Hi Camille, 
Your midwife seems to be confusing ketosis with ketoacidosis. This is not
surprising because many people in the medical field use the terms
interchangably. 

In diabetic ketoacidosis, a condition of high blood sugar is combined with
the elevated presence of ketone bodies, which can result in coma or even
death. 

In mild ketosis, most of the body/brain energy requirements are being met by
fats that have either been previously stored or recently ingested. Glucagon,
a hormone produced by the pancreas, is increased during conditions of low
blood sugar. It causes the liver to break down triglycerides from stored
body fat. The resulting free fatty acids and glycerol provide energy to the
cells. As this is only a fraction of the sugar needed by the body, the
remainder must come from protein breakdown. So a low-carb diet must include
lots of protein. If not, the liver will produce sugar from muscle proteins.


It is also important to recognize that ketone bodies are acidic. The reason
your body is excreting them is to maintain its acid/base balance and to
excrete fats in excess of energy requirements. A mild state of ketosis is
quite a healthy condition _unless_ it is accompanied by elevated blood
sugar. It is only in the context of ketoacidosis, or when fatigue,
headaches, and nausea signal insufficient blood sugar, that corrective
measures should be taken. 

I don't know of any research articles on the subject, but a good reference
is _The Ketogenic Diet_ by Lyle McDonald. ISBN: 0-9671456-0-0  


Ron Hoggan, B.A., B.Ed., M.A., Ed. D.
co-author of Dangerous Grains ISBN: 1-58333-129-8
http://www.dangerousgrains.com  


-----Original Message-----
From: Paleolithic Eating Support List [mailto:[log in to unmask]]
On Behalf Of Camille
Sent: Saturday, April 01, 2006 3:32 AM
To: [log in to unmask]
Subject: Ketones, Labor, and Delivery

Hi all,

As I am moving into the last 3 weeks, more or less, of my pregnancy,
things are going pretty well. I am plannng a home delivery with a
midwife. She, and her assistants, have been great. We all have the
same general attitude: birth is a natural process, not a medical
procedure, most of the 'standard treatments' can be safely refused,
etc. The only disagreement we are having is the occaisional presence
of ketones in my urine at my pre-natal visits.

I've been doing a fairly strict paleo diet since December and have
actually been off all my allergy medication since January. I haven't
been trying to do low carb, but I sometimes just don't eat enough
fruit to keep myself out of ketosis. Plus, if I eat a big bunch of
carbs, I get gassy and that is my major source of discomfort lately -
there just isn't room for the baby AND gas.

My midwife is fussing at me about the ketones and mentioned that she
would have to IV me during labor if I showed positive for them. I am
sure I could refuse this, but I don't really want to take her out of
her comfort level during labor. I don't want her worried and looking
for problems.  She brought up the whole ketones making the blood
acidic issue and it being bad for the baby. I just can't believe it,
personally. Otherwise, Inuits would never have had a successful birth.

I am going to be more diligent with my diet these last few weeks so as
to avoid the whole ketone issue when I go into labor, hopefully.
However, just in case, does anyone know of any research or articles in
this area? I think my midwife would be open to changing her mind on
the subject if I could bring her some good info.  She is a good
midwife, but she doesn't really know any more about nutrition than
most doctors, and most people for that matter. Well, she is better
than *that*, but no where near as knowledgeable as most of the people
on this list. :)

Any advice and/or references would be greatly appreciated.
Wish me luck,

Camille, 36 weeks & 4days

--
Support bacteria -- it's the only culture some people have!