The world is on the brink of a nutrition crisis and Pacific children living on the frontlines of the Covid-19 pandemic and the climate change crisis are most at risk.
These are findings in a new report, Nutrition Critical, released by Save the Children.
The report showed the impacts of both crises had led to an increase in poverty, a loss of livelihoods, and reduced access to health and nutrition services, pushing up rates of hunger and malnutrition.
The report found that 600 million children world-wide had missed out on vital assistance during both crises.
Jacqui Southey of Save the Children New Zealand said governments must implement child benefits to ease family hardships.
Southey warned the pandemic-related malnutrition could see an average of 153 children die a day over the next two years if action was not taken immediately.
Good nutrition matters, she said.
"It is vital for children to thrive, grow, develop and reach their full potential. And it's also a matter of survival. Good food keeps children alive."
The report found that the pandemic-related malnutrition projected an average of 153 children would die a day over the next two years if action was not taken immediately.
The Pacific had been struck with five cyclones - three of them category 5 storms - since January 2020.
"Even before the pandemic hit, conflict, natural disasters and climate change have led to many communities struggling to provide children with enough healthy food, with one in three children under five suffering from malnutrition," Southey said.
"Families in Fiji, like many others across the Pacific, live on the frontlines of Covid-19 and climate change.
"Increasing drought and water scarcity, rainfall changes, coastal flooding and erosion all combine to threaten children's food security and nutrition."
Physical and mental development
Southey said the prevalence of children suffering from stunting in the Pacific is 38.4 percent, higher than Asia (31.7), Eastern Africa (34.5) and Middle Africa (31.5 percent).
Stunting is the impaired growth and development that children experience from poor nutrition, repeated infection and inadequate psychosocial stimulation.
The World Health Organisation said children were defined as stunted if their height-for-age was more than two standard deviations below the WHO Child Growth Standards median.
Southey said stunting was also irreversible and in severe cases, it had a long-term impact on children's physical and mental development.
She said several Pacific island countries have a high prevalence of stunting in children under-five years old including Nauru, Marshall Islands, Solomon Islands, Tuvalu and Vanuatu.
In Solomon Islands, one out of three children suffers from stunting.
She said the Solomons' level of malnutrition is on a par with some countries in Sub-Saharan Africa.
According to the UN Children's Fund (UNICEF), six out of the 10 Pacific countries that keep data on stunting recorded higher than average numbers.
UNICEF's State Of The World's Children report urged parents be placed at the centre of any initiative hoping to have an impact on malnutrition.
The report recommended helping parents make their homes a thriving, healthy environment where breast-feeding is supported and encouraged, the food on offer is diverse and people eat neither too much or too little.
In December, New Zealand Prime Minister Jacinda Ardern was advised that child poverty levels in her country were set to rise due to the impact of Covid-19, with families already in significant hardship the most affected.
Save the Children warned vulnerable communities across the globe were already hit with an extreme food emergency as 11 million children under five faced extreme hunger or starvation.
It said this included five 'hunger hotspots' caused by conflict and the effects of climate change.
Recent UN data showed that 16.2 million people would face high levels of acute food shortages in the first quarter of this year.
This included 7.35 million children already experiencing severe acute malnutrition.
A report released last year by the United Nations Children's Fund (UNICEF) revealed the pandemic was having profound effects on children's mental health, social development, safety, privacy, economic security and beyond.
The report Humanitarian Action For Children also said the impact of the global crisis on children would be lifelong.
UNICEF Pacific's Sheldon Yett said while the majority of children had been spared Covid's direct health effects, the crisis is affecting their well-being.
"There are unseen issues. There are issues of mental health. There are issues of social health. When we see day after day images on TV of family members getting sick, there's a mental toll here. A toll of anxiety, sadness and lack of hope," he said.
Yett said the impact of Covid-19 was also expected to be most damaging for those children who were already in disadvantaged or vulnerable situations.
Chance to 'build better'
In New Zealand, children are facing similar challenges.
Southey said Kiwi youngsters are experiencing increased food insecurity.
"We have the second highest rates of child obesity in the OECD - a form of undernutrition and most likely to affect children living in poorer households.
"A recent study by the University of Auckland found that New Zealand children and adolescents are being targeted by advertising for unhealthy food."
Child rights advocate Gabriella Waaijman said the Covid-19 crisis had led to a wave of new malnutrition cases among vulnerable communities, and "we must stop this threat in its tracks".
Waaijman said to truly put an end to malnutrition and hunger, the world must tackle the root causes of acute nutritious food shortages.
"That means putting an end to global conflict, tackling changing climate, building more resilient communities and ensuring aid workers have unhindered access to the most vulnerable communities.
"Investing now can prevent these deaths. The pandemic has forced us all to rethink the society we live in, giving us a chance to build back better and support children in fulfilling their potential."
To avert a nutrition crisis in the coming years, governments and other organisations have been urged to include children in the decisions that impact them, including health and nutrition.
Save the Children said countries should also ensure financing by making long-term and flexible commitments to address malnutrition.
"Preserving and scaling up critical food, nutrition, health, water, sanitation, hygiene and livelihood assistance," Southey said.
"Prioritising humanitarian cash and voucher support for families in order to increase their household income.
"Urgently addressing malnutrition in fragile or conflict affected regions, and strengthening essential health and nutrition services."
The report's launch coincided with Nutrition for Growth 2021 this week. The event celebrated new policy and financing commitments to nutrition.
The World Nutrition Summit will be held in Tokyo in December.