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• Posted October 14, 2025

Infants, Kids Going Without Liquids Far Longer Than Necessary Before Surgery

Most kids go without clear liquids at least three times longer than guidelines recommend prior to surgery, a new study says.

About 4 out of 5 children and infants (79%) are on liquid fasts far longer than necessary, risking dehydration and anxiety, researchers reported Sunday at the American Society of Anesthesiologists’ annual meeting in San Antonio, Texas.

Guidelines recommend children not drink anything within two hours of a procedure, to reduce the risk of liquid entering the lungs and causing choking or pneumonia, researchers said.

But on average, kids are fasting from liquids hours longer than that, researchers found.

“Prolonged fasting from clear liquids of four hours or longer can be uncomfortable and increase thirst, anxiety, pain, nausea and vomiting,” said senior researcher Dr. Alexander Nagrebetsky, an anesthesiologist and intensivist at Massachusetts General Hospital in Boston.

“It can be harmful too,” Nagrebetsky added in a news release. “Children and infants are especially vulnerable to dehydration and calorie loss, which may heighten stress and slow recovery from surgery.”

For the study, researchers reviewed records from nearly 72,000 children 17 or younger who had elective surgery at one of 12 U.S. hospitals between 2016 and 2024. About 3,800 of the children were younger than age 1.

Results showed that the median length of time all the kids fasted from clear liquids decreased from about 11 hours in 2016 to just under nine hours in 2024 — far longer than the recommendation of two hours. (Median means half had longer fasts, half had shorter ones.)

But there was no significant improvement in infants, who fasted around 6.5 hours in both 2016 and 2024.

In 2024 alone, the median duration of clear liquid fasting was three times longer than the recommendation in infants and four times longer in all children.

Researchers couldn’t tell why this is happening, but they think people might be following outdated practices — the old standby of “nothing to eat or drink after midnight.”

People also might not know that current anesthesiology guidelines note that “efforts should be made to allow clear liquids in healthy children as close to two hours before the procedure as possible,” researchers said.

These clear liquids can include water, Gatorade, apple juice, Jell-O or broth – essentially, any liquids you can see clearly through.

“Drinking sugar-containing clear liquids such as juices or those with electrolytes provides water and calories that children’s bodies need for normal functioning, including dealing with the stress of surgery and recovery,” lead researcher Ethan Lowder, a student at Harvard Medical School, said in a news release.

Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

More information

Children’s National Hospital has more on preparing a child for surgery.

SOURCE: American Society of Anesthesiologists, news release, Oct. 12, 2025