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Ketogenic Diet for Children

Medically reviewed by Last updated on Dec 2, 2022.

What is a ketogenic diet?

The ketogenic diet may help decrease your child's seizures if they do not respond to epilepsy medicine. The ketogenic diet is high in fat and low in carbohydrates. It causes your child's body to produce ketones (chemicals) that can help decrease seizures. Your child may need to follow this diet for at least 3 months to find out if it helps to decrease his or her seizures. Your child may remain on the diet for about 2 years if it helps to decrease his or her seizures. Your child will gradually be weaned off this diet by a healthcare provider. Some children remain seizure-free after following a ketogenic diet.

What are the different types of ketogenic diets?

There are 4 different types of ketogenic diets. Your child's healthcare provider or dietitian can help choose the best ketogenic diet for him or her. He or she will also help you plan meals for your child. Your child's health will need to be monitored very closely while he or she is on a ketogenic diet.

  • The classic ketogenic diet allows about 3 to 4 grams of fat for each gram of carbohydrate and protein. This means that carbohydrates and protein are limited, and high amounts of fat are allowed. Heavy cream, butter, and vegetable oils provide this fat. Sweets, such as candy, cookies, and desserts, are not allowed. Foods must be weighed and measured carefully. This type of diet is usually recommended for infants and younger children. It is usually started in the hospital so your child can be monitored closely for side effects.
  • A medium-chain triglyceride diet includes a high amount of a type of fat called medium-chain triglycerides (MCT). MCT can produce more ketones than long-chain triglycerides (LCT). With this diet, the fats your child eats are made up mostly of MCT and only a small amount of LCT. Your child can have more protein and carbohydrate on this diet than on the classic ketogenic diet.
  • The modified Atkins diet limits carbohydrates to 10 to 20 grams each day. Protein, fats, fluids, and total calories are not limited. This diet may be recommended for older children and adolescents.
  • The low glycemic index (GI) diet limits carbohydrates to 40 to 60 grams each day. Protein, fat, and total calories are not limited. The carbohydrates your child eats must have a low GI. GI is the rate at which a food raises blood sugar. Low GI foods raise your child's blood sugar at a slower rate than high GI foods. The carbohydrates your child eats must have a GI of 50 or less. Examples include whole-wheat pasta and breads, brown rice, lentils, split peas, and sunflower seeds. Low GI fruits include fresh pineapple, peaches, and apples. Low GI vegetables include eggplant, tomatoes, beets, turnips, and lettuce. This diet may be recommended for older children and adolescents.

What side effects may occur with a ketogenic diet?

Your child may have low blood sugar, dehydration, and fatigue. Your child may also have nausea, vomiting, constipation, diarrhea, and abdominal pain. Your child's growth rate may slow down. Your child may develop kidney stones if he or she takes certain seizure medicines.

What do I need to know about my child's medicines if he or she follows a ketogenic diet?

  • Your child should continue to take seizure medicines as directed. Your child's healthcare provider will decide if and when the dose of seizure medicine can be decreased.
  • Talk to your child's healthcare provider before you give him or her any new medicines. Your child may only be able take medicines that contain little or no carbohydrates.
  • Your child should take vitamins and mineral supplements as directed. A ketogenic diet may cause deficiencies (low levels) of certain vitamins and minerals. Your child's healthcare provider may recommend that he or she take supplements to prevent deficiencies.

What else do I need to know if my child follows a ketogenic diet?

  • Your child must closely follow the ketogenic diet as directed. Any changes made to your child's diet can affect his or her seizure control.
  • Weigh your child as directed. You may need to weigh your child each week to check if he or she is gaining weight normally.
  • Check your child's ketones as directed. You may need to regularly check the ketones in your child's blood or urine. Ask how often you should check ketones. This information is used to adjust your child's diet as needed.
  • Keep a seizure diary. Write down the dates of your child's seizures, where he or she was, and what he or she was doing.
  • Tell family, friends, school officials, and babysitters about your child's diet. Give others instructions on the diet and how important it is that he or she follow it closely.
  • Follow up with your child's healthcare provider as directed. Your child may need to see the healthcare provider every 3 months, or more often. During visits, your child's provider will review his or her health, growth, ketones, and seizure history. The provider will use this information to adjust your child's diet if needed.

When should I contact my child's healthcare provider?

  • Your child is ill and does not feel like eating.
  • Your child is losing weight.
  • Your child has more seizures after he or she starts this diet.
  • Your child has side effects that are making it hard for him or her to follow this diet.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.