Understanding and preventing headaches in children

What is normal and what is not?
Overview: Understanding and preventing headaches in children

Even young children can experience recurring headaches. The good news: if we understand the causes, we can help children and, at best, protect them from new attacks.

Headaches in preschool age occur in around one in five children, according to the German Migraine and Headache Society. By the end of primary school, it is even more than half of the children. The older children and young people are, the greater the proportion.

The symptoms in children often express themselves differently than in adults. Tension headaches and migraines are the most common. With these tips from experts, you can identify the different types of headaches, prevent them in the long term and treat them in acute cases.

1. How do I know if my child has a headache?

School-age children are usually able to tell their parents that they have a headache.

Younger children who cannot or will not express their pain also show typical behaviors that parents can use to recognize a migraine, for example.

Overview: Understanding and preventing headaches in children

Photo: Christin Klose/dpa-tmn

Julia Wager, head of the research department of the German Children’s Pain Center in Datteln, lists the following points: The child…

  • withdraws, sits quietly in a corner of the room.
  • eat less.
  • sensitive to light and noise.
  • For example, I don’t want to watch TV.
  • looks pale and has dark circles under the eyes.
  • can also throw up.

2. When is a headache a migraine?

Typical for Migraine: The symptoms occur cyclically, for example once a month. Then you should definitely consult a pediatrician to clarify a possible migraine.

“In the case of recurring headaches, it makes absolute sense to keep a headache diary over a period of at least four weeks for better classification.

It should be noted here…

  • in which situations the headache
  • at what time and
  • with what intensity it occurs,” advises Paula Döllscher in connection with cyclic headaches. She is a child and adolescent psychiatrist and worked as a doctor with young headache patients at the University Hospital in Göttingen.

This sometimes helps to identify triggers and to distinguish between migraines and tension headaches. The pain clinic in Kiel, for example, offers such a headache calendar especially for children for download.

For older children and adolescents, child and adolescent psychotherapist Julia Wager recommends the headache calendar of the German Children’s Pain Center, which you can download here.

Tip for children: the hop test

Wager has a practical tip for how your child can learn to distinguish tension headaches from migraines: with the so-called hop test.

“The child jumps in place or runs up and down the stairs once. The children often stop the jumping test immediately when they have an acute migraine attack,” explains the trained psychologist.

In tension headaches, the pain is less intense. Exercise usually does not make the headache worse. Fresh air and distraction usually provide pain relief.

3. What causes headaches in children?

There are various factors that can trigger headaches in children. In some cases, it can also be due to a combination of several reasons. Possible causes are:

  • stress
  • lack of exercise
  • poor sleep
  • Noise, bad air, heat or too bright light
  • especially with migraine: general changes in daily rhythm (e.g. skipping meals)

Overview: Understanding and preventing headaches in children

Photo: Christin Klose/dpa-tmn

Although stress is an important risk factor for headaches, it does not need to be completely avoided. “Children can get stressed. It’s a part of life. It’s important that they always have the opportunity to compensate,” says Wager.

In addition to alternating between stress and relaxation, the diet should also be balanced. Parents can follow the guidelines in the food pyramid from the Federal Center for Nutrition.

4. How can you prevent headaches?

A balanced lifestyle prevents headaches in children.

Overview: Understanding and preventing headaches in children

Photo: Silvia Marks/dpa-tmn
  • Stress reduction: Techniques such as breathing exercises, imaginary journeys or progressive muscle relaxation according to Jacobson are suitable for long-term stress reduction – the child learns to tense individual muscles for a few seconds and relax them again. Relaxation exercises should be fun for the child so that they want to keep doing it. These techniques need little guidance and are more fun together. Therefore, parents should always use them with their children.
  • Movement: “Exercise is an important contributor to stress reduction,” says Wager. A little endurance sport is enough: walking, running, swimming or cycling. It is best for about 30 minutes, two to three times a week.
  • Curiosity: Observe your child and keep in touch. “A good exchange and a conversation with the child is important in order for parents to be able to find out: what is really busy with my child in everyday life?” says the expert. “What is beautiful and what is quite stressful – getting to those things is very important. Parents can then, together with their child, consider how stress can be reduced in everyday life.” It is often the small things in everyday life that eventually add up and lead to lasting stress.
  • Calm: A child must have regular breaks throughout the day. Time for yourself to calm down.
  • Sleep: To ensure a restful sleep, you should check the following things: Is the children’s room darkened? Is the room comfortably cool? Do you turn off your mobile phone or tablet or put it aside at least half an hour before going to bed?

How much sleep your child needs depends on their age. You can, for example, find information from the professional association of paediatricians.

5. What helps if your child has an acute headache?

In an acute pain situation, one should first try to break through this with general measures, advises Döllscher.

  • For migraines, rest and sleep in a dark room.
  • For tension headaches, get some fresh air and distraction.
  • A cool washcloth on the forehead.
  • A gentle head massage.

Important: Essential oils such as peppermint oil, but also camphor, clove or lemon scallion oil work to relieve pain in adults, but must not be used in children under 2 years of age.

Children may react to this with shortness of breath. This is stated in the respective package insert. Take this advice seriously and only give your child preparations that a doctor or pharmacist expressly recommends for the respective age.

If the headache persists, you can relieve it with a well-tolerated pain reliever, Döllscher recommends. For example with ibuprofen or paracetamol, which you should dose according to body weight.

Important: Medicines should only be given after consultation with a doctor. Because if painkillers are given too often, there is also a risk of drug-induced headaches in children and young people. The German Migraine and Headache Society, for example, points this out in its brochure Headaches in children.

In addition, headache medications that help adults are sometimes unsuitable for children. Acetylsalicylic acid, found in aspirin for example, can cause side effects in children that damage the brain and liver.

Correct use of medication:

When it comes to migraines, it is especially important to take the medication correctly. “The sooner you give the drug, the more likely it is that the attack will actually be stopped,” explains Wager.

The right dose is also important: Do not give more, but also not less, than the doctor recommends. The seizure is usually over after half an hour to an hour.

6. When should you take your child to the doctor?

According to the aforementioned brochure from the German Migraine and Headache Society, you and your child should consult a doctor in the following situations:

  • The headache keeps coming back (several times a month or weekly) and the child has no infection.
  • The pain is very strong once.
  • The child wakes up at night with a headache.
  • Conspicuous accompanying symptoms occur, such as aura symptoms (eg, blurred vision) or fever.
  • A usual headache changes significantly.

7. Who can help children with frequent headaches?

Julia Wager points out that – in addition to the above criteria – you should definitely consult a pediatrician if the child is absent from school because of the headache or no longer does the usual leisure activities.

A visit to the ophthalmologist is also advisable. According to the German Migraine League, ametropia can be a trigger for headaches.

Correct diagnosis is essential for successful treatment. It can be greatly facilitated by keeping the headache diary mentioned above.

If the family doctor does not know what to do, special children’s pain centers or a headache clinic can also be points of contact. Doctors and psychologists work together in these clinics.

Headaches can be triggered by stress of any kind: school work, bullying, but also family problems. To track down the exact trigger, joining psychotherapy in consultation with the pediatrician can also help.

Like adults, children with migraine are treated not only with medication, but on several levels, i.e. multimodally. Different approaches such as physical activation, stress management methods and relaxation techniques are combined.

The German Children’s Pain Center has posted a nice film online that explains to children what migraines are and how to get them under control.

8. Can migraines be cured?

A migraine may disappear during puberty or adulthood. However, there is no treatment that cures migraines.

“It is important that the child receives treatment that takes into account the special characteristics of children and young people and also includes the psychosocial aspects,” says Wager.

Parents and children must have the opportunity to understand each headache and learn to manage it together.

© dpa-infocom, dpa:211028-99-773370/57


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