Headache  

This Care Guide Covers:

  • Pain or discomfort of the head
  • This includes the forehead to the back of the head
  • Not caused by a head injury

If not, see these topics
When to Call Your Doctor

Call 911 Now (your child may need an ambulance) If
  • Hard to wake up or passed out
  • Acts or talks confused
  • Weakness of arm or leg
  • Walking not steady
  • You think your child has a life-threatening emergency
Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Stiff neck and can't touch chin to chest
  • Severe headache
  • Vomiting
  • Blurred vision OR seeing double
  • 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 lasts more than 24 hours
  • Sore throat lasts more than 48 hours
  • Any headache lasts more than 3 days
  • Headaches are a frequent problem
Parent Care at Home If
  • Mild headache
  • Migraine headache, just like past ones
Causes & Health Information

Causes

  • Viral illnesses. Most headaches are part of a viral illness, especially with colds. Most often, these last a few days.
  • Muscle tension headaches. Most common type of frequent 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. This can happen when reading or using a computer. Other children get tension headaches as a reaction to stress or worry. Examples of stress in children are pressure for better grades or family arguments.
  • Migraine headaches. Severe, very painful headaches that keep your child from doing normal activities. They are throbbing and often occur on one side. Vomiting or nausea are present in 80%. Lights and sound make them worse. Most children want to lie down in a dark, quiet room. Will recur.
  • Other common causes. Hunger, hard work or sports, sunlight, coughing.
  • Frontal sinusitis. Can cause a frontal headache just above the eyebrow.  Rare before 10 years old because frontal sinus not formed yet.  Other sinuses cause face pain, not headache.
  • Serious causes. Meningitis or encephalitis. Symptoms include a headache, stiff neck, vomiting, fever and confusion.

Pain Scale

  • Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
  • Moderate: The pain keeps your child from doing some normal activities.  It may wake him or her up from sleep.
  • Severe: The pain is very bad. It keeps your child from doing all normal activities.
CARE ADVICE FOR HEADACHES

Treatment for Mild Headache
  1. What You Should Know:
    • Headaches are very common with some viral illnesses. Most often, these will go away 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:
    • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.
    • Headaches due to fever are also helped by bringing the fever down.
  3. Food:
    • Give fruit juice or food if your child is hungry.
    • If your child hasn't eaten in more than 4 hours, offer some food.
    • 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. Cold Pack:  
    • Put a cold pack or a cold wet washcloth on the forehead.
    • Do this for 20 minutes.
  6. Stretching:
    • Stretch and rub any tight neck muscles.
  7. Call Your Doctor If:
    • Headache becomes severe
    • Vomiting occurs
    • Headache without other symptoms lasts more than 24 hours
    • Headache lasts more than 3 days
    • Your child becomes worse
  8. Extra Advice - Muscle Tension Headache Prevention:
    • If something bothers your child, help him talk about it. Help him get it off his mind.
    • Teach your child to take breaks when he is doing school work. Help your child to relax during these breaks.
    • Teach your child the importance of getting enough sleep.
    • Some children may feel pressure to achieve more. This may cause headaches. If this is the case with your child, help him find a better balance.
    • Caution: Frequent headaches are often caused by too much stress or worry. To be sure, get your child a medical checkup first.
Treatment for Migraine Headache
  1. What You Should Know:
    • This headache is like the migraine headaches that your child has had before.
    • Here is some care advice that should help.
  2. Migraine Medicine:
    • If your child's doctor has prescribed a medicine for migraines, use it as directed. Give it as soon as the migraine starts.
    • If not, ibuprofen is the best over-the-counter drug for migraines. Give ibuprofen now. Repeat in 6 hours if needed. See Dose Table.
  3. Sleep:
    • Have your child lie down in a dark, quiet place.
    • Try to fall asleep.
    • People with a migraine often wake up from sleep with their migraine gone.
  4. Prevention of Migraine Attacks:
    • Drink lots of fluids.
    • Don't skip meals.
    • Get enough sleep each night.
  5. Call Your Doctor If:
    • Headache becomes much worse than past migraines
    • Headache lasts longer than past migraines

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
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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: 9/1/2012

Last Revised: 1/13/2013

Content Set: Child Symptom Checker

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