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Is the keto diet safe during pregnancy and breastfeeding?

Published on: April 23, 2018

Is the keto diet safe during pregnancy and breastfeeding?

The ketogenic diet is one of the rare diets that actually have research to back up its benefits such as weight loss, improved cognitive performance, and many other therapeutic advantages. However, women trying to get pregnant are often warned not to do keto while pregnant. We’re going to discuss this topic in detail to see what research has to say about it.

What Is Keto Diet?

The ketogenic diet is high fat, low carb, and moderate protein diet in which approximately 60-75% of your diet will consist of healthy fats, 20% protein, and the rest carbs. Although it is now famous for weight loss and other health benefits, the keto diet was initially invented to treat epilepsy in 1921.

This diet causes your body to switch from running on glucose for fuel to using ketones. Since it’s a very low carb diet, your blood sugar will drop and cause your body to use glycogen (stored glucose) for energy.

At some point, glycogen will not be sufficient enough to meet the body’s needs which will cause it to enter a process called ketogenesis. In this process, fatty acids are metabolized and converted into ketone bodies (beta-hydroxybutyrate and acetone) [1].

Your body organs, especially the brain, heart, muscle, and kidneys are capable of using ketones for energy. In fact, ketone bodies have been found to produce more ATP for energy than glucose. Achieving this state of using ketones for fuel instead of glucose via a the keto diet is called nutritional ketosis.

Is Keto Diet Safe During Pregnancy?

You might have come across the statement that doing keto while pregnant is not safe. Women who’re trying to get pregnant and those who are already pregnant often have to be extra cautious about everything they eat and do. This is because their body goes through many metabolic changes during pregnancy. Let’s clear out some misconceptions about keto diet and pregnancy before we discuss further the safety.

Ketosis and Pregnancy

Misconceptions of ketosis on pregnancy

Ketoacidosis: This is when there’s an abnormally and dangerously high level of ketones in the blood. It’s more common in those who have diabetes and can be dangerous if left untreated. In some cases, the hormonal and metabolic changes that take place during pregnancy can result in ketoacidosis [2,3]. Ketoacidosis is caused by high blood sugar, and a lot of people confuse it with ketosis which is harmless. As stated earlier, ketosis can be achieved via the ketogenic diet or fasting and is not the same as ketoacidosis.

Ketosis in Pregnant Women

Early pregnancy

The metabolic changes during pregnancy can often come with a set of symptoms such as nausea, dizziness, fatigue, and vomiting. These are more common during the first trimester, and it is also the time when a lot of pregnant women skip meals or eat late due to these symptoms and lack of appetite.

This can be compared to intermittent fasting that a lot of people practice on the ketogenic diet. Fasting promotes ketosis, and pregnant women who skip meals or eat late after waking up are likely to be switching back and forth from mild ketosis.

Late pregnancy

During the second half of pregnancy, glucose is mostly consumed by the fetus. Thus lipolysis increases the availability of free fatty acids to be used as energy for the mother.

Safety of ketosis on pregnancy

The safety of following the ketogenic diet during pregnancy or breastfeeding stage still lacks more evidence. There are stories of some pregnant women who practice it without any problems; however, most of them were already on the ketogenic diet and fat adapted before they got pregnant.

You should never attempt to try the keto diet for weight loss purposes during pregnancy and also avoid any forms of fasting as well.

If you wish to try it when you’re pregnant, start slow and don’t drop all your carbs at once. You can start by reducing sugar and junk food intake and replacing them with some healthy fats such as grass-fed butter and avocados.

Please consult your doctor before to make sure you don’t have any health complications or risks that could be worsened if you try this diet.

Ketones Effect

Ketones mother

Research states that ketogenesis during pregnancy is three times higher at night in pregnant women than those who not pregnant. As stated earlier, whenever the fetus mostly consumes glucose, the mother’s body allows her to obtain energy from free fatty acids which are converted into ketones.


Ketones can be used as fuel for the baby too. A 2002 research paper states that the fetus can benefit from ketone bodies [4]. However, quite a few studies published on the effect of the ketogenic diet and pregnancy state that it might not be good for the baby [5].

Keto and Gestational Diabetes

Gestational diabetes is a type of diabetes that some women may develop during pregnancy. Currently, there’s not much reliable evidence to support the ketogenic diet or any low carb diets for gestational diabetes. If you suffer from it, it’s best to stick with the diet type recommended by your doctor.


It is possible to try the keto diet while pregnant; however, we recommend you stick with a whole food diet plan suggested by your doctor with plenty of greens, nuts, fruits, and healthy grains. Although the keto diet is safe for a lot of people, there’s a considerable lack of evidence for its effect on pregnant women.

The limited research done so far doesn’t sound positive for the health of the baby. Therefore, please consult your doctor if it’s safe for you and stick with what’s recommended by your doctor.


  1. Masood W, Uppaluri KR. Ketogenic diet. 2018 October -
  2. Frise CJ et al. Starvation ketoacidosis in pregnancy. 2013 March -
  3. Sinha N, Venkatram S, Diaz-Fuentes G. Starvation ketoacidosis: a cause of severe anion gap metabolic acidosis in pregnancy. 2014 May -
  4. Herrera E. Lipid metabolism in pregnancy and its consequences in the fetus and newborn. 2002 October -
  5. Sussman D et al. Effects of a ketogenic diet during pregnancy on embryonic growth in the mouse. 2013 May -

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