Ketosis dynamics in human newborns

Blood glucose concentration falls rapidly after birth, reaching its minimal level by 1 h of age and then rising to stabilize by 3 h of age even without feeding

During the first 8 h, newborns have low plasma ketone body concentrations despite adequate levels of precursor free fatty acids

Newborn brain potentially can utilize ketone bodies at a rate that is up to 40-fold greater than that of infant or adult brain

• Starting from 12 h of age, newborns show high ketone body turnover rates approaching those in adults after several days of fasting
• By the 6th postnatal day, breast-fed infants have lower blood glucose concentrations than formula-fed newborns but significantly higher ketone body concentrations and lower insulin responses

These findings suggest:

1. ketogenic properties of breast milk, e.g., lipase content allowing delivery of fatty acids to the liver
2. anti-ketogenic properties of protein, fat and energy load in the formula-fed infant

Sources: Denne, Kalhan, 1986; Kraus et. al, 1974, Bougneres et al., 1986, Hawdon et al., 1992; Persson B, Settergren, 1972; Stanley et al., 1979; Lucas et al., 1981