 Kwashiorkor: protein deficiency  Marasmus: calories and protein deficiency

 36% of children in the world are underweight  43% stunted  9% wasted

 Social and Economic › Poverty › Ignorance › Inadequate weaning practices › Child abuse › Cultural and social practices  Vegan  Low fat diets

 Maternal malnutrition, prematurity › Start life with poor stores  Infectious disease › Diarrhea, Aids, TB, measles  Environmental › Unsanitary living, poor quality water › Agricultural/cultural patterns › Droughts, floods, wars, forced migrations

 Infants and young children › High nutritional needs › Early weaning or late weaning › Poor hygiene  Marasmus – frequently under 1 year of age  Kwashiorkor - over18 months with starchy weaning foods

› Decreased brain growth and resulting learning difficulties › Electrical changes similar to dyslexia › Susceptibility to other diseases/infection › Loss of work potential – weak and lethargic › Reduction in physical growth

 Slow re-feeding › Small frequent feeding around the clock › Patient encouragement of food  Nutritional rehabilitation › Play and teaching › Control infections › Education of carer