Images of Gaza’s starving babies have gone round the world. This is what malnutrition does in the first 1,000 days of life

Last week, the United Nations warned more than 14,000 babies would die of malnutrition in 48 hours if Israel continued to block aid from entering Gaza.

After the figure was widely reported, that timeline has been walked back, with a UN spokesperson clarifying the projection is for the next 11 months.

Between April 2025 and March 2026, there will be 71,000 cases of acute malnutrition among children under five, including 14,100 severe cases.

Severe acute malnutrition means a child is extremely thin and at risk of dying.

An estimated 17,000 breastfeeding and pregnant women will also require treatment for acute malnutrition during this time.

Starvation and malnutrition are harmful for anyone. But for infants the impact can be profound and lasting.

What is malnutrition?

In infants and young children, malnutrition means they have a height, weight and head circumference that don’t match standard charts, due to a lack of proper nutrition.

Nutritional deficiencies are especially common among young children and pregnant women.

The human body needs 17 essential minerals. Deficiencies in zinc, iron and iodine are the most dangerous, linked to a higher risk of infants dying or developing brain damage.

When malnutrition is acute to severe, infants and young children will lose weight because they’re not getting enough food, and because they’re more susceptible to illness and diarrhoea.

This leads to wasting.

A child experiencing wasting has lost significant weight or fails to gain weight, resulting in a dangerously low weight-for-height ratio.

A persistent lack of adequate food leads to chronic malnutrition, or stunting, where growth and development is impaired.

Risk of infections and mortality

Malnourished infants have weakened immune systems. This makes them more vulnerable to developing infections, due to smaller organs and deficits in lean mass. Lean mass is the body’s weight excluding fat and is crucial for supporting healthy growth, strength and overall development.

When children are starving, they are much more likely to die from common illnesses such as diarrhoea and pneumonia.

Infections can make it harder to absorb nutrients, creating a dangerous cycle and worsening malnutrition.

Chronic malnutrition affects the brain

The human brain develops extraordinarily rapidly during the first 1,000 days of life (from conception to age two). During this time, adequate nutrition is essential.

Children’s developing brains are more likely to be affected by nutritional deficiencies than adults.

When prolonged, malnutrition may lead to structural brain changes, including a smaller brain and less myelin – the protective membrane that wraps around nerve cells and helps the brain send messages.

Chronic malnutrition can affect brain functions and processes such as thinking, language, attention, memory and decision-making.

These neurological impacts can cause life-long issues.

Can brain damage be permanent?

Yes, especially when malnutrition occurs during crucial periods of brain development, such as the first 1,000 days.

However, some effects are reversible. Early, intensive interventions – such as access to nutrient-rich food and medicines to treat hypoglycaemia (low blood sugar) and fight infections – can help children catch up on growth and brain development.

For example, one review of studies involving undernourished preschool children found their cognitive abilities – such as concentration, reasoning and emotional regulation – improved somewhat when they were given iron supplements and multivitamins.

However malnutrition during the crucial window under two years old increases the risk of lifelong disabilities.

It’s also important to note recovery is more likely in an environment where nutritious food is available and children’s emotional needs are taken care of.

In Gaza, Israel’s military operations have destroyed 94% of hospital infrastructure and humanitarian aid remains severely restricted. The conditions necessary for children’s recovery are out of reach.

Pregnant and breastfeeding mothers

Severe maternal malnutrition can increase the mother and child’s risk of dying or experiencing complications during pregnancy.

When a breastfeeding mother is malnourished, she will produce less breastmilk and it will be lower quality. Deficiencies in iron, iodine, and vitamins A, D and zinc will compromise the mother’s health and reduce the nutritional value of breast milk. This can contribute to poor infant growth and development.

Starved mothers may experience fatigue, poor health and psychological distress, making it challenging to maintain breastfeeding.

Other organ impacts

Data from those born during the Dutch famine of 1944-45 have helped us understand the lifelong health impacts on children conceived and born while their mothers were starving.

Among this group, malnutrition affected the development and function of many of the children’s organs, including the heart, lung and kidneys.

This group also had higher rates of schizophrenia, depression and anxiety, and lower performance in cognitive testing.

They also had a higher risk of developing chronic degenerative diseases (such as cardiovascular disease and kidney failure) and dying prematurely.

Is the damage irreversible?

Recovery is possible. But it depends on how severely malnourished the child is, and when and what kind of support they receive.

Evidence shows children remain vulnerable and have a higher risk of dying even after being treated for complications from severe acute malnutrition.

Effective interventions include:

• nutritional rehabilitation (giving the child nutrient-rich foods, specialised feeding, and addressing underlying deficiencies)

• breastfeeding support for mothers

• providing rehabilitation and health care in the community (so families and children can return to everyday routines).

This seems difficult if not impossible in Gaza, where Israel’s blockade on aid and ongoing military operations mean safety and infrastructure are severely compromised.

Repeated or prolonged episodes of malnutrition increase the risk of lasting developmental harm.