The National Migraine Centre state that, because migraine in children can involve subtly different symptoms to adult migraine, half of those affected never receive a diagnosis. With migraines in children and young people, stomach pains are more frequent. Studies suggest that around 60 per cent of children aged between seven and 15 experience headaches, but a diagnosis of migraine may be delayed because tummy pain, vomiting, travel sickness, limb pain and episodic dizziness can all confuse the picture. Children may experience migraine without a headache, which is less common in adults. 

During last month's Migraine Awareness Week, the Migraine Trust launched new research, which found that children often feel left out of their own healthcare and think that their care is poor. The findings also suggest that migraine can limit their ability to take part in education, social activities and other important parts of growing up. Ninety per cent of affected young people report that migraine made it harder to do their school work, whilst 76 per cent of education professionals surveyed felt that their school did not provide information, resources and processes to help these children. It can also be hard for children to understand and explain their pain, and there are fewer treatment options for them than there are for adults. The Migraine Trust report, 'Dismissed for too long: the impact of migraine on children and young people', therefore calls for clearer guidance and training for both health and education professionals on understanding and supporting young people impacted by migraine, and for more resources for the parents and carers of children living with migraine. They suggest that young people themselves need more information about their condition and how to take control of their own care, and that pathways and reviews of local migraine care in the NHS should account for the impact on children and young people. 

Key findings of the report include that schools don't have the knowledge or policies in place to help children with migraine. A survey of parents and carers with a child living with migraine found that 70 per cent were concerned about the impact of migraine on their child's education. Asked how often their child had to stay home from school because of their migraine, over half—51 per cent—said at least once a month. And 85 per cent of parents and carers had spoken to their child's school about their migraine, but only 17 per cent were completely satisfied with the support from the school in managing their migraine. 

A survey of children with migraine found that 90 per cent said that their migraine made it harder to do their school work. However, when asked if they think that their school has the information about migraine to help them manage it at school, 64 per cent said no. When asked if they had ever been taught about migraine at school, 90 per cent said that they hadn't. A survey of 64 education professionals found that three quarters, 76 per cent, felt that their school did not have the information, resources and processes to help children in school with migraine. For example, school policies were often not geared towards helping children manage their migraine triggers and avoid being unnecessarily sent home. This compares to other common long-term conditions, such as asthma, which schools often have plans in place for. 

Children don't feel that they're getting the healthcare they need. Common symptoms of migraine in children, such as abdominal pain, often look different from adult symptoms and can be missed, which can slow down a diagnosis and may result in a child's symptoms being missed. Of the children and young people responding to their survey, 33 per cent felt that the treatment for their migraine was poor, 30 per cent said it was fair, 23 per cent said it was good, and only 8 per cent said it was very good. None described it as 'excellent'. Seventy two per cent of the children with migraine have said that it made them feel worried. Children, particularly younger children, often need help in explaining their migraine and need to be included in discussions about their treatment. There needs to be better communication, where possible, between health services and schools and colleges. As a case study in the report states,

'I missed a lot of school last year because of my migraines and I couldn't do the things I enjoy such as football and dancing and that made me sad.'

The report's recommendations on how problems could be addressed include that local health boards,

'must include children and young people in reviews of local migraine needs and ensure they have services to meet those needs.' and that local health boards,

'must ensure there are strong links between migraine care and mental health services. Mental health must also be a component of the healthcare pathway for children with migraine'.

The Welsh Government should explore ways that it could support pharmacists' training on the management of migraine in both adults and children, and work with education partners to ensure that teaching staff have training and information on this issue, so that they can support children and young people effectively. As a 2021 academic review into children and migraine states,

'Migraines negatively influence the quality of life of affected children. Early diagnosis and management decisions are needed to reduce the burden and maximize the treatment outcome.'

The Migraine Trust would welcome working with the Welsh Government and health boards on making progress in these areas, and as our motion states, we call on the Welsh Government,

'to work with The Migraine Trust and representative bodies for schools, health services, and parents/carers to (a) strengthen guidance; (b) provide training on how to support and accommodate young people impacted by migraine; and (c) provide resources for the parents/carers of children living with migraine and for the young people themselves on how to take control of their own care.'

Migraine in children and young people is common, with a considerable impact upon quality of life, yet it remains undiagnosed and poorly treated. Less than 10 per cent of children with problematic headache will seek medical help for their problem. Migraine can have severe impacts on the life of a child, affecting family relationships, school life and social activities.

The pattern of migraines in teenagers starts to change. Migraine affects boys and girls equally until puberty, after which migraine is more common in girls. A late or missed diagnosis can result in poor management of their symptoms, anxiety about future attacks, poor school attendance, inappropriate or ineffective medication use, a loss of confidence and low self-esteem. Severe pain and vomiting that aren't treated effectively can mean that children often have to remain at home during their attacks and are unable to participate in normal daily activities. I move and commend this motion accordingly.