The Problem

What is Severe Malnutrition?

Severe malnutrition occurs when a child reaches the most serious stage of any form of malnutrition and is at the greatest risk of death, disease, and long-term disability. High-risk forms of malnutrition include children who are too thin (wasted), too short (stunted), too small (underweight). Risks increase when you have combinations of these in the one child, when a child is sick, or when a baby is born malnourished.

Why Severe Malnutrition?

  • Every year, millions of children worldwide are severely malnourished, and roughly 3 million children die because of severe malnutrition.
  • Not only are severely malnourished children much more likely to die than their well-nourished peers, those who survive are also much more likely to suffer from lifelong illness and impaired cognitive development.
  • Severe Malnutrition is the number one killer of kids under 5, killing more kids every year than AIDS, malaria, and tuberculosis combined.
  • Severe malnutrition stunts potential and wastes lives, but it doesn’t have to. Scaling up proven nutrition interventions will allow children around the world to escape these preventable deaths.

Why Now?

After years of steadily declining rates around the world, malnutrition is on the rise again.

  • We know that implementing proven nutrition interventions at scale will reduce malnutrition rates, but the number of severely malnourished children is growing.
  • These children’s deaths are preventable and their increase is a tragedy we can act to avoid.

The Power 4 Nutrition Interventions

How Can We Help the Children Who are Dying

Malnutrition has many root causes including poverty, lack of education, erratic seasonal crop cycles, climate change, women’s inequality, and poor access to water, sanitation, and hygiene. As the world works to tackle these major challenges, which will help end child malnutrition in the long-term, there are four essential actions we can take now to prevent children from dying of severe malnutrition. These interventions span the course of the critical 1,000-day period between a woman’s pregnancy and a child’s second birthday when there is a unique window of opportunity to build healthier and more prosperous futures for mothers and their babies.

  • Supply all pregnant women with prenatal vitamins

Despite the proven benefits of supplying pregnant women with a full dosage of multiple-micronutrient supplements (MMS), the majority of women do not have access to these critical supplements. MMS increases the chances a baby will be born at a healthy weight and survive to his or her second birthday.

  • Support breastfeeding mothers

Babies get the best start at life when they drink nothing but breastmilk until they are 6 months old, and continue breastfeeding until they are 2 years old while also consuming other nutritious complementary foods. Even though breastfeeding is the best way to protect newborns from malnutrition, infections, and disease, only 41% of babies around the world are exclusively breastfed. Many mothers who would like to breastfeed cannot access the support and information they need to be successful. One-to-one and group breastfeeding counseling helps provide mothers with the support they need to reach their breastfeeding goals.

  • Continue large-scale Vitamin A Supplementation

Supplying a child with two high doses of Vitamin A every year is one of the most cost-effective ways to protect children from blindness, diarrhea, and other fatal illnesses. Until recently, Vitamin A supplementation was routine and easily accessible because it had been paired with national polio vaccination efforts. However, now that polio has been mostly eradicated, these vaccination campaigns are being phased out. After years of increasing, the number of children who have access to Vitamin A coverage has started to drop alarmingly. Transitioning national Vitamin A supplementation efforts to a sustainable delivery platform is essential to ensuring children continue to receive this critical preventive regimen.

  • Expand coverage of specialized foods for treatment

The first priority of any nutrition program should be to make wasting treatment unnecessary by preventing children from ever becoming wasted. Unfortunately, millions of children every year still require wasting treatment. Ready-to-Use Therapeutic Food (RUTF) is an energy-dense, life-saving product that gives wasted children the nutrients they need to survive. Yet we are reaching less than a quarter of even the most severely malnourished children. Expanding coverage of services will help ensure no child dies because they don’t have access to the fundamental treatment they need to stay alive.

Find an infographic with information on the Power 4 here and in the Resources section below.

The Power 4 and Pandemic Response

Rates of severe malnutrition are on the rise, and experts predict that as COVID-19 continues to disrupt food and health systems, cases will continue to grow. The indirect effects of the pandemic risk the lives and potential of an entire generation. Now, more than ever, it is critical that we act quickly to implement a targeted package of essential nutrition interventions.

Photo Source: UNICEF/UNI316644/Frank Dejongh

Severe Malnutrition Learning Series

In light of new terminology and research on the most effective ways to prevent malnutrition-related child mortality, 1,000 Days launched a learning series focused on severe malnutrition. The learning series features monthly presentations by subject-matter experts on topics designed to help a non-technical audience ​unpack the latest evidence and craft more effective, informed severe malnutrition policies and advocacy campaigns.

Upcoming Sessions

Past Sessions

Scaling Up Nutrition Interventions: Stories from the Field

Preventing significant child deaths from malnutrition requires the delivery of high-impact interventions at scale. Though many projects attempting to scale up encounter insurmountable obstacles, and the vast majority of proven practices are not implemented at scale, the nutrition sector has also seen innovative solutions to common scaling roadblocks. In this session, co-hosted with the Nutrition Scaling Working Group, experts shared their first-hand experiences working to scale MMS, wasting treatment, and breastfeeding support.

Dr Steve Collins, Founder and Executive Director at Valid International
Chytanya Kompala, Senior Research Program Officer at the Eleanor Crook Foundation and Co-Chair of the Nutrition Scaling Working Group
Spencer Kirk, Founder and Managing Director at Kirk Humanitarian
Albertha Nyaku, Technical Advisor at FHI360

Predictive Modelling for Nutrition: Using Projections to Enhance Advocacy

July 23, 2020

The COVID-19 pandemic will have devastating consequences for health and nutrition around the world. As organizations prepare for a sharp rise in severe malnutrition cases, predictive modelling has been a critical tool. It has allowed us to anticipate when, where, and how rates of malnutrition will surge, how many cases we should expect, and how much funding organizations need to adequately address this crisis. Watch leading experts for a non-technical explanation of predictive modelling basics, how to turn these numbers into policy recommendations, and how to effectively communicate these recommendations to policymakers.

Dr. Derek Headey, Senior Research Fellow in the Poverty, Health and Nutrition Division at the International Food Policy Research Institute (IFPRI) – Myanmar
Dr. Rebecca Heidkamp, faculty member in the Center for Human Nutrition, Department of International Health at the Johns Hopkins University (JHU) Bloomberg School of Public Health
Blythe Thomas, Chief Strategy Officer, 1,000 Days

Rounding Out the Power Four: MMS, Breastfeeding, and Vitamin A Supplementation

June 19, 2020

The ‘Power 4’ are a targeted set of high-impact nutrition interventions we can scale today to immediately reduce the number of children dying from severe malnutrition. Along with wasting treatment, which was the primary focus of the first two learning series sessions, MMS, Breastfeeding, and Vitamin A Supplementation are foundational interventions in the fight to improve nutrition for children around the world. Leading experts represented each of these key interventions for a non-technical overview of the interventions’ significance, delivery, and current challenges.


  • Dr. Rolf Klemm, Vice President, Nutrition at Helen Keller International and Associate Scientist at Johns Hopkins Bloomberg School of Public Health
  • Dr. Saskia Osendarp, Executive Director Micronutrient Forum
  • Dr Rukhsana Haider, Founder and Chair, Training & Assistance for Health & Nutrition Foundation (TAHN), Bangladesh, Co-Chair, Steering Committee, World Alliance for Breastfeeding Action (WABA), Penang, Malaysia

Management of Wasting: Programming Insights and Areas for Action

May 29, 2020

In this session, Marie McGrath, Technical Director at the Emergency Nutrition Network (ENN) and Co-Editor of ENNs long running technical publication, Field Exchange, offered an accessible synthesis of key takeaways from a special 60th issue that examined management of wasting in children. Framed within the recently launched UN Global Action Plan (GAP) on wasting, this session shared insights from this rich collation of programming experiences and research to inform your advocacy efforts to build and scale capacity to care for wasted children worldwide.

*Note correction to dates on Slide 15:
Should read 2019 (not 2020) as follows:
ECF & ENN Donor Roundtable, London, July 2019

Donor letter to the UN Secretary General from the core philanthropic donors, October 2019
Letter to UN Secretary General, 20th Dec 2019 – urgent action & reform

Severe Malnutrition 101: Understanding the Fundamentals

April 30, 2020

In this kick-off session, Saul Guerrero Oteyza, Child Wasting Nutrition Specialist at UNICEF, gave an overview of the current global mechanisms for preventing and treating severe malnutrition. The session offered an accessible background to foundational issues including: the history of wasting treatment; an overview of current treatment protocol; an explanation of the link between wasting and stunting; an elaboration on the uses and availability of ready to use therapeutic foods (RUTF); and an update on current efforts to streamline wasting treatment through the Global Action Plan (GAP) on Wasting.

Simple Science

Key research and technical publications distilled into easy-to-follow points, quotes and stats to inform your advocacy.


Fast Stats