During general anaesthetic, in adults and children alike, the protective reflexes that prevent lung aspiration of stomach contents are inhibited. Preoperative fasting is thought to reduce the risk of regurgitation and gastric aspiration during surgery. Several professional body guidelines have recommended a more relaxed fasting period than the traditional ‘nil by mouth from the midnight before surgery’ policy. However, practices vary widely due to a lack of confidence in the evidence. The aim of this Cochrane Review was to determine the effects of different fasting regimens (duration, type and volume of permitted intake) and the impact on perioperative complications and patient well being (aspiration, regurgitation, related morbidity, thirst, hunger, pain, comfort, behaviour, nausea and vomiting) in children. The search for this review was updated in 2009