Headaches In Children & Young People

Key points about headaches in children and young people 

• headaches are common in tamariki and rangatahi 
• most headaches in tamariki and rangatahi are not due to a serious problem but can be upsetting for them
• drinking fluids and resting in a dark room can help
• regular healthy meals and enough sleep and exercise help prevent headaches
• some headaches can be serious - if your child is unwell or the headaches are ongoing or worsening, see a health professional

What is a headache?

A headache is a pain or discomfort in the head or face that can range from a mild ache to severe pain. Tamariki and rangatahi may describe the pain as throbbing, constant, sharp or dull. Headaches are common in tamariki and rangatahi. 

There are 2 types of headaches - primary and secondary.

Primary headaches

Primary headaches happen when the head pain itself is the main problem. These include tension headaches which can be caused by stress and lack of sleep. And, migraines, which can run in families.

Secondary headaches 

Secondary headaches happen when the head pain is a symptom of another condition. This can be due to things such as a viral infection, eye strain, lack of fluid, or a head injury. In rare cases, it may be caused by a tumour, meningitis, or bleeding inside the skull.

What are the symptoms of headache? 

The main symptom of headaches is head pain and discomfort. It's important to remember that it may be difficult for tamariki to describe their symptoms.

Tension headaches

Tension headaches are often described as a dull ache and can be described as a ‘tight-band’ around the head. The pain is usually felt on both sides of the head. Your child might also get sore muscles in their neck. Tension headaches can come and go and can last for up to several weeks. 

Migraines

Migraines are usually felt as a throbbing pain on one side of the head or behind the eye. Your child might get other symptoms like feeling sick, vomiting, dizziness and sensitivity to light or sound. Some tamariki with migraines might also get an ‘aura’ before the head pain starts. With aura, your child might see flashes of light or feel tingling over one side of their body.

See the KidsHealth page on migraines to learn more

For other types of headaches, including secondary headaches, the type of pain and how long it lasts depends on what’s causing the headache.

What are some common triggers for headaches?

There are lots of common triggers for headaches in tamariki and rangatahi. These include:

• not getting enough sleep
• stress and anxiety
• eye problems
• not drinking enough (dehydration)
• viral infections like the flu or COVID-19

Should my child with a headache see a doctor?

Rarely, headaches have a serious cause. If you are worried about your child, see a health professional. Here are some things to watch out for with your child. 

See a doctor immediately if your child:

• develops a sudden, severe headache 
• develops a headache that hurts most when they wake up, that comes with nausea or vomiting
• has a headache that keeps coming back
• repeatedly wakes up because of a headache
• has a headache that is affecting their school, home or social life 
• has a severe headache that's made worse by straining, such as when coughing, sneezing or going to the toilet

See a doctor immediately if your child has any of these symptoms with their headache:

• a high fever (over 38 degrees Celsius)
• seizures or fits
• confusion, drowsiness or slurred speech
• blurred vision
• unsteadiness when walking
• weakness down one side of the body
• a drooping face
• stiff neck
• a head injury, including concussion
• an unusual rash

What tests might my child with a headache have?

Most tamariki and rangatahi with headaches won’t need any tests. Your doctor can usually make a diagnosis after talking with you and your child and examining your child. This might include measuring your child’s blood pressure and looking at your child’s nerves, muscles and eyes.

Your doctor may recommend your child see an optometrist who can check your child’s eyes. 

If your doctor is concerned that there’s a serious cause for your child’s headache, they may refer you to a paediatrician (child health doctor). Very occasionally, your child might need a CT scan or MRI scan of their head.

See the KidsHealth page on CT scans for children for more information

See the KidsHealth page on MRI scans for children for more information

What are the treatment options for headaches?

You can care for most headaches at home. Here are some things you can try with your child:

• drinking plenty of water
• resting or lying in a dark room
• having a sleep 
• having a cool, wet cloth on the forehead
• massaging the head and neck muscles if they are tight or tender
• relaxation and meditation - these might be helpful for older tamariki

Does medicine help with headaches? 

Headaches often respond well to simple pain relief, such as paracetamol or ibuprofen. You must follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose. If you aren’t sure of the correct dose, check with your doctor or pharmacist.

Do not use pain medicine for more than 2 days in a week without advice from your doctor. Overuse of pain medicine can cause other problems.

Never give your child aspirin, as this may increase the risk of Reye syndrome, which is a rare and serious illness.

What things can help prevent my child from having headaches?

Some things that may help reduce the chances of your child having headaches include:

• avoiding dehydration by drinking plenty of water
• regular meals, snacks and exercise
• getting plenty of good quality sleep
• having a regular routine for going to bed and getting up
• limiting screen time, especially before bed 
• avoiding caffeinated drinks like cola, coffee and energy drinks 
• managing stress 
• getting their eyes checked 

Should my child keep a headache diary?

If your child has headaches often, your doctor may ask you to keep a headache diary. This can help to identify certain triggers. The diary will also help your child’s doctor work out the best way to manage and treat your child’s headaches in the future.

The headache diary should include:

• when the headache started and what seemed to trigger it
• how long it lasted
• which part of the head hurt
• how bad it was on a scale of 1 (mild) to 10 (severe)
• if anything helped to soothe the headache
• any other symptoms with the headache