The issue of stopping intake of food or anything before anaesthesia and sedation is that the drugs may depress the gag reflex, and some of them also increase the risk of vomiting. Thus, if the child vomits while sedate, s/he may aspirate. That is the problem. There are various opinions about how long before a child may take fluids or other things before anaesthesia. Certainly 4 hours for breastfeeding before is very conservative. Afterwards, as soon as the child is away and interested. Jack Newman, MD, FRCPC