Lactation Ketoacidosis: A case series

Abdullah M Al Alawi, Usama Al Amri, Henrik Falhammar

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Lactation ketoacidosis is an extremely rare type of high anion gap metabolic acidosis. We report two lactating women who were diagnosed with lactation ketoacidosis. The first patient presented to the Emergency Department at Royal Darwin Hospital, Darwin, Australia, in 2018 with lethargy, nausea and abdominal pain after she commenced a new diet regimen based on three meals of protein per day and free of glucose, gluten and dairy products. The second patient presented to the Emergency Department at Sultan Qaboos University Hospital, Muscat, Oman, in 2018 with headache, severe malaise, epigastric pain and worsening of gastroesophageal symptoms. Blood investigation results showed that both patients had high anion gap metabolic acidosis, ketosis and hypoglycaemia. The patients responded well to intravenous dextrose and resumption of a balanced diet. Both patients were able to continue breastfeeding and remained well on follow-up.

Original languageEnglish
Pages (from-to)e359-e363
JournalSultan Qaboos University Medical Journal
Issue number4
Publication statusPublished - Nov 2019


  • Abdominal Pain
  • Adult
  • Breast Feeding
  • Diet, Carbohydrate-Restricted/adverse effects
  • Directive Counseling
  • Exercise/physiology
  • Feeding and Eating Disorders/complications
  • Female
  • Fluid Therapy
  • Gastrointestinal Diseases/complications
  • Glucose
  • Humans
  • Hypoglycemia/etiology
  • Hypoglycemic Agents
  • Ketosis/diet therapy
  • Lactation/physiology
  • Maternal Nutritional Physiological Phenomena/physiology
  • Nausea
  • Nutrition Assessment
  • Treatment Outcome


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