Immediate vs On-demand Maternal Oral Feeding for Parturients After Caesarean Section: A systematic review and meta-analysis of randomised controlled trials.

This review compared the efficacy and safety of immediate oral feeding (initiated within 2 hours post-operation) versus on-demand feeding following caesarean section (CS). A systematic search of electronic databases up to 20 February 2025 identified three randomised controlled trials (RCTs) including a total of 1,158 patients. The quality of the included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Statistical analysis was performed using Review Manager (RevMan) software to calculate mean differences (MDs), standardised mean differences (SMDs), and risk ratios (RRs). Immediate oral feeding was associated with a shorter time to first bowel sounds (MD -0.34 hours), although this difference was not statistically significant (P = 0.16). However, it significantly reduced the time to first flatus (MD: -1.27 hours, P <0.0009) and time to the second meal (MD: -1.76 hours, P = 0.0006). No significant differences were observed between the groups regarding nausea, vomiting, analgesia use, initiation of breastfeeding, patient satisfaction, or discharge time. These findings support the incorporation of immediate oral feeding into enhanced recovery protocols following CS.