Frequently Asked Questions

A child of any age can be considered for a dietary therapy. If your child has glucose transporter deficiency syndrome or pyruvate dehydrogenase deficiency, the ketogenic diet is the treatment of choice. Additionally, the ketogenic diet is recommended for children with difficult-to-control seizures that fail to respond to the most commonly prescribed anti-epileptic medications used by neurologists at Children’s National. 

Maintaining the ketogenic diet can be very challenging and requires that all foods are weighed using a food scale. Dedication from parents and patients is a key part of ensuring success on the diet. If you are not sure if your child can maintain a diet as strict as the ketogenic diet, our team can talk with you to determine if one of the lesser-restrictive diets would be a better choice.

Because studies show that most patients show a benefit within the first few months, your neurologist will ask that you try the diet for at least three months. If the diet is effective in preventing or reducing seizures, your child could be on the diet for at least two years. Continually weighing the benefits, quality of life and side effects with your neurologist will help to determine how long your child will continue the diet. 

If your child is fed by tube, there are formulas that are made in the right proportions to be ketogenic. 

A typical oral meal includes:

• A large proportion of fat
•  Meat, eggs or a form of protein
• A small amount of fruit or vegetables
• A sugar-free beverage

The ketogenic diet has come a long way from when heavy cream, butter and eggs were components of meals day-in and day-out. Thanks to creative parents, the internet and more manufactured formulas and foods in the marketplace, there are currently more options and resources. 

Our dietitians will help determine how much fat, protein and carbohydrates your child should have each day. He or she will also help you come up with meal ideas your child will enjoy. Using the help of an online program, meals will be pre-calculated to provide the correct amount of nutrients and each item of food will need to be weighed on a gram scale.

It may be surprising how small the portions of food look, but remember that fat provides a lot more calories per gram than protein or carbohydrates. We will also monitor your child’s weight and height, and will adjust the calories and amount of food to ensure that your child is meeting appropriate growth milestones.

To begin this process, please call our Dietary Therapies for Epilepsy Clinic (also known as the Ketogenic Diet Clinic) at 202-476-3611 to make an appointment. Please complete the intake form (en español) and if possible, email it to us prior to your appointment.

At your first appointment, you will meet with a neurologist and a dietitian. You and your child will learn details of each of the diets, and discuss whether a dietary therapy would be right for your child. If the ketogenic diet is the best option, we will talk with you about it in detail.  

Your child will start the ketogenic diet while staying at the hospital. The purpose of starting the ketogenic diet in the hospital is to monitor for immediate side effects in a medical setting and to be educated about the diet during daily meetings with a dietitian. The hospital stay usually lasts for four to five days (Monday through Friday).

Children’s National will then see you one month later and again three months after starting the ketogenic diet. If it is decided that your child will continue on the diet, periodic appointments will be made throughout the year to monitor his or her progress on the diet. Additionally, your child will continue to have follow-up appointments with his or her neurologist.

If it is decided that the modified Atkins diet or low glycemic index therapy are the best next steps for your child, you will not need to be admitted into the hospital to start either of those diets. Children’s National will continue to follow up with you and your child in an outpatient clinic environment.

• The Epilepsy Foundation
• The Charlie Foundation
• KetoCook
• The Keto Cookbook
• Ketogenic Diets: Treatments for Epilepsy and Other Disorders 

See articles written by our team:

• Can Dietary Changes Improve Epilepsy Outcomes? | Neurology Times
• Dietary Therapy to Improve Epilepsy Outcomes: Case Vignettes | Neurology Times
• The Ketogenic Diet: Overcoming Challenges for Optimal Utilization in Epilepsy Treatment | Neurology Times