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A Mom’s Guide to Headaches

The worst headaches I've ever had came on during two of the happiest times in my life: the first trimesters of each of my pregnancies. They were doozies, the throbbing pain behind my eyes so relentless and severe that I'd have to lie in my bed with the lights off, in total silence, for hours on end. In both cases, the headaches disappeared by my second trimester. Looking back, I'm pretty sure that they were migraines brought on by my skyrocketing estrogen levels.

I still get headaches, though they're milder. And headaches are the story for many other moms too. "Mothers of young children are especially prone to headaches because they tend to be sleep-deprived, multitasking, and stressed," says Jan Lewis Brandes, M.D., clinical instructor of neurology at Vanderbilt University Medical School, in Nashville. Dr. Brandes, a mom of two, suffers from migraines herself.

Most often, moms suffer from tension headaches or migraines; others get cluster headaches. Whichever kind you get, here's how to keep aches at bay.

Taking It Easy Helps

1. Relax your neck. It's only one stop away from your head, so when it's stiff or strained, pain may follow. Keeping your neck loose through regular exercise (including stretching or yoga) and being aware of your posture can help. "For moms who nurse or carry a baby around all day, neck strain is common," says Dr. Diamond. "It can lead to a tension headache. And as many as seventy-five percent of migraine sufferers also get neck pain before a headache."

To stave off tightness, cradle your baby in your arms, near your waist -- no higher -- so that you don't scrunch up your shoulders (and your neck). But when it happens anyway, try this move:

Slowly tilt your head back so that you're looking at the ceiling, then all the way down until your chin touches your chest. Bring your head to the center, turn it all the way to the right (touching your chin to your shoulder), and then turn it all the way to the left. To get the full stretch, hold each position for a few seconds.

2. Have a snack. Waiting too long to eat can lead to a drop in blood-sugar levels, which can dilate blood vessels and trigger a headache. "During the first trimester of my pregnancy, if I went too long without eating anything, I would get terrible headaches," says Beth Irving of Putnam Valley, New York. "But if I munched on pretzels, fruit, or crackers at the very first hint of hunger, I could often stave them off."

3. Get a good night's sleep. It's the rare mom who's able to snooze straight till morning. Irregular sleep patterns are a headache culprit, though scientists aren't sure why. So as often as possible, go to sleep and wake up at the same time every day, even on weekends. After a really bad night, try to take a 20- to 30-minute nap -- it might drive the headache away. That night, go to bed at your regular time.

4. Move it. If a tension headache's coming on, exercise (aerobic or stretching), a proven stress tamer, may stop it in its tracks. Such regular activity as swimming, running, or walking is just as effective for preventing these headaches -- it improves sleep quality, reduces stress, and promotes the release of endorphins, your body's natural painkillers. If you're prone to migraines or cluster headaches, however, going to the gym or running around the playground with your kids may exacerbate a looming headache. It's better just to lie still.

5. Take a coffee break. Many headaches, especially the tension variety, are caused by overdilated blood vessels -- and caffeine constricts blood vessels. That's why some headache remedies contain caffeine. A cup of coffee or tea or a 12-ounce caffeinated soda a day can help soothe an aching head. But you shouldn't have more than that, says Merle Diamond, M.D., associate director of the Diamond Headache Clinic, in Chicago. The 50 milligrams of caffeine in these beverages are just enough to do the trick, but drink more on a daily basis and you could set yourself up for caffeine withdrawal if you don't continue to get enough. You know the feeling if you've ever had a splitting headache on a morning when you missed your daily fill. If you can't have just one serving of your favorite coffee, tea, or soda, switch to the caffeine-free version after your first cup.

Relaxing and Knowledge Is Key

6. Chill (briefly). There's no question that stress is linked to headaches, but finding ways to de-stress when it seems you're doing everything at once is easier said than done. Try to take at least 15 minutes a day to be alone in a quiet place where you can focus on breathing deeply and relaxing, say experts.

I call my own stress reducer "coffee time." For the past six years, I've made myself a cup of decaf and sat and read the paper for 15 minutes after dinner. When my kids, now 13 and 7, interrupt, I simply point to the cup and say, "Coffee time!" They know to come back later. When the cup is empty, I'm refreshed and ready to help them with their homework or reading.

For other moms, de-stressing may simply mean putting your baby in a play yard and going into another room for a few minutes, or resting while she naps.

7. Understand your hormones. When they're in flux -- you have your period, you're ovulating, or you're newly pregnant -- it can set off headaches, says Nanette Santoro, M.D., director of reproductive endocrinology at the Albert Einstein College of Medicine and Montefiore Medical Center, in Bronx, New York. There's little you can do to control your hormones, though some migraine sufferers are helped by birth-control pills. So be aware of your cycle and try to avoid other triggers -- skipping meals or missing sleep, for example -- during critical times of the month.

8. Use painkillers wisely. They can be lifesavers, but if you find you need to take any nonprescription medicine three or more times a week, see a doctor. You may be having "rebound headaches," which affect 3 million to 4 million Americans. Although researchers don't fully understand how these headaches come about, it's believed they begin with other health issues. "You may take ibuprofen for several days to relieve cramps or the pain of a sports injury, for example. When you stop, you start having headaches; to counter them, you take more ibuprofen until gradually a headache problem develops where there wasn't one before," says Dr. Brandes. The cure? See your doctor, who may have you stop the medication cold turkey and prescribe something else (such as one of the triptans) for a few days or suggest tapering off your intake of the OTC drug.

9. Consider natural solutions. Some nonmedical approaches to prevention and treatment have gained wide acceptance with both headache sufferers (especially pregnant and nursing moms, who can't take certain medications, like ergot alkaloids) and many doctors. The top choices include:

  • Meditation or progressive muscle relaxation. Try a class if there's one near you.
  • Cognitive behavioral therapy, which helps you learn to control the anxiety that can trigger headaches.
  • Biofeedback, which lets you monitor and control heart rate and blood pressure until you're relaxed.

10. Keep a headache diary. If you get frequent headaches of any kind, the best first step is to keep a diary for two to three months, to pinpoint your triggers.

After a headache, write down what you did before the pain developed (including what you ate and drank, how you treated it, and how successful that treatment was). With your doctor, you can use the diary to determine when and why you get your headaches -- and to launch a plan for getting rid of them.

To make it easier, we've created a headache diary you can download. See the sidebar below.

When you're a busy mom, it's easy to put off dealing with your headaches and instead just bear the pain. But, says Dr. Brandes, "mothers shouldn't settle for that. Eventually, you will find something that helps prevent or alleviate your headaches and lets you fully experience all of the joys of being a mom."

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