Nearly every adult gets a headache at least once in awhile and we usually don’t think much of it. But when our children get headaches, we often worry more and think the worst.
Soe Mar, MD, a pediatric neurologist at St. Louis Children’s Hospital, reassures parents that contrary to what parents think, headaches are very common in kids. “Headaches are one of the most common reasons children see a pediatric neurologist,” she explains. “The usual diagnosis is a migraine or tension headache; it’s rare to have a brain tumor.”
Headaches affect 50 to 80 percent of children from age 7 to 15 years. Up to 30 percent of teenagers suffer from migraine. While they can begin as young as age 2, they tend to worsen during the teen years. “Teens experience more stress from social activities and schoolwork and their hormones are fluctuating, which all can trigger migraines,” Dr. Mar says.
Tension headaches affect teens, too, but kids as young as 9 also may experience these. These headaches are more common in girls and are usually caused by stress.
Prevention and Treatment for Headaches
According to Dr. Mar, there are three key ways to deal with headaches: abortive medication; preventive medication; and behavioral/lifestyle changes.
Abortive Medication
As soon as a headache begins, ibuprofen (Advil) or acetaminophen (Tylenol) can be used to treat it. “That’s usually all most kids need,” Dr. Mar says. “Consult with your doctor on dosages, but kids shouldn’t take these over-the-counter medications more than once or twice a week because of the risk of rebound headaches. If headaches are more frequent, they may need preventive medication.”
Migraines can be effectively treated with prescription medication, such as triptan derivatives, taken at the onset of headache.
Preventive Medication
Preventive medications are taken daily to prevent headaches. These are ideal for kids who have headaches two or three times a week, or who don’t have headaches frequently but when they do, the headaches last several days. “When deciding if preventive medications would help, I look at how much headaches are affecting a child’s life,” Dr. Mar explains. “If kids are missing a lot of school and social activities due to headaches, then a preventive medication could be helpful.”
Behavioral/Lifestyle Changes
Another form of treatment is modifying lifestyle issues that can cause headaches in the first place. Here’s a starting point:
- Get regular, age-appropriate hours of sleep. “Teens need 8 to 9 hours of sleep each night, but they tend to get less during the week, stay up late on weekends and then sleep in late,” Dr. Mar says. “This irregular pattern can trigger headaches.”
- Eat a healthy diet that limits nitrates and preservatives found in foods such as hot dogs and other processed foods. Choose fresh juice and water over colored, sugary drinks and sodas. “Some children reduce their headaches by eliminating foods and drinks with artificial colors and preservatives,” Dr. Mar says.
- Limit caffeine. Kids should only have caffeine such as soda once or twice a week at the most, Dr. Mar advises.
- Get regular exercise — at least two to three times a week.
- Control stress, especially in older kids. “Biofeedback therapy can be a good way to learn how to reduce stress,” Dr. Mar says.
Headache Red Flags
Dr. Mar says a few headache symptoms are red flags that could indicate a more serious problem that needs a doctor’s evaluation:
- Headache that is increasing in severity and frequency within a short time period
- A child who has never had headaches before who suddenly starts having them very frequently
- Headaches that regularly wake a child at night
- Early morning headaches with vomiting
- School grades are going down, or behavior changes such as aggression, regression or your child becomes unusually quiet
Find Trusted Help
St. Louis Children’s Hospital offers a Comprehensive Headache Center that includes a team of neurologists, psychologists and nurse practitioners who can evaluate and treat headaches. For an appointment to the Comprehensive Headache Center or more information about headaches, please call the St. Louis Children’s Hospital Answer Line at 314.454.KIDS (5437).