Ketogenic Diet for Seizures in Children
A ketogenic diet is a special type of diet that causes the body to make ketones. The diet is very high in fat, and very low in carbohydrates. It includes enough protein to help your child grow.
Why the diet is used
The diet is sometimes used as a treatment for children with seizures when medicine isn’t working well. Researchers aren’t sure why the diet works. But some children become seizure-free when put on the diet. The diet doesn’t work for every child. Your child's healthcare provider will determine if the diet is right for your child. Most children stay on the diet for about 2 years. The diet is then slowly changed back to a regular diet. Some children may stay on the diet for many years.
The diet causes the body to make ketones. Ketones are chemicals made from the breakdown of body fat. During normal health and with a normal diet, the body generally does not make or need to make ketones. They are an energy source that the body uses normally during fasting states. The brain and heart work normally with ketones as an energy source. When ketones are being created in the body, this is called ketosis. Ketosis is confirmed with urine testing.
The presence of ketones is key to the success of your child's diet. Your child's diet must be strictly followed. Even one small snack that is high in carbohydrates can stop ketosis.
What is in a ketogenic diet?
The ketogenic diet is very high in fat. About 90% of the calories come from fat. Protein is included in amounts to help your child grow. Only a very small amount of carbohydrate is included in the diet. The diet mostly includes high-fat foods such as:
Starting the diet
Your child will be admitted to the hospital before starting the diet. Your child may be in the hospital for 4 to 5 days while his or her body starts making ketones. During this time, you’ll also learn how to plan your child’s diet. You may also be taught how to test your child's urine for ketones.
While in the hospital, your child may not be able to eat for 1 to 2 days until ketones are measured in the urine. Once ketones are in the urine, your child may be given high-fat, low-carbohydrate shakes. These are also known as keto shakes. After several meals of keto shakes, your child will start eating solid foods.
Managing the diet at home
The ketogenic diet can be very challenging to prepare. All foods must be weighed using a food scale. The diet is not nutritionally balanced. Your child will also need vitamin and mineral supplements. The dietitian will tell you how much fat, protein, and carbohydrate your child can have. This is usually divided into 3 meals a day.
A sample ketogenic meal is:
53 g eggs
10 g cheddar cheese
10 g bacon
21 g butter
60 g heavy cream
21 g strawberries
A sample ketogenic shake is:
500 g Ross Carbohydrate-free Formula (concentrate)
270 g heavy cream
13 g Egg Beaters
Avoiding too many carbohydrates
While on the diet, your child will not be able to have high-carbohydrate foods such as:
Fruit and fruit juice
Breads and cereals
Starchy vegetables such as corn, peas, and potatoes
Snack foods such as chips, snack cakes, and crackers
Carbohydrates are not just found in food and drinks. Some medicines have carbohydrates. So do some products such as toothpaste and mouthwash. Your child needs to avoid these things. Ask your child's healthcare team for a list of medicines and other products that are safe for the diet.
May 05, 2017
Overview of the Classification, Etiology and Clinical Features of Pediatric Seizures and Epilepsy. UpToDate., Overview of the Treatment of Seizures and Epileptic Syndromes in Children. UpToDate.
Turley, Ray, BSN, MSN