Intended for healthcare professionals

Minerva Minerva


BMJ 1999; 319 doi: (Published 31 July 1999) Cite this as: BMJ 1999;319:328

Pregnant women who smoke risk premature delivery, intrauterine growth retardation, and perinatal complications. Even after delivery their babies continue to inhale their mothers' tobacco smoke or ingest it in breast milk (Archives of Pediatrics and Adolescent Medicine 1999;153:689-91). In one study, breastfed babies had five times as much of the metabolite cotinine in their urine than bottle fed babies, if their mothers smoked. This result leaves health educators in a dilemma: if women can't or won't stop smoking, should they be advised to stop breast feeding too?

Cheap and cheerful thiazide diuretics are the best first line treatment for hypertension, according to a systematic review in the Canadian Medical Association Journal (1999;161:25-32). They are consistently better at lowering systolic blood pressure than other classes of drug, and are more acceptable to patients than β blockers, it concludes. More importantly, the review shows that a small dose of a thiazide diuretic prevents more coronary artery disease and stroke and saves more lives than β blockers, calcium channel blockers, or angiotensin converting enzyme inhibitors.

Children need calcium, but nutrition authorities are cautious about how much they recommend for preschool children because of fears that dietary calcium might interfere with iron absorption. At least one study, albeit a small one, shows that it doesn't …

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