Marasmus is a form of severe malnutrition, that develops when the intake of vital nutrients and energy is deficient. It is categorised by chronic wasting or loss of body fat, muscle, and tissues. Malnutrition occurs when the body is deprived of protein and calories. This lack of nutrition can range from a shortage of certain vitamins to starvation.

Marasmus can occur in anyone with severe malnutrition but typically occurs in children and a child suffering from this condition may not grow as a normal child. Bodyweight is remarkably reduced to less than 62% of the expected weight for the age of marasmus children. Marasmus is one of the most severe forms of protein-energy malnutrition (PEM) across the globe. It is mainly observed in children in developing countries where poverty, lack of food supplies and contaminated water are common.

Symptoms Of Marasmus

The most common symptom of marasmus is underweight, shrunken and wasted appearance. In children with marasmus, there is an excess loss of muscle mass and subcutaneous fat, while dry skin and easily breakable hair are other symptoms.

Some of the other signs that are observed in marasmus children include:

Chronic diarrhoea


Hypovolemic shock



Corneal lesions



Respiratory infections

Intellectual disability

Stunted growth

Severely malnourished children may look much older and totally lack energy for performing daily activities. Children are very short-tempered and irritable.

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Causes Of Marasmus

Nutritional deficiency is the prime cause of marasmus, and it develops in children who do not get adequate protein, calories, carbohydrates, and other vital nutrients. This is mainly due to poverty and a scarcity of food. Some of the contributing factors of marasmus include:

Maternal malnutrition

Maternal anaemia


Cyanotic heart diseases


Necrotizing enterocolitis

Pyloric stenosis

Lactose intolerance


Anorexia nervosa


Infants and young children with marasmus suffer from serious complications. Deficiency of important nutrients results in delayed physical and mental development. Complications of untreated marasmus can be severe and may include:

  • Improper growth and development in children
  • Joint deformity
  • Loss of strength
  • Loss of vision and blindness
  • Organ failure
  • Unconsciousness and coma

Diagnosis And Treatment

The healthcare provider makes a preliminary diagnosis of marasmus by evaluating a complete physical assessment. Measuring height and weight may help find out whether a child is underweight and has marasmus. Poor mobility in a malnourished child may also confirm a diagnosis of marasmus.

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The main aim of treatment is to correct the nutritional deficiency and provide the child with all the essential nutrients to promote growth and development. The child is given dried skim milk powder with boiled water initially, later the mixture includes sesame oil, casein, and sugar. Casein, the milk protein meets the protein needs and oil adds the energy content and density of the mixture.

As the child starts to recuperate, a wholesome and balanced diet with plenty of fresh fruits, vegetables, whole grains, and protein will lower the risk of malnutrition and other marasmus related problems. Furthermore, adequate hydration with a rehydration plan and regular monitoring is required to avert complications associated with marasmus.

Infections associated with marasmus are treated with appropriate antibiotics or other standard medications. Addressing the infections and other health issues may help the child to better chance of recovery.