Protein-energy malnutrition may result from the following factors:
1. A child may be weaned too soon from the breast milk and put on to a diet which does not supply sufficient protein and energy.
2. Prolonged nursing on the breast milk and the late introduction of supplementary food also lead to PEM. In the later stages the mother’s milk may not be sufficient to fulfill the needs of the child.
3. Inadequate and insufficient supplementary food due either to the lack of knowledge or to the inability to purchase. Some mother does not know that the child has greater need for protein rich food. Some mother dilutes cow’s milk with water to feed the child.
4. Due to unhygienic conditions, the child may suffer from diseases like diarrhea. In order to cure diarrhea the child may be fed on very mild diet, which may lead to PEM.