Headaches and Migraine in Pregnancy and Breastfeeding
What to expect from migraine when you are planning a pregnancy, while you are pregnant, and after your baby arrives, and which headaches need prompt care.
Planning a pregnancy
Migraine is most common in women during the years they may have children, so family planning comes up often. Migraine does not lower your chance of getting pregnant. Even so, about 1 in 5 women say they have avoided pregnancy because of migraine. Headache experts say there is no evidence that having children is harmful for women with migraine overall.
The best time to plan is well before you start trying. Some medicines can affect a developing baby very early, often before you know you are pregnant. Bring up both your daily preventive medicines and the ones you take during an attack. Some newer preventives, such as CGRP antibodies, stay in the body for months, which is one more reason to plan early. If you take migraine medicine and learn you are pregnant, contact your doctor right away.
Your obstetrician and your headache doctor can work together on a plan. The FDA’s guide to medicines in pregnancy and the LactMed database (a government resource on medicines and breast milk) are helpful references.
How migraine changes during pregnancy
Estrogen rises during pregnancy and stays high. Steady, higher estrogen tends to protect against migraine, so most women notice fewer and milder attacks, often most in the last six months. People who have migraine with aura may not improve as much. Some people keep having attacks, and everyone’s experience is different.
Untreated migraine is not harmless during pregnancy. It can lead to dehydration, poor eating and more stress, which can affect both you and your baby. Safe treatment is available.
Treatment during pregnancy
Headache experts put non-medicine approaches first during pregnancy:
- Regular sleep, plenty of fluids and small, frequent meals
- Avoiding known triggers and lowering stress
- Meditation, deep breathing, biofeedback (learning to control body responses such as muscle tension) and prenatal yoga
- Acupuncture done properly by a trained provider
- Cold packs on the head and neck
When medicine is needed, your doctor weighs benefits and risks for each one. The National Headache Foundation describes acetaminophen as a first choice for mild to moderate pain. Some triptans and some anti-nausea medicines have been studied and may be used when the benefit outweighs the risk. NSAIDs such as ibuprofen are generally avoided in the first and third trimesters. Some blood pressure medicines are used for prevention. Never start or stop a medicine without talking to your doctor.
Nerve blocks with a local anesthetic (numbing medicine) are described by the American Headache Society as a safe option that can break a headache cycle or give short-term prevention during pregnancy.
After delivery
Estrogen and progesterone fall sharply after birth. This drop can bring migraine back, or start it for the first time. Postpartum headache means new or increased headaches in the first six weeks or so after delivery.
- About 1 in 4 women have a migraine attack within two weeks of giving birth, and nearly half within the first month.
- About 5% of women who never had migraine have their first attack after delivery.
- Lost sleep, stress and missed meals, all common with a newborn, can add to attacks.
It helps to talk with your doctor about this before your baby is born, and to plan with family for help with childcare and night feedings during an attack. Migraine treatments that were paused in pregnancy may become options again after delivery.
Breastfeeding
Breastfeeding may help with migraine. It can keep estrogen low and steady, and while your periods stay away, attacks may be fewer. Attacks often return when your cycle comes back. Having migraine should not by itself decide whether you breastfeed.
Much less of a medicine reaches breast milk than reaches your blood, but newborns and premature babies can react differently. The American Migraine Foundation lists these as generally considered compatible with breastfeeding, to be confirmed with your doctor:
- Acetaminophen and ibuprofen
- Some triptans, some anti-nausea medicines and some beta-blockers
- Neuromodulation devices (devices that use mild electrical stimulation)
It lists these as usually avoided while breastfeeding: aspirin, ergotamine, ditans, gepants, CGRP antibodies, opioids and butalbital. Botox is not usually recommended because research is limited.
Practical tips include staying well hydrated, asking a partner to take some night feedings, and pumping at the end of a feeding to build supply.
How Dr. Park can help
Dr. Hannah Park is a dual board-certified, fellowship-trained headache medicine neurologist with over 10 years of specialized experience, and she has lived with migraine herself. She treats headaches during pregnancy planning, pregnancy and breastfeeding.
Every patient starts with a 90-minute new patient consultation with Dr. Park ($520): a full history review, a neurological exam, a diagnosis and a personalized treatment plan. The practice focuses on targeted injection treatments rather than a cycle of prescription medications, and does not prescribe opioids. In-office options include the occipital nerve block ($395) and other peripheral nerve injections. See services and fees.
Appointments are Monday to Friday, 9 a.m. to 6 p.m., usually within days. The practice is direct pay with no referral needed.
When to get emergency care
Call 911 or go to the nearest emergency room if you are pregnant or recently gave birth and you have a sudden, severe headache (especially one that peaks within about a minute), a headache with high blood pressure, or a headache with vision changes, weakness, numbness, confusion, trouble speaking or a seizure. High blood pressure with headache can be a sign of preeclampsia or eclampsia, serious blood pressure problems of pregnancy.
Contact your doctor promptly about any new headache during or after pregnancy, a headache that is different from your usual migraine, or ongoing vomiting and dehydration.
Related
Sources
This page summarizes patient information from these organizations, in our own words. It is general education, not medical advice.
- Migraine and Pregnancy, American Migraine Foundation
- Migraine and Pregnancy: Q&A With Dr. Matthew Robbins, American Headache Society
- Managing Migraine During Pregnancy, National Headache Foundation
- New Moms with Migraine: Understanding Postpartum Headache, American Migraine Foundation
- What to Know About Migraine While Breastfeeding, American Migraine Foundation
- Hormonal and Menstrual Migraine, American Migraine Foundation
- Thunderclap Headaches, American Migraine Foundation
- Red Flags in Headache: What if it isn’t Migraine?, American Headache Society
Last updated October 27, 2026.
Plan your migraine care around your pregnancy
Every patient starts with a 90-minute new patient visit with Dr. Park.