Dolores de cabeza en niños: cuándo preocuparse y cómo tratarlos

A child wakes up complaining of a headache. Most parents will recognize the moment: the hand pressed to the forehead, the request to stay home from school, the question of whether to worry. The truth is that more than nine in ten children will experience a headache before their fourteenth birthday. In the vast majority of cases, there is nothing to fear. But knowing the difference between a routine ache and something that demands immediate attention is part of what it means to care for a child.

Headaches in children arrive from many directions. The most common culprit is fever—the body's response to infection. A cold, the flu, an ear infection, sinusitis: these ordinary illnesses often bring head pain along with them. When no infection is present, when the headache stands alone, the causes tend to mirror what adults experience. Tension headaches are by far the most frequent type. They arrive as a dull, steady pressure across both sides of the head and the forehead, born from tight muscles in the neck and scalp. Lack of sleep, stress, anxiety—these are the usual architects. Rest and over-the-counter pain relievers typically bring relief.

Migraines are less common in children than in adults, though they can begin in childhood and typically become more frequent during adolescence. When they do occur, they announce themselves differently: a throbbing, intense pain that worsens with physical activity, often accompanied by nausea, vomiting, or visual disturbances like flashing lights. Some children become sensitive to light itself. In young people, migraines tend to be shorter than in adults, often lasting around thirty minutes, though they can stretch longer. Ibuprofen frequently helps, though some children eventually need more specialized treatment.

But headaches can also signal something more serious. Tumors, head injuries that went unnoticed, meningitis—these are rare, but they exist. When they are the cause, the headache does not arrive alone. It brings companions: dizziness, difficulty speaking, double or blurred vision, sudden vomiting without preceding nausea. The pain itself often appears abruptly, without warning.

Parents should know when to call the pediatrician and when to go to the emergency room. A headache that persists for several days in a row, or returns frequently, warrants a call to the doctor even if it seems mild. The pediatrician needs to determine whether it is simply tension or whether further investigation is necessary. Seek urgent care if the pain does not respond to common painkillers, if it is severe, if it wakes the child from sleep, or if it grows progressively worse. Go to the emergency room immediately if the child experiences sudden dizziness or vomiting, changes in vision, difficulty speaking or confusion, pain following a blow to the head, stiffness in the neck, or any noticeable change in behavior.

Treatment depends on the cause, which a pediatrician or pediatric neurologist must identify. For tension headaches, acetaminophen or ibuprofen are standard. But there is a caution: these medications can trigger a rebound effect if used too frequently—more than three times per week—making headaches worse rather than better. For migraines that do not respond to common pain relievers, a doctor may prescribe preventive medication and arrange ongoing monitoring. Serious causes like meningitis, tumors, or significant head trauma require hospital care and may demand surgery.

For children who experience benign headaches regularly, the Spanish Association of Pediatrics recommends a practical approach to prevention. Ensure adequate sleep and keep sleep schedules consistent. Do not let long stretches pass without food. Maintain proper hydration. Exercise regularly, but not in the hours before bed. Keep a symptom diary to identify patterns and triggers—stress, fatigue, emotional upheaval, anxiety, screen time. These small interventions, sustained over time, can reduce how often headaches arrive and improve a child's daily life.