Gaza’s fragile cease-fire has brought little relief to the strip’s youngest and most vulnerable, as UNICEF warns of a spiraling maternal malnutrition crisis that is leaving hundreds of newborns underweight, premature and at heightened risk of death.

The agency says the war’s long shadow – marked by food shortages, collapsed health services and staggering psychological stress – is now taking a generational toll.

That warning, delivered by UNICEF spokeswoman Tess Ingram from central Gaza via video link to a press briefing in Geneva, paints a bleak picture of a territory where the conflict has reached the womb.

She described a "devastating domino effect”: mothers who cannot eat enough give birth to babies who arrive too small to survive, or who endure a lifetime of weakened immunity and chronic health problems even if they do.

"No child should be scarred by war before they have taken their first breath,” she said.

Underweight births

Before the war erupted on Oct. 7, 2023, following Hamas' incursion into southern Israel, killing about 1,200 people in Israel – Gaza recorded an average of 250 underweight babies each month.

That represented roughly 5% of total births, consistent with previous years.

But after more than two years of bombardments, displacement and severe restrictions on food and aid, the numbers have doubled.

Between July and September this year, UNICEF reported around 460 babies per month born weighing less than 2.5 kilograms (5.5 pounds), even as Gaza’s overall birth rate dropped sharply due to the dangers of pregnancy during war.

During that same period, nearly 40% of pregnant women examined by UNICEF were malnourished, a level unprecedented in the enclave.

Ingram attributed the spike to the collision of three war-driven forces: chronic food shortages, intense maternal stress and severely limited antenatal care.

"In Gaza, we witness all three,” she said. "And the response is not moving fast enough nor at the scale required.”

Low birth weight is a major predictor of early death.

According to Ingram, underweight infants are about 20 times more likely to die than babies born at a healthy weight.

Neonatal deaths – those within the first 28 days – have surged from 27 per month in 2022 to 47 per month between July and September this year.

Cease-fire in name only

The crisis has persisted despite a U.S.-brokered cease-fire that took effect on Oct. 10.

While large-scale bombardments have waned, aid groups say the humanitarian situation remains dire.

Palestinian health officials report that more than 70,4000 people have been killed since the war began, a figure that includes both direct casualties and thousands who died from hunger, treatable illnesses and blocked medical access.

During the war, Israel severely restricted food and fuel delivery into Gaza, at times halting aid completely.

Israeli authorities now say roughly 600 aid trucks enter the strip each day – matching the level agreed upon in the cease-fire framework.

But the UN disputes this, reporting an average closer to 280-300 trucks, far below the 1,000 trucks per day the World Food Programme says are needed to stave off famine.

The Rafah crossing with Egypt remains largely inaccessible, cutting off a crucial artery for medical supplies and specialized care.

Northern Gaza – flattened, starved and heavily depopulated – faces the steepest deprivation, with acute malnutrition rates among children under five reaching 15%, triple the emergency threshold.

Mothers in crisis, babies in peril

The impact is starkest among pregnant and breastfeeding women.

In October alone – the first full month of the cease-fire – UNICEF treated 8,300 women for acute malnutrition. Before October 2023, the agency recorded virtually no cases of severe maternal hunger in Gaza.

Most families now live on one meal a day, and many women prioritize feeding their children over themselves.

Some rely on small distributions of fortified biscuits; others survive on tea and bread.

With Gaza’s markets emptied and food prices soaring beyond reach, even basic nutrition has become unattainable.

The consequences unfold immediately in delivery rooms – if women can reach them.

Gaza’s hospitals, crippled by power outages and a lack of medicine, often cannot provide incubators, oxygen machines or adequate neonatal care.

Many women give birth in crowded shelters, school buildings or tents. Winter rains and freezing temperatures have worsened the risks, leaving underweight newborns vulnerable to hypothermia and respiratory infections.

UNICEF says at least 165 children have died from malnutrition-related causes during the war – deaths that Ingram described as "painful and preventable.”

Long-term damage

For babies who survive, the health threats extend well beyond infancy.

Underweight newborns face higher odds of stunted growth, cognitive impairment, heart disease and diabetes later in life.

UNICEF warns that without massive and immediate intervention, Gaza’s next generation could suffer lifelong consequences.

"This is a generational crisis,” Ingram said. "These children will carry the physical and emotional scars of this conflict for years.”

Ingram closed her briefing with a blunt message: "So much suffering could have been prevented, if international humanitarian law had been respected.” She urged the reopening of Rafah, a dramatic scale-up of food and medical deliveries and renewed pressure on all parties to protect civilians.