Did you know that headaches are one of the most common reasons kids see their pediatrician?

“There are certain types of headaches that happen frequently in children,” says Dr. Pilar Bradshaw. “One is musculoskeletal or tension-based headaches and the other is migraines.”

What is the difference between a migraine and a headache?
Migraine pain is usually more severe than a typical headache. It often includes throbbing on one side of the head that can worsen with activity. Migraine headaches also tend to occur with other symptoms, such as nausea, vomiting, vision problems (e.g., seeing spots or flashing lights), light and sound sensitivity, and tingling.

“Migraines are those headaches that sort of hit really quickly and make your kid feel very unwell,” says Dr. Bradshaw.

Migraines often develop in stages:

  • Premonitory or warning phase: tiredness, stiff neck, mood changes (can last up to 24 hours)
  • Aura phase: seeing spots, squiggly lines, dizziness, weakness, numbness and/or confusion. These symptoms, which don’t happen with all types of migraines, may last up to an hour.
  • Attack phase: severe, throbbing or pulsating pain with nausea, vomiting and light sensitivity
  • Postdrome phase: may include extreme tiredness and sluggishness, post-migraine

Headache triggers

  • Genetics: Headaches, particularly migraines, tend to run in families.
  • Illness and infection: Common illnesses such as colds, flu, and ear and sinus infections are some of the most frequent causes of headaches in children. Meningitis or encephalitis may cause headaches, but very rarely.
  • Lack of sleep or change in sleep patterns
  • Emotional factors: Stress and anxiety play a role in children’s headaches. It’s common for kids with depression to complain that their head hurts, especially if they have trouble recognizing feelings of sadness and loneliness.
  • Foods and fluids: Skipping meals, eating certain foods — including aged cheeses, chocolate, citrus fruits and processed meats like bacon, bologna and hot dogs — as well as consuming additives, such as red and yellow food dyes, monosodium glutamate (MSG) and aspartame, can set off a headache. Dehydration is also a trigger, as is too much caffeine.

Dr. Bradshaw says another reason providers see so many kids complaining of tension-type headaches is due to technology.

“Because kids are staring at a screen in a fixed spot and are often looking down, it puts a lot of tension on the muscles that go up your back, up your neck, over the top of your head and attach onto your forehead. So, one thing that can help that is to put all of their screens up at eye level, so a child can be looking forward instead of slumped over their desk or on their bed looking at their screen.”

When to see a doctor
Most headaches aren’t serious and can be treated with over-the-counter pain relievers along with rest, drinking more fluids and reducing stress and tension. However, there are times when a child’s headaches are serious enough that they should see a specialist. Get immediate medical care if your child’s headaches:

  • Wake them from sleep
  • Worsen or become more frequent
  • Cause a change in your child’s personality
  • Occur following an injury, such as a blow to the head
  • Are accompanied by vomiting, fever, neck pain or stiffness

If your child exhibits neurological symptoms before, during or after a migraine episode, including double vision, changes in speech or balance or difficulty using their hands, see your doctor immediately. These are not symptoms of a headache.

Tracking headaches
One of the best ways to help your doctor identify what may be causing your child’s headaches is to keep a diary.

“Write down what time of day your child experienced a headache, how bad the headache was and any other factors that you think might be relevant, such as poor sleep, what they were eating and drinking prior to the headache, stress, anything that was a little bit different about that day,” Dr. Bradshaw says.

In addition, write down your child’s response to taking any headache medication. Over time, that diary can help you and your doctor better understand the causes behind your child’s headaches and how to best treat and prevent them.

Treating headaches
For some children, sleep alone is an effective treatment for headaches. Treating migraines can be challenging for kids who require something more, because most FDA-approved drugs to prevent migraines are not recommended for kids under age 12.

“However, there are some things you can try, like over-the-counter medications,” Dr. Bradshaw says. “Ibuprofen, Advil or Motrin given immediately at the onset of a mild to moderate migraine or tension-type headache can help ease the severity. It’s also helpful to immediately hydrate your child with plenty of water.”

If your child is experiencing headaches or migraines, talk with your pediatrician. Together, you can work on the best course of treatment for your child.