At what age do headaches start during childhood?

Headaches are less common in children under 5 years old. About half of children with migraine headaches get their first one before 12 years old.

How many headaches is considered too many for my child to have?

Headaches may be more common than you think. Approximately 57% of children get recurrent headaches. About 60% of children that have recurrent headaches have family members with similar headache issues. However, only about 1-2% of children have chronic headaches which is when they happen at least 15 days per month for more than 3 months.  Our goal for children that suffer from headaches is for them to have less than 4 headaches per month and for none of them to be prolonged for more than 2 hours.

What can I do to prevent my child’s headaches?

Drink 6-8 glasses of water daily. Sleep 8-10 hours per night while keeping a routine bedtime and waketime. Always eat approximately 3 meals and 2 snacks (healthy, balanced foods) per day. DO NOT SKIP MEALS. Be aware that some foods can trigger headaches such as aged cheeses, artificial sweeteners, caffeine, citrus foods, lunch meats, nuts, onions and salty foods. Try to exercise/play 30-60 minutes daily. Limit non-school/academic electronic use to 2 hours per day including no use about 1 hour before the intended bedtime. Do not treat headaches more than 3x per week with headache medications such as acetaminophen, ibuprofen or caffeine. This may cause rebound (MORE) headaches. Stress reduction is CRITICAL! Stress is thought to be the most frequent cause of headaches in children/adolescents. Reach out to your healthcare provider if you need help with stress reduction!

Are there other things I can do than give my child medicine when they get a headache?

Yes! You can always start by increasing hydration with water, sports drinks or other electrolyte drinks such as coconut water. You can try to get them to take a nap in a darkened room. Turn off electronics and use relaxation techniques. You can also use warm or cool (whichever they prefer) compresses.

Massages, acupuncture, biofeedback, cognitive behavioral therapy and guided imagery have also been found to be helpful for some children with chronic headaches.

When should I take my child to the doctor to be seen for headaches?

Please make an appointment for your child’s headaches if he/she is less than 5 years old, if they usually wake your child in the night (a one-time headache in the night may not be as worrisome), if they are early morning and/or with vomiting (without a known gastrointestinal illness), if your child’s mental status/mood/behavior seems different to you, if at-home therapies do not help them go away, if you regularly use more than 3 doses of headache medicine per week or if they routinely interfere with school attendance.

When coming into the office, headache diaries are very helpful to us and we encourage you to bring one with you. The good news is that most children with recurrent headaches, including migraines, do not require diagnostic testing or brain imaging.

This blog was written by Janel Saunders, Pediatric Nurse Practitioner.