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In Reply .—Dr Mimouni highlights two important points that I and my colleagues addressed in our report: (1) He indicates that there is no need to perform renal ultrasonography if a supernumerary nipple is identified in an otherwise normal individual without a history of urinary tract problems. (2) He believes that the presence of a supernumerary nipple in an infant or child with multiple congenital anomalies is an indication for an ultrasound examination of the kidneys. In his editorial, Dr Hoyme agreed with this approach. Recently, a follow-up study from Hungary 1 again demonstrated an increased incidence of renal malformations in infants and children with a supernumerary nipple who were otherwise normal. Renal abnormalities were found in six (8%) of 78 patients hospitalized for illnesses unrelated to the urinary tract and healthy newborn infants; the authors believed this reinforced the original recommendation by Mehes 2 to perform roentgenographic studies of