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Ketones: How long from stomach...

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OK, everyone, here's my latest query.

As Skyler's seizures are all nocturnal, awhile

back we began giving him a small (200 cal) tube feed at 3 AM. The idea was to

keep him in ketosis throughout the night as his seizures get decidedly worse

from around 4 AM on.

For the last week or so, the sudden increase seems to be occurring around

3:30.

Questions:

How long does it take for a ketotic meal entering the stomach to produce a

rise in blood ketones?

Would an earlier feed be more appropriate?

Would a higher calorie feed be worth investigating?

(Some of the literature on the MCT Oil diet, our version, shows a natural

circadian decline in ketone levels at 4 AM although not all patients have

seizures at that time, it is indeed our 'witching hour.' Anyway, that's why we

give the extra 'snack' in the night. The article mentions a bolus of MCT at

that time, but I've concocted a formula that is in keeping w/the rest of his

dietary ratios, fearful that a bolus of oil would give him immediately

diarrhea. Suppose it's worth trying, though....?)

Thanks, as always.

Tracey

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