A child who is malnourished is not getting enough vitamins, minerals or calories from food. According to Johns Hopkins Children's Center, 1 percent of American children under the age of 5 are chronically malnourished. A malnourished 4-year-old might not appear to be starving, but instead might be suffering from a lack of adequate nutrition in more subtle ways.
Health Problems
Malnourishment can result from inadequate nutrition, or from a condition such as lactose or gluten intolerance that prevents the body from accessing nutrients from food. Some children have genetic predispositions to anemia, a chronic iron deficiency, or inherited kidney disorders that can cause rickets, a weakening of the bones due to inadequate vitamin D. If your child is at-risk for malnutrition due to another health condition, monitor the child carefully for behavioral and developmental changes.
Growth
A child who looks extremely thin may be malnourished, but in developed countries like the U.S., it is not uncommon for a malnourished child to be overweight or even obese. This is usually because the child is not eating enough healthy foods, and is eating too many foods that are high in sugar, refined fats, and empty carbohydrates. In most cases however, a malnourished 4-year-old's growth or weight is noticeably below the average for a child that age. Depending on body type, a 4-year-old should weigh from 27 to 50 pounds, and be 37 to 46 inches tall. If you are unsure whether your child's growth falls in a healthy range, talk to your doctor.
Development
A malnourished child's social and intellectual development is slower than a healthy child's. Talk to your doctor about what you should expect of your 4-year-old. In general, 4-year-old children are able to feed and dress themselves, and manage routine personal care like brushing their teeth and combing their hair. They can hop on one foot and pedal a tricycle. They can name many colors and shapes, predict daily routines and say complex sentences accurately. They also tend to have active imaginations and make up stories, tell fibs or feel fear of the dark or of monsters. Most children of this age enjoy playing with other children.
Appearance
Often, appearance other than weight is an indicator of malnourishment. Thinning hair, pale skin that bruises easily, tooth decay, bleeding gums or dry, scaly skin are often indicators of malnutrition. Other visible symptoms include chronic fatigue, a tendency to get ill, slow reaction times or an inability to pay attention. Malnourished 4-year-olds may also have pain in their joints, be very sensitive to light or unable to see in the dark.
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