Headaches in Children: What Helps and When to Worry

Two common headache types

Tension-type headaches

Children may describe a dull ache, tightness, or a band squeezing around the head. The pain is usually mild to moderate and often does not stop ordinary activities.

Stress, tiredness, and muscle tension can contribute.

Migraine

Migraine can cause more intense pain, sometimes described as throbbing or pounding. In children, it may affect one side or both sides of the head and can worsen with activity.

Other symptoms may include:

• Nausea or vomiting
• Belly discomfort
• Sensitivity to light and sound
• Wanting to stop playing, lie down, or sleep

Some children have an aura, such as flashing lights or spots in their vision, before a migraine. New or unusual vision or neurologic symptoms should not automatically be assumed to be an aura.

Rest in a cool, dark, quiet room—and sleep when possible—often helps.

Repeated vomiting by itself should not be assumed to be migraine. It deserves its own medical assessment.

Can another illness cause a headache?

Yes. Migraine and tension-type headaches are called primary headaches: the headache is the main condition, rather than a symptom of another illness.

Secondary headaches happen because of something else. Common causes include viral illnesses and dehydration. Headaches can also occur after a head injury.

A secondary headache does not automatically mean something dangerous is happening. What matters is the whole picture: your child's symptoms, examination, and whether the pattern is changing.

Daily habits that may help

• Protect sleep. Keep a consistent schedule. Children ages 6 to 12 generally need 9 to 12 hours of sleep per day; teenagers ages 13 to 18 need 8 to 10 hours.
• Offer regular fluids. Encourage drinking throughout the day, especially during activity or hot weather.
• Keep meals regular. Skipped meals and hunger can trigger headaches.
• Protect bedtime from screens. Put screens away at least 1 hour before bed and keep phones and televisions out of the sleeping space when possible.
• Avoid caffeine and energy drinks. Caffeine can interfere with sleep, and changes in caffeine intake can contribute to headaches.
• Make room for activity and downtime. Regular movement, talking through worries, and support with school or family stress can help.

These habits can reduce headaches, but a child who still has headaches is not doing anything wrong. Some children need a more specific treatment plan.

What helps during a headache?

For a mild, familiar headache without warning signs:

• Let your child rest in a cool, dark, quiet room.
• Offer water and, if a meal was missed, something to eat.
• Let your child sleep if they can.
• Try a cool cloth or a cold pack wrapped in a cloth. Do not put ice directly on the skin.

Do not rely on home treatment when a headache is sudden, severe, unusual, or accompanied by the warning signs below.

Using pain medicine safely

Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help headache pain when appropriate for your child's age and health. Giving medicine early in a familiar headache may work better than waiting until the pain is severe.

• Use the correct dose for your child's weight and age. Follow the label or the clinician's instructions, and do not exceed the recommended amount.
• Choose a form your child can safely take. For liquid medicine, use the supplied oral syringe or dosing cup, not a kitchen spoon.
• Check the ingredients so you do not give two products containing the same medicine.
• Ibuprofen is generally used in children 6 months and older unless a clinician recommends otherwise. Avoid it when your child is dehydrated or vomiting repeatedly unless their clinician advises it.
• Do not give aspirin to children or teenagers unless their clinician specifically prescribes it. Aspirin use during viral illnesses is associated with Reye syndrome, a rare but serious condition.

See our Fever in Children guide for weight-based acetaminophen and ibuprofen dosing tables.

Do not keep increasing the dose or trying different products without advice.

Keep a simple headache diary

A few notes can make the pediatrician visit more useful. Record:

• When the headache started and how long it lasted
• Where it hurt and whether it interrupted school, play, or sleep
• Other symptoms, such as nausea or sensitivity to light
• Sleep, meals, fluids, and anything stressful or unusual that day
• Any medicine given, the dose, and whether it helped

You do not need a complicated app. A notebook or a note on your phone is enough. Tell the pediatrician if migraine runs in the family.

When should I make an appointment?

Arrange a visit if headaches:

• Happen often or interfere with school, play, or family life
• Come with ongoing mood, behavior, or energy changes
• Require frequent pain medicine
• Are not improving with your child's usual plan

Some children with frequent or disabling migraine benefit from prescription treatment or a prevention plan. Your pediatrician may recommend a specialist.

Which headaches need prompt assessment?

Call your child's pediatrician promptly for same-day guidance and assessment if a headache:

• Wakes your child from sleep or is present on waking in the morning
• Is progressively worsening or has a clearly different pattern
• Comes with unexplained or repeated vomiting, especially in the morning
• Is triggered or worsened by coughing, sneezing, bending, or straining
• Starts after a head injury

These features do not prove a serious cause, but they should not be watched for days without advice. They are especially important in younger children. A child under 4 years old with a headache should also be assessed promptly.

If prompt assessment is unavailable, or the headache is severe or worsening or your child appears ill, go to the emergency department. Use the emergency guidance below for symptoms that should not wait for a return call.

If your child already has diagnosed migraine, follow their treatment plan for a familiar episode—but seek reassessment for new warning signs or a change from their usual pattern.

Our Head Injuries in Children guide explains what to watch for after a bump or fall.

When should I seek emergency care?

Seek emergency medical care for:

• A sudden, severe headache that reaches its worst intensity within seconds to minutes
• Fever with a stiff neck, confusion, a purple or bruise-like rash, or a very ill appearance
• New weakness, numbness, trouble walking or speaking, or a seizure
• New double vision, loss of vision, abnormal eye movements, or newly crossed eyes with a headache
• Confusion, extreme drowsiness, or difficulty waking
• A severe or rapidly worsening headache with repeated vomiting or a child who looks very ill
• Headache after a significant head injury, or a worsening headache after an injury with repeated vomiting, confusion, or unusual behavior

Possible carbon monoxide or poisoning exposure

Consider carbon monoxide if several people in the same home develop headache, dizziness, or nausea, especially around fuel-burning appliances or a generator.

If carbon monoxide exposure is suspected, get everyone outside into fresh air immediately and call 911 from outside. Do not re-enter until emergency responders say it is safe.

For another possible poisoning, call Poison Control at 1-800-222-1222 in the United States for immediate instructions. Call 911 if your child collapses, has a seizure, has trouble breathing, or cannot be awakened.

Will my child need a brain scan?

Not usually. When the history and examination fit a typical migraine or tension-type headache and there are no warning signs, a scan is often unnecessary.

Your child's clinician will decide whether imaging or other testing is needed based on the symptoms and examination. A careful conversation and examination are important even when a scan is not needed.

The bottom line

Most childhood headaches are not caused by a dangerous problem. Rest, regular fluids and meals, enough sleep, and appropriate pain relief often help.

Frequent headaches deserve a plan, not simply more medicine. Keep a diary and talk with your pediatrician if headaches interfere with daily life.

Take a new or changing pattern seriously. Sudden severe pain, neurologic changes, difficulty waking, or a very ill child needs emergency care. When something about your child's headache worries you, seeking medical advice is reasonable.