Clearly from the studies that I have researched, it shows a direct 
  correlation between analgesics and hindrance in breastfeeding.  The question 
  I am posing is what techniques can be done to assist the mother and infant 
  in having a successful initiation of breastfeeding and ultimately continue 
  to breastfeed after receiving any form of analgesics or opioids?

  Teresa Romero, SN



Teresa,
You've done an excellent job of pulling together some good research on the effects of delivery medications on baby's behavior.  Contact with mother after delivery is very important, even if baby can't manage the rooting and suckling.  Frequently though, we'll see a very nice "honeymoon" breastfeeding before the baby falls asleep, so it's essential that the opportunity is offered whether vag or c/s within the first hour or two.

At our hospital, we are big fans of skin-to-skin care (STS).  This involves removing everything on the baby except a diaper and placing him tummy down between mom's breasts with his head under her chin.  Usually, a baby will wiggle and squirm until one ear is resting where he can hear mom's heartbeat.  If baby is too groggy to turn his head, I may do it for him.  We place a couple of receiving blankets over baby's back to trap mom's body heat, and if he has had trouble with low temps, we put the cap back on his head.  If mom has a pillow wedged under each arm, she will feel securely propped up so that if she dozes off, the baby won't roll anywhere.  

Moms usually love STS time.  It allows baby to sleep off the effects of the drugs, does not put pressure on mom's incision, and it reminds them both that the other is safe.  Baby's head should be outside the blankets where his nose has good free air exchange.

STS is intended to be continuous.  They can lay STS for an hour or two until baby starts rooting around.  Many people receive visitors, however, and the baby frequently gets taken away, but not wrapped back up.  It's important that mom and dad know baby needs to be dressed if he's not STS.

I hope this helps reassure the mom you're working with that babies can overcome unpleasant side effects from the delivery.  Breastfeeding can get off to a rough start, but it doesn't have to be permanent.

Good luck with your studies.
Jeanne Mitchell, RN IBCLC
Austin, TX

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