A randomised controlled trial of early initiation of oral feeding after cesarean section.

OBJECTIVE: To evaluate the safety and efficacy of early oral feeding after cesarean delivery.

METHODS: Two hundred women who had cesarean section were randomly assigned to early feeding or routine feeding. Women in the early feeding group were encouraged to take sips of water 8 h post-operatively, followed by oral tea of 100 mL at the time of supervision. Women in the routine feeding group were managed by restricting oral intake for the first 24 h and administration of sips of water 24-48 h post-operatively. The outcome measures include the rate of ileus symptoms, post-operative time interval to presence of bowel sounds, passage of flatus and bowel movement, time interval to return to regular diet, length of hospital stay, post-operative complications, acceptability and benefit of early oral feeding.

RESULTS: The early feeding group had a shorter mean post-operative time interval to bowel sounds 18.90 +/- 4.17 h versus 36.21 +/- 3.52 h (p < 0.001), passage of flatus 44.81 +/- 3.73 h versus 60.58 +/- 4.40 h (p < 0.001) and bowel movement 58.30 +/- 5.91 h versus 72.76 +/- 4.25 h (p < 0.001). There was no significant difference in paralytic ileus symptoms. Early feeding group had a shorter mean hospital stay 4.80 +/- 0.59 days versus 6.69 +/- 0.71 days (p = 0.001). Early feeding group required less intravenous fluid 7.14 +/- 1.34 bottles versus 11.8 +/- 1.32 bottles (p < 0.001).

CONCLUSIONS: Early feeding after cesarean section was well tolerated and safe and can be implemented without an increase in adverse outcome.