Early oral feeding compared with delayed oral feeding after cesarean section: a meta-analysis

Aim: The potential benefits and safety of early oral feeding (EOF) after cesarean section have not been well evaluated. We undertook a meta-analysis to assess postoperative bowel function and complications following EOF compared with delayed oral feeding (DOF) in women who had undergone cesarean section.

Methods: PubMed, EMBASE, and CENTRAL were searched to identify English language randomized clinical trials comparing EOF with DOF after cesarean section. The primary outcomes of interest were bowel motility and postoperative complications. The random-effect model was used to calculate pooled weighted mean differences (WMDs) and relative risks (RRs), with 95% confidence intervals (CIs).

Results: Eleven studies involving 1800 patients were included. The pooled results showed that EOF was significantly associated with the shorter time to return of bowel motility compared with DOF (-7.3 h for passage of flatus; -6.27 h for bowel movement; -8.75 h for bowel sounds). EOF was not related to increases in nausea (RR, 0.95; 95% CI, 0.69-1.33), abdominal distension (RR, 0.68; 95% CI, 0.43-1.07), diarrhea (RR, 0.63; 95% CI, 0.28-1.41), mild ileus symptoms (RR, 0.82; 95% CI, 0.53-1.25) and vomiting (RR, 0.91; 95% CI, 0.53-1.56).

Conclusions: This meta-analysis provides evidence that EOF after cesarean section enhances the return of bowel function and does not increase the risk of postoperative complications.