title: Early versus delayed oral feeding for patients after cesarean.
abstract: BACKGROUND
  Early oral feeding (EOF) after cesarean delivery is still controversial.
  
  
  OBJECTIVE
  To assess whether EOF is superior to delayed oral feeding (DOF) after cesarean in terms of safety and effectiveness.
  
  
  METHODS
  PubMed, Embase, and the Cochrane Library were searched for reports related to early feeding and cesarean published in English before June 30, 2014.
  
  
  METHODS
  Randomized controlled trials comparing at least one of six outcomes after EOF (≤12 hours after surgery) and DOF (after return of bowel sounds/movement or >12 hours) after cesarean delivery were included.
  
  
  METHODS
  Data were extracted using a predesigned extraction form. Risk ratios or mean differences were calculated.
  
  
  RESULTS
  A total of 20 studies were included, including 4584 women who had undergone cesarean. No significant differences were identified in patient satisfaction and frequency of postoperative complications. Compared with DOF, EOF promoted a quicker return of bowel sounds, flatus, bowel movement, and regular diet (P<0.001 for all). Significant reductions were also noted in duration and amount of intravenous fluids, length of hospital stay, and time to first breastfeeding (P<0.001 for all).
  
  
  CONCLUSIONS
  There are no obvious advantages in withholding fluid and food after cesarean. Indeed, EOF offers some short-term benefits.
authors.affiliation: Department of Anesthesiology, West China Women's and Children's Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Guo
authors.affiliation: Department of Gynecology and Obstetrics, West China Women's and Children's Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Shuyu
authors.initials: S
authors.lastname: Long
authors.affiliation: Department of Anesthesiology, West China Women's and Children's Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address: lihuafeng2005@hotmail.com.
authors.forename: Huafeng
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Luo
authors.affiliation: Department of Anesthesiology, West China Women's and Children's Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Han
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Teng
authors.initials: T
authors.lastname: He
mesh_terms: D002585:Cesarean Section; D004435:Eating; D005260:Female; D006801:Humans; D007902:Length of Stay; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D013997:Time Factors
keywords: Cesarean delivery; Delayed oral feeding; Early oral feeding; Postoperative recovery