Also wanted to add that the medications typically used for sedation for colonoscopy should not pose a problem for this mother who is breastfeeding.  These are usually performed with either sedation by the gastroenterologist, which usually consists of midazolam and fentanyl, or "monitored anesthesia care" by an anesthesiologist that usually consists of propofol.  Mom should be able to breastfeed (or pump, if babies are not immediately available) as soon as she feels able to in the recovery room, with no need to discard the breastmilk.

My other "standard" recommendations are to have this mom scheduled for first of the day -- most adult institutions want patients to be completely without solids or liquids starting at midnight the night before, and getting the procedure done first thing will help minimize the amount of time that she needs to be NPO.  Otherwise, if she can't be the 7:30 or 8:00 case, she should be able to consume clear liquids up to 2 hrs before the procedure (though most places have a 4-hr rule, so that if a case can be moved up, it won't be limited by NPO status).  She should plan to pump or breastfeed right before the procedure at the hospital, and honestly it may be less stressful for someone to watch the babies at home for her so she can just concentrate on herself.  I did a short phone interview with the Academy of Breastfeeding Medicine that is a podcast available on iTunes -- though I haven't been able to bring myself to listen to it yet -- and we discuss a lot of the practical issues involved.

Good luck to this mom,
Sarah Reece-Stremtan M.D. (pediatric anesthesiologist)

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