It is common practice to withhold food for 24 hours after cesarean section in order to prevent gastrointestinal complications, but evidence is accumulating that early feeding is equally safe, that bowel sounds return sooner, and that the hospital stay is shorter when patients receive a regular oral diet. This study compared the effects of early versus delayed feeding in a randomized, controlled trial of 200 healthy pregnant women. All had uncomplicated singleton pregnancies and underwent a planned or intrapartum cesarean section. Just over half the subjects (n = 103) formed a “delayed feeding” group, starting oral fluids 4 hours after surgery and restarting a regular diet at 24 hours. The remaining 97 women, the “early feeding” group, were offered a regular diet within 8 hours after surgery. Patient satisfaction was measured before discharge using a visual analog scale.
Satisfaction scores were slightly and insignificantly higher in the early feeding group, and pain scores were significantly lower. When undergoing planned surgery, patients fed early had higher satisfaction scores, but there was no difference in pain. In women undergoing intrapartum cesarean section, there was no group difference in satisfaction but women fed early had significantly less pain. Analgesic intake was comparable in the 2 groups, as was the mean hospital stay. No patients in either group had major postoperative complications before being discharged. Intention-to-treat analysis disclosed a small but statistically significant difference in satisfaction that favored early feeding, but this effect was not interpreted as being clinically relevant.
The investigators believe that present evidence supports the practice of implementing feeding shortly after cesarean delivery.