At one point it says "Muse latches and bolts on the refrigerator and cupboard doors to keep the children out between meals" (Skloot 2010, 111). This demonstrates the malnutrition suffered by children, which may have led to poor performance in school and poor decisions in life. According to the Orphan Nutrition website, poor nutrition can lead to cognitive delays including “learning difficulties, poor social skills, inadequate problem solving, and impaired language development, as well as a decrease in the body's immune system” (Orphan Nutrition 2016) . These implications may have affected the Lacks family's poor health and knowledge. In addition to starvation, children were forced to perform hard physical labor in the tobacco fields without interruption (Skloot 2010, 112). This increased the risk of malnutrition even more as their bodies worked on few calories. It was also most likely a contributing factor to the numerous health problems within the family. Deborah suffered from high blood pressure, insomnia, acid reflex and various other health problems. Skloot writes: “Deborah took an average of 14 pills a day […]” (Skloot 2010,