{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:22:46Z","timestamp":1790882566169,"version":"4.1.0"},"reference-count":50,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T00:00:00Z","timestamp":1592352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objective: Lactation ketoacidosis is a rare cause of high anion gap metabolic acidosis affecting breastfeeding mothers. We aim to review and analyze all cases of lactation ketoacidosis reported. Materials and Methods: A systematic search of PubMed\/MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL), identifying relevant case reports published from 1 January 1970 to 31 December 2019. We extracted the following data: the first author, country, year of publication, age of the mother, age of the child, weight\/body mass index (BMI) of the mother, precipitating factors, presenting symptoms, biochemical results, treatment, breastfeeding, and time from presentation to the resolution of ketoacidosis. Results: Sixteen case reports and 1 case series reporting 18 cases of lactation ketoacidosis were found. Presenting symptoms were nausea (72%, 13\/18), vomiting (67%, 12\/18), malaise (56%, 10\/18), abdominal pain (44%, 8\/18), dyspnea (33%, 6\/18), headache (22%, 4\/18), and palpitation (11%, 2\/18). Dieting and physical exercise to lose weight were reported in 76% (14\/18). The treatments included IV dextrose, sodium bicarbonate, insulin, rehydration, monitoring and replacement of electrolytes, and resumption of a balanced diet. The prognoses were good, with no mortalities. Conclusions: lactation ketoacidosis should be suspected in unwell breastfeeding women with high anion gap metabolic acidosis, after excluding other causes.<\/jats:p>","DOI":"10.3390\/medicina56060299","type":"journal-article","created":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T13:11:32Z","timestamp":1592399492000},"page":"299","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Lactation Ketoacidosis: A Systematic Review of Case Reports"],"prefix":"10.3390","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2077-7186","authenticated-orcid":false,"given":"Abdullah M.","family":"Al Alawi","sequence":"first","affiliation":[{"name":"Department of Medicine, Sultan Qaboos University Hospital, Muscat 123, Oman"},{"name":"Oman Medical Specialty Board, Muscat 123, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Al Flaiti","sequence":"additional","affiliation":[{"name":"Oman Medical Specialty Board, Muscat 123, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5622-6987","authenticated-orcid":false,"given":"Henrik","family":"Falhammar","sequence":"additional","affiliation":[{"name":"Division of Medicine, Royal Darwin Hospital, Darwin NT 0800, Australia"},{"name":"Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, 171 77 Stockholm, Sweden"},{"name":"Department of Molecular Medicine and Surgery, Karolinska Institute, 171 77 Stockholm, Sweden"},{"name":"Menzies School of Health Research, Darwin NT 0800, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,17]]},"reference":[{"key":"ref_1","first-page":"145","article-title":"Metabolic acidosis","volume":"39","author":"Lim","year":"2007","journal-title":"Acta Med. 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