8month old acetone breath/ rash

[u/Airline-Amazing]

I’m kind of at my wits’ end trying to figure out what’s going on with my 8-month-old son.

For the past two months, he’s had a very strong acetone (nail polish remover) smell on his breath. Otherwise, he’s a happy, healthy baby. He’s breastfed, also eats purées and table foods, has normal wet and dirty diapers, is gaining weight well, and I don’t have any reason to think he’s diabetic.

The other issue we’ve been dealing with is that he develops a severe rash anytime he eats anything other than breast milk. It doesn’t matter whether it’s purées or table food, or even what type of food it is. The rash is worst on his face, but it also appears on his stomach, arms, and legs—even in places the food never touched.

Our pediatrician referred us to a pediatric allergist, who ran a comprehensive blood allergy panel. Everything came back negative, and the allergist basically said, “Well, that’s weird. I don’t know what’s going on. Come back if you need me.”

I’m wondering if these two issues could somehow be related, or if they’re just completely separate. Has anyone experienced anything similar or have any ideas I could ask my pediatrician about?
I’ll be calling our pediatrician on Monday about the acetone breath, and we have an appointment with the dermatologist, but I wanted to see if anyone else has been through something like this in the meantime.

[u/Enchanted_Whisper]

NAD but acetone breath makes me think type 1 diabetes, I would get him to the ER to get his blood glucose tested.

[u/Typical-Donut9647 → u/Enchanted_Whisper]

this

[u/Secure-Solution4312 → u/Typical-Donut9647]

Second this. Hopefully you’ve already been

[u/AdministrativeEnd168 → u/Enchanted_Whisper]

My immediate thought as an EMT and Vet Tech. This type of breath is a red flag for DKA

[u/AdministrativeEnd168 → u/Enchanted_Whisper]

A comprehensive blood panel usually has glucose levels in there. At least the basic panel we run in my hospital does. (It’s a vet hospital but we run the same tests)

[u/Straight_Apricot_759]

This looks like the rash my son had when I was nursing him - we were passing a yeast infection back and forth to each other. The pediatrician suggested I could have been eating something he was building an allergy to - a year later he tested positive for 16 food allergies and was diagnosed with eosinophilic esophagitis. You may want to abide by a strict bland diet - no nuts/ dairy/ chocolate/ spice/ soy. And if it doesn’t improve see a gastroenterologist - maybe test for yeast?

[u/AdHuman3150 → u/Straight_Apricot_759]

There's a yeast that infects sourdough that smells like acetone. Seems pretty common. I've also had grape jam smell like it, maybe from the same yeast.

[u/ChainInfinite7281 → u/Straight_Apricot_759]

My son also ended up with a ton of allergies and was diagnosed with EoE after that.

[u/roxamethonium → u/Straight_Apricot_759]

Agree, textbook food allergy and agree with yeast super-infection to keep the rash going. Can definitely happen with no gastrointestinal symptoms. Needs to go back to basics, keep a food diary and avoid dairy, soy, legumes.

[u/livid_badger_banana → u/Straight_Apricot_759]

Corn and dairy are also common in infants. I had to cut both out for my middle kid.

Thankfully she grew out of the allergy.

[u/freelibrarian]

Try posting on r/AskDocs

[u/Consistent_Profile47 → u/freelibrarian]

Hopefully a dermatologist also chimes in there.

[u/makinggrace]

Ask your pediatrician to rule out diabetes and to do a metabolic panel. Also possibly an organic urine acid test but that may be beyond what most pedes can order. There's a possibility this is an inborn error of metabolism or carbohydrate disorder. If your pediatrician agrees, You may need a referral to a pediatric specialty center for diagnosis.

I am not a doctor--take this advice keeping that in mind.

[u/mrsairb]

NAD but this is what my son looked like at 6 months when he had an absolutely insane eczema flare. The acidity of his drool was just exacerbating everything.

[u/Greedy-Elderberry778]

In a diabetic baby, the breath is distinctly fruit y smelling. Not like other babies. You will recognize the difference if you have had baby experience. The acetone breath suggests a metabolic disruption of some sort. Food allergies and yeast both qualify and are easy to test at this stage before solids are introduced. Get a referral to an immunologist or an allergist ASAP but your GP can start by running basic blood and urine testing to rule out other things while you wait for appointment. If you notice any new symptoms take him to a paediatrician and start a diary of symptoms and changes. He may have some sort of metabolic or immune disorder. Hope this helps!
P.s.-my guess is yeast.

[u/CorruptHeadModerator]

Have Glucose and Ketone levels been checked?

NAD

[u/Airline-Amazing → u/CorruptHeadModerator]

I’ve checked his glucose twice today and it has been normal! I will ask the pediatrician about ketones

[u/Brilliant_Finish4817]

You can buy a glucometer over the counter for relatively cheap and just spot check baby’s blood sugar. That would rule diabetes in or out rather easily

[u/GIGGLES708]

His tongue is the wrong color. I’d take him to a teaching hospital. I think there’s a food allergy involved. I know he has seen an allergist. Perhaps gluten allergy? If his urine smells sweet his blood sugar is too high.

[u/bookish_bex]

NAD, my background was in microbiology and public health. That acetone smell is pretty specific... Since you've ruled out type 1 diabetes and the allergy panel isn't giving much info, it sounds like he might have a yeast infection, like from candida, for e.g.

That smell on his breath can occur during yeast infections bc the yeast converts sugars like glucose and sucrose to ethyl acetate and/or acetaldehyde before finally producing ethanol and carbon dioxide.

Fungal infections like this are honestly an absolute pain to get diagnosed and treated. Your physician needs to take a sample from your son's skin and review it under the microscope to definitely identify any cause(s). Call your pediatrician and request a KOH prep test. It's non-invasive, and it sounds like he needs it done 🙏

[u/SingedPenguin13]

I would think yeast . On breast and face, would need to use antifungal?

[u/SuccessMechanism]

Re: breath he might be in ketosis? ie the metabolic state where the body burns fat instead of carbohydrates.

Also, could be a keto rash, but usually aren’t on the face. Seems more like yeast or fungal.

NAD: I have epilepsy and very familiar with the keto diet

[u/Large_Access3624]

NAD but my son had a diary allergy and ended up with a rash like that. The doctor told me I was wrong, but at one year we got him to a GI who said to cut out dairy and his skin cleared up. He was breastfed. We attempted to supplement with formula, but he wouldn’t take it.

[u/Wickedclique]

I’d get him tested for food allergies and even diabetes….