General Topics: NPO Guidelines


This subject has recently undergone dramatic change. The ASA guidelines are followed by the Department of Anesthesia and can be read below.

To summarize, we strongly request that NPO times for liquids be kept as short as possible. In almost all cases, 3 hours after CLEAR Liquids exceeds our needs. Clear liquids can be given up to 3 hours before the surgery. We appeal that you help us move away from unnecessarily long periods of liquid starvation. This applies to both adults and children.

Fasting from solid food will remain unchanged at 6-8 hours. Oral medications may be taken with a sip of water almost up to the time of surgery.

As a simple and easy way to remember, generally - No solids or milk after midnight, then please encourage clear fluids until 3 hour before surgery.

Caution: Milk is not a clear liquid. It is treated as a solid food and needs to be withheld for 6 hours. Your patients can have black coffee in the morning 3 hours before surgery. DO NOT ADD MILK.

The same applies to children, milk or formula is not a clear liquid and needs to be treated as a solid -hold for 6 hours.

Breast Milk: Human breast milk is handled differently to cows milk. Breast milk may be given 4 hours before surgery. Cows milk remains at 6 hours before surgery.

(Recapping: A breast fed child can be breast fed up till 4 hours before surgery and then can take clear liquids up to 3 hours before surgery.)

Formula feedings are NOT human milk and is handled in the same way as cow milk. Formula feedings must be held for 6 hours before surgery.

View the official complete NPO policy of the Department of Anesthesia, Stony Brook University Medicine