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Are Tattoos Compatible with Breastfeeding?
Robyn Roche-Paull
San Diego CA USA
Karen Spicer
British Columbia Canada
From: LEAVEN, Vol. 41 No. 1, February-March 2005, pp. 3-4.
Body Art has been around
almost as long as breastfeeding. Tattoos have been found on Ice Age
remains and Egyptian mummies. Both breastfeeding and tattooing are enjoying
resurgence in popularity. More than 20 million Americans, half of whom
are women, have one or more tattoos.
Leaders who work with breastfeeding
mothers are noticing a rise in the numbers of phone helping and email
help forms asking about the compatibility of tattoos and breastfeeding.
The American Academy of Pediatrics,
American College of Obstetricians and Gynecologists, American Academy
of Family Physicians, and American College of Nurse-Midwives have made
no statements on the compatibility of tattooing and breastfeeding. However,
the books, The Breastfeeding Atlas and Maternal and Infant Assessment
for Breastfeeding and Human Lactation both state that already present
tattoos, on the breast or elsewhere, do not impact breastfeeding.
The word "tattoo"
comes from the Tahitian word tattau, meaning, "to mark." Many
women mark their bodies with tattoos to celebrate life passages, special
persons, places, and things in their lives. Tattooing is also done to
establish identity within a group, for spiritual reasons, beautification,
and social status, as well as for cosmetic reasons (permanent makeup)
and to camouflage disfigurements or scars.
Tattoos are created by injecting
ink into the dermal (second and third) 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 (Food and Drug Administration)
regulation as cosmetics, but none are approved for injection under the
skin. People who get tattoos should be aware that inks used by tattooists
do not have specific FDA approval for tattooing.
Tattooing Is Not without
Risk
It is important to screen
the tattooist and the shop carefully, checking with the local health
department for local laws and regulations. Tattooing is currently legal
in all US states except for Massachusetts, Oklahoma, and South Carolina.
It is illegal in a few US cities. It is also legal in all provinces
of Canada. However, the artist training, sterilization of instruments,
and inspections of the studios depend on state or provincial laws. Seventy-four
percent of US states require licensing, registration, and/or permits.
Reputable 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.
Many, if not most, professional
tattooists will not tattoo a woman who is currently pregnant or breastfeeding.
World-reknowned tattoo artist Pat Fish of Santa Barbara, California,
USA says:
There is always an element of risk in getting a tattoo. The tattoo could
have an adverse effect on the mother’s immune system that could
be transmitted to the baby.
While the body is healing
after a tattoo—and producing milk—and if the mother’s
body would "reject" the tattoo, the possibility exists that
it could harm the baby. This is especially a problem if the client does
not follow the aftercare instructions and develops an infection. Alex
Stewart of a former natural parenting Web site in the UK suggests that
mothers give their bodies 18 months to fully recover from childbirth
before asking it to heal a tattoo.
The general information about
tattooing also applies to breastfeeding women. According to the research,
local and systemic infections are the most prevalent risks of tattooing.
Local infections can occur. The aftercare regimen includes keeping the
tattoo clean with mild soap and water, not picking at the scabs, and
keeping the tattoo out of the sun. Systemic infections occur when universal
precautions are not followed by the tattoo artist and can include such
diseases as hepatitis, tetanus, and HIV.
Human milk banks will not
accept donations from mothers who have had a tattoo done in the previous
12 months, because of the possibility of various infections caused by
blood-borne pathogens. In 1985, the Centers for Disease Control in Atlanta,
Georgia, USA, issued national guidelines for protection during the tattoo
process. There has never been a recorded case of tattoo-transmitted
HIV infection; the last reported tattoo-related incident of hepatitis
was in 1950. Furthermore, according to an informal, unpublished survey
of tattooed or pierced mothers by Mary Jozwiak, IBCLC, a moderator at
HipMama magazine and e-zine, the risk for blood-borne illnesses was
not increased for mothers who were tattooed by a professional who followed
universal precautions.
The possibility of the ink
migrating into the mother’s blood plasma and then into the milk-making
cells of the breast is negligible, according to Frank Nice, RPh. It
is possible to have allergic reactions to the tattoo inks.
Is It Safe to Have a Tattoo
Removed While Breastfeeding?
It is estimated that 50 percent
of those who get tattoos later regret the decision and wish to have
them removed. The medical literature says little regarding the safety
of tattoo removal while breastfeeding, but the general information that
is available still applies.
Tattoo removal is now accomplished
with the use of lasers, specifically Q-switched lasers. The laser works
by producing short pulses of intense light that pass through the epidermis
to be absorbed by the tattoo pigment in the dermis. The laser energy
causes the tattoo pigment to fragment into smaller particles that are
picked up by the body’s immune system and filtered out. The removal
process is bloodless, low risk, and has minimal side effects. The same
aftercare as for a tattoo applies to its removal. A mild analgesic,
such as acetaminophen, is often prescribed for the pain, if needed.
Possible side effects include pigmentation changes, local infection,
and possible allergic reaction to the particles of ink that circulate
in the mother’s system after a laser treatment.
Mothers usually have no problems
if they follow the recommended aftercare procedures. The body filters
the ink particles via the white blood cells (macrophages and neutrophils),
and according to Dr. Jack Newman, "It is doubtful that tattoo removal
would influence breastfeeding in any way." When there are concerns
about a tattoo, the mother should consult the tattoo artist or the dermatologist
who performed the tattoo removal. In an emergency, she should contact
her physician immediately.
There is no evidence suggesting that tattoos affect the breastfeeding
relationship or have any effect on a mother’s milk. Regardless
of their personal views about tattoos, Leaders can offer current information
to women who are interested in tattoos.
References
Cadwell, K. et
al. Maternal and Infant Assessment For Breastfeeding and Human
Lactation. Sudbury, Massachusetts: Jones and Bartlett, 2002; 74.
Kuperman-Beade, M., Levine, V., and Asinoff, R. Laser removal of tattoos.
Am J Clin Dermatol 2001; 2(1):21-25.
Martin, J. Is nipple piercing compatible with breastfeeding? J
Hum Lact 2004; 20(3):319-21.
Millner, V. and Eichold, B. Body piercing and tattooing perspectives.
Clin Nurse Res 2001; 10(4):424-41.
Mothers Milk Bank San Jose. Donor FAQ 2004. [www.milkbanksj.org]
Newman, Jack, 2004. Personal communication.
Nice, Frank J., 2004. Personal Communication.
Wilson-Clay, B. and Hoover, K. The Breastfeeding Atlas, 2nd
edition. Austin, Texas: LactNews Press, 2002; 146.
Robyn Roche-Paull lives
in San Diego, California USA with her husband, Stephen. They have two
sons, Morgan (8) and Tiernan (18 months) and one daughter, Siobhan (5).
She was accredited in 2000 and has been leading meetings in San Diego,
California, USA. She is currently the Associate Area Coordinator of
Leaders for the San Diego District. She has four tattoos and has breastfed
successfully with them in place! Karen Spicer recently completed an
international move with her family from Tokyo, Japan, where she was
accredited as an LLL Leader, to a beautiful little town on the Sunshine
Coast of British Columbia, Canada. She is a proud mother to a three-and-a-half
year old boy, Jack Ichiro, and is expecting another baby any day now!
Special thanks to Norma Ritter, Contributing Editor, who originally
prepared this article for the Leaven column "Keeping Up to Date."
To submit an article to Norma for "Keeping Up to Date," contact
her at lllnormar at gmail dot com (email).
Page last edited Sun Oct 14 09:32:04 UTC 2007.
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