Neonatal food withdrawal before surgery should occur after how long of fasting?

• A. 1 hour
• B. 6 hours
• C. 3 hours
• D. 12 hours

Answer: (C)

Neonates are at high risk from both aspiration and metabolic instability, so preoperative fasting must balance these factors. They have very limited energy reserves and a high metabolic rate, meaning prolonged fasting can quickly lead to hypoglycemia, dehydration, and instability under anesthesia. A short fasting window helps reduce the volume of gastric contents enough to lower aspiration risk, but isn’t long enough to push glucose depletion or fluid loss to dangerous levels. About three hours provides this compromise: long enough for gastric contents to clear to a safer level, but short enough to protect against hypoglycemia. Longer fasts (several hours more) increase the risk of hypoglycemia in neonates, while very short fasts may not sufficiently reduce aspiration risk.