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Children and Headaches

Here's what you should know and do

Headaches in children are as real as they are for adults. Children complaining of head pain should be taken seriously.

Headaches in children also are surprisingly common. An estimated 39% of 6 year-olds have had a headache, and 70% of 15 year-olds have complained of one. Collectively, children suffering from head pain miss over 1 million school days each year. Headache symptoms have even been reported in children as young as 12 months old!

Here are some general facts that you should know about childhood headaches.

95% of them are not caused by a serious underlying medical condition.
Tension headaches are most common, as they are with adults.
Migraines are more common in children than in adults. If you have a family history of migraines, your child's headache is likely to be a migraine, too.
One-third of all children suffering from headaches eventually grow out of them. The news is even better for children with migraines: 50% of these headaches spontaneously resolve when children become teens, and another 25% disappear in the early adult years.

Tension headache symptoms are the same in children as in adults. The pain is felt in the forehead and back of the head and neck. Relief is generally easy to obtain through a combination of rest, reassurance and prudent use of over-the-counter pain relievers. Tension headaches in children usually occur only occasionally. In such cases there is no cause for concern. However, children who suffer from frequent tension headaches may be experiencing high levels of stress. In these cases, it's important to identify factors in your child's life that could be causing this. Pressures at school, home and with friends are common contributors.

Childhood migraine symptoms may differ from adult symptoms. Both include throbbing pain, nausea and sensitivity to light, but children may also experience abdominal pain, fever, listlessness, stuffy nose, rapid heartbeat and some dizziness. Beyond that:

Children frequently experience pain on both sides of the head, versus adults' one-sided pain.
Childhood migraines occur more frequently, ranging from once to several times a week. Adult migraines are more sporadic, averaging 1-3 times a month.
Migraines in children may last only 30 minutes, far shorter than adults' several hour to 3-day duration.
Children exhibit different warning signs. The auras that precede some adult migraines may also occur in children. But the day before an attack children may exhibit excessive yawning, sleepiness, listlessness and a craving for migraine-trigger foods such as processed sugar snacks, chocolate, hot dogs, yogurt and bananas.
Children may not experience head pain at all, but rather show symptoms referred to as migraine equivalents. These are unexplained symptoms including stomach pain with nausea and vomiting, or just unexplained vomiting. As the child gets older, these may turn into full-blown migraines.

If your child's headaches are severe or recurrent, it's important to seek medical attention immediately. Your doctor will perform a thorough physical examination and take an extensive history, which may include information about the entire family. This will help identify family stresses that may be contributing to your child's headaches. Your child may be referred to an ophthalmologist to rule out vision problems. There are also some uncommon but serious causes of childhood headaches. Your doctor may refer your child to an ear-nose-throat specialist, an allergist or a neurologist to help rule out these as causes.

Treatment for children's headaches may be approached in a series of steps as follows.

The first step is to make sure your child gets sufficient rest and maintains a manageable daily routine. A well-rested child who is not overextended will develop fewer stress-related headaches.
Children suffering from migraines will need to avoid or learn to handle the factors that trigger their headaches. These may include foods, missed meals, exciting or stressful events, physical activity, or hormonal changes, especially in girls approaching puberty. Your doctor may recommend keeping a headache diary to help identify triggers of your child's migraines.
Deep relaxation techniques or biofeedback may be recommended next, especially for children with migraines. Children may learn these techniques more easily than adults. They help not only to manage symptoms but give children a sense of control in their lives.
If these things are not effective, prescription medication may be tried next. It may be used to relieve headaches when they occur, or preventatively to decrease headache frequency.
If headaches are still not significantly improved, the next step may be to look for psychological factors that may be affecting the child and/or the family. Your child could be having problems in school or with friends, or may suffer from anxiety or depression. Psychological counseling can be effective in relieving childhood headaches with underlying emotional causes.

Coping with a child's chronic headaches affects the entire family. Siblings may resent the attention given to the headache sufferer. Parents shoulder the burden of keeping things as normal as possible while searching for a solution. The child may fall behind in school or socially. This can be a stressful situation for everyone.

For a referral to a physician in your area who specializes in headaches in children, contact the American Council for Headache Education at (609) 845-0322.

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