Perioperative Care Newborns/Infants — NPO Guidelines — Clinical Pathway: ICU and Inpatient

Newborn/Infant Perioperative Care Clinical Pathway — N/IICU

NPO Guidelines

  • Timing of NPO applies to all feedings regardless of route (i.e. gastric, post-pyloric)
  • Follow IVF recommendations at time of NPO
  • Discuss enteral medication volume/timing with patient's nurse and attending physician to determine if conversion to IV medication(s) is required
  • When NPO for OR, patients should not do non-nutritive sucking at the breast or have mouth care with swabstick
  • Oral sucrose may be used for IV start up to 1 hr prior to OR

For Patients Who Are Already NPO

  • Keep NPO
  • May continue TPN/lipids until 1 hour prior to surgery
  • Then follow IVF recommendations

For Patients Who Are Feeding

Age Formula or Breast Milk NPO Time*
Any infant Oral Electrolyte Replacement Solution (e.g. Pedialyte, Enfalyte) 0600
Unfortified breast milk 0400
< 6 months Unfortified formula (≤ 20 kcal/oz) 0300
6 - 12 months Unfortified formula (≤ 20 kcal/oz) 0100
Any infant Fortified breast milk or formula
(> 20 kcal/oz or any additives)		 NPO at 2300 the night prior to surgery

*For ALL surgery cases (both scheduled and add-on) make the patient NPO as if 1st case (0700). All feeds must be COMPLETED prior to NPO time.

Bowel Preparation

Discuss need for bowel preparation with attending surgeon 24-48 hours prior to surgery.
Some cases require NPO 24 hours prior to procedure.