Early versus Late Oral Feeding on the Recovery of Normal Bowel Functions After Caesarean Section: A Randomized Controlled Study Date submitted: August 31, 2019; Accepted: Oct 13, 2019; Published online: Nov 15, 2019


Mohammed Othman


Background. To compare early oral feeding (EF) versus late oral feeding (LF) on the return of normal bowel functions in spinally anesthetized women after having lower segment Caesarean section (LSCS). Secondary outcomes such as maternal satisfaction and gastrointestinal complications were also evaluated. Methods. Three-hundred and sixty-two singleton pregnant women undergoing elective LSCS with spinal anesthesia were assigned to receive either EF (n= 183) or LF (n= 179) after surgery. Participants began to take normal diet between immediately and 6 hours, or began sipping water after 12 hours and soft diet after 24 hours then normal diet after 48 hours of surgery. Results. The ages of participants ranged from 19 to 47, with a mean age of 35±12 years. There was no-loss follow up and no significant difference in patient characteristics. Participants given EF were more likely to experience bowel sound the next morning after surgery than patients given LF (EF 93% vs. LF 71%, P<0.05). However, there was no difference in time to passing flatus and time to passing stool. Maternal satisfaction, rated on a 5-point scale was significantly higher in the EF group. However, there was no significant difference in gastrointestinal complications between both groups.
Conclusion. The findings of this trial support the recommendation of EF for women who undergo uncomplicated LSCS under spinal anesthesia.


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Early oral feeding, Late oral feeding, Caesarean section, Spinal anesthesia, Bowel function

How to Cite
Othman, M. (2019). Early versus Late Oral Feeding on the Recovery of Normal Bowel Functions After Caesarean Section: A Randomized Controlled Study: Date submitted: August 31, 2019; Accepted: Oct 13, 2019; Published online: Nov 15, 2019. Advances in Medicine and Medical Research, 2(1), 21-25. https://doi.org/10.31377/ammr.v2i1.626
Original Articles


Betrán A, Merialdi M, Lauer J, Bing-Shun W, Thomas J, Van Look P et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediat Perinat Epidemiol. 2007;21(2):98-113..

Gehling M, Tryba M. Risks and side-effects of intrathecal morphine combined with spinal anaesthesia: a meta-analysis. Anaesthesia. 2009;64(6):643-651.

Hindle A. Intrathecal opioids in the management of acute postoperative pain. Cont Edu Anaesth Critical Care & Pain.2008;8(3):81-85.

Renuka P. A Comparative study of maternal and foetal outcomes in patients undergoing elective or emergency Caesarean section. J Med Sci Clin Res. 2016;04(12):15059-15069.

Rollins M, Lucero J. Overview of anesthetic considerations for Caesarean delivery. Br Med Bull. 2012; 101:105-25.

Masood SN, Masood Y, Naim U, Masood M. A randomized comparative trial of early initiation of oral maternal feeding versus conventional oral feeding after Caesarean delivery. Int J Gynecol Obst. 2014; 126:115-9.

Bauer A, Boeckxstaens G. Mechanisms of postoperative ileus. J Neurogastroenterol Mot. 2004; 16:54-60.

Miedema B, Johnson J. Methods for decreasing postoperative gut dysmotility. Lancet Oncol. 2003;4(6):365-372.

Chapman S, Thorpe G, Vallance A, Harji D, Lee M, Fearnhead N. Systematic review of definitions and outcome measures for return of bowel function after gastrointestinal surgery. BJS Open. 2018;3(1):1-10.

Chinachoti T, Nilrat P, Samarnpiboonphol P. Nausea, vomiting and pruritus induced by intrathecal morphine. J Med Assoc Thai. 2013; 96:589-94.

Jalilian N, Ghadami M. Randomized clinical trial comparing postoperative outcomes of early versus late oral feeding after Caesarean section. J Obst Gynaecol Res. 2014; 40:1649-52.

Mehta S, Gupta S, Goel N. Postoperative oral feeding after Cesarean section—Early versus late initiation: a prospective randomized trial. J Gynecol Surg. 2010;26(4):247-250.

Izbizky G, Minig L, Sebastiani M, Otano L. The effect of early versus delayed postcaesarean feeding on women’s satisfaction: a randomised controlled trial. Br J Obst Gynaecol. 2008;115:332-8.

Bar G, Sheiner E, Lezerovizt A, Lazer T, Hallak M. Early maternal feeding following caesarean delivery: a prospective randomized study. Obstet Gynecol Surv. 2008;63(6):352-354. .

Teoh W, Shah M, Mah C. A randomised controlled trial on beneficial effects of early feeding post-Caesarean delivery under regional anaesthesia. Sing Med J. 2007;48:152-7.

Chantarasorn V, Tannirandorn Y. A comparative study of early postoperative feeding versus conventional feeding for patients undergoing Caesarean section: a randomized controlled trial. J Med Assoc Thai. 2006; 89(4):11-6.

Kathpalia S. Early maternal feeding versus traditional delayed feeding after Caesarean section: a pilot study. J Obst Gynecol Ind. 2017;67:178-82.

Saad AF, Saoud F, Diken ZM, Hegde S, Kuhlmann MJ, Wen TS, Hankins GD, Saade GR, Costantine MM. Early versus late feeding after cesarean delivery: a randomized controlled trial. Am J Obstet Gynecol. 2015;212(1):S286.

Huang H, Wang H, He M. Early oral feeding compared with delayed oral feeding after Caesarean section: a meta-analysis. J Mat Fetal Neonat Med. 2016;29:423-9.

Guo J, S. Long S, Li H, Luo J, Han D, He T. Early versus delayed oral feeding for patients after Caesarean. Int J Gynecol Obst. 2015;128:100-5.