Stress
Tension-type headaches are almost always caused by emotional stress, and migraines can be aggravated by stress. So, it is critical to understand what causes your child's stress, as well as your own, and how you both can manage it. Counseling can be very helpful in identifying stress (which is particularly relevant for tension-type headaches), and in teaching a child how to more effectively deal with headaches in daily life. If counseling is possible, you may wish to try it. If your healthcare plan or HMO does not cover it, a note from your child's pediatrician can occasionally overcome this obstacle. Your kids cannot avoid stress, because it's everywhere. But if parents help their children deal with both good and bad stress, they will be helping them learn necessary life-management skills.

Headache at home
When your child develops a headache or feels one coming on, suggest a dimly lit room, offer medication, and an ice pack if it helps. Be responsive and sensitive to the headache without pampering, and treat this child the same as you treat your other children.

Healthy, moderate lifestyle
Successful control and management of headaches includes balanced, nutritious meals (especially breakfast), regular sleep patterns and a full night's sleep, physical exercise, activities, and avoiding food or environmental triggers. During the course of a headache, however, kids should minimize physical activity because it may aggravate the headache.

School and communication
It is important for parents of younger children, and for adolescents themselves, to discuss the headaches with school health professionals and teachers. Your child's doctor can write a letter about the tension-type or migraine headache, explaining the importance of treatment when the headache starts. Give the school nurse the medications and instructions for use. Explain to each teacher, every semester, that the moment a child feels the warning signs of a headache, he should be allowed to leave class, go to the nurse's office for medication, and rest there until the symptoms have decreased.

Missing school days
There will be times when a headache will cause a child to be late to school, to leave school early, or to miss a day of school, but your kid should not miss more than five days per semester as a result of headaches. If a child misses more than five days, then further evaluation may be indicated. If a child misses more than 20 days a year, then parents should look for signs of stress. Discourage "school refusal," and home schooling should not be considered a solution for headaches.

Parents and physicians
Some children, once diagnosed, will find immediate relief from prescribed treatment. With other kids, doctors might have to try a few approaches before achieving success. And, there are a few young people who will find some relief but not a totally successful treatment. Generally, however, if the symptoms persist despite the best efforts of your family physician or pediatrician, then it's time to ask your family doctor for a referral to a pediatric neurologist or headache specialist.

Activities
While a child with headaches should remain active, avoid over-commitment or too many activities. If a particular activity triggers a headache, avoid it if possible, and, if it cannot be avoided, discuss how it might become more manageable. Your pediatrician, psychologist, teachers or other kids might have suggestions for alternate activities.