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April 6, 2004

Other

Question from Milwaukee, Wisconsin, USA:

My daughter is seven months old. I recently noticed acetone smell on her breath. It is not constant, but I feel like at times I can really smell it. She seems to be growing perfectly, is energetic and happy, and is in the 95th percentile for weight and height. I am still nursing, and she also eats fruits, veggies, just started on meat. I called my pediatrician right away. We had her blood sugar tested and it was 102 mg/dl [5.8 mmol/L], then they didn't think it was necessary to check her electrolytes. I was also asked if she seems excessively thirsty or having very wet diapers. I said no, but this is hard to say in a seven month old. My pediatrician says I don't need to worry. I was reading some of the information on this site and suggestions for 24 hour urine test (what exactly is that?), as well as about ketotic hypoglycemia. I feel that my pediatrician won't follow up on this unless I do, and as was stated on your site, acetone breath is not normal in normal babies. Please tell me what else I should do, what possible tests can be done to rule out a potentially serious condition.

Answer:

On the contrary, it is quite common for there to be slight ketone smell on young children’s breath first thing in the morning after a nocturnal fast. This is especially true if they have a viral infection. This is usually an entirely normal phenomenon and only rarely associated with hypoglycemia. If your baby is otherwise entirely healthy, then I would not encourage further investigation.

KJR