Safety Update: Breast-feeding on the Keto Diet

Ketogenic diet safety concerns have hit headlines over the years, sparking debates about whether it’s a good option for some patients. Here’s what you should know from our latest update.

Be aware of concerns for patients who are breastfeeding. Eager to shed baby weight, some patients might consider trying the ketogenic diet after giving birth. While uncommon, there are several reports of lactation ketoacidosis occurring in breast-feeding patients following a ketogenic diet – this is a serious health concern, in some cases resulting in hospitalization requiring intensive care. Breast-feeding requires a significant amount of energy, especially for those exclusively breast-feeding. This might increase the risk of ketoacidosis. Nausea, vomiting, dizziness, lethargy, and chest pain are other possible side effects. The risks aren’t worth it – guide these patients toward more balanced options without major safety concerns in breastfeeding, like the Mediterranean diet.

While there are concerns during breast-feeding, for most people, the ketogenic diet is likely safe when followed appropriately. The most common side effects are typically described as the “keto flu,” including headache, fatigue, nausea, and weakness. Adherence can also be challenging – carb intake is usually limited to 20-50 grams daily. And significant weight loss seems to require carb restriction of less than 20 grams daily. It’s also not clear if the keto diet benefits weight loss any better than other diets that limit calorie intake.

Review our recently updated monograph for more safety details, as well as evidence for the ketogenic diet in obesity, epilepsy, and diabetes.