Definition

• Pain or discomfort of the head
• This includes the forehead to the back of the head

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 is present in 80%. Lights and sound make them worse. Most children want to lie down in a dark, quiet room. Will recur.
• Head injury. Pain and tenderness at the site of an injury can last 1 to 2 weeks.
• Other common causes. Hunger, hard work or sports, sunlight, coughing.
• Frontal sinusitis. Can cause a headache on the forehead 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

1. Overview:
   • Headaches are very common with some viral illnesses.
   • Headaches also occur after hard exercise, too much sun or fasting too long.
   • Unexplained headaches can occur in children, just as they do in adults.
   • Here is some care advice that should help.
2. Pain Medicine:
   • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
   • 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.
   • Also get enough sleep at night.
5. Cold Pack:
   • Use a cold pack or a cold wet washcloth. Put it on the area that hurts the most.
   • Do this for 20 minutes.
6. Stretching:
   • Stretch and rub any tight neck muscles.
7. What to Expect:
   • Headaches from exercise or too much sun usually go away in a few hours.
   • Headaches with viral infections often go away in 2 to 3 days.
   • Headaches without a cause usually last less than a day.

Call Your Doctor If

• Headache becomes severe
• Vomiting occurs
• Headache lasts more than 3 days
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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