Friday, September 24, 2010

Smart Phone Aps for Pregnancy

Here are pregnancy apps every parent or would-be parent should know about:

Contraction Timer for Android, free. Don't expect a lot of bells and whistles with free or cheap apps, but this one still gets the job done by letting users track time of contractions, duration and frequency. Available:

Foods to Avoid When Pregnant for iPhone, 99 cents. Moms-to-be may not be able to chomp down those spicy burritos or shrimp-flavored hotdogs anymore. And she must think about everything she eats to make sure it is healthy for a budding baby. This app allows users to choose foods that are safe and healthy for mom and baby and reveals which ones to avoid. Categories include Cheese & Dairy, Dressings, Sauces & Condiments, Drinks & Beverages and Fish & Seafood. Tips include whether or not feta should make the cut. (Only if it is made with pasteurized milk). Available: iTunes.

Contraction Calc for Blackberry, $2.99. Mom no longer needs a pen and pencil to track contraction activity. Whether you're at home or visiting friends when labor contractions kick in, this app helps you monitor and calculate how far apart they are and when to get ready for the hospital. Available: Blackberry AppWorld.

BabyBump for Android, $2.99. This app makes it easy to maintain a daily journal of the pregnancy experience. It can help keep a record of mom's weight, stomach growth and even body changes with the help of photos. Available:

Menstruation and Ovulation Pro for Blackberry, $3.99: Use this app to track menstrual cycles and to predict menstruation periods and probably ovulation days. Available: Blackberry AppWorld.

iPregnancy for iPhone, $4.99. This one delivers a wealth of helpful pregnancy information. Check out the Due Date Calculator, which offers predictions based on mom's last period, conception date and ultrasound dates. OB Visit Tracker helps monitor mom's weight, blood pressure and more. And the Baby Name Picker offers even more names to argue about. The app informs parents about average lengths and weights of babies at various gestational stages. Available: iTunes.

From Here to Paternity by Andrew Cullen for iPad, $7.99. A father chronicles his journey to parenthood on this e-book optimized for the iPad. It's romantic, funny, thrilling and easy to call up on your Apple tablet. Available: iTunes.

Pregnancy Calendar for iPhone, $9.99. This app features a happy bundle of tools for every soon-to-be-moms, including the ability to plan and track pregnancy from day one through birth. Record doctor visits, vital stats on the growing fetus and keep an eye on your diet. You can even keep a record of how many times the baby kicks. Available: iTunes.


Selecting Child Care While Pregnant

"I always tell parents the minute you get pregnant you need to go look," says Jenni Marsh with Hope Lutheran Church and School. "Especially for infant care, it's really hard, there aren't a lot of daycares that take infants and then, those that do, fill up pretty quickly."

In addition to getting that early start, workers with the Department of Family and Protective Services advise parents to ask friends and family for recommendations and research past violations.

"You need to look not just at numbers, because any daycare's going to have violations," says Greg Cunningham with the Department. "But you're going to want to look at the nature of them."

And don't ignore your mommy gut, says Marsh.

"Mother's intuition plays a lot into this and so I would visit the place and set what you get."

Those instincts can help when it comes to picking a pediatrician as well, says Dr. Jeremy Dalton.

"Generally, if a pediatrician is board-certified, then it's a pretty rigorous test."

The pediatrician also advises to "know whether you're going to mesh with them personality-wise."

If you ever don't feel comfortable experts say that's a clear sign to keep looking.


Safe Co-Sleeping Tips

Just like how there are rules to making your crib safe, there are rules to making your bed safe for co-sleeping, too.
Don't leave dangerous items on the floor.
Although your goal is that your baby never falls from your bed, it can happen. Babies can suffocate in a pile of your dirty laundry if they land face-down in it. Or drown if you happen to keep buckets by your bed. If your baby DOES fall off your bed, let's hope you actually hear it. Which leads me to ...
Don't leave baby unattended without a monitor ON the bed.
Unlike crib-sleeping, you cannot leave a half-awake baby on your bed. You only leave once they're out, and the second they make a peep, you need to be with them. The best way to make sure you accomplish this is to put the monitor receiver ON your bed, near the baby. You'll be able to hear them breathe, move, and unfortunately, even poop.
Commit to co-sleeping. Or just don't do it.
One of the problems with co-sleeping is when it's only done sometimes. You need to choose. Parents who co-sleep "sometimes" are at much higher risk for problems because they're not used to it -- baby or parents. No bringing the baby in at 2 a.m. because you're exhausted -- start the night there with your husband's consent or deal with the crib struggles.
It's not co-sleeping if you're not on a bed.
Some studies will count a drunk father passing out on the couch with a baby as co-sleeping or mark a woman passing out on an airplane and smothering her baby with her boob as a co-sleeping death, I don't count it, and neither do some more credible, non-crib-and-formula-manufacturer-biased sources. (The main promoter and funding of the US's anti-cosleeping campaign is done by the JMPA -- makers of cribs.) Co-sleeping is both parents intentionally and knowingly taking a baby into their own bed with them at night, every night. Passing out elsewhere is risky, so get to bed when your eyelids start drooping. Included in "unsafe things to sleep on" are waterbeds too.
Be sober and don't co-sleep if you have sleep issues.
Excessively obese folk can struggle with sleep apnea, which in turn, can make it harder for them to be aware of goings-on during the night, so co-sleeping's not recommended. If you're a heavy smoker, drugged up on Ambien, or just drank a bottle of scotch, not only should you probably have someone who isn't messed up responsible for your children, but you certainly shouldn't pass out with a baby tucked under your arm.
 Watch the fluff.
Make sure you're not putting warm blankets or your pillow on your baby's head. Wear a warm shirt so you're comfortable with your blanket being much closer to your waist, and if you've got one arm around the baby (as people who breastfeed while side-lying often do), train yourself to keep that arm on top of the blanket. Then you literally cannot pull the blanket over the baby. And on that note, if you're going to use a blanket, use something breathable, like a crocheted blanket. Unless it's winter and you have no heat, baby doesn't need a blanket really anyway -- footed jammies are pretty warm, and after the first week or so, babies need no more warmth than you do. Of course, keep your sheets pulled tight, don't put a million pillows or blankets on the bed, and make sure baby sleeps on her back.
 Keep it a one-kiddo affair.
Not to say you can't co-sleep with multiple children at once, but if you do, they need to be separated in the bed. Don't allow children to sleep next to each other, especially a much larger child with an itty bitty infant. Your fur-babies, too, need to know they can't lay with human-baby. Baby is best off being next to mom at all times (sorry Dad) because mothers have been shown to be uniquely aware of baby, even in the deepest sleep. Ask seasoned co-sleeping moms about the times they've caught their baby as they rolled toward the edge -- and THEN woke up and realized what happened.
When in doubt, skip it.
If you're not entirely comfortable with co-sleeping, don't do it! While numerous studies have shown that babies (especially in the SIDS risk time frame) are safest sleeping near their parents, this doesn't have to be in the same bed. Check out the Arm's Reach Co-Sleeper ($99.97 at Wal-Mart), or if you have a crib, you can even side-car your crib.
Don't take flak.
If other people start telling you it's unsafe, correct them. Point out that just like cribs, there are rules to do it safely, and done safely, baby is better off near mother as it helps them regulate their breathing, and moms are more aware of silent changes in the baby's body -- such as bouts of apnea or other distress. When babies are breastfed and co-sleep, they have the lowest rates of SIDS of any other category. And don't believe people who insist that the longer your child sleeps with you, the harder it will be to get them out -- this is almost always said by people who have never co-slept, think it's dangerous, or know one person with a horror story about how their child snuck in and climbed in bed with them until they were 8. It's really easy to gently wean toddlers out of your bed (Rowan slept on my floor on his mattress for six months before he chose to move into his room), especially when once they're weaned from the breast. It just takes time and understanding.


Thursday, September 23, 2010

Abbott recalls infant formula on bug contamination

Drugmaker Abbott Laboratories said Wednesday it is recalling millions of containers of its best-selling Similac infant formula that may be contaminated with insect parts.
The voluntary action affects up to 5 million Similac-brand powder formulas sold in the U.S., Puerto Rico, Guam and some Caribbean countries. The company said the products may contain a small beetle or larvae, which could cause stomach ache and digestion problems.
The recall does not affect any liquid formulas or other Abbott-brand products.
A company spokeswoman said Abbott uncovered the insects last week in one section of a manufacturing plant in Sturgis, Michigan.
"We immediately shut down that one area and began an investigation," said Abbott's Melissa Brotz. "We're in the process of resolving it now." Abbott manufactures Similac at several U.S. sites.
Brotz said the company has been consulting with the Food and Drug Administration, which determined there was no "immediate health risk" from the contamination.
Consumers can enter the lot number on their containers online to determine if they are subject to the recall. The products should be returned to Abbott for a full refund.
"Delivering anything less than the highest quality infant formula is unacceptable to us," said Brotz. "We will do whatever is necessary to maintain the trust of parents in the coming weeks."
The affected products were sold in plastic containers and various can sizes, including 8-ounce (227-gram), 12.4-ounce (352-gram) and 12.9-ounce (366-gram).
Similac is the best-selling infant formula in the U.S. Abbott's nutritional products — which include adult brands like Ensure — had sales of $5.3 billion last year.

Author Explains Autism Fertility Drug Connection

On May 20, 2010, researchers from the Harvard School of Public Health reported the results of a study in which they found that women who used fertility drugs to get pregnant had almost double the risk of having a child with autism spectrum disorder (ASD) as nonusers. The drugs studied included Clomid (clomiphene citrate) and Pergonal (gonadotropin). This was immediately picked up by the lay media, with many expressing shock and skepticism. But for attorney Terence Mix, it came as no surprise at all – he had predicted it over two years earlier. "I had been studying fertility drugs for 35 years," says Mix, "and it all made biological sense once I put the pieces of the puzzle together."

Mix’s book, The Price of Ovulation, although officially published in 2009, was completed well over a year earlier. “The key that tied all of the pieces together,” says Mix “was cholesterol – or the lack of it – to be more accurate. Approximately 58% of ASD children have low total cholesterol – less than 160 – and 19% have extremely low total cholesterol. About one in five ASD children have a total cholesterol count of less than 100.”

What was even more convincing to Mix was something he learned about children born with Smith-Lemli-Opitz syndrome or SLOS. These infants are born with a defective enzyme that impairs the body’s ability to produce cholesterol. This condition leads to a wide array of birth defects, but Mix noticed that about 70-85% of them are also born with autism spectrum disorder. “In my mind,” he says, “it was almost inescapable that low cholesterol during early pregnancy was at least one of the causes of ASD. We also know that cholesterol is essential for growth of the myelin membranes that cover the brain and abnormalities in the myelin sheath are believed to be a contributing cause of ASD.” For this reason, many experts believe that low cholesterol during early embryonic development is one of the causes of this condition, Mix points out.

But how did he tie this in with fertility drugs? “When I first saw the research on how low cholesterol could impact the formation of our organs during pregnancy, it was a jaw-dropping moment that I will never forget. That moment, which is captured in my book,” he points out, “brought everything together for me.” Clomid has a long half-life and remains in the body for well over a month, Mix explains. “Studies have shown that it can accumulate over successive cycles of treatment, and in the Harvard study they found that the longer the use of fertility drugs, the higher the risk of developing ASD.” He notes, “It is another piece of the biological puzzle.”

The clincher for Mix was something he had known about Clomid for over a decade, but he had placed little importance to it – the drug was a cholesterol inhibitor, just like Lipitor and other statin drugs. Its chemical structure was also similar to the cholesterol-reducing drug, Triparanol, which was briefly available during the 1960s. “It was a perfect fit,” says Mix. “Clomid impairs cholesterol production during the first 4-6 weeks of pregnancy, which along with a number of birth defects also has a problematic impact on the myelin sheath of the brain, resulting in autism spectrum disorder.”

Pergonal likewise reduces cholesterol, Mix explains, but via its ability to elevate estrogen production. Studies have established that following hyperstimulation of the ovaries by Pergonal, the resulting elevated estrogen suppresses the level of total cholesterol. “Both of these drugs have the ability to deprive the unborn baby of vitally needed cholesterol during a critical stage of development,” say Mix. “As a consequence, many are born with a number of birth defects and others with ASD.”

“The key is maintaining an adequate level of cholesterol throughout the pregnancy,” says Mix. “The animal studies cited in the book have demonstrated the feasibility of this, even in the presence of a cholesterol-reducing drug. This would allow women to use fertility drugs and at the same time reduce the risk of birth defects and ASD that might otherwise be caused by those drugs. All that remains to be done are human clinical studies to establish the desirable levels of cholesterol.”


Wednesday, September 22, 2010

Official of EU Parliament Brings Baby to Work

It's probably one of the few occasions when sleeping on the job would be positively encouraged.

Afterall, if Licia Ronzulli's baby did wake up, she would prove something of a distraction to other members of the European Parliament.

Mrs Ronzulli, an MEP from Italy, took her tiny daughter Victoria to a vote at Strasbourg. She kept her baby carefully cradled against her in a sling and occasionally lent to kiss her on the forehead.

The 35-year-old was taking advantage of relatively relaxed rules in the Parliament that allow women to take their baby to work with them.

Mrs Ronzulli won her seat in last year's elections and is a member of Italian Prime Minister Silvio Berlusconi's People of Freedom Party.

Victoria was born on August 10. Her father, Renato Cerioli, is also a member of People of Freedom.

Mrs Ronzulli is from the Lombardy region of northern Italy and won her seat with 40,000 votes.

She is a member of the environment, health and food safety commission in Strasbourg and has also worked as a nurse in Milan and Bangladesh before become a hospital director and then turning to politics.


Flu Shots & Pregnancy

Ever question if it's safe for you to get a flu shot while you are pregnant? It is! It's recommended by the Centers for Disease Control and Prevention (CDC) for all pregnant women to get influenza (flu) shots during flu season (flu season peaks from November to April). The CDC recommends that we should get our flu shots in October to prevent an outbreak of the flu virus.

Why are pregnant women on the priority list for flu vaccines? According to the Mayo Clinic, pregnancy puts extra stress on your heart and lungs, and also affects your immune system. Because of these factors, pregnant women are not only at risk for catching the flu, but also at an increased risk for developing serious complications (like pneumonia and respiratory problems) from the flu virus. In some cases, the flu virus may even lead to miscarriage, premature labor, or other pregnancy-related complications.

Nowadays, there is the option of receiving flu vaccines through a needle (a typical flu shot) or through a nasal spray. Mayo Clinic obstetrician and medical editor-in-chief Roger W. Harns, M.D. states that pregnant women should request the flu shot rather than the nasal spray. This is because the flu shot contains the inactivated virus (rather than the live virus vaccine found in the nasal sprays). The inactivated flu shot virus is healthier for mother and baby.

For the 2010-2011 flu season, only one flu shot is needed to stay protected. Flu.Gov explains how this years flu shots contain protection from both H1N1 (swine) flu and the seasonal flu.

The flu shot given during pregnancy has been shown to protect mother and baby (for up to 6 months after birth). For extra protection for your newborn, exclusively breastfeeding provides needed antibodies and safety for your baby that will help protect against flu viruses.

For extra information about keeping you and your baby safe from the flu, check out:


Tuesday, September 21, 2010

More moms in China do confinement after childbirth

When Noelle Leung learned she was pregnant, the first person she called was her doctor. The second was a confinement lady.

So-called confinement ladies are highly sought after in Hong Kong and other parts of Asia as experts who can guide women through what's believed to be a critical month after birth.

According to traditional Chinese medicine, the month after giving birth is when new mothers are especially vulnerable to health problems, so they're not supposed to go outside, take a bath, brush their teeth or do anything else that could allow "bad wind" into their bodies.

Today, the rules of confinement, called cho yuet, are being rewritten to adapt to the realities of life. Relatives used to care for new mothers and their babies, but today's changing needs are spawning alternatives, such as confinement ladies and postpartum hotels.

In Hong Kong, confinement helpers have become so popular that newly pregnant women have to reserve them immediately — and sometimes, that's not even soon enough. "It's very competitive," says Leung, 39, who practiced confinement after the births of Colin, now 5, and Chloe, nearly 3.

The concept of cho yuet, which translates to "sitting through the month," dates back thousands of years. Today, living conditions are more sanitary and hot water is readily available. So while it might not be necessary to follow every rule of confinement, the overarching principle is that "you have to be careful and let the body recover," says Lixing Lao, director of the University of Maryland's Traditional Chinese Medicine Research Program.

The American Congress of Obstetricians and Gynecologists has no official position on the practice. But Laura Castleman of ACOG's committee on global women's health says she has seen no evidence that not brushing your teeth, showering or going outdoors after childbirth provides "any benefit."

No numbers are available for how many women hire confinement helpers in Hong Kong. But providers here say they're coping with surging demand for their services.

Kwun Tong Methodist Social Service says that when it began offering confinement ladies in 1999, it was one of the only such groups in Hong Kong. Now, more than 20 organizations have similar services. Kwun Tong has expanded from 10 confinement ladies to 90, "but it's not enough ... the need is very large," says Tang Choi Hung, a coordinator for the group's social enterprise services.

When Mei Ng, 49, worked as a confinement lady, her duties ranged from changing diapers to cooking special meals. One reason there is such demand for these ladies, she says: Hong Kong "couples are richer, so they can hire people to help them.

"This has become a status symbol."


Hotline Advises on Safe Meds for Pregnancy and Breastfeeding

Have a question about taking a medication while breastfeeding or pregnant? The Infant Risk Center is now open.

Medications and Mothers' Milk, might be the best resource out there for information on medications and breastfeeding. But few mothers have this book, and far too few physicians and pharmacists have it. In fact, one recent study of two large retail pharmacy chains found that "for 75 percent of drugs that are considered unequivocally safe for breastfeeding, pharmacies were inappropriately advising mothers to stop nursing."

There is a online database, LactMed, which also can be helpful.

So here's the great news: Now anyone can have access to this gold mine of information. The author of Medications and Mothers' Milk, Dr. Thomas Hale, has opened the Infant Risk Center. The Center, which is associated with Texas Tech University Health Sciences Center at Amarillo and the Laura W. Bush Institute for Women's Health, is now open for calls on medication use during pregnancy and breastfeeding.

The goal of the center is to "provide accurate information regarding the risks of exposure to mothers and babies," which will "reduce the number of birth defects as well as create healthy breastfeeding relationships."

The center is now open for calls from Monday through Friday, 8-5 pm Central Time. The number to call is (806) 352-2519.


Encouraging Fetal Brain Development

Author John Medina outlines a workable formula for growing your baby's brain to its healthiest potential. It starts in utero, as you probably guessed. And it does not include playing classical music up against your bulging waistline or sitting in poetry readings at the public library. It DOES include eating healthy foods, getting plenty of rest, trying not to stress out, exercising and otherwise leaving your fetus alone.

Researchers say the good news is that the brain takes a long time to fully develop, so you have months and years to contribute to the healthy growth of your child's brain. Your baby's brain has to tie together 1.8-million new connections per second to make up a complete brain. Only 17-percent of that work is done before birth. 83-percent continues AFTER birth, up until the child is in his/her early 20s. Obviously, in humans, the brain is the last organ to finish developing. So take a deep breath... your child's healthy brain development has a long growth-curve that you can continually contribute to.

The first senses to develop are for survival...the senses of touch, sight, and hearing come by 4 weeks in the womb. The senses of smell, balance and taste come in weeks 5 to 8 during pregnancy.

To help your newborn during this developmental stage, take what Medina calls the "GOLDILOCKS" approach, where conditions are not too hot, not too cold, but just right. So try to eat the right amount of foods that are obviously healthy, so that you'll gain a healthy amount of weight during pregnancy (that differs for each woman, but approximately 25 pounds for a single fetus.) Your baby's IQ rises with their birth weight, so a full-weight baby is a smarter baby (up to 8 pounds, then a chubby baby's IQ starts to drop). And try to get plenty of Omega-3 fatty acids which are found in prenatal vitamins regularly prescribed during pregnancy.

Avoid stress during your pregnancy. Stress can make your infant more irritable, can lower your child's IQ and literally be the difference between a bright baby and a child with an average IQ. Stress can also limit your baby's motor skills and ability to concentrate as well as his/her stress-response system from birth to age 6. In effect, stress during your pregnancy can shrink your baby's brain. David Laplante, lead author of a key study on baby brain development says "we suspect that exposure to high levels of stress may have altered fetal neurodevelopment, influencing the neurobehavioral abilities in early childhood." Getting a little stressed out one day in a traffic jam is one thing. But frequent, severe recurring stress will hurt your little one. Take a stretch or yoga class, take a warm shower, get a pedicure, take a walk around the whatever lessens your stress level and your baby's brain will thank you!

Also try to get a moderate amount of exercise to both relieve stress and to help grow your baby's brain. It will reduce the toxic effects of day-to-day stress during pregnancy and will make delivering your child quicker and less painful, which is less stressful for both you and your baby. Because when your heart rate goes up, so does your baby's. Which is good in moderation for the baby's heart and oxygen supply. But overly strenuous exercise near the end of the pregnancy is also bad. It can overheat the baby and actually cause his/her oxygen supply to restrict from lack of blood flow. Again, think GOLDILOCKS - not too much of anything.

Interestingly, evolutionary biologists say morning sickness has a positive role to play, because it tends to make a mom stick to a bland diet, rest more and stay away from harmful activities - all of which protect her unborn baby. And here's one that will save you some money: Medina emphasizes that despite the boastful claims, no commercial product has EVER improved brain performance in a developing fetus! So don't buy expensive books, videos and DVD's expecting to increase IQ.


Monday, September 20, 2010

Women facing baby blues process negative emotions differently

Your hormones have nothing to do with those recurring baby blues. A new study has found that the brains of women with post-natal depression process negative emotions differently than new mothers without the condition.

Mary Phillips at the University of Pittsburgh, Pennsylvania, and colleagues, used functional MRI scans to compare the brains of 14 women with post-natal depression and 16 new mothers without while they looked at pictures of angry and sad faces.

They found that the depressed women had less activity in the dorsomedial prefrontal cortex - an area of the brain thought to pick up on emotional cues and mediate emotional responses - than the non-depressed women.

Women with post-natal depression tend to find it hard to bond with their babies, reports New Scientist.

Phillips suggests that this might be linked to a more general loss of interest in social interactions.

It was previously found that people with depression tend to be more sensitive to negative images than people free of it.

The new study has shown that new mothers with post-natal depression seem to buck this trend - shutting out negativity and not reacting to it.

The apparent deficit in brain activity was not seen in the healthy new mothers, she says, so it is unlikely that pregnancy alone causes the effect.

But more research is needed to find our whether the deficit is caused by depression or if women with less activity are predisposed to post-natal depression.

The study has been published in The American Journal of Psychiatry. (ANI)


"Snus" tobacco linked to stillbirth risk

Pregnant women who use a smokeless form of tobacco known as "snus" may have a risk of stillbirth on par with women who smoke cigarettes, a large study of Swedish women suggests.

The findings, say experts, should serve as a warning to women who are or may become pregnant that snus is not a "safe" alternative to cigarettes.

Snus, also called moist snuff, is different from other smokeless tobacco products because it is "spitless" and has lower levels of toxins called tobacco-specific nitrosamines.

Snus is generally thought to be less harmful than cigarettes as far as the risks of heart disease and cancer, and the product has been advocated as a "socially acceptable" way for smokers to get their nicotine fix -- and as a way to help them cut down on cigarettes.

Snus originated in Sweden and is still mainly used there. But in the past few years tobacco makers have been test-marketing their own snus products based on the traditional Swedish one. Brands such as Camel Snus and Marlboro Snus are now available in the U.S.

Smoking during pregnancy is well-known to carry risks, including elevated odds of miscarriage, low birth weight and stillbirth.

Much less has been known about the potential harms of using snus during pregnancy. But a study published earlier this year by the research group behind the new study found that women who used snus during pregnancy had a higher risk of preterm delivery than those who used no tobacco products.

For the current study, published in the journal Epidemiology, the Swedish team used a national birth register with information on nearly 611,000 women who were pregnant between 1999 and 2006. Of these, 58,502 were tobacco smokers and 7,629 used snus.

Overall, 1,926 of the women in the register -- or about 0.3 percent -- had a stillbirth. (Stillbirth generally refers to a pregnancy loss after the 20th week; but in this database, it was defined as a pregnancy loss after the 28th week or later.)

The study found that women who reported using snus during pregnancy had a 60 percent higher risk of suffering a stillbirth than women who used no tobacco products. The risk was 40 percent higher for light smokers, and for heavy smokers it was more than double that of non-users of tobacco.

Among the women who reported using snus, 0.5 percent (40 women) suffered a stillbirth; that compared with just under 0.3 percent (1,386 women out of more than 500,000) of those who used no tobacco products during pregnancy.

Of the 41,488 women considered light smokers -- nine or fewer cigarettes per day -- 0.4 percent (172) had a stillbirth. And among the 17,000 women who smoked more heavily, the stillbirth rate was 0.7 percent (120).

Although snus may appeal to pregnant women who are trying to avoid cigarettes, "using moist snuff is not a safe way to quit smoking when you are pregnant," lead researcher Dr. Anna-Karin Wikstrom, of Karolinska University Hospital Solna in Sweden, told Reuters Health in an e-mail.

The study has limitations. Dr. Gregory N. Connolly, director of the Tobacco Control Research Program at the Harvard School of Public Health noted that women were asked only whether they used snus or not, and not how often. It would have been helpful, he said, to see whether heavier users had a higher stillbirth risk than light users (as was seen among cigarette smokers); such a "dose-response" relationship would provide stronger evidence that the snus itself was the reason for the increased stillbirth risk.