Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 16 , ISSUE S3 ( December, 2024 ) > List of Articles

RESEARCH ARTICLE

Effect of Early vs Delayed Oral Feeding Following Cesarean Delivery: A Randomized Controlled Trial

Dharani Saravanan, Karthiga Prabhu, Shanmugapriya Chandrasekaran, Prithiv Raj, Anuradha Murugesan

Keywords : Bowel function, Cesarean section, Oral feeding, Passage time, Patient satisfaction, Postoperative

Citation Information :

DOI: 10.5005/jp-journals-10006-2580

License: CC BY-NC 4.0

Published Online: 03-02-2025

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Background: Early oral feeding within 6 hours post-uncomplicated cesarean section is associated with early return of bowel sounds, less postoperative pain, quick postoperative recovery, and increased postoperative comfort. The objective of the study was to determine the safety and benefits following the early initiation of oral feeds in postoperative management following a cesarean section. Methods: This randomized controlled trial was conducted in the Department of Obstetrics and Gynecology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chengalpet, from December 2020 to March 2022. One hundred sixty-four patients were divided into the early oral feeding group (82) and the delayed oral feeding group (82). The groups were monitored for the onset of bowel sounds, the passage of the first flatus, bowel movement and postoperative day at which the patient was fit for discharge. Patient satisfaction in relation to thirst, hunger, postoperative oral food consumption, and postoperative care was assessed. Results: There was no significant difference in age, obstetric score, gestational age at delivery, previous mode of delivery, indication for cesarean section, and intraoperative presence of adhesions between the early feeding and delayed feeding groups. Time of passage of first flatus within 12 hours in 17.07% in the early feeding group was compared to 8.53% in the delayed feeding group (p = 0.0002). Majority of patients were fit for discharge within 72 hours in the early feeding group compared to delayed feeding group (75.6 vs 43.9%, p = 0.001). Postoperative satisfaction regarding thirst and hunger was significantly more in the early feeding group compared to the delayed feeding group (p = 0.021, 0.016, respectively). Conclusion: Early initiation of oral feeding after cesarean delivery is well tolerated, associated with rapid return of normal bowel function, shorter hospital stays, and improved patient satisfaction.


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  1. Sung S, Mikes BA, Martingano DJ, Mahdy H. Cesarean Delivery. 2024 Dec 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. PMID: 31536313.
  2. Malomo OO, Kuti O, Orji EO, et al. A randomized controlled study of non-closure of peritoneum at caesarean section in a Nigerian population. J Obstet Gynaecol 2006;26(5):429–432. DOI: 10.1080/01443610600720287.
  3. Ezechi OC, Kalu BKE, Njokanma FO, et al. Uterine incision closure at caesarean section: A randomised comparative study of intraperitoneal closure and closure after temporary exteriorisation. West Afr J Med 2005;24(1):41–43. DOI: 10.4314/wajm.v24i1.28161.
  4. Worthington LM, Mulcahy AJ, White S, et al. Attitudes to oral feeding following caesarean section. Anaesthesia 1999;54(3):292–296. DOI: 10.1046/j.1365–2044.1999.00740.x.
  5. Adupa D, Wandabwa J, Kiondo P. A randomized controlled trial of early initiation of oral feeding after caesarean delivery in Mulago Hospital. East Afr Med J 2003; 80(7):345–350. DOI: 10.4314/eamj.v80i7.8716.
  6. Malhotra N, Khanna S, Pasrija S, et al. Early oral hydration and its impact on bowel activity after elective caesarean section—our experience. Eur J Obstet Gynecol Reprod Biol 2005;120(1):53–56. DOI: 10.1016/j.ejogrb.2004.08.009.
  7. Burrows WR, Gingo AJ, Rose SM, et al. Safety and efficacy of early postoperative solid food consumption after caesarean section. J Reprod Med 1995;40(6):463–467. PMID: 7650662
  8. Kramer RL, Vansomeren JK, Qualls CR, et al. Postoperative management of caesarean section: The effect of immediate feeding on the incidence of ileus. Obstet Gynecol 1996;88(1):29–32. DOI: 10.1016/0029-7844(96)00131-7.
  9. Patolia DS, Hilliard RLM Jr, Toy EC, et al. Early feeding after caesarean section: Randomized controlled trial. Obstet Gynecol 2001;98(1): 113–116. DOI: 10.1016/s0029-7844(01)01387-4.
  10. Mawson AL, Bumrungphuet S, Manonai J. A randomized controlled trial comparing early versus late oral feeding after cesarean section under regional anaesthesia. Int J Womens Health 2019;11:519–525. DOI: 10.2147/IJWH.S222922.
  11. Saad AF, Saoud F, Diken ZM, et al. Early versus late feeding after cesarean delivery: A randomized controlled trial. American J Perinatol 2016;33(4):415–419. DOI: 10.1055/s-0035-1565918.
  12. Mehta S, Gupta S, Goel N. Postoperative oral feeding after cesarean section—early versus late initiation: A prospective randomized trial. J Gynecol Surg 2010;26(4):247–250. DOI: 10.1089/gyn.2009.0092.
  13. Short V, Herbert G, Perry R, et al. Chewing gum for postoperative recovery of gastrointestinal function. Cochrane Database Syst Rev 2015;2015(2):CD006506. DOI: 10.1002/14651858.CD006506.
  14. Teoh WH, Shah MK, Mah CL. A randomised controlled trial on beneficial effects of early feeding post-caesarean delivery under regional anaesthesia. Singapore Med J 2007;48(2):152–157.
  15. Soriano D, Dulitzki M, Keidar N, et al. Early oral feeding after cesarean delivery. Obstet Gynecol 1996;87(6):1006–1008. DOI: 10.1016/0029-7844 (96)00049-x.
  16. Ogbadua AO, Agida TE, Akaba GO, et al. Early versus delayed oral feeding after uncomplicated Cesarean section under spinal anesthesia: A randomized controlled trial. Niger J Surg 2018;24(1):6–11. DOI: 10.4103/njs.NJS_26_17.
  17. Mulayim B, Celik NY, Kaya S, et al. Early oral hydration after cesarean delivery performed under regional anesthesia. Int J Gynaecol Obstet 2008;101(3):273–276. DOI: 10.1016/j.ijgo.2007.11.023.
  18. Huang H, Wang H, He M. Early oral feeding compared with delayed oral feeding after cesarean section: A meta-analysis. J Matern Fetal Neonatal Med 2016;29(3):423–429. DOI: 10.3109/14767058.2014.1002765.
  19. Kim H, Jeon Y, Yoon S, et al. Effects of early oral feeding versus delayed oral feeding on bowel function, gastrointestinal complications and surgical recovery after cesarean section under regional anesthesia: Systematic review and meta-analysis. J Korean Acad Nurs 2021;51(6):732–745. DOI: 10.4040/jkan.21127.
  20. Barat S, Esmaeilzadeh S, Golsorkhtabaramiri M, et al. Women's satisfaction in early versus delayed post-caesarean feeding: A one-blind randomized controlled trial study. Caspian J Intern Med 2015;6(2):67–71. PMCID: PMC4478453.
  21. Saxena RK, Indrani C, Roshini P, et al. Early versus delayed initiation of oral feeds among mothers after caesarean delivery: A comparative study. J Clin of Diagn Res 2022;16(12):QC01–QC04. DOI:10.7860/JCDR/2022/59075.17193.
  22. Choudhari V, Patil Y, Thiyagarajan K, et al. To evaluate early feed vs late feed in post-lower-segment cesarean section patients at a tertiary care center: A randomized controlled study. J South Asian Feder Obst Gynae 2023;15(4):385–388. DOI:10.5005/jp-journals-10006-2265.
  23. Kanwal T, Homer A, Saghir A, et al. Comparison of early hospital outcome in early versus delayed (2 vs. 8 hours) oral feeding in females after cesarean section under regional anesthesia. Asian J Res Surg 2023;6(2):377–384. Available from: https://journalajrs.com/index.php/AJRS/article/view/183.
  24. Mba SG, Dim CC, Onah HE, et al. Effects of early oral feeding versus delayed feeding on gastrointestinal function of post-caesarean section women in a tertiary hospital in Enugu, Nigeria: A randomized controlled trial. Niger J Clin Pract 2019;22(7):943–949. DOI: 10.4103/njcp.njcp_353_16.
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