For The Breastfeeding Mom With Body Mods

Last year at a La Leche League Conference, a woman held a seminar called “Babies, Breasts, and Body Mods: Where Body Art and Breastfeeding Collide.” Robyn Roche-Paull, BSN, RNC, MNN, IBCLC, LLLL, USN veteran (say all that ten times fast!) was herself clearly no stranger to permanent and semi-permanent body decor.

The room was packed with Leaders, lactation specialists, medical workers, and breastfeeding advocates who all wanted to know: What’s a mama need to know about body art and possible impact upon her boobie monsters?

Roche-Paull’s lecture got me thinking… especially since I’ve had my eye on the prize of a new tattoo since before my last pregnancy, and waiting until weaning years from now sounds a tiny, wee bit torturous.

These days, there’s not such a strong stigma or taboo attached to mothers who have body modifications, but many women find themselves wondering what’s the best protocol for fresh body mods during the lactation period. When they consult their care providers, many really haven’t the faintest clue how to answer.

What exactly are body modifications? Popular types include branding (3rd degree burns to create scars), piercing, scarification (cutting), and tattooing. Here we’ll focus on the most prevalent: piercings and tattoos.

Now a little crash course for you curious body art geeks…

Who Gets Body Mods & Why Do They Want Them?

Tattoos and piercings have been performed on people for at least 5,000 years. Current estimates say 20 million Americans (young and old) have body mods. 30% have piercings; 22% have tattoos; 10% have both. The average age of a woman with body mods today is 25. For the most part, body mods are viewed as culturally acceptable.

Whereas body mods are often a religious, spiritual, or cultural rite in many corners of the world, in United States history the intent was for earlier generations to achieve an alternative look or to signify rebellion.

Today, the reasons why individuals choose body mods are seemingly boundless:

• Aesthetics
• Pop culture influence
• Sexual enhancement/stimulation
• Trends/cosmetics (permanent makeup)
• Post-mastectomy (recreate the look of areolas or a design over scarring)
• In memoriam/commemoration of life event
• Religious/spiritual
• Rebellion OR conformity

Especially for new mothers:

• Reclaim body after pregnancy
• Closure after birth/childbearing

What Do Body Mods Have To Do With Breasts?

Women today see their breasts as hyper-sexualized, decorative, and changeable (we need only look to climbing plastic surgery rates for proof). Breasts are not primarily seen as a feeding tool because, although we’ve made great strides toward re-normalization of breastfeeding, it’s still not viewed as critical to infant survival.

Side-effects of surgery and body mods are rarely discussed in relation to breastfeeding because essentially, as we’re oft reminded, “you can always just give formula.”

In this way, self beauty trumps baby’s needs and this thought process is socially accepted, if not encouraged.

As such, release forms for body mods don’t typically mention potential future breastfeeding complications.

Hey, breastfeeding people are people too! Why isn’t this covered by standard?

When legalities get in the way, we end up dealing with a lot of ignorance and even cruel and unusual punishment that ultimately affects children more than the original ‘crime’ ever would have. Case in point: A judge banned a mother from breastfeeding her 11 month old baby after she got a tattoo.

Breastfeeding mothers deserve fully informed consent when making choices for their bodies, and deserve to make their own choices free of unnecessary restrictions.

For Breastfeeding Mothers Who Want A Piercing

Yep, you can breastfeed with nipple piercings. Some women have one nipple pierced, some have both; they can be horizontal, vertical, diagonal, a combination, or some other crazy configuration only the imagination could conjure, in a variety of gauges, materials, and sizes.

So, they might interfere with breastfeeding, or they might not. As you can see, it’s no piece of cake keeping track of the variables.

Pre-existing, well-healed nipple piercings typically won’t block all of the milk pores, and are therefore unlikely to pose any significant issues with breastfeeding (jewelry must always be removed prior to nursing). Leaking, nipple pain, and duct obstruction have been reported among some women with established nipple piercings, however.

Roche-Paull mentioned a case study on a woman who produced milk from both breasts but couldn’t transfer on her left. Both of her nipples were pierced but the left was chronically irritated.

Most piercing professionals tell their clients that a nipple piercing requires 6-9 months to heal, with some setting the mark at a full year. A reputable piercer will also say s/he cannot emphasize enough how VITAL aftercare is to the healing process.

For fully informed consent, it’s important to know we may run into:

• Infections
• Delayed healing
• Duct damage
• Hyper/reduced sensitivity
• Phantom pain upon removal
• Body rejecting jewelry
• Tender flare-ups during menstruation
• Nipples ‘developing’ after piercing

Additional special risks for lactating mothers:

• Leaking
• Duct obstruction
• Breastfeeding infections (mastitis, abscesses)
• Sore/cracked nipples, pain
• Ejection reflex issues
• Nerve damage (too sensitive or lacking sensation)
• Jewelry stimulating milk production post-weaning
• Inability to remove jewelry before nursing
• Inadequate infant weight gain from poor milk transfer
• Latch problems
• Jewelry not fitting into pump flanges (for pumping mothers; hand expression may work fine)

PRECAUTIONS:

Timing is everything. In Roche-Paull’s opinion, getting a nipple piercing 18-24 months before pregnancy is ideal. A reputable piercing professional will not pierce a woman who is known to be pregnant. She advises removing the jewelry about six months into pregnancy due to increased sensitivity, and shifting hormones may lead to embedding or rejection of the piece.

The vast majority of good piercers will also not provide this service to a known breastfeeding mother. This is because saliva is not supposed to enter the freshly-pierced area, and jewelry must remain in constant place for at least six months — which poses a real conundrum as nipple jewelry must be removed prior to each nursing session (if you’ve somehow forgotten, babies nurse far too OFTEN for this to be convenient or worthwhile).

Roche-Paull advised it’s best to wait to get a new piercing until after weaning when breast tissue has returned to normal. If nearing the weaning period, a mother can stagger drying out each breast to pierce her nipples one at a time.

If removed during the breastfeeding period, the holes may close. A woman can opt to wear insertion tapers, but this increases risk of bacterial infection and she will need to remove them prior to each nursing session anyway. Another option is to wear PTFE Teflon barbells while nursing. She must absolutely ensure the ends are fully tightened, must keep an eye on her baby’s latch, and must remain aware of any developing mouth sores or infections.

She should inform her IBCLC/LC that she has (or used to have) pierced nipples as this information might be pertinent to the recommended solutions to a feeding problem.

For Breastfeeding Mothers Who Want A Tattoo

Theoretically it’s no threat to a woman’s milk quality if she’s really got the itch to ink and ends up with a La Leche League logo needled into her bicep.

Lots of mothers are not only considering tattoos during their lactation days, they’re getting tattooed to specifically and decidedly commemorate those days. (Check out some beautiful, touching examples here).

Most artists won’t tattoo a known breastfeeding woman. The thought process is that a lowered immune system can be detrimental to the required healing, spread of disease is possible if proper precautions are not taken, allergic reaction is possible, and liability is a huge concern among tattoo studios.

A note of reassurance for those with pre-existing, well-healed tattoos: they don’t pose any risk to breastfeeding.

THE RISKS

The same systemic and local infection risk that applies to the general populace is 100% present for breastfeeders, too.

The CDC has reported that no known instances of HIV transmission in the United States have occurred from tattooing since 1985. However, hepatitis B, C, and syphilis are still evidenced to pose a risk in certain environments.

Ink is not regulated under the FDA for sub-dermal injection purposes; it’s regulated as cosmetic (on top of the skin) and deemed proprietary.

Most tattoo inks contain synthetic and natural pigments and heavy metals. Do these elements transfer to breast milk? Though tattoo ink is injected into the second and third dermal layers of the skin, ink molecules may be too big to enter breast milk. Still, given the ethical concerns, no studies have been performed to confirm this.

“Tattoos are permanent because the ink remains walled off within the body via the body’s inflammatory process, making the possibility of the ink migrating into the mother’s blood plasma and then into the milk-making cells of the breast, next to impossible.” – Robyn Roche-Paull

As for laser removal of a tattoo during the breastfeeding period, the main risks include infection and allergic reaction. The procedure is considered otherwise safe, though again, no studies have been performed to corroborate this.

Roche-Paull and Karen Spicer wrote in Leaven, Vol. 41 No. 1, February-March 2005, pp. 3-4:

“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.[…]

[A]ccording 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.”

TIPS TO CONSIDER:

• Choose a tattoo studio that follows universal precautions.
• Breastfeed before a tattoo session for an oxytocin boost.
• Wait until baby is older (9-12 months) OR not as dependent on exclusive breast milk.
• MUST visit a reputable, licensed artist.
• Breast milk may be helpful as a healing agent on a tattoo.
• A tattoo can take up to 3 weeks to heal; be prepared to care properly for your body during this time (diet, hygiene, routine attention).

NOTE FOR MILK DONORS: Human milk banks won’t accept donors who have gotten a new tattoo or piercing in the past year – a conservative approach to protect super-fragile preemies.

IF YOU’RE NOT COMFORTABLE WITH BODY MODS RIGHT NOW … but still have that itch — fake it for a while! Many online sellers have large collections of faux nipple piercings and high-quality temporary tattoos.

More Resources:

• “Are Tattoos Compatible with Breastfeeding?” – LLLI
• “Babies, Breasts, and Body Mods: What You Need To Know” – Robyn Roche-Paull
• “Body Modification and Breastfeeding: What You Need To Know” – LLLI
• “Body Mods (Piercing & Tattoos) & Breastfeeding” – LLLI
• “FAQ on Tattoos and Breastfeeding” – LLLI
• “Tattoos And Breastfeeding. Is It Safe? What Are The Risks?” – The MilkMeg
• What Every Breastfeeding Mother Needs to Know About Body Modifications (handout for personal use only)