Getting ahead of children’s headaches

Some of the most painful questions I get are about headaches in children and when parents should be concerned. Let me ease some of the tension surrounding this topic by providing some information.

Most of the time, there is a good reason for your child’s head to ache, such as staying up too late, playing in the sun too long, or bumping their head. Ear and sinus infections can also be a culprit.

Migraines vs. tension headaches

Children and teens can also get migraines and tension headaches. Migraines, which can run in families, occur in about 1 in 20 children. These are believed to be due to blood vessels in the head contracting and expanding, producing a localized throbbing headache pain. Migraines can last anywhere from 30 minutes to hours and are associated with nausea, vomiting and dizziness, and are worsened by rapid motion or activity. Chocolate, caffeine and even some dairy products like cheese might also trigger migraines.

Tension headaches, which give a sense of tightness around the head, can be seen with prolonged use of video games or computers and are also a symptom of stress. They are believed to be caused by tightening of the scalp muscles around the skull. They are not associated with nausea and vomiting and are not worsened by motion or activity like migraines are.

How to ease the pain

Treatment of a simple migraine or tension headache can be similar and can involve lying down in a dark room and giving acetaminophen or ibuprofen. Prevention can involve good sleep hygiene, meaning getting eight to 10 hours of sleep daily, and a healthy diet. Biofeedback and relaxation techniques may also reduce the frequency of both migraines and tension headaches. Occasionally your child’s health care professional may recommend other medications by prescription to prevent the onset of migraines, but check with them to see if your child qualifies for the use of these medications.

When to call the doctor

So when do we worry about headaches in children? You should seek medical attention if your child’s headache pain is severe and causes crying, if the headache lasts for over 24 hours, occurs several times a month or is associated with fever or lots of vomiting especially in the early morning hours. We also worry if along with a headache, your child is confused, difficult to awaken, speech is slurred, vision blurred, or there is trouble moving an arm or a leg. This might represent a rare and more serious type of headache that warrants further testing and treatment on an emergency basis.

Hopefully, tips like these will give you a head start when it comes to dealing with your child’s headaches.

Lewis First, MD, is chief of pediatrics at the University of Vermont Children’s Hospital of Vermont Children’s Hospital and chair of the Department of Pediatrics at the University of Vermont’s Larner College of Medicine. You can also catch “First with Kids” weekly on WOKO 98.9FM and NBC5.


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