Keto and Pregnancy
Is It Safe to Get Through Ketosis During it?

Keto and Pregnancy

Let's get something out of the way right off the bat: ketosis is a natural state. The body gleans energy typically from carbohydrates. But if it is deprived of carbs, it will naturally revert to its backup energy source, fats. To do this, it creates what is called "ketone bodies" which enable the fat to be metabolized. Anyone can trigger ketosis simply by fasting. As such, there is no reason for pregnant women or those who may be planning a keto pregnancy to fear the low-carb diet. But that doesn’t mean there aren’t certain things she’ll need to keep in mind regarding the lifestyle and her own particular nutritional needs.

Is Keto Safe During Pregnancy?

Yes. Unless there are specific extenuating circumstances regarding a particular woman, the ketogenic diet in and of itself should pose no particular threat to pregnant women or their developing baby. [1] As some have pointed out pregnant women in ancient times were almost certainly in a state of ketosis on a fairly regular basis as high carb foods were not always easy to come by.

Today, many women go through their entire pregnancy and the childbirth process while on the famous low-carb lifestyle with no adverse effects. [2] So how do they accomplish this? Let’s take a look.

confused girl

So, Ketosis and Getting Pregnant...

A woman who indulges in the standard Western diet of high-carb, high sugar foods while pregnant are not usually doing themselves or their baby any favors. It's been known for some time that the diet of the mother during pregnancy, as well as lifestyle habits like smoking and drinking, can have serious long-term repercussions on the health of the child. And not just in infancy, but as he or she progresses on through all stages of life. "You are what you eat" is as true today as it ever has been and with pregnant women that saying can be expanded to read "Your baby is what you eat."

young mother biting nails

The low carb diet then is not only safe if appropriately managed but may be preferable to the standard Western style of the early 21st century when it comes to pregnant women. For some women, especially those who have long struggled with weight and general fitness issues, there is little doubt of this. Still, while being in ketosis at the start of pregnancy may be preferable to being overweight and consuming excessive amounts of sugar and other carbs, many women still have questions about whether the low carb lifestyle should be practiced throughout the entire term of the pregnancy. This is in large part because a woman's nutritional needs tend to change as the pregnancy progresses. So, is it safe to be on the keto diet throughout the entire course of a pregnancy? Before we address that, let's discuss a couple of related myths that are clanging around out in cyberspace. [3]

Some Pregnancy Myths and Misconceptions:

Most of the hand-wringing around keto and pregnancy tends to derive from a state called diabetic ketoacidosis or DKA. There is no doubt that DKA can be a hazardous and harmful condition, particularly for a pregnant woman. However, the fact that "keto" appears in the name diabetic ketoacidosis does not mean it has anything to do with the keto diet. We’ll explain.

  • The lifestyle is designed to tip the body over into its natural backup state of deriving energy from fats rather than its default state of acquiring energy from carbohydrates. The diet when appropriately practiced typically results in normal, stable blood sugar levels, low ketone levels, and a healthy acid-base balance. As such it typically enables the body to run much more efficiently and effectively and can increase both physical and mental acuity.
  • ​Diabetic ketoacidosis, however, is a very different and unrelated animal. DKA is a condition that affects people with diabetes who have done a poor job of managing their blood sugars. In such cases, ketone levels in the blood become elevated and are accompanied by extraordinarily high blood sugar levels. Together these two states generate an acid-base imbalance that is potentially deadly. In this case, a ketosis-like state is prompted by the fact that the person with diabetes cannot create enough insulin to handle all the blood sugar, so their body instead starts to generate ketones. The result is a confused state where the body is not short on carbs but is producing ketone bodies anyway. Symptoms of this condition include stomach aches and vomiting, a fruity odor to the breath, confusion, fatigue and respiratory distress. DKA can also have a negative effect on fetal brain development.
book about Diabetic ketoacidosis

Again, however, the misconceptions around keto and pregnancy tend to arise naturally because DKA has "keto" in its name so people naturally assume that if DKA is bad, then the keto lifestyle must also be bad, especially for pregnant women. But that's rather like assuming the heart is bad because the phrase "heart attack" has the word “heart” in it.

It’s Only a Natural Process

baby bump

It's no secret that a well-balanced diet often suffers during the early stages of pregnancy. That's largely because of morning sickness, a general sense of nausea and various food aversions that seemingly come out of nowhere that can affect appetite. As such it's all too common for women to eat sporadically and even then not particularly well during the first months after conception. The result is that many pregnant women dip in an out of ketosis on a fairly regular basis without even knowing it. The kicker is that those times they are in ketosis maybe the times, they feel good because their blood sugars are stable, their minds are clear, and they tend to have energy.

The fact that many pregnant women feel worse after resuming their regular carb-heavy diet while pregnant should be enough to give any woman pause and make her want to get back to feeling lighter, stronger and more alert. While some will point to the fact that there have been precious few health studies done on the subject of keto and pregnancy we respectfully suggest that misses the point. Studies on the matter are not necessary because women have been naturally going through ketosis while pregnant for eons.

Exercising Your Common Sense

With all of the above said, and with a long established history between pregnant women and ketosis in place, there are still some common sense considerations that need to be touched upon when it comes to the keto diet and pregnancy.

young girl question
  • Keto during pregnancy is not about weight loss - Getting enough calories for the two of you takes precedence over weight loss while pregnant on the keto diet. If you go on something like this before becoming pregnant, you may indeed lose weight, but once pregnant weight loss should not be the primary goal.
  • Try to avoid fasting - Fasting from time to time can be beneficial to people but not so much too pregnant women. It's important to eat enough for two as we said and to make sure you're not only consuming enough fats but also the right kind of carbs as well.
  • ​Avoid processed foods - Even if you are overcome with cravings for various types of processed foods or foods with lots of refined sugars you should resist. Not just because it may bump you out of ketosis but because the quality of the food you eat impacts fetal health.

​​​Is Keto Safe for Breastfeeding?

a mother breastfeeding her baby

As with keto and pregnancy, in general, there have been precious few studies on the effects of the keto diet on breastfeeding. But again, as is the case with keto and pregnancy [4], there have been few scientific studies about keto and breastfeeding because women on low carb diets have been breastfeeding since the dawn of time. Those with a naturally skeptical temperament, however, should be able to find some solace in a study published in 2009 which found: 

  • Breast milk production was unaffected by the eating habits of the mother. Including whether or not she was on the keto diet while breastfeeding.
  • While neither a low-carb high-fat or a “standard” high-carb diet had any effect on protein concentrations or milk lactose in breast milk, the low-carb high-fat diet did produce breast milk with higher milk fat content.

​Both centuries of anecdotal evidence and the study mentioned above point to the fact that the answer to the question "Can you do keto while breastfeeding?" is "Absolutely yes." Therefore, any concerns that the keto diet and breastfeeding are somehow incompatible should be put to rest once and for all.  

So, What is Our Final Thoughts on this?

While women need to use common sense while on the keto diet during pregnancy, there is no evidence that ketosis itself poses any danger to pregnant women or women who intend to breastfeed after giving birth. The keto lifestyle for pregnancy may be a much better option for both mother and baby than the standard high-carb, high-sugar Western diet.

About the Author

Ryan is a personal trainer, athlete, health enthusiast, and entrepreneur. He is researching and expanding his knowledge about the ketogenic diet. He spends most of his time writing content about his new learnings of the ketogenic diet and shares it on Ketogenic Supplement Reviews. You can find me on: Facebook, Twitter and Pinterest.