Headaches can be caused by muscle tension, an underlying illness or infection, or disturbances in the blood vessels in the head. The latter scenario produces migraine headaches, which typically recur periodically and are characterized by severe pain, often concentrated on one side of the head, that is aggravated by light, sometimes preceded by disturbances in vision, and is often associated with nausea and vomiting. Headaches can sometimes be related to disorders that warrant
further investigation, such as infections of the scalp, ears, sinuses, or spinal fluid. They can also be caused by allergies, fever, high blood pressure, epilepsy, brain tumors, severe cavities or oral infections, certain drugs, or an injury to the head.
Most often, headaches are related to tension. However, if your child awakens crying and holding his head, the cause is most likely something other than tension. If your child has a headache in combination with a high fever, severe vomiting, a stiff neck, confusion, disorientation, or extreme fatigue, see your doctor immediately. This can be a sign of a serious illness, such as meningitis or encephalitis. If a child’s headache is so severe that he isn’t tempted by a promise of his favorite activity or a favorite food, or if the headaches are frequent and chronic, you should consult with a physician.
A young child with a limited vocabulary may be unable to describe how his head feels. A tension headache often feels like a tight band around the head. The pain may be throbbing or dull, mild or severe. Sudden movements often seem to make a tension headache worse. A headache may develop suddenly, or come on gradually. Tension headaches most often develop during the day, worsen as the day goes on, and may be relieved with sleep.
An attack of migraine, on the other hand, can last for days; sleep may or may not be helpful in easing the pain. Some children with migraines may not even complain of head pain, but rather of nausea, vomiting, and stomachache. Migraines can be triggered by a number of different factors, including emotional stress, hypoglycemia, food allergies, head injuries, oral contraceptives, or hormonal changes related to the menstrual cycle, which may be why more females than males suffer from them. The disorder also tends to run in families.
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Conventional Treatment
A mild pain reliever, such as ibuprofen (found in Advil, Nuprin, and other medications) or acetaminophen (Tylenol, Tempra, and others) can relieve a headache. These drugs are most effective when given early; headache pain becomes increasingly difficult to relieve as it becomes more severe. ibuprofen generally works better for headaches, especially migraine headaches, than acetarninophen does.
Note: Ibuprofen is best given with food to avoid possible stomach upset.
Acetaminophen can cause liver damage if taken in excessive amounts. If you give
your child acetaminophen, make sure to read package directions carefully so as
not to exceed the proper dosage for your child’s age and size.
Do not give a child aspirin for a
headache unless a viral illness has been ruled out by your doctor. The
combination of aspirin and certain viral infections is associated with the
development of Reye’s syndrome, a dangerous liver disease.
For extremely severe headaches, a combination of acetaminophen and codeine may be prescribed. Codeine is a powerful narcotic painkiller that can cause serious side effects, including nausea, sleepiness, and constipation, and that can also be highly addictive.
If your child suffers from migraines, ibuprofen or acetaminophen is likely to be suggested first, and maybe all that is needed to ease the pain. The antihistamine diphenhydramine (Benadryl) may also be suggested. The reason it works is not well understood, but it may offer relief for your child.
If your child has migraines that are not relieved by ordinary painkillers, an ergotamine preparation may be prescribed. These drugs work by constricting blood vessels. They are available in forms that can be taken orally, rectally, as a nasal spray, or placed under the tongue; some formulations contain caffeine. Ergotamine works best if it is taken as soon as possible after the pain begins, but it should be used with care because it is possible to become dependent on it. Possible side effects include stomach and/or muscle cramps, dizziness, nausea, vomiting, and diarrhea.
A relatively new drug, sumatriptan (sold under the brand name Imitrex), appears to be very effective in alleviating a severe attack of migraine. It works by increasing the amount of serotonin in the brain. Serotonin is involved in vasoconstriction (the constriction of blood vessels); since migraine is in part a result of a disturbance in circulation in the brain, increasing serotonin levels may help to restore balance in the tension of blood vessels. This treatment is expensive, however, and as of this writing, must be administered by injection. It can also produce unpleasant side effects, including increased heart rate, elevated blood pressure, and a feeling of tightness in the chest, jaw, or neck. An oral form may be approved in the near future, and it may be better tolerated. Although this drug may be safe for children, especially teenagers, it is not yet officially indicated for use in children.
There is some evidence that a daily low dose of the beta-blocker propranolol (Inderal) may help if a child suffers from recurrent, incapacitating migraine headaches. This drug should not be taken by a child with asthma or diabetes, however, and it can cause such side effects as fatigue, depression, shortness of breath, and cold hands and feet.
If your child’s headaches are chronic and debilitating, it may be helpful to consult a pediatric neurologist to investigate the possibility of an underlying problem.
Dietary Guidelines
Because low blood sugar can provoke a headache, see to it that a headacheprone child has three whole-foods meals and several snacks each day. Do not offer sugary foods. Sugar causes blood sugar levels to soar, then crash, making a headache worse.
Limit fat, which is difficult to digest and can lead to a stomachache and headache. Avoid greasy and fried foods.
Chocolate, monosodium glutamate (MSG), and the preservatives in hot dogs and other processed meats have been found to cause headaches, especially migraines. If your child typically gets a headache after eating one of these foods, banish the offender from the menu. Be aware of hidden MSG in processed food products. For example, if the label lists an additive called hydrolyzed protein, the product contains MSG. Other additives that contain MSG include autolyzed yeast, sodium caseinate, and calcium caseinate. Read labels carefully.
A food allergy or sensitivity can provoke headaches. Use an elimination diet or a diet diary to uncover hidden food allergies (see For age-appropriate dosages of nutritional supplements, see Elimination Diet.
Nutritional Supplements
Calcium and magnesium help to calm muscles and relax blood vessels. A transitory deficit of magnesium especially has been associated with the onset of migraine. Give your child one dose of a liquid combination supplement containing 250 milligrams of calcium and 125 milligrams of magnesium, twice a day, until the headache is better.
If your child’s headache (whether tension or migraine) is centered in the front of the head-especially if you suspect it may be related to something he ate-try giving him an acidophilus supplement. Give one dose, as directed on the product label, every four hours, until the headache is gone.
For persistent migraines, a supplement called EPA, derived from fish oils, can help to thin the blood and block the cycle that leads to recurrent headaches. Give an older child one capsule, three times daily, for one to two months.
Herbal Treatment
For age-appropriate dosages of nutritional supplements, see Dosage Guidelines for Herbs and Nutritional Supplements.
Chamomile relaxes the nervous system and can bring relief for a tension headache. Give your child one dose of chamomile tea as needed. You can also prepare a chamomile bath and encourage a long, relaxing soak. The herb’s beneficial effects will be absorbed through the skin.
If your child suffers from migraines, try feverfew. This herb has an anti-inflammatory effect and may be taken at the onset of a migraine. Or you can give your child one dose, twice a day, over a period of several months as a preventive.
Ginger tea is helpful for either a tension or a migraine headache that is located in the front of the head. Give your child one dose as needed.
Peppermint tea is helpful for a congested and full headache. It can also help relieve a headache caused by overeating. Give your child one dose as needed.
Skullcap is excellent for headaches due to nervous tension. Give your child one dose as needed.
Note: This herb should not be given to a child less than six years old.
When used as a rub, an herbal tincture of arnica or peppermint oil can be effective in resolving a headache. Rub arnica tincture into the temple or forehead area, or peppermint oil into the temple area. Be very careful to keep tinctures away from your child’s eyes and do not use them on broken skin.
Tiger Balm liniment works very well for tension headaches. Rub the ointment into the temple area.
Homeopathy
For tension headaches, choose the homeopathic remedy most suited to your child’s symptoms and administer it as follows: Give your child one dose of the remedy. Wait twenty minutes. If there is no relief after twenty minutes, give a second dose and wait another twenty minutes. If your child still feels no relief, wait thirty minutes and select another remedy that suits your child’s symptoms and temperament.
- Bryonia 30x or 9c is recommended for a child who has a headache in combination with constipation and much eye pain.
- Ferrum phosphoricum 12x or 5c is for the child whose face may be pale and cold, or red and flushed, and generally alternates between the two. His hands and feet are cold. This child may get a headache when he is fatigued.
- Gelsemium 12x or 6c is useful for the child who describes visual disturbances, such as blurring, and for the type of tension headache that is associated with performance anxiety and commonly occurs before a test, school play, or similar event.
- Give Natrum muriaticum 30x or 9c to a child who develops a headache after any kind of intense mental work, such as a school project or homework that has a grade riding on it. The Natrum muriaticum child is very ambitious, hard on himself, and eager to achieve. This child also has a craving for salt.

- Iris 30x or 9c is recommended for the child who complains of impaired or blurred vision. This child may also be vomiting and the pain may recur periodically-he may have a headache every Sunday, for example.
- Use Lachesis 30x or 9c if the pain begins or is worse on the left side of the head.
- If your child’s migraine begins or is worse on the right side of the head, choose Lycopodium 30x or 9c.
- Silica 30x or 9c is for a migraine that starts at the base of the back of the head and travels into one eye.

If headaches are chronic, and an underlying illness has been ruled out, it may be helpful to consult a homeopathic physician for a constitutional remedy.
Acupressure
For the locations of acupressure points on a child’s body, see ADMINISTERING AN ACUPRESSURE TREATMENT.
Large Intestine 4 relaxes tension in the head. It is especially comforting to a child with a frontal headache.
Neck and Shoulder Release will unkink and relax the muscles most often tight and tense during a headache.
When your child has a headache, rub the two muscles that run along the spine to help him relax.
General Recommendations
Encourage your child to lie down in a darkened, quiet room.
Put a cool washcloth on his forehead.
A tension headache may get better on its own when you give your child the time and attention he needs to express his concerns. Be loving and supportive.
A very important and effective course of action for a child who suffers from migraines is to learn a relaxation exercise. As soon as the sensation of the headache appears, he can begin a relaxation or visualization exercise. This can relax the blood vessels and prevent the development of a full-blown headache.
Give your child chamomile tea for its calming, relaxing effect.
Rub Tiger Balm into your child’s temples.
Choose a symptom-specific homeopathic remedy.
Use acupressure.
A back rub or foot rub can help release tension and make a tense or upset child feel cared for and nurtured.
For a child whose headache is related to constipation, give an Epsom salts bath. The salts will increase circulation and help relax tension. A bowel movement will usually occur an hour or two after the bath.
If headaches are due to a structural stress, chiropractic work may be helpful.
Prevention
Some children tend to get tense, depressed, or overwhelmed. By carefully observing and responding to your child’s needs, you can help him deal with emotional and physical stresses and perhaps avert tension headaches.
To help a child release the tensions of the day, give him a warm herbal bath and a loving massage before bed. Encourage him to talk about the day, express concerns or anxieties, and ask for help.
Offer three good meals every day and have healthy snacks on hand. Avoid sugars, fried foods, and heavy fats. Eliminate any foods that have been shown by experience to trigger a headache.
Do not expose children to cigarette smoke.
Explore meditation or relaxation techniques with
your child. Massage or chiropractic adjustment may also help.
A variety of different drugs may be recommended as preventives for a child who suffers recurring migraines. These include beta-blockers (propranolol [Inderal] is one of the most popular of these), calcium-channel blockers, and low-dose antidepressants, among others. All of these are powerful medications that can have serious side effects, and should be used with caution, if at all.
If your child suffers from migraine headaches, keep a diary that records the circumstances surrounding each attack, such as foods recently eaten, exposure to possible environmental allergens, activities, emotional factors, physical environment, etc. Try to be as observant as possible. Notice the obviously unhealthy things, such as cigarette smoke or car exhaust, but don’t overlook things that seem harmless or even pleasant, such as perfumes or the smell of new fabrics. Once you do this, a pattern may emerge pointing to certain factors that could be triggering your child’s headaches. You can then make appropriate alterations in your child’s diet or lifestyle.
Acupuncture and biofeedback have both been used to good effect against chronic headaches, whether from migraine or tension. If frequent headaches are making your child miserable, it may be worthwhile to consult a qualified acupuncturist or a practitioner skilled in biofeedback techniques.
From Smart Medicine for a Healthier Child by Janet Zand, N.D., L.Ac., Robert Rountree, MD, Rachel Walton, RN, ©1994. Published by Avery Publishing, New York. For personal use only; neither the digital nor printed copy may be copied or sold. Reproduced by permission.