Nutrition Interventions for Children with Special Health Care Needs

Assessment Intervention Evaluation/Outcome
Begin supplementation with L-carnitine if needed. 4 Normal carnitine levels
Free carnitine
Esterified carnitine
Most children become deficient at
some point on the diet, especially at
the higher ratios.
Deficiency can decrease
effectiveness of the diet to control
seizures. Depakote can deplete
carnitine. Recommend adding
L-carnitine before diet start as the
combination of the two can deplete
stores more rapidly.
Section 3 - Condition Specific Nutrition Interventions
Normal electrolyte levels
Electrolytes Monitor for severe dehydration.
Recommend using table salt to taste when cooking. Consider use of
potassium chloride (salt substitute) to maintain normal serum levels
if needed.
Bicarbonate of soda (baking soda) may be used to normalize low
serum carbon dioxide. Low serum carbon dioxide can contribute to
vomiting, especially during the initiation phase.
Serum creatinine, BUN, magnesium,
phosphorus, calcium, protein levels,
Vitamins A, E, D and retinol binding
protein within normal limits.
Nutrition Interventions for Children With Special Health Care Needs 251
Minor abnormalities may not need to be corrected. Consult with
ketogenic diet team.
Creatinine
BUN
Magnesium
• Maintain Vitamin D
supplementation; profound drop
in D serum values seen when MVI
not taken by child.
• Maintain normal vitamin and mineral intake by using appropriate
supplemental vitamin with iron.
• Start supplement before starting the diet.
• Antiepileptic medications (AED’s) interact with vitamin D;
generally any child on an AED needs a vitamin D supplement.
Vitamin D low in almost all cases at start of diet
• The diet is low in calcium; supplementation to equal the DRI is
recommended.
Phosphorus
Calcium
Protein
Vitamins E, D
Vitamins A /Retinol binding protein