Medical Nutrition Therapy: Starting the Ketogenic Diet in the Hospital HF#517

 

Your child will be starting the ketogenic diet during an upcoming hospital stay.  Your child’s neurologist is a member of the Ketogenic Diet Therapy Program Team, or has referred you to the Ketogenic Diet Therapy Program at UW Health.

 

The ketogenic diet is a strict, very high fat, low carbohydrate diet that is used to treat epilepsy. The diet removes foods such as dessert, bread, cereal, pasta and milk.  Every food to be eaten is measured out on a gram scale and every meal must be totally eaten for the diet to work the best.

 

When the body is using mostly fat for energy, it makes ketones.  The presence of ketones has been linked with less seizure activity in some children.  Studies have found that 1/3 of children treated with the ketogenic diet for a long period of time have more than 90% seizure control.  Half of these children become seizure free.

 

The ketogenic diet will be started in the hospital under close medical and dietary care. The strength of the diet will be increased slowly over 3-4 days. Blood glucose (sugar) levels, ketone levels and fluid status will be monitored frequently during the admission. If your child is not able to maintain fluid balance by drinking, a short-term feeding tube may need to be used to prevent body tissues from drying out.

 

Before the Hospital Stay

 

• Your neurologist will check some labs to make sure it is safe for your child to start the ketogenic diet.
• Complete and return the Pre-Ketogenic Diet Intake Form.  Your nurse can get you the form. The information in the packet is crucial to calculating the diet for your child.
• Order the gram scale and Ketogenic Diet Parents Guide from the Charlie Foundation: http://www.charliefoundation.org/
• Find 36% Heavy Whipping Cream in your local grocery store (per serving: 50 calories, 5 grams fat and 0-1 gram carbohydrate) if your child is going to eat the ketogenic diet by mouth.
• Your neurology nurse will work with you to switch all of your child’s medicines to the lowest carbohydrate form.

 

Preparing for the Hospital Stay

 

• Feed your child a good breakfast the morning you are scheduled to come to the hospital.
• Bring all home medicines, and any equipment needed to give medications, with you to the hospital.
• Purchase some Extra Strength Tylenol Caplets and bring them with you to the hospital. 
• Bring your gram scale and Ketogentic Diet Parents Guide with you to the hospital.
• Bring a small cooler with you to the hospital.
• Plan on staying with your child during the entire hospital stay.

 

 

Checking in to the Hospital  

• Arrive at the hospital mid-morning, or when told to arrive by your neurology nurse. Please understand that if an emergency situation or high hospital census occurs, your admission may be delayed.
• Once you are settled into your room, your dietitian will come by to meet you and go over the schedule for the next 3-4 days.  There will be set times for education each day.
• The ketogenic diet will begin at lunch time with a ketogenic “shake” your child can drink. If your child receives tube feedings, they will start at this time as well.  Usually, solid foods are introduced on the second day if your child eats by mouth. 

 

 

Teach Back:

 

 

What is the most important thing you learned from this handout?

 

 

 

What changes will you mkae in your diet/lifestyle, based on what you learned today?

 

 

 

If you have more questions please contact UW Health at one of the phone numbers listed below.

 

 

 

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 03/29/2013

Copyright © 03/29/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#517

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