NPO Guidelines for Elective Surgery/Procedures/Sedations

Clear Liquids

  • stop 2 hours before surgery/procedure/sedation

Breast Milk

  • stop 4 hours before surgery/procedure/sedation

Formula and Fortified Breast Milk (Children over the age of 12 months must stop formula at midnight before surgery/procedure)

  • stop 6 hours before surgery/procedure/sedation

Solid food (including: candy, gum, non-human milk (cow/soy/etc), thickened formulas including commercial ones such as AR, (which is added rice).

  • stop at midnight the day before surgery/procedure/sedation

G-tube formula feeding should be stopped after midnight except for children under 1 year of age who may continue g-tube formula up to 6 hours prior to the time of surgery/procedure/sedation.

Clear liquids include: water, apple juice, Pedialyte. No carbonated beverages should be consumed after midnight.

For emergency surgery/procedures appropriate NPO status may be determined by the attending anesthesiologist or emergency medicine physician in consideration of patient acuity and urgency of surgery/procedure.

Reference
Anesthesiology:
March 1999 - Volume 90 - Issue 3 - pp 896-905
Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures
A Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting
www.asahq.org/publicationsAndServices/NPO.pdf