OTTAWA – As a child, Jodie Cook hung back from the action on the soccer field picking dandelions and trapping grasshoppers rather than chasing the ball. Sports were never encouraged at home and fitness just didn’t interest her.

“I was the chubby girl in class, you know, 10 pounds heavier than the other kids,” she said. “It’s always been something I’ve dealt with.”

Cook is now 31, medically obese and pregnant with her first child. She worries her baby will grow up and repeat her experience: grappling with his weight and hanging back.

So she jumped at the opportunity to be part of the MOM trial – the Maternal Obesity Management study run by the Children’s Hospital of Eastern Ontario.

Amid growing evidence that obesity begins in the womb, CHEO’s Healthy Active Living and Obesity Research group is testing whether a nutrition and exercise program for overweight and obese pregnant women will influence the birth weight and growth patterns of their children.

“We know that pregnancy is a really important teachable moment,” said Dr. Kristi Adamo, the MOM trial’s lead researcher.

“Women will do all sorts of things in pregnancy that they would not do in their normal life.

“We’re hoping to capitalize on that period of time, where a woman is willing to change and motivated to change, not necessarily for her own health but certainly for the health of her child.”

Adamo said 40 per cent of women carry more weight during pregnancy than is considered healthy.

“If mom and dad are overweight or obese, their children tend to follow the same trajectory.”

The longer obesity persists, the harder it is to treat. The CHEO team is intervening at the earliest possible stage to see if they can stop the cycle of generational obesity.

The team’s goal is for the women to stay within recommended pregnancy weight gain limits. For obese women, that means gaining no more than 20 pounds throughout the pregnancy.

If the moms achieve that goal, Adamo’s team believes their babies will be more likely to have normal birth weights. Once born at a healthy weight, the babies will then be more likely to follow normal growth patterns throughout childhood. That would reduce their risk of obesity later in life.

Twice a week since January, the moms-to-be have gathered for a one-hour fitness class designed specifically for pregnant women. The focus is on strengthening the pelvis and upper back. The program changes as their bellies grow and some moves – such as knee-lifts – become challenging.

Cook, who is nearly eight months pregnant, found the workouts gruelling at first. Making time after a day’s work can be a challenge and the aches and pains that come with pregnancy make the sessions more daunting.

But she said she’s starting to feel a real difference in her body.

“I have better balance and I have more strength … I’ve been able to basically maintain my weight now. So in essence I’m gaining baby weight, losing body fat.”

The study will monitor about 30 women through their pregnancies over the next few years and compare their results with 30 others in a control group.

On top of the fitness class, the participants are encouraged to walk for 30 minutes three times a week. They also see a dietitian to develop a healthy eating plan that is laden with fruits and vegetables, controlled portion sizes and limited calories.

Dr. Michelle Mottola has been studying pregnant women for two decades at the University of Western Ontario’s exercise and pregnancy lab. She helped develop Canada’s first exercise and fitness guide for expecting moms.

Mottola found the overweight and obese women she studied were giving birth to larger than average babies and she’s now looking closely at the babies in a separate study.

She said it’s important to make the womb a healthy environment, but the home has to be prepped as well.

“Without incorporating family into the whole idea of behaviour change these women will actually pick up the bad habits that they had prior to pregnancy.”

A second intervention after pregnancy – with more nutrition and exercise – is critical to long-term success, she said.

“Without that … the women kind of fall off the bandwagon and pick up the bad habits that they had previously.”

Mottola’s team will monitor the babies in their trial until their first birthdays.

She said she would love to track the children for longer – especially looking at the critical period where they enter the school system – to see how successful their program really is. That depends on future funding.

Cook’s baby and other MOM trial kids will be monitored until they are two years old.

The MOM trial fitness program ends after the babies are born. But Cook said she and her partner are determined to continue the healthy lifestyle even after bringing home their new baby boy.

“I want him to have the start where we’re introducing physical activity into his life from a really young age.

“I want it to increase his health, or chances of being more healthy, and I also just want it to kind of spiral into something better for myself.”

WASHINGTON – U.S. federal health regulators say Johnson & Johnson managers failed to test for contamination of more than 40 varieties of children’s cold medicines recalled over the weekend .

An inspection report released Tuesday by the Food and Drug Administration lists more than 20 manufacturing problems found at the Fort Washington, Pa., plant where the formulas were produced.

The products were recalled in the U.S., Canada and 10 other countries. The recall included children and infant formulations of Tylenol, Motrin, Zyrtec and Benadryl.

In Canada, the company said the impact of the recall was limited to all lots of children’s Motrin and infants’ Motrin liquid suspension products and children’s Tylenol cough and runny nose liquid suspension only.

FDA inspectors visited the plant in mid-April and wrapped up their inspection Friday. J&J issued its “voluntary” recall later that night.

Among other problems, FDA inspectors said the company did not have laboratory facilities to test drug ingredients and failed to follow up on customer complaints.

The FDA previously said serious medical problems with the products are unlikely, but advised consumers to stop using the medicine as a precaution.

J&J’s McNeil Consumer Healthcare unit said some of the recalled medicines may have a higher concentration of the active ingredient than listed on the bottle. Others may contain particles, while still others may contain inactive ingredients that do not meet testing requirements.

The sweeping recall, which involved products sold in the U.S. and 11 other countries, is the latest quality issue to taint J&J’s over-the-counter medicine franchise.

In January, the company recalled a line of adult Tylenol pain relievers due to complaints of a mouldy smell associated with wooden pallets used to transport the drugs.

WASHINGTON – More than 40 over-the-counter infant’s and children’s liquid medications are being recalled in the United States and 11 other countries because they don’t meet quality standards.

McNeil Consumer Healthcare issued the recall for children’s versions of Tylenol, Tylenol Plus, Motrin, Zyrtec and Benadryl after consulting with the Food and Drug Administration.

The company is recalling the products because some did not meet required quality standards, the company said in a statement Friday. Some of the products recalled may have a higher concentration of active ingredient than is specified on the bottle. Others may contain particles, while still others may contain inactive ingredients that do not meet internal testing requirements.

The company is advising consumers to stop giving the products to their children as a precautionary measure. The recall was not undertaken because of any adverse effects, the company said.

The medicines were made and distributed in the United States, and exported to Canada, the Dominican Republic, Dubai, Fiji, Guam, Guatemala, Jamaica, Puerto Rico, Panama, Trinidad and Tobago and Kuwait.

Details, including NDC numbers, are available by telephone at 1-888-222-6036 or on the Web at www.mcneilproductrecall.com.

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On the Net:

McNeil Product Recall Information: http://www.mcneilproductrecall.com

Food and Drug Administration: http://www.fda.gov/medwatch

TORONTO – Taking high doses of vitamin D during pregnancy is safe and appears to reduce the risk of pre-term 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.

In the 1950s and ’60s, there was concern that vitamin D could cause birth defects, said Wagner, a pediatric researcher at the Medical University of South Carolina in Charleston.

That idea was later debunked and growing evidence has shown that the so-called sunshine vitamin is critical for maternal and infant health, including ensuring strong bones and proper function of the immune system.

“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 pre-term labours and-or pre-term 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 pre-eclampsia, compared to expectant mothers taking 400 units.

“So that blew us away.”

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.

And given the responses of several experts asked to comment on the study, Wagner is right.

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.

The Canadian Cancer Society recommends that adults should consider taking 1,000 units a day during the fall and winter. However, older and darker-skinned adults should think about taking that amount year-round.

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.

“Yes, absolutely. They’d be foolish not to.”

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.”

VANCOUVER, B.C. – New mothers who want to give up their infants because they face addiction, poverty, or are still just children themselves, will soon be able to walk away after anonymously dropping their babies off at a Vancouver hospital.

St. Paul’s Hospital will launch its Angel’s Cradle program, the first of its kind in Canada, on May 3. The downtown hospital said Thursday the initiative is designed to provide a safe haven for troubled mothers who can’t care for their infants.

Mothers will be able to place their babies inside a bassinet in the emergency department and leave. The cradle, which sits in a secure area, is equipped with an alarm that lets hospital staff know 30 seconds after the baby has been put inside.

Neither hospital employees nor Vancouver police will make any effort to track the mother down.

Dr. Geoffrey Cundiff, who works in the hospital’s obstetrics and gynecology department and helped design Angel’s Cradle, said he doesn’t believe it will lead to more children being abandoned.

“I think that there’s a sizable subset of people who, when they first hear about it, it seems wrong because the whole idea of a mother abandoning a baby is hard to take,” he said.

“But I think when they actually stop and think about what we’re trying to do, we’re trying to make sure that there’s an alternative for the baby, I think that it’s usually well received.”

Providence Health Care, a faith-based organization that operates the hospital, said infant abandonment is a fact of life and this initiative provides a better option than simply leaving a baby outside, or worse.

St. Paul’s has had abandoned infants before, including a three-to four-hour old newborn that was found wrapped in a towel and plastic bag. A newborn’s body was found in a Richmond, B.C., dump last February.

Once a health assessment on any infant left at St. Paul’s is complete, the baby will be placed in the care of the Ministry of Children and Family Development.

If the mother later decides she wants her baby back, she has the option of contacting the ministry and arranging a meeting with social workers.

“We feel that women who are in this situation are part of our patient population and there is really no other resource for them that specifically allows them to remain anonymous and so we thought it was in our mission to provide this,” Cundiff said.

“Women who are in these circumstances, obviously, it must be a very difficult situation.”

Greg Smith, executive director of Vancouver-based Options for Sexual Health, previously known as Planned Parenthood, said his organization is firmly behind the Angel’s Cradle program.

“From our perspective, this is a good idea. Anything that supports the health of new babies and new mothers is good,” he said.

Like Cundiff, Smith said it’s unlikely the program will lead to a greater number of babies suddenly being abandoned.

“I don’t think that anybody will be less careful about their decisions on sexual health or sexuality just because the Angel’s Cradle is there,” he said.

Smith said mothers leaving their babies behind is very rare and when it does happen, it speaks to the extreme level of crisis in one’s life.

“I think we need to really appreciate what kind of crisis a woman is in to come to this decision,” he said.

“Having a baby can be overwhelming for anybody but if you’re young and not very capable in terms of looking after a baby and so on, then that becomes a very daunting prospect.”

Sarah Payne, coordinator at Sheway, a Downtown Eastside pregnancy outreach program that’s located just a couple of kilometres from St. Paul’s, said age isn’t the only obstacle new moms in the area might face. There’s also poverty and addiction.

BEIJING – China’s top health body said Thursday that health workers who improperly dispose of dead babies will be “severely dealt with” following an investigation into the dumping of several bodies along a river in eastern China.

A scandal erupted last month when the bodies of 21 babies and fetuses – some with hospital identification tags around their ankles and at least one stuffed in a yellow bag marked “medical waste” – were found washed ashore on the Guangfu river on the outskirts of Jining city in Shandong province.

The Ministry of Health said on its website that hospitals should dispose of dead babies as they would any other corpse.

“The incident exposed loopholes in the hospital management, created negative social influence and yielded profound lessons,” the Ministry of Health report said.

The report said dead babies and fetuses should not be treated as medical waste, but did not give details on how local hospitals normally dispose of medical waste.

Calls to the Ministry of Health rang unanswered Thursday afternoon.

Two hospital mortuary workers, Zhu Zhenyu and Wang Zhijun, were fired by their hospital and detained by police as suspects, the official Xinhua News Agency reported, citing Jining government spokesman Gong Zhenhua. The babies’ families had paid the pair to dispose of the bodies, but they instead dumped them at the river.

In China, most families are permitted to have only one or two children and a traditional preference for sons remains strong and the abandoning, aborting and killing of newborn baby girls is still common in rural areas.

Infants who die from disease are often abandoned or buried in unmarked graves, not being old enough to be formally considered part of the family.

Parents who purchased Foaming Baby Wipes Solution at four stores in Ontario and Quebec will want to pitch them after Health Canada issued a warning they could pose a health risk.

Northern Essences of Georgia produces the solution, which is contaminated with bacteria, Health Canada said in an advisory.

Consumers who have the product are being told to stop using it immediately and throw it out.

Foaming Baby Wipes Solution is in a clear bottle with a white label and carries the Universal Product Code 2008100227.

The product is contaminated with a Micrococcus species of bacteria, which may cause urinary tract infections, skin infections, or result in more serious complications in people with weakened immune systems.

Health Canada became aware of the contamination through its routine sampling and testing program.

It’s unknown how many units were sold in Canada, but there are four retailers listed on the company’s website. They include Boutique Pousse-Pousse in Longueil, Que.; Calins et Popotin in Montreal; Vive la vie in Ste-Marie de Beauce, Que.; and A Mother’s Touch in Ottawa.

Health Canada says it hasn’t received any complaints related to the use of the product.

CALGARY – Cassandra Murray is a true believer in the benefits of infant chiropractic care.

The 35-year-old mother of four from High River, Alta., just south of Calgary, has been bringing her brood to Calgary chiropractor Dr. Judy Forrester for the past six years, and is just one of a growing number of parents looking to chiropractors as an alternative to traditional health care.

“She adjusted both of us today. I’m getting adjusted just because of carrying a baby around in a car seat,” said Murray, holding three-month-old Brady in her lap following an appointment at the clinic last month in northwest Calgary.

“Through all of my pregnancies she adjusted me to help align my hips and kind of helped baby drop near the end and actually while I was pregnant with Brady she helped me because I had a lot of sciatica, sharp pains up my back.”

Anyone who has ever heard the sharp crack of a chiropractor adjusting a patient’s spine might cringe at the idea of an infant being treated. But for babies, the manipulation amounts to little more than a light touch or massage.

Proponents of infant chiropractic care say a child can experience misalignments of the spine during the birth process which can be corrected with this gentle manipulation. And although there’s skepticism in the medical community, they also believe it can be a cure-all for digestive problems as well as for constipation, colic and even ear infections.

“I knew she wouldn’t adjust a baby the way she would adjust an adult,” explained Murray. “When I got adjusted the first time it scared the crap out of me. It is just such a loud crack I had never experienced it before. But no, it’s a lot different.”

Murray had successfully brought her daughter Rylee, 4, to Forrester to deal with colic. Now she is worried about the range of motion in Brady’s neck.

“He would not turn his head to the left. That’s why he had a flattening of his head and in three appointments he looks to the left all the time now and it’s done wonders,” she said.

Forrester, who has been on the job for 32 years, estimates that about 65 per cent of her practice is infants and young children, and she sees about 20 new babies each month.

“A lot of people go to a chiropractor as a last resort. They’ve tried everything else. We’re only the last few years considered more mainstream so there’s been all those years where we’ve been held in a little bit of suspicious light,” Forrester said as she treated Brady.

“I’m just feeling his neck. We want to feel what the structures are doing because there can be just a normal deformity or what we call an anomaly,” she explained.

“I’m moving his head a little bit because I’m determining what the range of motion is between the vertebra, looking to see if there is any imbalance between the musculature which, in this little guy, is one of the specific things.”

Forrester said most patients who seek her services have done their homework but still need reassurance.

“What they want to do is the laying on of the eyeballs, especially if they’re pregnant because they are making decisions for more than themselves or they’re bringing their babies in,” she said with a chuckle.

“But they’ve usually been referred and kind of have their ducks in a row but want to make sure that I don’t have hairy armpits and chew garlic and I’m going to be gentle.”

There was a time when the gap between chiropractors and doctors was very wide indeed. That has changed, said Forrester, who receives referrals from some family doctors and pediatricians.

“It’s more of a collaborative approach now.”

The president of the Alberta Chiropractic Association said the number of parents bringing in their little ones for treatment is growing, and he’s seen many children in his 35 years of practising.

“People would believe as the twig is bent so grows the tree. People would bring kids in for spinal checkups in the same way they would make their first dental appointment,” said Dr. Clark Mills, who has an office just west of Edmonton.

But there are no guarantees.

“I’m not saying it’s the kind of thing where chiropractic bats a thousand but in the odd infant, if you’ve got one of those screaming mimis who is going night and day these parents are literally at their wits’ end,” he noted.

“Sometimes a little bit of manual adjustment of the spine seems to calm them down. Sometimes it’s miraculous and sometimes it takes a few sessions.”

According to the U.S. National Library of Medicine there is no actual evidence that spinal manipulation helps with the treatment of colic.

“The totality of this evidence fails to demonstrate the effectiveness of this treatment,” read the website. “It is concluded that the above claim is not based on convincing data from rigorous clinical trials.”

Some members of the medical profession were hesitant to discuss the practice but Dr. Paul Woods, the clinical/medical director for the Department of Family Medicine at the University of Calgary, was willing to weigh in.

Woods said he is “open-minded about complementary therapies” and does refer some of his patients to chiropractors for treatment for some muscular-skeletal problems, back disorders, and problems with peripheral joints such as shoulders and knees.

“A lot of it depends if it is the type of person that think they would benefit and I do have that conversation because some people are terrified of chiropractors and some embrace them for all things,” said Woods.

He is not enthusiastic about infants being taken to chiropractors for treatment because they are not able to verbally communicate what is wrong with them. But he acknowledges there’s no indication that it will be harmful.

“I haven’t see a child that has been injured by it and I don’t think there are any reports of any miraculous life changing events for these children,” he added.

“I am doubtful about claims such as food intolerance or ear infections and that sort of thing. It’s kind of outside scientific feasibility which is one of the sort of assumptions that we do to evaluate any treatment.”

But Woods acknowledges that the two professions are working a lot more hand-in-hand now then they did in the past.

“I trained 25 years ago and back then it was doctors hate chiropractors and chiropractors hate doctors,” said Woods.

“I really have tried to get away from that because I do believe chiropractors do provide valuable care in certain conditions. I try and make it a collaborative relationship rather than a turf issue.”

LONDON – The number of women dying in childbirth worldwide has dropped dramatically, a British medical journal reports, adding that it was pressured to delay its findings until after U.N. meetings this week on public health funding.

A separate report by a group headed by the United Nations reached a very different conclusion on maternal mortality, saying the figure remains steady at about 500,000 deaths a year.

The disagreement reveals the politics behind public health, where progress made in tackling a health problem can jeopardize funding. Public health officials are gearing up to ask for billions of dollars this week at U.N. meetings .

The British medical journal Lancet rushed out a paper on Sunday that found the number of women who die in pregnancy or childbirth has dropped by more than 35 per cent over 28 years.

Richard Horton, editor of the Lancet, said he was disappointed when maternal health advocates pressured him to delay publishing the report until September, after several critical fundraising meetings. He also wrote a commentary in Lancet on the pressure.

“Activists perceive a lower maternal mortality figure as actually diluting their message,” he told The Associated Press on Wednesday. “Advocacy can sometimes get in the way of science.”

He did not name any group or individual who tried to pressure him.

In their paper, Christopher Murray and colleagues at the Institute for Health Metrics at the University of Washington found that maternal deaths have fallen from about 500,000 deaths in 1980 to about 343,000 in 2008. The study in the Lancet was based on more data than was previously available in addition to statistical modeling and was paid for by the Bill & Melinda Gates Foundation.

It was a surprising finding for experts who have long assumed that little progress has been made in maternal health.

But on Tuesday, another report by the Partnership for Maternal, Newborn and Child Health, a global alliance hosted by the World Health Organization, claimed progress in maternal health has “lagged.” According to their “detailed analysis,” from 350,000 to 500,000 women still die in childbirth every year. The authors did not explain where their data came from or what kind of analysis was used to obtain that wide range of figures.

In that report, U.N. officials also claimed they need $20 billion every year between 2011 and 2015 to save women and children in developing countries.

Dr. Flavia Bustreo, director of the Partnership for Maternal, Newborn and Child Health, denied there was any conflict between her group’s study and the Lancet study. She said her group was not involved in pressuring the journal not to publish Murray’s study.

“The debate on numbers may continue,” Bustreo said Wednesday. “But we welcome this as good news. There is hope at last for maternal health.”

In the world of public health, good news can paradoxically be bad news. The more people who are dying, the more money U.N. officials can raise, making some experts less keen to acknowledge that a problem is not as bad as they once thought.

The U.N. is hosting a meeting of public health experts and heads of state on maternal and child health this week in New York, followed by another one in Washington in June.

For years, U.N. AIDS officials threatened that the epidemic would spread among general populations in countries worldwide, and claimed more than 40 million people were infected. Money for projects fighting AIDS, meanwhile, grew exponentially.

When U.N. officials finally admitted they had been overestimating the numbers for years and dramatically revised their figures – down to 33 million – donors began to rethink their financial commitments.

Experts say public health figures need to be taken with a huge grain of salt, particularly when they come from people who are also soliciting funds for the campaign.

“The U.N. has a track record of inflating disease figures to keep the aid money flowing, so I’d probably place more faith in the figures which show a lower disease burden,” said Philip Stevens, of International Policy Network, a London think-tank . “This is yet more confirmation that whoever paints the most apocalyptic picture gets the most cash, even if they have to manipulate and spin the data.”

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On the Net:

www.lancet.com

www.who.int

Dozens of countries are unlikely to meet U.N. goals to significantly reduce the deaths of mothers and children by 2015 without a new approach to health care and an additional $20 billion annually, according to a study released Tuesday.

The study, conducted by the scientific-advocacy group Countdown to 2015, found progress lagged mainly in sub-Saharan Africa and South Asia where an estimated 82 per cent of maternal, newborn and child deaths take place.

The study was released on the eve of a press conference by Secretary-General Ban Ki-moon to kick off a new global initiative on reproductive, maternal and newborn health.

“This is a multi-layered problem that can be addressed with a combination of many, very simple interventions,” said Dr. Flavia Bustreo, director of The Partnership for Maternal, Newborn and Child Health, a group of more than 300 organizations, foundations, institutions and countries hosted by World Health Organization, working to achieve the U.N. goals.

What’s needed is “seamless” continuing care that includes family planning, breast feeding, hand washing, skilled attendants at delivery and childhood immunizations, Dr. Zulfiqar Bhutta of Pakistan’s Aga Khan University, who co-chairs of Countdown to 2015, said in a statement.

While countries have almost doubled their donations for maternal, newborn and child health in recent years, the study found there is a funding gap of about $20 billion per year between 2011 and 2015.

The U.N. Millennium Development Goals call for reducing the under-five mortality rate by two thirds and the maternal mortality ratio by three quarters by 2015.

According to UNICEF, 135 countries have child mortality rates of less than 40 per 1,000 live births or have a rate of reduction sufficient to meet the U.N. goal, but 39 show insufficient progress and 18 show no progress or a worsening of child mortality.

Countdown to 2015 estimated 350,000 to 500,000 women still die in childbirth every year.

If the funding gap was filled by 2015, the study found the lives of up to 1 million women, 4.5 million newborn babies and 6.5 million children aged 1 month to 5 years would be saved.