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Q: My 8-year-old has started experiencing headaches more frequently. What could be going on, and how concerned should I be? 

Headaches in school-aged children are a common complaint. It can be difficult to sort out whether this is an “I don’t want to go to school” headache versus something else. Children can experience many types of headaches. These include tension, migraine, sinus/congestion and stress (including from anxiety or depression). Ironically, using ibuprofen frequently can also sometimes cause medication rebound headaches. Here’s what to know, what to watch for and when to be seen by the pediatrician.

Kids tend to describe tension headaches as “squeezing” or “band-like pressure,” like wearing a hat or visor that is too tight. They usually start midday or toward the end of the school day and can be associated with fatigue and neck pain, but never fever. Migraines are more often on one side (but can be both), throbbing and often associated with nausea, vomiting, and light or sound sensitivity. They will sometimes have an aura which can look like flashes of light that precede the headache. Stress can trigger both types of headache. A key question is whether they go away or get better on weekends or school holidays.


Worrisome features of headaches are: daily headaches; headaches that are worsening in severity or frequency; worse in the morning when they wake up; nighttime awakening — with or without vomiting — due to a headache; or a headache associated with fever and neck pain, which can be signs of meningitis. If your child ever has a sudden onset headache associated with confusion, vision changes, numbness, or sleepiness/behavior changes, then you should go to the ER for further evaluation.

Most headaches will resolve with over-the-counter pain medication like acetaminophen or ibuprofen, rest, hydration, and eating regular, balanced meals. If you find you are using medication more than a few days per month or the headaches have any of the above features, it’s a good time to have your child evaluated by the pediatrician.

If you’re looking for more expert advice from Dr. Baynham, check out her column here!

Dr. Allison Baynham
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