700 Children's® – A Blog by Pediatric Experts

NPO: What Can Kids Eat and Drink Before Surgery?

Aug 21, 2024
Image of a girl drinking water

No matter what the surgery is for, there are risks with your child going under general anesthesia. If a child vomits and food content goes into their lungs (aspiration) while going to sleep or waking up during anesthesia, they can get pneumonia – or worse. For a scheduled, elective procedure, no one wants to increase the risk for your child. Most of the time nothing happens, but it’s important to be attentive when it comes to eating and drinking instructions. 

Here we will answer frequently asked questions by parents before their child has a medical procedure requiring general anesthesia.

Why Can’t My Child Eat Eight Hours Before Their Procedure?

It can be tempting, if your child is cranky and irritable, to just feed them a little piece of candy or fruit right before their procedure. Nobody will know, right? This is just something doctors and nurses recommend, but it doesn’t truly cause issues.

False. If stomach contents go into your child’s lungs, it is a serious problem. 

If your child cannot tolerate not eating for eight hours or drinking for two hours, let your child’s nurse know when scheduling so that the time for the operation can possibly be moved. 

A Liquid Is a Liquid. Why Does It Matter What They Drink?

Milk is very different from apple juice and water. It is made up of proteins, fats and carbohydrates and is more complex. It takes longer for the body to break down. Apple juice is mainly water and carbohydrates, which are easier for the body to digest. Orange juice has pulp, putting it in the same category as food. It is important to follow the rules of what to drink and when. If you are not sure, please call the hospital and find out if it is safe for your child to drink before their surgery. 

Does a Little Apple Sauce or Ice Cream to Take Their Medicines Count as Food?

Yes, it does. Please let the nurse know if your child takes medications with apple sauce or ice cream. The hospital staff may try to see if your child can take medicine with an apple juice slushy or administer it through an intravenous line while your child is asleep.

What About Formula or Breast Milk with Thickener or Rice Cereal?

A thickener or rice cereal is generally added to formula or breast milk due to reflux or other problems keeping formula down. Please let the nurse know if your child is on this supplement. You will not be able feed your child for longer times due to this supplement.

Would We Really Need to Delay or Reschedule the Surgery If My Child Eats or Drinks After the Time We Are Told?

The safety of your child is most important. It may be inconvenient to delay the procedure, but it is only due to safety concerns and making sure everything goes well during their procedure.

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Nationwide Children's Hospital Medical Professional
Giorgio C. Veneziano, MD
Comprehensive Pain Services

Giorgio Veneziano, MD, FAAP, is the medical director of the Comprehensive Pain Services at Nationwide Children’s Hospital and Associate Professor of Clinical Anesthesiology and Pain Medicine at The Ohio State University College of Medicine.

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700 Children’s® features the most current pediatric health care information and research from our pediatric experts – physicians and specialists who have seen it all. Many of them are parents and bring a special understanding to what our patients and families experience. If you have a child – or care for a child – 700 Children’s was created especially for you.