Malnutrition afflicts more than 200 million children throughout the world and is responsible for 50% of deaths that occur before age 5. Malnutrition robs young children of good health, growth, and development. Many internationally adopted children are malnourished prior to adoption. Prenatal malnutrition is common: more than 25% of international adoptees are low birth weight. Postnatal malnutrition befalls children who reside with impoverished or neglectful birth families, in institutions, or in indifferent foster care. Some children suffer from prolonged, sever, and/or recurrent episodes of malnutrition. Others endure a single episode of malnutrition due to illness, food shortages, or loss of a beloved caregiver. Poor appetite, impaired oral-motor function, and improper feeding techniques (bottle-propping) all reduce food intake. Chronic undernutrition is much more common than malnutrition, and has long-lasting effects as well.
Although most international adoptees display remarkable growth recovery after adoption, the consequences of early malnutrition or undernutrition may still be observed in some children years later. Genetic factors, prenatal exposures, and neglect all amplify the effects of early malnutrition. This course describes the interactions of malnutrition and neglect, and the effects of malnutrition on growth, cognition, behavior and immunity. The effects of recovery from malnutrition on growth, cognition, and behavior are reviewed, along with practical considerations for internationally adopted children.