Ketogenic Diets and Your Student

Ketogenic diets are medical treatments to control seizures. There are 2 types:

• The classic ketogenic diet (keto diet)
• The modified Atkins diet (MAD)

Most children who eat by mouth will be on the modified Atkins diet, which is less restrictive than the ketogenic diet.

Both diets are made up of foods that are high in fat (butter, cream and oil), medium in protein (meats and eggs) and very low in carbohydrates (sugars, fruits, vegetables and grains). The higher intake of dietary fat changes the metabolism in the body to use fat as fuel for the brain.

• Potential to reduce seizures
• Potential for improve behavior and thinking ability (cognition)
• Potential to reduce or stop seizure medicine

• Upset stomach, nausea, vomiting and trouble pooping (constipation)
• Stomach acid going up into the esophagus (reflux)
• Not getting enough water (dehydration)
• Delayed growth
• Vitamin deficiency (children on the diets must take vitamin and mineral supplements)

• Yes. The ketogenic diets are a medical therapy for epilepsy and must be precisely followed 100% of the time.
• The diets require strict control over carbohydrates eaten (orally) and applied to the skin (topical).
• Like exposure to peanuts for a child with a peanut allergy, accidental carbohydrate ingestion or exposure can result in a medical emergency.

• As much as possible, treat the child just like any other student. Children on ketogenic diets do not need any physical restrictions and should be included in all classroom activities.
• Hydration: Children on ketogenic diets should always have access to water and carbohydrate-free fluid. Encourage them to drink lots of fluids.
• Eating meals provided by parents: Fat is the most important part of any meal when following the modified Atkins diet. As long as the child eats the fat in their meal from home, it is OK if they do not finish the entire thing. Work with the child’s parents to determine if meals need to be monitored to verify what is eaten.
• Craft supplies: Children on the ketogenic diet need to wear gloves when working with paint, playdough, glue or other craft supplies that can get on the skin. Gloves protect the child from accidental carbohydrate exposure through the skin. Using crayons and markers is OK.
• First aid: Bandages (Band-Aids) are OK. Antibiotic ointments with neomycin, polymyxin, and bacitracin (Neosporin) are OK. Petroleum jelly (Vaseline) is OK. Do not use antibiotic creams.
• Medicine: A parent or guardian must supply any medicine their child needs to take at school.
• Creams, lotions and sprays: A parent or guardian must supply carbohydrate-free creams, lotions or sprays, like sunscreen or bug spray.
• Treats and rewards: Provide non-food rewards in the classroom. If events include food or treats, tell the child’s parent or guardian in advance, so they can give you a ketogenic-friendly option.
• Sharing food: Do not allow children on ketogenic diets to share any food with other children.
• Have an emergency plan: Accidental carbohydrate exposure may increase the chance of seizures. Please refer to the seizure action plan in the case of medical emergency.
• Communication with parents is key! Plan regular check-in times and modes of communication that work well for everyone (such as email, daily notebook, in-person and phone meetings).