Nutrition Interventions for Children with Special Health Care Needs

Section 3 - Condition Specific Nutrition Interventions
and diet control. The motivation to control their seizures can be enough to keep
compliance adequate (11,13).
The KD is best initiated under the supervision of an experienced KD team. A team
is best defined as a physician or epileptologist, nurse, registered dietitian (RD) and
social worker who all have experience with the KD (8,10,14). A pharmacist can also
be a valuable part of the KD team. The KD is not an exact science, and since all
children are different, an individualized approach based on current best practices is
advised. Much is learned through experience, and by adjusting the diet as needed.
RD’s are charged with the job of translating the science of the diet into a palatable
form. The advent of the Nutricia Ketocalculator and the Stanford Ketocalculator have
decreased the time involved in calculating menus. KetoCal (http://www.shsna.com/
pages/ketocal.htm), new sugar-free products (http://waldenfarms.com/) and even
low carbohydrate noodles made from mushroom fiber (http://www.miraclenoodle.
com) have expanded diet options for the diet.
The availability of the team, especially the RD during the diet initiation and the
first three months of the diet are crucial to the success of the diet. It is difficult for
families to absorb all of the information during the hospital admission, and they need
constant guidance from the KD team in order to address their concerns.
The remainder of this chapter presents guidelines for nutrition assessment,
intervention, and evaluation/outcome for monitoring a child on the ketogenic diet.
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