Breaking the Cycle: Addressing Mental Health and Malnutrition Together

By: Michael Mike

Every year, millions of children around the world suffer from malnutrition—a crisis that is all too visible in their frail bodies and tired eyes. But 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, the upward surge in children admitted for the treatment of malnutrition in MSF nutrition programmes has been an alarming trend. 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, its teams are often overwhelmed.
In 2024 alone, over 300,000 malnourished children were collectively 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 caregivers. They both go through a cycle of emotions from the day they are admitted up to the time of discharge.
Kauna Hope Bako, MSF’s mental health supervisor in the Bauchi project, and her team—just like in other project locations in Nigeria—are working to break this cycle. Their approach recognises that malnutrition is not just a medical emergency, but a psychological one as well.
The Hidden Toll of Malnutrition
“Malnutrition is one disease that doesn’t just affect the child physically,” explains Bako. “It has psychological, emotional, and behavioural 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Children suffering from malnutrition often become irritable, withdrawn, and unresponsive.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 real.
“The child is feeling detached, sad that he cannot play like other children, and is trying to understand what is going on with him,” Bako says. “He’s going through a lot of pain and stress—not just from malnutrition, but from other diseases that often come with 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’re 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 past few years has shown that integrating these activities contributes to faster weight gain, shorter lengths of stay in inpatient feeding centres, and improved caregiver well-being.
The Caregiver’s Burden
The impact of malnutrition extends beyond the child. Mothers and caregivers, who are often the primary source of support, face immense stress and emotional strain.
“At triage, the emotions you’ll find most prominent are anxiety, stress, and fear,” Bako shares. “The caregiver is not really comfortable. She’s worried.”
Additionally, many feel helpless, frustrated, or even ashamed, sometimes blaming themselves for their child’s condition.
“It’s important that we give care not just to the child but also to the caregiver,” Bako emphasises. “If the mother is not able to manage her own stress, it may unconsciously spill over to the child.”
Breaking the Vicious Cycle
MSF’s mental health team uses a holistic approach to support both children and caregivers. There’s a playroom in all MSF-supported hospitals in Nigeria where mothers or caregivers and their children meet every day for mental health sessions. Their daily activities include:

• Psycho-stimulation sessions: Using play, colours, 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, building a sense of community and resilience.
• Recreational activities: These sessions offer caregivers and their children a chance to relax and distract themselves from the stress of hospital life.
• Individual counselling: For those experiencing acute distress, one-on-one support is available.
  Recognising the role of fathers, the team also organises men’s sessions to educate and encourage them to support mothers emotionally and make informed decisions about their children’s care.
  Additionally, 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 is sometimes service treatment,” Bako says. “When the mother feels listened to, when the child feels safe with the doctor or nurse, that already is 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 says. “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, body and mind.
  Since 2022, MSF has been raising the alarm over the worsening malnutrition situation in northern Nigeria. The situation has continued 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 centres, and 136,255 children in outpatient therapeutic feeding centres 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.
• Breaking the Cycle: Addressing Mental Health and Malnutrition Together