An update on Fasting for Children before surgery

Children and adults are fasted before procedures requiring sedation or general anaesthesia in the belief that this will reduce the incidence of regurgitation and possible aspiration of gastric contents into the lungs. The rationale behind this is that anaesthesia reduces protective cough reflexes, unlike natural sleep where these are maintained, making aspiration more likely. Aspiration may then cause significant morbidity associated with pneumonitis. (Mendelson 1946, Teabeaut 1952, Roberts and Shirley 1974)

Unfortunately there are many unanswered questions when it comes to these rationales and assumptions and there is a lot we do not know about fasting in healthy children.

This education video looks at what we do know and why we have formulated current recommendations.

Our discussion looks at aspiration in children, its incidence and outcomes, and fasting for solids and breast milk in babies.

The main focus, however, is on on clear liquid recommendations, as this is where most research has been directed. (Splinter and Schreiner 1999, Cochrane 2009, Andersson et al 2015)

This video aims to help Healthcare Professionals to have an improved understanding of:

1. Explain why we need to fast before procedures.
2. Describe the problems faced when fasting children.
3. List gastric emptying times for solids, milk and clear liquids.
4. Outline new Guidelines for Fasting.