Traditionally fluids and solid food are gradually introduced following uncomplicated cesarean delivery (CD), starting after 8 to 24 hours when bowel sounds are heard. The underlying view is that CD is a major abdominal operation and that early feeding might increase the risk of ileus and other gastrointestinal complications.
On the supposition that bowel function is basically preserved after uneventful CD, a prospective randomized study was carried out in 179 women having a first or repeated CD. Eighty-two of them were traditionally fed, receiving clear fluids only for 8 to 12 hours postoperatively until bowel sounds were heard. The other 97 women received clear fluids and solid food within 8 hours of surgery as requested. The 2 groups were well matched with respect to maternal age, gravidity, parity, ethnicity, gestational age, and birth weight. Most operations in both groups were elective and performed under general anesthesia. The frequency of previous operations and complexity of surgery (for instance, the need to lyse adhesions) also were similar in the 2 groups.
Few women had postoperative complications. No significant differences were noted between the 2 groups in the frequency of fever, ileus, or wound infection. Women fed early were significantly more satisfied than those fed in the traditional manner. On multivariable analysis, adjusting for previous operations, no association was evident between early feeding and the risk of postoperative complications. In this trial, women offered early feeding following CD were satisfied with this practice and were not more prone than those fed in the traditional way to develop gastrointestinal complications.