Has your child recently started complaining of headaches? Or if they already have a history of headaches, do they seem to be happening more often?

Headaches are a common problem in children and have been on the rise over the past few years. Much of this uptick was caused by the COVID-19 pandemic and other recent viruses as well as an increase in the number of hours spent on screens. 

Fortunately, many headaches can be managed with pediatric acetaminophen or ibuprofen. But if your child is still struggling or frequently needs to take over-the-counter medications, it’s time to see a physician. Pediatric neurologists like Matthew McCarthy, MD, at Summit Health help diagnose and treat headaches. He tells us what to do if your child’s headache seems out of the ordinary, is more severe, or won’t go away. 

“When the frequency, severity, or symptoms associated with the headache are impacting quality of life in a way that limits normal functions or activities like school and sports it is beneficial to see a pediatric neurologist,” explains Dr. McCarthy. “We work with children and their families to get an accurate diagnosis and come up with an individualized headache management plan that can help them feel more comfortable.” 

At what age can children get a headache? 

Headaches can occur at any age. Children as young as 3 or 5 may begin to say their head hurts. In general, headaches are more common during adolescence. 

Migraines are a severe type of headache that can last anywhere from a few hours to several days. The pain, which is often described as pulsating, can be so debilitating that the child needs to call in sick from school or miss sports. 

Oftentimes, migraines are accompanied by other features, such as light and sound sensitivity, nausea, and vomiting. Some children experience an aura, which most commonly presents as a sensory disturbance like a flash of light or blind spot in their vision, often starting before the headache. 

“Half of the people with migraine have the first episode occur before age 12,” explains Dr. McCarthy.  

What are the symptoms of migraines in a child?

Migraines are more than just an intense headache. The pain is usually accompanied by other signs and symptoms, including: 

• A long duration, lasting anywhere from 2-72 hours
• A severe intensity that causes incapacitation such as needing to miss school or an activity 
• Preference for resting in a dark and quiet room
• Pulsating pain 
• Nausea and vomiting
• Sensitivity to light, sound, and visual or sensation changes

Are migraines different in children vs adults?

Yes. Migraines generally look different in children when compared with adults. 

Episodes are usually shorter in children and more often will be located on both sides of the head. In adults, migraines are more often unilateral, meaning the pain only occurs on one side.

What triggers should my child avoid?  

“There are many triggers for headaches,” explains Dr. McCarthy. The first step in treating migraines is to optimize lifestyle and avoid these triggers as much as possible. 

Some triggers are avoidable while others are not, and may include:

• Skipping meals
•  Having certain foods or beverages such as chocolate, caffeine, aged cheeses, MSG, nuts, and nitrites
• Certain stimuli including bright lights, strong smells, and loud noises
• Stress
• Sleep deprivation
• Postural or eye strain
• Inactivity
• Dehydration
• Hormonal changes
• Changes in weather

What are some treatments for migraine in children and teens? 

Your child does not need to suffer. There are many things that can be done to help manage the symptoms of a headache. Dr. McCarthy tells his patients to treat their symptoms right away before the pain builds for too long and it becomes more difficult to find relief.

Some of the most common treatments include:

• Reducing triggering stimuli like lights and sounds.
• Lifestyle interventions including staying hydrated, drinking caffeine, and eating a snack.
• Over-the-counter medications like such as acetaminophen, ibuprofen, or naproxen 
• Resting or taking a nap
• Applying a cold or warm compression to the head or neck
• Engaging in relaxation techniques like deep breathing or meditation

What effect has COVID-19 and increased screen time had on headaches?

The COVID pandemic had a profound impact on headaches in both children and adults. While many of these factors have begun to improve there is still some residual effects. Some of these factors include: 

• Headaches that lingered after being infected with COVID-19
• Stress
• Inactivity
• Prolonged periods of sitting 
• Increases in screen time
• Eye and postural strain
• Changes to sleep routines/habits
• Decreased social activity and connectedness 

What causes headaches?

There isn’t one single reason why headaches develop in children. Some headaches are caused by triggers like stress or too much screentime. Hormones, environmental factors, and medical conditions also play a role. Children are more likely to develop migraines if their parents also suffer from the condition. 

When do you need to see a doctor right away?

You may be wondering if your child’s headache is something that needs urgent attention. Generally, headaches are not a reason to be alarmed. Visit your local CityMD urgent care immediately if you notice any concerning symptoms along with the headache such as: 

• High fever 
• Stiffness in the neck
• Severe or progressing pain
• Nausea or vomiting
• Dizziness 
• Decreased level or loss of consciousness 

Summit Health can help 

Headaches are a common part of life, but they do not have to be debilitating. Talk to your pediatrician or schedule a visit with a pediatric neurologist if your child is experiencing frequent headaches or has signs of a migraine disorder. If your child has any red flags visit your local CityMD for immediate evaluation and treatment.