Headaches in children

This is for anyone looking after a child who is experiencing headaches.

How common are headaches in children?

Headaches are common in children and teenagers. They may be less obvious in younger children. They are often different from the sort of headaches that adults get, so parents and healthcare professionals may not notice them at first.

Headaches often start suddenly in children. Your child may look pale or unsettled, and the headache may make them feel sick or vomit. However children can recover quickly because their headaches, including migraines, tend to be short lived.

Children’s headaches can also affect their stomach, so a tummy ache is a common complaint.

What causes headaches in children?

Some lifestyle issues can cause headaches or make existing headaches worse. These include:

• poor quality sleep (see More information section)
• not drinking enough fluids
• having much less to eat than usual
• looking at screens for a long time (including TVs, tablets, phones)
• eyesight problems. Children do not often complain about their eyesight, but headaches can be a sign of being unable to see properly. It is important that you take your child for an eye check. These are free for children under 16 years of age.
• migraines. These are a particular type of headache that tend to run in families. Unlike adult migraines, child migraines can often affect both sides of the head.
• emotional problems, for example problems at school or changes in family circumstances
• using too much medication such as paracetamol (for example Calpol) or ibuprofen (for example Nurofen). Talk to your GP if you are giving your child medication to control a headache more than 3 times a week.

What is a headache diary?

A headache diary can enable your GP to identify trigger factors or the impact of medication on a headache. This can help them to make a diagnosis. If you keep a headache diary, you should take it with you to any GP or hospital appointment for your child.

It is a good idea to keep a record of when your child has a headache and record any accompanying change in their normal routine. For example a missed meal, a sports activity or a late night, or an emotionally upsetting incident. If your child is old enough, you can suggest they keep their own diary.

You can download a headache diary from The Migraine Trust (see More Information section). Headache diary apps are also available for your smartphone.

When do I take my child to a GP about their headaches?

You should make an urgent appointment with your GP if your child experiences any of the following:

• frequent headaches. Particularly if the headache wakes them up in the middle of the night or they have a headache early in the morning.
• balance or coordination problems
• daily nausea or vomiting, especially if this happens early in the morning
• their headache is worse when bending forwards
• there is a change in their ability to see, or they experience blurred or double vision
• a sudden change in behaviour
• they are holding their head or neck in an unusual position.

When do I call 999 for an emergency ambulance?

You should call 999 if your child experiences one or more of the following:

• a fit or seizure for the first time
• a fit or seizure that continues for longer than 5 minutes.

When do I take my child to the nearest Emergency Department (A&E)?

You should call go to your nearest Emergency Department (A&E) if your child experiences one or more of the following:

• A new headache which is much worse than before, especially if it causes pain across the back of their head.
• A fever and a headache and a stiff neck, and they are complaining about the light. Or if they have a rash that does not fade away when you press the side of a glass firmly against the rash. These could be signs of meningitis.

More information

You can download a headache diary from The Migraine Trust using this www.migrainetrust.org/live-with-migraine/self-management/keeping-a-migraine-diary/
NHS information on meningitis www.nhs.uk/conditions/meningitis/
NHS information on sleep in young children https://www.nhs.uk/conditions/baby/health/sleep-and-young-children/
YoungMinds information on sleep problems www.youngminds.org.uk/young-person/my-feelings/sleep-problems/

_{Drinking image by syarifahbrit and diary image by rawpixel.com; both on Freepik}

Contacts

Your GP or pharmacy
Paediatric Admin Team, Monday to Friday, 9 am to 5 pm	020 8934 6403 khft@paediatricadmin@nhs.net