“My head hurts!”A common complaint from a child to their parent. This complaint is more present now than ever before. You may wonder why is this the case. I have my own theories, but unfortunately this is not the topic for discussion here. This article is to help you, as a parent, to address some issues at home, before making your way to the Pediatrician’s office. You can start your own investigations in the home setting and ultimately have more information when you decide it is truly necessary to see the Pediatrician for this complaint.
One of the most common causes of headaches in children of all ages is vision problems. Have you noticed your child squinting when trying to read a sign or small print? Has your son or daughter recently experienced a drop in grades at school? Has your child been to an optometrist ever for an evaluation? If not, this would be a good first step in your investigation. You do not need to call your Pediatrician for a referral. A simple eye exam can be done by any optometrist at your request. All children, should have an eye exam and vision screening by an optometrist yearly if possible. Also, please remember that even children who have received corrected lenses should follow-up regularly for eye exams. Many children continue to have gradual changes in their eyes over time, leading to the need for a change in “strength” of their corrective lenses. These changes can be significant over periods as short as 6 to 12 months.
While we are talking of vision. Is your child a heavy reader? Yes! That is excellent! (Truly, few things make a Pediatrician more happy than this.) What kind of light does your child use to read? Does he/she have a reading lamp at bedside or is your child straining to finish that last chapter with a dim ceiling lamp? On the other hand, is your child a computer fanatic? Whether it be excessive video games, or actual school work, excessive screen time can also lead to some straining. It’s becoming more and more difficult in this “world of technology” to strip children away from computers, but excessive screen time may be causing eye strain. Strive to keep your child’s screen time below 2 hours in every 24 hour period. Also screen light filters seem to be of benefit to some. Regardless of the presence of perfect vision on visual testing, eye straining may result in headaches, so please keep this in mind.
Another major investigation to be had, is one into the duration and quality of your child’s sleep. Children need a minimum of 8 -10 hours of sleep. Possibly even more important than the duration is the quality of their sleep. A person who falls asleep while watching TV (in comparison to another person who is reading in bed) will take longer to transition into sleep phases in which the brain actually rests and recovers. In fact, some studies seem to show that actually 2 hours of non stimulation (no TV, video games cell phones) are required for normal transitioning into sleep cycles ideal for adequate brain rest. This means that, if your child’s bedtime is 8 pm, he/she should not be watching any shows or playing any video games after 6 pm. While lack of sleep generally results in grumpy, irritable adults, children may manifest symptoms such as inattention, hyperactivity and headaches!
Let’s take a closer look at what your child is eating. Sugary foods are known to cause headaches. You may not think your child is having much candy, but something as simple as an excess of juice, may be at the root of this complaint. More importantly, inadequate hydration can also lead to increased incidence of headaches. Upon openly and honestly questioning my pre-teen and teen patients, some admit to me that they drink NO water whatsoever. A larger proportion report occasional water drinking, around 1 cup every other day. For their liquid intake they enjoy drinks like coolaid ( and other sugary powder drinks), juice and soda. This is completely unacceptable! Soda should be avoided in all children, for as long as possible. All non-water beverages should be treated as a “treat” similar to candy and not given more than once a day. Juice is no longer recommended by the American Academy of Pediatrics for children under the age of 2, except when indicated, such as 1-2 oz daily as needed for relief of constipation.
While on the topic of food and liquid intake, a headache diary is a very helpful tool to a Pediatrician. Often times, a specific food item or food group may be linked to headache occurrence. In such cases, this usually only becomes clear after very precise and clear documentation of dietary intake along with the precise timing of the headaches in relation to the meals.
Lastly, you must investigate what is going on in school. Have a discussion with your child’s teachers about any recent changes in behavior or any new conflicts in school. Very often children will begin having non specific complaints such as headache or abdominal pain due to emotional issues and problems at school. The big clue here would be a lack of complaints during the summer with sudden onset and increased frequency as the school months progress along. This could be a clue to a possible bullying incident, or a conflict with a teacher or other student.
By following these steps and doing these investigations most parents can discover the cause/trigger of their child’s headache without an MD’s involvement. Even if a conclusion cannot be made the parent now has an immense amount of information to provide to the Pediatrician which would result in a more focused work up.
In conclusion, please understand that although most cases of headaches in children are benign, any rapidly worsening headache or headache associated with symptoms, including but not limited to; blurry vision, altered mental status, abnormal behavior, high fevers or recurrent vomiting should be evaluated immediately in the Emergency Department.
Good luck!