“Mom, my head hurts.” It's a familiar refrain for many parents, but what does it really mean coming from a small child, and how should a parent respond? While not nearly as common in very young children as in adults, the causes of headaches in children range from the simple and not serious to the life-threatening. Sorting among the possibilities requires a systematic approach.
Is it Really an Ache in the Head?
The younger the child, the less able he or she is to tell us accurately what is being felt. A ‘headache’ can be the most logical description to a child for multiple problems. This especially applies to the toddler and preschool age groups. Take an ear infection causing deep ear pain, for example. A child may call it a headache, but grab the area right behind or above the ear, or even the ear itself, and ask your child where the pain is. Likewise with sinus pain, your child may have pain located above or between the eyes or over the cheekbones. Throat or tooth pain can also become a ‘headache.' To an adult these types of pain may seem easily distinguished, but not necessarily to a child who has never experienced them before. By the nature of the pain fibers in this part of the body, pain from the throat or jaw can be ‘referred’ and felt in other locations (similar to the way an adult’s heart attack can present as pain in the jaw or left arm).
Another possibility is that the complaint of a headache is actually a young child’s way of verbalizing emotional upset, anxiety, depression, or stress. Children, especially those who live with adults who frequently complain of head pain, can describe in physical terms what is really an emotional difficulty.