Short answer:  NO, a typical general anesthetic does not require mom to "pump and dump" for 24 hrs.

Since there is no good review article available on the topic of breastfeeding following anesthetic agents (and yes, I'm *still* working on getting it written), you could certainly take the approach of checking on the various medications that may be used.

Meds I would give for a general anesthetic for an otherwise healthy patient would be:

Midazolam/Versed
Fentanyl
Lidocaine
Succinylcholine
Propofol
Rocuronium
Glycopyrrolate and Neostigmine (if rocuronium used)
Ondansetron/Zofran
Dexamethasone
Desflurane or Sevoflurane as the inhalational agent
Ephedrine or pheynylephrine (possibly, if needed for blood pressure support)

I believe these are all referenced in "Medications and Mothers' Milk."

You can see it is quite a cocktail, and I might not give every one of those meds every time, but I certainly use them all routinely (sometimes all of them in one patient).  There are *so* many variables that I can't begin to go into here -- surgeon's technique, whether or not I need to intubate, whether or not muscle relaxation is needed, etc. 

Now.  This mom is quite likely already on oral pain medications and obviously still breastfeeding without adverse effects in the infant.  If I were doing her anesthetic, I would skip the midazolam.  It's not required, and while the infant dose transferred into milk is small and not likely to cause any issue, it IS orally bioavailable (I squirt it into uncooperative young patients' mouths every day!).  This seems to be the med that freaks anesthesiologists out in breastfeeding moms, but it really doesn't *need* to be used and if her baby were older, I'd consider using it.

I have no concerns about lidocaine IV, propofol, or the inhalational agents, nor the ondansetron or dexamethasone (anti-emetics).  Fentanyl in judicious/normal doses should be fine too.

Muscle relaxants and reversal agents should be okay too but I don't use them unless I need to just because I like to avoid polypharmacy as much as I can.

As has been suggested, mom should try to pump ahead of time to have milk available for her baby while she's in surgery and in case she doesn't feel up to nursing right after the surgery.  It would not be unreasonable to suggest pumping/dumping a single time in the PACU, just to make everyone involved feel better because this baby is so young.  Certainly by a few hrs post-op, her milk will contain very little in the way of anesthetic meds.  And if mom can't bear to throw milk away, she can certainly save it and think about feeding it later or even mixing it with "non-anesthetized milk" so that whatever may be present will be diluted quite a bit.

Adults are frankly big *slugs* in the recovery room, at least compared to kids, and she may find that she just generally feels crummy for longer than she expects as she's recovering from anesthesia -- she may not feel up to nursing right away anyway, and pumping might be a little easier to maneuver if she's feeling pretty yucky.  But honestly, if she were my patient and she wanted to nurse in the PACU, I'd say go for it and certainly advocate for that being her decision.

That's my $0.02.

Oh, and nursing after a c-section is usually fine because the volume of colostrum that baby will receive is SO small that there is very very little in the way of medication that could be present.  Those infants are also being monitored to whatever degree in the hospital with mom so there is less concern there.  And we always coordinate the administration of the general anesthetic with the OB, with a literal goal (at least at my hospital) of the baby being delivered within 4(!) minutes of us getting the endotracheal tube in, to minimize the amount of anesthetic and medications that the baby is exposed to, so they are usually born with very little anesthetic or medication in their system already.

And as far as I know, the availability of anesthesiologists in terms of pre-op consultation greatly varies from hospital to hospital and depends on how the hospital is structured and how the anesthesiologists are employed (contractors vs hospital employees vs academic group, etc).  I work at a large academic pediatric hospital and we have a great pre-operative care clinic where patients can be seen by an anesthesiologist ahead of time, or the parents contacted by phone to discuss things if there is a particular concern (usually brought about by the surgeon).  Even so, I frequently read the notes written by my colleagues and frankly disagree with their management recommendations and do something completely different for my anesthetic.  And it is often very difficult to have the same anesthesiologist be present for pre-op consultation (since we work in the operating rooms all day) and then be available to actually do the anesthetic.  It's just a reality of how things work.

-Sarah Reece-Stremtan M.D. (pediatric anesthesiologist in Washington DC)

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