Nothing by mouth NPO instructions (1018)

Key points below


For your child’s safety, it is very important that these instructions are followed the night before and the day of a procedure or surgery.

The procedure or surgery may be cancelled if instructions are not followed.

Your procedure is scheduled for ____________________(date) ______________(time)

 

Your child’s instructions for getting liquids and food are based on when they will get to the hospital which is ____________________(time)

Last usual or full meal _____________________(time)

No milk, formula or breast milk with additives after _____________________ (time)

No breast milk after _____________________(time)

No clear liquids after _____________________ (time)

The times may need to be changed if unexpected schedule changes are needed.

**Please fill in the blanks after times are provided to you by the Pre-op Call Nurse.

Type of liquid or food allowed / Definition

Usual / full meal: Any food and all juices are fine.

Formula / milk:  Cow’s milk, soy milk, infant or adult formulas; expressed breast milk with additives.

Breast milk: Breast milk, without additives.

Clear liquids: Enfalyte® / Pedialyte, apple juice, white grape juice, Jell-O, popsicles, only apple juice or white grape juice, water. No red or purple liquids

These instructions are based on the following NPO guidelines.

Type of Feeding | Number of hours to stop before hospital arrival

Usual, full meal (by mouth): 8 hours

Formula, Milk or breast milk with additives (by mouth or NG/G-tube):  6 hours

Breast Milk (by mouth or NG/G-tube): 4 hours

Clear Liquids (by mouth or NG/G-tube): 2 hours

Any J-tube Feeds: 2 hours

Special Information

For more information

https://kidshealth.org/ChildrensWi/en/parents

ALERT

Call your child’s doctor, nurse or clinic if you or your child have any concerns or your child has special health care needs not covered by this information.