KetoCal LQ

Tube-Feeding and the Ketogenic Diet

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feeding_tubes_bannerThe ketogenic diet can be much easier to manage when your child is tube-fed since the diet can be given with a special ketogenic formula. In addition, research suggests that an all-liquid ketogenic diet may even be more effective, perhaps because there is less room for errors with measuring foods[1].

Tube-feeding can be given in a variety of ways. Whether given via a bolus, syringe, or feeding pump, the ketogenic diet can easily be given with a feeding tube. Ideally, the feeding schedule should be similar to the way your child was previously fed, just with the new formula.

As usual, the ketogenic diet will be started in the hospital under close medical supervision. You will work with your doctor and dietitian to determine the appropriate ketogenic diet ratio and amount of formula you should give to your child daily. Oftentimes your child will be gradually transitioned from their previous formula to the new ketogenic formula over a period of a few days. While in the hospital for diet initiation, your ketogenic diet health care team will teach you everything you need to know about preparing, administering, and managing your child’s new ketogenic diet when you go home.

KetoCal is a nutritionally-complete ketogenic formula that can be used to provide the ketogenic diet for tube-fed children. It comes in a 3:1 or 4:1 ratio, and as a ready-to-feed liquid or easy-to-prepare powder. KetoCal is milk-based so it may not be appropriate for children who have milk protein allergies. However, your dietitian can put together a modular ketogenic tube-feed with a variety of ingredients that are safe for your child’s food allergies. The KetoCal 4:1 powder and KetoCal 4:1 LQ are both low in lactose, so they are usually okay for children with lactose intolerance.

Tips for Tube-Feeding KetoCal:

  • KetoCal LQ Unflavored is the ideal formula for tube-fed children because it is ready-to-feed. No need to mix! Just shake and administer the formula! In some cases, your child’s dietitian may recommend adding extra water or other ingredients to the formula, so be sure to follow these instructions carefully.
  • If your child is using the KetoCal powder, be sure to mix your formula per the instructions given by your child’s dietitian. For best results, be sure to mix with the correct temperature of water to allow the formula to dissolve fully. It is recommended to use water between 113-122 °F. For more information and tips on mixing KetoCal powder, check out our KetoCal mixing video on YouTube!
  • Once the powdered formula is mixed, store in a closed container in the refrigerator and use within 24 hours. Discard after 24 hours and mix a new batch. Be sure to mix or agitate the formula just prior to feeding since some settling may occur.
  • Once the KetoCal 4:1 LQ has been opened, it can be stored in a closed container in the refrigerator for up to 24 hours.
  • For both the KetoCal Powder and KetoCal LQ, the recommended hang time is 4 hours. The hang time refers to the amount of time the formula can safely remain at room temperature after preparation.
  • Some settling of Ketocal may occur in the feeding bag which is a normal feature of the product. This settling should not block the feeding tube, however, it is recommended that the tube is flushed with water between each feed. It may also help to occasionally agitate the feeding bag.

If you have any questions or concerns, contact your child’s health care team for assistance. For questions about KetoCal, you can also call our Nutrition Services support line at 1-800-365-7354, Option 2.

For assistance with getting insurance reimbursement for KetoCal, contact our Nutricia Product Coverage Navigator program.

–Ellen

[1] Kossoff EH, McGrogan JR, Freeman JM. Benefits of an all-liquid ketogenic diet. Epilepsia. 2004 Sep;45(9):1163.

 

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Back to School on the Ketogenic Diet: Part 3

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ketoschoollunchFor the final post in our Back to School on the Ketogenic Diet Blog Series, we’ll talk about getting KetoCal® through the National School Lunch Program. We’ll also share some school lunch recipe ideas incorporating KetoCal®LQ. In case you missed them, be sure to read Part 1 on notifying the school about the ketogenic diet and Part 2 on packing the ketogenic diet lunchbox.

KetoCal and the National School Lunch Program

If your child attends a U.S. public school, you may be able to get KetoCal LQ provided by the school for the cost of the standard lunch meal. The Rehabilitation Act of 1973, the Individuals with Disabilities Education Act, as well as the regulations governing the National School Lunch Program (NSLP) stipulate that substitutions to the regular school meal must be made for children who are unable to eat school meals or have special dietary needs due to a qualified disability, such as epilepsy, when that need is certified by a licensed physician. Best of all, our Nutricia Product Coverage Navigator can guide you through the steps to request KetoCal from the school. For more information, visit our Epilepsy and the School Lunch Program webpage.

Quick & Easy KetoCal School Lunch Recipe Ideas

Speaking of KetoCal and school, we are excited to share some ketogenic school lunch recipe ideas that incorporate KetoCal LQ. If your child gets KetoCal LQ provided by the school, you can just send the additional ingredients to go along with it. We hope that your keto kids love the recipes and we hope they save you precious time in the morning!

As always, be sure to consult with your child’s health care provider about all meal ideas to ensure that they work for your child’s specific ketogenic ratio and calorie requirements.

Thanks for reading our Back to School on the Ketogenic Diet Blog Series. We hope everyone has a happy and healthy school year. We’d love to see photos of your little ones and their keto lunches on the first day back, so please share on our Facebook page!

-Mallory

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Back to School on the Ketogenic Diet: Part 2

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Continuing with our “Back to School on the Ketogenic Diet” blog series (see Part 1), today we’ll provide some tips and meal ideas to help you pack a school lunch that your keto kid will love.

Packing the Ketogenic Lunchbox

Many parents face a daily challenge when it comes to packing their child’s lunch box. It can be difficult to come up with lunch ideas that are transportable, nutritious, and that your child will actually eat. When your child is on a ketogenic diet for epilepsy, this task is even more daunting. Not only does the meal need to be carefully weighed and prepared, but oftentimes your child must eat the entire meal to maintain the ketogenic ratio. This is challenging enough at home but it can be even more difficult in the school cafeteria when you aren’t there to supervise. We’ve put together some tips and ideas to help you come up with keto-friendly school lunches that your child will enjoy.

Before school starts, ask your child’s dietitian to help you come up with some transportable meals that can be sent along to school. Find out from the school whether there is access to a refrigerator or a microwave since this will determine the types of meals that will work.

Presentation is Key

Because the ketogenic diet is high in fat and fat is denser in calories than carbohydrates and protein, ketogenic diet meals appear smaller than regular meals even though they provide the same amount of calories. Many parents find that small, fun food containers help to make ketogenic meals look more appealing and kid-friendly. Bento-style lunch boxes are very popular right now and are perfect for packing keto school lunches. If you’re not familiar with them, bento-style food boxes have multiple compartments to hold small amounts of different foods that can be packaged in clever, kid-friendly ways. You can find bento-style and other kid-friendly food containers at major department stores, kitchen goods stores, or online*.

  • Meal Inspirations:

If you are looking for some lunchbox inspiration, check out these creative bento school lunch ideas on Pinterest. Once you get some ideas, you can work with your child’s dietitian to make keto-friendly versions of Bento meals by substituting the ingredients in the compartments with low-carb, high fat foods like olives, pepperoni, or macadamia nuts.

  • Accessories

If the Bento-style boxes weren’t cute enough, there are additional accessories to make meals even more kid-friendly. For example, there are bento food picks* to hold foods together and bento forks* to send in place of utensils (keep in mind these could be a choking hazard for very young children). Then there is my personal favorite accessory, the bento vegetable cutter*. You can use these to cut low-carb vegetables (such as cucumbers or zucchini) into fun shapes that can be eaten with mayonnaise or other high-fat keto dips.

Mind the Ratio

For younger kids, it may be a good idea to send meals that have a consistent ratio regardless of how much is eaten since you can’t be there to ensure your little one eats the entire meal. For example, tuna salad that has all ingredients combined vs. a hot dog with a side of mayonnaise that must be eaten in entirety. With combined meals, you don’t have to worry that the ketogenic ratio will be off if your child doesn’t finish it all.

KetoCal®LQ can be very handy for school lunches since it is ready-to-drink, nutritionally complete, and has a 4:1 ratio regardless of whether your little one takes a sip or drinks the whole box. Plus, if your child gets distracted by all the commotion in the school cafeteria, it may actually be easier for him or her to drink a meal at lunchtime. Kids love the KetoCal LQ drink boxes since they look like the juice or milk boxes all the other kids are drinking. Consider keeping a few boxes of KetoCal LQ at school as a back-up lunch in case the one you pack is left on the school bus or accidentally spilled on the cafeteria floor.

 

As always, be sure to consult with your child’s health care provider about all meal ideas to ensure that they work for your child’s specific ketogenic ratio and calorie requirements.

For those of you who have already mastered the art of packing your child’s ketogenic diet lunchbox, which meals are your child’s favorites? What tips would you offer other parents who are new to this?

–Mallory

For more information on this topic, read Part 1 and Part 3 of the Back to School on the Ketogenic Diet series.

 

*Nutricia North America is not affiliated with Amazon.com nor the bento-style products included in these links. These links are shared for example purposes only.

Photo: Flickr

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