Starting Ketogenic Therapy in the Hospital
Ketogenic therapy is a strict, very high fat, low carbohydrate medical nutrition therapy used to treat
epilepsy. Foods such as dessert, bread, cereal, pasta and milk are removed or very restricted. Foods are
measured out on a gram scale and every meal must be eaten completely for the therapy to work best.
When the body is using mostly fat for energy, it makes ketones. The presence of ketones has been
linked with less seizure activity in some children. Studies have found that 1/3 of children treated with
ketogenic therapy for a long period of time have more than 90% seizure control and 1/2 of these
children become seizure free.
Ketogenic therapy is started in the hospital under close medical and nutrition care. The strength of the
therapy is increased slowly over 3-4 days. Blood glucose (sugar) levels, ketone levels and fluid status
are watched often during the admission. If your child is not able to maintain fluid balance by drinking,
a feeding tube may be needed to prevent negative side effects.
Before the hospital stay
Your neurologist will check some labs to make sure it is safe for your child to start ketogenic
Complete and return the Pre-Ketogenic Therapy Intake Form. Your nurse can get you the
form. The information you provide is crucial to calculating the therapy for your child.
Order the gram scale and Ketogenic Diet Parents Guide from the Charlie Foundation:
If your child eats by mouth, find 36% Heavy Whipping Cream in your local grocery store (per
serving: 50 calories, 5 grams fat and 0-1 gram carbohydrate).
The ketogenic therapy team and pharmacist will work with you to switch all of your child’s
medicines to the lowest carbohydrate form.
Preparing 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 with you the following to the hospital:
o All home medicines and any equipment needed to give medicines
o Regular Strength Tylenol® 325 mg tablets and pill cutter
o Your gram scale and Ketogenic Diet Parents Guide
o A small cooler
Plan on staying with your child during the entire hospital stay.
Checking in to the hospital
Arrive at the hospital mid-morning, or when told to arrive by your neurology nurse.
Please understand that if an emergency situation or high hospital census occurs,
your admission 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
The ketogenic diet will begin at lunch time with a ketogenic “shake” your child can drink.
If your child receives tube feedings, they will start at this time as well. Usually solid foods
are introduced on the second day if your child eats by mouth.
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.
Your health care team may have given you this information as part of your care. If so, please use it and call if you have any
questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical
advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health needs are
different, you should talk with your doctor or others on your health care team when using this information. If you have an
emergency, please call 911. Copyright © 10/2015 University of Wisconsin Hospitals and Clinics Authority. All rights
reserved. Produced by the Clinical Nutrition Services Department and the Department of Nursing. HF#517