title: A randomized comparative trial of early initiation of oral maternal feeding versus conventional oral feeding after cesarean delivery.
abstract: OBJECTIVE
  To compare the effects of two maternal feeding policies-early versus conventional oral feeding-after cesarean delivery.
  
  
  METHODS
  This prospective multicenter randomized comparative trial was conducted at tertiary care hospitals in Sindh, Pakistan, from 2010 to 2012. Women with an uncomplicated cesarean delivery under spinal anesthesia were allocated to an intervention of early (after 2 hours) or conventional (after 18 hours) initiation of oral feeding. Outcomes included maternal ambulation, maternal satisfaction, gastrointestinal functions, and length of hospital stay.
  
  
  RESULTS
  In total, 1174 women (n=587 per group) were included in the final analysis. Gastrointestinal complications were not significantly different between the two groups. Lower intensities of thirst and hunger and a higher rate of maternal satisfaction were observed in the early feeding group (P<0.05), and 53.8% of women in this group were able to ambulate within 15 hours of surgery, compared with 27.9% of women in the conventional feeding group. The frequencies of readmission, febrile morbidity, and wound infection were insignificant.
  
  
  CONCLUSIONS
  Early oral dietary initiation after cesarean delivery resulted in early ambulation, greater maternal satisfaction, and reduced length of hospital stay, with no detrimental outcomes, making this practice cost-effective. Hence, day-care cesarean delivery might be an option in resource-constrained settings.
  
  
  BACKGROUND
  ChiCTR-TRC-13003651, http://www.chictr.org.
authors.affiliation: Sobhraj Maternity Hospital, Karachi Metropolitan Corporation, Karachi, Pakistan. Electronic address: sh_naz@yahoo.com.
authors.forename: Shabeen N
authors.initials: SN
authors.lastname: Masood
authors.affiliation: Department of Surgery, Ziauddin Medical University, Karachi, Pakistan.
authors.forename: Yasir
authors.initials: Y
authors.lastname: Masood
authors.affiliation: Department of Surgery, Wayne State University, Detroit, USA.
authors.forename: Uzma
authors.initials: U
authors.lastname: Naim
authors.affiliation: Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA.
authors.forename: Muhammad F
authors.initials: MF
authors.lastname: Masood
mesh_terms: D000328:Adult; D002585:Cesarean Section; D004434:Early Ambulation; D004435:Eating; D005260:Female; D006801:Humans; D007902:Length of Stay; D011182:Postoperative Care; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors
keywords: Day-care cesarean delivery; Early ambulation; Early oral maternal feeding; Length of hospital stay; Maternal satisfaction; Maternal thirst and hunger