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| |  Study Finds No Evidence to Support Restriction of Fluids, Food for Women During Labour MALDEN, Mass -- February 2, 2010 -- The traditional practice of restricting food and fluids during labour does not provide any benefits, finds a new Cochran review. “Based on our review, there is no convincing and current evidence to support restriction of fluids, and perhaps food, for women during labour. Women should be able to choose for themselves,” said co-author Joan Tranmer, MD, School of Nursing, Queen’s University, Kingston, Ontario. Practitioners have been concerned about eating and drinking during labour since the 1940s. The restriction is thought to prevent Mendelson’s syndrome, a rare, but sometimes fatal, condition caused by regurgitation of acidic stomach contents into the lungs when a general anaesthetic is given. However, “with medical advances over the past 60 years, including the increase use of epidural anaesthesia, we thought it was time to question the widespread ban on food and drink now that we are in the 2000s,” said Dr. Tranmer. “The use of general anaesthesia during C-sections is low. And even when used, the techniques have improved since the 1940s, so the risk of maternal death or illness is very, very low.” There is tremendous variation in the practice of fluid and food restriction across birth settings (home births versus hospitals). “The food and fluid restriction can be stressful and uncomfortable for some pregnant women, especially for those who are in labour for more than 12 hours and unable to eat,” added Dr. Tranmer. “Instead of eating ice chips, a snack can provide some nourishment, comfort and much needed energy.” The authors’ review looked at the data from 5 randomised trials that involved 3,130 women who were in active labour and with a low risk of requiring general anaesthesia. One study looked at complete restriction versus giving women the freedom to eat and drink at will, 2 studies looked at water only versus giving women specific fluids and foods, and 2 studies looked at water only versus giving women carbohydrate drinks. There were no significant differences identified in caesarean section, operative vaginal births, and Apgar scores less than 7 at 5 minutes, nor in any of the other outcomes assessed. Women’s views were not assessed. The pooled data were insufficient to assess the incidence of Mendelson’s syndrome.. Other comparisons showed similar findings, except 1 study did report a significant increase in caesarean sections for women taking carbohydrate drinks in labour compared with water only, but these results should be interpreted with caution as the sample size was small. SOURCE: Queens University
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