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Kwashiorkor

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Kwashiorkor 

Kwashiorkor is a dangerous, overlooked form of malnutrition that is often seen in young children of communities facing food shortages, famine, or lack of nutritional awareness. The worst part is that even if children are getting enough calories, they can still get this disease. This is because they are not getting the protein their body needs to grow and heal. Read on to learn more.

1.0Kwashiorkor Meaning and Overview

Kwashiorkor disease is a severe form of malnutrition caused by a dangerously low intake of protein. It’s most common in areas affected by famine or extreme poverty, where children often survive on starchy foods that lack essential nutrients. One of the most visible signs of kwashiorkor is swelling, especially in the belly, feet, and ankles, while the rest of the body appears alarmingly thin and wasted. The liver also becomes enlarged due to fat accumulation.

If caught early, recovery is possible with proper medical care, including a diet rich in calories and high-quality protein. But when left untreated, kwashiorkor can lead to lasting damage, slowed growth, developmental delays, or even coma. In its most severe form, it can be life-threatening, especially for young children. Early intervention can make all the difference.

Kwashiorkor's meaning lies in the body’s response to a protein-deficient diet, despite adequate or near-adequate calorie consumption. Unlike starvation, where fat and muscle wasting is prominent, children with kwashiorkor appear swollen due to fluid retention caused by low plasma protein levels.

2.0Kwashiorkor Symptoms

Kwashiorkor severely affects a child’s body, appearance, and behaviour. Common kwashiorkor symptoms include:

  • Dry, brittle hair that may turn reddish
  • Patchy, flaky, or discoloured skin
  • Swelling (oedema) in the feet, belly, and face due to low protein
  • Frequent diarrhoea, reducing nutrient absorption
  • Muscle wasting, with thin, weak limbs
  • Extreme fatigue and a lack of interest in the surroundings
  • Irritability and emotional outbursts
  • Stunted growth and poor weight gain
  • Cracked or pigmented skin lesions
  • Weak immunity, leading to frequent infections
  • Enlarged fatty liver (hepatomegaly)
  • In severe cases, shock and organ failure

The condition often follows illnesses like diarrhoea or pneumonia, which drain the body’s nutrients. Signs like loss of appetite, apathy, and fluid retention are classic indicators. Early detection is vital to prevent lasting damage or death.

Causes of Kwashiorkor

Now, let’s take a look at the causes of kwashiorkor.

Kwashiorkor develops when the body doesn’t get enough protein, a nutrient essential for building and repairing cells, especially during periods of rapid growth like childhood or pregnancy. Proteins do more than just help with growth; they also play a key role in maintaining the body’s fluid balance. Without enough protein, fluid starts to leak out of blood vessels and collects in the tissues, leading to the swelling and puffiness (oedema) that’s often seen in this condition.

While kwashiorkor is extremely rare in developed countries like the UK or the US, it can still occur in cases of severe neglect, chronic illness, or restrictive diets where essential nutrients are missing, often due to a lack of awareness or access to proper nutrition.

3.0Kwashiorkor vs Marasmus

Understanding the difference between kwashiorkor and marasmus is vital for accurate diagnosis and treatment. Both are forms of severe malnutrition, but they differ significantly in clinical presentation and underlying causes.

Feature

Kwashiorkor

Marasmus

Type of Malnutrition

Protein deficiency, despite adequate calorie intake

Calorie deficiency, including lack of protein, fats, and carbohydrates

Common Age Group

6 months to 3 years

6 months to 1 year

Appearance

Swollen belly, puffy face, thin limbs (due to fluid retention)

Severe thinness, visible bones, sunken cheeks and eyes

Oedema (Swelling)

Present, especially in ankles, feet, and abdomen

Absent

Subcutaneous Fat

Retained, may give a misleading "healthy" look

Absent, due to severe fat depletion

Weight Loss

Moderate, often hidden by swelling

Severe, with a drastic reduction in body weight

Appetite

May appear normal or voracious

Usually poor appetite

Muscle Wasting

Less noticeable due to oedema

Prominent, with visible wasting of muscles

Liver Condition

Fatty liver and enlargement

No fatty liver

Hair Changes

Hair becomes dry, brittle, and may turn reddish or lose pigment

Hair is dry and sparse, but no discolouration

Skin Texture

Flaky, peeling skin resembling "flaky paint"

Dry and wrinkled skin

Underlying Cause

Lack of adequate protein in the diet

Overall lack of food and essential nutrients

Regions Commonly Found

Rural or famine-affected areas with limited protein availability

Areas with extreme poverty and food scarcity

Treatment Needs

High-protein diet, micronutrient supplementation, and treatment of infections

High-calorie diet with balanced macronutrients, vitamins, and hydration

Complications

Developmental delays, liver damage, increased infection risk, and possible coma

Severe weakness, delayed growth, organ failure, higher mortality risk

4.0Diagnosis of Kwashiorkor Disease

Diagnosing Kwashiorkor is often straightforward, starting with a child’s physical appearance, like a swollen belly, thin limbs, or flaky skin, and a discussion of their diet and living conditions. To confirm the diagnosis and rule out other conditions, doctors may order blood and urine tests to check protein, blood sugar, vitamin, and mineral levels. Liver and kidney function are also evaluated. In some cases, growth measurements, BMI, body water content, or even hair and skin samples are examined. Early and accurate diagnosis is crucial to begin life-saving treatment and prevent long-term complications.

5.0Treatment

In its early stages, kwashiorkor can be treated with milk-based therapeutic feeds or RUTF (Ready-to-Use Therapeutic Food), a high-energy mix of peanut butter, milk powder, oil, sugar, and essential vitamins and minerals. If complications like infections or dehydration are present, hospital care is required.

Treatment focuses on stabilising the child:

  • Preventing low blood sugar
  • Keeping the child warm, as kwashiorkor affects heat regulation
  • Using rehydration solutions to treat dehydration
  • Administering antibiotics to fight infections
  • Replenishing vitamin and mineral deficiencies

Feeding is reintroduced gradually, starting with small portions and increasing over time. With proper care, children often begin to improve within a week, though full recovery typically takes 2 to 6 weeks. Early intervention can make all the difference in saving a life.

Table of Contents


  • 1.0Kwashiorkor Meaning and Overview
  • 2.0Kwashiorkor Symptoms
  • 3.0Kwashiorkor vs Marasmus
  • 4.0Diagnosis of Kwashiorkor Disease
  • 5.0Treatment

Frequently Asked Questions

Kwashiorkor disease is a severe protein deficiency disorder affecting mostly children. It causes swelling, liver damage, and growth retardation, despite sufficient calorie intake.

Key symptoms include swollen belly, oedema, irritability, skin discolouration, liver enlargement, and hair lightening or thinning.

Kwashiorkor results from protein deficiency with normal calories, while marasmus is due to overall energy (calorie) deficiency, causing visible wasting and thinness.

It is caused by low protein intake, often after early weaning or in situations of poverty, poor nutrition, infections, and food insecurity.

Yes, with timely medical intervention, proper nutrition, and supportive care, recovery is possible, though long-term damage may occur if left untreated.