Headache Causes and Advice

Different situations can be stressful for children. Stress is not always obvious. Something pleasant can also be stressful and cause headaches.

Stress could come from:

• Problems at school (starting at a new school, worry about learning, too much school work, school work that is too hard, stress from tests, pressure to be a straight-A student, kids that are “over-achievers”).

• Problems with other children (bullying, not having close friends, pressure from friends)

• Problems at home (moving, job changes, sibling problems, financial problems, safety problems, death of a family member or pet, birth of a sibling, or parents dealing with stress)

• Activities (competition in sports or other activities, too much time needed for activities, too many activities, doing something that the child does not enjoy)

• Other health problems (chronic illnesses, chronic pain, anxiety, depression, or an acute injury)

Advice:

Pay close attention to your child’s mood and behavior. Stress can come from many places, even if you do not expect it. It is important to talk to your child about stress. Parents can help set boundaries or priorities to reduce stress. Also, counseling or support from other adults can help a child deal with stress.

Poor nutrition can cause headaches. Skipping meals can lower the blood sugar and trigger a headache. Breakfast is important to give the body energy and jump start the metabolism for the day. Going for too many hours at a time without eating can cause headaches. We also worry about children who are picky eaters, weigh too little or too much, or who have other stomach problems.

Advice:

Have breakfast, lunch, dinner and snacks (when appropriate) on a regular schedule. Skipping meals or going too long between eating times can allow one’s energy level to dip too low. This can trigger headaches or make them worse.

Children who get a lot of caffeine in their diet can have a lot of headaches. When the effect from caffeine wears off, it can create a rebound headache. Caffeine also acts as a diuretic, which means it makes a person urinate often. Urinating more often can dehydrate the body. This can also trigger headaches.

Advice:

Caffeine is in most sodas (even diet sodas), energy/sports drinks, tea (hot tea or iced tea) and chocolate. Some over-the-counter pain medicines include caffeine. In some cases, caffeine can be a useful headache treatment when taken as a medicine. Treating some types of headaches with caffeine should be talked over with your child’s provider.

One of the most common triggers for headaches is dehydration. Children who do not drink enough can have more headaches. Also, children who do not drink fluids all day long, or wait until the evening to drink, can have more headaches.

Advice:

Drink enough fluids. We recommend at least 64 ounces of non-caffeinated drinks each day. This equals eight measuring cups. It is also important to drink fluids all day. Offer fluids—do not wait for the child to feel thirsty. Lack of fluids can lead to headaches.

For some patients with migraine, certain foods or additives are thought to trigger migraine.

• Meats prepared with nitrates (bacon, pepperoni, hot dogs, bologna)

• Aged cheeses (cheddar, Gruyere, Brie, and Camembert)

• Yogurt and sour cream

• Some fruits (citrus, fruit juices, bananas, pineapple, raspberries)

• Baked goods with yeast

• Food dyes

• MSG (monosodium glutamate) sometimes used in Asian foods

• Artificial sweeteners

Advice:

If a certain food causes a headache, do not eat that food. Then, keep a headache diary to track headache frequency. Talk with your provider if you have concerns about a food trigger for headache.

A full night of sleep is very important for the health of every child. Children need at least 8 to 9 hours of sleep at night. Young children and adolescents may need even more. Too little sleep, interrupted sleep or sleeping too long throughout the week can increase headaches. Sleep apnea (a disruption in breathing during sleep) and other sleep problems can be an unnoticed trigger for headache. If your child snores, wakes often during the night, or is very tired during the day, we may recommend further testing for sleep disorders. Napping during the day can disrupt sleep at night. Sleeping longer than 12 hours at a time can also disrupt sleep cycles.

Advice:

All children need enough sleep at night. We recommend at least 8 hours of continuous sleep at night. Younger children and adolescents need 10 to 12 hours each night. Naps during the day can disrupt sleep at night. Staying up late and sleeping in late on the weekends can disrupt sleep cycles. These ups and downs in sleep can make a child more likely to have headaches, or may trigger a headache the next day. Your child should go to bed every night and wake up each morning at the same time.

Children who are not active will often have more headaches.

Advice:

Get enough exercise and activity (at least 30 to 60 minutes of physical activity each day). This promotes better blood flow, oxygen to the brain, and helps your mood. All these things can help decrease headaches. Being active is good for everyone’s health. What is good for your body is usually good to prevent or decrease headaches.

Sudden changes in a regular day can trigger a headache. Changes in sleep, diet, stress and activities can cause headaches. Special events, trips, vacations or long illnesses can disrupt normal life and bring on more headaches.

Advice:

We recommend keeping the same schedule every day. Regular sleep, meals, nutrition, fluids and activity can work together to lessen or prevent headaches.

Hormonal changes in girls can trigger headaches or make headaches happen more often. Headaches tend to be worse a day or two before menses begins and for 5 to 7 days during the menstrual period. Some women have headaches that get worse when they ovulate (near the middle of the cycle). Some birth control pills can make menstrual headaches worse. Birth control pills without estrogen or with very low amounts of estrogen can make menstrual headaches better.

Advice:

Girls and parents can keep track of menstrual cycles and headaches on a calendar. This can help you to see if there is a pattern or relationship between menses and headaches. Take this information to your appointment to share with your provider.