How can I treat migraines safely while pregnant?

Q: I'm 28 years old and have had migraine headaches since I was 20. Now that I'm six weeks pregnant, how can I safely treat them?

A: First, avoid dietary triggers such as alcohol, aspartame (an artificial sweetener), aged cheeses, and nitrates (used as preservatives in bacon, sausage and lunchmeats). Environmental triggers include strong odors such as perfumes and cleaning products.

A warm bath, a soothing compress over the eyes or a nap in a quiet, dark room may help prevent or minimize symptoms. If not, try acetaminophen (Tylenol). If that doesn't work and your migraine is incapacitating, your doctor may prescribe Fioricet, a non-narcotic sedative. While the prescription drug sumatriptan (Imitrex) is very effective in treating migraines, I cannot recommend its use, particularly in the first trimester--the most critical time for embryologic development--as not enough research has been done on its use during pregnancy.

There is some evidence that a sudden decrease in caffeine consumption may bring on migraines, so if you've abruptly stopped drinking coffee, your migraines may subside after your body adjusts to the change.