A stark warning issued by the UN's humanitarian office, Ocha, said the malnutrition situation is "alarming".
It added that nearly one million Somalis, one in 12 of the population, "struggle... to meet their food needs".
The drought in Somalia has been partly caused by the El Nino weather phenomenon which has affected east and southern Africa.
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The worst-affected areas of the country are parts of Puntland and the self-declared republic of Somaliland.
Many of those in need of help are people who have been displaced by years of conflict in the country.
In all 4.7 million people, nearly 40% of the population, need some sort of humanitarian assistance.
As the drought is intensifying there "many more people risk relapsing into crisis,"  said the UN's Humanitarian Coordinator in Somalia Peter de Clercq.
Highlighting the condition of the children, he said that 58,300 will die "if they are not treated".
Mr de Clercq appealed for more funds so they can be helped quickly.
In neighbouring Ethiopia more than 10 million people need food assistance following the failure of the rains.
And Zimbabwe has declared a state of disaster in some drought-affected areas of the country.

Dan Lawrence (75) and Adam Wheater's (64) 127-run partnership helped Essex create a platform before they were all out for 295, having resumed on 120-4.
Middlesex, also aided by Toby Roland-Jones' 3-81, chose to not enforce the follow on, despite being 212 ahead.
Sam Robson hit 77 and Nick Gubbins 64 as the hosts declared on 239-3, and Essex ended 19-0 chasing 452 to win.
Given the forecast for rain on the final day, the decision not to put Essex back in to bat again was surprising. However, Robson and Gubbins built on their first-innings centuries to ensure the best chance for victory possible if the weather holds out.
After dismissing former England captain Alastair Cook cheaply on day two, Roland-Jones took his third wicket of the match with the 14th ball of the third morning, as Ravi Bopara was caught at third slip, continuing his poor batting form this season.
That brought Wheater to the crease, and alongside Lawrence the pair dragged Essex away from a disastrous reply to Middlesex's 507-7 declared, but Wheater was eventually out to a brilliant one-handed tumbling catch by Stevie Eskinazi at square leg to reduce the visitors to 253-6.
Ryan ten Doeschate (20) was then trapped plumb lbw by Tim Murtagh, Simon Harmer hit a wide ball to Eskinazi's hands, and Lawrence and Neil Wagner were dismissed by Finn (4-51) as the final four wickets tumbled in nine overs.
At a pace of more than six runs an over, Middlesex thundered to a lead of 451, thanks to Robson, Gubbins and fellow first-innings centurion Eskinazi, who hit 62 in 34 balls, going to his fifty with three successive sixes into the Grand Stand off Jamie Porter.
Essex faced six overs late in the day and opener Nick Browne survived a scare when Ollie Rayner dropped him at second slip off Roland-Jones when he was on eight.
Middlesex head coach Richard Scott told BBC Radio London:
"We decided not to enforce the follow-on because our bowlers had sent down almost 100 overs in their first innings.
"We wanted to give them a session's rest so they could come back again strong and also have the chance of bowling fresh in the morning.
"Our batsmen actually did brilliantly to accelerate the scoring rate and get us a lead of 450 in time for us to have six overs at them before stumps."
Essex wicketkeeper-batsman Adam Wheater told BBC Radio Essex:
"We tried to slow the scoring rate in their second innings but their top three all played really well.
"With the small boundary on one side it is hard to defend it.
"We just have to bat well on the last day and you never know what can happen."
More than 50,000 children in Somalia "face death" because of the ongoing drought there, the UN says.
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Steven Finn took four wickets as Middlesex continued to dominate against Essex on day three at Lord's.