Friday, May 07, 2010

How did Mother's Day Come About?

Mother's Day is a special day to honor mothers everywhere for their sacrifice, dedication, endless patience and limitless love.

Mother's Day was first suggested in 1872 by Julia Ward Howe (who wrote the words to the Battle Hymn of the Republic) as a day dedicated to peace. She began holding an organized Mother's Day meeting in Boston, Massachusetts every year. But it wasn't until 1907 when Anna Jarvis of Philadelphia began a campaign to establish a national Mother's Day. Ms. Jarvis persuaded her mother's church in Grafton, West Virginia to celebrate Mother's Day on the second anniversary of her mother's death, the second Sunday of May. By the next year Mother's Day was celebrated in Grafton as well as Philadelphia.

Mr. Jarvis and several of her supporters began to petition ministers, business and community leaders and politicians in their effort to establish a national Mother's Day. In 1910, the governor of West Virginia proclaimed the second Sunday in May as Mother's Day and just a year later every state celebrated it. In 1914, President Woodrow Wilson officially proclaimed Mother's Day as a national holiday that was to be held each year on the second Sunday of May.

Take advantage of your special day and treat yourself to something special - from something as small as a decadent dessert to a full-on day of celebration. And if your partner seems to be stumped and needs some help coming up with a special way to celebrate and honor you this Mother's Day, here are some hints:

  • Spa day - Send her to a local spa for a day of pampering to relieve her aching back, swollen ankles, and pregnancy stress. If this isn't financially feasible, treat her to an at-home spa day. Give her a foot and shoulder massage, then let her relax on the couch with her feet up and a stack of her favorite magazines or DVDs while you cater to her every whim.
  • Couple's Day - If this is your first baby, you only have a few months until finding time to be alone (and awake) together becomes a challenge. Take advantage of this opportunity and arrange to do all your favorite things together. Be sensitive to what she can't do now that she's pregnant, such as riding a bike, and focus on things she can still do and enjoy.
  • Indulge Her - What are her favorite dishes? Is she a choco-holic? Indulge her food fantasies by making her favorite foods or splurging on meals at her favorite restaurants, complete with dessert and treats.
  • The Basics - Who can argue with jewelry? It's a guaranteed hit. Select a meaningful piece, such as a necklace featuring a charm of a baby rattle or baby's feet. Don't forget a huge bouquet of flowers to let her know how much you admire and love her.
  • Pour Your Heart Out - Write her a love letter telling her exactly how much you love her and how excited you are to share with her the adventure that is parenthood.

Happy Mother's Day from all of us at ParentingWeekly! May this be the first of many!


Thursday, May 06, 2010

7 Tips to Get Ready for Breastfeeding

The world tells us breast is best, but when you're pregnant for the first time, planning to breastfeed can be intimidating.

All the conflicting advice doesn't help -- toughen up your nipples! No, don't touch them!

You're going to be leaking milk like crazy! No, that milk won't come in for days after baby's born!

The Stir got the skinny on what you really need to know to be ready to breastfeed from Laura Keegan, a family nurse practitioner and author of Breastfeeding With Comfort and Joy: A Photographic Guide for Mom and Those Who Help Her, who maintains a holistic family practice in southern Dutchess County, New York.

"Communication with your partner, family, and friends about your plans to breastfeed and what you'll need from them in the early weeks is THE most important component of breastfeeding preparation during pregnancy," says Keegan. "There's a learning curve experience to breastfeeding and everyone in your circle needs to be prepared."

  1. Chat up your family. Limiting visitors postpartum is recommended by the World Health Organization's Baby Friendly Hospital guidelines to get acclimated to breastfeeding. But you'll have to tell grannies and aunties beforehand.

    "A good rule for visitors in the first weeks is to limit their stay to 15 minutes per visit and request that they bring a meal," Keegan says. "To provide perspective, in cultures where breastfeeding is the norm, women and their families have a period of 40 days with minimal visitors and activities outside the home combined with full support from their community in terms of meals and child care."

  2. Talk to your partner about what to expect. "Although it's difficult to anticipate the experience of a crying baby having difficulty taking the breast in the middle of the night, it's important to talk about the importance of staying calm and focused during those challenging times and understanding and anticipating that it's a normal part of the learning curve," Keegan says.

  3. Talk to your health-care provider. "Let them know that you want to have your baby placed immediately on your chest at birth and to delay all routine procedures until after you've had time skin to skin with your baby, allowing your baby the opportunity to feed within the first hour of birth," Keegan suggests. "Consider writing a birth plan to communicate your preferences, because how you birth your baby can impact breastfeeding. With a Cesarean birth, the baby can be brought to the chest and feed even as the incision is being closed."

  4. Find a pediatrician with breastfeeding expertise or a lactation consultant. "Ask if someone will be able to observe and evaluate your baby feeding during an office visit, if there's a concern about the baby’s weight," Keegan says. "Have a phone number available for a trusted lactation specialist or consultant in your area to call should you need assistance."

  5. Talk to the hospital staff. Ask for the baby to "room in," and let them know there should be no use of artificial nipples (i.e., pacifiers, formula bottles).

  6. Find breastfeeding moms. Talk to them for tips now but also so you'll have someone to reach out to when baby comes. They can work with you on ways to hold the baby that "facilitate ease in breastfeeding rather than the ways you may be accustomed to seeing for bottle-feeding," Keegan says.

    "In cultures where breastfeeding is the norm, moms hold their babies more to the center of their bodies than you might expect because with bottle-feeding, we hold our babies more to the side of our bodies for bottle placement," she explains. "This bottle-feeding imprinting causes many unnecessary challenges for breastfeeding, and the desire to correct this imprinting was the inspiration for Breastfeeding With Comfort and Joy."

  7. Talk to your boss. "Seek out comfortable places to nurse in advance for when you're on the go, so you'll feel prepared to nurse outside your home in comfort just as a bottle-feeding mom is comfortable nursing outside her home," Keegan suggests.


Alcohol in pregnancy may boost child's leukemia risk

Women who drink alcohol while pregnant raise the risk that their child will develop a rare type of blood cancer called acute myeloid leukemia, or AML, a new study suggests.

In a pooled analysis of data from published studies, researchers found that drinking alcohol during pregnancy was associated with a 56 percent increased risk of AML in children.

But in an email to Reuters Health, Dr. Julie Ross of the University of Minnesota in Minneapolis, who was not involved in the study, said it's important for women to know that childhood AML is rare (about 700 cases are diagnosed each year) and likely has many causes.

Moreover, she said: "The vast majority of women who consume alcohol during pregnancy will not have a child who develops leukemia. However, given other risks associated with alcohol drinking during pregnancy, these results can help to reiterate the message that it is probably best to abstain from alcohol if you are pregnant or planning to get pregnant."

What causes leukemia in children is largely unknown, but researchers suspect it may be an interaction between genes and the environment, including drinking alcohol, Dr. Paule Latino-Martel of the Research Center for Human Nutrition in France and colleagues note in a report published online today.

When the researchers looked at 21 previous studies of women's drinking habits during pregnancy and childhood leukemia, they found that women who drank during pregnancy had a 56 percent increased risk of childhood AML, they report in the journal Cancer Epidemiology, Biomarkers & Prevention.

Ross cautioned, however: "While a 56 percent increased risk sounds like a lot, in real terms it means that with a childhood AML incidence rate in the US of about 8 cases diagnosed per million children, the risk might increase to about 12 cases diagnosed per million children. Thus about 4 more cases per million children."

Despite the recommendation that women abstain from alcohol while pregnant, it's estimated that 60 percent of Russian women drink while pregnant, as do 59 percent of their Australian counterparts. Fifty-two percent of French women, 30 percent of Swedish women and 12 percent of American women drink while pregnant, according to estimates.

For American women, Ross further explained: "If we are to believe that the risk (of childhood AML) is increased by about 56 percent, and that about 12 percent of US women drink alcohol sometime during pregnancy, this means that perhaps up to about 6 percent of childhood AML in the US might be attributable to alcohol consumption."

On the flip side, "this also means that 94 percent might be attributable to other causes," Ross noted.

Only a few of the studies reviewed by Latino-Martel's group reported results according to type of alcohol consumed -- beer, wine, or spirits -- and the existing evidence does not suggest that one type of alcohol could be more related to leukemia risk than another, they say.

The limited available data also make it impossible to tell whether it matters when women drink in the course of a pregnancy, although risk tended to be higher when alcohol was consumed later in pregnancy.

The researchers say it's possible the results were skewed because some women who drank during pregnancy did not admit to it "due to the stigma." There were other limitations: Only a few of the studies adjusted for smoking during pregnancy and factors such as exposure to pesticides, folate intake, birth weight and age of the women were largely not taken into account.

Despite these limitations and caveats, the current findings serve to strengthen the public health recommendation against drinking alcohol during pregnancy, the study team, and Ross, conclude.


Both parents' race may affect gestational diabetes risk

Researchers found that among nearly 140,000 women in one large California health plan, Asian women had the highest rate of gestational diabetes, at nearly 7 percent. They were followed by Native American women, at 5.6 percent, and Latina women, at 5 percent.

Rates of gestational diabetes among white and black women, meanwhile, stood between 3 and 4 percent.

But it wasn't only women's race and ethnicity that mattered, the study found. Expectant fathers' backgrounds also showed an independent association with the risk of gestational diabetes.

When the father was Asian or Hispanic, the researchers found, a woman's risk of gestational diabetes was 41 percent and 29 percent higher, respectively, compared with when the father was white. That was with other factors -- including the mother's race and ethnicity, age, body weight and education -- taken into account.

Native American ethnicity was also linked to relatively higher risks, though the association was weakened when other factors were considered.

Estimated to affect between 3 percent and 8 percent of pregnant women in the U.S., gestational diabetes arises during pregnancy and goes away soon after childbirth, though women who develop it have a higher-than-average risk of eventually developing type 2 diabetes.

Gestational diabetes can raise the risk of certain pregnancy complications, like high blood pressure in the mother and having a larger-than-normal baby, which may require a C-section.

Studies have shown that in the U.S., minorities generally have a higher risk of gestational diabetes than white women do.

These latest findings, published in the American Journal of Obstetrics & Gynecology, confirm a role for women's race and ethnicity in gestational diabetes risk.

But they also suggest that "in addition to women who are Asian, Latina, or Native American, women whose partners are of these racial/ethnic groups also appear to be at higher risk for (gestational diabetes)," write Dr. Aaron B. Caughey and his colleagues at the University of California, San Francisco.

The findings may help guide gestational diabetes screening, the researchers note.

For women at average risk of gestational diabetes, doctors typically perform a blood sugar test at some point in the second trimester. Those considered to be at high risk may be screened at their first prenatal visit and then retested later in pregnancy.

It is not clear why certain racial and ethnic groups are at increased risk of gestational diabetes, but genetic predisposition likely plays a role, according to Caughey's team.

They point out that a number of studies have found increased risks among Asian women, despite the fact that they have relatively low levels of obesity, a risk factor for both gestational and type 2 diabetes.

As for why the father's race and ethnicity matters, the researchers explain that fathers' genes, as well as mothers', influence hormones in the placenta. Placental hormones, in turn, affect a pregnant woman's sensitivity to the hormone insulin, which regulates blood sugar. Impaired insulin sensitivity can then lead to gestational diabetes.


Heavier Birth Weight Tied to Later Conduct Troubles

Among twins whose weight differs markedly at birth, the heavier child is more likely to have conduct problems at ages 3 and 4, a new study finds.

"The findings suggest an effect of birth weight differences on development of subsequent conduct problems," researchers led by Dr. David Mankuta of Hadassah Hebrew University Hospital in Jerusalem, said in a news release. "Further studies are needed to clarify the mediating factors of this effect."

The team studied 112 pairs of Israeli twins in which one weighed at least 20 percent more than the other. The twins were born in 2004 and 2005.

The researchers found that the heavier twin had more conduct problems in 41 percent of the twin pairs. The twin who weighed less had more conduct problems in only 21 percent of the cases.

The study findings were published in the May issue of Archives of Pediatrics & Adolescent Medicine.


Wednesday, May 05, 2010

Embryo mix-up baby 'loved by two families'

Someday, the little boy known as baby Logan will come to know about the extraordinary circumstances of his birth.

For the moment, the perfect little infant, dressed in plaid pants, a white polo shirt and sweater vest, remains blissfully ignorant of the international news he created, not to mention the emotional turmoil that accompanied his arrival in the world.

“He’s doing great. He’s doing wonderful. He’s healthy. He’s a happy baby,” his proud mom, Shannon Morell, told TODAY’s Meredith Vieira Tuesday in New York as her husband, Paul, cradled the nattily attired little boy, who slept serenely through his moment on network TV.

Logan was born just seven months ago, the result of a colossal mix-up at a fertility clinic that had implanted embryos belonging to Shannon and Paul Morell into another woman, Carolyn Savage. After first communicating anonymously through their lawyers, the Morells and Savages became friends and went through most of the pregnancy together.

After Logan’s birth, the Savages were given time to say hello and goodbye to the baby Carolyn had carried in her womb. Then they handed him over to the Morells. The couples, separated by about 150 miles, remain close and share e-mails, pictures and news about Logan. They also visited over the Christmas holidays.

Both families would learn that their bond is unusual among the rare cases when women have been implanted with the wrong embryos. Most often, experts say, the cases end in bitter lawsuits, custody battles and even abortions.

The cases are so rare and so jarring that the story was news around the world, and both the Savages and the Morells made appearances on TODAY in the days before Logan was born slightly prematurely last September.

Now, the Morells have written a book about their miracle baby, “Misconception: One Couple’s Journey From Embryo Mix-Up to Miracle Baby,” and hope that their experiences will help others entering the world of in vitro fertilization (IVF).

“We want to turn a negative to a positive, to help other couples who are out there,” Paul Morell told Vieira. “We wish we had this book when we experienced what we did. We thought it would be a tremendous help to a lot of people.”

The Morells said their message is not to avoid IVF. They have 3-year-old twin daughters who were born through the procedure as well as Logan.

“I say go ahead and do it. We have three great kids because of it,” Shannon Morell said. But, she added, couples contemplating IVF should be aware of the possible pitfalls and know what questions to ask of a prospective clinic.

In a statement to TODAY, Carolyn and Sean Savage said they’re not yet prepared to talk about their experience with Logan, but are writing a book to be published in 2011.

“We would like to thank everyone for their continued thoughts, prayers, and support. Unfortunately, these past seven months have been much more difficult for us than anticipated. As a result, we are still trying to gain perspective on this life-changing event. We will share our story in early 2011. Until then, we pray Logan Morell grows to understand his birth was a blessing and his life a gift,” the statement said.

The Morells are grateful for the Savages’ graciousness.

“They’re like extended family. We keep in contact. Whatever their schedule is, whatever they want to do, we’ll be happy to accommodate,” Paul Morell said.

“We’re just happy that they’re willing to continue to have a relationship so one day he’ll know who they are,” Shannon said, adding that one reason for writing the book is to let people know what extraordinary people the Savages are.

“Carrying a pregnancy isn’t easy. To say goodbye and be in the hospital and we’re taking the baby home — it had to be hard,” Shannon said. “A lot of people should know how great Carolyn is and what she did.”

The Morells aren’t sure how they’ll tell Logan about how he came to exist. “I think a little bit at a time,” Shannon said. She added that the infant will know that it was all very positive.

“It’s part of God’s plan and he’s been blessed. He’s loved by two families.” she said. “We’re going to make it sound as if it’s perfectly natural.”


Tuesday, May 04, 2010

Recalls of children's medicines spark worries

Parents may be worried by this weekend's recall of dozens of versions of Children's Tylenol and several other infants' and children's medications made by Johnson & Johnson's McNeil Consumer Healthcare division.

Parents voiced fears to pediatricians and pharmacists, and asked questions about the affected products - two dozen formulations of Tylenol, known generically as acetaminophen, along with liquid formulations of Motrin (ibuprofen), Benadryl (diphenhydramine), and Zyrtec (cetirizine).

So far, the advice for parents, at least, is clear: McNeil says they should stop using any of the affected products - essentially, any liquid formulation of those medications made by McNeil, which is based in Fort Washington.

Doctors and pharmacists recommend that parents replace the medications with generics of the same drugs or other brand-name versions, none of which are affected by the recall. Consumers can obtain refunds directly from McNeil or from at least some pharmacies.

What went wrong? Little is known. McNeil, in announcing the voluntary recall late Friday "in consultation with the U.S. Food and Drug Administration," says some of the products "may not meet required quality standards."

McNeil says the children's products may have "a higher concentration of active ingredients than is specified." They may also have contaminants that spokesman Marc Boston describes as "solidified product ingredients or manufacturing residue, such as tiny metal specks." He declined to say what metal or metals had been found.

Nor is it clear if McNeil is responding with an abundance of caution or faces greater concerns.

"They've had a lot of problems," says Don Mays, senior director of product safety for Consumer Reports. "It seems like they need better quality control and process control in the manufacture of these products."

This is the second major recall of children's Tylenol products in the last year. In September, more than 20 versions were recalled because of possible bacterial contamination.

Was there a danger to my child? It's impossible to say for sure, but McNeil is suggesting not.

"We have received consumer inquiries," Boston says. "But I can confirm that the recall is not being undertaken on the basis of adverse medical events" reported to the company.

Nor has the FDA so far suggested otherwise.

"While the potential for serious health problems is remote, Americans deserve medications that are safe, effective, and of the highest quality," FDA Commissioner Margaret A. Hamburg said in a statement Saturday. "We are investigating the products and facilities associated with this recall and will provide updates as we learn more."

By contrast, when McNeil voluntarily recalled some related products in January because of a contaminant it said caused "an unusual moldy, musty, or mildew-like odor," the company acknowledged "a small number of cases" of reactions such as nausea, stomach pain, vomiting, or diarrhea.

What if I'm worried? David Pollack, a Children's Hospital pediatrician and senior physician at the hospital's Care Network in Delaware County, says parents should report any concerns to their pediatrician, who will then notify the FDA and McNeil.

Based on the information available, Pollack said, "I could certainly believe that there's been no adverse effects on kids."

Can you substitute an adult version? Pollack and McNeil both warn against doing this, even with older children who can swallow pills, because of the danger of incorrect dosages.

"Every day we're faced with a misdosage when a mother is trying to convert an adult dosage to her kids," Pollack says. "If it's not really designed for children, we would tell them not to use it."

So what are the alternatives? Doctors and pharmacists say generic versions are widely available and considerably less expensive.

For more information on the recall or how to obtain a refund, go to You can also call 1-888-222-6036, but the company says it has been overwhelmed with calls and may not be able to answer.


Birth Defect Risk from Insect Bites Received by Mother During Pregnancy

A North Carolina State University researcher has discovered that bacteria transmitted by fleas-and potentially ticks-can be passed to human babies by the mother, causing chronic infections and raising the possibility of bacterially induced birth defects.

Dr. Ed Breitschwerdt, professor of internal medicine in the Department of Clinical Sciences, is among the world's leading experts on Bartonella, a bacteria that is maintained in nature by fleas, ticks and other biting insects, but which can be transmitted by infected cats and dogs as well. The most commonly known Bartonella-related illness is cat scratch disease, caused by B. henselae, a strain of Bartonella that can be carried in a cat's blood for months to years. Cat scratch disease was thought to be a self-limiting, or "one-time" infection; however, Breitschwerdt's previous work discovered cases of children and adults with chronic, blood-borne Bartonella infections-from strains of the bacteria that are most often transmitted to cats (B. henselae) and dogs (B. vinsonii subsp. berkhoffii) by fleas and other insects.

In his most recent case study, Breitschwerdt's research group tested blood and tissue samples taken over a period of years from a mother, father and son who had suffered chronic illnesses for over a decade. Autopsy samples from their daughter-the son's twin who died shortly after birth-contained DNA evidence of B. henselae and B. vinsonii subsp. berkhoffi infection, which was also found in the other members of the family.

Both parents had suffered recurring neurological symptoms including headaches and memory loss, as well as shortness of breath, muscle weakness and fatigue before the children were born. In addition, their 10-year-old son was chronically ill from birth and their daughter died due to a heart defect at nine days of age.

Results of the parents' medical histories and the microbiological tests indicated that the parents had been exposed to Bartonella prior to the birth of the twins, and finding the same bacteria in both children, one shortly after birth and the other 10 years later, indicates that they may have become infected while in utero.

"This is yet more evidence that Bartonella bacteria cause chronic intravascular infections in people with otherwise normal immune systems, infections that can span a decade or more," Breitschwerdt says. "Also this new evidence supports the potential of trans-placental infection and raises the possibility that maternal infection with these bacteria might also cause birth defects."


Antidepressant tied to risk of newborn heart defect

Women who use the antidepressant bupropion during early pregnancy may have an increased risk of having a baby with a particular type of heart defect, a new study suggests.

Researchers caution that it is not clear whether the medication, marketed as Wellbutrin, is the cause. And even if it is, they say, the absolute risk of the heart defect would be small -- affecting just 2 out of every 1,000 infants born to women who used bupropion during the first trimester.

But the findings, published in the American Journal of Obstetrics & Gynecology, do add to questions about the risks of using antidepressants during early pregnancy.

Some studies have already linked other antidepressants -- including some of the commonly used selective serotonin reuptake inhibitors (SSRIs) -- to higher-than-average, though small, risks of certain birth defects.

A study last year, for example, found that among nearly half a million Danish children born between 1996 and 2003, the risk of heart defects was elevated among those whose mothers had used SSRIs such as fluoxetine (Prozac), sertraline (Zoloft) and citalopram (Celexa) during early pregnancy.

In this latest study, researchers found that among more than 12,700 U.S. infants born between 1997 and 2004, those whose mothers used bupropion during early pregnancy had more than double the risk of heart defects known as left outflow tract defects, compared with infants whose mothers had not used the drug.

Left outflow defects affect the flow of blood from the heart's left chambers to the rest of the body. In this study, the most common type of this defect was coarctation of the aorta -- a narrowing in the body's main artery that, in children, typically requires surgical repair.

The findings do not mean, however, that depressed women on bupropion should stop taking it if they are planning a pregnancy, according to the researchers.

"I think it's important that women understand that they should not just stop taking their medication," said Dr. Jennita Reefhuis, a senior epidemiologist at the U.S. Centers for Disease Control and Prevention and one of the researchers on the study.

Instead, she told Reuters Health, women should talk with their doctors, ideally when they are planning a pregnancy rather than after they conceive.

The potential risk of birth defects from using antidepressants must be weighed against the risks of a woman stopping her current depression therapy, Reefhuis said.

"This study needs to be replicated before we can say anything conclusive," Reefhuis said, noting that the findings point to an association between bupropion and left outflow defects, but cannot by itself prove cause-and-effect.

If the association is causal, she said, the absolute risk to any one woman would be small. For every 1,000 births, there are an estimated 0.8 cases of left outflow tract heart defects; based on the current findings, that rate would be 2 per 1,000 among women who use bupropion in the first trimester.

Reefhuis also pointed out that with any pregnancy, the overall risk of having a baby with some form of birth defect is 3 percent.

Guidelines released last year by the American Psychiatric Association and the American College of Obstetricians and Gynecologists state that psychotherapy may be an effective alternative to antidepressants for pregnant women with mild to moderate depression.

However, the guidelines say, women with a history of more severe depression, or other major psychiatric disorders, may need to continue with their medication.

Bupropion is also prescribed for smoking cessation, under the brand-name Zyban. In the case of smoking cessation, Reefhuis said, it may be easier for women to find an effective alternative to the drug.


Monday, May 03, 2010

Jodie Sweetin is Expecting Second Child

Jodie Sweetin is expecting her second child.

The Full House actress - who is already mom to 2-year-old daughter, Zoie, with ex-husband Cody Herpin - is expecting a baby with her boyfriend of one year, Morty Coyle.

"They’re happy," Sweetin’s rep says, and adds that the actress, who has struggled with addiction, "is in a good place."

The 28-year-old finalized her divorce from Cody Herpin, the father of 2-year-old Zoie earlier this month, and the two are reportedly sharing joint custody.


High-dose vitamin D safe during pregnancy

Taking high doses of vitamin D during pregnancy is safe and appears to reduce the risk of preterm birth and infections, say the authors of a study that compared different amounts of supplementation in expectant mothers.

But their recommendation that pregnant women should take 4,000 international units of vitamin D daily -- at least 10 times the standard recommended amount -- is sure to generate controversy.

"When we first proposed the study in 2002, it was heresy to even think about giving more than 400 international units a day of vitamin D," co-principal investigator Dr. Carol Wagner said from Vancouver, where the two-part study is being presented at an international pediatrics meeting.

"Diet doesn't provide enough vitamin D, and we don't go in the sun as much as we need (to)," said Wagner, adding that her research team set out to determine the optimal dose of vitamin D supplements for pregnant women that would promote health without doing harm.

The researchers enrolled 494 pregnant women at 12 to 16 weeks' gestation in the study and assigned them to three groups: one group received 400 IUs of vitamin D a day until delivery; the second got 2,000 IUs; and the third 4,000 IUs. The women were tested monthly to ensure they were not suffering any negative effects.

Neither the women nor the researchers knew what dose of vitamin D they were receiving in the study, a "blinded," randomized controlled trial whose methodology is considered the gold standard of medical science.

"What we found was that 2,000 was better than 400, and 4,000 was the best, without any adverse events that were associated with vitamin D," said Wagner. "And then ... we found fewer infections in the 4,000 group and fewer preterm labors and-or preterm birth deliveries in the 4,000 group compared to the 400 group."

Analysis of the data also showed that the women taking 4,000 units of vitamin D had half the rate of pregnancy-related disorders, such as gestational diabetes and preeclampsia, compared to expectant mothers taking 400 units.

However, Wagner conceded that the notion of pregnant women taking a daily dose of 4,000 IUs of vitamin D will likely stir some debate, especially within the medical community. The current recommended daily dose is 200 to 400 IUs daily.

Dr. Gideon Koren, head of the Motherisk Program at Toronto's Hospital for Sick Children, said the study is too small to provide such a definitive recommendation and to "declare therapeutic superiority" of 4,000 units of vitamin D.

"I think for now women should be sure that they get the recommended dose. I don't know that this study by itself should send women to buy 4,000. No, no way. I don't think this is sufficient."

"The study's important to show that it doesn't cause side-effects, but I think to tell women that they need 4,000 - to go from 400 to 4,000 - is huge."

However, Dr. Reinhold Vieth, head of the Bone and Mineral Laboratory at Mount Sinai Hospital in Toronto, has long argued that recommended daily amounts (RDAs) for vitamin D are outdated and woefully inadequate.

Vieth, who has conducted numerous studies on vitamin D in different patient populations, said the Canadian Pediatric Society has been advocating 2,000 units during pregnancy since 2007.

"The next step, 4,000, well, I bet you they'll come up with that in a couple of years, because this (the Wagner-group study) has to get published first," he said, adding that he agrees that pregnant women should be taking that level of vitamin D daily.

Dr. Robert Gagnon, a spokesman for the Society of Obstetricians and Gynecologists of Canada (SOGC), said the study was well-designed and its findings are important.

The Montreal specialist said SOGC is in the process of reviewing the medical literature before deciding on its official recommendation for expectant mothers.

"We need to see all the details of the study before we come to the recommendation," he said. "To say (pregnant women) should take 4,000, I think it's a little premature for that."