Signs You Shouldn’t Ignore: Early Warnings About Your Child’s Health

By: Somaya Noor eddin Yousef

Raising children is not an easy task, especially when it comes to their health. Many parents face questions and concerns about whether certain behaviors or symptoms in their children are normal or require medical attention. In this interview with pediatrician Dr. Mohammad Atef Fouda, we explore the most important signs and symptoms that may indicate serious health issues or developmental delays, and how parents can distinguish between urgent and normal situations to ensure the safety and well-being of their children from an early age.

What are the signs that may indicate a real delay in a child’s motor or speech development? And how can parents distinguish between a normal delay and one that requires concern—without randomly comparing their child to others?

Motor and cognitive developmental milestones in children are assessed starting from the age of four months. At this stage, a child is expected to have begun holding their head steadily and to be able to extend their legs if lifted or supported on a surface, such as a table. By six months, it is normal for a child to begin sitting up, and between six to nine months, they typically start crawling. By the time they reach one year of age, they are expected to stand on their own, and between twelve to eighteen months, they usually begin to walk. However, if a child misses these milestones—such as being unable to sit by their first birthday or being unable to stand or walk by eighteen months—this is considered a concerning sign that requires thorough medical evaluation and intervention. As for cognitive development, a child is expected to recognize their mother and father between the second and third months, and to begin interacting with those around them by the age of four months. Regarding speech, it is normal for a child to start saying meaningful single words between the ages of one and two years—such as saying “Mama” to refer to their mother or “Papa” for their father. However, if a child reaches four months without showing any interaction with their parents or recognizing them, or turns two years old without uttering a single meaningful word, this could indicate a possible intellectual delay. In such cases, the doctor conducts specific assessments to determine whether the delay is functional—which means it is temporary and not a cause for concern—or pathological, requiring specialized treatment and intervention.

Can persistent loss of appetite in a child be a sign of a more serious underlying health issue?

Loss of appetite is not always a serious issue, but if it is accompanied by noticeable weight loss, it becomes a cause for concern and requires consulting a doctor. In such cases, the doctor typically begins by requesting some basic tests, such as a stool analysis and a complete blood count (CBC), to determine whether the loss of appetite is linked to a specific health condition, such as anemia, intestinal worms, or an autoimmune disease. If anemia is confirmed, it is treated accordingly; if worms are found, they are also treated—depending on the diagnosis. It is worth noting that teething can also cause a temporary loss of appetite, which is normal and not worrisome as long as it is not accompanied by weight loss or extreme lethargy.

When does frequent constipation or diarrhea become a sign of a problem that needs a doctor’s attention, rather than just a temporary condition?

Frequent constipation since birth is a sign that should not be ignored, especially if the mother notices that the child only passes stool every four or five days, or even once a week. In such cases, the doctor conducts specific tests, including an abdominal ultrasound of the colon, and sometimes a contrast enema (barium X-ray) to detect any congenital abnormalities in the colon that may be causing chronic constipation. These conditions often require medical intervention. However, it is important to understand that there are other situations where constipation may be normal and temporary—such as in some infants who experience constipation during their first month, but the issue resolves on its own, or in formula-fed babies, as formula milk may slow down bowel movements. Genetic factors also play a role: if the mother suffers from constipation during breastfeeding, the baby may also experience it. But if constipation persists continuously for four or five months, medical evaluation is necessary to identify the underlying cause. As for chronic diarrhea in children, it may indicate several medical conditions, such as milk allergy, the presence of a specific intestinal infection, or even ulcerative colitis. The most important aspects to evaluate are the frequency and duration of the diarrhea. If the child experiences diarrhea six or seven times a day, and it continues for more than ten consecutive days, this is a condition that requires immediate medical attention. The risk increases if the diarrhea is accompanied by the presence of blood, as this could indicate severe internal inflammation or diseases of the colon. In such cases, the doctor conducts thorough examinations to determine the cause and provide appropriate treatment promptly..

When should a fever be considered concerning and require more than just at-home treatment?

A child’s normal body temperature ranges between 36.5°C and 37.5°C, and any deviation from this range—either lower or higher—requires attention. If the temperature drops to around 35°C, for example, the child should be wrapped in a wool blanket, kept warm, and given warm fluids until the temperature returns to normal. On the other hand, if the temperature rises above 39.5°C, it enters a danger zone, as the brain may lose its ability to regulate body temperature. This can lead to what is known as febrile seizures, a condition that commonly occurs in children between the ages of 6 months and 6 years.
One way to assess the severity of a fever is by checking the extremities: if the child’s hands and feet are cold while the rest of the body feels hot, this often indicates that the fever has exceeded 40°C. To measure temperature accurately, it is recommended to use a thermometer under the armpit—adding 0.5°C to the reading—or rectally—subtracting 0.5°C from the reading. If the temperature exceeds 39°C, cold compresses should be applied under the armpits and in the groin area only, until the fever drops below 39°C, at which point an appropriate fever reducer can be given. The key is to prevent the fever from reaching the point where seizures may occur.

What are the causes of sleep disturbances in children?

Insomnia in children may be caused by simple and temporary factors, such as the teething phase, which often causes discomfort that leads the child to wake up frequently at night. However, in other cases, insomnia may be related to the nature of the child’s diet, especially if the child consumes foods containing excessive preservatives. Additionally, certain neurological and psychological conditions, such as Attention Deficit Hyperactivity Disorder (ADHD), can lead to sleep disturbances, where the child has difficulty falling asleep or staying asleep for long periods. If insomnia persists for an extended period without a clear organic cause, it is important to consult a doctor to evaluate the condition and determine whether there is a disorder that requires medical intervention.

What are the signs that may indicate a child is not socially responsive or not reacting to sounds or people in a typical way?

From the age of one to two years, a child is expected to show clear social responses, such as maintaining good eye contact with those who call them and following simple instructions. For example, if you call the child’s name—like saying “Kareem”—and they look directly at you, this is a sign of proper eye contact. If the child responds by bringing something when asked, it indicates a good ability to understand and follow instructions. However, if the child does not show any response when called or fails to follow simple commands, this could indicate a communication disorder and may be an early sign of Autism Spectrum Disorder (ASD). In such cases, it is recommended not to leave the child in front of the TV or electronic devices for long periods and to provide opportunities for social interaction, such as enrolling them in daycare and encouraging play with others. Speech therapy sessions are sometimes used as a way to help the child improve their communication skills.

When do tantrums, isolation, or aggressive behavior become indicators of a psychological or neurological issue?

There are five signs that, if present in a child who is showing psychological symptoms, strongly suggest the possibility of Attention Deficit Hyperactivity Disorder (ADHD). The first is hyperactivity, followed by the inability to stay in one place for more than five minutes. The third is impulsivity, the fourth is aggressive behavior, and the fifth is academic underachievement. In such cases, we conduct a specific assessment to determine whether the child is indeed suffering from ADHD.