When children have headaches
- Johanna
- Sep 3
- 5 min read
Many parents are surprised when their child complains of headaches at a young age. However, headaches are actually quite common in children, and their effect on daily life, school performance, and emotional health is often overlooked. Below, you'll find an overview of headaches.
Frequency
Headaches occur even in preschool age, with a sharp increase in school age and a very high incidence in adolescence.
Preschool age: approximately 10.3% affected (Cavestro et al., 2014).
Elementary school children: approximately 31.4% - 37.5% with headaches, often with abdominal pain and a family history (Cavestro et al., 2014; Park et al., 2024; Jo et al., 2024)
Teenagers: Strong increase since 1990. Almost 50% of girls and 33% of boys report regular headaches (Krause et al., 2019). This number ranges from 41.4% to 63.6% (Aromaa et al., 2000; Lu et al., 2025).
Worldwide: Migraine and tension headaches account for approximately 37.5% of headache cases in children and adolescents (Leonardi et al., 2020; Onofri et al., 2023).
Causes and triggers of headaches in children
The causes of headaches often go undetected and are diverse, ranging from harmless triggers to serious illnesses. Important categories include:
Physical factors: lack of sleep, irregular meals, low fluid intake, physical overexertion, poor posture, prolonged screen time, high blood pressure, poor posture due to prolonged sitting, and tooth growth
Psychological stress: stress, anxiety, excessive demands at school or in the family, bullying
Secondary causes: infections (e.g., colds, sinusitis), head injuries, dental or jaw problems, ametropia or, rarely, more serious diseases such as meningitis
External stimuli: noise, bright light, bad air, heat
Types of headaches
A distinction is made between primary headaches, such as migraines or tension headaches, which occur independently. Primary headaches are particularly common among adolescents.
Migraine in children is the most common primary headache diagnosis in pediatric neurology. Approximately one in ten children is affected. Typical features include:
moderate to severe, throbbing pain, often bilateral,
Duration usually between 1 and 48 hours,
Accompanying symptoms such as nausea, vomiting, sensitivity to light or noise, and sometimes abdominal pain.
Reinforcement through movement,
An early diagnosis is crucial so that appropriate measures can be determined in consultation with the doctor and family.
b. Tension headaches in children are usually less debilitating than migraines, but if they occur frequently, they can significantly impair quality of life. Typical symptoms include:
dull, pressing pain (“like a solid helmet”),
mostly bilateral,
mild to moderate,
no reinforcement through movement,
often accompanied by tension in the neck and shoulder area.
Triggers are often tiredness, stress, lack of exercise, or too much screen time.
Secondary headaches are the result of another cause, such as a cold, poor vision, concussion, or injury to the cervical spine. Secondary headaches occur significantly more frequently in preschool children.
What helps against headaches
Parents can do a lot to reduce the risk of headaches and ease acute episodes. The triggers mentioned above are a good starting point. Reducing these can reduce many cases of headaches.
Regularity in everyday life: Regular sleeping times, healthy eating at set times, and sufficient breaks have a preventative effect.
Exercise: Regular exercise and active breaks promote blood circulation, reduce stress, and prevent tension. (Helps generally, but not during an acute migraine attack.)
Limit screen time: Regular breaks relieve strain on the brain, eyes, and neck, and reduce stress levels.
Relaxation and retreat: Darkened rooms, heat pads, cool cloths, breathing exercises or peppermint oil 10% on the temples can be soothing.
Nutrition and fluids: Drinking plenty of fluids and eating a balanced diet protect against dehydration and blood sugar fluctuations.
Keep a headache diary: Record sleep times, diet, stress factors, possible triggers, and the duration of the symptoms. This makes it easier to recognize patterns. If your child is old enough, they can keep the diary themselves—this also strengthens their own awareness. With younger children, avoid constantly asking questions; instead, listen attentively and wait to hear what the child has to say.
In the case of repeated attacks or severe limitations, medications such as paracetamol or ibuprofen (never aspirin in children) can be used in consultation with the pediatrician.
When should you take your child to the doctor?
Many headaches can be relieved by getting rest, drinking fluids, and getting enough sleep. However, there are warning signs that require medical attention:
Sudden, very severe headache (“thunderclap headache”).
Pain that lasts longer than three days.
Neurological abnormalities such as paralysis, unsteady gait, speech or vision disorders, seizures.
Accompanied by fever, stiff neck, rash, or pronounced disease pressure.
Headaches following a head injury, particularly with vomiting or altered consciousness.
Recurrent nighttime headaches or morning vomiting.
Increasing frequency or intensity despite measures taken at home.
Rule of thumb: If headaches regularly interfere with your child's daily life or your gut feeling warns you, have your child examined by a doctor.
What happens at the pediatrician’s?
The pediatrician will first conduct a detailed discussion with you and your child. This will cover frequency, duration, triggers, accompanying symptoms, and family history. A headache diary is particularly valuable in this case. This will be followed by a physical examination, a check of the eyes, teeth, jaw, and posture, as well as a brief neurological examination. Depending on the findings, other specialists may be involved, such as an ophthalmologist, orthopedist, or psychotherapist. In rare cases, imaging studies (MRI/CT scan) may also be necessary.
Conclusion
Headaches in childhood are common and complex. They arise from an interplay of physical, psychological, and environmental factors. Parents can support their child by observing carefully, creating daily structures, reducing stress, and promoting healthy routines.
It's important to note that headaches are not a trivial matter. However, with the right support, they can usually be managed.
Status: 09/2025
Resources
Aromaa, M., Rautava, P., Helenius, H., & Sillanpää, M. (2000). Prevalence and incidence of headaches in children: A nationwide 8-year follow-up study. Cephalalgia.
Cavestro, C., et al. (2014). Headache prevalence and related symptoms in preschool and school-age children. Journal of Headache and Pain.
Krause, TG et al. (2019). Headache prevalence among children and adolescents in Germany.
Leonardi, M. et al. (2020). Global burden of headache disorders in children and adolescents. The Journal of Headache and Pain.
Lu, G., et al. (2025).Global Burden of Disease 2021 study: Headache prevalence, incidence, and disability-adjusted life-years in children and adolescents. The Journal of Headache and Pain.
Nieswand, V. et al. (2020). Trends in pediatric headache prevalence and impact. Cephalalgia.
Asraf, H. et al. (2022). Pediatric migraine: risk factors and management. Frontiers in Neurology.
Onofri, A. et al. (2023). Pediatric headache disorders: clinical burden and treatment gaps. Children.
