Malnutrition comes in many forms. Simply put, it means poor nutrition. It includes:
Starvation is a severe lack of food which can result in death.
In emergencies, people are at higher risk of undernutrition and micronutrient deficiencies. Those whose nutrition was poor before the crisis are even more vulnerable. Acute malnutrition weakens the immune system, which then becomes more susceptible to developing diseases that can be fatal.
Undernutrition and micronutrient deficiencies can be widespread among refugees and displaced people, as adequate food and health services are often not readily accessible.
Inadequate nutrition and repeated bouts of infection during the first 1000 days of a child’s life can cause stunting, which has irreversible long-term effects on the physical and mental development of children. Worldwide in 2015, there were 156 million stunted children, about 45% of them living in fragile and conflict-affected countries.
Emergencies can also aggravate diet-related noncommunicable disease, such as heart disease, high blood pressure (hypertension), diabetes and cancer. Healthy foods may not be regularly available and appropriate medical care may not be accessible, leading to the interruption or cessation of treatments for these diseases. Given that many populations have high levels of noncommunicable diseases, emergencies can cause a significant increase in illness and even death from these diseases.
Young children and women who are pregnant or breastfeeding are most vulnerable to undernutrition. Their bodies have a greater need for nutrients, such as vitamins and minerals, and are more susceptible to the harmful consequences of deficiencies.
Children are at the highest risk of dying from starvation. They become undernourished faster than adults. Severely wasted children are 11 times more likely to die than those with a healthy weight. Undernourished children catch infections more easily and have a harder time recovering because their immune systems are impaired. Globally, undernutrition is an underlying factor in more than half of child deaths from pneumonia and malaria, and more than 40% of measles deaths.
Severe acute malnutrition is when a person is extremely thin and at risk of dying. They need immediate treatment. The response to acute malnutrition is broad and includes several elements such as medical, food, water and hygiene, and social services.
Children who still have an appetite can stay at home and receive outpatient care. They need treatment with specially-formulated foods, and their recovery must be monitored regularly by a trained health worker.
Children who have medical problems and do not have an appetite need inpatient care in a clinic or hospital. They need specially-formulated milks and treatment for infections or other potential complications.
Breastfeeding can be life-saving for young children in emergencies.
Breastfeeding in all environments has major health benefits for both children and mothers. Breast milk gives infants all the nutrients they need for healthy growth and development. It is readily available and contains antibodies that protect infants from common childhood illnesses. Breastfeeding also reduces mothers’ risks of breast and ovarian cancer, type II diabetes, and postpartum depression.
Breastfeeding becomes even more critical for child survival in humanitarian emergencies. Young children in emergencies face higher risks of diarrhoea, pneumonia and undernutrition. Lack of food, unsafe water, poor sanitation, overcrowding and overburdened health systems put infants and young children at greater risk.
WHO recommends that all babies should be fed only breast milk for the first 6 months, after which they should continue breastfeeding (as well as eating other foods) until 2 years of age, and potentially for longer, even in emergency situations.
Often the poor physical and mental health of mothers in emergencies leads to poor breastfeeding outcomes. Displaced mothers may struggle to find comfortable, private places to breastfeed and their support network of family and friends is often not accessible in emergencies. Health workers who would usually offer support may be redeployed to cope with other aspects of the emergency response.
Well-meaning donors may distribute breast-milk substitutes (such as infant formula) in emergencies. This can undermine breastfeeding and, if there is a lack of clean water to make formula or clean bottles and teats, put children at increased risk of infections which can be deadly.
Governments and humanitarian organizations have a key role to play in protecting, promoting and supporting breastfeeding in emergencies.