Ketogenic diet therapy is often considered for children with epilepsy, especially when medication alone cannot manage epilepsy. “If a child fails two or more seizure medications, then it is not unusual for us to explore a ketogenic diet as part of other treatment options,” SSM Health Cardinal Glennon pediatric neurology nurse practitioner Kelly Schober explained.
What is a ketogenic diet?
A ketogenic diet is a specialized medical nutrition therapy high in fat, moderate in protein, and very low in carbohydrates. Unlike typical eating patterns that rely on carbohydrates for energy, this diet helps the body use fat as its main fuel source. This shift creates substances called ketones, a state known as ketosis. In some children with epilepsy, this diet change may help stabilize brain activity and reduce seizures.
What does a ketogenic diet look like day to day?
Ketogenic‑friendly foods may include:
- Healthy fats such as olive oil, butter, cream, and avocado
- Full‑fat dairy like cheese
- Eggs and fatty fish
- Carefully measured portions of protein
- Low‑carbohydrate vegetables such as spinach or broccoli
Foods high in sugar and starch, such as bread, pasta, rice, and sweets are limited or avoided.
How is the ketogenic diet monitored?
“This is not something families do on their own,” Schober emphasized. “It’s very structured, and we walk through it together. When families first meet with us, we take time to learn about the child, their medical history, their daily routines, and their current diet.”
Monitoring typically includes:
- Regular follow‑up visits to track seizures, growth, and overall health
- Support with meal planning and food tracking
- Periodic lab tests to monitor ketone levels and nutritional balance
- Medication adjustments as appropriate
“Every child is different. If epilepsy isn’t being managed, we look at all available options—medications, diet therapy, or surgery—and help families find what fits best,” Schober said.
