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NPO – No food/drink before non-surgical procedures

 

Some tests and procedures require your child to be completely still. Sometimes this means giving medicine to help your child sleep. We call this medicine anesthesia or sedation. If your child is going to have anesthesia or sedation to help her sleep through a procedure, diagnostic imaging (DI) test, or radiation therapy, you need to understand the hospital’s NPO policy. NPO is short for the Latin words nil per os, which mean “nothing by mouth.” In this handout, we will tell you about NPO guidelines for non-surgical tests and procedures and give
you ideas to help your child cope with clear liquids and no food.

The NPO policy is important because patients who have full stomachs are at risk for getting food or liquid in their lungs during anesthesia or sedation. This could cause pneumonia or other serious health problems. Even chewing gum or sucking on hard candies can delay your child’s sedation. For your child’s safety, please follow the NPO guidelines.

Be sure to follow the correct set of guidelines for the type of sedation your child is receiving—IV sedation, general anesthesia, or sedation by mouth.

NPO guidelines for non-surgical tests or procedures when receiving IV sedation or general anesthesia

  • Up until 2 hours before the procedure: your child may have CT contrast and clear liquids. Examples of items your child can have include water, apple juice, Sprite®, Sierra Mist®, white grape juice, white cranberry juice, popsicles, Gatoraid®, Jello®, and Pedialyte®. NOTHING RED, PINK, BLUE, OR PURPLE. Note: Ensure Clear™ and products like this are not considered clear liquids.
  • Up until 4 hours before the procedure: your child may have breast milk.
  • Up until 6 hours before the procedure: your child may have infant formula.
  • Up until 8 hours before the procedure: your child may have solid food and any liquid (including non-clear drinks).

Exception: If your child is having a PET scan, she must stop drinking everything but water or sugar-free flavored water that contains contrast medium at least 4 hours before the PET scan.

More than likely, your child has important medicines taken regularly, such as steroids and those for pain, seizures, or blood pressure. You can give these medicines to your child with a sip of water at any time.

NPO guidelines for non-surgical tests or procedures when receiving sedation by mouth

  • If your child is getting sedation in the form of a pill or liquid by mouth, she will be able to have solid food up until 4 hours before the procedure. Your child will be able to have clear liquids and CT contrast until 2 hours before the procedure. Examples of items your child can have include water, apple juice, Sprite®, Sierra Mist®, white grape juice, white cranberry juice, popsicles, Gatoraid®, Jello®, and Pedialyte®. No Ensure Clear™ or similar products. NOTHING RED, PINK, BLUE, OR PURPLE

Helpful hints for NPO when having non-surgical tests or procedures

To help your child cope with waiting, family members should not eat or drink around the child during the NPO period.

Many parents keep their children NPO after midnight even when the kids do not have procedures until late the following day. If your child has sedated procedures for several days in a row, this could cause nutrition problems, weight loss, or dehydration (not enough fluid in the body).

Try these ideas to keep your child satisfied

  • Set your alarm clock for early morning or the middle of the night. Then, feed your child a snack or full meal at that time.
  • You might try a late night pizza party. Keep in mind that the snack or meal must be finished before the NPO guidelines say that your child should stop eating solid foods.
  • Unless your child is having a PET scan, offer unlimited amounts of clear liquids (nothing red or purple) until 2 hours before the test or procedure. Encourage these clear liquids right up until the 2-hour mark. This can help keep a younger child from becoming dehydrated. Parents often limit sweet drinks because of sugar content. When you are trying to help your child cope with NPO rules, it is more important for her to feel full and have enough fluid, even though the sweet drinks lack nutrition.

Remember: Any patient having a PET scan, must stop drinking everything but water or sugar-free flavored water that contains contrast medium at least 4 hours before the scan.

What else should I know?

The staff schedules these tests and procedures with the patients’ best interests in mind. They consider these factors in making scheduling choices:

  • The child’s age,
  • Whether the child has diabetes, and
  • Whether the child has other sedated procedures planned for the same day.

We know it is hard to keep children from eating when they are hungry. However, your child’s safety depends on you following the NPO guidelines.

Questions?

If you have questions or want to learn more about NPO guidelines, please talk to your child’s doctor or nurse.


 

This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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