Small People With Big Headaches
Think only adults get headaches? The National Headache Foundation says more than 10 million children between the ages of five and seven experience chronic headaches. That number translates to 20% of all young people.
How Do You Know a Child Has Headaches?
Older children are able to verbalize their pain, while infants and many toddlers cannot. J. T. Jabbour, MD, pediatric neurologist at Baptist Memorial Health Care in Memphis, Tennessee, says that parents of children under the age of three should have their babies checked out for headaches if they "hold" their heads or rub their eyes a lot or are frequently cranky. Vomiting and avoiding light may also occur.
Stress Headaches At Age Three
Jennifer Nelson thought it was odd when her daughter, Ashley, started complaining of frequent headaches at age three. "I would give her chewable grape Tylenol," says Nelson. "She loved it. I began to think her headache was a ploy just to get the Tylenol."
When the headaches became more frequent, Nelson sought medical attention for Ashley. A pediatric neurologist performed a thorough examination and ordered a CAT scan to rule out a tumor. When the scan came back clean, the doctor decided that Nelson's daughter suffers from chronic tension headaches. Her symptoms include pronounced pain in the forehead area and behind the eyes. If Ashley wakes with this pain, it will usually stay with her all day.
Pinpointing the Cause
In both adults and children, migraine is probably the most common cause of headache. Migraine headaches are episodic (that is, they don’t happen every day). They are often associated with nausea and sensitivity to lights and noise. Children with migraine also tend to be susceptible to motion sickness. Migraine headaches may be triggered by certain foods and may be more common after a period of poor sleep.
Dr. Merle Diamond of the Diamond Headache Clinic in Chicago says the majority of children's headaches are not dangerous, but adds that children who have frequent or severe headaches, or have headaches associated with fever or neurological symptoms, should be evaluated by a physician. Doctors will ask questions to find out if they should refer the patient to a neurologist.
Dr. Diamond's questions include:
- Are the headaches associated with neurologic symptoms, such as falling?
- Is the child experiencing weakness?
- Is the child's speech slurred?
Diamond says most kids' headaches are of the migraine type. "While adults may have migraines that last four to twelve hours, kids' headaches are often gone in an hour or maybe two," says Dr. Diamond. She says 10% to 12% of children will be affected by migraines by the time they hit puberty.
The Food They Eat
Dr. Diamond explains that certain foods can trigger headaches. But she says making good diet choices is just as important as eating regularly. She says that teenage girls who habitually skip breakfast often come to her complaining of headaches.
Dr. Diamond advises doing a bit of detective work to try to determine possible triggers for your child's headaches. One way to accomplish this is by keeping a diary of when headaches strike and what your child was experiencing at the time.
She cites an example of good detective work:
A teenager began developing headaches every day at 3:00 p.m. right before coming home from school. After asking the mom several questions, Dr. Diamond discovered two factors that seemed the most likely causes of his pain. The teen's scheduled lunch hour was 11:00 a.m., and his dad packed him the same lunch every day: peanut butter and jelly sandwich and a chocolate peanut butter cup. On the weekends, when his mother fixed different foods, he didn't have any headaches. Diamond recommended a change in diet and adding an afternoon snack. The young man began eating foods other than peanut butter and jelly for lunch and had a snack at 2:00 p.m. every day, and his headaches went away.
Lori Hall McNary also credits a change in diet for preventing her 12-year-old son's severe headaches. He rarely gets a headache now that he avoids foods like cheese, nuts, peanut butter, chocolate, citrus fruits, or processed meats.
Physical And Psychological Causes
The National Headache Foundation lists the following as possible causes for headaches:
- As they do in adults, stress, anxiety, or depression can cause tension-type headaches in children. Something stressful at school or home could make your child anxious or depressed.
- Physical strain
- Your child's headache could be caused by eyestrain if he strains to see the words when he reads books or magazines, or if she complains that TV and movie screens look unclear or fuzzy. Poor posture or too many hours in front of a computer can cause neck or back strain that leads to headaches.
- If, after a full night's sleep and no food, your child does not eat breakfast before school, or does not eat lunch, he or she may be suffering from a hunger or fasting headache. The "treatment" is breakfast—at the very least, bread or fiber-rich cereal and milk. Encourage your child to eat a mid-morning snack, such as fruit, and a well-rounded lunch.
Problems at School
According to the Michigan Headache and Neurological Institute, headaches can affect how well a child does in school. About 37% of children with migraine note poor school performance during headaches. Most identify difficulty concentrating in class and on homework. One pediatric practice identified school problems in 46% of their adolescent headache patients.
Another recent study found that young headache patients rank school among their most potent headache triggers, ahead of parents and other common triggers such as weather, lack of sleep, or missed meals. School-related noise and bright lights emerge as a consistent problem for the headache-prone student. Peer problems, such as frequent bullying or harassment, are also associated with more frequent and severe headaches.
Dr. Diamond says there are a lot of different options. Most patients would prefer to take a tablet, but Diamond says an oral form may not be the best choice if the child is experiencing nausea and vomiting. For smaller children, she recommends ]]>naproxen]]> for headaches and suppositories for nausea. Also, there are pills and nasal sprays designed to control migraine headaches. "For teenagers, I will often prescribe ]]>sumatriptan]]> (Imitrex) in a nasal spray form because it works really fast," she says.
Numerous medications can be tried for preventing migraines, including antidepressant drugs, medications in the mood-stabilizer family, beta blockers, and calcium-channel blockers. Check with your child's doctor to explore which treatments may be best for your child.
National Headache Foundation
Michigan Head Pain and Neurological Institute
Caring for Kids, The Canadian Paediatric Society
Garcia-Mendez L. Headaches in Children:Practical Informative Guide for Parents, Teachers and Paramedical Personnel. Lemar Pub; 1996.
Gupta A, Rothner AD. Treatment of childhood headaches. Curr Neurol Neurosci Rep. 2001;1(2):144-154.
Kolar KR, Fisher W, Gordon V. "Nurse, my head hurts": a review of childhood headaches. J Sch Nurs. 2001;17(3):120-125.
Lainez MJ, Monzon MJ. Chronic daily headache. Curr Neurol Neurosci Rep. 2001;1(2):118-24.
Lewis DW. Headaches in children and adolescents. Am Fam Physician. 2002;65(4):625-32.
Nelson Textbook of Pediatrics . 18th Edition. RM Kleigman, RE Behrman, HB Jenson, BF Stanton, Eds. Saunders, Philadelphia PA, 2007.
Last reviewed May 2008 by ]]>Kari Kassir, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.