A tattoo involves injecting an ink into the dermis of the skin. Worldwide 10-20% of the population is tattooed (https://pubmed.ncbi.nlm.nih.gov/34605159/) but there is little research on the effects of the inks. The most common reactions are allergies particularly to red ink and infections (https://pubmed.ncbi.nlm.nih.gov/34969030/). Most of the ink stays fixed in the area to which it is injected but some of the ink is transported away from the skin via the vasculature or lymphatic system; it will end up in other organs or will be excreted. Coloured lymph nodes near tattooed areas have been known. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400116/).
Tattoo artists use a hand-held electric machine that is fitted with solid needles coated in the ink to pierce the skin to a depth of a few millimeters. Tattoo ink is assumed to be too large to pass into breast milk, so the baby is not exposed to it.
It is important to choose a tattoo artist with clear hygiene precautions to minimise risk of infection. Many studios will refuse to perform a tattoo on a breastfeeding mother because of public liability and insurance. Many councils stipulate this as a criteria of licensing premises. This largely goes back to the AIDS epidemic and the risk of transferring the HIV virus through blood contamination.
Professional tattoo artists should follow standard hygiene 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. Anaesthetic creams applied topically before the tattoo such as EMLA cream ™ are compatible with breastfeeding.
The decision to proceed should be an informed decision by the person choosing to have this body art.
Other sources of information
La Leche League International https://llli.org/breastfeeding-info/tattoos-and-breastfeeding/
E-lactancia Tattoo https://e-lactancia.org/breastfeeding/tattoo/product/
LactMed Tattooing https://www.ncbi.nlm.nih.gov/books/NBK500563/
