number of children, doctors may do tests to rule out other causes of headaches, but most children do not need them.

You should also take your child to see their doctor if:

• you are worried about their headaches, or they are getting worse
• their headache lasts for more than two days
• the headaches begin to disrupt their school, home or social life
• they are getting a headache more than once a week
• they are under five years of age and experiencing headaches
• the headaches wake them from sleep or get worse in the morning.

Call an ambulance (000) or take your child to the nearest doctor or hospital emergency department if your child has a headache as well as:

• neck stiffness, vomiting or high fevers
• increasing confusion, behaviour change or sudden weakness, numbness, difficulty speaking or loss of balance
• a head injury.

How to treat migraines

There are multiple ways to help your child while they are having a migraine attack:

• Comfort them if they are distressed.
• Give pain medicine as the headache starts before it gets more severe. Your doctor may prescribe your child specific medications for a migraine or recommend you give them pain relievers such as paracetamol or ibuprofen.
• If they can tolerate it, offer them water or a small amount of food.
• Encourage them to sleep in a cool, dark, quiet room – sleep is the best way to help migraine headaches.
• Use cold packs to help with their headaches and warm packs for neck tension.
• If a doctor prescribes medicine to reduce nausea or vomiting, give this medicine as required.

If your child has regular migraine attacks, it is a good idea to plan with their doctor about how to manage symptoms, including when to give medicine. The doctor may recommend supplements, or they may prescribe medicine to try and reduce how often your child gets migraine headaches.

How to prevent migraines

To help your child prevent future migraine attacks, you can try the following lifestyle measures:

• Avoid any known causes of migraine attacks if possible.
• Encourage them to get 15 to 20 minutes of cardio exercise a day; if tolerated, aim to increase activity to 30 to 60 minutes a day.
• Set a regular sleep, activity and school routine.
• Make sure they eat and drink water regularly throughout the day.
• Try to reduce their stress with relaxation exercises like mindfulness, yoga and meditation. If your child has mental health challenges, it is a good idea to speak with a psychologist, as conditions like anxiety and depression can make headaches worse.
• Limit time on video games and devices.
• Pay attention to when they need rest and when they can do normal daily activities.
• Talk to their teachers if they need help while at school.
• Organise regular eye tests; vision problems can cause headaches.

Headache diary

When your child first starts getting migraine headaches, a headache diary can help work out the causes. The headache diary should include:

• when the headache started and what seemed to trigger it
• how long it lasted
• which part of the head hurt
• how bad it was on a scale of 1 (mild) to 10 (severe)
• if anything helped to soothe the headache
• what time they went to bed the night before
• if there were any other symptoms
• if they missed school because of the headache.

Some people find it easiest to use a headache diary app – several good options are free to download.

For more information

• Speak to your child’s doctor.
• Kids Health Info fact sheet: Headaches
• Kids Health Info fact sheet: Pain relief for children
• Kids Health Info fact sheet: Head injury – general advice
• Smiling Mind App: Free meditation app developed by psychologists and educators
• Headspace App: Guided meditation and mindfulness

Developed by The Royal Children’s Hospital Neurology department. We acknowledge the input of RCH consumers and carers.

Reviewed January 2025

Please always seek the most recent advice from a registered and practising clinician.