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Pediatric - Headache


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Does this describe your child's symptoms?

  • Pain or discomfort of the scalp or forehead areas
  • The face and ears are excluded


  • Viral illnesses: Most headaches are part of a viral illness, especially with colds. These usually last a few days.
  • Muscle tension headaches: Most common type of recurrent headaches
  • Migraine headaches: Recurrent severe, incapacitating headaches
  • Other common causes: Hunger, exertion, sunlight
  • Serious causes: Meningitis or encephalitis

If not, see these topics

When to Call Your Doctor

Call 911 Now (your child may need an ambulance) If
  • Difficult to awaken or passed out
  • Confused thinking/talking or slurred speech
  • Blurred or double vision
  • Weakness of arm or leg or unsteady walking
Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Stiff neck (can't touch chin to chest)
  • Severe headache
  • Vomiting
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen
  • Fever
  • Sinus pain (not just congestion)
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Headache without other symptoms present over 24 hours
  • Sore throat present over 48 hours
  • Any headache present over 3 days
  • Headaches are a recurrent chronic problem
Parent Care at Home If
  • Mild headache and you don't think your child needs to be seen

Treatment for Mild Headache
  1. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief (see Dosage table). Headaches due to fever are also helped by fever reduction.
  2. Food: Give fruit juice or food if your child is hungry or hasn't eaten in more than 4 hours (Reason: Skipping a meal can cause a headache in many children).
  3. Rest: Lie down in a quiet place and relax until feeling better.
  4. Local Cold:  Apply a cold wet washcloth or cold pack to the forehead for 20 minutes.
  5. Stretching: Stretch and massage any tight neck muscles.
  6. Call Your Doctor If:
    • Headache becomes severe
    • Vomiting occurs
    • Isolated headache lasts over 24 hours
    • Headache lasts over 3 days
    • Your child becomes worse
Treatment for Migraine Headache
  1. Reassurance: This headache is similar to previous migraine headaches that your child has experienced.
  2. Migraine Medication:
    • If your child's doctor has prescribed a specific medication for migraine, give it as directed as soon as the migraine starts.
    • If not, ibuprofen is the best over-the-counter drug for migraine. Give ibuprofen now and repeat in 6 hours if needed (See Dosage Table).
  3. Sleep: Have your child lie down in a dark, quiet place and try to fall asleep. People with migraine often awaken from sleep with their migraine gone.
  4. Call Your Doctor If:
    • Headache becomes much worse than usual
    • Headache lasts longer than usual

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 6/18/2008

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.

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