Bringing keto to kindergarten, part 2

Me: “Mmmm, Nora. These pumpkin bars are so good. You are the luckiest keto-kid on the block.”
Nora: “No, I’m the only keto-kid on the block.”

And that pretty much sums up the social issue with starting school. Nora has been so amazingly compliant about her diet that the last 20 months has been relatively easy emotionally. Also, she has been home with her beloved Laura while I’m at work, socializing mostly with other families that we know and who know Nora. And if someone offers her food, our assertive little Nora clearly states: “no thanks, I can’t, I’m on the ketogenic diet for epilepsy.” I have heard it with my own ears. But I was also there to step in if Nora did not assert herself. When she is at school, she is on her own.

Starting kindergarten means that everything is new. All new people and kids who eat together 3 times per day. Nora is in school from 8:15 to 2:40, where they eat breakfast, snack and lunch together. Of course, Nora’s teacher and school staff are informed about her diet (I will address that in part 3), so it is not up to a 5 year old to explain it to the adults.

But she is her own advocate with her peers and she is well aware that she is the only keto-kid on the block. Other kids have other food issues to navigate, such as nut, dairy and gluten allergies. Plenty of other kids bring their own lunches and a few opt-out of breakfast. But after just the first day she was aware that *everyone* was drinking milk with their breakfasts and lunches and she wanted milk too.

IMG_4103I was trying to avoid liquids in her school meals, which are only asking to be spilled. But when she really wanted to have “milk,” I felt like it was more important to honor her wishes than avoid the risk of spilling. We’ve been giving her “keto milk” made with cream (an amount needed to achieve the ratio in the meal), diluted with water and with a drop of vanilla or other flavoring (she also likes banana). Our standard packing method is an 8-oz mason jar, the kind you use for canning jam. This summer I punched a hole in the top of a lid to fit in a straw. To make it spill-proof in a lunch bag, you just add a second solid lid under the screw cap, then to serve remove the second lid and insert a straw.

The straw is great for avoiding big spills while drinking, but I think that the changing of the lids is a bit much for a 5 year old who has 25 minutes to eat while surrounded by other kids. After the first day of school I tested her on unscrewing the lid to drink directly from the jar like a cup, which worked fine for the few days that we tried it.

IMG_2273I also started searching for small travel-and-kid-friendly cups that we could send to school. We came up with these reCAP mason jar lids and have used them successfully for the last week. They are plastic and have a rubber gasket to create a good seal. Nora can pop open the pouring lid herself. I am still nervous that the pour top will not stay closed in a lunchbox, but so far, so good. I check and double check it before I send her off.

I also brought in 6 of her Mexican Chocolate Protein Cupcakes with frosting and put them in the school freezer, so that she has a snack on hand if the class has a special treat. The question will be whether everyone remembers that she has a treat in the freezer. But if I tell Nora about it, she will be sure to inform everyone. Next I have to figure out how I will be informed that she had the extra snack at school. I suspect that I will hear it from Nora first, and they are at-ratio so if I don’t hear about it the ratio is fine, she just gets lots of extra calories that day.

She has been to school for 8 days now, and every day she comes back with empty food containers and no stories of spilling. It all seems to be working so far from her end. I feel pretty confident that Nora will tell me her wishes so that her lunches are appealing and easy to eat with her class, because the top priority is to keep her happy and independently choosing to stay on the diet.

The only mishap so far was one day when the whole class did not get morning snack because their schedule was rushed. When I picked her up the teacher reported that she had an emotional day, then when we got home I discovered that she had not touched her morning snack. She was adamant that no one ate snack, so the next day I told her teacher that if they don’t eat snack she needs to get that food at lunch time. Her calories are apportioned over the day, and missing some will make a girl cranky. It’s in everyone’s best interest to feed Nora.

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About Christy Anderson Brekken

In no particular order... Instructor and Researcher, Department of Applied Economics, Oregon State University. Educational background: University of MN Law School, 2005. MS in Ag and Resource Economics, Oregon State University, 2011. Teaches: Agricultural Law, Environmental Law. Mother: brilliant 9 year old boy; brilliant 6 year old girl with benign myoclonic epilepsy on a modified ketogenic diet therapy. Married to: Ted Brekken, OSU Department of Electrical Engineering. Ride: Xtra-cycle Edgerunner with kid seat; 400-pound cargo capacity. Grew up: Devils Lake, ND. Lived in: Minneapolis/St. Paul, MN, Pohang, South Korea, Trondheim, Norway, Corvallis, OR. Interests: Cooking, knitting, eating, yoga, laughing, hiking, traveling, staying sane.

10 thoughts on “Bringing keto to kindergarten, part 2

  1. My daughter just started preschool and we had to look for something for her drinks as well (for a different reason). I found a container by Aladdin that works great. You flip the lid open, and until you flip it all the way back andand press, the part where the liquid comes out is covered and spill proof. Very easy to use, even for a hypotonic child who is four.
    http://www.productpilot.com/en/suppliers/pacific-market-international-llc-/product/mf_bata_0033408639/en

    • Thanks Laurie, I will look into them more. I found a Thermos one with a flip lid, but Nora was not a big fan. I wish they would make them smaller!

  2. Hi there – we will be initiating our daughter on the keto diet on October 21st. I work full-time at moment, and I am struggling with trying to figure out how I will be able to maintain focus on work (which has been difficult generally the last couple of years) and still provide her with what she needs. Any thoughts or advice on how to balance? We really need this paycheck and health insurance, so cutting back hours or changing jobs may not be ideal…

    • Hi Renee. I really hope the diet works for your daughter, because you can shift from constant crisis management (I assume, based on our experience) to a routine in the kitchen. It does take a while to get started and figure out what works, so expect it to be a hard balance for awhile but it will get easier. It’s much easier to do the diet than manage seizures, in my opinion.

      My first piece of advice is to find some all-in-one recipes that your daughter likes. We love the cheddar crackers from the Keto Cookbook. You can set aside an hour on the weekend and make a big batch of them, and then you always have something quick ready. We have gotten into the groove of doing the same thing for breakfast and snack for long stretches. I will make a batch of pumpkin cheesecake bars (also from ketocook.com) and give one every day for breakfast for a week or two. You don’t have to think about cooking in the morning. Once you have a few meal plans under your belt, you can get a routine down.

      We probably average 1 to 1.5 hours per day feeding Nora now. Most of it happens in the evening after she goes to bed, when we pack her snack and lunch to bring to school. I also try to have easy after school snacks available so that I don’t have to cook when I pick her up. I spend a little time making a dinner from whatever is in the fridge (remember to always buy heavy cream when you are at a grocery store!) Then it’s bedtime snack of berries and cream, and we do it all over again.

      I also work during the school year. I go in during the hours that the kids are at school and do any additional work from home on evenings and/or weekends when necessary. You can certainly fit it into your life, so be gentle with yourself as you are getting up to speed and know that it will get easier over time.

      Really take advantage of any resources that you have–if you have a dietician that can make meal plans, get them! I have recipes for ideas and ketocook.com is wonderful. Don’t feel like you have to make it up yourself. I didn’t know all of these resources existed when I started, but when I found them it was like having a whole community of help around me, all online and the Keto Cookbook. If there is a recipe that you find on a blog you can ask your dietician to enter it into the ketocalculator for you (I’m assuming you are using it). And nothing really has to be fancy. See our post on Nora’s Top 15 foods–it’s all pretty simple common stuff that is easy to combine into a kid-friendly keto meal.

      Best of luck. Please write again if you have more questions.
      Christy

  3. Thank you!! I’m looking forward to when we actually get started – the anticipation of so many changes is definitely stressful, but we are looking forward to improving her symptoms and conditions.

  4. Ok, sorry for all the questions – this is all very new to me!! My daughter is in a mainstream pre-school from about 9 – 5. It is a daycare/preschool program, as she is 3 1/2 and my husband and I both work. She has a SEIT through her IEP, but someone suggested I consider a 504 plan to have someon in the school help with dietary compliance. On one hand, wouldn’t it be wonderful to have an aid that helps make sure she only eats off her plate and never eats a stray Cheerios on the floor, but on the other, I was told if she needs THAT much help she should be in a “special” school and not mainstreamed. We are assured that once on the keto diet, she will respond favorably and not only should see a reduction in symptoms but overall improvement in ability to learn, engage, etc. Although dietary compliance is critical, I don’t think a special needs school is the right answer. She is already mainstreamed and if she will improve, that would seem to be a step in the wrong direction. I am very confused, and don’t know who to ask for help! Hope this isn’t taking up too much of your time to respond to! Many thanks, Renee

    • Hi Renee,

      I’m no expert on the education plans and everything, so I’m just going to speak from general parental principles here. I’m not sure which state you are in, but my first suggestion would be to get in touch with a special needs advocate if you can find one. I’ve heard from other friends that it is hard in our community to navigate all of this too, so you are not alone.

      I think you are right on. Every child should have the chance to be mainstreamed and she should be in a place that will give her the most opportunity. Sounds like she has enough delays now to require an SEIT and IEP, so the diet should be a very small extra step in that process. I have read that a 504 plan is basically overwritten by an IEP plan, because the IEP plan should be comprehensive enough to cover everything in a 504. But every state can be different, so you need to get answers from someone in your state. A good resource on bringing the keto diet to school with links to different state considerations is at ketocook.com: http://ketocook.com/2012/08/13/the-ketogenic-diet-at-school/

      But besides her legal right to stay in the school with needed support, you want to have a good relationship with the people providing her care from 9-5. Right now, Nora’s diet administration is informal through the people at the school because we don’t have a 504 plan made yet. They are working down the list and Nora is just not a high enough priority (although I should start pestering the nurse!) I know it is probably hard to communicate with them about it now because you have not started it yet, but presenting it as a real medical treatment that only requires their supervision is important. I brought in the newspaper article about Nora and have used the NYT magazine article, Epilepsy’s Big Fat Miracle (http://www.nytimes.com/2010/11/21/magazine/21Epilepsy-t.html?pagewanted=all). It’s easy to read and accurate, so the staff can “get it.” Get a letter from her doctor. And emphasize that it will help her overcome her symptoms and catch up! Hope!

      Just think of this: So many children have food issues, running from life-threatening nut allergies to diarrhea-causing dairy intolerances. Schools deal with this stuff all of the time on an informal basis. You will be packing all of her snacks and lunches for school, they just have to make sure that she eats only her food, and all of her food. If they are dealing with 3 year olds, I’m sure that they already provide plenty of practical help with every child, for every meal. Adding the diet should be easy in the big scheme of things, but it is unknown territory to them and to you, so it is hard to imagine how it will go and seems like a big responsibility. Try to explain and share resources as best you can, but stand your ground and keep asking for what she is entitled to. You are her only advocate.

      Good luck and keep us posted!
      Christy

  5. First off, thank you for your blog. My two year old son has Glut1 DS and has been on keto for 4 months. You have given me so great ideas and helpful tips…so thank you!

    I do have a question regarding the pumpkin bars. I made them a few weeks ago and they didn’t go over well. I didn’t even like the taste of them so I’m pretty sure I did something wrong. At that time he was at a 4:1 ratio and I used Stevia to sweeten (which I don’t think we are used to that unique flavor yet). He was recently switched to a 3.5:1 ratio so I think the bars will go over better. Do you have any suggestions on how you upped the fat for the 3.5:1 ratio and how you sweeten them? He goes to a therapy school and this would be a perfect all-in-one breakfast recipe! Thanks!

    Sara

    • Hi Sara,

      Glad you are finding this helpful! Nora goes through a love-hate relationship with the pumpkin bars. Mostly she loves them and she loves the smell of them cooking, but sometimes I rely on them too much and she gets tired of them.

      Here’s my recipe at 3.54:1. I have a hard time getting them out of the silicone cups, so she usually eats them with a spoon. I have not used stevia for it. I don’t like it either. I either use no sweetener, or I use 1 packet of her Cytra-K (sweetened with saccharine already). I have found that being generous with the cinnamon or vanilla goes a long way to make things delicious even with minimal sweetening.

      22 g raw egg, mixed well
      16 g ground macadamia nuts
      13 g coconut oil, melted
      40 g pumpkin puree (I cooked down a fresh pumpkin, pureed it and froze it in small batches instead of the canned kind)
      17 g cream cheese, room temp
      1 g mix of cinnamon, cloves, nutmeg, allspice (I am generous with the cinnamon!)

      Mix all very well until smooth (I don’t bother with the crust method). I use the paddle attachment in my mixer. Divide into 3 silicone baking cups, 36 g each. Bake at 300 for 15 minutes or so.

      Please check with your dietician or ketocalculator for your brand of cream cheese and to get your specific breakdowns. This is 110 calories per serving, so if he needs a bigger serving you could divide it into 2 servings of 167 calories each (54 g of batter in each). I quadruple the recipe and make 12 at a time, but this is the original way I wrote it out.

      • Thanks so much for the detailed response! I’ll give it a try again, adjusting it to fit his breakfast needs. I did do the separate crust, but will probably just mix it all together for sake of time.

        Again, I appreciate your blog so much! I feel like I’m able to do keto somewhat healthier because of your information.

        Sara

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