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Headache
Headaches in children are common. Most of the time they are mild and only happen from time to time.
- There are plenty of things you can do to help your child to feel better such as making sure they drink plenty of water, taking regular exercise and ensuring they are sleeping well.
- Stress can often play a part in children's headaches, especially the older they get so make sure you have a good chat about what is going on in their life
- Sometimes headaches can be a sign of something more worrying. Please see the table below for some of this things to look out for.
If your child has any of the following:
- They are very sleepy: difficult to wake up or keep awake
- They are confused or behaving strangely
- New, persistent blurring of vision, seeing double, a new squint or unusual eye movements
- New weakness, loss of balance, coordination problems, are holding their head tilted to one side or have difficulty walking
- Vomiting overnight or persistent daytime vomiting without diarrhoea
- Breathing very fast or breathing that stops or pauses
- Working hard to breathe, drawing in of the muscles below the ribs (recession), or noisy breathing (grunting)
- Becomes pale, blue, mottled and/or unusually cold to touch
- Weak, high-pitched, continuous cry or extremely agitated
- Has a fit (seizure)
- Has a rash that does not go away with pressure (the ‘Glass Test’
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
- Neck stiffness or pain
- Discomfort with bright lights
- A headache waking them from sleep
- A headache worse on coughing or straining
- A headache impacting on school attendance
- Concerns about early or late puberty
- Needing to use paracetamol or ibuprofen more than 3 days a week for their headache
- A headache that does not get better after advice or treatment from your doctor or nurse
- Breathing a bit faster than normal or working a bit harder to breathe
- Dry skin, lips, tongue or looking pale
- Not had a wee or wet nappy in last 8 hours
- Poor feeding in babies (less than half of their usual amount)
- Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
- Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
- Getting worse and I am still worried
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If symptoms persist for 4 hours or more and you have not been able to speak to
either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features
If none of the above features are present.
- Watch them closely for any change and look out for any red or amber symptoms
- If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you.
Self care
Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111– dial 111
In school aged children, physical symptoms such as headaches can commonly occur if they are feeling anxious. Click here to learn more about how you can help your child if they are feeling worried.
The two main types of headache are ‘tension type headaches’ and ‘migraines.’
Tension type headaches are the common type of headache that most people get now and again. They can last from 30mins to several hours (occasionally several days) and usually feel like a constant ache or painful tightness throughout the head. Although unpleasant they are usually not severe enough to prevent your child continuing with every day activities.
‘Migraines’ are more severe headaches – this type of headache can be all over the head or sometimes just one side of the head. Your child will typically have to stop what they are doing and rest until the migraine has passed. They will often find normal light, noises and smells distressing and prefer to lie quietly in a dark room. They might look pale, feel sick or actually vomit. They may complain of a nasty taste, be a bit clumsy or sweaty.
‘Migraine with aura’ Sometimes there will be a warning that a migraine is coming – this is called an ‘aura’. A common ‘aura’ is to experience changes in your vision like blurriness or unusual patterns of lines or circles/dots in black and white (your child may be able to draw this for you!). You might notice that your child behaves differently leading up to a migraine: they may have a craving for certain foods (like sweets or chocolate), have mood swings, be hyperactive or the opposite - feel very tired or yawn a lot.
‘Abdominal Migraine’ Some children with migraine may have tummy pain more than headache. This can make the migraine less obvious to diagnose. Your doctor or nurse will be able to consider other possible causes for the tummy pain and can recognise abdominal migraine by the overall pattern of symptoms, particularly because there will also be other features typical to migraines described above.
There are no specific tests to diagnose migraine or tension type headaches – this is done by taking a clear history of what happens and examining the child to check for other possible causes of the headache. Scans of the head are not helpful in diagnosing migraine.
How can you help your child with their headache?
Most headaches are not a problem: they are not severe, do not happen often and cause little disruption to your child’s life. It is enough simply to let them rest until it is over, or give them some paracetamol or ibuprofen. Sometimes they can be more troublesome, either because they cause severe symptoms or are happening too often; they get in the way of normal life too much. If this is happening it can be helpful to look for ‘triggers’ that make having a headache more likely.
Some common triggers include:
- Skipping meals and/or not drinking enough water
- Eating certain foods or drinks: for example coffee, chocolate, cheese, tea, baked beans, tomatoes (including ketchup), fizzy drinks/cola, or citrus fruit/juices (oranges, lemon, lime). Some food additives may also act as triggers (monosodium glutamate in processed food).
- Oversleeping or not getting enough sleep (e.g. a late night)
- Stress and anxiety are common causes of headaches
- Hormonal changes. Headaches may start to happen more in teenagers. In girls and women there may be a clear link to their period cycle.
- Drugs, alcohol and smoking are not only bad for health generally, they can also cause headaches to happen more often.
Keeping a headache diary that records when the headaches happen and what else is going on may help you to recognise the particular trigger(s) for your child (it will also be helpful for your doctor or nurse if you need to go back for more advice). If you can avoid the trigger(s) the headaches will happen less often.
Even if there are no direct triggers, it really helps for your child to keep to a regular routine:
- Have regular mealtimes
- Take regular exercise
- Have regular bedtimes
- Have regular drinks (water is best!) so they do not get thirsty
- Limit screen time
Eye strain can cause headaches – if your child has not had a recent eye check then take them to an opticians.
Finally, simple painkillers like paracetamol or ibuprofen can be used, but it is important not to do this too regularly. If they take painkillers for more than 3 days a week for headaches, week after week after week, they can get a ‘medication overuse headache’. This is a daily headache that can only be stopped by having a complete break from medication.
Treating migraines
Migraines usually affect your child’s gut as well as causing a headache (that’s why they can feel sick or vomit, dislike strong smells or have bad tummy pains). In this case if you are needing to use a painkiller if can be very helpful to use a soluble form that is absorbed quickly – dispersible tablets or liquid medicine. It may also be helpful for them to take anti-sickness medication at the same time – if so your doctor will have prescribed this. Taking the anti-sickness medication and painkiller early on during the attack is important for them to work best – make sure you always have them available when you are away from home.
Sometimes, if these treatments are not successful, your child will be prescribed a special migraine medication called a triptan.
For wear and tear, minor trips and everything in between.
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
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