Oral fluids and food after caesarean section: early versus delayed initiation

The review aims to evaluate the benefits and harms of a policy of early versus delayed initiation of oral fluids and food after caesarean section operation. The definitions of 'early' and 'late' varied in different trials. Although, 6 trials were included in the review, most of the findings of the review are based on the results from one or two trials. Early initiation of feeding was associated with: reduced time to return of bowel sounds (one study, 118 women, -4.30 hours, 95% confidence interval (CI): -6.78– -1.82 hours); reduced postoperative hospital stay (2 studies, 220 women relative risk (RR): -0.75 days, 95% CI: -1.37– -0.12 days); and with suggestion of reduced abdominal distention (3 studies, 369 women, RR: 0.78, 95% CI: 0.55–1.11). The reviewers concluded that there was no evidence to justify a policy of restricting oral fluids or food after uncomplicated caesarean section and recommended further well-designed trials.

The evidence base to guide decision-making is weak due to variations in definitions of the interventions, small sizes of the trials and the possibility of performance bias (1) in some of the trials. Except for the type of analgesia other planned subgroup analyses could not be conducted due to lack of data.

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