This condition is well known among dairy cows, and is called bovine ketosis. We review the available case reports of lactation ketoacidosis in humans and the mechanisms thereof. This guide is based on scientific evidence, following our policy for evidence-based guides. Low-carb diets can put you into a state of ketosis, which means that ketones are potentially included in your breastmilk. One way to make sure you get enough carbs is to add three fruits per day or extra servings of root veggies, to an otherwise strict low-carb or keto menu. By eating low carbs, the body is forced to break down body fat for energy, causing a rise in blood and urinary ketones. Nephrology, Dialysis, Transplantation Plus 2009: A case of bovine ketoacidosis in a lactating woman[case report; very weak evidence] The ketogenic diet is a weight loss strategy involving a diet that is high in fat, adequate in protein, and very low in carbohydrates. ↩ Here are a few examples of cases in which breastfeed women developing ketoacidosis while fasting or eating very little due to surgery or illness: Nutrition Journal 2015: Ketoacidosis in a non-diabetic woman who was fasting during lactation[case report; very weak evidence], La Revue de Médecine Interne 2015: Starvation ketosis in a breastfeeding woman[case report; very weak evidence]. Subscribe to IABLE Express and Clinical Question Newsletters for updates on our activities and weekly reviews of a broad range of contemporary breastfeeding issues. There have been several published case reports of ketoacidosis during lactation among non-diabetic mothers. Breastfeeding on a low-carb diet – is it dangerous? But you can choose whichever way you prefer to get the extra carbs, like selecting moderate and liberal low-carb recipes (using the advanced recipe search). It can be an excellent way to lose excess weight, while still eating all the nutritious foods that you and your baby need. Have you ever created a breastfeeding education handout about relactation? Lactating mothers frequently ask me about whether a low carb diet is safe during lactation, because they have used this strategy successfully in the past, and lactating women often look for advice on weight loss. Severe reduction by any means can place the mother at risk. We have created a breastfeeding education handout on Low Carb Diets During Lactation. A meta-analysis [strong evidence] ↩ There are no studies defining where a “safe” level of carb intake is for breastfeeding mothers. But when breastfeeding, extremely low carb intake can possibly lead to a dangerous condition called ketoacidosis, in rare cases. If you are not interested in membership, please consider making a donation to support our efforts. Prompt diagnosis and immediate treatment cannot be overemphasized. If you’re breastfeeding you should not do a strict low-carb diet. Based on the cases in the literature, it would seem wise to advise breastfeeding mothers to avoid a strict low carb diet, particularly in situations of very high energy demand, such as if she is exercising heavily, donating extra milk, or nursing multiples. Lactation ketoacidosis is well established in bovine literature but remains a rare phenomenon in humans. The process of breaking down one’s body fat into ketones will not be altered by the types of fats. It’s simply important to get enough nutrients while breastfeeding. High-quality research has consistently found that carb restriction is safe and effective for weight loss: The British Journal of Nutrition 2016: Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomized controlled trials [strong evidence]. Thank you for your interest in IABLE! We've added you to our mailing list. Treatment includes hospitalization for intravenous fluids, carbohydrates, a correction of the acidosis and electrolyte imbalances. Click for more info. The type of fat will not make a difference where ketosis is concerned. Although ketogenic diet has been shown to be safe in nonpregnant individuals, the safety of this diet in lactating mothers is not known. Current Developments in Nutrition 3(supplement 1) June 2019. Breastfeeding moms on Keto or Low-carb diets need to eat more healthy fats. For reasons that aren’t entirely understood, it seems to be related to the metabolic changes and increased nutritional demands of producing milk.3. It is known to induce ketosis but is not an established cause of clinically significant ketoacidosis. To our knowledge, this is the first reported case of life-threatening lactation ketoacidosis associated with ketogenic diet while consuming an adequate number of calories per day. A ketogenic (low carbohydrate) diet during lactation increases the risk of life threatening ketoacidosis. Health professionals and mothers should be made aware of the potential risk associated with a strict ketogenic diet when combined with lactation. Ketogenic Diet-Induced Severe Ketoacidosis in a Lactating Woman: A Case Report and Review of the Literature, IABLE is a member of The United States Breastfeeding Committee, Starvation during lactation due to abdominal pain, Frequent skipping of meals while on a high protein low carb diet, Gastroenteritis in the setting of a low carb diet, A urinary tract infection in the setting of a weight loss reduction diet. Therefore, it seems reasonable that moderate or liberal carb restriction (above 50 grams per day) should be adequate to minimize risk. Further, some of the case reports involve lactating mothers who are ill, so breastfeeding mothers following a low carb diet should be advised to consume carbs in the event that she is ill, such as when experiencing a viral or bacterial infection. Which do you believe were real case reports? Visit our Submission page for question guidelines and to fill in the submission form. Ketosis is the breakdown of one’s body fat, and if no carbs are ingested, fat is broken down into ketones. Here we present a life-threatening case of severe ketoacidosis in a nondiabetic lactating mother on a strict ketogenic diet. [overview article; ungraded] ↩ Stay updated like 500,000+ subscribers with our weekly Diet Doctor newsletter. Required fields are marked *. The ketogenic diet (KD) is a high-fat, adequate-protein, and low-carbohydrate diet that leads to nutritional ketosis and weight loss. Little research has been done on the impact of ketones on a growing baby, so this is a big reason most professionals recommend that breastfeeding mothers include healthy carbs like fruits, vegetables, and whole grains in their meal plans. Do you want to eat a low-carb diet while breastfeeding? I truly appreciate the weekly Q & A. 3 It is known to induce ketosis but is not an established cause of clinically significant ketoacidosis. Comment document.getElementById("comment").setAttribute( "id", "a79664341ed474fe7386429b8e7754fd" );document.getElementById("j278a3eeed").setAttribute( "id", "comment" ); Notify me via e-mail if anyone answers my comment. For reasons that aren’t entirely understood, it seems to be related to the metabolic changes and increased nutritional demands of producing milk. When carbs are low in quantity, the body will first use the stored glycogen but then the body switches to creating glucose from non-carb sources (Gluconeogenesis), and this is required to sustain lactation as glucose is ABSOLUTELY needed for milk synthesis. What is the ketogenic diet and is it safe during lactation? The Institute for the Advancement of Breastfeeding and Lactation Education / Copyright Thank you either way. I know it is a broad subject, but something that comes up quite often with women who have quit breastfeeding, usually within the past 1-2 months, but are considering relactation. 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