Kwashiorkor /kwɑːʃiˈɔrkər/ or Ga k is a form of severe protein–energy malnutrition characterized by edema, irritability, anorexia, ulcerating dermatoses, and an enlarged liver with fatty infiltrates. Sufficient calorie intake, but with insufficient protein consumption, distinguishes it from marasmus. Kwashiorkor cases occur in areas of famine or poor food supply. Cases in the developed world are rare.Jamaican pediatrician Cicely Williams introduced the name into the medical community in her 1935 Lancet article. The name is derived from the Ga language of coastal Ghana, translated as "the sickness the baby gets when the new baby comes",[citation needed] and reflecting the development of the condition in an older child who has been weaned from the breast when a younger sibling comes. Breast milk contains proteins and amino acids vital to a child's growth. In at-risk populations, kwashiorkor may develop after a mother weans her child from breast milk, replacing it with a diet high in carbohydrates, especially starches, but deficient in protein.[citation needed]