In Reply:—
In our case report, we state that the magnetic resonance imaging scanning was performed without contrast because the patient was breast-feeding.1As Camann and Stuebe wrote, current recommendations suggest that the use of radiographic contrast media is compatible with breast-feeding.2
However, the informative sheet of all three contrast brands in use at our hospital state that breast-feeding is a relative contraindication to contrast medium use. One contrast medium producer recommends a 24-h suspension of breast-feeding for lactating women in case of contrast medium administration. Kubik-Huch et al. 3have demonstrated that small amounts of radiographic contrast medium are excreted into human breast milk during lactation, but the amount transferred to a nursing infant orally is so small that the authors state that the recommendation of a 24-h suspension of breast-feeding for lactating women should be reconsidered.
The clinical relevance of contrast medium excretion into human breast milk is not known. But because magnetic resonance imaging scanning without contrast gave us a satisfactory diagnostic certainty, we decided not to expose the patient to an avoidable risk.
*Vita-Salute University of Milan, IRCCS San Raffaele, Milan, Italy. albertin.andrea@hsr.it