My child has headaches: What should I do?

Did you know 20% of adults who develop headaches will begin having them before 10 years of age? Frequent headaches in children may cause concern for parents, and we can help. Headaches are a common problem in children, which is why it’s important to know when to treat them at home and when it’s time to seek a neurologist. Learn the answers to the most common questions we receive about headaches in children. 

What are headaches and how do they affect kids? 

There are many types of headaches and causes, but most commonly, we see children with migraines and tension-type headaches. These headaches are caused by several parts of the brain, including blood vessels and pain centers.

During a migraine, messages from these areas are sent, releasing chemicals that inflame and irritate the nerves and vessels. This type of headache can make even normal sensations, such as lights or noise, seem more intense and painful. Children may need to “sleep it off” but occasionally headaches are debilitating, causing children to miss activities and even school. If this is the case, parents may seek the help of their pediatrician. 

A tension-type headache often feels like a tight band around the head. While we don’t know what causes them, we do know that stress is the most reported trigger.

Why do kids get headaches? 

Children may have headaches for several reasons:

• Colds, flu and ear and sinus infections are among the most frequent causes of headaches in children.
• Bumps and bruises on the head may cause headaches. (Contact your child’s pediatrician if your child’s head pain continues to worsen after a head injury.)
• Stress and anxiety can also result in headaches.
• Genetics may also play a role, as some types of headaches tend to run in families.
• Certain foods and beverages, such as nitrates found in bacon or hot dogs, can trigger headaches. Caffeine, chocolate and sports drinks are also common triggers.
• Problems in the brain are rare, but can cause a chronic, worsening headache. In this case, however, you’ll typically see other symptoms as well, such as vision problems or coordination issues. 

Frequent or chronic headaches in children

Headaches in children are considered chronic if they occur 15 days or more in a month for more than 3 months.

While the exact causes of headache aren’t completely understood, chronic headaches are often caused by lack of sleep, poor sleep quality or neck or eye strain. Rarely, problems in the brain may cause chronic, worsening headaches. In these cases, headaches are usually accompanied by other symptoms.

Headaches and fevers in kids 

It’s not uncommon for kids to have a headache and fever at the same time. Several causes can result in headaches with fever: a cold or the flu, bacterial infections and ear infections are among the most common. 

Fever and headache are also among the first symptoms of meningitis, inflammation of the membranes around the brain and spinal cord. Meningitis is rare but serious, so you should talk with your child’s pediatrician right away if you think your child is experiencing symptoms.

Headaches in children: When to see a doctor

Often, headaches are easily treated at home. When headaches continue despite these interventions, are frequent or if there’s a question regarding the cause of the headache, pediatricians will usually refer to a neurologist. If you notice the following “red flags,” you should seek the help of a neurologist.

You should be concerned if your child has headaches that change over time, increase in frequency and/or involve any of these following symptoms:

• Loss of vision or visual changes
• Weakness or loss of sensation
• Headache on awakening
• Confusion or difficulty thinking

These symptoms signal a concern regarding secondary headaches, a headache caused by an underlying medical problem. Please note that migraines can involve these symptoms, but other secondary causes should be considered first. If any of these issues are present, talk with your child’s pediatrician.

Headache relief for kids and headache medicine

You can typically treat your child’s headaches at home with rest, decreased noise, fluids, healthy food and over-the-counter pain medicine, such as acetaminophen or ibuprofen (Advil, Motrin® IB). For older children, managing stress and relaxation techniques may also help relieve headaches. Learn about the importance of sleep to help headaches.

Consult your child’s pediatrician about headaches in children and see a pediatric neurologist

Your child’s pediatrician may recommend that you see a pediatric neurologist for their headaches. At Texas Children’s Headache/Migraine Program, we provide comprehensive evaluation and treatment for headache disorders in children.

What to expect when seeing a pediatric neurologist for headaches in children

Your neurologist will likely recommend you keep a headache diary that notes headache frequency, triggers, etc. He or she will advise avoiding any known headache triggers and suggest treatments for the headaches. Treatment may include preventive headache medicine and/or medicine to stop headaches once they begin.

Your neurologist may also refer your child to physical therapy, psychology or a variety of other specialty care providers with helpful insight. Imaging (such as an MRI) may be obtained when there is a concern that the headaches are coming from an underlying issue. Other tests might also be considered. A thorough history and neurologic examination of your child is necessary in providing an accurate diagnosis.

Get help with headaches in children at Texas Children’s

To make an appointment with Texas Children’s Headache/Migraine Program, call 832-822-2778. The referral should indicate that the patient has unsuccessfully tried more than one headache medicine through their primary care physician.