The Effect of Preoperative Oral Carbohydrate on Breastfeeding After Cesarean Section: A Double-Blind, Randomized Controlled Clinical Trial

ABSTRACT

Delay in the initiation of breastfeeding is one of the problems of cesarean section. Its causes are insulin resistance, pain, anxiety, stress, thirst, hunger, and so on. Preoperative oral carbohydrate (OCH) reduces postoperative insulin resistance and improves postoperative recovery. The present study was conducted to evaluate the effect of preoperative oral carbohydrate on breastfeeding after cesarean section. In this double-blind randomized clinical trial, 91 pregnant women who underwent elective cesarean section were randomly assigned to preoperative OCH (Nutricia Preop; n = 45) or control group (water flavored with lemon; n = 46). The patients ingested 800 ml + 400 ml of liquid before the surgery. The time to first breastfeeding after surgery (min), the duration of breastfeeding (min), and breastfeeding frequency were measured using a questionnaire for up to 36 h after the surgery. Time to first breastfeeding after surgery was significantly shorter in the OCH group than in the control group (27.47 ± 11.51 vs. 51.96 ± 20.20 min,   p< .001). The mean frequency of breastfeeding (6.14 ±  0.55 vs. 4.82 ± 0.46, p < .001) was significantly higher and the mean duration of breastfeeding (116.48 ±  19.68 vs. 82.13 ± 12.40 min, p < .001) was significantly longer in the OCH group compared with the control group in the first 36 h after the surgery. Preoperative oral carbohydrate improves breastfeeding after surgery (time to first breastfeeding, breastfeeding frequency, and breastfeeding duration). Further clinical trials and precise measurement tools are needed to assess breastfeeding to confirm these effects. The study was registered at http://www.IRCT.ir (IRCT2016072629082N1).

KEYWORDS:

• breastfeeding
• cesarean section
• oral carbohydrate
• preoperative

Acknowledgments

We are grateful to the nurses of Women's Surgical Ward, Shabihkhani Hospital, Kashan, Iran, for their help and kind cooperation.

Declaration of interest

The authors declare no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

This work was supported by Vice Chancellor for Research, International Campus, Tehran University of Medical Sciences.

About the authors

Razieh Khalooei Fard, MSc, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences. Research interests: Nutrition in hospitals. Member of ERAS in Iran.

Zohre Tabassi, MD, Obstetricians, Associate professor in the Department OB & GYN, Kashan University of Medical Science, Kashan, I.R., Iran.

Mostafa Qorbani, MD, PhD, Assistant professor in the Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran.

Saeed Hosseini, MD, PhD (Ph.D. Major: Nutritional Science, Minor: Microbiology & Immunology Department of Nutritional Science, The University of Arizona Tucson, Arizona, USA, 1997-2000), Fellowship (Post Doctoral Research Fellowship USC-UCLA Research Center for Alcoholic Liver and Pancreatic Diseases, Los Angeles, California, USA, 2002-2000), Department of Clinical Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences. Associate Professor, Nutrition and Biochemistry Department. Member of ERAS in Iran.