Early versus delayed oral feeding for patients after cesarean

Background: Early oral feeding (EOF) after cesarean delivery is still controversial. Objectives: To assess whether EOF is superior to delayed oral feeding (DOF) after cesarean in terms of safety and effectiveness. Search strategy: PubMed, Embase, and the Cochrane Library were searched for reports related to early feeding and cesarean published in English before June 30, 2014. Selection criteria: Randomized controlled trials comparing at least one of six outcomes after EOF (<= 12 hours after surgery) and DOF (after return of bowel sounds/movement or >12 hours) after cesarean delivery were included. Data collection and analysis: Data were extracted using a predesigned extraction form. Risk ratios or mean differences were calculated. Main results: A total of 20 studies were included, including 4584 women who had undergone cesarean. No significant differences were identified in patient satisfaction and frequency of postoperative complications. Compared with DOF, EOF promoted a quicker return of bowel sounds, flatus, bowel movement, and regular diet (P < 0.001 for all). Significant reductions were also noted in duration and amount of intravenous fluids, length of hospital stay, and time to first breastfeeding (P < 0.001 for all). Conclusions: There are no obvious advantages in withholding fluid and food after cesarean. Indeed, EOF offers some short-term benefits. (C) 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.