Case Report: Lactation Ketoacidosis Can Complicate the Ketogenic Diet

Ketoacidosis is a metabolic condition caused by the buildup of ketone bodies. The most common causes are diabetes, alcoholism, and starvation. This is a case of a lactating mother on a ketogenic diet who developed a community-acquired pneumonia and then went into life-threatening ketoacidosis.

A 32-year-old, lactating, 8-week-postpartum woman presented to the hospital complaining of nausea, vomiting, rhinorrhea, and cough. She had no history of diabetes or of alcohol or drug use but reported following a ketogenic diet and was found to have a pneumonia. The pneumonia was treated with antibiotics, and the acidosis resolved with a dextrose solution.

We report the case of a mother who, while lactating and losing weight on a ketogenic diet, developed a pneumonia and then went into ketoacidosis. Physicians should be aware that patients on the ketogenic diet are at risk for life-threatening acidosis, especially if they develop a second and/or third stressor or energy requirement on top of the low-carbohydrate diet. This case and those reviewed in the literature indicate that ketogenic diets may not be safe during lactation and could be associated with increased morbidity.