My three and one-half year old son has been diagnosed with ketotic hypoglycemia. He has has two events where he had seizures that occurred early in the morning before breakfast. We feel like he could wake up and have a seizure any morning. Any neural disorders have been eliminated and also metabolic disorders. Our doctors said to feed him frequently, which we are. We have also eliminated enriched flour and refined sugar products. What exactly is ketotic hypoglycemia? What else should we be doing for him?

Ketotic hypoglycemia is not very well understood. It sounds like you are doing all the right things in avoiding simple carbohydrates and making sure that he always has something with protein and fat every 3-4 hours. When he is ill, it may also be important to wake him up and feed him in the middle of the night since illness often can trigger such severe episodes of hypoglycemia. The key medical workup includes making sure that there is not excess insulin levels at the same time a documented low blood glucose level is measured. There are also several metabolic syndromes where hypoglycemia occurs in this fashion so it is important to check for them as well as for liver, adrenal and pituitary problems. Working closely with your pediatric endocrinologist, being able to check capillary blood glucose readings and knowing under which circumstances (e.g., illness) to do special feedings will help you to deal with this issue. Often it goes away with a few years time.

SB