Breaking The Cycle: Addressing Mental Health And Malnutrition Together

Every year, millions of children around the world suffer from malnutrition—a crisis evident in their frail bodies and tired eyes. However, what is often less visible, yet just as devastating, are the psychological wounds that malnutrition inflicts on both children and their caregivers.

Over the years, there has been an alarming upward trend in the number of children admitted for the treatment of malnutrition in MSF nutrition programmes. In the 12 Inpatient Therapeutic Feeding Centres (ITFCs) and over 30 Ambulatory Therapeutic Feeding Centres (ATFCs) supported by Doctors Without Borders/Médecins Sans Frontières across seven northern Nigerian states, MSF teams are often overwhelmed.

In 2024 alone, over 300,000 malnourished children were treated in Zamfara, Kano, Katsina, Kebbi, Bauchi, Borno, and Sokoto—a 25 percent increase from 2023. With these admissions come psychological wounds that affect the mental health of both the children and their caregivers. They experience a cycle of emotions from the day they are admitted until the time of discharge.

Kauna Hope Bako, MSF’s mental health supervisor in the Bauchi project, and her team—like others in Nigeria—are working to break this cycle. Their approach recognizes that malnutrition is not just a medical emergency but a psychological one as well.

The Hidden Toll of Malnutrition

“Malnutrition is a disease that doesn’t just affect the child physically,” explains Bako. “It has psychological, emotional, and behavioral implications.” Children suffering from malnutrition often become irritable, withdrawn, and unresponsive. They may miss key developmental milestones—struggling to walk, talk, or interact with their environment like other children.

The emotional pain is significant. “The child feels detached, sad that he cannot play like other children, and is trying to understand what is happening to him,” Bako says. “He’s experiencing immense pain and stress—not only from malnutrition but also from other diseases that often accompany it.”

The relationship between mental health and malnutrition is deeply intertwined. Malnutrition can lead to emotional and cognitive problems in children, while traumatic factors such as neglect, abusive home environments, or lack of love can lead to psychological suffering and contribute to malnutrition. “They are two sides of the same coin,” Bako notes. “Malnutrition can lead to mental health problems, and mental health problems can lead to malnutrition.”

Experience from Niger and Nigeria over the past few years has demonstrated that integrating mental health support with malnutrition treatment contributes to faster weight gain, shorter lengths of stay in inpatient feeding centers, and improved caregiver well-being.

The Caregiver’s Burden

The impact of malnutrition extends beyond the child. Mothers and caregivers, often the primary source of support, face immense stress and emotional strain. “At triage, the most prominent emotions are anxiety, stress, and fear,” Bako shares. “The caregiver is uncomfortable. She’s worried.”

Additionally, many feel helpless, frustrated, or ashamed, sometimes blaming themselves for their child’s condition. “It’s essential that we provide care not just to the child but also to the caregiver,” Bako emphasizes. “If the mother cannot manage her own stress, it may unconsciously spill over to the child.”

Breaking the Vicious Cycle

MSF’s mental health team employs a holistic approach to support both children and caregivers. All MSF-supported hospitals in Nigeria have playrooms where mothers or caregivers and their children engage in daily mental health sessions. Their activities include:

– Psycho-stimulation sessions: Using play, colors, sounds, and gentle massages, these sessions help children regain lost developmental skills and foster emotional bonds with their caregivers.
– Psycho-education: Caregivers learn about the psychological impact of malnutrition, how to manage stress, and how their own well-being affects their child’s recovery.
– Support groups: Caregivers share experiences, coping strategies, and emotional support, fostering a sense of community and resilience.
– Recreational activities: These sessions provide caregivers and their children a chance to relax and distract themselves from the stress of hospital life.
– Individual counseling: One-on-one support is available for those experiencing acute distress.

Acknowledging the role of fathers, the team also organizes men’s sessions to educate and encourage them to support mothers emotionally and make informed decisions about their children’s care.

Moreover, MSF’s approach extends beyond patients and caregivers. The mental health team trains all staff—doctors, nurses, and support workers—in psychological first aid and communication skills. “Communication can sometimes be a treatment in itself,” Bako says. “When a mother feels listened to, and when a child feels safe with the doctor or nurse, that is a form of treatment.”

Hope for Recovery

By addressing both the physical and psychological needs of malnourished children and their caregivers, MSF is helping to break the cycle of suffering. “It’s not just about treating the disease,” Bako states. “It’s about restoring hope, dignity, and the bonds that help children and families heal.”

On World Mental Health Day, MSF reaffirms its commitment to holistic care—because every child deserves not just to survive but to thrive, both physically and emotionally.

Since 2022, MSF has raised the alarm over the worsening malnutrition situation in northern Nigeria. The situation continues to deteriorate, with alarming numbers of children suffering from severe acute malnutrition.

Between January and June 2025, MSF admitted 32,940 severely malnourished children in inpatient therapeutic feeding centers, and 136,255 children in outpatient therapeutic feeding centers in northern Nigeria.

To help families cope with the psychological toll of the crisis, MSF also conducted 30,880 mental health sessions during the same period. In Bauchi, since the beginning of the project in 2024, our teams have provided mental health support to 113,191 malnourished children and their caregivers.