9 Min Read
Every parent knows the puzzled look that follows a child rubbing their forehead. Headaches can be common and fleeting. Sometimes they are nothing more than tiredness or a skipped meal. Rarely can it be a red flag for an underlying serious brain problem. Asking “Is this normal?” is natural. But the tricky part is knowing when to watch and when to act.
Read on as we walk you through the red flags for childhood headaches, explain why some pain deserves urgent care, and give practical steps you can take at home. This blog also covers what your paediatric neurologist looks for, how headaches are investigated, and what to expect from diagnosis and treatment.
Synopsis
- Headaches in Children
- First Steps at Home: What You Can Do Right Now
- How Doctors evaluate a concerning Headache
- Common Causes of Serious Headaches in Children
- Recurrent Headaches and Migraines
- What to bring during your child’s appointment
- Preventive Habits Parents Can Adopt Now
- When is a Headache More than “Just a Headache”?
- When to go to the Emergency Room
- Myths And Realities - Calming the Confusion
- Conclusion
Headaches in Children
Most headaches in kids are benign. Tension-type headaches and migraines top the list. Both respond well to rest, hydration, and simple measures. But very rarely, a small number of headaches result from brain infections, tumours or even fits. The task for you and your doctor is to identify the warning signs which indicates something that needs prompt attention.
First Steps at Home: What You Can Do Right Now
When your child complains of a headache, your calm actions matter as much as the medicine. Try these simple steps first:
-
Move them to a quiet, dim room and have them lie down
-
Offer water; dehydration commonly triggers headaches
-
Check for fever, unusual drowsiness, or neck pain
-
Note the time the headache started and any possible triggers (falls, fever, new medication, decreased sleep, stressful situation or recent infection) and also the duration of the episode
-
Avoid aspirin in children; use Paracetamol as advised by your Paediatrician.
Keep a clear record of these details and carry this to your Doctor. It helps clinicians enormously when you can describe exactly how the headache began and what made it better or worse.
How Doctors evaluate a concerning Headache
When you present to a clinic or emergency room, the paediatric neurologist will ask specific questions and observe your child closely. Expect a careful history: timing, triggers, family history of migraine, recent infections, head injuries, and developmental milestones. Your doctor may check child’s blood pressure and may perform a basic neurological examination. You may also be directed to an Ophthalmologist next for evaluation of refraction and fundus examination.
Not every child need brain scans. Only if any red flags are present, your doctor may order further investigations.
Common Causes of Serious Headaches in Children
Understanding causes lets you follow the doctor’s plan more easily. Common serious causes include:
-
Meningitis and encephalitis are infections of the brain or it’s lining that often come with fever, vomiting, stiff neck, and lethargy.
-
Intracranial haemorrhage, bleeding in the brain after trauma or a bleeding disorder.
-
Brain tumours are rare but may present with persistent early morning headache and recurrent vomiting, with or without motor deficits.
-
Hydrocephalus is increased brain fluid (CSF) pressure, causing vomiting, lethargy, severe headache and a large head size in infants.
-
Stroke, uncommon but possible, especially with sudden onset weakness or speech defects.
-
Headache may be the presenting symptom of severe hypertension, high blood pressure, which can be associated with visual changes.
These are not every day diagnoses. Still, awareness helps you act without delay when the signs appear.
Recurrent Headaches and Migraines
If your child has recurring headaches without red flags, the focus shifts to prevention of episodes and improving the quality of life. Migraine in children can be common and disabling. Typical features include throbbing pain over one side of the head or both sides of the forehead, excessive sensitivity to light or noise, and nausea/ vomiting. Triggers vary: missed meals, poor sleep, dehydration, stress, excessive screen-time / mobile-use and particular foods. Management focuses on trigger avoidance, consistent sleep patterns, hydration, timely meals, and, when needed, medical therapy tailored to children. Almost 50% of children with migraine may have a positive family history of migraine or motion sickness. If headaches persist despite all these measures, revisit your doctor, who may start the child on some daily medications to prevent the episodes.
What is more common than migraine is a tension-type headache, which is related to poor, unhealthy lifestyle in children. Reduced sleep, increased screen-time, poor diet practices and excessive anxiety/stress may be triggers.
What to bring during your child’s appointment
If you decide to see a specialist, come prepared. Useful items include:
-
A headache diary with dates, times, and triggers.
-
Information about recent illnesses, injuries, and medications.
-
Video of any unusual episodes (falls, staring spells, vomiting).
-
Family history of migraine or neurological disorders.
These small pieces of information speed diagnosis and reduce repeat visits.
Preventive Habits Parents Can Adopt Now
You don’t have to wait for a diagnosis to improve daily life. These simple habits lower headache frequency:
-
Encourage regular sleep time; consistency helps hugely.
-
Ensure three regular meals and healthy snacks; low blood sugar often triggers pain. Do not skip breakfast and avoid periods of prolonged fasting.
-
Promote water intake throughout the day.
-
Limit continuous screen time; break screen use every 20–30 minutes.
-
Teach relaxation techniques, deep breathing, gentle stretches, or short guided relaxation before bed.
Lifestyle changes are powerful. They reduce dependence on medications and give children tools to manage symptoms.
When is a Headache More than “Just a Headache”?
Below are the red flags for childhood headaches you should never ignore. If any are present, seek medical help right away.
Key red flags for childhood headache:
-
A sudden, severe headache described as “the worst headache ever”
-
Headache with fever, stiff neck, or a rash
-
Headache associated with repeated vomiting, drowsiness, or altered consciousness.
-
Weakness, numbness, slurred speech, or trouble walking
-
A headache that wakes the child from sleep or is worse in the morning
-
A head injury followed by worsening headache, vomiting, or drowsiness
-
New-onset unexplained headaches in a child younger than five years
-
Progressive worsening over days or weeks despite home care
These signs often indicate more than a routine headache. They may point to brain infection (which is called as encephalitis or meningitis), increased pressure in the brain, bleeding inside the brain, or other serious conditions.
If these occur, you should treat the situation as potentially urgent. Children are resilient, but they can deteriorate fast if the underlying cause is serious.
-
CT scan for quick assessment after a head injury or sudden severe symptoms.
-
MRI for detailed brain imaging when suspecting space-occupying lesions or chronic issues.
-
Lumbar puncture if meningitis or encephalitis is a possibility.
-
Blood tests for infection, electrolytes, and inflammation markers.
These tests help distinguish benign causes from those needing urgent treatment.
When to go to the Emergency Room
If any of the following happen, go to the emergency room immediately:
-
Sudden collapse, severe drowsiness, or persistent vomiting.
-
Seizures (fits) or loss of consciousness.
-
Rapidly worsening headache after a head injury.
-
Any of the red flags for childhood headache listed earlier.
Do not wait to see if it gets “better by morning.” Quick evaluation can be lifesaving.
Myths And Realities - Calming the Confusion
Parents hear conflicting advice. Here are quick clarifications:
-
Myth: All severe headaches are migraines.
Reality: Severe headaches can be due to many causes; evaluation matters.
-
Myth: Only older kids get serious headaches.
Reality: Young children can have serious conditions too, though rarer.
-
Myth: If the child looks “okay,” the headache is harmless.
Reality: Behaviour can be deceptive. Persistent or unusual symptoms warrant a check.
Conclusion
You know your child best. When a headache feels different, louder, or lasts longer, trust that instinct. Early recognition of paediatric headache warning signs can change outcomes dramatically. When in doubt, seek medical advice. Don’t let embarrassment, avoidance, or delay stand in the way of care.
At Manipal Hospitals, our paediatric neurology team, led by specialists, offers fast assessment, compassionate care, and clear plans tailored to your child. If you’re wondering when to see a doctor for your child's headache, make the call sooner rather than later. Book an appointment today and get the reassurance and expert care your child deserves. Book a consultation at Manipal Hospital Old Airport Road; early action protects your child.
FAQ's
Fever and headache can occur together in minor conditions like viral fever as well. But if it is associated with warning signs such as neck pain or stiffness, recurrent vomiting, lethargy or drowsiness, do seek immediate care. These can be signs of an underlying serious brain infection called meningitis / encephalitis. But remember, these are very rare conditions.
Yes. A headache that wakes your child from sleep or is worse in the morning; a headache with weakness, numbness, or trouble walking; altered consciousness; vision problems or double vision; a headache following a fall or head injury; a headache with fever and neck pain or a stiff neck; a sudden, severe headache described as “the worst headache ever”; new-onset unexplained headaches in a child younger than five years; and progressive worsening over days or weeks despite home care are considered warning signs in headaches. You should contact a pediatric neurologist urgently if any of these warning signs are present.
Yes, headache in most situations is a lifestyle disease. Academic pressure, poor sleep, lack of physical activity, poor diet habits, increased screentime and emotional stress can either be the cause or trigger for recurrent headaches. Addressing school-related stress and improving sleep hygiene often reduces headache frequency. Incorporating yoga, any kind of physical activity and breathing exercises/pranayama is extremely beneficial.
My child had a bad headache after a fall but is now feeling better. Should I still get them checked?
Yes. Any significant head injury followed by red flags such as accompanying vomiting, double vision, or drowsiness, needs medical review. At times, bleeding inside the head can be slowly progressive and may show delayed symptoms. It’s better to get a prompt check than to wait in these circumstances.
Family history definitely increases the risk, but it’s not certain. Many children with a family history never develop migraines. Awareness helps in early recognition and management if symptoms appear.
Share this article on:
