January 16, 2017


Headaches are a common issue in all pediatric practices affecting far too many young children. The two main types are migraine and tension. The causes are numerous and range from dehydration and food reactions to stress and medication use.

A random and acute headache is likely to be a minor issue like sleep deprivation or dehydration. Management should be focused on a healthy meal, lots of water and a nap. If the headache persists, then I would try an anti-inflammatory like ibuprofen coupled with temporal/neck massage with essential oils. Red flag symptoms for an acute headache are:

1) "Thunderclap" or severe onset headache. worst ever felt
2) The headache worsens dramatically with a change in position
3) Neck pain, headache and fever together
4) Headache is accompanied by a change in mental status

5) Headache is associated with neurologic changes like a loss of function in a limb
6) Persistent vomiting with a severe headache

These are signs that would require immediate evaluation and management.

Chronic headaches are not normal and need to be handled appropriately with lifestyle management. Medications are not very effective at controlling most chronic headaches. See this article. Medications can be an adjunct to lifestyle management where necessary, but in my experience, medications alone almost never work in the long run.

What we do know is that many of these chronic headaches are triggered by simple lifestyle issues that also trigger acute headaches:

1) Not sleeping enough or oversleeping
2) Not drinking enough water
3) Eating trigger foods like dairy, gluten, yeast or cured meats
4) Excessive screen time
5) Skipping meals for some people is a trigger
6) Taking medicines like oral contraceptives, NSAID's daily
7) Consuming chemicals like dyes and non nutritive sweeteners
8) Over exertion in sports
9) Excessive heat exposure
10) Uncontrolled stress - physical or mental

What I think after 17 years of general practice is that like many other diseases, headaches are like a glass of water. When it overflows you have symptoms. Therefore, reducing the water level can prevent a triggering event or a recurrent issue.

Just reverse the above issues one by one and reduce the water level. This could make the glass half full which would prevent a one off event like acute stress or a sleepless night from causing a headache. To do this correctly is a blueprint for healing the body in general.

I think that the most effective of these lifestyle changes is eliminating trigger foods. I have helped more young people become headache free by elimination diets than any other method. The most common triggers are dairy and gluten primarily, followed by egg, soy and corn. Studies have shown that migraine sufferers have a higher incidence of childhood colic and dairy protein intolerance.

If you suffer from headaches, do yourself a favor and try an elimination diet while working on the other lifestyle changes.

Migraine handout and triggers.

Be headache free,

Dr. M