Both children and adults can experience occasional headaches with mild to moderate pain that lasts a few hours. For some, however, the headaches become severe, debilitating, or chronic.
What headache symptoms should parents look for?
A lot depends on your child's age and their ability to communicate with you. Children as young as infants can experience headaches, but the way they express their pain is different depending on their age. Babies who cannot speak yet may cry or tightly close their eyes to avoid painful stimuli. Toddlers or elementary-age children may say their head hurts, bright lights are bothering them or use visual imagery (i.e., feels like someone is using a hammer on their head) to express their level of pain. Teens may become moody or withdrawn. Children experiencing headaches may report pain in the front of their head, or all over their head. Headaches in children may occur repeatedly, be provoked by something (i.e., a loud noise, bright lights, or too much activity around them) or occur out of the blue.
When should you worry about your child's headache?
Headaches can occur on their own, or as a symptom of another condition. Thankfully, headaches very rarely signal a dangerous problem like a brain tumor. If your child develops a severe, new headache out of the blue, has a headache that is getting worse, or has a concussion, seek help from your pediatrician immediately. In 99% of cases, the headaches are related to a mild problem like a treatable infection, or related to a primary headache disorder, meaning that there is not another underlying problem.
Primary headache disorders include:
- Tension headache – the most common type of headache that produces mild to moderate pain
- Migraine – As many as one in six teens experience migraine headaches, which are severe, debilitating headaches that can last hours or days. In addition to pain children may experience nausea, vomiting, sensitivity to light and sound, and dizziness.
- Chronic migraine – Approximately 2% of teens have headaches daily or every other day
Most of the time your child's healthcare provider can make these diagnoses based on the pattern of symptoms, and tests are not needed. Primary headache disorders are not life-threatening, but they can cause significant problems, like absence from school. If your child is experiencing frequent headaches or migraines, talk to their pediatrician about treatment options.
How you can help your child with headaches
There are several things parents can do to support their children with headaches, especially during the school year. For many children, headache patterns differ depending on their routine and environment.
You can encourage the following helpful habits for your child who experiences headaches:
- Maintain consistent schedules for sleep, eating, exercise, and schoolwork. Ensure children get adequate uninterrupted sleep at night (8-12 hours per night depending on age).
- Be physically active each day, including at least 20 minutes of vigorous, sweat-producing exercise 3-4 days a week. If your child is experiencing a headache when exercise is scheduled, try to encourage them to be as active as possible for short periods of time or exercise on all non-headache days.
- Drink lots of water and eat well; discourage skipping meals. Keeping properly hydrated and fed can help avoid the onset or continuation of headaches.
- Pursue hobbies or interests such as crafts, reading, or cooking. By relaxing your child's mind after intense schoolwork, they can release stress and stop headaches from starting or worsening.
- Engage with friends and family for companionship and fun.
Coping with headaches in school and at-home
it is common for headaches to increase during the school year. Increased stress from academic demand can be a headache trigger. School can be overstimulating – especially after a prolonged absence. School also starts early in the morning so your child may get less sleep on school nights.
Nowadays, many schools utilize computers, iPads, and other electronic devices for learning. If your child notices worsening headache associated with screen use:
- Encourage 5- to 10-minute "screen" breaks frequently throughout the day to relax the neck and eye muscles.
- Consider purchasing blue-light blocking glasses or installing an anti-glare screen on any electronics (laptop, tablet, etc.) they use regularly.
- Ask your child's school for alternatives to computer/tablet use for some projects. For example, some work may be completed using paper copies or listening to audio files.
- Invite a friend over rather than communicating on devices.
When to see a doctor for your child's headaches
If your child is experiencing frequent or debilitating headaches that are preventing them from normal activities, schedule an appointment with your child’s pediatrician. The Division of Neurology at CHOP developed a Primary Care Headache Pathway to guide pediatricians in the first steps of headache management. Pediatricians think about how headaches may relate to lifestyle and other aspects of your child’s health. Thankfully, first line treatments are helpful for about 2 out of 3 children.
If first line treatments are not helpful, your pediatrician can refer you to a neurologist at the Children's Hospital of Philadelphia. When your pediatrician places a referral, or when you call, we will ask questions to match your child to a provider who can help. At that appointment the neurologist will determine the type of headache your child has, recommend appropriate evaluation if needed (such as an MRI or blood tests), and, if needed, suggest treatment that may include lifestyle habits, acute or preventive medications, cognitive behavior therapy (an effective form of counseling), and procedural or intravenous treatments.
When take your child to the Emergency Room for headaches
If you are not sure if your child needs emergency care, you can always call your pediatrician first. The ER is noisy and busy, which often makes headaches worse.
Circumstances when you may need to take your child to the ER include:
- Your pediatrician recommends the ER
- Your child is very confused or has had a seizure with the headache (if your child does not usually have seizures)
- Your child cannot walk normally, or has very severe pain with moving the neck
- Your child’s headache came out of the blue and was very severe within seconds of starting
- Headaches and vomiting are waking your child from sleep
While we wish they didn’t, kids get headaches. Thankfully, dangerous causes are uncommon, and most kids will have relief quickly with treatment. If your child needs more help, CHOP’s Primary Care, Neurology, and ER teams will working together to offer your family the best care.
Both children and adults can experience occasional headaches with mild to moderate pain that lasts a few hours. For some, however, the headaches become severe, debilitating, or chronic.
What headache symptoms should parents look for?
A lot depends on your child's age and their ability to communicate with you. Children as young as infants can experience headaches, but the way they express their pain is different depending on their age. Babies who cannot speak yet may cry or tightly close their eyes to avoid painful stimuli. Toddlers or elementary-age children may say their head hurts, bright lights are bothering them or use visual imagery (i.e., feels like someone is using a hammer on their head) to express their level of pain. Teens may become moody or withdrawn. Children experiencing headaches may report pain in the front of their head, or all over their head. Headaches in children may occur repeatedly, be provoked by something (i.e., a loud noise, bright lights, or too much activity around them) or occur out of the blue.
When should you worry about your child's headache?
Headaches can occur on their own, or as a symptom of another condition. Thankfully, headaches very rarely signal a dangerous problem like a brain tumor. If your child develops a severe, new headache out of the blue, has a headache that is getting worse, or has a concussion, seek help from your pediatrician immediately. In 99% of cases, the headaches are related to a mild problem like a treatable infection, or related to a primary headache disorder, meaning that there is not another underlying problem.
Primary headache disorders include:
- Tension headache – the most common type of headache that produces mild to moderate pain
- Migraine – As many as one in six teens experience migraine headaches, which are severe, debilitating headaches that can last hours or days. In addition to pain children may experience nausea, vomiting, sensitivity to light and sound, and dizziness.
- Chronic migraine – Approximately 2% of teens have headaches daily or every other day
Most of the time your child's healthcare provider can make these diagnoses based on the pattern of symptoms, and tests are not needed. Primary headache disorders are not life-threatening, but they can cause significant problems, like absence from school. If your child is experiencing frequent headaches or migraines, talk to their pediatrician about treatment options.
How you can help your child with headaches
There are several things parents can do to support their children with headaches, especially during the school year. For many children, headache patterns differ depending on their routine and environment.
You can encourage the following helpful habits for your child who experiences headaches:
- Maintain consistent schedules for sleep, eating, exercise, and schoolwork. Ensure children get adequate uninterrupted sleep at night (8-12 hours per night depending on age).
- Be physically active each day, including at least 20 minutes of vigorous, sweat-producing exercise 3-4 days a week. If your child is experiencing a headache when exercise is scheduled, try to encourage them to be as active as possible for short periods of time or exercise on all non-headache days.
- Drink lots of water and eat well; discourage skipping meals. Keeping properly hydrated and fed can help avoid the onset or continuation of headaches.
- Pursue hobbies or interests such as crafts, reading, or cooking. By relaxing your child's mind after intense schoolwork, they can release stress and stop headaches from starting or worsening.
- Engage with friends and family for companionship and fun.
Coping with headaches in school and at-home
it is common for headaches to increase during the school year. Increased stress from academic demand can be a headache trigger. School can be overstimulating – especially after a prolonged absence. School also starts early in the morning so your child may get less sleep on school nights.
Nowadays, many schools utilize computers, iPads, and other electronic devices for learning. If your child notices worsening headache associated with screen use:
- Encourage 5- to 10-minute "screen" breaks frequently throughout the day to relax the neck and eye muscles.
- Consider purchasing blue-light blocking glasses or installing an anti-glare screen on any electronics (laptop, tablet, etc.) they use regularly.
- Ask your child's school for alternatives to computer/tablet use for some projects. For example, some work may be completed using paper copies or listening to audio files.
- Invite a friend over rather than communicating on devices.
When to see a doctor for your child's headaches
If your child is experiencing frequent or debilitating headaches that are preventing them from normal activities, schedule an appointment with your child’s pediatrician. The Division of Neurology at CHOP developed a Primary Care Headache Pathway to guide pediatricians in the first steps of headache management. Pediatricians think about how headaches may relate to lifestyle and other aspects of your child’s health. Thankfully, first line treatments are helpful for about 2 out of 3 children.
If first line treatments are not helpful, your pediatrician can refer you to a neurologist at the Children's Hospital of Philadelphia. When your pediatrician places a referral, or when you call, we will ask questions to match your child to a provider who can help. At that appointment the neurologist will determine the type of headache your child has, recommend appropriate evaluation if needed (such as an MRI or blood tests), and, if needed, suggest treatment that may include lifestyle habits, acute or preventive medications, cognitive behavior therapy (an effective form of counseling), and procedural or intravenous treatments.
When take your child to the Emergency Room for headaches
If you are not sure if your child needs emergency care, you can always call your pediatrician first. The ER is noisy and busy, which often makes headaches worse.
Circumstances when you may need to take your child to the ER include:
- Your pediatrician recommends the ER
- Your child is very confused or has had a seizure with the headache (if your child does not usually have seizures)
- Your child cannot walk normally, or has very severe pain with moving the neck
- Your child’s headache came out of the blue and was very severe within seconds of starting
- Headaches and vomiting are waking your child from sleep
While we wish they didn’t, kids get headaches. Thankfully, dangerous causes are uncommon, and most kids will have relief quickly with treatment. If your child needs more help, CHOP’s Primary Care, Neurology, and ER teams will working together to offer your family the best care.