The plight of children at this North Korean hospital appears to underscore the severity of the nation's food shortages.
They show signs of severe malnutrition.
Without proper food and medical treatment some have little chance of survival.
Pyongyang says the food crisis has been made much worse by the severe winter.
North Korea is appealing for food aid in the aftermath of the extreme weather, coupled with rising global commodities prices and sanctions imposed over its nuclear programme.
The North Korean government invited Reuters Alertnet humanitarian news service on an unprecedented but tightly-controlled trip to South Hwanghae where this footage was shot.
The province is a crucial farming area in the nation's rural bread basket.
In March the World Food Programme estimated some six million North Koreans needed food aid.
It said a third of children were chronically malnourished or stunted.
The North Korean Red Cross says that was before floods in summer that inundated about 134, 000 hectares of crop land.
South Korea on Tuesday (October 4) ditched plans to provide emergency flood aid to the North saying Pyongyang had failed to respond to its offer of food assistance.
The United States suspended aid in 2008 in a dispute over monitoring of supplies.
It says it will only resume aid with agreement from South Korea which is sceptical of Pyongyang's latest appeals for food.
