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Underfeeding: Causes, Symptoms, Diagnosis, and Treatment

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Underfeeding is a term used to describe infants who have little interest in feeding. This can lead to low nutrition and growth problems. Read on to know more.

Medically reviewed by

Dr. Veerabhadrudu Kuncham

Published At June 2, 2023
Reviewed AtFebruary 27, 2024


Exclusively breastfeeding for six months has tremendous benefits for the infant and mother. Breast milk is also an essential source of energy and nutrition for children aged 6 to 23 months. It can meet more than half of a child's energy needs between 6 and 12 months of age and a third between 12 and 24 months. Breast milk is also an important source of energy and nutrients during illness and minimizes the risk of mortality in malnourished children. Poor growth combined with hunger can lead to another condition called stunted growth. Childhood malnutrition occurs when children do not consume enough calories, protein, or micronutrients to keep them healthy. It is widespread, and even in the short term, it can have long-term, irreversible health effects. Malnutrition is sometimes used interchangeably with malnutrition, although malnutrition can mean both undernutrition and overnutrition. Undernutrition is caused by a variety of factors. This is different from likes and dislikes, where babies refuse other forms of milk or toddlers refuse certain foods. Underfeeding may be managed by consulting a lactation consultant to improve milk supply, adding complimentary nutrition at six months of age, fortification, and supplementation of food for children and lactating mothers.

What Is Underfeeding?

Underfeeding means the baby is not consuming enough calories/kilojoules for healthy growth. This is one of the many reasons for poor growth. Underfeeding means that the child is not getting enough nutrients to grow and be healthy. This usually happens when the baby is too fussy about feeding or has trouble sucking or swallowing. Malnourished children can suffer from stunted growth.

What Are the Causes of Underfeeding?

The causes of underfeeding are listed below:

  • Premature and sick babies may not suck effectively.

  • Congenital disabilities or neurological problems affecting the sucking ability of the baby – e.g., cleft palate, wrinkled tongue, tongue tie.

  • Strict feeding schedule.

  • Improper feeding equipment makes it difficult for babies to feed effectively.

  • Improper preparation of the formula will dilute the formula.

  • Too much water is given to the baby.

  • Lack of sleep leaves babies exhausted and unable to seek food, feed effectively, and wake up at night to feed.

  • Aversion to eating. Babies may find breastfeeding aversive if past feeding experiences have been painful, uncomfortable, or stressful.

  • Reduced lactation flow.

What Are the Symptoms of Underfeeding?

The symptoms of underfeeding in babies are listed below:

  • Reduced number of wet diapers in 24 hours.

  • Less frequent, hard, and dry stools.

  • Baby can be restless, irritable, and less alert.

  • Weak, sick, or extremely underweight babies may become excessively sleepy and nondemanding.

  • No weight gain or a pattern of no weight gain for several weeks in a row.

When to Get Help for Underfeeding?

Underfeeding is a serious problem. Emergency treatment may be needed if other symptoms develop. Seek immediate medical attention if the baby exhibits any of the following symptoms:

  • Fever with a temperature more than 100 degrees Fahrenheit or 37.8 degrees Celcius.

  • Vomiting after each feeding.

  • Hematemesis (vomiting blood).

  • Cough with shortness of breath.

  • Continuous crying.

  • Bloody stools.

  • Gasping or wheezing.

  • Unresponsive to touch.

How Is Underfeeding Diagnosed?

Underfeeding is diagnosed in the ways listed below:

  • Physical observations and health history are often sufficient to diagnose underfeeding.

  • Measurement of the circumference of the child's arm.

  • Blood samples are taken to test for certain micronutrient imbalances.

  • Monitoring the activity levels of the baby.

  • Monitoring the number of wet diapers in 24 hours.

What Is the Treatment of Underfeeding?

The treatment of underfeeding in babies is done in the ways listed below:

  • Treatment of Infections - Underfeeding due to infection and illness usually stops when the condition is resolved.

  • Improving Milk Flow - Improving breast milk flow with the help of a lactation consultant.

  • Finding Suitable Formula - Identifying suitable formula milk that is easily digestible for the infant.

  • Introducing Solids at Six Months - Solids should be introduced in increments along with continued formula or breastmilk.

  • Stress Management - Stress can increase nutritional problems. The stress may interfere with a child's feeding attempts when he or she notices something is wrong.

  • Avoid Force Feeding - Forced feeding may lead to a negative association of the child with food which may lead to food aversion or picky eating.

What Are the Complications of Underfeeding?

The complications of underfeeding in babies are listed below:

  • Underweight, protruding bones, depleted fat and muscle.

  • Slender arms and legs with edema (fluid swelling) on ​​the abdomen and face.

  • Stunting of growth and intellectual development.

  • Weakness, fainting, fatigue.

  • Irritability, indifference, or carelessness.

  • Dry, inelastic skin with rashes and lesions.

  • Brittle hair, hair loss, loss of hair pigment.

  • Frequent and severe infections.

  • Low body temperature, not warm enough.

  • Low heart rate and low blood pressure.

How to Prevent Underfeeding?

The prevention of underfeeding can be done in the ways listed below:

  • Growth monitoring.

  • Oral rehydration in case of dehydration.

  • Frequent breastfeeding.

  • Proper immunization.

  • Female education on lactation, diet, and nutrition.

  • Family spacing.

  • Food supplementation.

  • Nutritional supplementation for children under five years of age.

  • Ensuring proper latch in babies while feeding.

  • Ensuring frequent wet diapers in babies after feeding.

  • Using cereals and fortified formulas.

  • Introducing solids in the diet at six months of age.


Malnutrition can lead to various health problems. It is a leading cause of death in children under the age of five because it increases a child's susceptibility to various diseases and infections and reduces their ability to recover from these diseases and infections. Malnutrition can also lead to developmental delays, including stunted growth, cognitive impairment, fragile bones, and dental problems. Poor nutrition in young children can lead to serious problems such as malnutrition and stunting. It is important for your baby to consume and digest the nutrients they need to grow and develop. The baby who is feeding poorly should be taken to a pediatrician for evaluation. After an accurate diagnosis, treatment may be required. In other cases, proper techniques and patience can correct underfeeding at home. If suspecting a nutritional problem is causing other health problems, contact the doctor immediately.

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Dr. Veerabhadrudu Kuncham
Dr. Veerabhadrudu Kuncham



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