Headache in Children (Bachon Mein Sar Dard): Causes and Red Flags
Most headaches in children are harmless and pass with food, water, sleep and a break from the screen. A few are not, and the ones to act on today are a headache that wakes a child from sleep or is there on waking with vomiting, a headache after a bump to the head, a headache with fever and a stiff neck, or a headache with a change in behaviour, walking or vision. This guide separates the two groups, by age, so you know when to relax and when to go.
Before you read on
- Under 3 years: children this age rarely say “sar dard”. Head-holding, crying with light, vomiting or unusual sleepiness are how it shows, and any of these with fever or after a fall means a doctor today.
- 3 to 6 years: headaches are usually hunger, tiredness, a cold, or too much screen. Watch for the red flags below.
- Over 6: tension headache and migraine both begin here, especially if a parent has migraine; school stress and glasses join the list.
- Painkillers: paracetamol or ibuprofen only by the child’s weight, from the pack or a pharmacist, never combined with another product containing the same drug, and never aspirin under 16.
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The red flags that mean a doctor today or emergency care now
Read this section first.
Go to emergency (1122 in Pakistan, 112 in India, or the nearest hospital) if your child has a headache with any of the following: a stiff neck with fever, or a rash that does not fade when you press a glass against it; a headache after a fall or a blow to the head, especially with vomiting, drowsiness or confusion; a sudden, very severe headache that came on in seconds; a fit; weakness of an arm or leg, a drooping face, slurred speech or trouble walking; a child who is drowsy, floppy, hard to wake or not making sense.
See a doctor the same day if the headache wakes the child from sleep, or is there every morning and eases as the day goes on, particularly with vomiting; if it has come more and more often over a few weeks; if the child’s behaviour, school work, handwriting or balance has changed; if there is a squint, double vision or the child tilts the head to see; if the headache is only ever in the same one spot; or if the child is under 3 and cannot tell you what is wrong but keeps holding the head.
Why children get headaches: the everyday causes
When none of the red flags fits, the cause is nearly always one of these. Run through them in order.
Hunger and skipped meals
A child who left for school on a sip of chai and came back at two o’clock with a headache is hungry. Blood sugar dips hit children faster than adults, and long gaps between meals are the commonest trigger at school age. The fix is breakfast plus a lunchbox that actually gets eaten.
Not enough water
Children forget to drink, and many schools make it hard. Dark yellow urine and a headache by afternoon go together, especially in May and June. Send a bottle. A child of 5 to 8 needs about a litre a day, more in heat.
Sleep
Children aged 3 to 5 need 10 to 13 hours, 6 to 12 year-olds need 9 to 12, and teenagers need 8 to 10. A late night on a phone plus a 6 am school wake-up produces a dull, all-over headache the next day that no remedy fixes. Sleep does.
Screens and eyes
Long, close screen time strains the focusing muscles, and a child who needs glasses works them harder still. Signs that eyes are the cause: the headache sits across the forehead or behind the eyes, comes after homework or a screen session, and the child squints at the board or sits very close to the TV. An eye test often ends it completely. See our screen time limits by age for what is reasonable per day.
Colds, sinus and ear infections
A blocked nose gives a heavy forehead pressure that goes when the cold goes. Earache in small children is often reported as “my head hurts”, so look at the ears too.
Migraine that runs in the family
If you or your spouse has migraine, your child has a real chance of it too. In children, migraine often sits on both sides of the head rather than one, lasts a shorter time (sometimes under an hour), comes with stomach pain, pallor and vomiting, and improves dramatically with sleep. Some children get “abdominal migraine” first: repeated bouts of tummy pain with no headache at all, which turn into typical migraine as they grow.
Stress and worry
Exams, a new school, a fight with a friend, tension at home: children carry all of it in the head and the stomach. A tension headache is a mild band that does not stop play. Only on school mornings, never on holidays? That is your answer.
What to do at home, step by step
For a headache with no red flags, this routine settles most children within an hour.
- Give a glass of water (150 to 250 ml, depending on age) and something to eat: a banana, a paratha, a bowl of dalia, whatever is quick.
- Switch off every screen and dim the room. Migraine children in particular want quiet and dark.
- Lie the child down for 20 to 30 minutes. Sleep, if it comes, is the best medicine for a childhood migraine.
- A cool, damp cloth on the forehead, or a warm one on the back of the neck for a tension headache. Ask the child which feels better; there is no rule.
- If pain is moderate and the child is miserable, a single dose of paracetamol or ibuprofen worked out by weight from the pack is fine for a child over 3 months. Check the label so you are not giving the same drug twice in two different syrups. Never aspirin under 16.
- Note it in the diary: time, what the child ate and drank, how much sleep, screen time, where it hurt, and how long it lasted.
A child needing a painkiller for headache more than 2 days a week needs a doctor instead. Frequent painkillers cause a daily headache in children just as in adults, and the way out is a doctor’s plan, not another syrup.
Never put balm, Vicks, menthol, camphor or eucalyptus on a baby or a young child’s forehead or under the nose; they can cause breathing trouble in small children. Nothing ever goes into a child’s ear for an earache. Do not give cough and cold medicines under 6, and do not give an adult’s headache tablet cut in half. Do not press hard on a child’s head or neck as a “massage” for a headache. And if the headache followed a bump to the head, do not let the child sleep it off unwatched; wake and check them, and go to hospital if they are hard to rouse, vomit, or seem confused.
How to tell a normal headache from a worrying one
Parents worry about brain tumours. They are rare, and their headaches look different: progressive (worse week on week), positional (worse lying down, on waking, on coughing or straining), and accompanied by something else, such as vomiting without diarrhoea, a change in walking, a squint or a personality change. A headache that comes and goes for months in a child who plays and eats normally between times is not that pattern.
The morning rule is the one to remember. Everyday headaches build through the day as the child gets hungry, tired and screen-heavy. Pressure headaches from inside the skull are worst first thing and improve after being up for an hour. If your child’s headache fits the second pattern for more than a few days, see a doctor and say those exact words.
The one-week headache diary
Seven rows, one per day, with these columns: date, start time, food and when, water, bedtime and wake time, screen minutes, where it hurt, how long, what helped. Fill it in for a week and bring it. Most parents spot the pattern before the appointment: the 4 pm headache on no-lunch days, or the one that only follows a long tablet session.
A warm oil massage of the scalp, a cool cloth, a dark room and an early night are old desi habits for a child with sar dard, and they are sensible ones. Tying a tight cloth around the head or applying balm on a small child are not. Tradition also says a headache after school means the child is “weak” and needs a tonic. Usually the child needs lunch, water and sleep, and no bottle from the shop does that job.
When the headache keeps coming back
A child who gets headaches most weeks deserves a doctor’s visit, even with no red flags, because recurring headaches in children have good answers: a pair of glasses, a migraine plan with trigger avoidance, a sleep schedule, or help with an anxiety that has been going unspoken. Take the diary. Expect a check of blood pressure, eyes, walking and reflexes; scans are for the few whose examination or pattern points that way.
If migraine is the diagnosis, the plan is mostly routine: regular meals and sleep, water, limited screens, a dark room and a painkiller by weight at the first sign. Preventive medicines are the doctor’s decision alone. Bring the family history; our migraine triggers guide shows what to track. The rest of the Bachon Ki Sehat series is on the hub.
Bachon mein sar dard: what parents ask most
Is it normal for a 5-year-old to have headaches?
Occasional ones are common at this age and usually mean hunger, tiredness, a cold or too much screen. A headache that keeps returning, wakes the child, comes with vomiting or follows a head bump needs a doctor.
Can I give my child paracetamol for a headache?
Yes, over 3 months of age, with the amount worked out by weight from the pack or by a pharmacist. Never combine it with another syrup containing the same drug, and never give aspirin under 16.
Why does my child get a headache every day after school?
No lunch, too little water, a hot classroom or eye strain are the usual reasons. Fix food and water, then book an eye test. If it continues beyond 2 weeks, see a doctor.
My child wakes up with a headache and vomits. What should I do?
See a doctor today. Morning headache with vomiting that eases as the day goes on is a pattern doctors take seriously in children.
Can headaches in children be caused by mobile phones?
Long, close sessions cause eye strain, and late-night use cuts sleep, which causes more. The signal does not; the habit does. Keep phones out of the bedroom at night.
Can a 3-year-old have a migraine?
Yes, though it is uncommon. It shows as pallor, vomiting, wanting a dark room and sleeping it off, usually with a parent who has migraine. Tell the doctor the family history.
Should I let my child sleep after hitting their head?
They can sleep, but wake them every couple of hours the first night and check they answer sensibly. Vomiting, confusion, unequal pupils or being hard to wake means hospital now.
Is a headache with fever in a child serious?
Usually it is a viral illness and goes with the fever. It is urgent if the neck is stiff, there is a rash that does not fade under a glass, or the child is unusually drowsy.
Can I put balm or Vicks on my child’s forehead?
Not on babies or young children; camphor and menthol products are not safe near their faces. A cool cloth does the job for an older child.