When most of us hear the word “malnutrition”, our first thought might be of famine-stricken countries far away. But here in the UK, malnutrition in children is quietly on the rise and it doesn’t always look the way we expect. Of course, children suffering in a famine will look a certain way, but a child can be overweight yet still malnourished if their diet lacks the nutrients needed for healthy growth and development.
This autumn, from the 17 – 21st November, Malnutrition Awareness Week returns, led by BAPEN (British Association for Parenteral and Enteral Nutrition) and the Malnutrition Task Force. It’s a chance for everyone to reflect on the part we can play in tackling this hidden, but growing problem, here at home.
What is malnutrition?
Malnutrition simply means ‘poor’ or ‘sub-standard nutrition’. It occurs when children either do not get enough of the nutrients they need, or when their diets are unbalanced. In the UK, this usually appears in two main ways:
- Undernutrition – where children are not getting enough calories, protein, vitamins or minerals. This can slow growth, weaken the immune system, and affect energy levels
- Hidden hunger – where children may eat plenty, but the foods are high in sugar, fat and salt rather than the much-needed nutrients. They may appear well-fed or even overweight, but lack essential nutrients such as iron, calcium, or vitamin D, leading to overall poor health
The result? Children may be physically present in our settings, but struggling with fatigue, poor concentration, or health issues that impact their learning and well-being.
The facts
Malnutrition is not new, but in recent years several factors have made the situation worse.
- Food insecurity is growing: The Food Foundation’s 2023 report found that 1 in 5 UK households with children experienced food insecurity in the previous year – meaning families had limited access to affordable, nutritious food
- The cost-of-living crisis: Rising food prices are pushing families towards cheaper, calorie-dense foods that fill stomachs but provide little nutritional value
- Obesity masking malnutrition: NHS data shows that almost 10% of children aged 4–5 in England are living with obesity, with rates even higher by the end of primary school. Many of these children are simultaneously nutrient-deficient
- Lack of access and skills: Some families live in “food deserts” where fresh produce is scarce or unaffordable. Others may lack time, equipment, or cooking skills to prepare healthy meals from scratch
These pressures mean more children are arriving at early years settings either undernourished or on diets that don’t meet their developmental or nutritional needs.
Signs of malnutrition to look out for
In early years children, malnutrition may show up in different ways, and early years practitioners need to be aware of these if we are to help find a solution. For example, children who are malnourished may present with:
- Tiredness, lack of energy, or difficulty concentrating
- Frequent colds and infections due to a weakened immune system
- Slow growth, delayed milestones, or being under/overweight for their age
- Pale skin, dental problems, or thinning hair
- Behavioural changes, such as irritability, low mood, or hyperactivity linked to blood sugar spikes
No single sign is proof, and body weight alone may be misleading, but patterns over time can be more telling. Practitioners are often well-placed to spot changes in children’s appearance, behaviour, and energy levels that might be missed elsewhere. When we adults get ‘hangry’, we can become less focused and more dysregulated and it is the same for children, especially if it is a regular occurrence.
What can we do?
It is not our responsibility to solve food poverty. However, safeguarding children is, so looking out for anything that could put children at risk of harm, is important. And settings can contribute to a solution in small, practical ways that can make a significant difference to individuals.
- Review your food and snack provision
- Ensure snacks include fresh fruit, vegetables, or wholegrain options rather than processed biscuits and crisps
- Keep sugar and salt to a minimum, following the EYFS welfare requirements and the School Food Standards
- Consider allergies and intolerances but aim to provide variety of foods so children are exposed to a wide range of nutrients
- Build food education into daily routines
- Run fun, hands-on activities about healthy eating such as food tasting, simple cooking sessions, or growing herbs and vegetables
- Use mealtimes as opportunities to model healthy eating habits and language. For example, talking about “energy foods” or “strong bones foods” can help children make connections between the good food they eat and how they feel
- Encourage conversations about where food comes from, linking to EYFS learning goals
- Use Malnutrition Awareness Week as a springboard
Malnutrition Awareness Week is a great time to help raise awareness of this problem with the families in your setting.
- Share practical, low-cost healthy recipes in newsletters or parent/carer workshops
- Highlight government support such as the Healthy Start voucher scheme, which provides free fruit, vegetables, and milk to low-income families
- Signpost to local food banks, community kitchens, or organisations like First Steps Nutrition Trust, which provide evidence-based advice
- Put up posters and leaflets in your setting to raise awareness
- Host a “Healthy Lunchbox” challenge where families bring in creative, balanced meals but be mindful not to embarrass
- Share staff training or a CPD session focusing on spotting the signs of malnutrition and supporting families
- 4. Create a supportive, non-judgemental culture
No one likes to admit that they are struggling to feed their family, so it is important not to isolate/embarrass families but build good relationships based on trust.
- Approach conversations with empathy rather than blame. Many parents are already doing their best under difficult circumstances
- Frame discussions positively: “We’ve noticed your child is very tired, sometimes this can be linked to diet. Can we share some ideas with you?”
- Celebrate small successes with families, such as a child trying a new vegetable
Building awareness is not about shaming families. It’s about creating environments where healthy choices are supported, encouraged, and made accessible. Malnutrition is not just a distant issue; it is happening here, in our communities. By offering nutritious food in settings, modelling healthy habits, and signposting families to support, we can work together to give every child the healthy start they deserve.
