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Modern fasting guidelines in children

Scott D Cook-Sather1, Ronald S Litman

  • 1The Department of Anesthesiology and Critical Care Medicine, The University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd, Philadelphia, PA 19104-4399, USA. sather@email.chop.edu

Best Practice & Research. Clinical Anaesthesiology
|November 4, 2006
PubMed

Insights

Updated pediatric fasting guidelines allow clear liquids up to 2 hours before anesthesia, improving patient safety and perioperative experience. Shorter fasting times for breast milk, formula, and light meals are now well-established for healthy children.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Perioperative Medicine

Background:

  • Pediatric fasting guidelines aim to prevent pulmonary aspiration and ensure safe anesthesia.
  • Recent guideline revisions prioritize patient safety and enhance the perioperative experience for children and parents.
  • Established practice for nearly 15 years supports current guidelines.

Purpose of the Study:

  • To review the established safety and benefits of current pediatric fasting guidelines.
  • To highlight the evidence supporting shortened fasting intervals for various food types in children.
  • To identify areas where further research is needed regarding fasting in pediatric patients with gastrointestinal disorders.

Main Methods:

  • Review of accumulated clinical experience and existing literature on pediatric fasting.
  • Analysis of evidence regarding gastric fluid volumes (GFVs) at the time of surgery.
  • Assessment of the impact of updated guidelines on patient safety and perioperative experience.

Main Results:

  • Allowing clear liquids up to 2 hours prior to anesthesia is safe and beneficial for healthy children.
  • Shortened fasting periods of 3 hours for breast milk, 4 hours for formula, and 6 hours for light meals are supported by evidence.
  • Evidence indicates minimal gastric fluid volumes (GFVs) with current fasting protocols.

Conclusions:

  • Current pediatric fasting guidelines, including shortened intervals, are safe and effective for healthy children.
  • The updated guidelines contribute to an improved perioperative experience for pediatric patients and their families.
  • Further research is required to determine optimal fasting intervals for children with gastrointestinal transit disorders.

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