Headaches in children: Common, but sometimes serious

Children of all ages experience headaches, but the causes aren't all the same. Here's how to help your child.

Headaches occur in more than 90 percent of school-age children. In most cases, the causes are simple. Your first-grader may have banged his or her head, or your teen may be worried about a big test. Maybe your child didn't get enough sleep or needs to eat.

The occasional headache is nothing to worry about. But head pain can be a symptom of something more serious. That's why it's important to pay attention to the specific symptoms of your child's headache, and to see a doctor if the headache seems out of the ordinary or occurs frequently.

Causes of children's headaches

A number of factors, singly or in combination, can make your child headache-prone. These factors include:

Genetic predisposition. Headaches, particularly migraines, tend to run in families. If you have a family history of bad headaches, your child will have a higher risk of getting them too.
Head trauma. Accidental bumps and bruises can cause headaches. Although most head injuries are minor, seek medical attention right away if your child falls hard on his or her head. Also contact a doctor if your child has a steadily worsening headache after a bang on the head.
Illness and infection. Headache is a frequent symptom of many common childhood illnesses. Ear infections, sinus infections, colds and flu are often accompanied by headache.
Environmental factors. Conditions in the environment, including weather changes, odors, loud noises and bright light all can cause headaches.
Emotional factors. High levels of stress and anxiety — often triggered by problems with peers, teachers or parents — play a role in many children's headaches. Children with depression may complain of headaches, particularly if they have trouble recognizing feelings of sadness and loneliness.
Certain foods and beverages. The food additive monosodium glutamate (MSG), found in such foods as bacon, bologna and hot dogs, has been known to trigger headaches. Also, caffeine, which is in soda, chocolate, coffee and tea, can cause headaches.

Types of children's headaches

Children get the same types of headaches that adults do, although their symptoms may be different. For example, a migraine in an adult almost always affects just one side of the head, while a child's migraine often affects both sides of the head.

Migraine
By the time they turn 17, as many as 8 percent of boys and 23 percent of girls have experienced a migraine. In addition to pain, migraines can cause nausea, vomiting, abdominal pain, and extreme sensitivity to light and sound. Even infants can have migraines. In very young children, migraines may last as little as an hour.

Tension-type headache
Often stress related, tension-type headaches feature a pressing tightness that occurs on both sides of the head. They can last from 30 minutes to several days.

Chronic daily headache
Both migraines and tension-type headaches can begin happening more and more frequently. If your child has headaches more than 15 days a month for more than three months, he or she is said to have chronic daily headache. This problem can occur when people take pain medications — even the nonprescription variety — too frequently.

Cluster headache
This is the least common type of headache in children. It's usually disabling and involves a sharp, stabbing pain on one side of the head that lasts less than three hours.

When to call the doctor

It's very rare that a child's headache is a sign of something more serious. However, you should seek a doctor's advice if your child's headaches:

Occur at least once a month
Keep him or her out of school
Follow an injury, such as a blow to the head
Awaken him or her from sleep
Feature persistent vomiting or visual changes
Are accompanied by fever, along with neck pain or stiffness

Clues needed for diagnosis

The causes of most headaches can be found with a little detective work. Your doctor will ask you and your child to describe the headaches in detail, to try to see if there is a pattern or a common trigger. It may help to keep a headache diary — listing each headache, when it happens, how long it lasts, and what might have caused it.

Your doctor might also perform a neurological exam to check for any problems with movement, coordination or sensation. Blood tests and imaging scans are occasionally needed to rule out other medical conditions that could be causing the headaches.

Preventing headaches

Prevention consists of a predictable daily routine, adequate sleep and rest, and healthy meals and snacks. Over time, the items you note in the headache diary should help you understand your child's symptoms and take specific preventive measures.

Be alert for things that may be causing stress in your child's life, such as difficulty doing schoolwork or strained relationships with peers. If your child's headaches are linked to anxiety or depression, consider talking to a counselor.

If you think your child is developing a headache, encourage him or her to take a nap in a dark, quiet room.

Treating children's headaches

Treatment depends on the type of headache. Acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others) usually relieve mild headaches and even some migraines. Don't give aspirin to children under age 16. Aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition in children.

If your child has migraines, there are a variety of prescription medications your doctor may suggest. Some of these medications are designed to treat migraines as they occur, while others are taken on a daily basis to prevent migraines.

Follow instructions carefully

Remember, the medication strategy differs from child to child. Ask your doctor or pharmacist if you have questions. Keep these points in mind:

Read labels carefully. Use only the dosages recommended for children, not adults. Some products come in infant, child and adult strengths but may look the same.
Don't give doses more frequently than recommended.
Ask about possible side effects of any medication.

Bottom line: If your child has chronic headaches, you can do more than simply surrender to the condition. Get help to find out how you can make a difference.