DKA & Ketones

How to Collect Urine to Test Ketones in Babies and Toddlers Who are Wear Diapers

If your baby or young child is still in diapers, how do you collect urine to test for ketones? It is not as hard as you think. Here are methods and tips to help you collect urine from an infant or child that is not potty-trained so that you can test for ketones. These tips may also be helpful for caregivers of adults who are unable to use the rest room on their own.

How do I test for ketones?

Testing for ketones is very simple and only involves soaking a ketone test strip in urine.

Infants (and those not yet potty trained)

If your child (still in diapers) requires ketone testing, you will need to be alert and patient and a little creative. If you are trying to collect a urine sample:

  • Thoroughly wash the urethra/penis and surrounding area.
  • Do not add baby powder, lotion, or creams.
  • Diaper the baby and check every 15 minutes, or hold them in your lap (you can usually feel a warm spot when the child urinates).
  • Do not use urine samples contaminated with fecal matter.
  • If you cannot get a urine sample within an hour call your doctor for further instructions.

Since urine samples need to be fresh, using old urine will not provide accurate results. As soon as your baby urinates in his/her diaper it will feel warm to the touch for a few seconds. Have your test strips and a paper cup ready so you can catch the urine while fresh.

Disposable Diapers

Remove the diaper and gently squeeze a small amount of urine into the paper/plastic cup. Insert the test strip immediately.

Cloth Diapers

If you are using a cloth diaper you may also be able to simply press the test strip into the urine soaked material. This does not work as well with disposable diapers which tend to quickly absorb urine.

Tip to Collect Urine from Any Diaper

You might also try to use something called a “diaper doubler” (they look like giant sanitary napkins and are sold in the diaper section of stores). You can also use an unscented, plain tampon or sanitary pad. Insert pad/tampon into the diaper (in front for boys, in back for girls) and diaper. The pad/tampon will absorb urine and make it easier to squeeze out into a cup. Do not use scented, medicated, or deodorized feminine products which can skew test results.

Using a Urine Bag

A doctor may suggest using a urine bag to collect urine. To use a urine bag, wash the area around, and including, the urethra/penis.  Open the urine collection bag (a plastic bag with an adhesive paper on one end), and place it on your baby as instructed by your doctor. (For boys, the entire penis can be placed in the bag and the adhesive attached to the skin. For girls, the bag is placed over the labia.)

Diaper the child as usual but do not use lotions, powder or creams. Check the bag frequently and remove the bag after the infant has urinated into it. You can drain the urine into a clean container or simply insert the ketone test strip into the bag.

Diabetes New Zealand
Joslin Diabetes Center; Ketone testing
Web MD; Ketones


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