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Tattooing must meet all known safety and hygiene standards and be performed in licensed professional tattoo shops to avoid transmission of Hepatitis B, Hepatitis C, HIV and other infections (MedlinePlus 2020, LLLi2019, Wong 2008, Millner 2001). As a safety measure, blood banks and many human milk banks do not accept donation of biological products until that a 4 to 12 months period has elapsed after tattooing (Roche 2015, Karp 2010).
Although there have been no published complications in infants of mothers who have undergone tattoo sessions during breastfeeding (Kluger 2018, 2015 & 2012), some authors suggest abstaining from the tattooing procedure until the end of breastfeeding. (Rademeyer 2020, Farley 2019, LLLi 2019, Kluger 2018, 2015 & 2012, Roche 2015)
Cadmium (yellow), Carbon or iron (black), Cinnabar, cadmium, iron or mercury (red), Cobalt (blue), Chromium or Cooper (green), Iron or Ochre (brown), Manganesum or aluminium (violet), Titanium or Zinc (white), plastics, Formaldehyde, diluent/solvents, contaminants (Nickel, antimony, arsenic), nanoparticles and some carcinogens are products used as dyes and pigments for tattooing. (Rademeyer 2020)
Although dyes and pigments used for tattooing may pose a risk for toxicity are kept under skin that prevents them from entering into blood stream. This is the reason for what an old tattoo or a new one done while breastfeeding is not contraindicated, provided that best standards of safety and sanitation are followed to warrant the prevention of infectious disease transmission. Many tattoo professionals refuse to tattoo while pregnant or breastfeeding. (LLLi 2019)
Creams used for anesthetic, antiseptic or anti-inflammatory purposes before or after tattooing are compatible with breastfeeding, so as Paracetamol or Ibuprofen used for pain relief.
There is a risk of distortion of the tattoo applied to the breast due to the distension of the skin due to the increase in breast volume that occurs during pregnancy and lactation.(Kluger 2010)
Tattoos on the nipple should be avoided since it poses a risk for swallowing of dyes that may be toxic.
Hide a tattoo with make-up or cover-up is compatible with breastfeeding. Removal by Laser-ray may disaggregate pigments of tattoo that get into lymph and blood and would be excreted into breast milk that is a reason to prudently wait, depending on the dye to be removed, until breastfeeding is finished.