Modern fasting guidelines in children

Pediatric fasting guidelines are intended to reduce the risk of pulmonary aspiration of gastric contents and facilitate the safe and efficient conduct of anesthesia. Recent changes in these guidelines, while assuring appropriate levels of patient safety, have been directed at improving the overall perioperative experience for infants, children, and their parents. Now after nearly 15 years of practice worldwide, the relative safety and benefits of allowing clear liquids up to 2hr prior to anesthesia for otherwise healthy children are well established. Shortened fasting periods for breast milk (3hr), formula (4hr) and light meals (6hr) are supported by accumulated experience and an evolving literature that includes evidence of minimal gastric fluid volumes (GFVs) at the time of surgery. Ideal fasting intervals for children with disorders that may affect gastrointestinal transit have yet to be determined.

Key words: anesthesia, pediatric, aspiration pneumonitis, pneumonia, children, fasting, gastric fluid volume, infants