Sick Day Fluid Goal/Ketone Monitoring

July 16, 2025 from Wing, MGH

Nathan 54 pounds

Nathan 7 years old

(1) Fluid Goal: His fluid goal remains the same on sick days. Based on his current weight, that would be 1590 mL (53 fl oz) per day. Checking his urine color for a pale lemonade shade can be a helpful indicator of good hydration. Darker color will indicate dehydration and will need more water. While when he has diarrhea and vomiting, electrolyte replenishment is needed and he might need extra electrolyte packet on those days.


(2) Glucose and Ketone Monitoring: During illness, it’s common for inflammation and stress to impact glucose and ketone levels, so it may be difficult to have control over glucose/ketone levels to reach a goal. I recommend monitoring to avoid low blood sugar (<50 mg/dL) and overketosis (ketones >6 mmol/L). If either occurs, giving 5 grams carbohydrates (like a few berries, apple slices, or a small amount of juice) and rechecking after 15 minutes is a good approach. Also, noting any symptoms that accompany those levels can help identify patterns in the future without always needing to test.

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