Abstract
Paediatric 1-h clear liquid fasting is now supported by multiple international guidelines. A systematic review together with EUROFAST strengthen the evidence for its safety. Despite this, clinical practice is still lagging, with inconsistent encouragement of clear liquids and unclear communication during delays. We highlight this evidence-practice gap to emphasise the need for simple systems and quality improvement measures that ensure 1-h fasting becomes routine for children undergoing anaesthesia.