Abstracts

Rationale: The ketogenic diet is a safe and effective treatment for intractable epilepsy in infants. Breastmilk is the optimal source of nutrition for infants less than one year of age. Breastfeeding has not been traditionally continued upon initiation of the ketogenic diet and to date, there have been few reports in the literature of successful treatment of seizures with the ketogenic diet and concurrent breastfeeding. Methods: Retrospective chart review was conducted of all patients who received ketogenic diet therapy in the Comprehensive Epilepsy Center at Children's Mercy Hospital between May 2005 and January 2011 (N=118). Seizure reduction and quality of life were collected by means of self report. Four patients were identified who continued to receive breast milk while receiving treatment with the ketogenic diet. All mothers expressed breast milk which was subsequently mixed with ketogenic formula. Results: Of the 4 patients that continued breastfeeding while receiving ketogenic diet therapy, all 4 experienced a >50% reduction of seizures during the first 3 months of diet therapy. While one patient discontinued the diet, the 3 remaining patients were able to maintain >50% reduction of seizures up to 6 months. One patient became and remained seizure free for a year. All of the patients reported improved quality of life on the ketogenic diet up to 3 months. Conclusions: We conclude that breastfeeding is both possible and efficacious in conjunction with the ketogenic diet for treatment of intractable seizures.