Migraine in Children: Early Signs and How to Help

When your child keeps getting car sick, complains of a sore tummy or suddenly stops playing and wants to lie down, it can be difficult to know what’s happening. Are they overtired? Coming down with something? Could it be migraine even if they haven’t mentioned a headache?

Recently, a parent shared their concerns in a migraine support group about their five-year-old son. What they had thought was travel sickness was beginning to look like it might be migraine. Episodes seemed to follow busy days, car journeys, missed meals and too little sleep. Their little boy would become unwell and vomit, and the pain medicines they had tried seemed to make him feel worse.

The parent sounded understandably worried and unsure. They were waiting for referrals and looking for answers: What might be happening? Was this something other families recognised? What could they do to help?

If you’ve been in a similar position, you may recognise that mixture of concern, confusion and wanting to make things better. And if you live with migraine yourself, seeing possible signs in your child can bring up another layer of feelings.

Let’s explore what you might notice and some ways to support your child. You don’t need to figure it all out at once.

Migraine in children doesn’t always look like adult migraine

Migraine is a neurological disease with a strong genetic component. Children may experience head pain across their forehead or on both sides, and their attacks can be shorter than an adult’s.

Younger children may show you how they feel before they can explain it. Leaving a favourite game, covering their ears or curling up somewhere dark may communicate that something feels uncomfortable.

Gentle, open-ended questions can help:

• “What are you noticing in your body?”

• “Can you show me where it feels different?”

• “What does it feel like?”

If they say their tummy feels “funny”, try: “Can you tell me more about funny?”

Give them time. “I don’t know” is an understandable answer. Drawing or pointing may be easier than describing, and you can return to the conversation when they feel better.

Could car sickness or tummy pain be an early clue?

Some childhood symptoms and conditions are associated with migraine and may appear before more recognisable migraine headaches. They’re useful clues to discuss with a clinician, rather than diagnoses to make at home.

Motion sickness: Migraine and motion sickness are associated. Frequent car sickness is worth mentioning, particularly alongside other recurring symptoms or a family history. But many children experience motion sickness without having migraine.

Recurring abdominal pain: Children can have tummy discomfort during a migraine attack. There is also a specific condition called abdominal migraine, where significant abdominal pain is the main feature, often accompanied by pallor, nausea, vomiting or loss of appetite, with periods of feeling well between episodes.

Under the International Classification of Headache Disorders criteria, headache is absent during abdominal migraine episodes. Tummy pain and head pain together may suggest migraine with accompanying abdominal symptoms, or another explanation.

Repeated vomiting: Cyclic vomiting syndrome involves recurring bouts of intense nausea and vomiting, with recovery between episodes. Episodes often follow a similar pattern for that child. Repeated vomiting deserves assessment even when it seems familiar.

Dizziness or vertigo: These are symptoms, not explanations of the underlying cause. Vertigo describes a sensation of movement, such as spinning or rocking. Some recurring childhood episodes are associated with migraine, but other causes are possible.

You might ask, “Can you tell me what you mean by dizzy?” Their own description can help the healthcare team decide what to explore.

An attack can begin before the headache

Understanding migraine phases may help you recognise patterns. Children won’t necessarily experience every phase, and phases can overlap.

• Prodrome: Early changes such as yawning, unusual tiredness, irritability or difficulty concentrating may begin before head pain.

• Aura: Some children experience temporary neurological symptoms, commonly visual changes. Many children never experience aura.

• Headache: Pain may occur alongside nausea, vomiting and sensitivity to light or sound.

• Postdrome: Even after pain eases, a child may remain tired or find it difficult to concentrate.

This is where triggers can get confusing. Tiredness may be a symptom of an attack already beginning, rather than its cause. Too little sleep can also make an attack more likely. Confusing, right?!

For my son, repeated yawning was an early clue, even when he wasn't tired. He also experienced severe cyclic vomiting syndrome. If we didn't catch an attack early, he could be vomiting for hours and hours (and hours!). Learning to recognise his particular warning signs became an important part of supporting him.

My daughter's experience looked different. She was extremely carsick from infancy and would often become quite unwell during early childhood without an obvious explanation. These episodes weren't necessarily all migraine-related, but they're the kinds of patterns worth sharing with your child's healthcare team.

Notice the sequence without trying to interpret every yawn. Ask the clinician which signs should prompt treatment under your child’s plan.

New visual, sensory or speech symptoms need assessment rather than being assumed to be aura. Sudden weakness, difficulty speaking or confusion warrants emergency care.

Trigger stacking: why the same activity feels different on different days

Perhaps your child manages a car journey comfortably one weekend, then becomes unwell on the same trip another day.

The migraine threshold model, sometimes called trigger stacking, offers one explanation.

A person with migraine has an underlying susceptibility to attacks, and their nervous system can be particularly sensitive to internal and environmental changes. Several factors—such as disrupted sleep, missed meals, bright light and a busy day—may add up.

Someone without migraine can feel hungry, tired or overwhelmed too. But they don’t necessarily have that same susceptibility to a migraine attack. Your child isn’t being difficult or failing to cope.

The threshold model is useful, rather than a precise formula. We can’t calculate exactly how many factors will lead to an attack, and some attacks occur without an obvious trigger.

The practical question becomes: “What might make this day more comfortable?”

Perhaps it’s breakfast before an outing, snacks for the journey or time to rest afterwards. The aim is to support ordinary childhood, without trying to control every experience.

SEEDS: everyday foundations for support

SEEDS stands for Sleep, Exercise, Eat, Diary and Stress management. It provides a framework to use alongside medical care. Choose one or two manageable changes rather than trying to overhaul family life.

Sleep: a migraine brain tends to appreciate routine

Similar bedtimes and waking times can help, including on weekends. Changes in routine may add to the trigger stack.

Enough sleep matters too. General recommendations are 10–13 hours for ages 3–5, including naps; 9–12 hours for ages 6–12; and 8–10 hours for teenagers.

Ask, “What helps you feel comfortable and ready for sleep?” A familiar story or quiet wind-down may help. Aim for consistency where possible, with flexibility when life happens.

Exercise: build comfortably and gradually

Regular movement can support prevention, but sudden or strenuous activity can bring on symptoms for some children.

Begin with activities your child enjoys and comfortably manages. If they’ve been less active or exercise seems to bring on attacks, start small and increase slowly.

If attacks repeatedly follow an activity, ease back and discuss the pattern with their clinician. A shorter session, gentler pace, different activity or adjustments to food, fluids and rest may help.

Ask, “How did your body feel while you were playing? How did it feel afterwards?”

Eat: steady nourishment before searching for food triggers

It’s easy to wonder what you should remove from your child’s plate. A more helpful starting point is often regular, balanced nourishment.

Migraine Canada’s paediatric guide specifically recommends maintaining blood-sugar levels, avoiding skipped meals and including protein and fibre-rich foods at each meal.

Research into individual food triggers in children is limited. Unless there’s a clear, recurring pattern, focus on balanced meals rather than cutting out foods “just in case”.

Offer meals and snacks suited to your child’s appetite and activities, and make water easy to access. There’s room for sweet foods too—balance and moderation don’t require banning sugar.

If dinner is early and your child is hungry before bed, an ordinary snack may help bridge the gap. But morning headaches have several possible causes. Don’t assume they mean low blood sugar; recurring morning headaches, especially with vomiting, need assessment.

Diary: keep it useful and manageable

A brief record can help you describe episodes and see whether treatment helps. Note symptoms, duration, medicines and effects on school or play. Include well days for perspective.

Apps such as the Canadian Migraine Tracker or Migraine Buddy may help; a paper calendar works too.

Ask, “What would you like me to write down about how that felt?” You don’t need to document every mouthful or sensation.

Stress management: support, downtime and mindfulness

School, friendships, family changes and excitement can all influence how a child feels. An attack doesn’t mean they’ve managed their emotions badly.

Downtime, enjoyable play and help with difficulties can support wellbeing. Relaxation, biofeedback and cognitive behavioural therapy can also form part of paediatric migraine care.

Mindfulness can be a gentle invitation to notice the present moment with kindness. Try listening for sounds together or noticing the support of a chair. Keep it short and optional: “Would you like to try something together and see how it feels?”

It’s a support for coping, not a task your child must perform to stop an attack.

Work towards a clear medical plan

Recurrent headaches, unexplained vomiting, abdominal episodes or dizziness deserve assessment. Bring your observations and your child’s words, even if the picture feels incomplete.

Ask for a written plan covering:

• When to begin treatment.

• Which medicine, formulation and dose to use.

• What to do if your child vomits or cannot tolerate it.

• What happens if treatment doesn’t help.

• When to seek urgent care.

Ibuprofen or acetaminophen may help some children. Certain migraine-specific medicines may be suitable depending on age and circumstances. Early treatment and the right route of administration matter.

If a medicine seems to make things worse, describe exactly what happens. One difficult experience doesn’t necessarily rule out other options. Don’t automatically repeat a dose after vomiting; ask a pharmacist or clinician.

Prevention is worth discussing when attacks are frequent, disabling or difficult to treat. Options can include behavioural therapies, medicines and sometimes supplements.

The first preventive treatment we tried for my son was a combination of magnesium, coenzyme Q10 and riboflavin (vitamin B2). For him, the difference was remarkable: his attacks reduced by about half. Given how difficult his episodes could be, that felt significant for our whole family.

These suppliments are included as preventive options in Migraine Canada’s Parent Education Guide, which is written for ages 6–17. Our experience won't be everyone's, and research in children remains limited. Ask your child's clinician or pharmacist about suitability, formulation and dosing, particularly for younger children.

What can help during an attack?

Follow the agreed treatment plan and offer simple comfort: softer lighting, less noise, rest, and small sips of fluid if tolerated.

Ask, “What would make this space more comfortable?” If open questions feel too difficult, offer a simple choice: “Would you like me nearby, or a little quiet?”

Some children like a cool cloth; others dislike touch. Let their preferences guide you.

Although some children feel better after vomiting, vomiting isn’t a treatment and should never be induced. Repeated vomiting can cause dehydration. Seek urgent advice if fluids won’t stay down, urine is much reduced or your child becomes increasingly lethargic. Difficulty waking is an emergency.

Allow recovery after the headache eases: “What do you feel ready to do now?”

Include school or childcare in the plan

Share your child’s familiar symptoms and agree on practical support, including water, snacks, rest and timely treatment.

Schools may require a doctor’s note, medication authorisation or both. Clarify who administers medicine and what happens when that person is unavailable.

From my own son’s experience, written neurologist instructions don’t always make access straightforward. Repeated questioning while unwell can be distressing and delay treatment.

Ask, “How can we make sure treatment is given promptly, following the clinician’s instructions, without our child repeatedly having to justify needing it?”

Your child might also help choose a discreet signal or trusted adult to approach.

When to seek urgent help

Seek emergency care for a sudden, severe headache; new weakness, difficulty speaking or sudden vision loss; seizure, marked confusion or difficulty waking; severe headache with fever and a stiff neck; or concerning symptoms after a significant head injury.

Prompt assessment is also needed for progressively worsening headaches, headaches waking your child or recurring on waking—particularly with vomiting—or pain brought on by coughing or straining. A migraine diagnosis doesn’t explain every new symptom.

You don’t have to become a perfect migraine detective

Your experience of migraine may help you recognise symptoms and advocate. Leave room for your child’s story to be their own, too.

Start with one useful step: book an appointment, note a pattern or ask what your child wants their teacher to understand.

Listening, believing them and building a workable plan together can make a meaningful difference.

A free guide to return to

For more detail, I’ve created Could It Be Migraine? A Parent’s Guide to Recognising Symptoms and Supporting Your Child. It includes questions to ask your child, practical home and school support, and prompts for healthcare appointments.

Download the free parent guide here

You’re also warmly invited to join my newsletter for reflections and practical support around migraine and wellbeing. No subscription is needed to access the guide.

This article provides general education, not medical advice. It does not replace individual assessment, diagnosis or treatment. Consult your child’s healthcare provider about symptoms and before starting or changing treatment, and never delay seeking care because of something you read here.

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