Ketogenic Diet

The ketogenic diet is sometimes offered to children who continue to have seizures while on anti-seizure medications. This is a special way of eating that is helpful for some children who have uncontrolled seizures.

Your child’s doctor will determine if this diet is right for your child. When the ketogenic diet is started, your child will be admitted to the hospital. It may take four to five days in the hospital to get the diet started and for you to learn how to plan the diet. Our inpatient Neuroscience Unit offers comfortable, kid-friendly accommodations and registered dietitians who will regulate your child’s diet closely, while also teaching your family how to continue the diet at home.

The ketogenic diet is very high in fat. Protein is given in amounts to help your child grow. A very small amount of carbohydrates is included in the diet. This very high-fat, low-carbohydrate diet causes the body to make ketones. Ketones are made by the body from the breakdown of fat. They are made for energy when the body does not get enough carbohydrates for energy. If your child eats too many carbohydrates, then his or her body may not make ketones. The presence of ketones is important to the success of the diet.

Once ketones are present in the urine, special high-fat, low-carbohydrate shakes may be started. These are sometimes called keto shakes. After several meals of keto shakes, your child will be started on solid foods.

You may also be taught how to check your child’s urine for ketones. The dietitian will help determine how much fat, protein and carbohydrate your child is allowed to have, usually divided into three meals a day. The ketogenic diet can by very challenging to prepare and requires that all foods be weighed using a food scale. The ketogenic diet is not nutritionally balanced, therefore, vitamin and mineral supplements are needed.

High-fat foods include:

• Butter
• Heavy cream
• Oil
• Mayonnaise
• Cream cheese
• Bacon
• Cheese

High-carbohydrate foods include:

• Fruit and fruit juice
• Breads and cereals
• Vegetables (corn, peas and potatoes)
• Beans
• Milk
• Soda
• Snack foods (chips, snack cakes, crackers)
• Sweets

Some medications and other products, such as toothpaste and mouthwash, contain carbohydrates. It is important to avoid these products if your child is on the ketogenic diet. Your child may not make ketones in their urine if too many carbohydrates are included in the diet. Your child’s doctor and dietitian can give you a list of medications, and other products, that are free of carbohydrates.

Children usually stay on the diet about two years. The diet is then slowly changed back to a regular diet.

The ketogenic diet may be helpful in reducing your child’s seizures. It rarely stops them completely and is typically used in combination with antiepileptic medications.

Sample Ketogenic Diet Meal

A sample ketogenic diet meal might include:

• 60 g heavy cream
• 21 g strawberries
• 53 g eggs
• 10 g cheddar cheese
• 10 g bacon
• 21 g butter