In 2003, 11.2 percent of families in the United States experienced hunger, compared with 10.1 percent in 1999, according to most recent official figures, released on National Hunger Awareness Day held this year on Tuesday, June 7.

Some pediatricians worry that cuts in welfare aid proposed in President George W. Bush's 2006 budget will only exacerbate the situation. By contrast Bush plans to keep tax cuts for more affluent sectors of the population, they note.

In the working class port city of Baltimore, Maryland, Dr. Maureen Black, a pediatrician, sees numbers of underweight babies in her clinic specialized in infant malnutrition located in one of the poorer areas.

"In the first year of life, children triple their birth weight," said Black, "and if children do not have enough to eat during those very early very times, you first see that their weight will falter and then their height will falter."

"If their height falters enough and they experience stunting under age two, they are then at risk for academic and behaviour problems" at school, said Black.

Dr. Deborah Frank, a professor of pediatrics at Boston University's School of Medicine, who also runs a specialised clinic for malnourished babies, has similar concerns.

"We are seeing more and more very young babies under a year of age which is a particular concern because they are most likely to die of under nutrition, and also their brains are growing very very rapidly," said Frank, in a telephone interview.

"A baby's brain increases 2.5 times in size in the first year of life," she says, adding that if the baby fails to get the nutritional building blocks he or she needs for the brain to develop, a child can have lifelong difficulties in behaviour and learning.

But infant-child protection centers do not exist in the United States, unlike it other countries, such as France, which makes children below the age of three or four years old somewhat invisible to authorities, laments Frank. "They don't come to my clinic until they are already quite underweight.

"Recently I have been alarmed because we are getting more children who are so ill that they go to hospital rather than they come to the clinic first" a situation which, in 20 years of practising medicine, Frank had seen reverse.

Some children in the United States occasionally look like the malnourished children we see in some parts of Africa, however, welfare programs targeting society's poorest ensures that problem is generally avoided, the pediatricians say.

Paradoxically, malnutrition is not always due to lack of food -- rather to the quality of the food being consumed.

"People often ask me how many children go to bed hungry. The answer is the parents work very hard so they don't go to bed feeling hungry. The parents try to fill the baby up with french fries and soda pop," said Frank.

In some areas, green vegetables and fruit are impossible to buy -- even in a can, because there may be no supermarket. Moreover, such items are costly.

"What happens in America is -- what seems bizarre -- that some of the recommendations that we give to families to prevent underweight of children are the same as we give to prevent overweight," said Black. "We recommend families not to give their children junk food."

In some families, eating junk food will mean one child is obese while the other is underweight, said Black. "The first will eat junk food and nothing else, the second will eat junk food and everything else."