Children of any age can be affected by migraine; however two peaks have been noted when migraines begin - one at age 5 and the second at age 10-12. Migraine occurs equally in both sexes up to the age of 12 years, after which it becomes more common in girls (who often experience their first attack around puberty).
As a school nurse there are some practical approaches you can take to help the child deal with his/her condition:
- Discuss any concerns that you may have with the parent/carer of a child you suspect of having migraine.
- Be understanding towards the child during an attack; who in addition to feeling ill, may also be feeling very embarrassed. A full-blown attack may be prevented if a child feels able to ask for help as soon as they begin to feel unwell.
- Be aware that many children will vomit in the early stages of an attack; this eases the attack especially if they are also able to rest quietly for approximately one hour.
- Work with the parent/carer and child to recognise any possible triggers if attacks frequently occur at school. Could anxiety due to work expectations or bullying be a factor? Would allowing the child to have a snack or drink during lessons help prevent an attack? Is the white board causing problems? Would opening a window help?
- Work with the child and parent/carer to discuss the most appropriate way to help if the child experiences an attack whilst in your care.
- A migraine attack in children may last for as little as an hour, but can be as long as three days. Generally they last for between two and four hours (shorter than the average adult attack).
A child can feel 'washed out' for a couple of days after an attack but the symptoms will resolve completely between attacks. The frequency of attacks varies, but the average is one per month. However some children may experience an attack each week, others may go for months before an attack reoccurs.
School nurses are in an ideal position to create awareness among school staff at all levels about the impact of migraine. If you would be interested in helping to raise awareness please get in touch.