Headache

Pediatric HouseCalls Online

DEFINITION

• Pain or discomfort of the scalp or forehead areas.
• The face and ears are excluded.

Causes

• Viral illnesses: Most headaches are part of a viral illness, especially with colds.
• Muscle tension headaches: Most common type of recurrent headaches
• Migraine headaches: Recurrent severe, incapacitating headaches
• Other common causes: Hunger, exertion, sunlight

See More Appropriate Topic(instead of this one) If

• Followed a head injury within last 3 days, see HEAD INJURY.
• Pain is around the eye or the cheekbone, see SINUS PAIN AND CONGESTION.

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WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child may need an ambulance) If

• Difficult to awaken or passed out.
• Confused thinking (delirium) or slurred speech.
• Blurred or double vision.
• Weakness of arm or leg or unsteady walking.

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick
• Stiff neck (can’t touch chin to chest)
• Severe headache
• Vomiting

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

• You think your child needs to be seen
• Fever
• Sinus pain or pressure of forehead

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• Sore throat present over 48 hours
• Headache present over 3 days
• Headaches are a recurrent ongoing problem

Parent Care at Home If

• Mild headache and you don't think your child needs to be seen.

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HOME CARE ADVICE FOR HEADACHES

Treatment for Mild Headache 

1. Pain Medicine:  Give acetaminophen (e.g. Tylenol) or ibuprofen for pain relief (see Dosage table). Headaches due to fever are also helped by fever reduction.
2. Food:  Give fruit juice or food if your child is hungry or hasn't eaten in more than 4 hours (Reason: Skipping a meal can cause a headache in many children).
3. Rest:  Lie down in a quiet place and relax until feeling better.
4. Local Cold:  Apply a cold wet washcloth or cold pack to the forehead for 20 minutes.
5. Stretching:  Stretch and massage any tight neck muscles.
6. Call Your Doctor If:
   • Headache becomes severe
   • Headache lasts for over 3 days despite using a pain medicine
   • Your child becomes worse  

Treatment for Migraine Headache

1. Reassurance: This headache is similar to previous migraine headaches that your child has experienced.
2. Migraine Medication:
   • If your child's doctor has prescribed a specific medication for migraine, give it as directed as soon as the migraine starts.
   • If not, ibuprofen is the best over the counter drug for migraine. Give ibuprofen now and repeat in 6 hours if needed (See Dosage Table).
   • Sleep: Have your child lie down in a dark, quiet place and try to fall asleep. People with migraine often awaken from sleep with their migraine gone.    

3. Call Your Doctor If:

   • Headache seems worse
   • Headache lasts longer than usual

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

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