What Is Kwashiorkor?

Medically Reviewed by Christine Mikstas, RD, LD on July 12, 2023
Written by WebMD Editorial Contributors
4 min read

Kwashiorkor is a severe form of malnutrition. It can be found in very severe cases of starvation and is more common in developing countries.

Malnutrition is when your body doesn’t have the right balance of nutrients that it needs. This can mean that you’re getting too few or too many nutrients. 

There are several types of malnutrition:

  • Undernutrition. This means not enough food has been eaten, or an illness has caused you to lose weight. 
  • Micronutrient-related malnutrition. This is a lack of vitamins and minerals or an excess of vitamins and minerals. 
  • Overweight and obesity. This means that too much food is eaten, and too little energy is used. 

About 45% of deaths worldwide in children under the age of 5 are linked to undernutrition.

There are two types of severe acute malnutrition in children. Kwashiorkor is a form of edematous malnutrition because one of its symptoms is edema, or swelling from fluid retention.

Another malnutrition disease is marasmus. It’s similar in appearance to kwashiorkor, but without the swelling. It happens because of a lack of calories and protein and is also known as the wasting syndrome.

Marasmus is more common than kwashiorkor. It tends to affect infants and young children.

Experts have not figured out why some people get kwashiorkor. It's usually thought to be due to a lack of protein. But in some cases, a high-protein diet has not improved the condition.

A study of 209 children in refugee camps with kwashiorkor found that some of these children were being breastfed. In some cases, they were exclusively breastfed. Breast milk contains protein and nutrients, leading the researchers to conclude that kwashiorkor isn’t due to lack of protein.

Some factors that are linked with kwashiorkor include:

  • Eating a diet that’s mainly rice, cassava, or maize
  • Recent infection, especially with measles
  • Recent weaning off breast milk
  • Major life changes in childhood (for example, poverty or the death of parents)

Kwashiorkor is more common in developing countries in Africa, Central America, and Southeast Asia. It’s seen more during times of famine.‌

Kwashiorkor is rare in the United States. It may be linked to human immunodeficiency virus (HIV), substance abuse, and as a complication from abdominal surgery.

Undernutrition can lead to many changes in your body because it may affect the function of every organ system.

The symptoms of kwashiorkor include:

  • Edema or swelling 
  • Dry hair that falls out easily and that may lose color
  • Dry and peeling skin with scaly patches
  • Dermatitis or skin lesions
  • Swollen abdomen
  • Loss of muscle mass
  • Round face
  • An enlarged liver (hepatomegaly)
  • Failure to grow 

There are many possible complications of kwashiorkor, such as:

Your doctor may do a physical examination and ask you questions about your diet.

Your doctor may also order some tests. These include tests for:

To check the function of your immune system, a skin test may be done. Your health care professional may inject an antigen under your skin. An antigen typically causes an immune reaction within a certain amount of time. This means that your immune system is working normally. Undernutrition can affect your immune system, and this may cause a delayed reaction or no reaction.

If your doctor thinks the kwashiorkor may be caused by a separate disorder, other tests may be needed. These include:

Undernutrition is usually treated by gradually adding calories to your diet. This is done by eating several small meals every day. Feeding too quickly can cause complications, such as imbalances in glucose, water, and nutrients.  

Your doctor may also recommend multivitamins as well as medication to improve your appetite. ‌

If you have a severe case of malnutrition, you may need to be hospitalized.  

Tube feeding or intravenous feeding may sometimes be needed if you can’t swallow or can’t eat enough to fulfill your daily nutritional needs. For tube feeding, a thin plastic tube is passed through your nose and throat, until it reaches your stomach or small intestine. If you will need it for a long time, a feeding tube can be inserted into your stomach through your abdomen. ‌

Intravenous feeding means that a large tube (catheter) is inserted into a vein. It is usually a large vein like the one under your collarbone. 

In developing countries, a kind of ready-to-use therapeutic food (RUTF) is given. It’s typically made up of peanut butter, dried skimmed milk, minerals, and vitamins. This food can usually be eaten directly from the package and provides the right nutrients for recovery.