Globally, over 14 million children under five years of age are believed to be suffering from severe acute malnutrition. When you hear the term "child malnutrition", you are most likely to think of them — chronically hungry kids, living in developing and often war-torn regions, whose food deprivation has left them too small for the ages and with swollen bellies.
That is certainly one face of malnutrition in children that urgently needs to be addressed, but it is far from the only one.
What is malnutrition?
The definition of malnutrition is both simpler and more complex than many of us would think. The World Health Organization describes malnutrition as "deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients", while the British NHS (known for its plain-English, yet science-based information) puts it even more simply. According to them, malnutrition is "serious condition that happens when your diet does not contain the right amount of nutrients", or "poor nutrition".
There are three broad types of malnutrition:
- Undernutrition — the type of malnourishment we tend to think of immediately, referring to a condition resulting from not getting sufficient calories for long periods of time.
- Nutritional deficiencies, also called micronutrient-related malnutrition. People suffering from this type of malnutrition don't get enough of the essential vitamins and minerals they need to be healthy, regardless of the number of calories they consume.
- Overnutrition, which means chronically consuming many more calories than recommended, leading to overweight, obesity, and eventually morbid obesity.
All these types of malnutrition impact children throughout the planet. Overnutrition can, like undernutrition, be associated with nutritional deficiencies — access to lots of food does not translate to a balanced diet.
What causes malnutrition in children?
Research has uncovered three leading causes of malnutrition in children across the globe — food insecurity, lack of care, and inadequate health care. Poverty on an individual or communal level would be a primary cause of all of these factors. The picture becomes more and more complex the deeper you look at it, however, and you also have to consider diverse questions like:
- Interrupted supply lines — caused recently by COVID-19, but also by wars and conflicts.
- Climate change, which is threatening harvests and access to food both due to droughts and floods, as well as new pests arriving from other regions.
- Modern western lifestyles that excessively rely on convenience foods that lack essential nutrition — and paradoxically, in the most developed countries (like the US), extremely large amounts of "fast" or "junk" foods may cost much less than nutritious foods in appropriate quantities. Hence, this is also a question of poverty in many cases.
- Children may be living with diverse medical conditions that impact their ability to digest and eat foods. These include physical conditions like Crohn's disease as well as neurological and psychological conditions. Autistic children may, for instance, be willing to eat large amounts of crackers or even carrots, while being unable to swallow foods with certain textures. This can result in malnutrition. Eating disorders of diverse types can also lead to malnutrition.
The most shocking symptoms of malnutrition in children
The most alarming symptoms of childhood malnutrition would include those you have seen in pictures charities and NGOs use to appeal for donations — and then some:
- Rapid weight loss.
- Low appetite.
- Chronic fatigue and weakness.
- A child who is significantly smaller and shorter than would be expected for their age and sex.
- Being more vulnerable to opportunistic infections, characterized by getting sick often.
- Bleeding gums.
- Swollen abdomens.
- Skin rashes and easy bruising.
- Achy joints and muscles.
- Sensitivity to light.
- Dry and pale skin.
- In female teenagers, lack of menstruation.
Not all of the signs of malnutrition in children are that obvious and shocking, however. Remember, malnutrition refers to poor nutrition in general — not only chronic hunger or starvation. While there is no beating around the bush about the fact that the most vulnerable children are those living in poverty (anywhere in the world, including, very much, in developed nations), malnutrition can affect children across the socioeconomic spectrum.
The signs are not always easy to spot. A child could have adequate calorie intake, seemingly growing and thriving, yet be malnourished. This is the case with children who have reliable access to food but who do not eat varied diets. That, itself, can happen for a variety of reasons. You can imagine scenarios in which hard-working low-income parents throw together the same low-nutrition microwave meals every day quite easily, but also consider very picky eaters. Such children may have a few preferred foods, which may even be incredibly healthy (like spinach or Brussels' sprouts), and refuse to expand their culinary horizons — sometimes leading to severe nutritional deficiencies.
If you are a teacher, for instance, the child you've pegged as disinterested because they don't seem to be paying a lot of attention in class and sometimes nod off may, in fact, be food insecure due to poverty. The one whose diet consists of nothing but McDonalds probably is, too — but the child who always munches on healthy foods could just as easily be malnourished, if they have an eating disorder, are a picky eater, or don't get sufficient calories.
Only a doctor can definitively determine a child's nutritional status — and if you're a parent, even your own child could be malnourished without you ever realizing it, even if you do your very best to provide a healthy home environment and a varied diet. This is why partnering with a pediatrician is so crucial.
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