Headaches in Children

A headache is one of the most common complaints of children and teenagers. There are many different types of headaches. Each type may be treated differently. A detailed history and physical exam can help figure out what kind of headache your child has.

Types of Headaches

Migraine headache – This is a severe type of headache that has specific symptoms and keeps coming back. If you think that your child has migraine headaches, you should make an appointment with their health care provider for a thorough evaluation.

Tension headache – This is a more common and milder type of headache. Your child may say the pain feels like a tight band around their head. Some of the common causes are emotional stress, getting too tired, and poor hydration (not drinking enough).

Headache from infection – These headaches occur with viral infections such as colds and flu. They usually stop when the illness is over. Sinus congestion and infections can cause head pain around the eyes and nose.

Medication overuse headache (analgesic rebound headache) – Do not give over-the-counter pain medicines more than 2 days a week. Taking them too often can cause medication overuse headaches. These are headaches that come back sooner, more often, and are more painful. If your child needs medicine more often, talk to their health care provider.

Headaches after a head injury – Headaches are common after a head injury. They are usually mild and go away within 2 weeks. Sometimes, though, the pain may occur for several weeks or months after an injury.

Headaches with dental problems (such as jawbone joint problems) – When a child has jaw pain or discomfort, pain in the temples (the soft spots between the eyes and the ears) or hears a clicking sound when opening the jaw, they should see a dentist. Grinding of the teeth may also cause this type of headache.

Home Treatments

• The best treatment for a mild, occasional headache is rest and relaxation.
• Use a cold compress or apply heat, whichever helps your child the most.
  Place a cold, wet washcloth or ice wrapped in a washcloth on the head or neck (Picture 1). Do not place ice directly on the skin because it can damage the skin.
• Place a warm, not hot, wet washcloth on the head or neck or have your child take a warm shower.
• You can give over-the-counter pain medicines like ibuprofen (Motrin^®, Advil^®), acetaminophen (Tylenol^®), or naproxen (Aleve^®). Read the label on the bottle to know the right dose and right timing for your child.
• To prevent medication overuse rebound headaches, do not give pain medicine more than 2 days each week.
• Do not give aspirin or other medicines unless the health care provider says it is safe to do.
• Do not give over-the-counter pain medicines too often. Doing that can cause medication overuse headaches.

Keep a Record

Keep a record of the headaches over a period of time. This will help the health care provider decide on a plan of treatment for your child. You can use the Headache Record on the last pages of this handout, a calendar, or a headache-tracking app.

When to Get Emergency Care

Take your child to an emergency room or call 911 right away if they have:

• Confusion
• Extreme sleepiness (hard to wake up)
• Sudden, severe head pain happening for the first time
• Double vision - sees 2 of the same thing when only 1 is there
• Frequent projectile vomiting - vomit shoots out of the mouth
• Headache with a stiff neck or complains of neck pain, especially with a fever

When to Call the Health Care Provider

Call your child’s health care provider if your child’s headaches:

• Happen every day, especially if they interfere with school or play.
• Occur along with pain in the eye or ear, confusion, nausea or vomiting, sensitivity to light and sound, or numbness.
• Keep coming back and get worse.
• Are similar to those that other family members have.
• Follow a head injury and do not go away after a week.
• Are severe enough to wake them up from sleep.

Prevention

• Make sure your child gets enough sleep and follows a routine. They should go to sleep and wake up at about the same time each day.
• Serve meals at regular times. Do not let your child skip meals.
• Your child should drink plenty of liquids, especially water. Sports drinks may also be given.
• Make sure your child gets regular exercise or active play.
• Provide support for stress and emotional upset. Encourage them to talk openly with you so you are aware of what is troubling them.
• Some children are sensitive to certain foods, such as chocolate, meats prepared with nitrates (hot dogs, lunch meats, pepperoni, and bacon), foods with monosodium glutamate (MSG), aged cheeses, fried foods, caffeine (coffee, tea, soft drinks with caffeine, and energy drinks). It may help to avoid these foods for a while to see if the headaches go away.

Follow-Up Appointment

• Your child’s health care provider will want to see them for follow-up. It is important to keep these appointments.
• Please bring the Headache Record with you when you see the doctor.

Headaches in Children (PDF), Somali (PDF), Spanish (PDF)

HH-I-158 6/92, Revised 1/22 Copyright 1992-2022, Nationwide Children’s Hospital