As another dangerously underweight toddler balances precariously on his set of scales, Dr Om Prakash knows he has to move fast to avert tragedy.
"The children who are severely malnourished can die between a few hours to a few days," says the doctor during a shift at an intensive care unit exclusively for children in India's poorest state.
"For the health of any person, nutrition is the first requirement. When nutrition is affected, all of the body's functions are deranged."
The 30-bed hospital at Darbhanga in the eastern state of Bihar teems with children with protruding bellies and sunken eyes -- telltale signs of wasting and stunting, owing to severe malnutrition.
While its economy is growing at a healthy rate, India still lags behind some of its poorer neighbours on child nutrition with more than 40 million stunted children, according to a recently released report.
Here's a glimpse of the harsh reality: