Effect of Early vs Delayed Oral Feeding Following Cesarean Delivery: A Randomized Controlled Trial

Background: Early oral feeding within 6 hours post-uncomplicated cesarean section is associated with early return of bowel sounds, less postoperative pain, quick postoperative recovery, and increased postoperative comfort.The objective of the study was to determine the safety and benefits following the early initiation of oral feeds in postoperative management following a cesarean section.Methods: This randomized controlled trial was conducted in the Department of Obstetrics and Gynecology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chengalpet, from December 2020 to March 2022.One hundred sixty-four patients were divided into the early oral feeding group (82) and the delayed oral feeding group (82).The groups were monitored for the onset of bowel sounds, the passage of the first flatus, bowel movement and postoperative day at which the patient was fit for discharge.Patient satisfaction in relation to thirst, hunger, postoperative oral food consumption, and postoperative care was assessed.Results: There was no significant difference in age, obstetric score, gestational age at delivery, previous mode of delivery, indication for cesarean section, and intraoperative presence of adhesions between the early feeding and delayed feeding groups.Time of passage of first flatus within 12 hours in 17.07% in the early feeding group was compared to 8.53% in the delayed feeding group (p = 0.0002).Majority of patients were fit for discharge within 72 hours in the early feeding group compared to delayed feeding group (75.6 vs 43.9%, p = 0.001).Postoperative satisfaction regarding thirst and hunger was significantly more in the early feeding group compared to the delayed feeding group (p = 0.021, 0.016, respectively).Conclusion: Early initiation of oral feeding after cesarean delivery is well tolerated, associated with rapid return of normal bowel function, shorter hospital stays, and improved patient satisfaction.