Bonitas – innovation, life stages and quality care

Safe cribs and playpens to use when travelling

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Make sure the mesh is less than 1/4 inch in size so it’s smaller than the buttons on your baby’s clothing. Make sure the mesh is in good repair without any tears, holes or loose threads that your baby can get caught on. Make sure the mesh is fully attached to the top rail and bottom of the bed so there are no holes for the baby to get caught in. Make sure there are no bare, missing or loose staples or nails. When in doubt throw it out – don’t use cribs or bedding that might pose a risk to your baby. It’s your job to keep them safe! Fire safety for home with newborn The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Check your smoke detectors and carbon monoxide detectors to make sure they have fresh batteries and are in working order – install them in your home if you don’t have them already. Check your fire extinguishers to make sure they are in working order – purchase them if you don’t have one on each floor of your home already. Make sure clothing and bedding meet fire safety standards – information on their fire safety rating should be on labels and tags. Insist that your home be smoke free to prevent your baby’s exposure to second-hand smoke and also as a fire prevention measure since cigarettes are a common cause of home fires. Review or update your fire escape plan to include your new baby – review the plan with everyone in the household. For more information on fire safety visit websites like the U.S. Consumer Product Safety Commission (CPSC). Fire safety prevention in home with newborn The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Do a fire safety walk-through of your entire house, check for burnable substances near heat sources, frayed or damaged electrical cords, matches or lighters within reach of children and other situations that may be a fire hazard. Never leave space heaters of any type unattended and turn them off while you are asleep. Never store flammable liquids like paint thinner, charcoal lighter fluid or gasoline in the house and always keep them a safe distance from heat sources. Check all mattresses, bedding and sleep apparel for your baby to make sure they meet fire safety requirements – this information should be on the product label. Early warning of a fire is key to keeping your family safe, so make sure your smoke detectors and fire extinguishers meet local codes and are in working order. Be prepared and have a fire escape plan that is understood by and has been practiced by the entire household, it could save lives in a fire emergency. For more information on fire safety visit websites like the U.S. Consumer Product Safety Commission (CPSC). Newborn safety tips The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Never leave your baby alone for even a minute unless they are in a secure place like a crib or playpen. Make sure you follow safe sleep recommendations when putting your baby to bed. When in the car always use a safety approved rear-facing car seat that is specifically made for newborns. Never ever leave your baby alone in a car – be especially careful during warm or cold weather. Always use safety approved car seats, cribs and toys – if they are hand-me-downs or you are buying them used, choose items that still have a safety tag attached and check to make sure they haven’t been recalled. To prevent burns never carry hot liquids or food while you are holding your baby. Pet safety and newborns The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. If you have a dog, know that certain breeds may require extra caution with a newborn – German Shepherds, Rottweilers and Pit Bulls account for more than 50% of fatal dog bites. Always closely supervise infants when in the presence of dogs even if they are not one of the above breeds – they may experience jealousy and have other unexpected reactions to a new member of the household. Keep in mind that some pet reptiles can carry infections, like Salmonella, so keep turtles, snakes and lizards away from children under 5 years of age to prevent the spread of infections. Small pets like rodents should be kept away from newborns and infants to prevent bites or the spread of Salmonella and other possible infections. Other issues: Make sure your pet is healthy – take them to the veterinarian for a check-up and any needed vaccinations before the baby is born. Keep your pet’s nails trimmed. For cats and dogs especially, you may need to work to prepare them for the new member of the family – for example, invite friends with babies over if your pets aren’t used to children – supervise their interactions as they learn about these new additions to their world. New situations can be stressful to pets so be patient and understanding with them as they adjust to the changes in their life – scolding and punishment will only add to their stress. There are many things you can do to ensure a smooth transition, so contact your local Humane Society or other animal-focused organization for additional suggestions on preparing your pets for the arrival of your new baby. Newborns and sun exposure The following information is to be used as a guide to and at the discretion of

Bonitas – innovation, life stages and quality care

New Dad’s roles

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Know that it’s normal to have fears – there is no simple way to prepare for parenthood and all new parents (yes Moms too!) have some concerns or fears about their new role. Learn as much as you can about your baby’s daily routine and offer to help out with activities you are comfortable doing. Make “Daddy Time” a special time every day by spending one-on-one time talking, reading or singing to the baby – work with Mom to build these activities into the daily routine. Offer to attend your baby’s doctors’ visits whenever possible – it helps you learn about your baby and provides a second set of ears to hear what the doctor has to say. Be actively involved in providing a safe environment for the baby – help keep an eye out for safety hazards. Make sure your baby is never exposed to second-hand smoke and has a drug free place to live. Be gentle with the baby – never shake your baby or toss them in the air. Be mindful of how you talk and act around the baby – a gentle voice and kind gestures are always best. Support from Mom to Dad The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Ask Mom to teach you to do things you may not know how to do yet – this way you can help out and support her as you learn about your new baby. Once you’re comfortable, offer to watch the baby so Mom can get some extra rest – this gives you time with the baby while supporting Mom as well. Take care of yourself, get regular check-ups and exercise daily – work to stay healthy for the newest member of the family. Set a good example and keep smoking and drugs out of your baby’s home. Talk with Mom about how she feels about herself after her pregnancy – she may need your support and encouragement to resume intimacy and sex since things like her self-image and her body may have changed. Treat Mom to small gifts and simple gestures that tell her that you care about her – these will help her understand that she is still special to you even if she is feeling tired and her self-image has changed. Emotional aspects for Dad The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Especially in the first few weeks after birth, use compassion when dealing with both Mom and baby. They both have just been through a difficult experience and your compassion will go a long way in supporting them as they move into the next part of their journey. You may often find yourself in new and challenging situations where you have the choice to either laugh or cry – choose humour, it helps everyone survive and thrive during challenging times. Life doesn’t always prepare us for our role as a parent so as a new Dad you will often find yourself in new situations with no rulebook – rise to the occasion by using your creativity and imagination to overcome new challenges. Remember that patience is a virtue – this is especially true when you have a newborn, so remember to slow down, take a deep breath and relax before you react to trying situations. Always keep in mind that much of what you are doing in the early days after the birth of your baby is a form of service for both baby and Mom – don’t see it as a negative, rather see it as a time for you to develop a new leadership role as you offer yourself in service to others. Dad comforting a crying baby The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. As a first step, always make sure your baby has been fed and changed and that they are comfortable – if so then go on to the next steps to soothe them. Swaddling: holding a baby close can help them feel more secure, so snuggle them in a soft blanket. Side/Stomach: holding your baby on their side or stomach may help calm them. Shhh: making this noise often helps sooth your baby. Sucking: is very comforting for your baby, so if it’s not feeding time, give them a pacifier to suck on. Swinging: gentle movement is often soothing to a baby, so gently rock them in your arms or put them safely in an infant swing. Remember that even though it may be frustrating, it’s important for you to be patient and gentle with your baby. Use this time to bond with your baby and allow Mom a much-needed break from her role as a caregiver. Getting Dad involved The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Talk with Dad about his thoughts, feelings and concerns regarding his role in caring for your newborn – this will help you understand his comfort level. Get Dad involved in your baby’s care – he may need help in learning how to hold the baby or change diapers so include him in as many of the day-to-day activities as you can. Have Dad help with a night feeding when possible – if you are breast feeding consider pumping a feeding ahead so he can take one feeding for you during the night. Have him talk, read or sing to the baby every day – build these activities into your baby’s daily routine. Involve Dad in doctors’ appointments whenever possible. Ask Dad

Bonitas – innovation, life stages and quality care

Reasons why your baby is crying

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. If your baby is crying, the first step is trying to figure out the reason.  Some of the most common reasons why a baby is crying are: Hunger is usually the first thing you should think of – they may give other signs first like rooting, fussing, smacking their lips and putting their hands to their lips. A dirty diaper – many infants don’t like a wet or dirty diaper, so changing their diaper when they cry is a simple thing you can do to help calm them. In need of sleep – babies may not just nod off to sleep when they are tired, they may get fussy and cry, so after feeding and changing diapers you may want to try soothing activities like finding a quiet place, holding them close and rocking them to help them get to sleep. Wanting to be held – babies like to be cuddled, so if you have tried all of the above tips without success it could be that your baby just wants you to hold and cuddle them; also talk in a soft voice or sing softly. Tummy troubles – babies can develop gas pains, colic, constipation, milk allergies and other conditions that make them cry; if this happens often talk with your doctor about ways you can soothe their tummy. Needing to burp – a trapped gas bubble in your baby’s stomach can make them uncomfortable, so if they are crying after a feeding, try burping them to see if that helps. Additional reasons are mentioned in the following tip. Additional reasons why your baby is crying The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. In addition to the reasons mentioned in the previous tip, the following are reasons why your baby may be crying: Temperature troubles – babies will often cry if they are too cold, this may happen when you are changing them or washing them; it can also happen if they are too hot, though this is less common. Little irritations – babies are very sensitive to small discomforts like a hair wrapped around a finger or toe, scratchy clothing or being placed in the wrong position, so look for little discomforts if the big things don’t appear to be the cause of their distress. Teething – newborns don’t have teeth coming in but sometimes their teeth will move around under the gums causing them discomfort; their teeth won’t usually start to come in until they are about 4-7 months; a cold washcloth and gentle pressure on their gums may be soothing. Over stimulation – newborns can’t always process all the things that are going on around them, so if you think your baby may be suffering from too much stimulation take them to a quiet spot away from bright lights, hold them close and soothe them until they can calm down. Not enough stimulation – some babies are outgoing and like to see what’s going on around them, so if you think this is your baby’s issue try carrying them in a sling, front carrier or backpack so they can get the extra stimulation they need. Not feeling well – if you’ve met all your baby’s basic needs and they are still crying and fussy they could be coming down with something, so keep a close eye on them, check their temperature if you think they might have a fever and contact your doctor if needed. Things to try to comfort a crying baby The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Sucking is soothing for a baby and can lower their heart rate and relax their stomach, so give them a pacifier or a clean finger to suck on when nothing else seems to stop their crying. Babies are used to being warm and secure in the womb so when all else fails try imitating that experience by swaddling them and holding them securely or carry them with you in a sling. Some babies respond well to sound and movement, so try putting on some music and dancing with them – gently of course! Try white noise – often babies like noises that mimic the whooshing sounds they heard before they were born, so try running the vacuum cleaner, a fan or the water faucet or use a recording of a water fountain, a gurgling stream or waves. A change of scenery can sometimes help, so dress your baby appropriately and step outside your front door; walk around slowly and talk in a soothing tone. Get them moving – babies like motion so try carrying them around or take them for a ride in the stroller or the car; sometime this will work when nothing else seems to help. Massage may be helpful for some babies – don’t worry about knowing the right movements, just try a soft, gentle massage in a warm place free from drafts. Start all over again – sometimes it’s helpful just to start at the top of the list again; change their diaper, hold them close, feed them if their hungry and see if something works the second time around. If you ever think your baby is in distress because of a health-related issue don’t hesitate to contact your doctor. No question is ever “dumb” if it involves the wellbeing of your baby! Feeling frustrated when a baby won’t stop crying The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Keep in mind that crying won’t hurt your baby, they may just need a release so let them cry. Put your baby down and let

Bonitas – innovation, life stages and quality care

Everything you need to know about having a miscarriage

Deciding to become a mom, or even finding out by chance that you’re pregnant can be an exciting time in your life. However, sometimes you will spontaneously lose the embryo before 20 weeks and this is known as a miscarriage. You may be wondering what causes a miscarriage and how to notice the symptoms and signs of one.  What is a miscarriage and what causes them? Miscarriages are defined as the spontaneous ending of a pregnancy before 20 weeks. Miscarriages can both be emotionally and physically painful to deal with, but it is thought (according to the NHS) that 1 in 8 pregnancies end in miscarriage, with many happening before a woman notices that she has missed her period (meaning she probably won’t even know that she’s been pregnant.  American Pregnancy Association (APA) states that the most common cause of miscarriage is an embryo that is genetically abnormal, which can be either genetic or spontaneous. However, miscarriages can be caused by underlying health conditions such as diabetes, or poor lifestyle choices, such as drug use and drinking. Maternal age is also a contributing risk factor, as women over 35 have higher chances of pregnancy loss.  How do I know if I ‘m having a miscarriage? Symptoms of a miscarriage can be similar to that of your menstrual period. You may experience cramps and abdominal and back pain, as well as bleeding which can vary from light spotting to heavy discharge. It is normal to have pain and bleeding after a miscarriage, and these period-pain type signs should stop after two weeks.  If you experience heavy bleeding, fever or chills be sure to seek professional help as you could have an infection. Unfortunately, the miscarriage process can’t be reversed and if you think you are having a miscarriage you should speak to your doctor about how to manage it.  Can I have a normal pregnancy after having a miscarriage? Many women may worry that having a miscarriage may affect their chances of getting pregnant again – however, many women have healthy pregnancies after miscarriage. Most doctors recommend waiting a period of time before trying again, so speak to your health care provider about the best way forward. 

Bonitas – innovation, life stages and quality care

Cwebeni gets a lifeline of water

In many rural villages across South Africa, access to clean, running water is not a convenience – it’s a lifeline.  For the villagers of Cwebeni in rural Port St Johns in the Eastern Cape, fetching water for drinking, cooking and bathing is a daily struggle.  It requires long, exhausting and treacherous walks along a narrow path to a spring, while balancing buckets. Today (November 21) there is cause for celebration as the lives of this local community are being transformed, thanks to the provision and activation of a borehole and access to running water. The need The village of Cwebeni of around 400 households and 3 000 residents, face many challenges. There are few employment opportunities and little access to basic services – such as clean water, sanitation and road infrastructure. They have not had water in the communal taps for the last eight years. This means locals, including the elderly, walk up to 5km every day to access water from a water hole they share with the livestock.  ‘The entire community has suffered because we don’t have easy access to water,’ says Zuzukeli Duna, Principal of Cwebeni Junior Secondary School.  ‘Without water, daily tasks like cooking, bathing and growing food in our gardens are very difficult. A borehole would make a significant difference to us. It will greatly improve life for thousands of people in our community as well as the 361 learners at our school.’ ‘For many of us, water is readily available, so we don’t stop to think what life would be without it,’ says Dr Imtiaz Sooliman of Gift of the Givers.  ‘But access to water is a human right and, without it, communities face huge challenges including the threat of diseases, poor hygiene and malnutrition. Clean water and sanitation go hand in hand with dignity.’ Which is why when Gift of the Givers visited Cwebeni on a hunger alleviation intervention and were alerted to this crisis, they stepped in and approached Mr Duna for permission to drill on the school grounds to look for a good source of water. ‘We always attempt to place boreholes at institutions, such as schools, to secure the infrastructure,’ explains Dr Sooliman.  ‘This provides a solution for both the school and community as we extend the water outlets to outside of the school property, so that the community can benefit too.’ The intervention Gift of the Givers began exploring the possibility of a borehole and approached Bonitas Medical Scheme for funding, as part of the Scheme’s ongoing commitment to community upliftment. Feasibility studies were conducted in March, drilling began in April when water was found, yielding 960 litres per hour. The borehole, at a depth of 200 metres, was completed in July and is solar powered. The pump and control box are run off 4 x 430-watt solar panels and the system has a 1.1 kw solar motor and a Dab 24-1/37 pump. The borehole has been lined with a PVC casing to lessen the risk of collapse and 2 x 5 000 litre storage tanks are on site, as well as two taps – one inside the school grounds and the other outside for community access. Due to the water testing results showing elevated levels of coliform bacteria and to provide  safer and better-quality water, 4 x UV lights have been installed to kill the bacteria. However, it is recommended that water be boiled for drinking. The perfect partnership The partnership between Gift of the Givers and Bonitas began in 2018, the key objective: To provide relief to the most vulnerable and marginalised communities, specifically in the field of healthcare interventions.   Lee Callakoppen, Principal Officer of Bonitas says, ‘It’s wonderful to be able to make a difference in the lives of the villagers of Cwebeni. This precious resource is essential to every aspect of life. Water provides the chance for a brighter, healthier future and no one should be denied this fundamental right. ‘This project – and others – rolled out with Gift of the Givers, reinforces our commitment to being the medical aid for South Africa.   It’s the perfect partnership, as we have the same passion and drive to assist where it is needed most. We have over 65 000 members based in the Eastern Cape and so are pleased to support this Province, in a small but meaningful way and help change lives.’ Impacting lives ‘We are so grateful to Gift of the Givers and Bonitas for undertaking this project,’ says Duna.  ‘Life has been tough, especially during the winter but we’re so happy that we now have a borehole and access to running water within the village. It is going to make the lives of our community so much easier’.   Dr Sooliman says, ‘The simple act of turning on a tap and seeing water flowing, inspires hope and possibility for a more prosperous life.’ Future investment Bonitas has committed to continuing to work with Gift of the Givers on projects that help impact the lives of vulnerable and marginalised communities, with a bias towards health interventions and access to clean water. 

Bonitas – innovation, life stages and quality care

Due soon? What to include in your hospital bag

With your due date fast approaching, this is a very exciting, yet stressful time for most moms to be. Here is a great list of what to pack for the big day! Ideally, you should have your bag ready to go by 36 to 37weeks, apart from the last minute grabs such as your tooth brush and phone charger. Please see our extensive list of the essential items and also items to make you feel more comfortable for mom and baby (and dad, of course!) Baby Car seat – Many hospitals won’t let you leave without one. Please make sure you know how to strap baby properly into the seat and the seat is secure in the car. Safety first! A going home outfit: It’s important to keep baby skin to skin (this means no clothes on baby; only a nappy) for as long as possible, as this promotes growth, bonding and a calming period for you and your baby. When it’s time to go home, pack different outfits in different sizes as you don’t know how big or small baby will be. Aim for an outfit in Newborn sizes, and 0-3 months. Don’t forget a beanie or socks if the weather is cold. Blankets or Muslin wrap to keep baby nice and cosy. Bottles – If you are going into the hospital knowing you are going to bottle feed, take your bottles with. The hospital usually supplies the formula, but if you have a preferred brand, take some along. If breastfeeding doesn’t work for you, don’t stress! The nurses will provide the bottles and formula. Nappies and wipes to keep baby clean and dry. The nurses in the hospital will show you how to change baby if you are a first time mom. Mom Your medical aid information, your pre authorization/ doctors forms, your ID card and all other important documents you may need. Keep this safely in a folder all together to avoid any stress. A robe or dressing gown – This is such a handy item to have to cover up and make you feel comfortable Pyjama’s that button down at the front – If you are breastfeeding it’s a lot easier to undo the buttons than lift your top continuously. Comfortable, soft and loose pants such as lights weight shorts, stretchy leggings or sleep pants are ideal. Maternity pads and disposable breast pads. Nursing bras are also wonderful and offers great support for breastfeeding moms. Slippers or slip in shoes. Your feet may be a little swollen after delivery, so don’t feel bad leaving the hospital in the snuggest and easiest pair of shoes you can slip into. Slipper socks also work great. Cotton underwear, preferably in a dark or black colour. One that fits you well but rises above the uterus. This is good for moms who have a caesarean section and natural birth as it offers support and doesn’t cause pain along the wound site. Nipple cream – If you’re planning on breastfeeding, your nipples will be happy you are being so proactive. Toiletries – You will want to brush your hair and have a shower after baby has arrived. Take your shampoo, face cream, lotion and body wash, as well as your toothbrush and toothpaste. Deodorant, lip balm and extra hair ties are also a great items to have on hand. Cell phone charger – Because your phone will be full of photos of your new addition to your family. Water bottle and snacks. Take a reusable water bottle as its very important to keep hydrated during and post-delivery. Snack on dried fruit and wine gums to keep your sugar up and to give you energy (with permission from your midwife or doctor of course) A magazine or book, your laptop or some music. Labour may sometimes become a little long. It’s good to keep busy. Most hospitals and birthing clinics supply towels, pillows and blankets. If you have a favourite, take yours along to the hospital. A set of clothes to go home in. Your make up bag and straightener or curling iron. While you won’t be focused on looking great during labour, you may want to take some photos after the birth of your little one. Get someone to help you and make you feel good about yourself (and the great work you’ve just done!) Dad/Birthing partner Camera – Take photos! Lots of them. This is a great job for dad to do during birth. It will make them feel a lot more involved. Snacks: Another great job for dad. Full his bag with plenty of snacks and treats that you can both enjoy during your stay. Comfortable clothes – As he may be sitting with you for quite some time, let him pack some tracksuit pants, t shirts, slippers and hoodies.  Extra underwear is also a winner if he is staying overnight. Chargers – For phones, laptops and cameras. The longer the wire, the better, as most plug outlets are likely to be far from you. Toiletries – He may want to freshen up during the course of your stay. Many private hospitals offer you a baby bag when you are admitted for delivery. This is a great item and will contain most, if not all baby’s toiletries such as soap and creams. If you forget something, it’s not the end of the world. The nurses may be able to help or someone can go to the shop for you. All baby ideally needs is a clean nappy, milk, and most importantly, you.

Bonitas – innovation, life stages and quality care

Putting together your birth plan

As you enter your third trimester you’ll have probably done a fair bit of research on the birth process (if this is your first) and may have a good idea of what you want before, during and after delivery. There are many options and opinions, from whether or not you want pain medication to how many people you would like supporting you. However, trying to keep track of your choices during labour may be tricky, which is why you’d put together a birth plan. So what exactly is it and how do you put one together? Why should I put together a birth plan?  Your birth plan is your choices or preferences before, during and after labour and delivery. While things may not always go according to plan, having your preferences written down and communicated means you, your midwives and doctor have a more mutual understanding. However, if your pregnancy doesn’t go accordingly, you need to be prepared to make adjustments on the day. What should be in my birth plan? Your birth plan is how you’d like everything would go in the best-case scenario. Your birth plan will also have to take into consideration what is available at the hospital or place where you are giving birth. Some birth plans are very basic, just outlining a simple overview, whereas others may be far more detailed and in-depth. The choice is yours. Typically a birth plan will include before, during and after labour and birth preferences. Such as who you want to assist you during birth, whether or not you want any pain medication,  you birthing positions, and requests for newborn care, such as skin-to-skin time. How can I learn more about the birth process?  If you feel like you need to top up your birthing knowledge before putting together a plan they are a few ways you can go about this. Joining antenatal classes are a good way to learn more and to meet other women in your position. Chatting to friends or family who has been through the birthing process themselves is another good way to see what would work best for you. If you and your partner are having a baby together, keep them in the loop as well. Find out what they expect during labour and you can chat about what you want, and what role you see them playing in the process.

Bonitas – innovation, life stages and quality care

Premature birth – what to expect

Expecting a baby is an exciting time of your life, and you want to make sure that you do as much as you can to make sure your new child is as healthy as possible. Premature birth is something you want to try to avoid or manage as carefully as possible. In many cases the cause is unknown, and according to The World Health Organisation, one in ten babies are born preterm. A birth is considered premature when a baby is born before the 37th week of pregnancy. The final few weeks in the womb are important to your baby’s full development, so being born prematurely can lead to longer hospital stays, short term, and long term complications. Why does it happen? Some of the more common risk factors which contribute to preterm births are having had a premature birth before, you’re pregnant with twins/multiples or you have issues with your uterus or cervix. However, often the cause of preterm birth often can’t be identified. Your health is also a factor that impacts on your likelihood to have your baby prematurely. Smoking during your pregnancy (which is not recommended), diabetes, high blood pressure (which can develop into preeclampsia) and being over or under weight are all potential premature birth causes. To try and avoid preterm birth you can talk to your doctor about any existing health issues, such as depression, diabetes or high blood pressure) before getting pregnant – this way you can manage any problems with a treatment plan. Waiting 12 months between pregnancies and eating healthy (making sure that you get the correct prenatal vitamins needed) can also help prevent premature birth. What if my baby is born preterm? If your baby is born prematurely they are at risk for long and short term complications. Many preterm babies lead completely healthy lives, however, the more premature and underdeveloped your baby is when they are born, the more likely they are to have issues. If your baby is born prematurely they may be put into a neonatal intensive care unit into an incubator. Some babies will spend longer in the unit than others, this all depends on when they are able to live without medical support.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 40 of your pregnancy

Congratulations, you’ve reached the milestone that you’ve been counting up to from the beginning. It may feel surreal to think that 40 weeks ago you had your last period and now you’re about to welcome your new baby into your life. The third trimester of your pregnancy may have been fairly difficult, as your baby and belly take up more room, and your body adjusts to accommodate your growing little one. Your body at week 40 At week 40 your body is ready to give birth after housing and growing your baby for 9 months. So close to birth you may notice changes in your baby’s fetal movement, however, they will still be moving around, so if you notice a big decrease in movement, contact your doctor. Until birth, you’ll experience typical pregnancy symptoms, including leg cramps, back and pelvic pain, trouble sleeping and diarrhoea, which is normal close to birth. Your baby at week 40 At week 40 your baby is now full-term. When your baby is born you’ll notice that they are covered in a mixture of blood, vernix and amniotic fluid. On average, baby’s at week 40 weigh about 3,5 kg and they’ll be roughly the size of a pumpkin. Even though they are just about to be born, the lungs, liver and brain are still developing. Things to keep in mind at week 40 Labour can be overwhelming, and it’s important to remember that you can do this. While your doctor will have given you a due date, it is possible that your baby won’t arrive on the dot. So make sure that you keep aware of the signs of labour and have your birth plan, hospital bags and any additional plans ready (such as making sure you have someone to look after your other kids if you have).

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 39 of your pregnancy

You’re now one week away from week 40 – the final week of your pregnancy. Strange to think back 39 weeks, where you wouldn’t even have known you were pregnant. Lots has changed since then, and a lot will continue to change before and after birth. Your body at week 39 At this point, you’ll definitely be feeling your pregnancy. Braxton Hicks contractions, leaking colostrum from your nipples and the frequent urge to urinate may all be part of your daily life. You may be having trouble sleeping, struggling with pelvic and back pain, and your vaginal discharge may be tinged with pink or brown as the blood vessels n your cervix rupture. It is possible to be diagnosed with preeclampsia in your last weeks of pregnancy. This is high blood pressure in pregnancy and is accompanied by protein in your urine and swelling of the hands and feet. Vomiting, nausea and dizziness are also symptoms you may have preeclampsia, and if you suspect you have it you’ll need to contact your doctor right away. Your baby at week 39 Your baby is now roughly the size of a honeydew melon and is considered full term if they’re born this week. At this point, their lungs are producing surfactant so that when they take their first breath, the air sacs won’t stick together. Things you should keep in mind at week 39 You may be wondering if you can still keep doing light exercise, or what you can do to keep active during this time. Exercise in late pregnancy is still doable and is a good idea if you’re feeling up to it. Although you may be worried about damaging your growing baby, exercise during this time is beneficial as it can help strengthen your body for delivery and birth. That being said, it’s important to clarify what you plan on doing with your doctor, and focus on short, low-intensity exercises such as certain yoga and water aerobics.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 38 of your pregnancy

There are now two weeks left of your official pregnancy span, however, there is even a chance that you may get to meet your little one sooner, as about 5% babies are born before or after their due dates. Your breathing may be feeling easier, as your baby moves lower down into your pelvis. But this can leave you with an increasingly shrinking bladder and smaller tasks that used to feel easy are now more difficult. Your body at week 38 Don’t be surprised if your nipples start leaking colostrum around this time. You may also be experiencing frequent Braxton Hicks contractions (which will be helping to prepare you for the real deal) and your nesting instincts may have kicked in, leaving you with a strong urge to clean and organise your house. Other common pregnancy symptoms at this time are frequent urination and pressure on your pelvis and hips as your baby has dropped lower into your abdomen. You may also be struggling to sleep, have swollen feet and ankles and your vaginal discharge may be tinged pink or brown. Your baby at week 38 Your little one is almost ready to meet the world! Your baby has probably shed the soft hair, lanugo, which covered their body (although some are born with patches). Although they are mostly fully developed, if born now, they will be considered early term. They are still continuing to add fat on their body, and the brain and nervous system are continually developing. Things to keep in mind at week 38 One of the questions you may have going through your mind, is how will you be sure that labour has started? Birthing classes are a good way to get to know what to expect, but if you haven’t been able to attend any of those, there are other ways to know that your baby is on its way. Your cervix will start dilating, which your doctor will be able to track in weekly check-ups. You may experience diarrhoea and during labour  you’ll have frequent contractions which will grow stronger over time.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 37 of your pregnancy

You are now in the final stretch of pregnancy, and at the end of this week you’ll only have 3 weeks left until your due date. 37 weeks ago you had your last period – a lot has changed since then! Although 40 weeks is the official length of time for pregnancy, many women give birth before or after this time. If your baby is born between week 37 and 38, they are known as early term babies. Your body at week 37 At this point in your pregnancy you may often feel tired, and this is usually made worse by the fact that you are generally getting a poor night’s sleep. Normal pregnancy symptoms are abdominal pressure, the frequent urge to urinate, a sore back and pelvis, Braxton Hicks contractions and stretch marks. Your baby at week 37 At this point almost all babies will have moved downwards into your pelvis, most commonly they will be in the cephalic presentation, which is head down, facing your spine. There are other positions that you baby can be in, such as cephalic posterior position, which is when they face outwards, or a breech position, which is feet first. If your baby is in an awkward position such as a breech, your baby may be delivered by c-section so as to minimise the risk to you and them. Things for your to keep in mind at week 37 Around week 37 of pregnancy you may start to experience the urge to organise and clean your house in preparation for your new baby. This is known as nesting and is an instinct shared with many other animals.  Nesting may have you rearranging your household to make it more baby friendly and you may feel the need to limit social interactions. While this most commonly occurs when your delivery date is close, it can happen at any time during your pregnancy – or sometimes not at all.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 36 of your pregnancy

Congratulations, you’ve almost made it to the last month of pregnancy. This last month you’ll likely feel both excitement and nervousness, and your belly may feel cumbersome as you go about your daily life. Your body at week 36 of pregnancy As your uterus takes up more space in your abdomen you’ll find it increasingly difficult to move with ease. This is also likely to be accompanied by an achy back and lower abdomen, leg cramps, Braxton Hicks contractions, constipation and difficulty sleeping. Your baby at week 36 of pregnancy Your baby is roughly the size of a large cabbage and is almost the weight they’ll be born at. Not only that, but they are gaining weight, looking more like the chubby baby you’ll meet at birth. Your little one’s kidney and liver are beginning to function normally,  and they’ll also almost be ready to start breathing on their own. At this point your baby should have dropped lower into your pelvis, getting ready for the big day. Although this may allow you to breathe easier, it’ll put more pressure on your bladder. Things to keep in mind at week 36 Although your belly may be feeling cumbersome it’s still important that you remain active during this time (if you’re feeling up to it) – as little as 20 mins a day is likely to boost your energy levels and help ease some of your pregnancy symptoms. Exercise in the third trimester will have to be more carefully considered than before but it is possible. It’s a good idea to clear what you plan on doing with your doctor first, so that they can chat to you about any potential issues or give advice on what would be best. Walking, swim aerobics, yoga and pilates are all low impact ways to stay fit and healthy.

Bonitas – innovation, life stages and quality care

Nipping allergies in the bud

Spring has sprung and while most of us welcome the warmer weather and seeing blossoms on trees, carpets of wild flowers and new buds, millions of people dread this time of the year because of seasonal allergies.  In fact, around 27% of the world’s population suffer with seasonal allergies twice a year – during spring and autumn.   Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund, gives us the low-down on seasonal allergies: What they are, how they can impact your life, avoiding triggers, how to alleviate the symptoms and when to seek help. What are seasonal allergies? Often referred to as hay fever or allergic rhinitis, these are triggered by airborne allergens, which are tiny particles that enter the body through the respiratory system.  These particles include pollen released by trees, grass and weeds, mould spores and dust mites.   When these allergens enter the body, the immune system mistakenly identifies them as harmful and releases chemicals, such as histamine, to fight them off.  The symptoms  Symptoms can last for a few weeks to several months, depending on the severity of your allergies and the length of the pollen season. Most common are: Sneezing Runny or stuffy nose Itchy or watery eyes Coughing or throat irritation Sinus pressure and headaches Fatigue Postnasal drip Ear congestion Less common symptoms include: Headaches Shortness Of Breath Wheezing Coughing If you suffer from asthma as well as hay fever, it is very likely that the seasonal allergy may trigger an asthma attack. Dr Hadebe advises asthma sufferers to take extra precautions and to carry an asthma pump. Impacting your life ‘Whatever the cause of your seasonal allergy, it can make you feel miserable,’ says Dr Hadebe. ‘Allergies can leave you feeling drained and exhausted. ‘This is usually because of disrupted sleep due to congestion and sinus issues, decreased productivity at work or school from fatigue and poor concentration, curtailed socialising by avoiding outdoor activities and compromised quality of life for those with asthma, as allergies can worsen respiratory symptoms. ‘They can cause significant discomfort, disrupt daily activities and your quality of life.’   Try over-the-counter remedies (OTC) Your pharmacist can recommend several types of non-prescription medications to help ease your allergy symptoms. Antihistamines are the first line of defence in treating seasonal allergy symptoms. They work by blocking the action of histamine  Decongestants help to relieve a stuffy nose by shrinking the blood vessels in the nasal passages. However, decongestants may raise blood pressure and should be used cautiously by people with cardiovascular conditions Nasal sprays can help reduce inflammation in the nasal passages and relieve congestion Eye Drops can relieve itching, redness and watery eyes Saline Nasal Irrigation. Using a saline rinse can help flush out mucus and allergens from your nose providing relief from congestion and a postnasal drip When to see a doctor While most seasonal allergies can be managed with OTC treatments, there are times when professional medical advice is needed. You should consider consulting a doctor if: Symptoms persist despite using OTC medications regularly You have breathing difficulties, particularly if you have asthma. Sinus infections or other complications develop  You experience severe reactions such as hives or swelling after exposure to allergens ‘Your doctor may prescribe stronger or more personalised treatment,’ explains Dr Hadebe.  ‘Immunotherapy, in particular, can provide long-term relief by gradually desensitising the immune system to allergens.’ Managing season allergies  Beyond medications, there are lifestyle changes you can make to minimise your exposure to allergens and reduce symptoms: Stay indoors during high pollen counts, especially in the morning when levels tend to peak Use air purifiers with HEPA filters to remove allergens from indoor air Shower and change clothes after spending time outside to remove pollen from your body and clothes Close windows in your home and car to keep pollen from entering Monitor allergy forecasts and take preventative measures when pollen levels are high If all else fails If your seasonal allergies are really bad and nothing else seems to work, your doctor may recommend that you have skin or blood tests to find out exactly what triggers your symptoms.  This can help determine what steps you need to take to identify which treatments are likely to work best for you.  ‘Seasonal allergies are a common but manageable condition,’ says Dr Hadebe.  ‘With the right combination of OTC medications, lifestyle adjustments and, in some cases, professional medical advice, you can reduce the impact allergies have on your life. Always pay attention to your body’s response and don’t hesitate to seek medical advice if your symptoms worsen or persist, despite treatment.’

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 35 of your pregnancy

You are now 5 weeks away from your due date, should everything go according to plan. This can be both an exciting and nerve-wrecking time, especially if this is your first pregnancy and you’ve never experienced birth first hand. Your body at week 35 At week 35 you’ll probably be feeling tired and heavy – your body will probably be feeling the strain of growing a baby. Frequent urination, lower back and abdominal pain, constipation, Braxton Hicks contractions, tender breasts and trouble sleeping are all normal symptoms at this time. When your baby moves further down into your pelvis (to get ready for birth) you may notice that your shortness of breath improves. While this may help your breathing, it probably won’t help your frequent need to urinate. Your baby moving down is known as lightening or dropping. Your baby at week 35 Your baby is now roughly the size of a pineapple or melon, has lungs that are almost developed, and a brain and nervous system that are still developing. The musculoskeletal system and the circulatory system are fully developed at this point, and if your baby was born premature they will have a very good chance of survival. Babies born between 34 and 37 are called late preterm, and while they may look like a smaller full term baby there are some challenges that they’ll face being born earlier.  Your baby will also start to move into position for birth around this time, moving down into your pelvis. Things to keep in mind at week 35 During the third trimester it is recommended that you go for a group B streptococcus test. Although this is a common bacteria in the gastrointestinal tract, it can be harmful to newborns. If your test is negative you won’t need to do anything, however, if you are positive you’ll be given antibiotics during labour which will lower the risk of your baby contracting early-onset GBS.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 34 of your pregnancy

You have now reached week 34 of your pregnancy. Your birth date is ticking closer and closer, it’s less than two months away now. During this week your baby may drop lower into your abdomen, getting ready for the big day. Your body in week 34 Your body may be feeling the strain of your growing baby. Your breasts are becoming fuller as you approach the final stages of your pregnancy, which could mean they are feeling tender and itchy as the skin stretches. Be sure to invest in a supportive bra to help with the discomfort. Your back and pelvis may also be feeling the strain, and this is generally accompanied by shortness of breath. Leg cramps, worry about your pregnancy and the frequent urge to use the bathroom can mean that your nights are lacking in sleep, leaving you feeling tired and drained during the day. A pregnancy pillow is one way which can help you feel more comfortable at night. Something else to keep in mind, is to be aware that your pregnancy hormones will have made your ligaments looser and muscles more relaxed, so take care when exercising so as to avoid injury. Your baby at week 34 Your little one is getting bigger, and is now roughly the size of a melon. The space inside your womb is also getting tighter, and you might see a little hand or foot pushing a bulge into the side of your belly when they kick. Things for you to keep in mind at week 34 Whether it’s a home birth or hospital that you have chosen, make sure that you feel familiar and comfortable with the process to eliminate any unexpected surprises. If you’ve chosen a hospital, make sure you know which buildings and rooms you need to be in beforehand, and make sure you know where the emergency exit is, just in case. The same goes for the prep of a home birth, ensure that you have a solid back up plan, should anything go wrong during the process.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 33 of your pregnancy

You now are in your thirty third week of pregnancy, and at the end of this week you’ll only have 7 more left to go (that’s just under two months!). You are probably often thinking of how your life is going to change with the newest addition to your family, and your sore and aching body serves as a constant reminder of what big changes are on their way. Your body at week 33 Your body may be feeling tired and run down. Pain and discomfort are fairly normal to you, and your body has changed significantly since week 1 of pregnancy. Common pregnancy symptoms at this time are shortness of breath, forgetfulness, constipation, heartburn, leg cramps and a sore back. Your baby at week 33 Your little one is now developing their own immune system, thanks to the antibodies being passed from you to them – enabling them to fight off germs once they are born. All five senses have developed now, and your baby can both hear and see (changes in light) in your belly. Their eyes stay open more regularly while awake and they are able to coordinate sucking and swallowing – an important skill to have once born. Things to keep in mind at week 33 You may notice that you feel irregular contractions from time to time, and these are known as Braxton Hicks contractions. However, it is a good idea to be aware of the difference between Braxton Hicks and the real deal. Braxton Hicks contractions are normally sporadic, irregular and don’t last long periods of time. These false labour pains aren’t painful and they may even stop when you change position or start doing a different activity. True labour contractions in contrast come in regular intervals and the contractions get stronger and closer together as time passes. The contractions won’t go away if you change your position and the pain from these contractions can be felt throughout your abdomen and lower back. If you go into labour before 37 weeks this is known as preterm labour. If you think you are going into preterm labour, call your doctor immediately, as they can do alot to delay your delivery.  Treatment for preterm labour isn’t guaranteed to work but it can help you stay pregnant longer – and therefore increase the likelihood that your little one is born healthy and happy.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 32 of your pregnancy

You officially have 8 weeks until delivery, but this is likely not to be exact, as many babies aren’t born on their due dates. Your body may be feeling sore and tired, thanks to the strain your growing little one puts on you. Your body at week 32 As you get closer to delivery day, you may notice more frequent Braxton Hicks contractions, which is just your body’s way of preparing for the real-deal. Your feet and ankles may be swollen and your back and pelvis are probably taking strain. Constipation, shortness of breath, fatigue, a sore mouth and leg cramps are also all common pregnancy symptoms at this time. Look after yourself (and your baby) and don’t be afraid to ask for help or to put your feet up for some well earned rest – growing a baby is hard work! Your baby at week 32 Your little one is now roughly the size of a melon and they are practicing breathing, sucking and swallowing to prepare their body for the outside world. Your baby is also busy shedding the lanugo, which is the fine hair covering their body. Most of it will be gone by the time they are born, although some babies are born with some lanugo covering parts of their body. Your baby’s finger and toenails are also growing – you may even find them fairly long when they are born. Things to keep in mind at week 32 of your pregnancy You may be wondering how realistic your due date is, although pregnancies are 40 weeks long, as little as 5% of moms give birth on their due date. Most women give birth to their babies between week 37 and 42, although about 11% of moms-to-be deliver prematurely. If you don’t go into labour within a week of your due date, you will most likely have a nonstress test which monitors your baby’s heart rate and checks they are reacting normally to stimuli. When you hit 42 weeks, your doctor may induce labour.

Bonitas – innovation, life stages and quality care

Strokes in children and adults under 45

Strokes, often associated with older adults, can also affect young people. Understanding the causes, risk factors, symptoms and preventive measures is crucial for addressing this serious health issue.  It is considered to be an early stroke if the person is younger than 45 – although not as common as older people, about 10-15% of strokes occur in children and adults under 45. Unfortunately, that number is rising.  A stroke changes your life in an instant and, although survival rates are high, around two-thirds of stroke survivors live with a disability. Dr Themba Hadebe, Clinical Executive with Bonitas Medical Fund, takes a look at some of the causes and risk factors associated with strokes as well as symptoms, treatment and preventative measures. What is a stroke? There are two main causes of stroke: Ischemic (caused by a blocked artery in the brain) and haemorrhagic (related to bleeding in the brain). A stroke may strike seemingly out of nowhere but, approximately 12% of patients may have only a temporary disruption of blood flow to the brain, known as a transient ischemic attack (TIA) or mini stroke up to 90 days before a full-blown stroke. TIAs may cause symptoms similar to an intense migraine when a clot temporarily blocks a blood vessel but gets dislodged. And a silent stroke? According to Harvard Medical School, ‘A silent stroke refers to a stroke that doesn’t cause any noticeable symptoms. Most strokes are caused by a clot that blocks a blood vessel in the brain, preventing blood and oxygen from reaching that area, resulting in brain cells dying.   Depending on the location of the clot, this can cause symptoms such as weakness in an arm or leg, trouble speaking or seeing. Sometimes, the area of damage is small and occurs in a part of the brain that doesn’t control any vital functions, so the stroke remains undetected. Causes and risk factors ‘There are a number of genetic conditions that can lead to a stroke,’ explains Dr Hadebe.  Hereditary conditions, such as sickle cell disease or connective tissue disorders Heart problems: Congenital heart defects, arrhythmias or infections like endocarditis  Blood vessel abnormalities: Conditions like arteriovenous malformations (AVMs) or aneurysms Blood clotting disorders: These can lead to the formation of blood clots that travel to the brain Infections and inflammatory conditions: Certain infections (like meningitis) or autoimmune conditions (like lupus) can cause inflammation and increase stroke risk Hormonal factors: Use of oral contraceptives, particularly in combination with smoking Trauma: Head or neck injuries can damage blood vessels, leading to a stroke He also lists some lifestyle factors that can add to the risk of having a stroke: Smoking Diabetes High cholesterol Heart disease Alcohol Obesity High blood pressure Lack of exercise Unhealthy diet Drug abuse (especially cocaine and methamphetamines) Signs and symptoms ‘The symptoms of a stroke in young people are similar to those in older adults,’ says Dr Hadebe. ‘In the youngest of stroke patients, congenital heart abnormalities or heart valve problems that lead to clot formation can cause a stroke. Most important is identifying a stroke and getting medical assistance quickly, the sooner you get treatment the better your chances are of survival and making a full recovery.’  He says you need to BE FAST when remembering stroke symptoms. Balance – trouble walking, dizziness or lack of coordination Eyesight changes – trouble seeing in one or both eyes Facial drooping Arm weakness, especially on just one side Speech difficulty – confusion and trouble speaking Time to get to hospital Women may experience other seemingly unrelated signs of stroke, such as difficulty breathing, general weakness, fainting, hallucinations or nausea and vomiting. Treatment for a stroke An IV injection of recombinant tissue plasminogen activator (TPA) is the gold standard treatment for ischemic stroke.  It breaks up the blood clots that block blood flow to your brain however, this type of medication must be given within 3 hours after stroke symptoms start. In cases of haemorrhagic stroke, surgery might be needed to repair blood vessel abnormalities. Recovery time Every stroke is different, the quickest recovery takes place in the days and weeks immediately afterwards but can continue for months and years. For all patients, the recovery process involves making changes in the physical, social and emotional aspects of their life. The injury to the brain can lead to widespread and long-lasting problems with rehabilitation and long-term support needed to help regain as much independence as possible. Brain exercises can help survivors regain thinking, reasoning and memory skills. Other activities include eating a heart-healthy diet, getting regular exercise and limiting alcohol consumption.  Mitigating the risks A healthy lifestyle – no matter what your age – that includes regular exercise and a balanced diet can certainly reduce, if not minimise, the risk of having a stroke.  Dr Hadebe says, ‘Many strokes can be prevented. Make sure you go for wellness screenings to check your blood pressure and cholesterol levels and work with your clinician to control health conditions that raise your risk. Being aware of the symptoms and following a healthy lifestyle can possibly prevent a stroke from happening in the first place.’ 

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 31 of your pregnancy

Your baby is getting bigger and plumper – looking more like the chubby baby you’ll expect to meet. You may be feeling a dip in your energy levels, thanks to a sore body and a less-than-ideal night’s sleep. Your body at week 31 Your breasts and belly are growing, preparing your body for birth and beyond. Your baby’s kicks may be uncomfortable (yet still a comforting reminder that everything is going well in there) and you may find yourself constantly feeling tired. A good night’s sleep may be harder to come by, so it’s important that you eat healthily and exercise as this can help your energy levels. Other common pregnancy symptoms are aching and swollen feet, a sore back, constipation, stretch marks and feeling bloated. Your baby at week 31 Your baby is now roughly the size of a coconut and their bones are slowly hardening. Their skull is soft and made up of unfused bone, so that delivery is easier and brain growth can easily be accommodated. Your little one will be moving around quite a bit at this point, and you may even start to notice some patterns in their movement. However, if you notice a sudden change or stillness in their movements, it’s important to call your doctor quickly as there may be an issue. Things to keep in mind at week 31 As your belly grows, you may find sleeping harder as it becomes more difficult to find a good position to lie in. It is recommended that you sleep on your side. In particular the left side is preferable as this allows optimal blood from the inferior vena cava and takes pressure off your organs. However, don’t worry if you lie on your right as well, whatever makes you feel most at ease.  You may feel more comfortable with your knees bent and a pillow tucked between them, and you could pop a pillow under your tummy for added comfort.

Bonitas – innovation, life stages and quality care

The lowdown on diabetes in children and teenagers

The diagnosis of type 1 diabetes in children can be overwhelming, especially in the beginning. Suddenly you and your child – depending on your child’s age – must learn how to count carbohydrates and monitor blood sugar levels and give injections. But even though there is no cure, it can be managed.  Diabetes is a chronic disease, characterised by high levels of blood glucose. ‘In type 1 diabetes your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing cells of the pancreas,’ explains Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund. ‘It can lead to serious damage to the heart, blood vessels, eyes, kidneys and nerves. However, advances in blood sugar monitoring and the delivery of insulin have improved blood sugar management and quality of life for children with type 1 diabetes.’ Statistics currently show that there are close to 5 000 adolescents that live with Type 1 diabetes in South Africa. Type 1 diabetes can be either: Hyperglycaemia: When your blood sugar levels are too high. It is the hallmark of diabetes onset and it usually continues to occur on and off after you start treatment Hypoglycaemia: Sugar levels are too low. This usually occurs as the result of diabetes treatment, particularly insulin administration which lowers blood sugar How does diabetes in children and adolescents start? It can come on suddenly or gradually in children and teens and parents often aren’t aware of the symptoms or patterns that point to a potential diabetes diagnosis. Symptoms may be similar to those of flu but, if diabetes is the cause, the sooner it’s diagnosed, the better. Symptoms of Hyperglycaemia: High blood sugar Increased hunger The body’s cells are not able to utilise glucose for energy due to a lack of insulin or insulin resistance, leading to a craving for more food. Dry mouth: A dry mouth is one of the most common symptoms which can cause trouble chewing, swallowing or speaking, dry cracked lips, sores or infections in the mouth or a furry, dry tongue Frequent urination (especially at night):  Excess glucose in the blood spills into the urine, drawing water with it and increasing the frequency of urination. This in turn increases thirst Weight loss:  Despite increased food intake, the body starts breaking down fat and muscle for energy, due to the lack of insulin Fatigue: The body’s cells cannot use glucose for energy efficiently, leading to feelings of tiredness and fatigue Blurry vision: High sugar levels in the blood can damage the tiny blood vessels in the eyes, causing fluid to seep into the lens, potentially causing blurry vision Slow-healing sores or frequent infections:  Over time, high blood sugar levels narrow your blood vessels, slowing blood circulation and restricting much needed nutrients and oxygen from getting to the wounds. As a result, even small cuts and wounds may take weeks or months to heal Fruity-smelling breath: The breakdown of fat for energy produces ketones, which can cause a fruity smell in the breath Ketoacidosis: This is when blood sugar levels are very high and the body starts making ketones. It is a very serious condition that needs immediate in hospital treatment, sometimes in the intensive care unit. If not treated right away, there is a  risk for diabetic coma. A child with a diabetic coma loses consciousness because of brain swelling due to very high blood sugar levels Symptoms of Hypoglycaemia: Low blood sugar  Trembling: Low blood sugar levels trigger the release of adrenaline, which causes shakiness Sweating:  The body’s response to low blood sugar includes releasing adrenaline, which can cause sweating Hunger: The brain detects low blood sugar and signals the body to eat Irritability or moodiness: Low blood sugar levels can affect brain function, leading to mood changes Fatigue: The brain and muscles are deprived of glucose, leading to feelings of tiredness Paleness: The body’s stress response to low blood sugar can cause blood vessels to constrict, leading to paleness Headaches: The brain is sensitive to changes in blood sugar levels, low levels can cause headaches How is type 1 diabetes treated? A daily dose of insulin is needed to keep the blood glucose level within normal ranges. Insulin is given either by injection or via an insulin pump. Your child’s healthcare provider will show you how to give your child insulin with either method.  Dr Hadebe says, ‘to make it easier for children and adolescents to monitor glucose levels and administer insulin the Scheme offers Insulin Pump Therapy and Continuous Glucose Infusion Monitoring device (CGM) to members under the age of 18.’ Eating the right foods to manage blood glucose levels. This includes timing meals and counting carbohydrates Exercise Regular blood testing Regular urine testing for ketone levels How can I help my child live with type 1 diabetes? The diagnosis affects the entire family emotionally – there are various support groups and organisations for children with Type 1 diabetes and their families. A younger child may not understand all the life changes, such as glucose monitoring and insulin injections, this can lead to anxiety and depression. They may feel different from their peers, try to treat them as a normal child, with managing diabetes as just one aspect of their daily life. Ask your healthcare provider for more information and call them if you need help.  Also ensure they are following the treatment plan and are eating the right foods, exercising and testing their blood and urine.  Early detection and comprehensive management are key to ensuring children with Type 1 diabetes lead healthy, fulfilling lives. Remember that your GP is your first port of call for all your healthcare needs. 

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 30 of your pregnancy

You now officially have ten weeks left of your pregnancy, this can be both an exciting and overwhelming realisation, and feelings of anxiety during this time are normal. Your little one’s kicks and growing baby bump are reminders that your due date is increasingly getting closer. Your body at week 30 Your back and feet may be increasingly getting more painful as your baby grows in size. Swollen ankles and feet are normal, so remember to give yourself some time to put your feet up and invest in some comfortable footwear. Bloating, constipation and  stretch marks are normal at this point in your pregnancy. The fatigue you felt in your first trimester may be returning. You could be struggling to sleep at night, which will leave you feeling drained during the day. Don’t be afraid to ask for help at this time, you’ll need extra hands now and after your baby has been born. Your baby at week 30 As your delivery date grows closer, your baby is constantly growing in size, and at this point she is roughly the size of a cabbage. Your little one is also prepping for the big day and they should have (or will be soon) changed position, facing head down with their face towards your back (known as the occipito-anterior position) – ready to enter the pelvis. This is the ideal position for birth, however it is possible for your baby to be lying another way inside you. Some babies will only turn this way closer to your due date. Things to keep in mind at week 30 It’s normal to feel anxious about your approaching delivery. Going to antenatal or birth classes can help you feel more prepared for what is to come. Do exercises that can help you prepare your body for what it will go though, certain yoga and pilates positions can strengthen your muscles and help make the process quicker and smoother. If you find that your anxiety is overwhelming, chat to a health professional, as you may be experiencing antenatal anxiety. This is nothing to be ashamed about, and is something that can be managed with the help of professionals.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 29 of your pregnancy

Week 29 of your pregnancy and you may notice that your body is taking more strain. Be mindful of this and don’t be afraid to take it easy if needed. Make sure that you’re still eating healthily (and remembering to take your prenatal vitamins) and exercising gently, both are important to your health as well as your growing baby’s. Your body at week 29 You are now entering the last phase of your pregnancy, and because of this you may find this very challenging, both physically and mentally.  Your back, pelvis and feet are probably aching, and you’ll experience constipation, frequent urination and shortness of breath. Your baby at week 29 Your baby is now filling more of your womb, this means that any kicks, which used to be soft and barely notable, may feel more like hard pokes now. Your little one is also growing rapidly, and will probably have doubled in weight before birth. At this point many of their organs are almost fully developed, meaning they have a good chance of survival if born premature. That being said, their lungs still have lots of developing to do, which is why preemies need help breathing via a ventilator. Things to remember If you haven’t already, start planning your maternity leave. In South Africa, moms are entitled to four months of unpaid leave. If you’re still feeling able to work, you’ll probably want to keep most of your leave for after birth, so that you can spend as much time with your growing baby as possible. Generally speaking, maternity leave begins about a month before birth –  and the good news is dads are now entitled to 10 consecutive days of parental leave. Your employer is obliged to keep your job for you until you return from leave, so you won’t have to worry about losing your job.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 28 of your pregnancy

Welcome to week 28 of your pregnancy, you are now in your third trimester – the final stretch before birth! Your baby will do lots of growing during this time, and your body may start taking some strain in the final weeks before delivery. You’ll probably be feeling both nervous and excited, soon you’ll be able to take your little one home! How your body will be feeling at week 28 If you haven’t started experiencing it already, you may notice that back ache and pelvic pain are becoming an issue. This is due to the fact that pregnancy hormones cause your ligaments to loosen, which can cause lower back and pelvic pain. Your changing centre of gravity also puts strain on your back. Excruciating pain in your pelvic reason is cause for concern and the culprit could be symphysis pubis dysfunction (SPD). Luckily this isn’t harmful to your baby, but is probably very painful to you. Chat to your doctor if you’re feeling pain that you see as abnormal. They’ll probably recommend a physiotherapist to you as physio can help minimise your pain and improve your muscle function. Other common week 28 pregnancy symptoms include Braxton-Hicks contractions, frequent urination, swollen ankles and feet, sleeping problems, stretch marks, heartburn and indigestion and constipation. Your baby at week 28 Your little one is growing fast, and is now the size of a head of lettuce. Around this time your baby will begin to open and close their eyes,  and can sense changes in light. Your baby’s heart rate will have lowered to about 140 bpm (and at birth this will have dropped to around 130 bpm). If you were to have an ultrasound now you may notice hair on your baby – this is known as lanugo, which is fine hair that grows on babies before birth. This will disappear at birth or shortly afterwards.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 27 of your pregnancy

Congratulations, you are now in the last week of your second trimester and approaching the third, which will start at the beginning of week 28 –  so you are nearing the final stretch of your pregnancy. You’ll find that you’re probably becoming more used to your little one moving around inside of you and while you may have enjoyed less fatigue during trimester two, this unfortunately may begin to change. Your baby at week 27 Your baby is starting to pack on the final pounds before birth (which should be in 13 weeks, but not all babies arrive at their due date). Inside of your uterus, your little one will be kicking and grasping, slowly developing their muscle tone before birth. Your baby will also be practicing breathing and swallowing with the amniotic fluid. Your body at week 27 Haemorrhoids are a common pregnancy, thanks to your uterus becoming larger and putting pressure on your veins. Haemorrhoids are swollen veins in the anus and rectum, and these are both uncomfortable and painful. While these are unwanted, they generally aren’t harmful to you or your growing baby and normally go away after birth. Other pregnancy symptoms common during this time are leg cramps, aching pelvis and back, heartburn bleeding gums,  constipation, trouble sleeping, frequent urination and stretch marks. Things to remember at week 27 At week 27, something you can start considering is putting together a birth plan. A birth plan is a written document that communicates your wishes during your pregnancy (think of the ideal way you’d like your birth to go) as when the time comes, you probably won’t be thinking clearly.  There is no right or wrong way to go about doing this – some may be detailed and others just cover the basics, the choice is yours!

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 26 of your pregnancy

Although you are yet to meet your baby, they are slowly taking over your life and you may notice weekly and even daily changes in your body. Some days you’ll feel better than others, and it’s important that you take each day as it comes. Both by taking advantage of your good days, and being gentle on yourself on the bad ones. How your body may feel during this time Tiredness, an achy body, a sore mouth and stretch marks are all part of your pregnancy journey. Your belly and breasts are also growing, so make sure that you accommodate your body and dress in clothes that are both supportive and comfy. Your baby’s growth at week 26 Your little one’s lungs are now working hard, getting ready for the day that she’ll need to start using them. At this time the lungs start to produce surfactant, which’ll make it possible for your baby to breathe at birth. Your baby’s suck reflex is  growing stronger (they may even suck their thumb!), and their eyes may open for the first time around now and they’ll start to practice blinking. Not only this, but your little one also has eyelashes that are starting to grow. Now that your baby can hear you, you can also spend some time talking to them. Research has shown that babies prefer the sound of their mothers voices and you may even notice that they start responding to the sound of your voice, and by late pregnancy they should be able to distinguish between voices. What you should keep in mind at this time Something to keep aware of during your pregnancy is the possibility for gestational diabetes. Gestational diabetes is high blood sugar levels during pregnancy, and it’ll go away after birth. However, moms who develop gestational diabetes are at higher risk of developing type 2 diabetes after birth. Warning signs are unusual thirst, frequent urination and dizziness, if you feel like you are checking these boxes then it’s important to speak to your doctor about treatment. If treated effectively, there is no reason you shouldn’t have a healthy pregnancy.

Bonitas – innovation, life stages and quality care

Debunking myths about Mpox

Myths are widely held beliefs about various issues, including illness and disease. They come about through frequent storytelling and retelling. Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund, helps debunks myths about monkeypox (mpox).  Myth 1: Mpox (formerly monkeypox) is a new disease created in a lab Fact: The mpox virus was discovered in Denmark (1958) in a colony of monkeys at a laboratory kept for research.  The first reported human case was in 1970 in the DRC. Mpox is a zoonotic disease, meaning it can be spread between animals and people. It is found regularly in parts of Central and West Africa and can spread from person to person or occasionally from animals to people.   Myth 2: Mpox comes from monkeys Fact: Despite its name, monkeypox does not come from monkeys. The disease earned the name when the ‘pox like’ outbreaks happened in the research monkeys. While monkeys can get mpox, they are not the reservoir (where a disease typically grows and multiplies). The reservoir appears to be rodents. Myth 3:  Only a handful of people have contracted mpox Fact: Globally, more than 97 000 cases and 186 deaths were reported across 117 countries in the first four months of 2024. South Africa is among the countries currently experiencing an outbreak.  On the 5 July, it was reported that the number of mpox cases in the country has risen to 20. This after four more cases have been confirmed in Gauteng and KwaZulu-Natal in the last few days. 15 patients have, however been given a clean bill of health.  Myth 4:  It is easy to diagnose mpox Fact: It is easy to mistake mpox for something else. While the rash can be mistaken for chickenpox, shingles or herpes, there are differences between these rashes. Symptoms of mpox include fever, sore throat, headache, muscle aches, back pain, low energy and swollen lymph nodes. Fever, muscle aches and a sore throat appear first. The rash begins on the face and spreads over the body, extending to the palms of the hands and soles of the feet and develops over 2-4 weeks in stages. The ‘pox’ dip in the centre before crusting over. Laboratory confirmation is required. A sample of one of the sores is diagnosed by a PCR test for the virus (MPXV). Myth 5: Mpox is easily treated Fact: ‘Currently,’ says the National Institute for Communicable Diseases (NICD), ‘there is no registered treatment for mpox in South Africa. However, the World Health Organization (WHO) recommends the use of TPOXX for treatment of severe cases, in immunocompromised people’. However, the Department of Health (DoH) has only obtained this treatment, with approval on a compassionate use basis, for the five known patients with severe disease.  There is no mpox vaccine currently available in South Africa. Myth 6: You can get mpox from being in a crowd or from a public toilet seat Fact: Mpox is not like Covid-19 which is highly contagious. It spreads through direct contact via blood, bodily fluid, skin or mucous lesions or respiratory droplets.  It can also spread though bites and scratches. Studies have shown that the virus can stay on surfaces but it is not spreading in that way or in a public setting. The risk of airborne transmission appears low. Myth 7: Mpox is deadly Fact: While mpox lesions can look similar to smallpox lesions, mpox infections are much milder and are rarely fatal. That said, symptoms can be severe in some patients, needing hospitalisation and, in rare cases, result in death. It is, however, painful and very unpleasant. So, it is important to avoid infection. Myth 8: Mpox is sexually transmitted  Fact: You can become infected though close, direct contact with the lesions, rash, scabs or certain bodily fluids of someone who has mpox. Even though this could imply transmission though sexual activity, it is not limited to that.  You can also be exposed if you are in close physical proximity to infected people, such as spouses or young children who sleep in the same bed.  Myth 9: I can’t protect myself from getting Mpox Fact:  You can take precautions: Avoid handling clothes, sheets, blankets or other materials that have been in contact with an infected animal or person. Wash your hands well with soap and water after any contact with an infected person or animal and clean and disinfect surfaces. Practice safe sex and use personal protective equipment (PPE) when caring for someone infected with the virus. Myth 10:  You can’t stop other people being infected by you Fact: You may not protect them by 100% but you can isolate. Also, alert people who have had recent contact with you.  Wash your hands regularly with soap and water or use hand sanitiser, especially before or after touching sore and disinfected shared spaces.  Cover lesions when around other people, keep skin dry and uncovered (unless in a room with someone else).  Mpox is a notifiable medical condition but is treatable, if you are concerned, call the DoH toll free number of 0800 029 999 but remember, your GP is your first port of call for all your healthcare needs. 

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 25 of your pregnancy

As you enter week 25 of pregnancy, you will be nearing the end of the second trimester and the start of the third. You may find that your rise in energy levels you felt at the beginning of your second trimester is now beginning to drop. Your baby at week 25 Your baby is now roughly the size of a cauliflower and they are slowly starting to become the chubby baby you’ll expect at birth, as fat is added to their body every day. Your little one is also starting to develop a sense of balance, becoming more aware of what is up and down. Not only this but your baby’s lungs are slowly developing closer to maturity, as blood vessels (caprillirs) grow and they start to practice breathing in amniotic fluid. Your body at week 25 As your baby grows, it is normal that your back and pelvis may be starting to take some strain. This is also thanks to pregnancy hormones which cause your ligaments to soften. To avoid any injuries, make sure you aren’t tempted to over stretch if you’re doing something such as yoga and don’t lift any heavy objects around the house or office. If your back is feeling sore, gentle exercise in water, such as aqua aerobics, can help alleviate the aching. However, if your back is seriously painful , chat to your doctor about finding a physiotherapist who can help you during this time. Other common pregnancy symptoms around this time are heartburn, sore feet and ankles, camping in your legs, swollen and bleeding gums, dizziness,  trouble sleeping and stretch marks. Although many aspects of pregnancy (and certainly afterwards) are rewarding, there are also many parts of it which can be uncomfortable. Things that you should keep in mind Cravings are a natural part of pregnancy (and these generally peak in your second trimester), and they are the sudden desire to eat a particular kind of food. These can be odd foods and combos that you’ve never had the urge to eat before, and generally these are personal to you. Strange combinations, such as pickles and ice cream, might suddenly be on your most wanted list. Just be aware of what you are consuming, as trying to keep things healthy will be best for your growing baby. Unfortunately big meals can also mean heartburn, so little and often can often be the answer here. The book: http://picklesandicecreamcookbook.com/

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 24 of your pregnancy

You’re a good few weeks past half way of your pregnancy, which means you are closer than ever to finally meeting your little one. In terms of months, you’re about 6 months in, which means you only have 3 left to go! Your Body at Week 24 As you near your third trimester, you may notice that your body is feeling more uncomfortable thanks to your growing baby. Back ache, tired swollen feet, leg cramps and constipation are all pretty common during pregnancy. You’ll also be gaining weight (which is completely normal) and your breasts are also bigger. Heartburn may be something that you’re struggling with and this is  normal during pregnancy thanks to hormones and your growing baby taking up space. Your pregnancy hormones are the reason the valve between your stomach and throat doesn’t close as it should, as the hormones relax the tight muscle between your stomach and your esophagus. Your growing uterus can also put pressure on the stomach, making it more likely that acid can spill out. Your Baby at Week 24 As your baby grows, they are putting on more and more weight, and their muscles are developing and gaining strength – which means their kicks are getting stronger and harder. Your little one also has hair at this point, however, none of it is pigmented yet. Your baby is pretty active now, and you should feel them move around regularly, however, unless you don’t feel your baby moving around for long periods of time, stillness is nothing to be concerned about. Things to take note of While it may seem obvious, eating healthily and frequent exercise are both ways to stay mentally, physically and emotionally happy and healthy during pregnancy. While a few stresses here and there are common, a constant state of worry or sadness is probably a sign of antenatal depression or anxiety. If you feel like you don’t have the energy for small tasks or every small detail of your pregnancy is triggering anxiety, it may be best to both seek the support of those you love, and medical professionals.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 23 of your pregnancy

Your growing baby is making her presence known, and you may regularly feel little kicks inside you when she is awake. Your body is also starting to take some strain, and you may have uncomfortable feet and back to name a few. While you are excited to meet your little one, you may notice this excitement in strangers who might attempt to touch your baby bump, and this added attention is not necessarily something you’re happy with. Your body at week 23 At week 23 you may be experiencing a variety of bodily aches and pains as your body takes on the strain of growing and carrying a small human. Leg cramps, swollen feet, bleeding gums and a tired, sore back are unfortunately all normal during pregnancy. During this time you may also feel stressed out and overwhelmed. Although pregnancy is a beautiful and exciting time, it can also be very stressful for moms to be. You may be under financial strain, and you may feel pressure at work to finish up pieces of work before going on maternity leave. All of this is normal, and if you feel like you’re not coping well it’s important to speak to a health professional who can help you through this tough time. Your baby at week 23 Your baby is now the size of a squash and in their 23 week, your baby is now able to survive outside your body if they are born prematurely (although they aren’t’ ready to be born yet and have lots of growing to do!). Their lungs are developing and their face is fully formed, it just needs to do some filling out first. Your baby is also gaining weight each week (they should double in weight in the next 4 weeks), so by the time your baby is born, she’ll be the plump, chubby little one you’re expecting. Their middle ear bone is also hardening, and they are able to hear you talking to them. Things you should remember at week 23 During your second trimester as your baby bump grows you may experience both wanted and unwanted attention to your baby bump, as well as advice from everyone – from strangers to your mother. Dealing with this added attention can be overwhelming at first, but be sure to state your boundaries clearly if strangers attempt to touch your bump. While some moms-to-be may not mind extra attention, others may not like the invasion of their space when strangers want to touch their growing baby belly.

Sidebar Image

Scroll to Top