Abstract
Objective This study aims to evaluate whether early feeding after cesarean delivery (CD) shortens
the time to pass flatus and bowel movement.
Methods Women at term undergoing CD were randomly assigned to start oral intake either within
6 hours (early feeding) or after 12 hours (late feeding) from surgery completion.
Women with preeclampsia, or requiring emergent CD, additional bowel surgery, or the
use of general anesthesia were excluded. Our primary outcome was time of passing first
flatus following surgery completion. Secondary outcomes included time of first bowel
sounds, time of first bowel movement, nausea/vomiting, and length of maternal hospital
stay (clinicaltrials.gov identifier NCT02396485).
Results A total of 177 women were randomized to early (n = 85) or late feeding (n = 82). There was no loss to follow-up, and outcomes were available for all patients.
There were no differences in baseline characteristics between the two groups. Early
feeding resulted in shorter time to pass flatus (median [interquartile range], 715
[485–1,208] minutes vs. 1,300 [820–1,760] minutes; p < 0.001) and to have bowel sounds (232 [168–537.8] minutes vs. 554.5 [202–706] minutes;
p = 0.001). Time to pass bowel movement was shorter in the early-feeding group, but
did not reach significance. The groups did not differ in length of stay or in rates
of nausea, vomiting, or ileus.
Conclusion In women undergoing CD, early oral intake is well tolerated and results in earlier
return of bowel function.
Keywords
cesarean - feeding - pregnancy - postpartum
