Children get the same types of headaches adults do, but their symptoms may differ. For example, a migraine in an adult usually starts early in the morning, but a child's is more likely to develop in the late afternoon. Also, migraine pain in children may last less than four hours, whereas in adults, migraines last at least four hours. Such differences may make it difficult to pinpoint headache type in a child, especially in a younger child who can't describe symptoms.
In general, though, certain symptoms tend to fall more frequently under certain categories.
Migraines can cause:
- Pulsating, throbbing or pounding head pain
- Pain that worsens with exertion
- Abdominal pain
- Extreme sensitivity to light and sound
Even infants can have migraines. A child who's too young to tell you what's wrong may cry and hold his or her head to indicate severe pain.
Tension-type headaches can cause:
- A pressing tightness in the muscles of the head or neck
- Mild to moderate, nonpulsating pain on both sides of the head
- Pain that's not worsened by physical activity
- Headache that's not accompanied by nausea or vomiting, as is often the case with migraine
Younger children may withdraw from regular play and want to sleep more. Tension-type headaches can last from 30 minutes to several days.
Cluster headaches are uncommon in children under 12 years of age. They usually:
- Occur in groups of five or more episodes, ranging from one headache every other day to eight a day
- Involve sharp, stabbing pain on one side of the head that lasts from 15 minutes to three hours
- Are accompanied by teariness, congestion, runny nose, or restlessness or agitation
Chronic daily headache
Doctors use the phrase "chronic daily headache" (CDH) for migraine headaches and tension-type headaches that occur more than 15 days a month for more than three months. CDH may be caused by an infection, minor head injury or taking pain medications — even nonprescription pain medications — too often.
When to see a doctor
Most headaches aren't serious, but seek prompt medical care if your child's headaches:
- Wake your child from sleep
- Worsen or become more frequent
- Change your child's personality
- Follow an injury, such as a blow to the head to
- Feature persistent vomiting or visual changes
- Are accompanied by fever and neck pain or stiffness
A number of factors can cause your child to develop headache. Factors include:
- Illness and infection. Common illnesses such as colds, flu, and ear and sinus infections are some of the most frequent causes of headache in children. More-serious infections, such as meningitis or encephalitis, also can cause headache, but are usually accompanied by other signs and symptoms, such as fever and neck stiffness.
- Head trauma. Bumps and bruises can cause headaches. Although most head injuries are minor, seek prompt medical attention if your child falls hard on his or her head or gets hit hard in the head. Also, contact a doctor if your child's head pain steadily worsens after a head injury.
- Emotional factors. Stress and anxiety — perhaps triggered by problems with peers, teachers or parents — can play a role in children's headaches. Children with depression may complain of headaches, particularly if they have trouble recognizing feelings of sadness and loneliness.
- Genetic predisposition. Headaches, particularly migraines, tend to run in families.
- Certain foods and beverages. Nitrates — a food preservative found in cured meats, such as bacon, bologna and hot dogs — can trigger headaches, as can the food additive MSG. Also, too much caffeine — contained in soda, chocolates, coffees and teas — can cause headaches.
- Problems in the brain. Rarely, a brain tumor or abscess or bleeding in the brain can press on areas of the brain, causing a chronic, worsening headache. Typically in these cases, however, there are other symptoms, such as visual problems, dizziness and lack of coordination.
Any child can develop headaches, but they're more common in:
- Girls after they reach puberty
- Children who have a family history of headaches or migraines
The following may help you prevent headaches or reduce the severity of headaches in children:
- Practice healthy behaviors. Behaviors that promote general good health also may help prevent headaches for your child. These lifestyle measures include getting plenty of sleep, staying physically active, eating healthy meals and snacks, and avoiding caffeine. There's some evidence that being overweight, smoking and getting little physical activity contribute to headaches in adolescents.
- Reduce stress. Stress and busy schedules may increase the frequency of headaches. Be alert for things that may cause stress in your child's life, such as difficulty doing schoolwork or strained relationships with peers. If your child's headaches are linked to anxiety or depression, consider talking to a counselor.
- Keep a headache diary. A diary can help you determine what causes your child's headaches. Note when the headaches start, how long they last and what, if anything, provides relief. Record your child's response to taking any headache medication. Over time, the items you note in the headache diary should help you understand your child's symptoms so that you can take specific preventive measures.
- Avoid headache triggers. Avoid any food or drinks, such as those containing caffeine, that seem to trigger headaches. Your headache diary can help you determine what prompts your child's headaches, so you know what to avoid.
- Follow your doctor's plan. Your doctor may recommend preventive medication if the headaches are severe, occur daily and interfere with your child's normal lifestyle. Certain medications taken at regular intervals — such as certain antidepressants or anti-seizure medications — may reduce the frequency and severity of headaches.