Key Point

When your child starts a ketogenic diet you might have a variety of questions that range from the topics of weighing food to using hand sanitizer. Here are answers to questions that other parents and caregivers have asked about the diet.

Q. Are dental check-ups allowed when my child’s on a ketogenic diet? Should we ask the dentist about alternatives for cleaning and fluoride treatments?

A. Yes, dental check-ups and fluoride treatments are allowed. Some dental cleaning solutions might contain carbohydrates, so you should ask your dentist about the solutions he or she uses. Some dentists will just use water if you ask.

Q. What should I do if my child vomits after a gastric tube feeding? 

A.  You need to ask your doctor or registered dietician about this. Vomit often looks like more food or formula than it really is because it’s mixed with stomach juices. In general, we advise you to wait to refeed until your child’s next feeding.

Q. What is a good way to transport food/water when traveling? What do we do if we are traveling and forgot the food, or don’t have enough? 

A.  Here are some suggestions:

  • Buy a large cooler to store foods.
  • Bring easy-to-take foods such as homemade peanut butter cookies. 
  • Make meals ahead of time and store them in small, sealable containers. 
  • Take food with you whenever you can—especially heavy whipping cream that might vary greatly in carbohydrate content. 
  • If you’ve forgotten any food, you’ll have to purchase what you need at a nearby grocery store.

Q. Is hand sanitizer OK to use on hands? 

A.  Yes, fragrance-free sanitizers such as regular Purell are best.

Q. Is there any variation in how much fluid my child can have? 

A.  Yes. Discuss how much you can vary your child’s fluid amount with the dietician.

Q. What if we forget to measure urine ketones one week? 

A.  This is generally fine. We like to monitor the level of urine ketones over periods of time to see if and how they affect seizures. This won’t have much impact in a child whose seizures are well controlled with few or no seizures. 

However, strict ketone testing is crucial during the initiation of the ketogenic diet, and when seizures increase or seizure activity differs from a child’s baseline seizure activity.

Q. Is it a major problem if the food weight (oral eater) is over or under by 1 to 2 grams? 

A.  When your child starts the ketogenic diet, we need you to be as precise as possible. That said, if you are inaccurate in measurements, it’s better to be under than over weight. For example, if you’re supposed to weigh 50 grams of cream and you end up only giving 49 grams, that doesn’t have as much of an impact as if you were supposed to give 5 grams of blueberries and gave 6 grams instead. 

Q. Should we bring a food scale when our child is admitted for initiation of the ketogenic diet? 

A.  We suggest you buy a food scale before your child is admitted for initiation of the ketogenic diet. Right now, we do not sell food scales.

Q. How often will my child need to have tests?

A. In general:

  • Ketogenic lab tests are done about two weeks before your clinic appointment.
  • Electrocardiogram tests (EKGs) are done once a year. Renal ultrasounds and bone age tests are done every six months. 
  • These tests might be done more frequently if your health care provider requests them. 

This information is for educational purposes only. It is not intended to replace the advice of your health care providers. If you have any questions, talk with your doctor or others on your health care team.