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Headache  
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Does this describe your child's symptoms?
Definition
  • Pain or discomfort of the scalp or forehead areas
  • The face and ears are excluded

Causes

  • Viral illnesses: Most headaches are part of a viral illness, especially with colds. These usually last a few days.
  • Muscle tension headaches: Most common type of recurrent headaches. Muscle tension headaches give a feeling of tightness around the head. The neck muscles also become sore and tight. Tension headaches can be caused by staying in one position for a long time, such as with reading or using a computer. Other children get tension headaches as a reaction to stress, such as pressure for better grades or family disagreements.
  • Migraine headaches: Recurrent severe, incapacitating headaches
  • Other common causes: Hunger, exertion, sunlight, coughing
  • Frontal sinusitis: can cause a frontal headache just above the eyebrow.  Rare before 10 years old because frontal sinus not developed.  Other sinuses cause face pain, not headache.
  • Serious causes: Meningitis or encephalitis. Symptoms include a headache, stiff neck, vomiting, fever and confusion.
If not, see these topics
When to Call Your Doctor
Call 911 Now (your child may need an ambulance) If
  • Difficult to awaken or passed out
  • Confused thinking/talking or slurred speech
  • Blurred or double vision
  • Weakness of arm or leg or unsteady walking
Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Stiff neck (can't touch chin to chest)
  • Severe headache
  • Vomiting
  • You think your child needs to be seen urgently
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen, but not urgently
  • Fever
  • Sinus pain (not just congestion) of forehead
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Headache without other symptoms present over 24 hours
  • Sore throat present over 48 hours
  • Any headache present over 3 days
  • Headaches are a recurrent chronic problem
Parent Care at Home If
  • Mild headache and you don't think your child needs to be seen
HOME CARE ADVICE FOR HEADACHES
Treatment for Mild Headache
  1. Reassurance:
    • Headaches are very common with viral illness, especially with colds. They usually resolve in 2 or 3 days.
    • Unexplained headaches can occur in children, just as they do in adults. They usually pass in a few hours or last up to a day.
    • Most headaches (including muscle tension headaches) are helped by the following measures.
  2. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief (see Dosage table). Headaches due to fever are also helped by fever reduction.
  3. Food: Give fruit juice or food if your child is hungry or hasn't eaten in more than 4 hours (Reason: Skipping a meal can cause a headache in many children).
  4. Rest: Lie down in a quiet place and relax until feeling better.
  5. Local Cold:  Apply a cold wet washcloth or cold pack to the forehead for 20 minutes.
  6. Stretching: Stretch and massage any tight neck muscles.
  7. Call Your Doctor If:
    • Headache becomes severe
    • Vomiting occurs
    • Isolated headache lasts over 24 hours
    • Headache lasts over 3 days
    • Your child becomes worse
  8. Extra Advice - Muscle Tension Headache Prevention:
    • If something is bothering your child, help him talk about it and get it off his mind.
    • Teach your child to take breaks from activities that require sustained concentration. Encourage your child to do relaxation exercises during the breaks.
    • Teach your child the importance of getting adequate sleep.
    • If over-achievement causes headaches, help your child find more balance.
    • Caution: Your child should have a complete medical checkup before you conclude that recurrent headaches are due to worrying too much or stress.
Treatment for Migraine Headache
  1. Reassurance: This headache is similar to previous migraine headaches that your child has experienced.
  2. Migraine Medication:
    • If your child's doctor has prescribed a specific medication for migraine, give it as directed as soon as the migraine starts.
    • If not, ibuprofen is the best over-the-counter drug for migraine. Give ibuprofen now and repeat in 6 hours if needed (See Dosage Table).
  3. Sleep: Have your child lie down in a dark, quiet place and try to fall asleep. People with migraine often awaken from sleep with their migraine gone.
  4. Prevention of Migraine Attacks:
    • Stay well hydrated.
    • Don't skip meals.
    • Get adequate sleep each night.
  5. Call Your Doctor If:
    • Headache becomes much worse than usual
    • Headache lasts longer than usual

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/15/2011

Last Revised: 8/1/2011

Content Set: Pediatric HouseCalls Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.

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