My 23month old daughter last weekend woke up in the middle of the night with a fever and vomited twice, next day didn't eat or drink very much and still had the fever through the next night. At some point during the weekend I notice an odd chemical smell on her breath that I realized was acetone (nail polish remover). I'm positive she did not drink something she shouldn't have. The viral symptoms and funny breath smell went away within 48 hours. I've since read about ketonic hypoglycemia and I'm concerned she may have this. She had almost a similar episode a few months ago and I ended up taking her to the ER for dehydration. They did mention then she had ketones in her urine but didn't seem concerned about it. I called my pediatrician's office this week and the nurse made me feel like a complete idiot. Should I insist on a fasting blood sugar or urine test for her? I have a glucometer at home because I had gestational diabtetes when pregnant with her. Should I test her with that first this in the a.m.? What level should I be concerned with? Thank you.
You are well read!!!
Well ketones are the product of breakdown of the body's fat stores, they occur during times of stress, illness or insulin deficiency or when we are on a crazy Atkins diet with no carbs and our poor body struggles to make energy!
Your daughter had a classic episode of a febrile illness with vomiting and probably little intake of adequate fluids for her acutely increased needs. So without the low sugar part or passing out etc etc. she sounds to be completely normal.
If she is having episodes of not withstanding prolonged periods of fasting without illness then I would definitely talk with her pediatrician, but meanwhile remember her tendency and when she is ill get on rehydration immediatlely with the use of gatorade, popsicles or whatever sugar or electrolyte containing fluids you can provide her with(in small quantities or she will vomit!!!)
You are NOT an idiot, quite observant. Do not test her though or you will go nuts!
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