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Initiating the ketogenic diet in infants with treatment refractory epilepsy while maintaining a breast milk diet

J B Le Pichon1, Lindsey Thompson2, Megan Gustafson1

  • 1Children's Mercy Hospital, Division of Neurology, Kansas City, United States.

Seizure
|April 9, 2019
PubMed

Insights

The ketogenic diet is safe and effective for infants with drug-resistant epilepsy, even when combined with breast milk. This study shows significant seizure reduction in most infants, supporting its use in early childhood epilepsy management.

Area of Science:

  • Pediatric Neurology
  • Nutritional Ketosis

Background:

  • Drug-resistant epilepsy is a significant challenge in pediatric populations.
  • The ketogenic diet is an established therapy for childhood epilepsy, with increasing use in younger children.
  • Maintaining breast milk feeding is recommended for infants up to six months.

Purpose of the Study:

  • To assess the safety and efficacy of the ketogenic diet in infants with drug-resistant epilepsy.
  • To evaluate the feasibility of initiating the ketogenic diet while continuing breast milk feedings.
  • To determine seizure reduction rates and tolerance in this specific infant population.

Main Methods:

  • A cohort study involving 9 infants (1-13 months) with drug-resistant epilepsy.
  • Treatment involved the ketogenic diet combined with ongoing breast milk intake.
  • Data collection included retrospective and prospective elements.

Main Results:

  • All 9 infants successfully achieved and maintained ketosis.
  • Three infants became seizure-free, and four experienced over 50% seizure reduction.
  • The diet was generally well-tolerated, with one case of dehydration and metabolic acidosis.

Conclusions:

  • The ketogenic diet can be safely and effectively initiated in infants while continuing breast milk.
  • This approach offers a viable treatment option for drug-resistant epilepsy in very young children.
  • Further research can explore long-term outcomes and optimal protocols.
Abstract

Keywords:
Breast feedingIntractable epilepsyKetogenic diet

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