Your health questions answered

Q. When my daughter, who is 10, has an upset stomach, she can't keep fluids down for 48 hours or more. We were told that it might be migraine, but that it's difficult to diagnose in children. Is there anything we can do to help her recover faster? She once had four episodes in three months.

A. Although you describe your daughter's illness as an "upset stomach" and a "bug", it's much more likely that she is suffering from migraine. The sequence of headache, nausea and vomiting is typical of migraine. It is also important that your daughter suffers from carsickness. There is a well-known link between migraines and carsickness in children, and many adults who get migraines had carsickness as children. Once a migraine attack gets going, it's quite difficult to treat, especially in children. The most effective treatments for migraine, drugs called triptans, are not licensed for use in children. One, sumatriptan nasal spray, can be used once a child is 12. Until then, I suggest trying ibuprofen at the first sign of headache. This is often effective in children, but must be given early in an attack. When your daughter is 12, discuss with her GP or a neurologist whether she could try sumatriptan nasal spray. It can be remarkably effective.

Q. Can I get a copy of the drugs dictionary that my doctor consults for doses, side effects etc?

A. You probably mean the British National Formulary (BNF), published twice a year. It costs £23.95, but is cheaper on the net. You can also consult it for free at bnf.org, but have to register for full access.

Send questions or suggestions to A Question of Health, 'The Independent', 191 Marsh Wall, London E14 9RS; fax: 020-7005 2182; e-mail: health@independent.co.uk. Dr Kavalier is unable to respond personally to questions

© Dr Fred Kavalier

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