Lifestyle Measures that Can Help Control Pediatric Headaches
Free time. All too often our teenage patients are involved in multiple afterschool activities. The child needs to understand the need for “down time “and should pick a limited number of activities that are really meaningful to her/him.
Eat regularly. I explain to my patients that the brain runs on energy. Skipping meals means depriving the brain of energy; and in simplistic terms “the battery runs dry.” Three meals a day are essential. Breakfast and lunch do not need to be large, but the child needs to eat something.
Maintain a consistent sleep cycle. Lack of sleep is often a migraine trigger. A relatively consistent sleep pattern helps assure that the patient is getting adequate restorative sleep.
Hydration. Many patients find that they have more headache issues when they are not adequately hydrated. Drinking plenty of fluids is essential for headache prevention. Some patients need to be allowed to keep a water bottle at their desk to achieve good hydration while in school.
Avoid migraine triggers. I am often asked if there are foods to be avoided. The list of foods suspected a causing migraine is huge, but avoidance diets are seldom helpful. If specific foods are noted to be headache triggers, then of course, they should be avoided. If bright sunlight causes a migraine, then our patients need to be educated to wear a shading hat and sunglasses. But be cautious. It is easy to allow our patients to become sedentary because “this, that, and the other thing” cause headache (see below).
Exercise. Regular exercise helps prevent migraines. The patient may need to start slowly and increase the exercise over time. Twenty to thirty minutes of aerobic exercise 5 times a week has been shown to decrease headache frequency.1
Address stressors. Stress is a major contributing factor for our patients. Are they afraid to go to school because they get bullied? Is family discord a factor? Are there too many expectations being placed on the patient? All these issues must be addressed.
The family. Family coping mechanisms are one aspect of the headache problem that is often ignored . . . what strategies (both helpful and detrimental) are being employed at home? Often, careful questioning will reveal that the family is inadvertently contributing to the headache problem by taking over care of the patient and not letting the patient be responsible for his own well being. I recently watched a mother ask her son how his head felt 4 times in 15 minutes. In attempts to help their child be comfortable, family members may accept lifestyles that are roadblocks to care. “The exercise hurts her head.” “He can’t sleep so he stays up all night on the computer to take his mind off the headache.” Such attitudes must be dealt with.
Mental health professionals. They are allies that often need to be brought into the care team. They can offer valuable help in uncovering behaviors that the patient and/or the family must changed before the headache problem can be successfully addressed.
Complementary approaches to care. Other approaches can often be exceedingly helpful. Acupuncture, relaxation therapy, and behavioral modification programs, biofeedback, and self-hypnosis can all help the headache patient who approaches these therapies with a positive attitude.
1. Sandor PS, Afra J. Nonpharmacologic treatment of migraine. Curr Pain Headache Rep. 2005;9:202-205.