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Acetone in a child: why vomiting occurs and how to drink it correctly

Other names: Ацетонемический синдром, ацетон у ребёнка, ацетонемическая рвота, кетоны в моче у ребёнка, запах ацетона изо рта, ацетон повысился у ребёнка, кетоацидоз у детей

Acetone syndrome is repeated episodes of vomiting in children, accompanied by the accumulation of ketone bodies in the blood and urine and a characteristic fruity odor from the mouth. The mechanism is simple: the reserves of carbohydrates in the children's liver are small, and during fasting, infection or stress, the body begins to extract energy from fats, the by-product of which are ketones. They irritate the vomiting center, and a vicious circle arises: the child cannot eat or drink, and there are even more ketones. Most often, episodes occur in preschool-aged children and disappear completely with age.

🧾 МКБ-10: R82.4 🏥 Where it is treated: 8 Ketones for glucose deficiencyDrink sweet drinksPasses with age
👨‍⚕️ Which doctor
Pediatrician, pediatric endocrinologist, gastroenterologist
🔬 Diagnostics
Ketones in urine test strip, blood glucose, electrolytes, complete blood count and urine analysis, abdominal ultrasound
💊 Treatment
Small sweet drinks, light carbohydrate food, in case of uncontrollable vomiting - intravenous rehydration
📈 Prognosis
Favorable, episodes stop by school age or adolescence
⚠️ At risk
Age 2–8 years, infections, long breaks in food, fatty foods, stress, overwork
⏱ When to see a doctor
Planned; with uncontrollable vomiting and lethargy - urgent

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

  • Рвота, при которой ребёнок не может удержать даже глоток жидкости
  • Выраженная вялость, сонливость, ребёнка трудно разбудить
  • Глубокое шумное дыхание с запахом ацетона — вызовите 103
  • Отсутствие мочи 8 часов и дольше, сухой язык, запавшие глаза
  • Сильная локальная боль в животе и напряжение мышц живота
  • Жажда, обильное мочеиспускание и похудение — исключить сахарный диабет
  • Эпизоды впервые начались у ребёнка старше 10 лет

Why does acetone appear?

A child's body uses energy faster than an adult, and glycogen reserves in the liver are small. If a child has not eaten for a long time, has been ill, has suffered stress, or has received too much fatty food, glucose is no longer enough and fats are used. When they decompose, ketone bodies are formed: acetone, acetoacetic and beta-hydroxybutyric acids. They are excreted in urine and exhaled air, giving rise to a characteristic odor. As ketones accumulate, they irritate the gastric mucosa and vomiting center, and vomiting begins, aggravating the lack of glucose.

  • Low glycogen reserves in children
  • Long breaks between meals
  • Infection with fever
  • Excess fatty foods
  • Stress, overwork, overexcitement
  • Vicious circle: vomiting increases ketosis

Symptoms of an attack

The episode often begins with warning signs: the child becomes lethargic or moody, complains of a headache, refuses to eat, nausea and abdominal pain appear. Then repeated vomiting occurs, sometimes every 10–15 minutes. There is a fruity odor from the mouth and urine. The skin is pale, with blush on the cheeks, lips are dry. The temperature is low. The attack usually lasts from one to several days and ends quickly as soon as glucose and fluid are replenished.

  • Lethargy, headache, refusal to eat
  • Repeated vomiting
  • Abdominal pain without clear localization
  • Smell of acetone from the mouth
  • Paleness with flushed cheeks
  • Dry lips and tongue
  • Low temperature

How to desolder correctly

Unlike an intestinal infection, here the child needs exactly glucose, so sweet drinks are suitable: dried fruit compote, weak sweet tea, glucose solution, alternating with saline solution to replenish salts. You need to drink in very small portions: a teaspoon every 5–10 minutes, otherwise the volume will provoke new vomiting. The drink should be at room temperature or cool. If the child refuses, the liquid is given with a syringe without a needle behind the cheek. It is helpful to measure ketones with test strips and monitor your urine output.

  • Sweet drinks: compote, sweet tea, glucose solution
  • Alternating with saline solution
  • A teaspoon every 5–10 minutes
  • Cool or room temperature
  • Syringe without a needle if you refuse to drink
  • Monitoring ketones with test strips
  • Monitor your urination frequency

Nutrition after an attack

As soon as the vomiting has stopped, the child is offered a light carbohydrate meal: crackers, biscuits, banana, baked apple, thin porridge with water, mashed potatoes. Fatty, fried foods, meat broths, creamy and sour cream dishes are excluded for several days, because fats support ketosis. Expand the diet gradually, adding one product at a time. It is fundamentally important not to allow long breaks between meals: a child with this tendency needs regular snacks, especially against the background of illness and active games.

  • Crackers, biscuits, banana, baked apple
  • Liquid porridge with water and mashed potatoes
  • Avoiding fatty and fried foods for several days
  • Avoiding rich broths
  • Gradual expansion of the diet
  • Regular meals without long breaks
  • Snack before bed if you are prone to seizures

When do you need a doctor and how to prevent attacks

You should consult a doctor if you have uncontrollable vomiting, lethargy, lack of urine, severe abdominal pain, and in any case, if the attack occurs for the first time: an intestinal infection, appendicitis and the onset of diabetes mellitus, which must be excluded by glucose analysis, give a similar picture. Severe dehydration requires an IV in the clinic. For prevention, diet, sufficient drinking, limiting fatty foods, avoiding overwork and overstimulation, as well as early consumption of sweets at the first signs of illness are important.

  • Mandatory examination at the first episode
  • Checking blood glucose to rule out diabetes
  • Intravenous rehydration for severe dehydration
  • Regular meals and snacks
  • Limiting fatty foods
  • Drinking enough in the heat and when sick
  • Avoiding overwork and stress
  • Early watering at the first signs

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

💊 Treatment

Frequently asked questions: Acetone syndrome in children

What to give a child with acetone?+
You need sweet drinks: dried fruit compote, weak sweet tea, glucose solution, which alternate with a pharmaceutical saline solution. Give a teaspoon every 5-10 minutes. Plain water without glucose will not eliminate ketosis.
Why can't I eat fatty foods?+
When fats break down, ketone bodies are formed, so fatty foods maintain and enhance acetonemia. In the acute period and several days after an attack, exclude fried, creamy, rich broths and fatty meats.
Is acetone in urine dangerous?+
In itself, moderate ketosis during fasting or illness is not dangerous and goes away after glucose is replenished. The danger is posed by dehydration from vomiting and situations where ketones are a sign of another disease, primarily diabetes.
Will this go away with age?+
As a rule, yes. Episodes usually cease by school age or adolescence, when glycogen stores increase and metabolic processes mature. If attacks first appeared in a teenager, you need to look for another cause.
Should my child be admitted to the hospital?+
Most often, no: if the ability to drink is preserved, they cope at home under the supervision of a pediatrician. Hospitalization is necessary for uncontrollable vomiting, severe dehydration, lethargy, and when the diagnosis is unclear.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.

Where it is treated acetonemic syndrome в Ташкенте

Similar симптомы дают кишечная инфекция, хирургические diseases живота и впервые выявленный сахарный диабет, поэтому нужен осмотр врача. Clinics Ташкента с педиатрами:

st. Mirzaeva 50, Yunusabad 17, Yunusabad district, Tashkent Landmark: opposite the Nazar M...
M Turkiston 🚶 1.5 km
M Yunusobod 🚶 2.0 km
M Shahriston 🚶 2.8 km
🚌 Nearest bus stop 🚶 100 m · buses: 7
Mon–Fri:09:00–18:00
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Mukimiy street 144/1, Chilanzar district, Tashkent Landmarks: Novza metro station (former...
M Novza 🚶 400 m
M Mirzo Ulug'bek 🚶 650 m
M Milliy bog' 🚶 1.3 km
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Branch No. 3: Birlashgan street, opposite the 4-City Clinical Hospital
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M Yashnobod 🚶 800 m
M Texnopark 🚶 1.4 km
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Tashkent, Mirabad district, st. Oybek, 34d
M Toshkent 🚶 550 m
M Oybek 🚶 850 m
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Tashkent, Yakkasaray district, st. Sh.Rustaveli, 109 A
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M Kosmonavtlar 🚶 2.6 km
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Tashkent, Khamza district, M. Ulugbek Ave., 5d
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M Olmazor 🚶 3.2 km
M Chilonzor 🚶 3.2 km
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🚌 Nearest bus stop 🚶 320 m · buses: 13, 17T, 33
Mon–Fri:09:00–17:00
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Tashkent, Yashnobod district, st. Dzharkurgon, 37d
M Quyliq 🚶 1.4 km
M Matonat 🚶 1.6 km
M Yangiobod 🚶 1.7 km
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Mon–Fri:09:00–17:00
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ICD-10 code

Official international classification codes — these are used in medical records and statistics.

Other diseases: Pediatrics

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