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Feed the Baby – Do We Need 6 Hours of NPO for Neonates?

July 15, 2021

Written by Clay Smith

Spoon Feed
There is no need for 6 hours of pre-procedural NPO time when healthy term newborns are fed formula. At most, 2.5 hours would be enough.

Why does this matter?
The ASA calls for 6 hours of fasting in neonates who have drunk formula. Fasting in a neonate is no small deal. Hypoglycemia is a risk as is hearing loss for the parent (i.e. they cry a lot!). Seriously, if we could reduce the time of pre-procedural fasting prior to sedating neonates, this would be good for everyone.

Feed the baby
This was a prospective analysis of 46 healthy term newborns with ultrasound of the gastric antrum every 15 minutes after formula feeding. They found that the average time to gastric emptying was 92.9 minutes, with a range of 45-150 minutes. What this tells us is that 6 hours of fasting is unnecessary in healthy term neonates.

Ultrasound Evaluation of Gastric Emptying Time in Healthy Term Neonates after Formula Feeding. Anesthesiology. 2021 Jun 1;134(6):845-851. doi: 10.1097/ALN.0000000000003773.

What are your thoughts?