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Protein-energy malnutrition results from low intake or poor absorption of food, usually due to inadequate availability or infection. In most cases, PEM affects children between six months and five years of age, and is a particular threat at the time of weaning. However, recently it has been demonstrated that the process of becoming malnourished already starts in infants younger than 6 months, stressing the importance of exclusive breastfeeding until the child is about 6 months of age. PEM takes three forms: nutritional marasmus, kwashiorkor, and marasmic kwashiorkor.