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HF 517

Starting the Ketogenic Therapy in the Hospital

Ketogenic therapy is a medical nutrition therapy. It is a strict, very high fat, low carbohydrate way of eating. It is used to treat seizures. Foods such as dessert, bread, cereal, pasta and milk are not eaten or eaten in very small amounts. Foods or formula are measured on a gram scale. It works best if every meal is eaten.

When the body is using mostly fat for energy, it makes ketones. Ketones in the body have been linked with less seizures in some children. About 1/3 of children treated with ketogenic therapy for a long time have more than 90% seizure control. About 1/2 of these children do not have any seizures.

Therapy starts in the hospital. The strength of the therapy is increased slowly over 3-4 days. Staff closely watch your child’s blood sugar and ketone levels. We also assess hydration. A feeding tube may be needed if your child is not able to stay hydrated by drinking.

Before the Hospital Stay

Lab tests. Your child’s neurologist will check labs to make sure it is safe for your child to start this therapy.

Pre-Ketogenic Therapy Intake Form and Seizure Log. We gave you these forms at the clinic visit. Fill out and return to us. We use your forms to figure out your child’s therapy.

Medicines. Your health care team will work with you to switch all your child’s medicines to the lowest carbohydrate form.

Scale. Order a gram scale and Ketogenic Diet Parents Guide from the Charlie Foundation, www.charliefoundation.org/. If you have not been asked to buy these items, we will give them to you in the hospital.

Getting Ready for the Hospital Stay

Feed your child a good breakfast or normal tube feeding the morning you are scheduled to come to the hospital.

Bring these items with you:

  • All home medicines and any equipment needed to give medicines.

  • Tylenol®325 mg tablets and pill cutter.

  • A small cooler and a 32-ounce see-through water bottle (e.g. Nalgene).

  • Your gram scale and Ketogenic Diet Parents Guide (if you were asked to buy these items).

Plan on staying with your child during the whole stay.

Checking in to the Hospital

Plan to come to the hospital mid-morning, unless you were told a different time by your nurse. If there is an emergency at the hospital your child’s stay 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 a set schedule and times for education each day.

The therapy will begin at lunch time. Your child will either have a ketogenic “shake” to drink or a tube feeding. If your child eats by mouth, solid foods are given the next day.

Teach Back

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

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

If you are a UW Health patient and have more questions please contact UW Health at one of the phone numbers listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s Hospital (AFCH) can be reached at: (608) 890-5500.

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608) 287-2770.