Headaches In Children

A headache is not a disease. Headaches are common among children and generally are not serious. One to two headaches per month are common in children. The most common headaches in children are tension headaches and migraines.

Headaches occurring more frequently than once a week, may be associated with health concerns that require further evaluation.

What Causes Headaches?

Headaches are most commonly caused by one of the following:

• Illness: Headaches often are a symptom of other illnesses. Viral infections, Strep throat, allergies, sinus infections, and urinary tract infections can be accompanied by headaches. Fever may also be associated with headaches.
• Stress, anxiety, and depression: Family problems, peer pressure, death in the family, school problems, etc. are examples of stress factors which may trigger headaches in your child.
• Poor eating habits: Fad diets can make your child hungry and result in a headache. Not getting enough fluids -which leads to dehydration - also may cause a headache.
• Drugs: Alcohol, cocaine, amphetamines, diet pills, and other drugs may cause a headache.
• Dental problems: Less commonly, headaches can be caused by a dental infection or abscess, and jaw alignment problems (Temporo-mandibular Joint Syndrome-TMJ).
• Eye problems: Although headaches are only rarely caused by eye problems, pain around the eyes - which can feel like a headache - can be caused by eye muscle imbalance or not wearing glasses that have been prescribed for your child.
• Miscellaneous: Headaches are often triggered by sleep problems, minor head injuries, or certain foods (dairy products, chocolate, food additives like nitrates, nitrites, and monosodium glutamate). Sometimes, headaches can also be caused by prescribed medication, such as birth control pills, tetracycline for acne, and high doses of vitamin A. Only in very rare cases are headaches a symptom of a brain tumor, high blood pressure, or other serious problems.

Types Of Headaches

Tension headaches: May feel like a tight band is around your child’s head. The pain is dull and aching and usually will be felt on both sides of your child’s head, but may be in front and back as well.

Pressure at school or at home, arguments with parents or friends, having too much to do, and feeling anxious or depressed can all cause a headache.

Migraines: Described as throbbing and usually are felt on only one side of your child’s head, but may be felt on both. A migraine may make your child feel light-headed or dizzy, and / or make your child’s stomach upset. Your child may see spots or be sensitive to light, sounds, and smells. If your child gets migraines, chances are someone in the family also has had this problem.

Psychogenic: Similar to tension headaches, but the cause is an emotional problem such as depression. Signs of depression include: loss of energy, poor appetite or overeating, loss of interest in usual activities, change in sleeping patterns (trouble falling asleep, waking in the middle of the night or too early in the morning), and difficulty thinking or concentrating.

When Should Your Child See A Pediatrician?

If you are worried about your child’s headaches - or if this problem begins to disrupt school, home, or your child’s social life - call our office. Other signs that may mean you should visit your pediatrician include:

• Head injury: Headaches from a recent head injury, such as a concussion or a fall.
• Seizure/convulsions: Headaches associated with seizures or fainting require immediate attention.
• Frequency: More than 1-2 headaches a week.
• Pain level: Headache pain is severe and prevents your child from participating in daily activities.
• Time of attack: Headaches that wake your child from sleep or occur in early morning.
• Visual difficulties: Headaches with blurred vision or other visual complaints.
• Other associated symptom: If fever, vomiting, stiff neck, toothache, or jaw pain accompany your child’s headache, your child may require an examination - including bloodwork or x-rays.

Treatment Of Headaches

If your child gets tension headaches or mild migraines, treat the headaches as follows:

• Rest until feeling better.
• Cool compress on forehead
• Acetaminophen (Tylenol) or Ibuprofen (Motrin, Advil).

(Tylenol and Ibuprofen dose charts available in our office and on our Web page)

If the headaches are causing your child more discomfort or you suspect a migraine headache, prescription medicine may be required. Please call the office if your child’s headaches do not improve with the above suggestions.

Headache Diary

A headache diary is helpful in pinpointing a cause for your child’s headaches and helping decide on whether treatment is necessary. A headache diary will help you keep track of the following important information related to your child’s headaches: The diary will be helpful in identifying the frequency and severity of your child’s headaches and allow us to recommend a specific treatment plan.

• How long does a headache last and how frequently does a headache occur?
• What was your child doing when the headache started?
• What was your child eating before the headache started?
• How much sleep has your child had?
• What seems to make the headache better or worse?
• Does the headache interfere with your child’s eating, sleeping, or daily routines?
• Does your child describe any visual or hearing problem at the time of the headache?
• Does your child complain of nausea or vomiting at the time of the headache?
• Does your child appear sick (fever, sore throat, abdominal pain, balance problems)?

Headaches that are caused by an emotional or psychological problem may require additional visits to your pediatrician or to other health care professionals to get to the cause of the problem. Sometimes entire families need counseling to eliminate the stress that is causing headaches.

Remember, feeling stress in children is normal. Stress can be the result of normal experiences that all children must learn to cope with. Common examples include: worrying about exams, having a fight with a close friend, worrying about one’s performance in a sporting event, or concern over being accepted by one’s friends.

Learning to cope with a specific stress factor may relieve your child’s headaches. It's important to know that, whatever the cause, your child’s headache pain is real.

If a specific food seems to trigger your child’s headaches, try eliminating that food from the diet.

The following foods may be triggers for your child’s headaches. Try eliminating one at a time to see if there is any improvement in the headaches.

• Ripened cheeses (cheddar, Emmentaler, Gruyere, Stilton, Brie and Camembert).

Cheeses Permissible: American, cottage, cream and Velveeta

• Herring
• Chocolate
• Vinegar (except white vinegar)
• Anything fermented, pickled or marinated
• Sour cream, yogurt
• Nuts, peanut butter
• Hot fresh breads, raised coffee-cakes and doughnuts
• Pods of broad beans (lima, navy and pea pods)
• Any foods containing large amounts of monosodium glutamate (Chinese foods)
• Onions
• Canned figs
• Citrus foods (no more than 1 orange per day)
• Bananas (no more than ½ banana per day)
• PizzaPork (no more than 2-3 times per week)
• Excessive tea, coffee, cola beverages (no more than 4-cups per day)
• Avocado
• Fermented sausage (bologna, salami, pepperoni, summer and hot dogs)
• Chicken livers
• Avoid all alcoholic beverages