Headaches in Children: From the Sprague School Nurse, Sharon Kahn RN

What causes children's headaches?

Children of all ages experience headaches and may even have them on a recurrent basis.  A number of factors, singly or in combination, can cause your child’s headache. These include:

—        Genetic predisposition: Headaches, especially migraines, tend to run in families.

—        Illness and infection: Headache is a frequent symptom of common childhood illnesses, including ear infections, strep throat, sinus infections, and colds.

—        Head trauma: Most head bumps are minor, but seek medical attention quickly if your child has dizziness, nausea, vomiting, blurred or double vision, ringing in the ears, any memory loss, poor coordination or emotional instability (anger, crying, anxiety) or has a steadily worsening headache after a bang on the head.

—        Environmental factors: Weather changes, odors, loud noises, bright light, and secondhand smoke can all cause headaches.

—        Emotional factors: Depression, stress, or anxiety, which may be affected by peer pressure, school problems and family concerns, can lead to headaches.

—        Certain foods, food additives, and beverages: MSG (in foods like bacon, bologna, hot dogs) and caffeine (in soda, chocolate, coffee and tea) are known to trigger headaches.

—        Sleep deprivation: Overtiredness or a change in routine or sleep pattern may cause headaches in children.

—        Inadequate hydration or skipping meals: Lack of fluids or food can cause headaches.

—        Eyestrain: If your child complains of headache and/or dizziness when reading and writing schedule an eye exam.

What kind of headache does your child have?

Headaches are typically hard to describe, especially for children. Some are related to stress, while others are the result of an illness or injury.  Headaches are classified into two main categories — primary and secondary. Primary headaches develop by themselves rather than as a result of illness or injury. This category includes:

—        Tension-type headache. Often stress related, the most common of children's headaches; the child may complain of a tightening or pressure in the head, neck and skull muscles.

—        Migraine. Approximately 5 percent of school-age children experience migraines. Before children reach puberty, migraines affect about the same number of boys as girls, but in the teen years, girls tend to have migraines more often. A migraine may be disabling, causing not just pain but nausea, vomiting and extreme sensitivity to light and sound. Children may also have all of the signs of a migraine with no head pain, known as an abdominal migraine. Unlike tension-type headaches, migraines often occur during nonstressful or recreational times.

—        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.

Secondary headaches result from some underlying condition, such as fever, cold virus, strep throat, head trauma, sinus or ear infection, medication side effects, meningitis, temporomandibular joint disorders (TMJ) or other jaw-related problems.

Preventing children's headaches - 

Measures that promote general good health will prevent all but the occasional headache in a child:

—        Adequate rest. Children need plenty of sleep on a regular schedule, at least 9 hours.

—        A healthy diet and fluids. Your child needs to eat breakfast, lunch, dinner and nutritious snacks throughout the day. Be sure your child drinks enough water, particularly in hot weather and after strenuous activity.

—        Take steps at the first sign of a headache. When your child develops a headache, encourage him or her to take a nap — if possible, in a dark, quiet room.

—        Keep a headache diary. Note times and places that headaches occur.  Describe any thoughts, behaviors or events that occur with headaches. Information from the diary will help to identify possible headache triggers. Wait for the child to volunteer that he or she has a headache rather than asking.

—        Avoid stressors. Be alert for things that may be causing stress in your child's life, such as difficulty doing schoolwork or strained relationships with peers.

—        Exercise. Regular aerobic exercise, such as walking, swimming or biking, can help reduce the frequency and intensity of headaches.  Exercise relieves stress, relaxes your muscles and increases the levels of the body's natural stress relievers.

When to Call the MD?

Seek your pediatrician’s advice if your child has recurrent headaches or any episode of head pain severe enough to keep him/her out of school or other activities.