In many countries both breastfeeding and tattooing are enjoying a resurgence in popularity.You may be wondering if it safe to breastfeed your baby if you already have a tattoo. You might be thinking of getting a tattoo or having a tattoo removed and wish to continue breastfeeding without interruption.

Is it safe to get a tattoo while breastfeeding?

Tattoos are created by injecting ink into the dermal (second) layer of the skin. Tattooists use a hand-held electric machine that is fitted with solid needles coated in the ink. The needles enter the skin hundreds of times a minute to a depth of up to a few millimeters. The ink that is used in tattoos in the United States is subject to FDA regulation as cosmetics, but none are approved for injection under the skin. Tattoo inks are made from various compounds, including heavy metals such as, cadmium, cobalt and manganese.  There are synthetic and vegan brands of ink available. It is generally assumed that ink molecules are too large to pass into breastmilk during the tattoo process. Once injected into the skin the ink is trapped, however it is unknown whether the ink can pass into breastmilk as it slowly breaks down in the body months to years later.

General information about tattooing also applies to breastfeeding women. Local and systemic infections are the most prevalent risks of tattooing. Local infections can occur when the recommended aftercare regimen is not followed. Allergic reactions to the ink used may occur as well, with red inks being the most prevalent, even after many previous tattoos. Aftercare includes keeping the tattoo clean with mild soap and water, not picking at the scabs and keeping the tattoo out of the sun. Tylenol is often prescribed for the pain, if needed. Systemic infections occur when universal precautions are not followed by the tattoo artist and can include such diseases as hepatitis, tetanus and HIV.

It is very important to screen the tattooist and the shop carefully, checking with the local health department for local laws and regulations. Professional tattooists will follow universal precautions such as sterilization of the tattoo machine using an autoclave, single-use inks, ink cups, gloves and needles, bagging of equipment to avoid cross contamination, and thorough hand washing with disinfectant soap.

Most tattooists will not knowingly tattoo a pregnant or breastfeeding mother. This is for liability reasons on the tattoo artists part, but also to prevent any disease that might affect the growing baby, and to allow the mothers body time to heal.  It is suggested that mothers wait at least until 9-12 months after birth, when the child is no longer dependent solely on breastmilk before getting a tattoo.  Reputable tattoo artists will have a waiver for the client to sign that asks about pregnancy and breastfeeding.

Is it safe to have a tattoo removed while breastfeeding?

Tattoo removal is now accomplished with the use of lasers. The laser energy causes the tattoo pigment to shatter and fragment into smaller particles which are picked up by the body’s immune system and filtered out via the liver. The removal process is lengthy, often taking 8-10 sessions spaced 4-8 weeks apart.  It may be painful, and may cause blistering and scarring.  The tattoo may not be fully removed. Many of the same risks of tattooing apply to laser removal including infection due to improper aftercare, and the possibility of an allergic reaction to the ‘free’ ink particles. There have been no studies done on the increased amounts of ink released into the mother’s body during the laser removal process, and it is unknown whether the ink particles are small enough to enter breastmilk. It is suggested that mothers wait until weaning is completed before having any laser removal of tattoos done.

There is little evidence surrounding the safety of tattoos and breastfeeding. While the act of having a tattoo placed will not affect the breastfeeding relationship itself, it is unknown whether the inks used may pass into breastmilk especially during laser removal. Carefully weigh your options and seek out a professional tattoo artist. You can chose to adorn your body with a tattoo or three, and give your baby the baby the best start in life by breastfeeding, with careful consideration of the pros and cons.

References

Armstrong, M., Roberts, A., Koch, J., Saunders, J., Owen, D., & Anderson, R. (2008). Motivation for contemporary tattoo removal: a shift in identity. Arch Dermatol, 144(7), 879-884.

Both, D. F., Kerri. (2008). Breastfeeding: An illustrated guide to diagnosis and treatment. Marrickville, NSW: Elsevier Australia.

DeBoer, S., Seaver, M., Angel, E., & Armstrong, M. (2008). Puncturing myths about body piercing and tattooing. Nursing, 38(11), 50-54.

FDA, (2008). Tattooing & Permanent Makeup.   Retrieved September 10, 2009, from http://www.fda.gov/Cosmetics/ProductandIngredientSafety/ProductInformation/ucm108530.htm

Gilbert, S. (2000). Tattoo History: A Source book. New York: Juno Books, LLC.

Gray-Wolfstar, T., & Wolfstar, G. (2007). Tattoos, body piercing, and nursing: a photo essay. Interview by Jason P Smith. Am J Nurs, 107(4), 54-57.

HMBANA, H. M. B. A. o. N. A. (2012). Guidelines for Establishment and Operation of a Donor Human Milk Bank. Raleigh, NC: Human Milk Banking Association of North America, Inc.

Hudson, K. L. (2009). Living canvas : your total guide to tattoos, piercing, and body modification. Berkeley, CA: Seal Press : Distributed by Publishers Group West.

Reardon, J. (2008). The Complete Idiot’s Guide to Getting a Tattoo. New York: Penguin.

Riordan, J., & Wambach, K. (2009). Breastfeeding and human lactation (4th ed.). Sudbury, MA: Jones and Bartlett Publishers.

Roche-Paull, Robyn. (2009). Body Modifications and Breasfeeding. New Beginnings, 29(4), 4-8.

Wilson-Clay, B., & Hoover, K. (2005). The breastfeeding atlas (3rd ed.). Manchaca, Tex.: LactNews Press.

Contributed by Robyn Roche-Paull, RNC-MNN, BSN, IBCLC, Retired LLL Leader.