The numbers tell a story that unfolds in waves. In January 2024, health workers in Gaza screened 722 children under five for malnutrition. Thirty-four showed signs of acute wasting, their upper arms measuring too thin against calibrated tape. By January 2025, after months of severe aid restrictions, that rate had tripled. Of 11,619 children screened that month, more than 1,600 were wasting away.
A new study published in The Lancet has tracked malnutrition among Gaza’s youngest children through 20 months of war, creating what amounts to a nutritional timeline of the conflict. The research, led by UNRWA and based on 265,974 measurements of 219,783 children, reveals a pattern: peaks in child malnutrition consistently follow periods when aid trucks stop crossing the border.
When the Gates Close
The clearest example came at the end of 2024. UN sources reported that daily aid deliveries had dropped to between 42 and 92 trucks per day, down from the pre-war average of 300 to 600. By January 2025, the prevalence of wasting had jumped to 14.3 percent. Then came a six-week ceasefire in early 2025, aid increased, and by March the wasting rate had dropped back to 5.5 percent.
It did not last. An 11-week blockade followed, restricting food, water, fuel, and medicines. The latest measurements, taken through mid-August 2025, found 15.8 percent of screened children acutely malnourished. Extrapolated across Gaza’s estimated 346,000 children aged six months to five years, that translates to more than 54,600 children in need of urgent therapeutic nutrition. Over 12,800 are severely wasted.
“Since October 7, 2023, an unprecedented war has unfolded across the Gaza Strip. From the outset, the territory’s infrastructure has been destroyed, the population repeatedly displaced and, with few exceptions, humanitarian aid has been severely restricted.”
Dr. Akihiro Seita, UNRWA’s Director of Health and senior author of the study, offered a stark assessment of what comes next without intervention. He warned that “unless there is a lasting cessation of the conflict coupled with unimpeded, competent, international humanitarian nutritional, medical, economic and social services, a further deterioration in early childhood nutrition with increased mortality are inevitable in the Gaza Strip.”
The geographic variations are particularly striking. In Rafah, wasting increased from 7.1 percent in April 2024 to 31.5 percent by January 2025, before dropping back to 8 percent in April 2025 during the ceasefire. Screening stopped there shortly after. In Gaza City, the rate jumped six-fold between March and mid-August 2025, from 5.4 percent to 28.8 percent.
The Measurement Challenge
UNRWA staff conducted the screenings at 16 functioning health centers and 78 medical points set up in shelters and tent encampments across Gaza’s five governorates. They measured mid-upper arm circumference, a method that correlates strongly with overall body mass and can be done quickly in difficult conditions. A thin arm means a thin body, and in young children, that means dangerous weight loss and severe nutrient deficiency.
The researchers acknowledge significant limitations. Two-thirds of screenings happened in Khan Younis and the Middle areas, simply because health centers in other locations were too damaged or dangerous to operate. Some children were screened multiple times over the study period. Identity information was often lacking. Data collection in a war zone is inherently incomplete.
Still, the temporal pattern holds across the data. Dr. Masako Horino, UNRWA’s nutrition epidemiologist and lead scientist, noted an important context: before October 2023, Palestinian refugee children in Gaza were food insecure with poor dietary diversity, but they were only marginally underweight. Regular access to food aid made the difference.
“Following two years of war and severe restrictions in humanitarian aid, tens of thousands of pre-school aged children in the Gaza Strip are now suffering from preventable acute malnutrition and face an increased risk of mortality.”
On August 15, 2025, the UN Integrated Food Security Phase Classification confirmed famine in Gaza City Governorate, with the rest of the Gaza Strip facing critical conditions or the prospect of famine. The new study reinforces that confirmation and provides longitudinal evidence of how child malnutrition evolved during the war.
In a linked commentary, researchers not involved in the study pointed to longer-term consequences beyond immediate starvation. Zulfiqar Bhutta, Jessica Fanzo, and Paul Wise noted that intergenerational effects of childhood starvation include elevated risks of non-communicable diseases and reduced life expectancy. The children who survive will carry these nutritional deficits for decades.
Wasting is a life-threatening condition. Treatment requires regular therapeutic feeding over several weeks, or in extreme cases, hospitalization. With inadequate food crossing the borders and crippled health services, few of the 12,800 severely wasted children have much chance of rehabilitation under current conditions. The study measured arms. The implications extend far beyond.
The Lancet: 10.1016/S0140-6736(25)01820-3
If our reporting has informed or inspired you, please consider making a donation. Every contribution, no matter the size, empowers us to continue delivering accurate, engaging, and trustworthy science and medical news. Independent journalism requires time, effort, and resources—your support ensures we can keep uncovering the stories that matter most to you.
Join us in making knowledge accessible and impactful. Thank you for standing with us!
