Abstract

Objective:Low-carbohydrate diets are a popular approach to weight loss, including among breastfeeding women. Seventeen published case reports show that inadequate carbohydrate intake while breastfeeding can contribute to lactation ketoacidosis. While these case reports describe the clinical markers of lactation ketoacidosis, no studies describe these women’s experiences in more detail. This study sought to provide insight into how and why women follow low-carbohydrate diets while breastfeeding.Methodology:This study was exploratory in nature, involving an online survey and follow-up phone interviews. Quantitative data were analyzed using simple descriptive statistics, while qualitative data were analyzed by thematic analysis.Results:Every respondent reported limiting carbohydrates to some degree, with the majority describing their diet as “ketogenic” (18 of 21 respondents). Qualitative results revealed that women approached such diets after what each believed had been thorough research of available resources. While these diets can be stringent, liberalizing carbohydrate and energy intake helped mothers maintain their milk supply. One interviewee described her own experience with hospitalization for lactation ketoacidosis.Conclusion:Given low-carbohydrate diets’ appeal for both weight loss and other reported health benefits, it behooves healthcare providers to recognize that carbohydrate restriction and its potential consequences may be more common than existing research demonstrates. Case studies comprise a large part of this research area thus far, and until more research is conducted, healthcare providers who care for breastfeeding mothers can use this study’s insights to cultivate a more detailed understanding of how and why this population follows low-carbohydrate diets.

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