Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Covid – how and when might it all end?

Covid-19 has disrupted the world in so many ways, including the uncertainty of what the future holds. The Bonitas Medical Fund clinical and actuarial teams unpack some of the pandemic versus endemic terminology and offer scenarios for the future. Since the start of Covid-19, the word ‘pandemic’ has been on everyone’s the lips. What is a pandemic and what is the difference between an outbreak, an epidemic and a pandemic? According to Harvard Medical School, ‘An outbreak is a sudden increase of an infectious disease in a particular place, an epidemic is a larger outbreak in a restricted country or community, while a pandemic means a global epidemic.’ Do the governments of various countries decide there is a pandemic? It is the World Health Organization (WHO) which declares a global pandemic as was the case on March 11, 2020, when the virus was present in over 110 countries. WHO will also decide the degree of severity and communicate this to the world? The declaration gives governments time to prepare for the pandemic, legislate laws and restrictions – such as travel and trade – and begin emergency procedures to protect their citizens. What are the criteria for a pandemic? There is no universally agreed definition of when a disease outbreak should be called a pandemic but there are three reasons WHO can declare a pandemic, when: The disease causes death There is persistent transmission between people It spreads in multiple countries The Centre for Disease Control (CDC) explains it as a ‘term most often applied to new influenza strains’ and says it’s used when viruses can infect people easily and spread from person to person in an efficient and sustained way in multiple regions. The declaration refers to the spread of a disease, rather than the severity of the illness it causes. What are examples of other pandemics? Past pandemics, which had a profound effect on the world, were the Plague or Black Death in the 14th Century, the outbreak of flu in 1918 each killing around 50 million people. Both the AIDS pandemic and Covid-19 are more recent. Who keeps a finger on the pulse of the pandemic? During pandemics, epidemiologists work as profilers. They are experts in the branch of medicine which deals with the incidence, distribution and possible control of diseases. Epidemiologists are scientists who: Trace, monitor and predict the movement and behaviour of a pathogen to create a detailed portrait. Key epidemiological questions include: What is the spectrum of disease severity? How transmissible is the virus and who is most likely to spread it? What are the risk factors for severe illness and death? How does the behaviour of the infection vary by location and does it change over time? Answers to these questions can determine what public health measures should be implemented and what resources should be allocated. These choices have a profound effect on the outcomes. Who decides that a pandemic is over? The pandemic may be widely considered over when WHO decides the virus is no longer an emergency of international concern. It is generally when the infection is mostly contained and rates of transmission drop significantly throughout the world. The expert committee reassess every three months and the world are waiting for a decision from WHO regarding the end of the pandemic as we know it. However, they are still anticipating a 5th wave. Despite this the organisation is calling for travel bans to be lifted as they have proved to be ineffective in stopping the spread of the Omicron variant. Downgrading from pandemic to endemic There is a consensus that Covid-19 will eventually settle into becoming a more predictable virus, like the flu. This means there will be seasonal outbreaks but not the huge numbers the world is experiencing now. It will transition from a pandemic phase to endemic phase and the world will adapt to living with it. What is the difference between endemic and pandemic? Endemic means the disease is still circulating but at a lower, more predictable rate — and with fewer people being admitted to hospital. Epidemiologists would consider a disease endemic when levels are consistent and predictable – unlike the ‘boom and bust’ waves we have seen so far in the pandemic. That said, just because it’s endemic it doesn’t mean to say it’s not serious. Smallpox, for example, was endemic for thousands of years and a third of the people who were infected, died. Malaria is also endemic and causes around 600 000 deaths a year. What are the hypotheses for the way in which the pandemic will end? It is difficult to predict when the pandemic will end but three scenarios emerge as the most probable. It is important to note that these will be determined by WHO and governments around the world. 1.Getting through it as quickly as possible This means the government allows people and communities to be exposed as quickly as possible so that most people have been infected or developed immunity. At some point herd immunity will be reached – when the virus cannot find new hosts -and the pandemic slowly peters out. The problem with this is that hospitals reach peak capacity very quickly and millions may die. 2.Slow it down or delay it and vaccinate As happened with most countries’, governments used various methods to slow down the spread. This reduces the number of lives lost but the virus still spreads slowly and many of these measures have a devastating effect on the economy. 3.Co-ordinate globally to crush it This is achieved by introducing travel bans, quarantining, social distancing and restricting travel. In this scenario the world should co-ordinate efforts to reduce transmission. In the best-case scenario this could end the pandemic swiftly with low loss of life. The virus will not be eliminated through this means alone but reduced transmission and spread. Each has its pros and cons but it’s generally accepted that vaccination, assisted by as much global coordination as possible, is the best possible scenario. What is

February 7, 2022

All about Boosters

As the COVID-19 pandemic waxes and wanes around the globe, it is universally accepted that as many people in the world as possible need to be vaccinated to develop immunity. Depending on which vaccine you received, you will either have had one or two initial vaccines doses and then, between 2 and 6 months afterwards are eligible for a booster. Kathy Malherbe speaks to Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, about COVID-19 immunity, vaccines, boosters and the way forward. What do boosters and vaccines do? They develop immunity against infections. In the case of COVID-19, when we are fully vaccinated, we acquire what is called ‘vaccine-induced immunity’. However, it has been shown that the immunity created by vaccines may wane over time so an additional dose of the vaccine (full or half strength) – in the form of a booster- is then given to provide the strongest and long-lasting protection possible. What exactly is immunity? Simplified, it is your body’s ability to protect you from becoming ill when you encounter a germ (virus, parasite, fungus, bacteria). It is not a simple process but essentially your body produces cells that try to stop the invading germs. This includes cells which ‘memorise’ a particular infection or germ and then recognise it when it returns and try to destroy it. Immunity can be natural or vaccine induced Natural immunity is your body’s natural ‘fighting mechanism’ which creates antibodies to fight an infection. If you get a disease mildly (like COVID) you do not develop a powerful natural immunity and your natural immunity, regardless of how strong it is, weakens over time – faster than immunity from a COVID-19 vaccine. For this reason, it is recommended that even if you have natural immunity, you still need a COVID-19 vaccine. Why is a booster necessary when you are fully vaccinated Fully vaccinated people have proved to be well-protected from becoming severely ill or dying from COVID-19. So, you may ask why a booster then? Even though vaccines protect you, their efficacy does lessen over time, regardless of which variant of COVID, especially with people 65 years and older. This is not only in the case if a COVID vaccine. If a vaccine does not contain a live, (weakened) virus, a booster is required in most cases. The COVID vaccine does not contain any form of live viruses and, like other inactivated vaccines, will need several doses over time to remain effective. The booster is designed to help people maintain their level of immunity for longer. It is important to know that immune responses can differ in people who get COVID-19 and recover from the illness There are many vaccines which require a booster so you’re more than likely going to receive at least one in a lifetime. When should you have a booster shot? For those who received the double-dose Pfizer vaccine, you’re eligible for a booster shot at least 6 months after the final dose of the vaccine was administered If you received the Johnson & Johnson vaccine, you should get a booster if you’re 18 or older and got vaccinated two or more months ago Can you have different booster shots from the original vaccine? The South African Health Products Regulatory Authority (SAHRPA) has not licensed mix and match vaccines. However, there is good evidence that mix and match vaccines are just as effective (and sometimes better) at increasing antibody levels. SAHRPA has requested submission of evidence to support this approach, so watch their website for updates. Do booster shots use the same ingredients as existing vaccines? Yes. COVID-19 booster shots are the same ingredients (formulation) as the current COVID-19 vaccines. Some boosters have the same ingredients but it is not a full dose. J&J and Pfizer boosters are the full dose. Are there side effects from the booster shot? There is a chance you may feel like you have mild flu after your booster shot. This could include a sore and even slightly swollen arm, a temperature, a headache and fatigue for a day or two. These symptoms mean that your immune system is responding to the shots and building up immune protection against the coronavirus. Can I have a booster if I am immune compromised? Yes, but should be referred by your doctor. Persons who are immunocompromised should receive an additional Pfizer or J&J booster at least 28 days after receiving their last vaccination. Presently, persons who are considered immune-compromised should have the same booster as the initial vaccine dose (or doses). Even though there is talk that COVID-19 will move from being a pandemic to endemic, there’s no getting away from the fact that this virus will be part of our lives for a long time and we will need to learn to live with it. Which means that in order for the world to develop immunity against the virus, as many people as possible need to be vaccinated and also receive booster shots.

January 31, 2022

Health at School

The school year is in full swing and children are as busy as ever with all their activities and homework. By following a few lifestyle tips you can keep your child healthy and cut down on their sick days says Bonitas Medical Fund.

January 30, 2022

Your pre- hospitalisation check list

Waves of Covid-19 and the emerging variants meant that several elective surgeries were postponed to minimise the use of hospital beds and to avoid unnecessary exposure to the virus. As the number of infections decrease, surgeons and hospitals are catching up on the backlog of elective surgeries. So, what exactly is elective surgery? It does not mean, as the name implies, that the surgery is optional but rather that it doesn’t need to be performed immediately. It can be scheduled at the patient’s and surgeon’s convenience. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, says there are pre-hospitalisation requirements for those going in for elective surgeries. Here’s a quick checklist. Hospital networks Medical schemes negotiate preferential rates with Designated Service Provides (DSPs) who have partnered with them to ensure that members get the best quality services, at the most cost-effective rate so that benefits are optimised. If you use a network hospital, doctor or pharmacy you will not be charged more than the agreed rate. This will help you avoid co-payments and make your medical aid last longer. So, to reduce co-payments and even avoid them altogether, find a healthcare professional on your schemes network. Pre-authorisation All procedures that take place in a hospital must be pre-authorised. Essentially, it’s an agreement between the medical aid and the hospital, indicating a willingness to pay for costs associated with the visit. But even if you do have pre-authorisation your medical aid is not promising to cover 100% of the costs. All pre-authorisation requests are evaluated against the different schemes’ rules and clinical funding policies however, you remain responsible for any shortfall, including any co-payments. If you are unsure how to go about the process speak to your broker or your medical aid. Quotes A quote is not the same as a pre-authorisation. Most medical aid plans have varying hospital benefits, according to the level of cover you have chosen and they also have a ‘rate’ and which they reimburse healthcare providers. This means that even if the payment is 100% of the rate, this is not necessarily what the healthcare provider will charge, they may charge 200% of your medical aid rate. Asking for a quote prior to being admitted to hospital means you will know what your medical aid will pay and what payment you might be responsible for. It gives you an opportunity to negotiate and eliminates any additional ‘surprise’ co-payments required after the procedure. Co-payments Medical practitioners, hospitals and pharmacies often charge more than medical aid scheme rates, which could be between 100% – 300% of the medical aid tariffs. A co-payment refers to the outstanding portion of the account, for which the member is responsible. This co-payment varies from one medical scheme to another and is sometimes not required if members use DSPs or network hospitals. Day hospitals Consult with your surgeon to see if your surgery can be done in a day hospital. Globally, day surgery hospitals have changed the experience of patients by offering an alternative to acute/conventional hospital surgery. The advantages include: No overnight stay, ideal for children so they don’t have the trauma of overnight stays; there is a lower risk of infection because patients go home on the same day and there is a decreased waiting list. Step-down facilities Your medical aid will stipulate the number of days you need to stay in hospital and check whether you will need a step-down facility when you are discharged. There are several facilities where patients can be cared for and start rehabilitation in conjunction with other medical professionals, for example physiotherapists. Home-based care Find out if you are eligible for home-based care after your procedure. Many patients prefer to be discharged from hospital as soon as possible and receive Hospital-Level Care at home. This means good, clinical quality care which translates into a great patient experience and is also more affordable With Hospital-Level Care at Home, nurses, other health providers and caregivers are an essential element of the care continuum and play a critical role in recovery. GAP Cover Gap Cover is an additional insurance cover that complements medical schemes. It helps to pay the difference in cost between the amount the specialist or hospital charges and the amount paid by a hospital or medical plan. You will be required to pay any shortfalls (co-payments), after which you may claim from your Gap Cover. Keep all documentation related to the surgery and hospitalisation to submit to the Gap Cover provider. Covid-19 Test For emergency admissions, a Rapid Antigen Test is performed at the hospital but for elective surgery you are required to have a PCR test a maximum of 72 hours before admission. If your test is positive, you will have to delay your surgery by at least 10 days and then re-test. Pre-admission Pre-admission can be done a few days before you are scheduled for surgery and makes the admission process less stressful on the day. Pre-admission involves answering a series of questions and tests to eliminate the possibility of allergic reactions, drug interactions or physical complications before, during and after the surgical process. For administrative purposes the following items are required upon admission: Your identification document or passport Your medical aid card Authorisation number supplied by your medical aid, or the letter of guarantee issued by your insurer X-rays, if applicable Chronic medication, if staying overnight Dr Mkhatshwa says, ‘In addition to these, remember to take any chronic medication you are on to the hospital and make sure the doctor/anaesthetists are aware of what you are taking. By following this checklist and making sure the surgeon and hospital have all the necessary information, you will eliminate unnecessary stress ahead of your procedure and prevent unpleasant surprises when you are supposed to be recovering.’

January 19, 2022

Give your body a leg up – immune boosting

Now more than ever we need to find ways to boost our immune systems as much as possible. And, while there are no medications or immunity-boosting supplements that can cure or prevent the coronavirus, there are some simple lifestyle changes we can make and steps we can take to strengthen our defences. Good nutrition can also reduce developing other health problems including obesity, heart disease, high blood pressure, diabetes, and some types of cancer. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund says, ‘Eating a healthy diet, high in immune-boosting nutrients, is just as important during this pandemic. What we eat and drink can affect our body’s ability to prevent and fight disease and recover from it. This is one of the ways in which we can improve our health proactively.’ What is the immune system? The immune system is a complex network of cells and proteins that defends the body against infection. It also keeps a record of every germ (microbe) it has ever defeated, so it can recognise and destroy the microbe quickly if it enters the body again. There is no magic pill that will instantly boost your immune system. However, together with a healthy lifestyle, various supplements can boost your immune system and give you a fighting chance. Together with those people who have not been vaccinated, it is well documented that people with co-morbidities and poorly functioning immune systems are at the highest risk of getting really ill from Covid-19. Although you cannot suddenly reverse a co-morbidity or instantly boost your immune system, now is a good time to make your health and natural defences a priority. Tips for maintaining a healthy diet: Eat a variety of food, including wholegrains (like maize, oats, rice, and legumes) as well as plenty of fruit and vegetables in your diet Limit salt intake to 5 grams (a teaspoon) a day Eat moderate amounts of fats and oils. Avoid saturated fat (animal fat). Try steaming instead of frying when cooking Limit sugar intake. This includes sweets, fizzy and sugary drinks. Choose fresh fruit over biscuits, cake, and chocolate Drink water. Good hydration is crucial for good health so make sure you drink enough water. There are many foods with high water content – such as cucumbers and celery – add these or lemon and mint, to a glass of water. ‘Ideally we should try and get all our vitamins from the food we eat. However, that’s not always possible which is why taking vitamin supplements can help bridge the gap,’ says Dr Mkhatshwa. ‘The recommendation for general health is a combination of essential vitamins and minerals to keep your body healthy.’ Vitamin C: Key to fighting infection is to increase white blood cell production, eating foods high in vitamin C – such as grapefruit, oranges, sweet red pepper, broccoli, strawberries, kale, and tomato juice – are thought to help plus Vitamin C has been shown to reduce the duration and severity of upper respiratory tract infections. Beta-Carotene: Beta-carotene converts into vitamin A, which is an anti-inflammatory vitamin that can help your antibodies respond to toxins, such as a virus. Beta-carotene is found in carrots, spinach, kale, apricots, sweet potato, apricots, and squash. Vitamin E: Is an essential antioxidant that helps fight cell damage and supporting immune system function. Foods rich in vitamin E include nuts, peanut butter, seeds, avocado and spinach. Antioxidants: Green tea is packed with antioxidants that have been shown to enhance immune system function. It also contains amino acids that may aid in the production of germ-fighting compounds in your T-cells, which reduces inflammation in the body and helps fight infection. Vitamin D: This vitamin also fights off infections and maintains strong bones. It is found in salmon, canned tuna, egg yolks, milk, cereals, breads, and mushrooms. Alternatively, make sure you expose your body to 13-15 minutes of sunshine three times a week for a natural Vitamin D fix. Studies have shown that Vitamin D can expedite healing and stall inflammation in the respiratory system but there has not been robust clinical evidence to prove its use against Covid-19. Probiotics: Live cultures, known as probiotics, are said to help stimulate the immune system to fight off disease. Yogurt, Kombucha, Sauerkraut, Kimchi, pickles as well certain types of cheese contain live cultures. Vitamin B-6: Is essential in the formation of new and healthy red blood cells and helps maintain the lymphatic system. Chicken, turkey, cold-water fish (salmon and tuna), chickpeas (traditional hummus), bananas, fortified breakfast cereal and nutritional yeast are great options for consuming vitamin B-6. Zinc: Is a mineral that our body doesn’t store or produce, however our Immune system cells need zinc to function as they are intended, it boosts the metabolism along with healing wounds. Red meat, shellfish, poultry, beans/legumes, and nuts/seeds are high zinc foods. ‘During this global pandemic we need to understand that our actions are not just to protect ourselves but also those around us,’ says Dr Mkhatshwa. ‘The risk of contracting Covid-19 is higher in crowded spaces so, reiterating what the President said, we need to heed the call to make sure you socialise outdoors or have plenty of fresh air flowing through your homes and workplaces. The World Health Organization talks about avoiding the 3Cs: Spaces that are closed, crowded, or involve close contact. ‘We need to work together to contain the spread of Covid-19 especially during the various mutations of the virus. With the 4th wave upon us, we need to vaccinate, wear masks, keep our distance, follow good hygiene protocols, boost our immune systems and get plenty of exercise and fresh air.’

December 10, 2021

Vaccinations proving to be the best defence

As the fourth wave of Covid spreads, South Africa is seeing a considerable increase in positive cases. Just as the Delta variant became part of our daily vocabulary, the Omicron or BI.I.529 strain has too. Omicron has more than 30 mutations (double those carried by Delta) that may have an impact on how it behaves. This includes how easily it spreads and the severity of the illness it causes. The Omicron variant was found in 74% of the 249 Covid-19 samples that were gene-sequenced in November in SA. It appears with more than double the mutations carried by Delta, Omicron is virulent enough to take over from Delta. Current international data shows that there are far more positive cases, meaning that Omicron appears to be highly transmissible. However, although more people are testing positive, they are presenting with mild symptoms with fewer hospital admissions. Medical professionals believe this is a direct result of the immunity acquired through vaccinations. The first wave of Covid-19 took the world by surprise but globally everyone is better prepared for this new wave. This includes a sustained effort to vaccinate as many people as possible. What the World Health Organization (WHO), the National Institute for Communicable Diseases (NICD) and most people involved in the healthcare sector agree on unanimously, is that the best form of protection from serious disease is vaccination. Lee Callakoppen, Principal Officer, Bonitas Medical Fund says, “We have been proactive in urging our members and the public to be vaccinated. Our statistics show that, of our members over 60, there are 90% fewer admissions to hospital after full vaccination and 56% fewer after one vaccination. Research across the public healthcare environment has shown the same results. With this information freely available it is disturbing that only 16 944 413 people living in SA have been vaccinated. This is only 35.5% of adults and 23.7% of the total population. ‘The cost of hospital admissions too, especially ICU, are very high. Our figures show that up to November 22, the Bonitas Covid-19 costs totalled R1.75 billion. 80% of this (R1 399 181 922) was hospital costs, while only 4.9% (R85 669 068) was for vaccinations. ‘The average cost of admission to ICU, per patient, was R533 969. There is no doubt that vaccinations not only save lives but also reduce the burden on the public healthcare system, as well as save the country billions in costs related to treating Covid. Vaccinations are a fraction of the cost of treating Covid.’ Both in the public and private sector, the unvaccinated are filling our hospitals. Dr Waasila Jassat, from NICD, announced at the end of November that ‘unvaccinated patients suffered more severe symptoms than vaccinated ones and were most likely to face hospitalisation if infected by the new Covid-19 variant.’ She said that 90% of patients admitted to hospital in Pretoria (one of the current hotspots) are unvaccinated. ‘Not only is there a higher incidence of hospital admissions but also that the chances of death amongst unvaccinated are considerably higher.’ Callakoppen says there is enough clinical evidence to show that the vaccination reduces the severity of Covid and he encourages everyone to be vaccinated. He urges those who have been vaccinated to encourage others to do the same. However, this doesn’t mean you can forgo following the Covid protocols: Wearing a mask; sanitising your hands, maintaining social distancing; staying in well ventilated spaces; coughing or sneezing into your elbow or a tissue. Bonitas has reported the following Covid related figures for 2021 as of 22 November. Total lives older than 18 estimated to have received at least 1 jab 66.4% Total tests performed: 441 929 Total Covid-19 hospital admissions: 20 376. (12 264 during 2021) Bonitas lives currently in hospital: 0.3% Admission rate: 25% ICU Admission Rate: 22% Total Covid deaths: 3 515 (2 292 in 2021) Total Bonitas membership vaccinated: 70% Highest number of people vaccinated is in the 35-49 age group followed by the over 60s ‘I must reiterate that our best defence against Covid-19 is to be vaccinated,’ says Callakoppen. ‘It won’t necessarily stop you from getting the coronavirus but it will reduce the severity of the disease. I contracted Covid in September but thankfully because I was fully vaccinated, my symptoms were mild which meant I was able to heal and recover at home. My experience is not unique.’ Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund answers some common questions around Omicron What is it? It’s a new, heavily mutated Covid variant known as BI.I.529. When was Omicron first detected? The earliest sample was detected on 11 November in Botswana. Is it more transmissible? Circumstantial evidence indicates it is. Within two weeks of its detection, it has outpaced Delta to become the main strain in Gauteng. Will vaccines work against it? Yes, most likely. A crucial objective remains to increase vaccination rates. Current vaccines remain critical to reducing severe disease, hospitalisation and death. Should updated vaccines be developed, they will be rolled out globally and used as guided by WHO. Will prior infection provide me with immunity? Preliminary evidence suggests there may be an increased risk of reinfection with Omicron but information is limited. More information on this will become available in the coming days and weeks. What about treatment? Currently Oxygen and Dexamethasone have been saving lives. There is however very exciting data coming from two antivirals. What about the current tests? The widely used PCR tests continue to be the global standard to detect infection including Omicron. Studies are ongoing to determine whether there is any impact on other types of tests including rapid antigen tests.

December 7, 2021

Advice from the experts

Should you test your child’s DNA?

To test or not to test… In countries like Norway and Finland, it is standard practice to test every new born baby for various genetic disorders. Conditions like Cystic Fibrosis, Sickle Cell Anaemia, Duchenne Muscular dystrophy, Tay-Sachs Disease, Phenylketonuria, and Thalassemia which are caused by a single gene mutation and respond well to early treatment which can prevent potentially serious complications or permanent disability. In other countries, for example Kuwait, compulsory DNA testing was over-ruled after being challenged in court, in favour of protecting the right to personal liberty and privacy. However, few diseases are the result of a single genetic mutation. Instead, multiple genes interact with each other and with environmental factors to influence the child’s risk of illness and the severity of any given disease or condition. This means that it is possible to make changes to the child’s diet and conditions to influence whether or not these conditions will manifest. Every parent at some stage worries about whether they have passed on a hereditary disease to their child, and the truth is that their susceptibility to those conditions is indicated in many of today’s DNA tests. Nonetheless, this information is not necessarily doom and gloom. The focus of precision medicine, which includes DNA testing is to use this information to avoid these conditions setting in. Prevention is more effective once one knows the risks. “Genetic tests can help parents to make informed lifestyle choices for infants and young children. For example, these tests can help identify the likely cause of digestive issues, to avoid further symptoms and promote healthy digestion” says Dr Christa North, nutrigenomics specialist at Genway. What lifestyle DNA testing will enable you to know about your child The risk of nutritional deficiencies can be identified in DNA test results. This way you can work out exactly which nutritional supplements should be given to the child. The Geneway Genediet test explains which food types are best suited to his / her system and which should be avoided DNA tests explain a child’s circadian rhythm and give insights regarding their optimal sleep times and needs. The Geneway Genesport test explains whether one’s body is better positioned for anaerobic (power/ strength) or aerobic (endurance) sports, as well as how well their body will respond to exercise. This explains their sport potential and will help guide you on how to manage this aspect of their development. New DNA tests identify the strengths and weaknesses of each person’s immune system and give indications of how these can be addressed for optimal health The onset of Diabetes in children has increased tremendously in the past decade. Testing the child’s DNA helps explain his / her predisposition for this condition so that parents can structure their diet accordingly, and know the signs to look out for. The details are in the DNA Here are a few of the genes that are tested by South African DNA testing company Geneway and what they indicate: MTHFR – Switching genes on / of. Sometimes your child’s focus is great, other days s/he has major anxiety, complains about headaches or is simply just grumpy. Even autism is a possibility….. COMT – “laid-back or tense?” The gene that determines whether your child is cheerful and focused or quickly irritated, impatient, has a high pain sensitivity and sleep is a challenge DAO – “sensitivity to certain foods” You know your child is allergic to ‘something’ or sometimes you feel like he / she is allergic to ‘everything’, but cannot figure out what? GSTs – “Detox issues” Chemicals and smells make your child feel sick and they probably will develop grey hair early. In addition, they are more vulnerable to DNA damage. MAO-A – mood swings & carb cravings This gene helps govern the levels of dopamine and serotonin, brain chemicals that affect mood, aggression, productivity, vulnerability to addictions, self-confidence, sleep and carb cravings! NOS3 – heart issues Are heart problems on the way? Cold hands and feet can indicate that blood flow and blood vessel formation are affected. PEMT – liver and brain issues No! Your child is not made to be a vegetarian! In addition, gallbladder problems and muscle pain are common. APOE – want to play rugby? The ApoE gene promotes repair and growth in brain cells after traumatic injuries such as concussions. Contact sports are not a good idea HFE – “iron man” Iron deficiency is the most common nutrient deficiency in the world, however, the opposite, an iron overload, can have far more devastating consequences. Too much iron in the body causes liver disease, fatigue, weight loss, abdominal pain and has an effect on normal puberty development. F2 & F5 – blood clotting issues Blood clotting disorders, heart disease and strokes. Diseases that start young but are often only diagnosed when too late To test or not to test The information obtained in DNA tests can be used to dramatically improve a child’s quality of life if this is accompanied by proper medical interpretation and thorough recommendations. You as a parent will be in a position to make more informed choices regarding their health, wellness, sport and diet if you are equipped with detailed information. What is important is to ensure that a qualified healthcare provider interprets and presents the results to you. DNA reports are highly detailed, and while some international companies do offer a test and report (without consultation) a professional consultation is highly recommended to ensure that both you the parents and your child gets the full benefit of the test. More information is available at https://www.geneway.co.za/ or call (012) 346 2469

August 25, 2020

Stimulating your baby’s senses

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. Believe it or not your baby will learn a lot in their first year of life. One way you can help them learn is to provide stimulation for them in different forms. This can be done in a variety of ways such as stimulating their vision and hearing or through touch and movement. Remember to spend some time every day working to help your baby explore the world around them. Stimulating your baby’s visionThe 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 eye contact with your baby during times when their eyes are open. Look them right in the eye. They recognize faces very early in life, especially yours! This helps them develop their memory. Use a mirror to let your baby stare at his or herself. They will enjoy looking at “another” baby and watching the movements it makes. Stick out your tongue for your baby or make funny faces. Starting at 2 days old newborns can begin to mimic simple facial movements as they begin to develop problem solving skills. Hold up two pictures for your baby to look at. They should be similar, but with some sort of difference between the two – maybe one has a house and the other doesn’t. Even young babies will look back and forth between the two to try and figure out the difference between them. This can help them develop letter recognition and reading skills later on. Stimulating your baby with laughing and singingThe 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. Find ways to get your baby laughing. This can be through methods like gentle tickling, blowing on their arms and tummy, or making funny faces. As they get older you can joke around more too. Laughter is great for babies! Sing songs to your baby. Learn as many as you can or make up your own words to songs you already know. Play music to your baby. This can be Bach or Mozart or even the Beatles. Learning music rhythms may help them learn math skills later on. Talk away. In other words, have a silly, fun conversation with your baby. Chat away and pause at places where your baby would speak in the conversation. As your baby grows, they will learn to start chatting to fill in the spaces you leave. Be sure to make eye contact and smile a lot! Play peek-a-boo, it’s great for getting babies to giggle and laugh – it also teaches them that objects can disappear and then come back. Physical activities for your babyThe 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. Turn yourself into a playground by lying on the floor and letting your baby crawl all over you. This will help boost their problem-solving skills and coordination. Teach them to move to music. You can teach them to do the twist, twist and shout or even twirl like a ballerina. This helps them develop skills like balance and coordination as well as a sense of rhythm. Create an obstacle course by laying toys, boxes or sofa cushions on the floor and then show your baby how to crawl over and around or under the items. This helps with problem-solving, strength and coordination. Play pick-up by allowing them to drop toys or pieces of wadded up paper off their highchair into a bucket or other safe container. This helps them learn and explore the laws of gravity. Newborn hearingThe 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. Newborns can hear immediately upon birth and are able to distinguish their mother’s voice above all else. If your baby does not seem to react to your voice or does not startle with a loud noise, be sure to tell your paediatrician.

August 17, 2020

Childhood Poisoning

A small child exposed to a potentially poisonous substance causes great anxiety in parents. In South Africa, just under half of the calls to the Poisons Information Helpline relate to accidental poisoning in children under the age of 5 years. Fortunately, accidental poisoning is seldom fatal; childhood poisoning contributed only 0.3% to deaths in children under the age of 5 years for 2017 in South Africa. Accidental poisoning is commonest in children under five years, with a peak at two years of age. At this age, children are becoming more mobile, they like to explore, and copy older children and adults, but they do not yet recognise danger. For a pre-school child, home is the main living environment, so exposures to household substances are common. Household substances include cleaning agents such as bleaches and soaps, which can cause a local chemical (burn) injury. Cosmetics are common in the home, but unlikely to cause significant poisoning. Common medicines that children can find at home if they are not stored safely include flu remedies, pain medication, antihistamines, tablets for heart and mental health conditions. These can cause serious poisoning in small children. Homes such as those seen in informal settlements may have paraffin and pesticides which are easily accessible. Pesticides can be swallowed, breathed in or absorbed through the skin. Toddlers often find rat pellets and granules which have been mixed with food and put out behind cupboards and on the floor. Poor ventilation after fumigation can also result in poisoning. Paraffin is the single most common substance to cause poisoning in children. Many parents decant paraffin into smaller juice bottles, which children confuse with water, particularly in the hot summer months when they are thirsty. Just a small sip can cause harm to the lungs resulting in shortness of breath and breathing difficulty. Other factors may influence the risk of childhood poisoning. Family stress plays an important role. Overcrowding, moving home or holidays away from home, lack of child supervision, single or unemployed parents, and anxiety or depression in parents increases the risk of poisoning for the child. Grandparents’ homes may be particularly risky to the under-5s if adult medicines are kept in unprotected places. Potential causes of harm are not limited to the home, as substances in the environment such as plants, mushrooms, snakes and spiders can also result in poisoning. Assessing the risk for my child Exposure does not necessarily mean poisoning. A substance may not be poisonous at all, or too little may have been taken to cause harm. If you suspect your child has been poisoned, find the container; identify the exact name of the substance, the amount taken, the time since exposure and note how the child is doing. Do this first, then consider calling the 24/7 Poisons Information Helpline, 0861 555 777. What first aid can I do immediately? Rinse the child’s mouth out with water and offer a few sips of water to drink if necessary. Forcing a child to drink a cup of milk or making them vomit is not advised as it can do more harm than good. Remove all contaminated clothes. Exposed skin should be washed thoroughly, as soon as possible, with soap under a constant stream of water that drains away, so use a shower, not a bath. Eyes should be washed with water for many minutes, with the eyelids held apart. If the child is unconscious, turn them onto their side and gently tilt the chin up (the recovery position). If a poisonous gas or smoke has been breathed in, move the child to fresh air. What might happen at the clinic or hospital? A child with poisoning is usually seen quickly at the clinic or hospital. If the child has taken a lot of a particular poison, and is seen within an hour of drinking it, a mixture of charcoal and water may be given to the child to drink which binds to the poison inside the stomach; this should only be done by a health worker. Most poisons have no antidote, so treatment is guided by symptoms (e.g. treating pain) and aimed at supporting the function of affected body organs (e.g. oxygen for difficulty in breathing, fluids if significant diarrhoea and vomiting etc). Children mostly recover well from poisoning. How can I prevent poisoning in my home? Always store potential poisons out of sight and reach of children, like in a locked cupboard or in a wire cage with a padlock, high up where children can’t reach. Always put medicines away immediately after use. Remember that childproof containers are not 100% childproof. Never refer to medicines as sweets. It makes them more attractive to a child. Avoid taking medicines in front of children. They love to imitate adults, especially their parents. Do not share medicines. Do not store medicines in handbags. Dispose of unnecessary medicines. Unused medicines should be returned to the local clinic or pharmacy and must not be thrown away in the dustbin where children may find them. Be especially careful when visiting other homes, as medicines may not be stored as safely as in your home. Buy pesticides from shops and in proper packaging with all the warning labels. Always wear gloves when using pesticides. Always leave chemicals and detergents in their original containers; don’t transfer them to cooldrink bottles. Keep loose batteries and battery-controlled devices away from children and place a piece of sticky tape over the battery case. Teach your children about the dangers of eating anything from the garden. If your child has been poisoned, call the 24/7 Poisons Information Helpline, 0861 555 777.

August 14, 2020

Cancelling your medical aid should be a last resort

When your income is threatened, reduced or, in the worst-case scenario has dried up, deciding where to spend and where to save becomes critical. In circumstances such as retrenchment, or periods of reduced employment, it may be tempting to consider quick-fix solutions and take a break from your medical aid but, during a global pandemic, you may want to think twice. ‘South Africans are faced with many challenges during this tough time and we are aware of the financial implications the lockdown has placed on everyone,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘The pandemic has put a spotlight on the need for quality healthcare, which means a decision to cancel your medical aid is not recommended and should not be taken lightly.’ Let’s consider the costs involved if you are not on medical aid, become infected with the Coronavirus and are admitted to a private hospital. Cost realities The cost for a patient spending two weeks in a general ward for the treatment of COVID-19 is around R99 201. But if that patient is transferred to ICU for a period of two weeks, the cost rises to about R392 340. These costs include specialists, pathology, radiology and allied services. The alternative: Public healthcare. However, the exponential spike in the number of COVID-19 cases has meant that hospitals are overcrowded, resulting in a shortage of staff, equipment and ventilators. ‘Our advice is to consider your specific medical needs, as well as your budget, when deciding how to proceed, particularly if you have chronic conditions or are at greater risk. Buying down is definitely a key consideration, or look at network options which offer marked savings. The Bonitas Select Plans, for example, are priced 15% cheaper than non-network options. In addition, we strongly advise that you consider benefit richness against your contributions.’ Key questions to ask yourself include: Does my medical aid offer additional benefits that are paid from risk rather than savings or day-to-day benefits? Does my medical aid offer alternatives like virtual GP consultations, chronic medicine delivery and online antenatal classes to deal with the concerns posed by the lockdown? Another big factor to consider when it comes to COVID-19 medical care is comorbidities, or the coexistence of two or more diseases or disorders. ’The Minister of Health, Dr Zweli Mkhize, warned early on in the pandemic that South Africa has a significant burden of non-communicable diseases, or chronic conditions, with diabetes and hypertension topping the list,’ says Callakoppen. Projections are highly uncertain at this time but our actuarial team has estimated around 30%, or 215 851, members of the Bonitas population are at risk of contracting COVID-19, based on comorbidities. The conservative financial impact to the Scheme could potentially exceed R450m, in addition to annual claims costs, which amounts to R15bn. Although there is a high level of uncertainty around the level of care required, we project that COVID-19 cases will be managed as follows: 20% requiring hospitalisation 5% requiring treatment in ICU What will the consequences be on members if they cancel their policies? ‘Unfortunately, members who resign from the Fund are unable to access healthcare benefits. There are strict rules and regulations governing the medical aid industry, in place to protect both members and the financial sustainability of medical schemes.’ Cancelling your membership This should be your last resort. If you do cancel, try to rejoin or join a new scheme within three months otherwise the new scheme can impose: A three months’ general waiting period A 12 months’ exclusion from cover for any existing medical condition Late joiner penalties on all people over 35 years of age. Before you make any important decisions, it might be worth considering what options are available to you, what your priorities are and where you cannot afford to fall short. It is also advisable to speak to your medical aid provider to find out what they can offer you. Joining a medical aid now Callakoppen says they have a seen a marked increase in queries about joining the Fund. Waiting periods apply as normal with a 12 month’s exclusion cause. However, Prescribed Minimum Benefits (PMBs) are covered immediately, this includes COVID-19. ‘Medical aids have needed to adapt during the pandemic, offering added value to members including education, advice, virtual care, etc. COVID-19 has meant we have to be more innovative and re-evaluate the way we consult with members. The need for social distancing has accelerated access to virtual care to protect health practitioners as well as patients. As a Fund, we continue to explore new ways to ensure our member have access to quality healthcare at all times.’ Added value is essential, particularly during this tough economic time and we’ve introduced a range of elements to support members on a clinical, emotional and financial basis. These include: Introducing free 24/7 virtual care with GPs to all South Africans through the Bonitas app. We have had over 33 000 downloads of the app over the past six weeks Through our partner, Pharmacy Direct, we offer home delivery of chronic medication and, during COVID-19, six month prescriptions are being delivered. Around 187 995 members are enrolled on the chronic medicine programme, of these over 55% use the home delivery service Setting up a dedicated Rapid Response Unit in our managed care team to address COVID-19 concerns and support members who are Persons Under Investigation, test positive or are in recovery Creating a COVID-19 hub on our website so that members have access to accurate information on the Coronavirus and the steps they can take to protect themselves and their loved ones Creating a corporate return to work programme to support employer groups with daily screenings, occupational health and safety, etc Creating isiXhosa, isiZulu, isiSetswana and Afrikaans videos to help educate on steps to take to curb the spread of COVID-19 Launching new self-service channels through the Bonitas app and WhatsApp that allow members to access statements and tax certificates, submit and view claims and access electronic membership cards. There is also a

August 13, 2020

Guidance for raising a child with food allergies

Raising a child with food allergies can be daunting and definitely requires extra time, attention, and effort. There are, however, a number of measures you can take to alleviate stress while maintaining a safe eating environment for your baby. Know that you are not alone in this effort. According to the Centre for Disease Control (CDC), food allergies are on the rise, with about 1 in 13, or 8 %, of children being allergic to at least one food. The good news is that the rise in food allergies has led to increased allergy awareness, education, regulation, and labelling; as well as more allergy-friendly restaurants and food allergy policies in schools and day cares. First and foremost, always be your own detective when it comes to food allergens, and never make assumptions based on word of mouth or past experiences. Reading labels (when available) is critical but know that food ingredients and menu items can change, even in longstanding products. Keep in mind that allergens may not be obvious – they can (and do) hide in coatings, thickeners, spices, natural flavours and other ingredients found in fresh, frozen, refrigerated and shelf-stable foods, salad bars and restaurant meals. Did you know that germ, seitan, and tabbouleh all contain wheat? When in doubt, ask! Ask the staff of grocery stores, restaurants and food manufacturing companies to get all the facts. Also keep an eye open for market recalls due to cross contact, which is when an allergen comes into contact with, and therefore contaminates, another food or food product. Cross contact can occur in manufacturing facilities, restaurant deep fryers, deli meat blade slicers, ice cream scoops, prep bowls, even the cutting boards in your own home. Cross contact is a serious issue, as even a tiny amount of an allergen is enough to cause a reaction in some people. Strategies for eating at home Preparing more foods at home is a smart strategy for maintaining greater control over your child’s food sources, minimising cross contact, and limiting their processed food consumption. Not to mention that limiting processed foods is generally an additional boost to their good health since processed foods tend to be higher in salt, sugar, and fat. When food shopping, read labels carefully. Foods containing major allergens must clearly declare those allergens on the label. The allergen will be stated either in parenthesis after a particular ingredient (for example, albumin (egg), lecithin (soy)) or listed at the very end of the ingredient list proceeding the word “contains” (for example, “Contains egg and soy”). Strategies for eating out When eating out, there is no shame in speaking with your waiter about your child’s dietary restrictions and asking for a detailed ingredients list. If a waiter cannot answer your questions, then ask to speak with the chef or a manager. The chef knows exactly what goes into each dish, and in many cases, they will be able to create a dish not listed on the menu, or change one of the dishes on the menu to accommodate your child’s allergy. We also recommend, when feasible, calling a restaurant in advance, during slower service times – such as at 11am before the lunch rush, or 5pm before the dinner rush – to plan ahead. Managing a food allergy may seem daunting at times, but there are some simple steps you can incorporate into your daily life to both protect your child, and maintain your sanity. Basic steps you can take to protect your child: Read food labels Always check ingredient lists. Don’t hesitate to ask chefs, waiters and manufacturers about any unfamiliar or ambiguous ingredients (like spices or natural flavours). Inform anyone handling your child’s food about specific allergies Educate caregivers and schools about your child’s specific allergies and be ready to strategise with them. It is very important that your child’s teachers, principal and friends know about their allergy. If your child is of an age where they visit or sleep over at friends without your presence, talk to their friend’s parents, and pack them a lunch box or home-prepped dinner to ensure they don’t eat anything they’re not supposed to (this will also help out the other parent who may be nervous about cooking for a child with allergies). Be prepared to combat exposure to an allergen Keep antihistamine and epinephrine (if prescribed by your physician) with you (or with your child if they are away from you) at all times. Consult with your paediatrician and/or allergist to have a plan of action in place should exposure to an allergen occur. Ensure you have the necessary medication in various places, so that you can get quick access regardless of where you are. For example, keep medication at home in the first aid kit, keep some in your handbag for when you are out, in the cubby hole of your car and ensure your child’s teacher has a supply and knows how to issue it to your child. Older children should also carry their own medication with them and should be taught when and how to take it if necessary. Avoid riskier food choices Buffets, bakeries and restaurants with pre-made foods are full of potential allergy pitfalls. Ask questions, or avoid these establishments altogether. Spread the word Carry cards that list your child’s food allergies and hand them out to caregivers, waiters, chefs, family members, babysitters and more! For severe allergies, you might also want to have an allergy medical alert bracelet made for your child. Plan ahead! And take special precautions when traveling Call restaurants in advance and speak to the manager to find out if your child’s food needs can be accommodated. Pack safe, non-perishable foods and snacks just in case. Also be sure to notify airline attendants, hotel agents, and visiting family members of any allergies when traveling (if traveling abroad, you can purchase translation cards made for this purpose). Cook at home more often and eat fewer processed foods Taking these steps alone will lessen the risk

August 12, 2020

Naturally why women won’t suffer in silence anymore

Because it’s not common knowledge, it’s hard to imagine that 30% of women suffer from menorrhagia or heavy menstrual bleeding every month. Painful symptoms and discomfort are just some of the things these ladies contend with behind closed doors despite their busy lives. A South African based company, 3Sixty Biomedicine believes that too many women suffer from this kind of commonplace health issue without realizing that they’re not alone and that there are more natural treatments and alternatives available to them. Symptoms of menorrhagia include soaking through one or more sanitary pads or tampons every hour for several consecutive hours, needing to use double sanitary protection to control your menstrual flow, needing to wake up to change sanitary protection during the night, bleeding for longer than a week and passing large blood clots. In most cases it’s accompanied by mild to severe cramps lasting from 12 to 72 hours as well as nausea, vomiting, fatigue headaches and diarrhea. Some patients even complain about pain in the hips, lower back, inner thighs and pressure in the abdomen. Debilitating symptoms like these add pressure to the lives of busy women but interestingly the condition is largely undertreated. For those who do seek medical intervention, there are several treatments that can be administered depending on a woman’s age, coexisting medical conditions, family history and desire for fertility. These include contraceptives, non-steroidal anti-inflammatory drugs, tranexamic acid or even surgery such as a hysterectomy. However, with a growing shift and demand for more natural treatments by consumers and medical practitioners – companies like 3Sixty Biomedicine are in the ideal position to offer relief to consumers from a myriad of common but often neglected women’s health issues based on natural ingredients with the added benefit of minimal side effects. The herb capsella bursa-pastoris, also known as shepherd’s purse, is a perfect example of how natural ingredients can be used in alternative treatments. This plant has been shown to significantly reduce the blood flow volumes for women suffering from heavy menstrual bleeding, containing compounds such as tannins, acetylcholine, thiamine, and flavonoids. This herb has been used for decades to treat uterine bleeding and post-partum hemorrhaging and because it has been shown to increase smooth muscle contraction in the uterus, it also facilitates the regulation of menstrual blood flow. The good news for heavy menstrual bleeding sufferers is that there is now an alternative product to assist with management of this condition; with 3Sixty Biomedicine having introduced a natural remedy into the market. SA consumers can get Salome Heavy Menstrual Bleeding, a natural product with 400mg dry extract of capsella bursa pastoris, for the reduction of heavy menstrual bleeding in women with regular menstrual cycles after serious conditions have been excluded by a medical doctor from Takealot.com and 3Sixty Biomedicine’s website, as well as independent pharmacies nationwide. This means that women who suffer from this debilitating and inconvenient condition can finally be able to manage it naturally without the risk of complications or undesirable side effects. For more information about Salome Heavy Menstrual Bleeding and the rest of the Salome range, go to www.3SixtyBioMedicine.co.za or connect on social media: Facebook: Salome Range Twitter: @SalomeRange Instagram: SalomeRange

August 10, 2020

Collaboration addresses the challenges of COVID-19

‘Collaboration between all the stakeholders is the cornerstone of tackling the coronavirus pandemic,’ this according to Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘This includes engaging both the public and private healthcare sector to find a way forward to address the challenges faced by South Africans. Negotiations, strategising and robust discussion with The Council for Medical Schemes(CMS), The Board of Healthcare Funders (BHF), hospital groups, healthcare practitioners and strategic healthcare service providers will enable us to find the best possible solution during this pandemic.’ Callakoppen highlights some of the key challenges facing consumers and the way forward. COVID-19 testing Challenge: Costs and availability of Coronavirus tests Solution: Negotiation and co-ordination to manage tests and a payment plan put in place Our administrator and business partners are collaborating with the National Institute for Communicable Diseases (NICD), the Department of Health (DoH), pathology laboratories and the Radiology Society of South Africa to try to monitor and manage the availability and cost of tests. In addition, we are collaborating on the provision and delivery of medicines and co-ordination of treatment available in order to ensure sustained, quality healthcare is available to all members. Bonitas covers COVID-19 as a Prescribed Minimum Benefit (PMB), paying for up to three PCR tests from risk – regardless of the result. ‘One of the problems has been a shortage of tests in South Africa and we have urged our members to follow the guidelines from the Government and the World Health Organization, only testing when absolutely necessary, such as when they have come into contact with a known COVID-19 positive case, are showing symptoms and have received a referral from a healthcare practitioner for a test,’ Callakoppen says. This step aims to ensure that tests are reserved for those who really need them. These measures also go a long way in helping to curb misuse of tests and mistaking the symptoms of other respiratory illnesses for COVID-19. ‘We note that as the number of COVID-19 positive cases increase, there is a significant increase in the number of tests conducted. However, again we strongly urge the public to only test when absolutely necessary or when advised by their Healthcare practitioner to do so, as a shortage of tests could have a much more far-reaching impact on the spread of the disease.’ Addressing affordability Challenge: Helping cash-strapped members continue paying their medical aid premiums Solution: Proactive application to CMS for concessions and looking for ways to add value to our members and South Africans ‘The economy and livelihoods of many South Africans have been adversely impacted by the pandemic. We definitely sympathise with this and, as the cost of living continues to increase it was very clear to us that affordability of medical aid, as well as daily living expenses, would become a concern. We began engaging with the CMS prior to the issuing of the CMS Circular 28 of 2020 containing COVID-19 Medical Schemes Industry Guidelines to try and offer our members some respite from the harsh economic impact. However, as medical schemes we are highly regulated in terms of our operations. As such there is a lack of parity between the level of relief we would have liked to offer our members to the level of relief that was approved.’ CMS issued an additional industry circular in April 2020, outlining how medical schemes can apply for exemptions to the Medical Schemes Act to launch lifelines to members, such as contribution holidays or accessing their medical savings accounts to cover premiums. The R160bn medical scheme market covers about 8.9-million members, most of whom are subsidised by their employers. Callakoppen says, ‘The CMS regulates the industry and has been very specific in terms of what medical aids may and may not do. Schemes are required to request exemptions from the Medical Schemes Act to relax certain credit management policies through the CMS. ‘We approached the CMS in April with requests for concessions and have implemented those they approved. At present, our concessions include allowing contributions to be funded from savings. In addition, we have special concessions in place for members who belong to employer groups.’ Despite the regulatory environment, Bonitas has been agile in its approach. ‘We used the challenges of the current landscape to become more innovative in terms of what we can do, within our environment, to assist our members and South Africans at large with some relief. We therefore introduced free virtual GP consultations to all South Africans through the Bonitas Member App so that they would continue to have access to healthcare during this time. We continue to keep the issue, of how members are impacted due to the economic challenges, top of mind and this informs your strategies to respond and address the challenges consumers are experiencing. Hospital beds Challenge: Shortage of high care and ICU beds Solution: Negotiations to have access to facilities outside of network hospitals and standardised tariffs Together with Medscheme, our administrator, we have implemented tariff enhancements to ensure that sub-acute and day hospitals can accommodate admissions where provincial licence exemptions have been granted, when the time comes. There are about 25 800 adult acute beds in the private sector and about 3 700 day hospital and sub-acute hospital beds that stable patients could be sent to. In addition, there are 3 600 dedicated paediatric beds nationally. ‘As a Fund we have negotiated with hospital groups to ensure that members do not have to go to a network hospital during this time when private hospitals may experience capacity constraints. Our key mandate is to act in the best interests of our members at all times and as such we strive to ensure that they have access.’ Virtual Care 24/7 for everyone Challenge: How to maintain your health during the Government’s call to stay at home and social distancing Solution: Virtual Care Early in April, Bonitas launched its Virtual Care, offering it to all South Africans, at no cost, during the COVID-19 crisis. These virtual medical consultations, with GPs and

August 7, 2020

Painful period cramps to be a thing of the past

Dysmenorrhea, the technical term for extreme period pain, is a common women’s health issue that impacts up to 20% of women with their menstrual cramping being severe enough to interfere with daily activities, according to the American Academy of Family Physicians. Symptoms typically begin in adolescence and may lead to school and work absenteeism, as well as limitations on social, academic, and sports activities. Since the start of 2020, an innovative South African based pharmaceutical company, 3Sixty Biomedicine, has been searching for treatments to assist females suffering from common but often neglected women’s health issues. 3Sixty Biomedicine’s latest product within the Salome range will hopefully be the answer to most women’s battle with painful menstrual cramping, even those as young as 13 years old. The new Salome Menstrual Pain product was launched and made available to South African consumers on Takealot.com, independent pharmacies nationwide and 3Sixty Biomedicine’s website in July, draws on natural ingredients and includes yarrow (Achillea millefolium) which has antispasmodic, anti-inflammatory & analgesic effects which may provide relief for spasm associated with menstrual periods known as dysmenorrhoea. Primary dysmenorrhoea is defined as painful cramps that occur with menstruation and although estimates of its prevalence vary widely, it is the most common gynecologic problem in women of all ages and races. Primary dysmenorrhea is thought to be caused by excessive levels of prostaglandins – hormones that make your uterus contract during menstruation and childbirth. The pain results from the release of these hormones when the lining (endometrium) is sloughing off during your menstrual period. The symptoms of menstrual pain may include lower abdominal or pelvic pain with or without radiation to the back and the pain usually occurs at the onset of menstrual flow and typically lasts 8 to 72 hours. “Nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended as the first line treatment for primary dysmenorrhoea. We are delighted to now provide women, from as young as 13 years old, with a safe alternative option to manage painful menstrual cramping that includes natural ingredients and is available in a user-friendly capsule pack online and at pharmacies countrywide. As a business we are passionate about breaking the silence on common women’s health issues. Too often conditions like menstrual cramps, PCOS and heavy menstrual bleeding are often considered taboo and are not spoken about or even treated – leaving millions of women suffering in silence and worse yet – not allowing them to reach their full potential. We want to be part of the solution by not only providing natural remedies that assist women with treating their health issues, but by also offering women educational platforms that connect them to other women and health experts via our social media channels to help #BreaktheSilence and reassure them that they are not alone”, explained 3Sixty Biomedicine’s CEO, Walter Mbatha. For more information about Salome Menstrual Pain and the rest of the Salome range, go to www.3SixtyBioMedicine.co.za or connect on social media: Facebook: Salome Range Twitter: @SalomeRange Instagram: SalomeRange *Sourced information from: https://medbroadcast.com/condition/getcondition/dysmenorrhea#:~:text=Primary%20dysmenorrhea%20is%20thought%20to,off%20during%20your%20menstrual%20period.

August 7, 2020

BREASTFEEDING & COVID-19: BUSTING THE MYTHS

We’ve had an overload of fake news over the past pandemic months. One of the most damaging falsehoods to emerge has been that COVID-19 + moms can transmit the virus through breastmilk to their little ones, and should stop breastfeeding. Spokesperson for ADSA (The Association for Dietetics in South Africa), Andiswa Ngqaka, a registered dietitian says, “There are anecdotes from various countries indicating that this misinformation is causing moms to avoid breastfeeding during the pandemic. While some may see infant formula as a ‘safer alternative’ during this time, this is not the case. Breastmilk is the safest and most nutritious food for babies, and COVID-19 does not change that.” There is no evidence of COVID-19 transmission through breastmilk As the medical profession’s foremost experts in nutrition, registered dietitians are constantly keeping up to date with the latest scientific evidence. Worldwide, there is currently no evidence that breastfed babies have been infected by mothers who have tested positive to COVID-19. Andiswa explains, “The WHO cites one study where there was a detection of non-infectious COVID-19 viral RNA in breastmilk, and this is definitely not the same thing as finding viable and infective virus. Therefore, there is unanimous agreement across international health organisations that moms can have complete peace of mind breastfeeding their children through the pandemic, even if they are COVID-19 + or suspect they might be infected. The benefits of skin-to-skin contact with your baby and breastfeeding as normal are overwhelmingly immune-boosting and protective of your baby’s health.” Lisanne du Plessis, Associate Professor at Stellenbosch University and ADSA spokesperson, gives her top 5 tips for breastfeeding moms during the pandemic: Mothers should breastfeed on demand, whenever baby wants to breastfeed, day and night. Breastfeed exclusively for 6 months. Breastmilk provides all the food and water that babies need during this time. Breastmilk also protects babies against sickness or infection. Do not give any other food or liquids to babies, not even water, during the first 6 months of life. Even during very hot weather, breastmilk will satisfy babies’ thirst. Giving babies under 6 months anything other than breastmilk will cause them to suckle less, will reduce the amount of breastmilk that a mother produces and may make babies sick. Practice hygienic measures to protect moms and babies against COVID-19 and other harmful bacteria and viruses in our environments. Breastfeeding is food security for babies Breastfeeding from birth supports the healthy development of babies and plays an important role in prevention of all forms of childhood malnutrition including wasting, stunting, obesity and underweight and micronutrient deficiencies. Breastmilk protects against many infections including COVID-19. At a time when many South African families are facing serious food shortages, breastmilk provides complete food security for babies under 6 months, and boosts nutrition and health for other young ones. Breastfeeding saves on the food budget, making more money available to feed the family. When it comes to food, you can’t get anything safer, more convenient and more economical than breastmilk. “It would make good sense to see a boost in breastfeeding across South Africa at this time,” says Lisanne. What precautions should a COVID-19 + mom take? The WHO provides the following breastfeeding guidelines if you suspect or know you have COVID-19: Wash hands frequently with soap and water for at least 20 seconds or use alcohol-based hand rub and especially before touching the baby; Wear a medical mask during any contact with the baby, including while feeding; Sneeze or cough into a tissue. Then dispose of it immediately and wash hands for at least 20 seconds again; Routinely clean and disinfect surfaces that you have touched. It is vital that partners, family and friends support breastfeeding moms who may be COVID-19 infected. They need to understand that there is no evidence that the virus is transmitted through breastmilk, and that by continuing breastfeeding, the mother is doing the best she can do to protect her baby from COVID-19. What should happen if you’re just too ill to breastfeed? Andiswa says, “If you’re too ill to breastfeed, try to express your milk for your baby and give it with a clean cup or spoon and cup. Expressing breastmilk is important to sustain your milk production so that you can carry on breastfeeding when you recover. If you can’t express your breastmilk, you can consider donor human milk. Wet nursing is another option if culturally acceptable to you. Your last option would be to provide a breastmilk substitute. Reunite with your baby as soon as your recover. Get support if you need help re-lactating and bonding with your baby.” Get Messages for Mothers – M4M A global pandemic is certainly not the easiest time to be a new mom and the mom of young children. Mothering babies and small children is often an isolating experience at the best of times, so now, with social distancing and staying-at-home, you may need to make some extra efforts to ensure you are well-supported at this critical parenting time. Grow Great, a campaign to prevent stunting by 2030, partnered with other NGOs Embrace, ilifa labantwana and the Perinatal Mental Health Project, to launch Messages4Mothers, a new digital platform to connect with South African moms during the pandemic. Messages for Mothers can be accessed at M4M or you can connect with Grow Great on social media @GrowGreatza on both Twitter and Facebook. Grow Great Communications Specialist, Duduzile Mkhize says, “Some of the biggest concerns for mothers are around how they can safely continue to breastfeed their children while dealing with COVID-19. Some mothers are essential workers and they worry about how they can continue to keep their families safe. Mothers of small children worry about taking them for immunisations as they fear clinics might not be safe. Pregnant mothers who have to go for checks ups also worry about this. COVID-19 lockdown has caused a lot of anxiety for many people, so many mothers ask questions about how to cope with anxiety and depression.” You’re not alone On a daily basis,

August 6, 2020

Teddy Bear hugs bring comfort to littlies

One of the biggest challenges for foundation phase teachers during Covid-19 restrictions has been the inability to show appropriate physical affection to pupils. High fives, hugs and physical touch are more likely to be used by children in the foundation phase, and teachers often make use of appropriate physical touch to comfort and contain the emotions of these children. The absence of this interaction and the changes brought about by Covid-19 restrictions has left many children feeling anxious. As a way to bridge the gap between Covid-19 restrictions and the need to comfort their small learners, HeronBridge Pre-Preparatory has implemented the Teddy Bear Initiative. How this works: Each child is required to bring a reasonably sized teddy bear from home with them to school daily. This helps with the settling in process and provides a sense of familiarity and comfort as a transitional object that reminds children of a safe place. During different times of the day, the teacher implements “ Teddy Bear Time” where the class as a whole holds their teddy bears, hugs them tightly then releases, and repeats this process. Physical compression through squeezing and then releasing something is a way to activate then relax muscle groups. When repeated, this activity helps the body to find a rhythm and the mind to re-focus. It is a cognitive behavioural process, that reduces panic, regulates breathing, lowers cortisol levels (responsible for panic) and subsequently reduces anxiety. If at anytime during the day a child is feeling distressed, the teacher can ask the child to pick up their teddy, hug it tightly, release and repeat, while maintaining eye contact. “It has been so lovely to see the children finding comfort in their teddy bear hugs throughout the day,” says Wendy Beyneveldt, Pre-Preparatory Head at HeronBridge College. “At a time when things are so chaotic, we want to make sure that we are creating a happy, loving and safe learning environment for all our children, the Teddy Bear initiative helps us to do that.”

August 4, 2020

C-section questions, answered

One of the biggest decisions you’ll make about your baby’s birth is whether to have a vaginal birth or a Caesarean section, also known as a c-section. Neither method is objectively better than the other, some moms need to have c-sections for physical or health reasons, or decide that they would rather opt for a c-section for personal reasons. Focusing on the c-section, we’ll let you know what you can expect when having one and what the average recovery time is. When making this decision you should consult with your health practitioner, but it won’t hurt to know more about what is happening to your body during the process so that you can make the most informed decision for you and your baby. So what exactly is a c-section? C-section is the surgical delivery of a baby. During the process you doctors will cut into your abdomen and your uterus and lift your baby out of this. As you are having a major surgery, you’ll typically have an epidural. This way you’re numb, but still awake so you can experience the magic of your baby’s birth. Both c-sections and vaginal births have their pros and cons. You’re likely to take longer to recover from a c-section birth and you’ll probably feel pain in the incision area for a few weeks. As it’s a surgery, there’s a risk of damage to surround organs, infection and excessive bleeding. Make sure to consult with professionals about what works best for you and your baby before making a choice. When is a c-section necessary? Some moms elect to have c-sections before the time, whilst others may need to have an emergency c-section due to complications that arise during birth. If you are expecting twins, have high blood pressure, diabetes or have an infectious disease, such as HIV or genital herpes you’ll schedule your c-section ahead of time. Unplanned c-sections are necessary if your labour doesn’t start or stalls, if you become too exhausted or your baby goes into distress, if the umbilical cord slips into the birth canal before the baby (as there is a risk of the baby’s air supply being cut off) or if your uterus ruptures. How long will I take to recover from a c-section? Don’t expect too much of yourself after having a c-section, you’ll typically spend around 3 to 4 days in hospital and take about 4 to 6 weeks recovery time at home before you start feeling normal again. Some moms experience muscle or incision pain for a few months following the c -section.

August 3, 2020

Boosting the immune system during the pandemic

The outbreak of the global coronavirus pandemic earlier this year had caused much anxiety and uncertainty for many. It has been a roller-coaster of emotions for parents since lockdown started and the decision to implement home-schooling either by distant-learning or privately was something no parent was prepared for. The pandemic shifted the roles and responsibilities of parents alike, adding “home-school teacher” to the already long list of roles. Public schools in South Africa are set to close from 27 July to late August with the exceptions of grades 12s and 7s. Grade 12s will only take a week’s break and return on 3rd August 2020. Grade 7s will get a two-week break returning on 10th August 2020.President Cyril Ramaphosa, said that the decision to close schools was not taken lightly by the government. The decision to reopen schools has been met with mixed reviews as parent’s stress over the wellbeing and safety of their children and family. Boosting the immunity during the pandemic has been a high priority according to pharmacies. Parents have been taking extra precautionary measures to ensure that their little ones stay healthy and well. We asked registered Pharmacist, Ashleigh Bruce for advice on what parents can do to boost their kids immune system during this pandemic, “The whole family should be taking Vitamin C and Zinc supplements daily”, says Ms Bruce. Not forgetting the basic and simple action of washing the hands often and sanitizing. The Delite Foods jelly range is packed with Vitamin C! An oblivious way to ensure kids get the Vitamin C they need without them realising it. She has also advised on trying DIYs, meditation and yoga as a form of self-care distraction to manage your stress and emotions during this difficult time. Stay connected and engage with us on Facebook, Instagram and Twitter.

July 31, 2020

COVID-19 and Allergies

The coronavirus pandemic is a time of anxiety for most people, particularly those with existing health concerns. Millions of South Africans live with long-term conditions, including coeliac disease and allergic disorders such as eczema (atopic dermatitis), hay fever (allergic rhinitis) and asthma, one of the most common chronic diseases affecting children. According to Professor Michael Levin, Head of Allergy at Red Cross War Memorial Children’s Hospital and CEO of Allergy Foundation South Africa (AFSA) there is potentially harmful misinformation around coronavirus and allergies circulating. “Patients are unsure about symptoms and whether their allergies increase the risk of serious COVID-19 complications. We want to reassure people and enable them to manage their allergies as well as possible during this time. To do this, we’re providing factual, up-to-date resources and support for allergy patients and caregivers, thanks to the generous support of Sanofi.” Professor Levin stresses that people with allergies and asthma should always take good care of themselves, whether or not there is a pandemic. “It is conservatively estimated that 80% of asthma deaths could be prevented with better treatment and access to medication. Not managing your condition does not only negatively impact your health, it can be fatal.” Dr Candice Royal of the KidsAllergy Paediatric and Allergy Centre in Cape Town, agrees the most important message for allergy sufferers is to continue good care. “Allergic disorders are systemic diseases and should not be looked at in isolation. They can be well-managed with education, correct medication and ongoing support from your healthcare professional. Whilst people with uncontrolled asthma may be in a high-risk group for severe illness from COVID-19, recent studies have shown this is not the case in well-controlled asthmatics.” Continue to take and seek treatment, safely: “Do not to stop taking prescribed allergy or asthma medications, including inhaled or oral corticosteroids. Find ways to access care and medication that limits potential exposure to the virus. For example, have medication delivered, or send someone to collect. A telephone appointment with your doctor may be an option than going to the clinic or surgery.” Symptoms of allergies and COVID-19 can be similar, which has been a source of concern for many. Coughing for example, is common to asthma and coronavirus; yet fever, body aches and pains which are usually experienced during coronavirus, are rarely related to asthma. Speak to your healthcare provider for clarity or refer to AFSA’s useful symptoms checklist – www.allergyfoundation.co.za/covid-19-symptoms. “If you have asthma, continuing to control it could help you defend against the virus. Taking prescribed controller therapy daily, whether you have symptoms or not, helps repair swelling and inflammation in the lungs so that you’re better able to fight off viruses – including the coronavirus,” says Dr Royal. “There is no evidence that the use of inhaled or nasal steroids increases one’s risk of contracting COVID-19, and using them regularly might even help prevent you from getting the infection or from suffering with more severe symptoms.” Nebulisers are not recommended, as they can increase the risk to those around you. Professor Levin advises using an asthma pump with a spacer, rather than a nebulizer. “Spacers deliver medication to the airways more effectively than a pump on its own.” For people with skin or eye allergies, itching may mean touching and potentially increased infection risk. To prevent this, experts recommend regular skincare and steroid use as needed whilst also maintaining excellent hygiene measures – washing hands regularly, always wearing a mask and maintaining social distance. Allergy care may change for people who become infected with COVID-19. According to Dr Motohiro Ebisawa, President of the World Allergy Foundation, “Professional help is essential to understanding what is causing symptoms such as shortness of breath, chest tightness, or difficulty breathing. Patients should not assume these symptoms are either from their asthma or COVID-19 but consult their physicians immediately in case emergency care is needed.” For further information and free, up-to-date resources on allergies and COVID-19 – including asthma, allergies and COVID-19; coronavirus and asthmatic children; coronavirus and coeliac disease and a useful symptoms checklist – visit www.allergyfoundation.co.za/covid-19-and-allergy For further information visit www.allergyfoundation.co.za, follow @SAallergy on social media or contact Lynn Kämpf, Business Manager of the Allergy Foundation South Africa on [email protected].

July 31, 2020

Food security for children starts at the breast – support breastfeeding

South Africa has one of the lowest breastfeeding rates in the world. Not because women do not understand the importance of breastfeeding for their children but because women face a hostile environment to care for their children. This World Breastfeeding Week, observed from 01 to 07 August, the South African Civil Society for Women’s, Adolescents’ and Children’s Health (SACSoWACH) are focusing on creating an environment that enables and supports women to breastfeed successfully. Due to our current global crises, with the engulfing COVID-19 pandemic and the subsequent economic crash, women are bearing the brunt of job losses. Female-headed households, especially, are experiencing a financial shock,1 adding to the burden of finding food for their families and caring for their children. In South Africa, nearly one in two households are headed by women, skewing the need to provide unfairly on mothers. South Africa is known as ‘the fatherless nation’ as it has one of the highest numbers of absent fathers in the world. It is estimated that nine million children in South Africa grow up without fathers.2,3 In a recent media report, even our Springbok captain has had to call on men to support and eradicate the scourge of abuse and violence against women.4 Breastfeeding is excellent for infants and young children as a food source, for immunity and for neurocognitive development, and emotional self-regulation.5 “The first step to creating a supportive and safe environment for women and children is the essential provision of food for pregnant women and breastfeeding mothers. Safety and protection for moms, as the life-carrier and carer of children, is non-negotiable,” explains Dr Tshepo Motsepe, First Lady of South Africa, patron of the Coalition, passionate breastfeeding activist and humanitarian. The high rates of violence in South Africa cannot be ignored. Breastfeeding is associated with less violence in societies.5 Research also shows that 80% of rapists are the product of absent fathers.3 Young men who grow up without involved fathers are more likely to develop ‘hyper-masculine’ behaviours such as aggression and emotional instabilities. In contrast, young women are more likely to develop lower self-esteem and become victims of violence.3 Many hungry and stunted children live in fatherless homes1 where suicide is more likely in these individuals.3 “We need fathers and empowered men to step up and invest in the future of our society. Children are our future; the outcomes we want for tomorrow begins with what we do today. We call on all men to set an example and provide emotional and financial support, as far as possible, for the family and breastfeeding partners. This will help women to breastfeed exclusively and relieve them of the pressure to return to work too early,” explains Patrick Shivuri, Maternal and Child Health Programme Manager from Save the Children and a father himself. “Food security for infants and young children starts at the breast. Breastmilk is a living food; it protects against many infections that include COVID-19. If we want to protect children’s health, we need to protect and support their mothers,” adds Dr Chantell Witten, nutrition lead for SACSoWACH and lecturer at the University of the Free State. This has never been more relevant in a time when food is scarce and financial resources constrained. “Reducing Gender-Based Violence starts with protecting, promoting and supporting breastfeeding mothers at all cost. Paternal presence both emotionally and financially is a long-term investment for a healthy and less violent South Africa,” ends Precious Robinson, SACSOWACH chairperson and health advocate from Right to Care. In celebration of World Breastfeeding Week, SACSoWACH will host a breastfeeding dialogue on Thursday, 06 August 2020. The discussion will be live-streamed on their website; please visit www.sacsowach.org.za to find out more and sign up.

July 31, 2020

COVID-19 is taking its toll on SA’s mental health

Fear and anxiety have gripped the globe as COVID-19 continues to take its toll on human life, economies and society at large. Experts are becoming increasingly concerned about the psychological effects of the epidemic, particularly on the poor, elderly, children and teens, and frontline healthcare workers. Abdurahmaan Kenny, mental health portfolio manager at Pharma Dynamics, says levels of distress are bound to increase as more South Africans become infected, lose their income and social isolation becomes a way of life beyond the lockdown. “Vulnerable populations, such as the elderly, those with mental health conditions and pre-existing health concerns are likely to experience higher levels of psychological distress due to the major threat that the outbreak poses to their own personal health. “Another high distress category is likely to include the poor who rely on odd jobs to make a living. Staying at home means they cannot provide for themselves or their families. “Doctors and nurses, particularly those at the frontline of the crisis, may experience secondary traumatic stress (STS) reactions—a by-product of working in a traumatic environment. “Equally, parents who are dealing with childcare responsibilities during school closures and work-from-home obligations may experience greater levels of anxiety as they try to juggle it all while taking care of elderly parents and reassuring their children.” He says that stress during the outbreak can include fear and concern about one’s own health and the health of loved ones, which is completely normal. More detrimental changes to watch out for include sleeplessness, difficulty concentrating, feelings of hopelessness, suicidal thoughts and worsening of chronic health problems. Those with pre-existing mental health conditions are also encouraged to continue with their treatment. Should their symptoms worsen, they should contact their healthcare provider (remotely if possible). Advice to parents “Arming yourself with the real facts about COVID-19 and the risk that it poses to yourself and your family can make the outbreak less stressful. If you remain calm and provide reassurance, children will follow your lead. However, teens are likely to be exposed to more communication from friends and social media, which may lead to excessive worry or sadness, unhealthy eating or sleeping habits or acting out. “Keep the lines of communication open between you and your children. Answer questions they may have around COVID-19 based on facts provided by credible organisations such as the World Health Organisation (WHO) or the SA government (sacoronavirus.co.za). Share advice on how to cope with stress and try stick to a routine with educational, fun and relaxing activities to make the days meaningful. “Be a role model to your children. Limit your news coverage of the outbreak to once a day, including social media. Stick to a wholesome routine of your own by getting enough sleep, eating healthily, exercising and connecting with friends and family. Your children will take their cue from you.” Feature Supporting frontline responders “Many of our doctors, nurses and other healthcare personnel will be directly involved in the diagnosis, treatment and care of people with COVID-19, which places an extraordinary burden on them both physically and mentally. “It is vital that they remain focused by taking care of their own health in order to continue to respond to the outbreak. “Take regular breaks, eat right, practice deep breathing and relaxation techniques, get enough sleep and work in teams to help ease the burden. Also ensure that childcare, household and pet care responsibilities are in hand while you’re on duty. Communicate with loved ones, even if it’s just once during a shift. Helping those in quarantine “For the 112 people who have been released from quarantine in Polokwane, many of whom have been separated from their families for more than 65 days (first while being in lockdown in China for 51 days and then another 14 days in SA), a range of emotions may follow. “These could include feelings of relief, stress from constant monitoring for signs and symptoms, sadness, frustration and even anger. Guilt about not being at home and caring for children or other emotional or mental health challenges may surface. Families should be extra supportive and allow those returning from quarantine time to adjust. “It can also be traumatic being separated from loved ones after testing positive for COVID-19. Remain in contact as much as you can via phone or video calling to provide patients with the love and support they need.” Kenny says knowing how to respond to these challenges when they arise will help you to stay mentally focused while caring for those closest to you. “For now, we need to embrace the new rhythm of life and the chance it gives us to connect with others in different ways.” As a leading provider of central nervous system (CNS) medication for the treatment of depression, anxiety and bipolar disorders, amongst others, Pharma Dynamics is committed to the mental wellbeing of all South Africans. The company advocates for prevention services, early identification and intervention for those at risk. Those who feel mentally overwhelmed by COVID-19 or experience signs of depression can contact Pharma Dynamics’ toll-free helpline on 0800 205 026, which is operated by trained counsellors who are on call from 8am to 8pm, seven days a week. The call centre is a critical service to the public and is therefore operational during the lockdown. Also visit www.letstalkmh.co.za for additional tips and videos to ensure mental well-being during the lockdown. The public is also being encouraged to share photos and ideas of their own on the platform to help others get through this challenging time.

July 30, 2020

Easy tomato soup with cheesy bread dippers

This comforting tomato soup can be made in less than 20 minutes and enjoyed by both you and your toddler. Don’t forget to make the cheesy bread dippers – sure to be the most fun part of the meal for your toddler! This meal is suitable for toddlers 12 months+. Makes four small and two adult servings. What you’ll need Ingredients for soup: 1 tablespoon olive oil 1/2 cup chopped onion 2 cloves garlic, minced 1 tin diced tomatoes 1 cup low-sodium vegetable broth / vegetable stock 1/2 teaspoon dried basil Pepper to taste (optional) 1/2 cup plain Greek yogurt Ingredients for cheesy bread dippers 4 slices of whole wheat bread 1 tablespoon butter or olive oil 1/2 cup shredded mozzarella cheese 2 teaspoons Italian spice mix How to make it: In a medium pot, heat olive oil over medium heat. Add the onion and garlic and cook until tender, roughly 4 minutes. Add in the tomatoes, broth, basil and pepper. Bring to a boil, then reduce heat and simmer for 10-15 minutes. Meanwhile, you can make the cheesy bread dippers. Heat the oven to a broil and line a baking sheet with tin foil. Butter or oil one side of the bread and place it (butter side up) on the baking sheet. Broil until golden brown. Remove from oven, carefully flip the bread over and sprinkle the non-cooked side with cheese and Italian spice mix. Place back under the broiler and heat until cheese is golden brown. Let cool and then cut into 2-inch strips. When soup is done, add in the yogurt and using a blender or hand immersion blender, blend the soup until smooth and creamy. Let cool slightly and then serve the soup with the cheesy bread dippers. Always check with your child’s doctor first if you have any questions about introducing new foods and textures. Launched on Mother’s Day 2006, Happy Family Organics is one of the largest and fastest growing organic food brands to offer a comprehensive line of nutritious foods for babies, toddlers, kids and their mothers. Constantly innovating, Happy Family strives to offer families the right nutrition for every stage of development, and is on a mission to change the trajectory of children’s health through nutrition. Happy Family Organics products are available at all Baby City stores, Babies R Us, Wellness Warehouse, Selected Clicks, Selected Spars, Selected Pick N Pay stores, Selected Baby Boom, selected Dis-Chem and selected Medicare pharmacies, and online from Takealot.com, Babiesafrica.com and Faithful to Nature.

July 28, 2020

Five brain-boosting foods and drinks

Our bodies need “fuel” for every organ, and the brain is no exception. Giving our brains the right food can aid concentration and memory greatly, both of which are necessary for studying and completing tasks and assignments. In today’s article, we discuss five of the best foods and drinks for boosting brain function. Fatty fish Omega-3 is a type of fatty acid that is most commonly found in fatty fish like salmon. Our brain cells consist mostly of fat, 50% of which is the same kind as omega-3 fatty acids! By eating fatty fish or taking omega-3 supplements, your brain maintains optimal levels of fat. It also helps strengthen the structure of the brain cells themselves, both of which result in optimal brain function. These acids also increase blood flow, which is essential for optimal organ performance. One last benefit of this fatty acid is that it increases the amount of grey matter in your brain, which is the other component of the nerve cells (the other is fat), and more grey matter means better cognitive function. Younger children might not enjoy the taste of fish like salmon, so be sure to incorporate an omega-3 supplement in their daily vitamin regimen! Nuts Nuts contain high levels of something called antioxidants, which are natural compounds that slow down oxidation. Oxidation is a naturally occurring process that can damage the body’s cells. With particular regard to the brain, oxidation negatively affects our cognitive function, and consequently our ability to focus, learn and remember. By consuming foods high in antioxidants, we can improve these cognitive functions that are critical for academic success. Antioxidants can also be found in blueberries. Here, they take the form of something called anthocyanin, which is a type of flavonoid. Flavonoids are molecules that give food its colour, and they contain high levels of antioxidants. Blueberries also improve cell-signalling (how brain cells communicate with one another). Good cell signalling is essential for making and storing both short-term and long-term memory, both of which are crucial for studying and writing tests and examinations. Also read: Do’s and Don’ts for Making Healthy Food Choices During the Lockdown Leafy greens Leafy greens like lettuce and spinach contain a compound called carotenoids. These are similar to the flavonoids found in blueberries as they are the compound which gives food its colour and, like flavonoids, they also contain antioxidants and help improve cell signalling. When digested and absorbed, carotenoids often migrate to the frontal cortex, which is the region of the brain that is responsible for such functions as problem-solving and memory – in essence, it is the “control panel” of our brain, so keeping it healthy is essential for optimal cognitive functioning! Unlike many other foods, chopping and cooking foods that are rich in carotenoids actually increases the strength of the nutrients when they enter the bloodstream, so be sure to incorporate plenty of steamed spinach or cooked kale in your child’s diet. Water We all know hydration is important given that our body’s cells consist of 60% – 70% water, but it’s particularly important for our brains. This is because dehydration leads to a lack of sufficient water in our cells which, in turn, leads to poor organ function. In the brain, this means reduced/impaired cognitive function, particularly the brain’s ability to create short-term and long-term memories. As a result of this, we are unable to convert the information we are learning into memories, and if we are unable to create these memories in the first place, we’re unable to recall them later on. Experts recommend drinking 6 – 8 glasses of water a day, but fewer are needed depending on your child’s age (generally one 235 ml cup for every year of the child’s age): Green tea Green tea contains a compound called L-theanine, which is an amino acid (amino acids are compounds that make up the proteins in your body’s cells). L-theanine is thought to increase GABA activity (GABA is a brain chemical that reduces the activity of brain cells). Higher levels of GABA tend to make people feel more relaxed, which leads to decreased stress, which in turn helps improve concentration. L-theanine also increases your brain’s alpha waves, which are a type of brain activity that is thought to aid mental coordination, calmness, alertness, and learning, all of which are essential for studying. Now, green tea might not be to the taste of younger children, but certainly, teens might enjoy the flavour, so give it a go! by Jacqui Smit

July 24, 2020

Tips for keeping coughs and colds away

Winter is an incredibly beautiful season. Apart from the inconvenience that the seasonal weather can bring, in a country where drinking water is often scarce, the rain is always welcome! Less welcome, however are the germs and nasties that creep into our homes. With people coughing and spluttering all around us during winter, it’s important to step up our own personal hygiene. This rings particularly true in the current circumstances we find ourselves in. With Covid-19 still very much a part of our daily lives, keeping germs at bay, is now more important than ever. What can you do to prevent catching a cold or flu this winter? Wash hands religiously With the number of people catching the flu virus at an all-time high, it’s important to keep the spread of germs to a minimum. Wash your hands regularly – particularly after a cough or sneeze, with warm, soapy water for at least 20 seconds. Also, keep hand sanitiser gel and wipes within easy reach if necessary. Vital Baby’s Hygiene Hand & Face Wipes (R35.00) are great to keep in the car, at home and in your handbag. They’re gentle enough to use on baby’s face, and effective at removing germs and dirt. Cough into elbows This is one that both adults and kids can adopt. Encourage coughing and sneezing into the elbow crease rather than hands. Sneezing into hands can spread germs even more as we use them to do so much. Make up a silly song If your child doesn’t like washing their hands for long, or with soap, make it fun. Make up a silly song or find one on the internet that encourages them to do it thoroughly. For example, make up words to the tune of ‘Row your boat’ such as: Wash, wash, wash your hands, make them nice and clean, scrub the germs and wash them off, dry them in between. Get rid of the snot Help to clear little noses using a nasal decongester. This handy little device helps to remove snot quickly, efficiently when they are sniffling and unable to do it themselves. Sterilise after use to make sure it remains hygienic. Stay active Staying active and taking regular exercise can also boost your immune system. Encourage your child to play outside, take them to a park, or head to an activity centre where they can tear around without worrying about the weather. Watch out for fevers If your child has caught a cold, keep an eye on their general health. Take their temperature regularly and their body temperature seems hotter than normal, offer the correct dosage of children’s paracetamol and ibuprofen to keep their temperature under control. Try to focus on fruit and veg We all know that eating a balanced diet packed full of fruit and veggies can give our immune system a boost. During the winter months, try to sneak even more into your child’s diet. If they reject it, hide them in their favourite meals or sauces. Get enough rest Ok, ok, so if you’re a parent, don’t laugh at this suggestion! We know that sleep might be something that you struggle to get enough of, but it really does affect wellbeing. If you think your child is coming down with something, cancel some plans and encourage them to get plenty of downtime. Take the idea on board for yourself too; switch off your phone and try to get an early night. Even an hour extra can really help with your own energy levels. We hope that you manage to stay healthy this winter! Follow Vital Baby on social media: @vitalbabysa Vital Baby products are available at Clicks, Babies R Us, Loot, Baby City, Takealot and at www.babiesafrica.com.

July 23, 2020

Mental strength when you need it

The pandemic has shown us we are more resilient than we think Covid-19 has had devastating effects on the people of South Africa and the world over. As the rate of infection continues to skyrocket, especially in our urban centres, people are starting to grow more fearful of what the future holds. This is on the backdrop of an already ailing economy where our country’s official unemployment rate surpassed 30% in June. Despite the government’s Covid-19 economic stimulus and relief package, the unemployment rate is projected to peak anywhere between 41% and 54% as a result of the lockdown. Projections by the International Monetary Fund suggest that debt repayments will account for more than 80% of our GDP by the end of next year. These statistics paint a gloomy portrait. At the start of 2020, we never thought we’d be forced to retreat into our homes in an attempt to survive this ruthless virus, and social distancing wasn’t even a part of our lexicon. We didn’t anticipate such a sudden, severe threat to our lives and livelihoods. Adjusting to this new way of life and pervading sense of uncertainty has been challenging. It’s easy to lose perspective, to forget what we’re trying to accomplish, to feel scared and alone. The irony, however, is that the physical distancing forced us into a space of introspection, and we were able to connect on a deeper level with not just ourselves but each other. This sense of connection is what drew us closer together, because we were able to see that we might not physically be with one another, but we’re in this together, united in a common cause to overcome an invisible enemy. Sometimes when we feel overwhelmed – whether it’s about our health, children, finances or broader social issues – it helps to have a friendly reminder that adversity is a test of strength, and that we are much stronger than we think. Metropolitan’s Three Word Stories campaign did just that. The radio and social media campaign ran on Ukhozi FM, Thobela FM, Lesedi FM, Umhlobo Wenene and Motsweding FM, which have a combined listenership of around 22 million people, and hundreds of thousands of followers on Facebook and Twitter. By encouraging listeners to speak openly about their concerns, Metropolitan’s Three Word Stories sought to build resilience and inspire mental strength to help us cope with the stresses of a new and uncertain world. It created a much-needed platform for us to share our experiences and gain wisdom through our collective knowledge. The conversations emphasised that mental health is essential for our wellbeing. It eased our anxiety about the future by helping us find ways to navigate new challenges. Sharing our stories reminded us that we already have the fortitude to handle whatever life throws at us, especially when we’re there for one another. The voices we heard during the campaign spoke to our resilience, our shared humanity, our deep connection to everyone in South Africa and the world. We needed reminding. Jane Mokoena from Limpopo shared how – amidst the difficulties presented by the pandemic – she was able to use the time at home to reconnect with her children. Anna Maake from the Free State said that the turbulent past few months were reminiscent of her humble beginnings. She was reminded of her innate strength and resilience, which helped her get through dark times before – and reminded her that she will again get through this. Financial concerns featured prominently in stories such as: ‘Smart Money Goals” Should we be trying to save more? How should we restructure our finances? How can we pull ourselves out of debt? What can we do to help others while we wait out the storm? How do we balance the need to stay safe with the need to earn a living? Hearing these fears articulated let us know that there are thousands of people in similar situations who are willing to listen and help. So is Metropolitan. Take comfort: we’re here for you and will continue to be for the long run. But more importantly, we hope the insight we were able to share into the hearts and minds of ordinary South Africans during this campaign helped remind them just how strong, capable and resilient they are. Post-Covid our lives are likely to be forever changed, but what will remain is our ability to overcome whatever challenges we encounter. We’re all strong, but we’re stronger together, and even though we can’t always be with one another, we have more friends than we realise. Continue to stay safe and strong, South Africa, and remember that the only thing we should be spreading right now is our love for our country, one another, our families and ourselves. By Nontokozo Madonsela, Chief Marketing Officer for Momentum Metropolitan

July 22, 2020

COVID-19 Immune Boosting Claims Debunked

A happy immune system is an important component of wellness. In light of the recent flu outbreak associated with the Coronavirus (COVID-19), the task associated with supporting immune health has become increasingly significant. Avoiding illness is not always possible, but there are several steps one could put in place to support immune health and reduce the risk of getting sick, as well as minimise duration and complications if they do. However, across social media we’ve heard that a variety of methods including taking large numbers of supplements and strange diets can “boost our immune system” and combat against COVID-19. Immune supportive ingredients are actually very individual and differ from person to person. There is no blanket advice when it comes to so-called ‘immune boosting’ advice. Factors involved in supporting the immune support depends very much on an individual’s genetic composition, current diet and lifestyle e.g. stress and sleep. This article will explain why there are no single foods or supplements that will prevent or cure COVID-19, and debunk recent diet claims related to this. How does the immune system work? Before we dive into the details surrounding the immune system and the specific foods as well as supplements, we first need to consider how does our immune system defend our body? People have this idea that the immune system is some kind of internal force field that can be boosted or patched up. This couldn’t be further from the truth. As the name suggests it’s not a single thing and has no central organ of control BUT is a system that involves many organs and biological functions. Their interactions defend the body against foreign invaders such as pathogens. Each day, the body confronts an environment teeming with disease-causing organisms. The immune system is designed to implement rapid, specific, and protective responses against these organisms. The immune system can be broadly split into two parts, the innate and the acquired response. On detection of infection, it’s the innate response that acts first. Though fast, it lacks in finesse, and deals with an invading pathogen in much the same way that the Ghostbusters might try to remove a ghost from a haunted hotel. It gunges the halls and doorways to try to flush it out (that’s why you fill up with phlegm and snot), it yanks up the thermostat to try to boil it (why you run a fever), and it shuts down the building until the problem is solved (it makes you lethargic so you don’t go out and pick up another infection while your immune system is at work). What the innate response doesn’t do is eliminate the intruder from the body. That is the job of the acquired system, a specialised SWAT team by comparison that identifies the enemy and makes the specific weapons, or antibodies, needed to destroy it. It can takes round about 5 to 10 days for the acquired system to identify the antibodies needed and clone them up to sufficient numbers to make a meaningful attack. DID YOU KNOW? Our immune system’s response varies over the course of 24-hours. At certain times, we may be more resilient to fighting off viruses and at other times of the day, we may be more susceptible to pathogens. For example sleep is vital for your body’s immune function the next day, so if you haven’t slept well your immune defences may be compromised. “Immune boosting” claims are flawed The term “boosted immune system” is unscientific and is often used in headlines and marketing of diets, potions and dietary supplements. Dietary choices and supplements don’t boost the immune system; rather it can allow the immune system to function adequately and more efficiently. According to experts the only way to ‘boost your immunity’ is through vaccination. Getting vaccinated against the flu and other diseases stimulates the immune system to protect against illness. Vaccines teach the immune system to recognise specific pathogens and prepare them to mount a defence if they are encountered. Therefore, our current goal (considering the COVID-19 pandemic) is to SUPPORT and OPTIMISE our current immune system with an overall healthy diet and lifestyle. For example, a balanced diet provides a range of nutrients which play an important role in our immune system. How to optimise the immune system? COVID-19 is a scary time for most individuals. Largely because we don’t have much data on the disease as it is brand new. Before we can make any reliable claims during this pandemic, we need repeated, robust, human clinical evidence. However, until more research is available, we want to do our best in optimising our immune system. So, what can we do to keep the immune system functioning optimally? I would suggest the following: Immune supportive nutrients. A good starting point is a healthy balanced diet and to take a comprehensive, high quality multi-vitamin and mineral supplement. We should be very cautious of just taking supplements that has been touted as ‘immune boosting’. Correct nutritional deficiencies. Consider having nutrient levels checked by means of a blood tests in order to identify any deficiencies in key nutrients that are important to a healthy immune system activation. Supplementation can then take place according to underlying nutrient deficiencies. Identify and address ways to reduce inflammation. Initially we believed that anti-viral supplements were the way forward for prevention of COVID-19 and more and more evidence is emerging that the secondary focus needs to be on reducing inflammation. In fact controlling the local and systemic inflammatory response in COVID–19 may be as important as the anti-viral therapies. Taking an Omega-3 supplement is sensible since it is anti-inflammatory. Know your genes. Consider DNA testing. Knowing more about your genes can help your healthcare practitioner make positive changes through nutrition to improve and optimise cellular defence mechanisms. Immune supportive nutrients: Vitamin C There is no question that vitamin C plays a role in the immune system, however the research has found that vitamin C supplementation does not reduce the risk of the common

July 20, 2020

Beating the COVID-19 Blues

We have all been cooped up in our homes for weeks, so cabin fever is real! For most people, there is nothing better than getting together with family and friends and when these interactions are taken away, it is natural to feel off.

July 20, 2020

Do’s and Don’ts to keep the weight off this winter

Longer nights, shorter days, colder weather and decreased exercise can all contribute to winter weight gain. Add the temptation of rich comfort food and it’s easy to see why so many of us battle to keep to our health goals during winter. According to Dr Riekie Smit, an aesthetic medicine practitioner from Pretoria with a special interest in weight management, women tend to gain an average of between two and four kilograms every winter and generally only lose half of what they gained in the upcoming summer. Unless it’s stopped, this pattern will result in gaining more weight every year. We feel sorry for ourselves when it is cold outside and opt for comfort food, and then regret it when summer arrives. However, Dr Smit recommends that we should all make an effort to eat healthier food and increase our intake of vegetables, especially green ones. “This will not only keep the weight off, but also keep your immunity levels high,” she says. Dr Rosetta Guidozzi, a general practitioner from Johannesburg, says that in order to boost immunity during winter it is important to follow a healthy diet, including lots of vegetables and citrus fruits. Foods should be enhanced with herbs such as sage, rosemary, oreganum and coriander as they have powerful antioxidant effects and are flavour enhancers, which can help you to eat less. The same applies to spices such as curry and peri-peri, which flavour foods and induce a decrease in consumption. Clinical psychologist and cognitive behavioural therapist, Dr Colinda Linde from Randburg, Johannesburg, also agrees that eating for immunity is important. “Winter tends to be when we get sick, so make sure to include immune boosting foods like citrus, garlic, herbs, mushrooms and a dose of probiotics. Winter is also a great time for ‘slow food’—casseroles, soups and stews that are easy to put together, warm and hearty to counter the cold,” she says. Although it can be more difficult to exercise in winter, Dr Smit says that if the cold is putting you off your walk or cycle, opt rather for indoor exercise programmes, either at the gym or at home. She says that there are now multiple apps to help you with this. Dr Guidozzi reiterates that continuing exercise and eating correctly in winter is a priority. This includes the preparation of healthy stews and soups using lots of herbs and spices. “The trick is to remain motivated during winter,” she says. Even if you change the type of exercise you do during the winter months, it is important to at least continue with activity. Dr Linde says that while she would definitely recommend including exercise in winter, it is also important to be realistic about it. She recommends possibly starting the day with stretches, which warm you up and can be done on a yoga mat in your bedroom at home. She says in this way you consciously include exercise in your daily routine, with the option to also add something outside of home such as the gym, a walk or a run. Dr Guidozzi says that winter can also trigger the “winter blues” in some people, an onset of lowered moods. “To prevent this, it is necessary to exercise and also to spend time outdoors, and absorb the sunlight when one can,” she says, and reiterates the importance of maintaining good sleeping habits. She says that sleep deprivation will lower immunity and can lead to making less favourable food choices. While healthy eating and exercise is important, so too is taking time for yourself. Dr Linde, who is launching the second edition of her book entitled Get the balance right—Coping tips for working moms, which was first published in 2005, says that winter is associated with hibernation in nature, where animals and many plants slow down, and renew themselves by spring. “We have a short winter here, only three months really, so it could become an annual stocktake, going inward by meditating quietly or journaling for a few minutes daily”, she says. The time saved by putting a stew in the slow cooker can be used to curl up on the couch with a magazine. Another tip to remember in winter is to care for your skin, which can become dry and irritated during the winter months, leading to loss of collagen and wrinkling. Dr Smit recommends using a milk cleanser and rich moisturiser to stay hydrated. Keeping up an adequate intake of water is also essential. “In winter you could opt for hot herbal teas or hot water with lemon or mint leaves,” she suggests. Some healthcare practitioners suggest taking a supplement with added vitamin C and zinc in winter, although this should not replace a healthy diet, especially a diet which includes fruit and vegetables with adequate vitamin C. Adding probiotics to your daily routine can also help your immunity to resist viral infections. Remember also that hand hygiene is vital to avoid germs. Instead of associating winter with comfort eating, hibernation and a bowl of creamy pasta on the couch, be proactive. Spice up your winter menu with healthy vegetable soup, download an app to start getting more active in the comfort of your home and remember that while summer bodies can be made in winter, eating healthy foods, exercising and upping your immunity can help you to enjoy a healthier winter. Whether in winter or summer, some people trying to lose weight will struggle too much with hunger, especially at the start of their weight loss journey. These people might benefit from a prescription medication which, together with appropriate lifestyle adjustments, can help kick-start a weight loss journey, or can help someone get back on track. If you are worried about your weight, speak to your doctor for advice about how to lose or manage your weight. Visit www.ilivelite.co.za for tips, support and further information about weight loss.

July 17, 2020

How to help a child struggling with (Corona Virus) anxiety

We’re all on edge because of the coronavirus. Our daily lives have been disrupted, we aren’t sure what tomorrow may bring, and, for many of us, the nonstop news and social media coverage are overwhelming. Therefore, it is not uncommon to feel anxious or worried during this time. If you or your children are feeling worried, learning how to deal with anxiety in a healthy way can help the whole family be more resilient, both now and when the pandemic is finally over. What is anxiety? Anxiety can be described as feelings of uneasiness or being worried when there is not necessarily any imminent danger present. It is often accompanied by intrusive and often unrealistic “What if” types of thoughts, experienced in the body as stress that continues even after the cause of the stress is gone. What can parents do to support their children? Many parents are experiencing a more difficult time dealing with COVID-19 than their children and some of the anxiety that kids are experiencing may be unintentionally passed on by worried parents. As parents, it is important to be a positive role model for your children and this includes showing them how to deal with anxiety during stressful events. You can create a positive and safe atmosphere in the home environment by doing the following: Living in the “here and now” by focusing on, and staying in touch with, what is actually happening and not getting carried away with worst-case scenarios. Identifying and getting help for your own anxieties first. Being smart about what you read. Make sure your information comes from trustworthy and credible sources. While it is important that we are informed about how best to keep our families safe, we should be mindful about what we are reading online to make sure it’s actually helpful and not making our anxiety worse. It is easy to get sucked into clicking on “fake news” inadvertently or forwarding social media posts to your family group without verifying them or applying common sense. Being aware of feel-good news and sharing these stories with your children to facilitate a more positive mindset and create awareness of the “silver lining” despite the crisis. Sticking to an established routine that involves exercise, regular meals, and healthy amounts of sleep – this is crucial for regulating our moods and our worries. It can be hard to accept that our old routines are no longer possible because of COVID-19 precautions. Looking for ways to be flexible and starting new routines can help you and your family create a more productive and healthier lifestyle that can help to lower the amount of anxiety you experience. Monitor your children Parents do not always recognise signs of anxiety in their children. Identifying anxiety in your child can be tricky because it involves a pattern of behaviours that is unique to each child. The following behaviours could indicate anxiety: Reassurance-seeking (“Are we going to be okay? Is Grandpa going to be okay?”) Reluctance to separate from parents Physical symptoms like headaches or stomach aches Moodiness and irritability Tantrums or meltdowns Trouble sleeping Talk about their anxiety Younger Learners – Younger children may not always be able to express how they are feeling. For younger children, use a “feelings chart” with pictures describing emotions instead of saying “Tell me how anxious you are”. With a feelings chart, which you can find on the internet, you can ask your child to point to the feeling and/or picture representing an emotion that they are currently experiencing. They can also draw pictures about things they feel happy or sad about. Older learners – For children who are more aware of, and able to articulate, how they are feeling, it is better to ask what psychologists call “forced-choice questions.” If you ask a vague question, you’re going to get a vague answer. So instead of asking “How was your day?” which is pretty vague, maybe ask “Did your anxiety get in the way of you having a good day today?”. Teenagers – If you have teenagers, start talking about yourself first. You can start the conversation with something like, “I saw this article today and it made me wonder about this and that. Did you experience something like that? What’s your reaction to it?”. Do not force your teenager to talk about their feelings unwillingly as this can create tension and cause them to feel hostility towards you. Wait a bit first and then attempt to discuss the matter with them at a later stage when they are calm and more willing to talk. If this still does not work, they can use a journal or art activities to express their feelings and experiences. Also read: Five tips on how to motivate your teen during lockdown How to help your anxious child Structure their day. As parents, we often think that setting boundaries for a child is a way to make our lives easier, but kids benefit from boundaries, too. It is easy for children to get bored or fretful if they are facing a day without structure and anxiety can thrive under those circumstances. Make sure that you are structuring their days when they are “cooped up” at home. Alternate chores or schoolwork with more fun activities that your children enjoy and periods of free time. As restrictions lift, be sure to incorporate safe, outdoor activities that comply with social distancing principles as well. Make sure children are still getting the chance to exercise. Encourage your child to socialise with friends via video chats and social media if they have access to these platforms. This is especially important for teenagers who thrive on social interaction with their peers. Avoid giving too much reassurance. Avoid getting into a cycle of providing too much reassurance. Children of all ages can become too reliant on reassurance and want to hear it more and more often, and when a parent isn’t able to give them complete reassurance, their anxiety can worsen. Instead, try the following: Remind kids of the things they are

July 17, 2020

Tips to keep schools clean and students and teachers safe

When schools are back – albeit staggered over the rest of the year – it is critical that school management teams have plans in place to keep their staff and learners safe from the coronavirus. “They must develop this plan, implement the plan, and make sure they maintain the plan,” according to Emma Corder, Managing Director of industrial cleaning manfucaturer Industroclean. Schools across the country have varying degrees of access to proper sanitation and other assets needed to protect learners. It might certainly be a daunting prospect for any school principal to try and prevent the spread of the coronavirus if, for example, the school does not even have access to running water. Corder says there are thankfully basic safety measures that can be implemented almost anywhere, which she recommends. The essential first step she says is to stick to the basics. “This being hand hygiene, correct mask usage, respiratory etiquette and physical distancing.” When it comes to smaller children, it might be less easy to remind them to not share their lunch, stationery or even climbing structures, playgrounds swings and slides.” Unfortunately, the above is just the basics and schools are going to need to develop a checklist that they can abide by on a daily basis. General engineering and administrative measures need to be implemented, to ensure that all classrooms have proper ventilation e.g. cleaning of air-conditioners with correct filter installed beforehand, or during school hours all windows are opened. All schools must have a dedicated isolation room; this is needed should a pupil or staff member show any symptoms of Covid-19. “I strongly recommend that all staff and teachers be put through the correct training to make sure they understand and properly implement health measures. They will need to be intimately familiar with the basics such as the difference between cleaning and disinfecting a surface, as well as the safe disposing of any potentially hazardous medical waste,” adds Corder. But there is also a responsibility on all parents and caregivers to ensure students are fully prepared, by creating a “Covid-19 Back to School Pack”. The use of a big sized pencil box is perfect to pack two clean masks, pack of wet wipes and hand sanitizer. It’s also advised that the learners take their own water bottles so as to not fill them at the school or use public water taps, and especially to not drink directly from the mouthpiece of a tap. Remember the three best cleaning practices: Prepare for cleaning and disinfecting. Correct PPE for cleaning Use all chemicals correctly Cleaning equipment must be clean e.g. mop sleeves must be soaked in cleaning solution before being used. Disinfectants should be freshly prepared and NRCS registered. Do the Job. Top to bottom from clean to dirty. For normal cleaning use the spray and wipe method. And colour code all cleaning materials to prevent cross contamination. End of Task Dispose of dirty water and waste according to safe procedures. Wash and dry all equipment before storing it in a clean space. Dispose of all PPE wear before washing up. “If headmasters or members of staff need any assistance or have any questions about measures that are planned for a school, they must get in touch with the Departments of Health or Education immediately. Proper disinfection and preparation must be completed, before learners return,” says Corder.

July 17, 2020

Nutrient Enhancers: my kind of food additives!

This is an excerpt from my book ‘Mila’s Meals: The Beginning & The Basics’ I’m talking about egg yolk, ghee, flaxseed oil, coconut oil, hemp seed oil, olive oil, sauerkraut liquid, kefir, cinnamon, nutmeg, clove, vanilla, ginger, cardamom, allspice, turmeric, broth, dulse, liver, blackstrap molasses, baobab, cacao, hemp, lucuma, maca, moringa. It is important for me to make every mouthful of food that Mila swallows as nutritious as possible because: Good nutrition is so important at this stage of life Only a small amount of food is going to go in (at the beginning for some, or forever like with Mila) And because a lot of food is going to be turned away or spat out when the toddler emerges… So I developed a list of ‘nutrient enhancers’ – nutrient-dense foods which can be added to almost any purée or meal without significantly changing the taste, texture or appearance… because trust me… there is no greater food detective than an 18-month old! An excellent example of where nutrient enhancers shine their bright light is in the preparation of plain noodles. “Plain noodles?” I can hear you exclaim! Trust me, there will come a time when your toddler will only want to eat plain noodles, repeatedly, for months on end – and you will make them for her… because you need to choose your battles wisely, because it is the end of a long day, because you have another baby to take care of or because you are tired! So this is as plain as Mila’s plain noodles got: I cooked the gluten-free noodles in bone broth with some seaweed (wakame or kombu). Once cooked, I stirred in a raw egg yolk, some coconut oil, a pinch of sea salt and a sprinkle of dulse. Ta da! Plain noodles… that were eaten with glee! Get creative… there is no end to how sneaky you can be! Nutrient Enhancer: Why is it valuable? Eggs Eggs are a source of high-quality protein and have all the B vitamins (including vitamins B1, B2, B3, B5, B6, B12), as well as choline, biotin, folate and cholesterol, selenium, iodine, omega-3 fatty acids, vitamins A, D and E. Avoid the egg whites for your little one’s first year as these contain difficult-to-digest proteins and are what usually cause an allergic reaction. Egg yolks should be softly cooked in the beginning, but from 1 year of age you can add them in raw. They can be blended into all plant-based purées to add fat and protein. GheeFlaxseed oilCoconut oilHemp seed oilOlive oil Adding some healthy fats to your little one’s plant-based purées and meals will aid the absorption of vitamins A, D, E and K. Healthy fats are essential for your little one’s brain development Sauerkraut liquidKefir These will supply probiotics – vital friendly gut bacteria that complete the digestion process, produce vitamins, keep pathogenic (‘bad’) bacteria in check, and support the immune system. Get my sauerkraut recipe here CinnamonNutmegCloveVanillaGingerCardamomAllSpiceTurmeric Spices are a great way to develop your little one’s flavour palette. They also have medicinal qualities and are a source of nutrients. Cinnamon is a great source of manganese, fibre, calcium, potassium, iron, zinc, magnesium and vitamin A. It is known to have antioxidant, anti-diabetic, antiseptic, local anaesthetic, anti-inflammatory, warming and anti-flatulent properties. Nutmeg is a good source of potassium, calcium, iron, manganese, vitamins A, B’s and C. It is a useful remedy for: insomnia, anxiety, nausea and vomiting, indigestion (gas) and diarrhoea as well as being anti-inflammatory and antibacterial. Cloves are a great source of manganese, vitamin K, dietary fibre, iron, magnesium and calcium. They are well known for their ability to relieve tooth and gum pain, aid digestion and provide relief from asthma and bronchitis. Vanilla has antioxidant, anti-depressant and anti-inflammatory properties. Ginger is a good source of vitamin C, magnesium, potassium, copper and manganese. It is a remedy for headaches, motion sickness, nausea, indigestion, wind, colic, cold, flu, bronchitis. Ginger tea is a useful remedy for morning sickness. It boosts the immune system and protects against bacteria and fungi. Cardamom is a great source of iron, manganese, potassium, calcium, magnesium, dietary fibre, riboflavin, niacin and vitamin C. It is used as an antiseptic, antispasmodic, carminative, digestive, diuretic, expectorant, stimulant and tonic. It is a remedy for sore throats, constipation, indigestion and colic. Allspice has a good amounts of potassium, manganese, iron, copper, selenium, magnesium, vitamin A, vitamin B6, riboflavin, niacin and vitamin C. It has antiinflammatory, warming and soothing and anti-flatulent properties and is known to aid digestion. Turmeric is a powerful anti-inflammatory and antioxidant and an excellent source of iron, manganese, vitamin B6, dietary fibre, potassium, vitamin C and magnesium Broth Instead of using water to thin a purée or to cook the vegetables in, use bone broth. Bone broth: builds a healthy gut and digestion aids muscle repair and growth fights inflammation creates a balanced nervous system and a strong immune system inhibits infection caused by cold and flu viruses helps protein and mineral absorption promotes strong, healthy bones It is a source of calcium, magnesium, phosphorus, sulphur, boron, zinc, peptides (healing amino acids and natural antibiotics), collagen, omega-9s, iron, vitamin B6 and B12. All the nutrients are easily absorbed by your little one’s body (bio-available). Get the bone broth recipe here Dulse Dulse is an excellent source of calcium, potassium and vitamin B12 – making it a useful addition to any dairy-free or vegan diet. It is also a great source of protein, vitamins B6 and A, iron, phosphorus, manganese and iodine. Sprinkle dulse flakes into purées, or other meals. Liver Liver is an excellent source of high quality protein, omega-3 fatty acids, vitamin B complex (including choline, B12 and folate), a highly bio-available form of iron, vitamin D, vitamin E, pre-formed vitamin A (retinol), vitamin K2, various amino acids and trace minerals such as copper, zinc, chromium and cholesterol. A small amount (1 teaspoon) of raw liver can be grated into any purée. The liver must be frozen for 2 weeks before using it raw (fourteen days will ensure the elimination of pathogens and parasites). Alternatively add some Chicken Liver pâté into purées of other meals. Blackstrap molasses Blackstrap molasses is one way to boost your little one’s iron intake. Its other nutrients include manganese,

July 13, 2020

Vegan – Is it healthier?

As popular campaigns like ‘Veganuary’ fuel New Year’s pledges to cut back on meat, MANY people has been asking my opinion on vegan diets and on documentaries such as ‘The Game Changers’. If you are intrigued – keep reading.

July 13, 2020

Lockdown Weight Gain

Since being back at the practice and seeing patients, we found that majority of people have gained 1-3kg during the lockdown period. This weight gain occurred despite eating ‘ok’ and doing some form of exercise.

June 29, 2020

How to incorporate yoghurt into your child’s diet by Happy Family Organics

The yoghurt section in the grocery store seems to be expanding every year, and it’s no wonder why! Yoghurt is a versatile food that can be eaten as part of a meal or snack, and can be incorporated into many recipes from dips to dressings to desserts. Yoghurt contains protein, fat and carbohydrates, as well as the nutrients calcium, potassium, phosphorus and is often enriched with vitamin D.

June 25, 2020

Face masks in children: how safe are they?

If you follow me on social media you would have noticed me going on a lot about face masks recently. It’s very important for the public to know how to use them correctly because otherwise it’s such a wasted effort.

June 22, 2020

Delite Foods, the local guilt-free brand keeping your family healthy and happy!

You might have seen our Tantalize range in the sugar alternative and wellness aisles at major retailers but doubt that you know who we are, so let’s introduce ourselves.

June 22, 2020

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