BALTIMORE -- Headaches are a real medical problem for children, though they are often underdiagnosed in both children and adults.

"Ask an adult with migraines when they started having headaches and they'll say childhood," said Jack Gladstein, director of the Pediatric Headache Clinic at the University of Maryland Hospital for Children. "There are two peaks when children experience headaches. The first is at age 6, when children enter first grade, and the second is at age 12, when they typically begin to enter puberty."

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Migraines can be debilitating, and children who suffer from these headaches often miss school and afterschool activities. They sometimes must spend an entire day in bed to help alleviate the pounding and piercing pain in their heads.

Gladstein explained why some children get migraines.

"The main reason children have migraines is due to their genes. One of their parents probably has headaches. If they have this predisposition, stress can exacerbate the problem," Gladstein said.

To prevent migraines in children, Gladstein said parents should try to eliminate triggers.

"Some children may need to avoid caffeine, eat breakfast and get enough sleep. If this does not work, there are effective medications available," Gladstein said.

The University of Maryland Hospital for Children is home to one of the first pediatric headache clinics in the United States. When it opened in 1989, it was only the second clinic in the United States exclusively dedicated to headache problems in children.

Gladstein sees patients ranging in age from 3 to 18. These children experience a range of headache pain, including migraines, chronic daily headaches and headache complications from other conditions like inflammatory bowel disease and abdominal pain.

When a child or adolescent comes to the clinic, they meet with Gladstein. He takes a thorough "headache history," performs a physical examination and assesses the best treatment options. Those options range from relaxation techniques to medications.