By Drs. Sally Robinson and Keith Bly

Many adults know what it’s like to have headaches, but children also get them. In fact, by the age of 5, 25 percent of children have had at least one headache, and by the age of 15, 75 percent have experienced a headache.

Even though a headache may feel as if the pain is coming from the brain, what usually causes the pain comes from outside the skull, in the nerves, blood vessels and muscles that cover the head and neck, or from increased pressure in the blood vessels inside the skull. The muscles and blood vessels can swell or tighten and put pressure on surrounding nerves.

Children can develop headaches for a variety of reasons, including dental cavities, ear infections and sinusitis. Headaches can also come about due to lack of sleep, stress or bumps on the head, or they can be triggered by certain foods and drinks. Children can also suffer from migraines and tension headaches.

Headaches are classified into two different categories — primary and secondary. Primary headaches include tension headaches, migraines and cluster headaches. Secondary headaches result from specific causes, including infection, meningitis, tumors or head injuries.

Most headaches will go away on their own with little or no medical intervention, but you should take your child to a doctor if the headaches:

· Are very painful
· Wake the child from sleep
· Will not go away easily
· Develop after a head injury
· Affect your child’s vision
· Are accompanied by a tingling sensation
· Cause your child to act differently
· Occur more than once a month
· Keep your child from going to school
· Are accompanied by fever or a stiff neck
· Occur early in the morning without nausea

Having your child lie down in a cool, dark room, or giving him or her acetaminophen may help. You should not give your child pain medication every day, because it can make the headaches worse over time.

Here are other steps that may help prevent your child from getting headaches:

· Make sure your child drinks enough fluid. Children need about 4-8 glasses of fluid a day.
· Avoid giving your child caffeine.
· Keep your child on a regular sleep schedule with at least 8-10 hours of sleep per night.
· Do not let your child skip meals.
· Avoid foods that seem to trigger headaches.
· Avoid overly busy schedules or stressful situations.

If you decide to see a doctor about your child’s frequent headaches, the doctor will examine your child’s medical history and may ask you to keep a record of the headaches by writing down how severe they are, what seems to help or make them worse, and what seems to trigger them. Your doctor may also suggest a change in diet, a change in sleeping habits, relaxation exercises or, if necessary, prescription medication to control the headaches. If you get a prescription, you will need to inform the school nurse, so that your child can receive treatment if a headache comes on at school.
Dr. Sally Robinson is a pediatrician in the division of children’s special services at the University of Texas Medical Branch at Galveston. She teaches medical students about caring for children with chronic medical conditions. Dr. Keith Bly is a hospitalist and assistant professor of pediatrics at UTMB.

The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. If you have any questions about the column, or would like to suggest topics, please contact John Koloen, media relations specialist, at (409) 772-8790 or email