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Headaches in Children: When Do Parents Need to Worry?

Watch out for triggers, or signs of more serious illness, says pediatrician at Nationwide Children's Hospital

By: Dr. Wendy Anderson-Willis


How many times has your child said "Mom, I've got a headache". It's not just adults who get headaches. We're actually seeing more and more children who complain of these types of problems as well. The two types of headaches that we see most commonly in children are tension headaches and migraines. It's important to watch out for the triggers. Sickness is one of the most obvious times when a child will have a headache. Female soccer player heading soccer ball

Major causes

Here are some of the other major causes:

  • Stress, crying
  • Skipping meals
  • Dehydration
  • Sleep problems
  • Vision changes, not wearing glasses or overuse of contact lenses
  • Menstrual cycles in girls
  • Congestion from allergies
  • Concussion

Environmental triggers

There are other triggers that can be environmentally based:

  • Children who consume artificial sweeteners, MSG, and caffeine (also caffeine withdrawal) can be at risk for headaches.
  • Sometimes even certain kinds of cheeses will give them headaches.
  • You may also notice that loud music and long car trips can trigger a headache.
  • Often children will get what we call a rebound headache from the overuse of headache medication.

What to do about headaches

So what do you do if your kid says he/she has a headache?

I recommend having something to eat and drink and then for the child to take some time to lie down in a dark and quiet room. Sleep is very important in headache relief and this will often help the symptoms go away.

Sometimes headaches do not respond to sleep so an over-the-counter pain reliever like acetaminophen or ibuprofen can be helpful. If you give your child an over the counter medication, make sure it is not aspirin. Never give aspirin to anyone under 18 years of age. It can cause Reye syndrome, which is a serious illness.

The biggest thing I tell parents is to track how many times a month their child complains of a headache.  If it is mild and less than once a month, then go ahead and treat it at home. If headaches are happening more than once a month or if it is severe, it is time to see a doctor.

Your doctor should ask about how often this happens and what you think may be triggering it. I always ask the child what their typical day looks like, so I can get a sense of what is going on that may lead to headaches. I look for whether they regularly skip meals, or if they are taking in too much caffeine. I want to know if they are sleeping at night and if they are drinking fluids throughout the day. If you as a parent can keep a "headache diary," it will be helpful to the doctor. Write down everything from when things start, to what they had to eat or drink that day, to how bad the pain is and how you treated it.

Signs requiring immediate medical attention

If your child has any of the following symptoms it is important to see a doctor right away to rule out anything more serious:

  • Fever
  • Neck pain/stiffness
  • Vomiting
  • Seizures
  • Dizziness
  • Vision changes
  • Head injury
  • Loss of consciousness
  • A headache that is present when waking up
  • If the headache fails to resolve with sleep

Most headaches aren't signs that something more is wrong, but occasionally headaches are caused by more serious medical conditions.

Bottom line for parents: If your son or daughter has frequent headaches, you can do more than simply surrender to the condition or manage the symptoms. One of the best ways to treat headaches in children is to stop them before they start. Work to see if you and your child's doctor can identify the causes and find a solution.

Dr. Wendy Anderson-Willis


Dr. Wendy Anderson-Willis is a pediatrician in the Ambulatory Pediatrics department at Nationwide Children's Hospital in Columbus, Ohio.

Posted July 25, 2014