Insufficient diets are a fact of every day life for hundreds of millions of children. The signs of malnutrition are so common – a short child or a child who has lost some weight – that we often don't see these children as sick or suffering. But they are. Malnutrition is not merely the result of too little food. It is a pathology caused principally by a lack of essential nutrients which not only causes growth to falter, but also increases susceptibility to common diseases. This is why a common cold or bout of diarrhea can kill a malnourished child.

Most of the damage caused by malnutrition occurs in children before they reach their second birthday. This is the critical window of opportunity when the quality of a child's diet has a profound, sustained impact on his or her health, physical and mental development. Breast milk is the only food babies need for the first six months. After this time, breastfeeding alone is not sufficient and the types of foods introduced into the diet are of paramount importance. Diets that do not provide the right blend of energy including high-quality protein, essential fats, and carbohydrates as well as vitamins and minerals can impair growth and development, increase the risk of death from common childhood illness, or result in life-long health consequences. The fortified cereals currently distributed through food aid do not meet this minimal standard.

UNICEF estimates that there are nearly 195 million children suffering from malnutrition across the globe. Malnutrition plays a huge role in child mortality because the immune systems of these children are less resistant to common childhood diseases. In fact, malnutrition contributes to at least one-third of the eight million annual deaths of children under five years of age. Despite the vast numbers of preventable deaths worldwide, international assistance over the past decade has amounted to an estimated $350 million annually out of $11.8 billion the World Bank estimates is required to adequately combat malnutrition in 36 high-burden countries, where 90 percent of the malnourished children live today. MSF is advocating for an additional $700 million, identified by the World Bank study, as the amount of funds needed to reach the 32 countries with the highest prevalence of malnutrition among their child population under five.

And current approaches to address malnutrition have serious limitations. In places where families have little or no access to highly-nutritious foods, behavior change approaches to malnutrition that focus on education about proper food choices, hand-washing, and breastfeeding are not enough to address the problem. Such strategies are insufficient because in the world’s “malnutrition hotspots,” the Horn of Africa, the Sahel, and South Asia, many families simply cannot afford more expensive nutritious food. They need access to energy-dense, nutrient-rich foods, including animal-source foods like milk, meats, and fish to provide the 40 essential nutrients a young child needs to grow and be healthy. Exclusive breastfeeding meets nutritional needs until six months of age, and beyond that, young children need the addition of dairy, eggs, meat, or fish.

Tested strategies to address malnutrition are effective and are showing promising results in many countries. Some, including Mexico, Thailand, and Brazil, have reduced early childhood malnutrition through direct nutrition programs that ensure infants and young children from even the poorest families have access to quality foods, such as milk and eggs. Through such programs, substantial progress has been made towards freeing children from the consequences that come with malnutrition at an early age. At the same time there is growing political will in Asian and African countries to replicate successful programs.

Unfortunately, most current food aid programs for developing countries rely almost exclusively on the fortified cereal blend of corn and soy that may relieve a young child's hunger, but does not provide proper nourishment. International donors must end this double standard. They should only support programs that respect the minimal nutritional needs of infants and young children, and work with countries most affected by the crisis to put access to nutrient-rich foods at the center of their efforts to tackle childhood malnutrition.