Loe de Jong (1914–2005), author of The Kingdom of the Netherlands During World War II, estimated at least 22,000 deaths occurred due to the famine.
This precisely coincided with the beginning of Operation Market Garden, the Allied forces' sharp thrust offensive deep into eastern Dutch territory that same month.
The Allies were able to swiftly liberate southern portions of Dutch territory, but ceased their advance further into the Netherlands when Operation Market Garden failed in its attempt to seize a bridge across the Rhine at Arnhem after a German counter-offensive.
Meanwhile, after a public warning by the German administration's Reichskommissar Arthur Seyss-Inquart on September 24 that sabotage of the railways, telephone lines, or post offices would be severely and collectively punished, the Nazi military command led by Wehrmachtbefehlshaber Friedrich Christiansen began to implement the German retaliation by placing an embargo on all food transports to the western Netherlands.
The drastic food scarcity that was ignited continued to persist as a result of the increasingly harsh winter, increasing scarcity of other resources such as fuel and vehicles, the ongoing administrative and logistic inconveniences caused by the Germans, such as transport restrictions, shipment delays, and defensive flooding; as well as due to farmers and traders who had switched to supplying the black market during the embargo remaining in that parallel circuit.
The overall Allied advance into Germany was delayed by supply problems as the strategic port of Antwerp was not usable until the approaches had been secured and cleared in the Battle of the Scheldt.
But Montgomery had given priority to "Market Garden" and to the capture of the French Channel ports like Boulogne, Calais, and Dunkirk, which were resolutely defended and had suffered demolitions by the retreating Germans.
[6] These developments led to Germans becoming more securely entrenched north of the major rivers in all of the Netherlands, which originally had been anticipated to fall into the hands of the Allies before the end of 1944.
In the last months of 1944, in anticipation of the coming famine, tens of thousands of children were brought from the cities to rural areas where many remained until the end of the war.
This led to significant amount of land, particularly in the north and west, up to 250.000 hectare in total, to become flooded, further distorting supply routes and isolating regions from each other.
As the south-eastern (the Maas valley) and the south-western part of the Netherlands (Walcheren and Beveland) became one of the main western battlefields, these conditions combined to make the transport of existing food stocks in large enough quantities nearly impossible.
[9]: 275 Deaths in the three big cities of the Western Netherlands (The Hague, Rotterdam, and Amsterdam) started in earnest in December 1944, reaching a peak in March 1945,[10] but remained very high in April and May 1945.
Ongoing and new humanitarian assistances took place in the liberated country and the death rate quickly returned to normal figures by the early summer of 1945.
[12] Grandchildren of pregnant women carrying female babies during the famine were also shown to be smaller at birth and suffer increased health issues later in life.
Audrey Hepburn spent her childhood in the Netherlands (officially residing in Arnhem, then in Velp) during the famine and despite her later wealth she had lifelong negative medical repercussions.