On Malnutrition: What is Kwashiorkor and Marasmus?

On Malnutrition: What is Kwashiorkor and Marasmus?



Kwashiorkor is a severe form of protein-energy malnutrition in early childhood. This may occur in children four months to five years of age, but is common among kids between one and three.

kwaThe main cause is nutritional imbalance in early childhood—a diet very low in protein and dominated by carbohydrates such as cassava, sweet potatoes, bananas, rice and corn. They don’t contain enough protein to support growth and development.

Deficiency in other nutrients such as vitamins B, vitamin A, certain minerals and amino acids, as well as diseases such as respiratory infections, diarrhea, hookworm infestation, malaria, and tuberculosis also contribute to the development of kwashiorkor.

Any one or a combination of the following may characterize kwashiorkor:

– Hair changes: lack of luster, “flag sign” (alternating light and dark bands in the hair, indicating alternating periods of protein adequacy and deprivation), loss of hair, brittle dry hair

– Anemia due to iron and folic deficiencies; may be aggravated by hookworm infection

– Edema or accumulation of fluids in body tissues. Sometimes it is so light as to be detectable. This is manifested by puffiness of the tissues in the face. There is rounded prominence of the cheek, which is a relatively frequent early sign.

– Diffuse depigmentation of the skin. There is a general lightening of the pigment of the skin of the face. Depigmentation of the skin occurs all over the body especially in areas where the skin has peeled.


Marasmus is the term used for the severely underweight child. This condition results from a diet that is very low in both protein and calories. It is also called “balanced starvation.”

This may occur among kids of all ages, but is more common among one- year-olds. If breast-feeding is unsuccessful or the mother has insufficient breast-milk supply and little or no alternative food is given to the infant, the result could be marasmus.

[pq]Lactation problems in the mother may result from stress and other psychological factors, certain illnesses, malnutrition.[/pq]


Associated diseases or conditions include dehydration resulting from infectious diarrhea, tuberculosis, and the presence of intestinal parasites.

The following characterize marasmus:

– Failure to gain weight followed by loss of weight until emaciation results

– Skin becomes wrinkled and loose

– Face becomes shrunken and the child looks like an old man

– The abdomen is distended or thin

– Muscle wasting (buttocks, thighs, shoulders, and upper arms)

– Loose skin folds in the buttocks

– Growth retardation (body weight is 60 percent or less of expected weight)

– Infant is usually quiet and apathetic