Do not give a child aspirin for a
headache unless a viral illness has been ruled out by your doctor. The
combination of aspirin and certain viral infections is associated with the
development of Reye's syndrome, a dangerous liver disease.
For extremely severe headaches, a combination of acetaminophen and codeine may be prescribed. Codeine is a powerful narcotic painkiller that can cause serious side effects, including nausea, sleepiness, and constipation, and that can also be highly addictive.
If your child suffers from migraines, ibuprofen or acetaminophen is likely to be suggested first, and maybe all that is needed to ease the pain. The antihistamine diphenhydramine (Benadryl) may also be suggested. The reason it works is not well understood, but it may offer relief for your child.
If your child has migraines that are not relieved by ordinary painkillers, an ergotamine preparation may be prescribed. These drugs work by constricting blood vessels. They are available in forms that can be taken orally, rectally, as a nasal spray, or placed under the tongue; some formulations contain caffeine. Ergotamine works best if it is taken as soon as possible after the pain begins, but it should be used with care because it is possible to become dependent on it. Possible side effects include stomach and/or muscle cramps, dizziness, nausea, vomiting, and diarrhea.
A relatively new drug, sumatriptan (sold under the brand name Imitrex), appears to be very effective in alleviating a severe attack of migraine. It works by increasing the amount of serotonin in the brain. Serotonin is involved in vasoconstriction (the constriction of blood vessels); since migraine is in part a result of a disturbance in circulation in the brain, increasing serotonin levels may help to restore balance in the tension of blood vessels. This treatment is expensive, however, and as of this writing, must be administered by injection. It can also produce unpleasant side effects, including increased heart rate, elevated blood pressure, and a feeling of tightness in the chest, jaw, or neck. An oral form may be approved in the near future, and it may be better tolerated. Although this drug may be safe for children, especially teenagers, it is not yet officially indicated for use in children.
There is some evidence that a daily low dose of the beta-blocker propranolol (Inderal) may help if a child suffers from recurrent, incapacitating migraine headaches. This drug should not be taken by a child with asthma or diabetes, however, and it can cause such side effects as fatigue, depression, shortness of breath, and cold hands and feet.
If your child's headaches are chronic and debilitating, it may be helpful to consult a pediatric neurologist to investigate the possibility of an underlying problem.
Because low blood sugar can provoke a headache, see to it that a headacheprone child has three whole-foods meals and several snacks each day. Do not offer sugary foods. Sugar causes blood sugar levels to soar, then crash, making a headache worse.