SAFETY AND EFFICACY OF EARLY POSTOPERATIVE SOLID FOOD-CONSUMPTION AFTER CESAREAN-SECTION

Traditionally patients have received a physician-dictated regimen of g radual expansion of their diets following cesarean section. This has b een based upon concern about the possibility of ileus from expanding t he diet too rapidly. Given the economic necessity of earlier postopera tive discharge following abdominal delivery, many patients have solid food reintroduced in their diets around the time they leave the hospit al. This prospective, randomized, controlled study compared a traditio nal, gradual dietary expansion scheme with patient-determined reintrod uction of solid food, which was offered within eight hours of surgery. The hypotheses were that women would eat more rapidly after cesarean section when given the opportunity and that early solid food consumpti on would reduce the need for analgesia. The results indicated that bot h hypotheses were correct. Given the opportunity, women will eat solid food very soon after cesarean section (mean +/- SD 10.2 +/- 5.2 hours from surgery to onset of solid food consumption) as compared to women on a traditional dietary expansion regimen (mean +/- SD 41.5 +/- 16.0 hours, P < .001). Women offered food within hours of cesarean section required less patient-requested injectable narcotic postoperatively t han did women on gradual dietary expansion (median, 75 mg versus 225 m g meperidine, P < .05). There was no evidence of compromise of safety or comfort from introducing solid food early and allowing the patient to decide when to eat postoperatively. The conclusion from these data is that early postoperative feeding after cesarean section is a safe a nd effective alternative for most women, who now face early hospital d ischarge.