Early feeding after cesarean: Randomized trial

OBJECTIVE: To study the rate of ileus symptoms and hospital course of women who are offered solid food shortly after cesarean delivery. METHODS: This study involved women delivered by cesarean under regional ane sthesia, Exclusion criteria included general anesthesia, magnesium sulfate, intra-operative bowel injury or bowel surgery, or other conditions that pr ecluded early feeding. Early-fed women were offered regular diets within 8 hours of surgery, and controls were given nothing by mouth for 12-24 hours, advanced to clear liquids on the first postoperative day, and then given s olid food on the second or third postoperative day. RESULTS: Sixty women were assigned randomly to each method, Early-fed women received solid food sooner after surgery, 5.0 +/- 1.2 hours versus 40.0 +/ - 10.6 hours. The incidences of mild ileus symptoms and postoperative compl ications were similar in both groups; however, the study did not have an ad equate sample size to definitively assess safety concerns, Women in the ear ly-fed group had shorter hospital stays (49.5 +/- 12.7 hours versus 75.0 +/ - 12.3 hours, P < .001), and shorter time intervals from surgery to bowel m ovement, 34.5 hours (interquartile range 25.3-48.8) versus 51.0 (43.3-62.0) hours, P < .001. In the early-fed group, women whose operative times excee ded 40 minutes were more likely to have symptoms of mild ileus, CONCLUSION: Early initiation of solid food after cesarean delivery appears to be well tolerated and may be associated with a shorter hospital stay, Ea rly-fed women whose operations exceed 40 minutes may be more likely to have mild ileus symptoms. (C) 2001 by the American College of Obstetricians and Gynecologists.