This is an absurdly long time to have to force a child to fast. It is also cruel to both mother and child. In places where anaesthetists are experienced with children, the length of fasting before general anaesthesia is 3 hours (Boston Children's, Philadelphia Children's, I wish I could say Sick Children's Hospital in Toronto, but I can't, though even in that haven of "only we know how to do things" the length of fasting is 6 hours). With six hours, it is possible, with scheduling the surgery for the afternoon, to manage. It is much easier to distract a child for six hours during the morning than all night. Here are a couple of articles which support short fasting times. Litman RS, Wu CL, Quinlivan JK. Gastric volume and pH in infants fed clear liquid and breastmilk prior to surgery. Anesth Analg 1994;79:482-5 The following is a comment on the study: Nicolson SC, Schreiner MS. Feed the babies. Anesth Analg 1994;79-407-9 If the dentist cannot manage a short fasting time, the mother would be well advised to find someone else who can. Jack Newman, MD, FRCPC