Monday Briefing: What malnutrition does to children’s bodies
Plus, new details in the Kirk shooting.
Morning Briefing: Europe Edition
September 15, 2025

Good morning. We’re covering malnourished children in Gaza. Also:

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This is what happens to children in a famine

Author Headshot

By Stephanie Nolen

I’m a global health reporter.

When health workers screen small children for signs of malnutrition, they often collect a simple measurement with a tape measure.

A diagram showing how the circumference of a child’s arm is used to gauge muscle atrophy, bone loss and malnutrition.
Sources: Integrated Food Security Phase Classification (I.P.C.); SoP Nutrition Cluster | Notes: Data for Gaza City includes its surrounding region | By Pablo Robles

A typical 2-year-old has an upper arm that measures about six inches (15.2 cm) around. Those six inches are made up of layers of bone, muscle and fat.

When a child age 5 or younger has an upper arm that measures less than 4.5 inches (11.4 cm) in circumference, it’s a sign that the child is experiencing severe malnutrition. When children begin to starve, they start to burn fat reserves to keep functioning. When these reserves run out, their bodies begin breaking down other sources of fuel to stay alive. When a child’s upper arm becomes that thin, the body is consuming its own muscle and bone.

The Gaza Strip, where Israel has imposed restrictions on the entry of aid throughout the war, is experiencing some of the highest levels of malnutrition since the fighting began. A panel of food-security experts backed by the United Nations said that Gaza’s largest city was officially under famine in July, with 16 percent of the children it screened suffering from malnutrition.

Two bar charts showing that a rising share of young children screened in Gaza City were malnourished and that many more children in Gaza were treated for malnutrition this summer.
Sources: Integrated Food Security Phase Classification (I.P.C.); SoP Nutrition Cluster | Notes: Data for Gaza City includes its surrounding region | By Pablo Robles

Even children who recover will carry the physical consequences for the rest of their lives. That could include stunted growth, soft bones, liver and kidney problems and cognitive issues in the short term, and increased risk of stroke, diabetes and heart disease later on.

Israeli officials have consistently played down the severity of hunger in Gaza. Prime Minister Benjamin Netanyahu’s office called the recent Gaza City famine declaration “an outright lie.”

As a foreign correspondent and, these days, a reporter covering global health, I’ve seen children suffering acute malnutrition in many different settings: civil wars, displacement camps, droughts in East Africa and villages in central India, where caste and gender discrimination left some children chronically underfed.

For a child, food is not just energy for the day at hand — but the essential building block for a life ahead, needed for the development of muscle, bone and brain.

What’s often the most striking about treatment centers for malnourished children is the silence: The patients are too weak to cry, and they gaze blankly at their caregivers.

These children can be lethargic to the point of motionlessness. They may not eat or drink even when offered food. Their bodies are trying to conserve energy — and eating takes energy that they don’t have.

In the most severe cases, the body begins breaking down vital organs to stay alive. The immune system starts to fail, making the child extremely vulnerable to disease. Minor infections become dangerous. Rashes or wounds don’t heal.

It’s not a simple undertaking, to treat a child in this condition. You can’t just put a hot meal in front of them. They need special high-energy therapeutic foods that their bodies can absorb, delivered in carefully monitored quantities.

Food and other critically needed supplies began trickling back into Gaza this summer after months of a blockade imposed by Israel. That has eased the desperate hunger that gripped the enclave’s two million people in late July.

But food shortages remain widespread, and, with the Israeli Army poised to advance on Gaza City, it will become even more difficult for medical workers to provide the kind of careful treatment necessary to restore these children to health.

Additional reporting by Pablo Robles and Aaron Boxerman.

Related coverage:

  • Arab foreign ministers met in Qatar to formulate a response to Israel’s brazen missile attack there last week.
  • Secretary of State Marco Rubio traveled to Israel to consult on security issues, including the war in Gaza, which is testing relations with the U.S.

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