A tattoo involves injecting coloured ink into the skin to make permanent body art. Some resources state that tattoos do not affect breastfeeding apart from possible infection risks from blood-borne diseases1 while others say there is no data with which to make a considered opinion 2. Is it safe to get a tattoo while breastfeeding? This article discusses the information available about the safety of having tattoos or having tattoos removed during lactation.
Can you get a tattoo while breastfeeding?
There isn’t any available research about the safety of getting a tattoo while breastfeeding however it is usually recommended that mothers wait until after breastfeeding has ended before having a tattoo procedure.34 There are many different colourants, additives and impurities in tattoo ink and permanent make-up (PMU) and the pigments used are not specifically produced for tattoo/PMU use and most are not authorised for use in cosmetic products.5 Concerns include the potential risk of transferring toxic chemicals from the ink to a nursing baby via breast milk or the transmission of an infection acquired through the procedure but neither risk has been scientifically evaluated (Kluger, 2015). LactMed, a database of the compatibility of drugs and other chemicals to which breastfeeding mothers might be exposed, says:
No data are available on the safety of tattooing during breastfeeding. Theoretical concerns relate to transmission of pigments or infections to the infant during breastfeeding and in the United States, blood donation is not permitted for 12 months after a tattoo as a precaution. Opinion appears to favor not obtaining a new tattoo during breastfeeding.
Can tattoo ink get into breast milk?
It is not known whether tattoo ink could leave the compartment of skin where it has been injected and reach breast milk. Research has shown that over time ink from tattoos can travel in the blood stream and be deposited in the lymph nodes or liver67 8 but there isn’t any research on breast milk. E-lactancia recommends against tattoos on the nipple as this poses a risk of swallowing tattoo ink which could be toxic (E-lactancia. 2018) and breastfeeding charity La Leche League International says:
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.
What are the safety concerns for mother and baby?
Infections
A tattoo creates a substantial shallow wound on the body and therefore strict hygiene precautions are needed to avoid local infections or transmission of blood borne diseases. E-lactancia explains:
Tattooing must meet all known safety and sanitation standards in order to avoid transmission of Hepatitis B, Hepatitis C and HIV infections. As a safety measure, blood banks and many human milk banks do not accept donation of biological products until a 4 to 12 months period has elapsed after tattooing.
Articles from the Journal of Midwifery and Women’s Health9 and lactation consultant Robyn Roche-Paull10 explain how to minimise risks of infection including:
- Find an experienced professional tattoo artist. Ask about their training and licensing. Check with your local health department for local laws and regulations.
- Check that the studio is clean with sterilised equipment including sterilised needles from sealed packaging and that the artist uses single use inks and wears medical gloves to avoid cross contamination.
- Follow the recommended aftercare procedures carefully to avoid infections at the site of the tattoo.
Allergies
It is possible to have an allergy to the tattoo ink which may cause persistent swelling, itching and redness at the tattoo site. 11
Medical reasons for not having a tattoo
The following excerpt from the Journal of Midwifery and Women’s Health describes existing health issues that may mean a tattoo is not suitable for a mother:
You should not get a tattoo if you are pregnant, breastfeeding, or have an allergy to nickel or chromium. A tattoo should never be placed near the scar of a skin cancer. If you have any serious health problem such as HIV, heart problems, blood clotting problems, latex allergy, psoriasis, lupus, or sarcoidosis, talk with your health care provider to see if getting a tattoo is safe for you. If you have skin problems such as eczema or if you make keloid scars, a tattoo might cause those problems to become worse.
Can I breastfeed with an existing tattoo?
There haven’t been any studies done on breastfeeding mothers with tattoos however breastfeeding is not contraindicated (E-lactancia. 2018) and none of the main health organisations (or evidence based lactation textbooks) have statements on the compatibility of tattoos and breastfeeding.12
Is it safe to have laser removal of a tattoo during lactation?
During laser treatment to remove a tattoo, the laser breaks the pigments in ink down into smaller particles which travel through the body and are stored in lymph nodes or other tissues. A portion of ink may be excreted by the liver however the ink mostly doesn’t leave the body.13 Removing a tattoo can involve having many repeat laser treatments and it is not known whether the broken down ink particles could enter breast milk. La Leche League International states:
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.
Wait until baby is no longer breastfeeding
Due to the lack of research it is recommended that mothers wait until breastfeeding has ended before having tattoos removed by laser treatment.1415
Summary
There is very little information available about having a new tattoo or having a tattoo removed during breastfeeding. Due to insufficient information on the safety of ingredients in the inks used and how ink particles might move through the body it is generally recommended that mothers wait until breastfeeding has ended before having a tattoo procedure.