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Infant Ketosis

Hypoglycemia In Infants And Children

Hypoglycemia In Infants And Children

Hypoglycemia in Infants and Children Authors: Robert A. Felter, MD, FAAP, CPE, FACPE, Professor of Clinical Pediatrics, Georgetown University School of Medicine; Assistant Director, Pediatric Inpatient and Emergency Service, Inova Loudoun Hospital, Leesburg, VA. Ron D. Waldrop, MD, FACEP, CPE, FACPE, Assistant Professor of Clinical Pediatrics, Georgetown University School of Medicine; Director, Pediatric Inpatient and Emergency Services, Inova Loudoun Hospital, Leesburg, VA. Peer Reviewer: Ademola Adewale, MD, FAAEM, Assistant Professor of Emergency Medicine, Assistant Program Director, Florida Hospital Emergency Medicine Residency Program, Orlando, FL. Hypoglycemia is the most common metabolic disorder in children. The causes for hypoglycemia are many and diverse.1 One of the most frequent causes of hypoglycemia is insulin/glucose imbalance in diabetic children; since the management of diabetes and its complications is a subject on its own, this topic will not be included in this issue. The authors focus on issues important to the emergency physician, with emphasis on the need to diagnose and treat hypoglycemia quickly. In the very young infant, failure to recognize and treat hypoglycemia may lead to permanent neurological sequelae. It is also important to remember that hypoglycemia is a symptom and not a diagnosis or a disease entity and always has an underlying etiology that must be ascertained. Sometimes the emergency department (ED) physician may determine the underlying cause, and sometimes the symptom must be treated without knowing the underlying cause. Because hypoglycemia can be rapidly and easily determined at the bedside, there is little reason not to obtain this important piece of clinical information. Recognition of hypoglycemia in the seriously ill child Continue reading >>

Epilepsy, Children, And The Ketogenic Diet

Epilepsy, Children, And The Ketogenic Diet

Some parents of children with epilepsy are skeptical of the ketogenic diet when they first hear about it. A diet that can control epilepsy and stop seizures without any medication? It almost sounds like a scam. But the ketogenic diet is real and legitimate. It works very well in many people. The catch is that it's extremely demanding and difficult to follow. In fact, it is so difficult to follow that most doctors recommend it only for people who haven't been able to control their seizures with medicine. The ketogenic diet is an extremely high-fat diet that requires a child to eat four times as many fat calories as calories from protein or carbohydrates. A meal might include a small portion of chicken, a little bit of fruit, and a lot of fat, typically butter or cream. Frankly, it's a difficult diet to swallow. Your child may start the diet in the hospital, so nurses and doctors can observe the first few days. Your child will probably need to go without any food for 36 to 48 hours before beginning the diet. After that, food is gradually increased over a few days. This diet does not provide all the vitamins a body needs, so your child will probably have to take sugar-free vitamin supplements. No one knows why the ketogenic diet -- which was developed in the 1920's -- works so well. But we do know something about how it affects the body. By reducing the number of carbohydrates a person eats, the body is forced to burn fat for energy, a process called ketosis. This ketosis is the same process that kicks in when someone is fasting -- on purpose or because of starvation. Fasting has been a traditional seizure treatment for centuries. How ketosis helps with epilepsy isn't known, but it does. Researchers at Johns Hopkins University studied 150 children with epilepsy in one impo Continue reading >>

Babies Thrive Under A Ketogenic Metabolism

Babies Thrive Under A Ketogenic Metabolism

The Ketogenic Diet for Health Babies thrive under a ketogenic metabolism Some people, even some scientists who study ketogenic metabolism, have the idea that ketogenesis is somehow abnormal, or exceptional; an adaptation for emergencies only. We disagree. One reason we think a ketogenic metabolism is normal and desirable, is that human newborns are in ketosis. Despite the moderate sugar content of human breast milk, breastfeeding is particularly ketogenic. This period of development is crucial, and there is extensive brain growth during it. Although the composition of breast milk can be affected by diet [1], it is reasonable to assume that breast milk has always been ketogenic, and this is not an effect of modernisation. When the brain is in its period of highest growth, and when the source of food is likely to be close to what it evolved to be for that period, ketones are used to fuel that growth. If nothing else, this suggests that learning is well supported by a ketogenic metabolism. It is also consistent with the ability of ketogenic diets to treat a variety of seemingly unrelated brain disorders and brain trauma. In brief Newborn infants are in ketosis. This is their normal state. Breastfeeding is particularly ketogenic (compared to formula feeding). Breastfeeding longer (up to a point) is associated with better health outcomes. This suggests the hypothesis that weaning onto a ketogenic diet would be healthier than weaning onto a high-carb diet. (Mark-up ours) Human babies are in ketosis Soon after birth, human babies are in ketosis, and remain so while breastfeeding [2]. They use ketones and fats for energy and for brain growth. When this has been studied, in the first couple of hours after birth, babies aren’t immediately in ketosis. There is a short delay [3]. Continue reading >>

Experience With The Ketogenic Diet In Infants

Experience With The Ketogenic Diet In Infants

Abstract Objective. To evaluate the effectiveness, tolerability, and adverse effects of the ketogenic diet in infants with refractory epilepsy. Methods. A retrospective review of 32 infants who had been treated with the ketogenic diet at a large metropolitan institution. Results. Most infants (71%) were able to maintain strong ketosis. The overall effectiveness of the diet in infants was similar to that reported in the literature for older children; 19.4% became seizure-free, and an additional 35.5% had >50% reduction in seizure frequency. The diet was particularly effective for patients with infantile spasms/myoclonic seizures. There were concomitant reductions in antiepileptic medications. The majority of parents reported improvements in seizure frequency and in their child's behavior and function, particularly with respect to attention/alertness, activity level, and socialization. The diet generally was well-tolerated, and 96.4% maintained appropriate growth parameters. Adverse events, all reversible and occurring in one patient each, included renal stone, gastritis, ulcerative colitis, alteration of mentation, and hyperlipidemia. Conclusion. The ketogenic diet should be considered safe and effective treatment for infants with intractable seizures. Continue reading >>

Ketosis In Infants And Children+

Ketosis In Infants And Children+

Summary The biochemical reactions related to the formation of ketone bodies have been reviewed. An attempt has been made to indicate the metabolic interrelationship of fats, carbohydrates, and hormones. Although there has been notable progress in the field of fat metabolism in the last 10 years, there remain many unanswered questions. In relation to ketosis the fundamental question is the mechanism of regulation of acetoacetate synthesis. The following are some of the factorswhich need to be considered when studying the mechanisms involved in the accumulation of ketone bodies: 1.The mobilization of fatty acids. Several clinical conditions associated withketosis are briefly surveyed, and it is found that the factors noted above vary in degree and in different situations. Attention is directed to the resistance of small infants to ketosis, and the possible mechanisms involved are discussed. To access this article, please choose from the options below Continue reading >>

Stop Being Confused About Health

Stop Being Confused About Health

I’ve heard several times now about this idea that babies are in ketosis, and in other words are “keto-adapted.” This idea is then used to support the ketogenic diet in human adults. Let’s break this idea down here and examine its veracity. It’s important to define our terms. I’ve heard the saying “babies are in ketosis” rather than “infants are in ketosis” or “infants less than 6 months old are in ketosis.” What age group are we talking about? Infants are rapidly growing little people. Thus it become problematic already to assume that just because we have been in ketosis for a period of time during our breastfeeding careers we may be able to continue it as our bodies grow in every way and direction. So we’re really talking about infants, and more specifically, the typical age that breastfeeding occurs. Since this is pretty variable I can’t specify an exact age, but I’m guessing 12 months or less. It would also be interesting to discuss how the energy needs of infants may change as they develop physically. I would expect that as they learn to crawl, walk, and run, their bodies might start to prefer glucose. Adults who go on ketogenic diets typically go through an adaptation phase for the first two weeks of the diet. This adaptation period usually brings some discomfort, GI symptoms like constipation, and fatigue (which is often corrected with additional electrolytes). After this period, many people feel better and it is believed they have “adapted” to ketosis. Infants however are in a state of mild-ketosis. Their brains use ketones more so than the adult brain. From this paper (which has a very strong point of view and suggests that brains “prefer” ketones, which is up for debate): “Postnatally, the brain’s dependence on ketones Continue reading >>

Introduction Of A Ketogenic Diet In Young Infants.

Introduction Of A Ketogenic Diet In Young Infants.

Abstract The ketogenic diet is a rational treatment for pyruvate dehydrogenase complex deficiency (McKusick 312170) and GLUT1 deficiency syndrome (McKusick 138140). An increasing number of patients are diagnosed in early infancy, but few data are available on the introduction of a ketogenic diet in this age group. GLUT1 deficiency syndrome was suspected in four infants presenting with seizures and unexplained hypoglycorrhachia. A ketogenic diet was introduced at 6-28 weeks of age. Ketosis was initiated by fasting, monitored by bedside blood glucose and 3-hydroxybutyrate determinations, and was maintained successfully using supplemented carbohydrate-free infant formula and emulgated triglycerides. All patients developed ketosis within 24 h. 3-Hydroxybutyrate concentrations available at the bedside correlated inversely with the base excess. At glucose levels < or = 40 mg/dl patients remained asymptomatic in the presence of ketones. The ketogenic formula was tolerated well, parental compliance was good, and all patients remained seizure-free on the diet. GLUT1 deficiency was confirmed in two patients; the diet was discontinued in the other two patients. In one infant, failure to thrive on medium-chain triglycerides was effectively reversed using long-chain triglycerides. Urine dipstick analyses failed to detect ketosis in another infant. Adverse effects of the diet were limited to renal stones in one patient. The ketogenic diet can be introduced and maintained successfully in young infants using long-chain fat emulsion. Monitoring 3-hydroxybutyrate at the bedside was useful for metabolic control and superior to urine dipstick analysis. Seizure control was effective and adverse effects were limited, but evaluation of the long-term effects of the ketogenic diet in this age g Continue reading >>

Pediatric Ketogenic Diet

Pediatric Ketogenic Diet

A ketogenic diet is a high-fat, adequate-protein, and very-low-carbohydrate diet which has been found to help many children whose seizures are not well-controlled by anti-seizure medications. In some children, the ketogenic diet is combined with standard anticonvulsant medications. While the actual mechanism of the ketogenic diet's effectiveness against seizures is unknown, many children on the diet are able to have their epilepsy medication dose lowered, decreasing unwanted medication side effects. We are consistently ranked among the top hospitals in U.S.News & World Report, distinguished for our pediatric care. Read More Because this is a medical treatment, the ketogenic diet must be supervised by a medical team, consisting of a neurologist and dietitian, who can anticipate and manage possible nutritional deficits or other medical side effects or complications. The team helps children and their families establish and maintain the diet, and learn how to incorporate the diet into daily living. Children on the ketogenic diet are seen several times throughout the year for close monitoring, while they continue to follow with their primary neurologist for potential medication changes. In addition, the team also implements the Modified Atkins Diet and Low-Glycemic Index Therapy, other dietary therapies for which there is increasing data about benefit in the treatment of difficult-to-treat epilepsy. Conditions treated by the Ketogenic Diet Team include: Epilepsy such as Myoclonic Astatic Epilepsy and other epilepsies Glucose transporter type-1 deficiency Lennox Gastaut syndrome Pyruvate dehydrogenase deficiency Dravet syndrome What is a ketogenic diet? The ketogenic diet is sometimes offered to children who continue to have seizures while on seizure medication. When medicati Continue reading >>

Keto Baby!

Keto Baby!

You know that downer at the party who turns down a dish because ‘oh sorry, I don’t eat flour’? Yeah, that’s me. I never used to be “that guy”. I was the one polishing off every dish in front of me with the raging appetite of a hungry cyclist. Until a year and a half ago, that is, when I made a major life style change and “went keto”. A lot of people have asked why. So this is a summary, as short and sweet and to the point as I can make it. My interest in the ketogenic diet began as a way to improve my performance in long distance racing and reduce inflammation, particularly as I was having serious trouble with my knees and other joints. I began reading up on all the material I could find as it related to endurance sport. There are a number of scientific studies made on the pros and cons of a ketogenic diet, with controlled tests showing its merits and drawbacks, though to date these studies have demonstrated few drawbacks and an overwhelming number of benefits. Some of the more remarkable of these being the useful treatment against inflammation in the brain which causes epilepsy and other seizures. It is also much discussed as a diet which may help fight against, or at any rate help to slow cancer, as cancer cells primarily feed off glucose. Most of the studies and books written were done on and by men are and I found little information focusing on the effects of a keto diet on women. So, as per my usual MO, I decided I would play the guinea pig and experiment on myself. I can only tell you what I did and the effects I felt doing it. I have no definitive data collected over the last year and a half since I have successfully crossed over to the ranks of fat adapted athletes. I have, however, done numerous blood tests over the last year which show a perfec Continue reading >>

Babies In Ketosis

Babies In Ketosis

This post topic was inspired by the following article: Ketosis - key to human babies’ big brains? It is hosted on Tim Noakes' website and written by one of his associates in nutritional information misdirection, Tamzyn Murphy Campbell, RD. I'm going to address this misdirection and the disturbing parts of this article vis a vis Campbell in a future BabyGate Files, but for now I want to discuss the role of ketones in metabolism. In doing so, I'd also like to explain my somewhat cryptic recent post on heating my kitchen. (I've C&P'd that entire post to the end further down in this one, so if you don't wish to go to another page, you can just scroll down to The Kitchen Heating Analogy). I'm going to structure this post a little differently than most and get to my point, then provide the back up information. Let's see how this goes. The major source (6 of 12 numbered citations, 1 of 6 unique sources) for her article is: Survival of the fattest: fat babies were the key to evolution of the large human brain (2003) Stephen C. Cunnane, Michael A. Crawford (I'll call this C&C) In this paper, they make the following points: Human babies have higher body fat than other mammals and this may be as a source of ketones in early infancy. Infants have slightly elevated ketones (mild ketonemia) regardless of feeding status which differs from adults who only have elevated ketones when food is restricted (no details here). Glucose is the primary fuel for the human brain Ketones are an alternate source of fuel when glucose is less available Ketones "appear to be" an essential fuel for the midterm fetus, and may provide as much as 30% of the developing brain's needs Ketones are both an energy source and carbon source for fat and cholesterol synthesis in the brain. Campbell relates these so Continue reading >>

Lactation

Lactation

(redirected from lactation ketosis) Also found in: Dictionary, Thesaurus, Encyclopedia. Lactation Definition Lactation is the medical term for yielding of milk by the mammary glands which leads to breastfeeding. Human milk contains the ideal amount of nutrients for the infant, and provides important protection from diseases through the mother's natural defenses. Description Early in a woman's pregnancy her milk-producing glands begin to prepare for her baby's arrival, and by the sixth month of pregnancy the breasts are ready to produce milk. Immediately after the baby is born, the placenta is delivered. This causes a hormone in the woman's body (prolactin) to activate the milk-producing glands. By the third to fifth day, the woman's breasts fill with milk. Then, as the baby continues to suck each day, nursing triggers the continuing production of milk. The baby's sucking stimulates nerve endings in the nipple, which signal the mother's pituitary gland to release oxytocin, a hormone that causes the mammary glands to release milk to the nursing baby. This is called the "let-down reflex." While the baby's sucking is the primary stimulus for this reflex, a baby's cry, thoughts of the baby, or the sound of running water also may trigger the response. Frequent nursing will lead to increased milk production. Breast milk cannot be duplicated by commercial baby food formulas, although both contain protein, fat, and carbohydrates. In particular, breast milk changes to meet the specific needs of a baby. The composition of breast milk changes as the baby grows to meet the baby's changing needs. Most important, breast milk contains substances called antibodies from the mother that can protect the child against illness and allergies. Antibodies are part of the body's natural defense Continue reading >>

Babies Thrive Under A Ketogenic Metabolism

Babies Thrive Under A Ketogenic Metabolism

Some people, even some scientists who study ketogenic metabolism, have the idea that ketogenesis is somehow abnormal, or exceptional; an adaptation for emergencies only. We disagree. One reason we think a ketogenic metabolism is normal and desirable, is that human newborns are in ketosis. Despite the moderate sugar content of human breast milk, breastfeeding is particularly ketogenic. This period of development is crucial, and there is extensive brain growth during it. Although the composition of breast milk can be affected by diet [1], it is reasonable to assume that breast milk has always been ketogenic, and this is not an effect of modernisation. When the brain is in its period of highest growth, and when the source of food is likely to be close to what it evolved to be for that period, ketones are used to fuel that growth. If nothing else, this suggests that learning is well supported by a ketogenic metabolism. It is also consistent with the ability of ketogenic diets to treat a variety of seemingly unrelated brain disorders and brain trauma. Newborn infants are in ketosis. This is their normal state. Breastfeeding is particularly ketogenic (compared to formula feeding). Breastfeeding longer (up to a point) is associated with better health outcomes. This suggests the hypothesis that weaning onto a ketogenic diet would be healthier than weaning onto a high-carb diet. (Mark-up ours) Human babies are in ketosis Soon after birth, human babies are in ketosis, and remain so while breastfeeding [2]. They use ketones and fats for energy and for brain growth. When this has been studied, in the first couple of hours after birth, babies aren't immediately in ketosis. There is a short delay [3]. During that brief period before ketogenesis starts, lactate (confusingly not to do Continue reading >>

Infant Ketosis

Infant Ketosis

Learn what other patients are saying about Ketosis and Infant. ... Neonatal Ketosis . [ KETOSIS PRONE DIABETES ] The REAL cause of Diabetes (and the solution),Ketosis Prone Diabetes News diet studies is always that that 1 week a week low-calorie diet was beaten two days a week low Ketone body transport in the human neonate and infant. ... absence of suckling ketosis. As part of this process, it makes compounds called ketones. Learn what other patients are saying about Ketosis and Infant. @ Diabetic Ketosis Infant Of Diabetic Mother The 3 Step Trick that Reverses Diabetes Permanently in As Little as 11 Days. babies in ketosis, low carb kids, ketogenic pregnancy, low carb kids, paleo kids, paleo pregnancy, low carb pregnancy < Back to listing. If the bulk of transported ketone body fuels are oxidized in the infant as they are in the adult, ... Neonatal ketosis; List of causes of Ketosis and Infant symptoms, alternative diagnoses, rare causes, misdiagnoses, patient stories, and much more. Diabetic Ketoacidosis in Infants, Children, and Adolescents A consensus statement from the American Diabetes Association JOSEPH WOLFSDORF, MB, BCH Did you know that soon after babies are born they enter a natural state of ketosis? Tim Noakes deposition to the Health Professions Council of South Africa in Rondebosch, Cape Town, South Africa. Ketosis is a normal metabolic process, something your body does to keep working. @ Diabetic Ketosis Hypoglycemia Treatment In Infants Pals The 3 Step Trick that Reverses Diabetes Permanently in As Little as 11 Days. Diabetic Ketoacidosis in Infants, Children, and Adolescents A consensus statement from the American Diabetes Association JOSEPH WOLFSDORF, MB, BCH Treatment Of Diabetic Ketosis ::The 3 Step Trick that Reverses Diabetes Permanently in As Lit Continue reading >>

Introduction Of A Ketogenic Diet In Young Infants

Introduction Of A Ketogenic Diet In Young Infants

Abstract The ketogenic diet is a rational treatment for pyruvate dehydrogenase complex deficiency (McKusick 312170) and GLUT1 deficiency syndrome (McKusick 138140). An increasing number of patients are diagnosed in early infancy, but few data are available on the introduction of a ketogenic diet in this age group. GLUT1 deficiency syndrome was suspected in four infants presenting with seizures and unexplained hypoglycorrhachia. A ketogenic diet was introduced at 6-28 weeks of age. Ketosis was initiated by fasting, monitored by bedside blood glucose and 3-hydroxybutyrate determinations, and was maintained successfully using supplemented carbohydrate-free infant formula and emulgated triglycerides. All patients developed ketosis within 24 h. 3-Hydroxybutyrate concentrations available at the bedside correlated inversely with the base excess. At glucose levels < or = 40 mg/dl patients remained asymptomatic in the presence of ketones. The ketogenic formula was tolerated well, parental compliance was good, and all patients remained seizure-free on the diet. GLUT1 deficiency was confirmed in two patients; the diet was discontinued in the other two patients. In one infant, failure to thrive on medium-chain triglycerides was effectively reversed using long-chain triglycerides. Urine dipstick analyses failed to detect ketosis in another infant. Adverse effects of the diet were limited to renal stones in one patient. The ketogenic diet can be introduced and maintained successfully in young infants using long-chain fat emulsion. Monitoring 3-hydroxybutyrate at the bedside was useful for metabolic control and superior to urine dipstick analysis. Seizure control was effective and adverse effects were limited, but evaluation of the long-term effects of the ketogenic diet in this age g Continue reading >>

Initiating And Maintaining The Ketogenic Diet In Breastfed Infants

Initiating And Maintaining The Ketogenic Diet In Breastfed Infants

The ketogenic diet has been used as an effective treatment for intractable epilepsy since 1921. Its efficacy in the treatment of epilepsy in infants has been reported to be similar to that in older children. However, there have been no reports in the literature addressing the possibility of continuing breastfeeding during treatment with the ketogenic diet. The authors performed a retrospective chart review of the patients initiated on the ketogenic diet and identified 5 infants who continued to receive breast milk while on the ketogenic diet treatment. All 5 experienced a >90% reduction of seizures during the first month on the ketogenic diet treatment with continued breastfeeding. Four of the 5 were able to maintain >90% reduction of seizures for the duration of their time receiving breast milk while on the ketogenic diet treatment. Traditionally, infants have discontinued breastfeeding prior to diet initiation because of the concern that the carbohydrates in the breast milk will prevent attaining adequate levels of ketosis. It is the authors’ experience with these 5 patients that infants can continue to breastfeed while successfully using the ketogenic diet for seizure treatment. Nordli DR, Kuroda MM, Carroll J., et al. Experience with the ketogenic diet in infants. Pediatrics. 2001;108:129-133. Google Scholar, Medline Kossoff EH, Pyzik PL, McGrogan JR, Vinig EPG, Freeman JM Efficacy of the ketogenic diet for infantile spasms. Pediatrics . 2002;109:780-783. Google Scholar, Medline Jambaqúe I., Chiron C., Dumas C., Mumford J., Dulac O. Mental and behavioural outcome of infantile epilepsy treated by vigabatrin in tuberous sclerosis patients. Epilepsy Res. 2000;38:151-160. Google Scholar, Medline Freeman JM, Kossoff EH, Freeman JB, et al. The Ketogenic Diet: A Treatme Continue reading >>

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