Millions of children live in homes where food is scarce, and doctors are going to start to seek them out by asking a few new and important set of questions. The American Academy of Pediatrics (AAP) released a new policy that advises doctors to ask not only what a child is eating, but how much. The new recommendations will make routine checkups more in-depth and give pediatricians a better tool to screen for malnutrition.

"The health effects of hunger on children are pervasive and long-lasting, which is why our new policy urges pediatricians to take action in and outside of the clinic to conquer food insecurity and promote child health," said the policy's lead author Sarah Jane Schwarzenberg, a pediatrician at the University of Minnesota Masonic Children's Hospital, in a press release. "As is the case with many childhood health conditions, being malnourished or not getting enough healthy food early in life has effects that can last well into adulthood."

According to the United States Department of Agriculture, 15.3 million children under the age of 18 lived in what are known as "food-insecure homes" in 2014. People who live in these homes don't have consistent and reliable access to enough nutritious food, and although it's harmful to an individual of any age, it's especially dangerous to children. A child's mental, emotional, and physical development reportedly relies on having enough nutritious, healthy food for social and academic success. Yet today, this issue is either overlooked or left unaddressed.

Asking a child what they eat may be just as important as asking if they're hungry. Families that rely on the government's Supplemental Nutrition Assistance Program, more often referred to as food stamps, usually eat about the same number of calories as higher-income Americans. But according to a recent study published in the Americans Journal of Preventive Medicine, those families eat far fewer fruits, vegetables, and other nutrient-dense foods. This can lead to calcium deficiencies and other necessary vitamins and minerals for healthy childhood development.

"Some families do rely on starchy, filling foods that may not provide all the vitamins and minerals they need," Schwarzenberg told NPR News. "Hunger, malnutrition and food insecurity are tied to adult cardiovascular disease, obesity, and diabetes."

The new policy outlined the reasons why pediatricians need to start asking more intimate questions about their youngest patients'. Children who live in food insecure households, the AAP policy wrote, tend to "get sick more often, recover more slowly from illness, have poorer overall health and are hospitalized more frequently."

While the AAP has recognized the long-term negative impact of living in a food insecure home, it's harder to recognize a child in need. Schwarzenberg said a lot of the times the signs are masked by the parents or children because, "they're embarrassed, or don't think the doctor will care."

So, instead of pediatricians waiting for their young patients or their parents to highlight the nutrition gap, it is the doctors who will start actively searching and identifying potential signs. One example of the questions the AAP has recommended pediatricians ask is a yes or no question: "Within the past 12 months, the food we bought didn't last, and we didn't have money to get more."

"Pediatricians can have this information at their fingertips," Schwarzenberg said. Providing doctors with the new screening tools, along with a list of community resources like food banks and social workers, can help empower doctors to better treat their patients.

Source: Schwarzenberg SJ, et al. Food Insecurity: Starving Our Future. Pediatrics. 2015.