Pediatric Epilepsy

Ketogenic Diet for Children with Epilepsy: A Practical Meal Plan in a Hospital

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Introduction

Learn more about Epilepsy symptoms, diagnosis, and treatments from experts at Boston Children's, ranked best Children's Epilepsy is a complex condition that makes a child susceptible to seizures. Best childrens and pediatric hospital. Epilepsy is a disorder of repeated, unprovoked seizures more common in young children than in adults. Most children's seizures will be controlled without.

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Most children with epilepsy can achieve good seizure control with treatment, and some can live seizure-free. A new technique, noninvasive brain stimulation, is also being studied. Finding a treatment approach that works for your child can involve some trial and error. Patient Resources Patient Story Two life-threatening conditions. Notes Blog Read clinical updates and the latest insights from Boston Children's specialists.

Flu Season is Here Talk to your healthcare provider about getting your child immunized today. Contact the Epilepsy Center Request an Appointment Request a Second Opinion. The meals are provided in accurate amounts by weighing food with digital precision scale. Ketogenic diet, Total calories: In order to achieve the ideal ratio, more fat from vegetable oils is needed not only from foods but also from others. In our hospital, we usually supply olive oil as a main fat source.

Pediatric Neurology

In order to improve the composition of fatty acids, we combine olive oil with sesame oil, perilla seed oil, canola oil and others. We also provide nuts in order to improve flavor of meal and reduce the amount of vegetable oils. In our hospital there are three basic types of formulation; all-in-one, separated and semi-separated types. All-in-one type is a blended or pureed form for the children at initial stage of the KD, and also for children who have difficulties in chewing and swallowing.

All-in-one type has an advantage of maintaining the desired ratio of the meal and does not affect feeding time which can be extended by meal tolerance of a child. However users often complain about the small volume of the meal. Separated type is for children who have enough abilities to chew and swallow. It is generally recommended to finish the meal completely within 30 minutes.

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Boston Children's Hospital has been named the 1 children's hospital in the nation by U. Before starting the KD, the dietitian evaluates the nutritional status of the child at the initial day and evaluates his or her ability to take food, activity level and growth pattern such as current height, weight and weight change. In our hospital, we usually supply olive oil as a main fat source. The dietitian needs to keep in touch with the parents of the child to adjust dietary therapy. Home Journals Pediatric Neurology. This goal is achieved by meals composed of g of fat, 18 g of protein and 12 g of carbohydrate per, which makes the ratio of fat g to nonfat 30 g is 4:

But when the child has difficulties in eating oils, it can be mixed with nuts and milk. This is classified as a semi-separated type. Liquid type formula is used for bottle-feeding infants and tube-feeding children who are fed by using a nasogastric tube or a gastrostomy tube. The dietitian monitors children's tolerance and preference of the KD in order to modify consistency, palatability and formulation of the diet.

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Maintaining the desired ratio of fat and non-fat is the most important thing in the KD. Eating all foods in each meal should be completed within 30 minutes. Meals are planned based on individual nutrient requirement which is divided by number of meal supply.

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If the child wants snacks, meal and snacks are planned based on the required calories and ratio. Multivitamins and minerals including calcium and vitamin D supplements are needed every day during the KD.

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The dietitian provides education to parents of the child during the period of the KD. The education is very important because the child generally stays in the hospital for weeks and should continue the KD at home.

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After returning home, follow-up monitoring for the KD is needed at 1, 3, 6, 12, 18, and 24 month intervals to control seizure and metabolic complications [ 3 ]. The most common complications in the KD are gastrointestinal discomforts including nausea, vomiting, constipation and diarrhea.

High fat diet can affect on serum levels of lipid profile and can results in dyslipidemia such as hypertriglyceridemia and hypercholesterolemia.

Late onset complications of the KD are infectious disease, osteopenia and renal stones [ 4 ]. The dietary treatment continues years in order to achieve seizure control.

Pediatric Neurology

The ratio of fat and non-fat decreases slowly from 4: The dietitian needs to keep in touch with the parents of the child to adjust dietary therapy. But it contains sufficient protein unlike the KD.

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The ratio of fat and non-fat in the MAD is almost 1. In our cases, the MAD provides sufficient amount of protein so this diet is beneficial for children who complain about starvation during the period of the KD therapy.