Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Gestational Diabetes: Reasons, risks and recovery

Kathy Malherbe speaks to the clinical team at Bonitas Medical Fund to get some insights on Gestational Diabetes (GDM) and tells the story of mother-of-two, Theresa’s (36) experience with Gestational Diabetes. Diabetes is a condition whereby your body is unable, in varying degrees, to produce or respond to the hormone insulin. This causes abnormal metabolism of carbohydrates and elevated levels of glucose in the blood. Diabetes is commonly divided into four types: Type 1, Type 2 (often lifestyle related,) Gestational Diabetes and Diabetes Mellitus. Normally when you eat, your blood sugar rises. The pancreas, a gland deep in your abdomen, releases a hormone called insulin. It helps move sugar from your blood into your cells for energy and storage. In a non-diabetic person, the blood sugar will go back down to normal after eating. What is Gestational Diabetes? Gestation comes from theLatin gestare, which means ‘to bear’ or ‘give birth to’. Medically speaking it is the period between conception and birth. There are two types of Gestational Diabetes. Women with class A1 can manage it through diet and exercise. Those who have class A2 need to take insulin or other medications. Gestational Diabetes usually goes away after you give birth. But it can affect your baby’s health, and it raises your risk of getting Type 2 diabetes later in life Unlike Type 1 diabetes, Gestational Diabetes is not caused by a lack of insulin but by other hormones produced during pregnancy that can make insulin less effective, a condition referred to as insulin resistance. Gestational Diabetic symptoms disappear following delivery. Why does it develop? During pregnancy, your placenta makes hormones that cause glucose to build up in your blood and produces a hormone called the Human Placental Lactogen (HPL). HPL breaks down fats from the mother to fuel the growth of the baby. Usually, your pancreas can send out enough insulin to handle it. But if your body can’t make enough insulin or stops using insulin as it should, your blood sugar levels rise and you get Gestational Diabetes. It can lead to insulin resistance and carbohydrate intolerance in the mother. Who is at risk? About 10% of pregnancies result in Gestational Diabetes. The causes are not known but the risk factors include: Age-older women High blood pressure, high cholesterol, heart disease Obesity Not exercising Immediate family history of diabetes History of Gestational Diabetes in a previous pregnancy Have had a miscarriage or a stillborn baby Polycystic Ovarian Syndrome It is important to note that there is no definitive way to prevent Gestational Diabetes. Even mothers who have had Gestational Diabetes in a previous pregnancy may not get it with a later pregnancy. Warning Signs of Gestational Diabetes Sugar in the urine Unusual thirst Frequent urination Fatigue Nausea Blurred vision Vaginal, bladder and skin infections. When and how is it detected? In most cases, Gestational Diabetes develops in the second or third trimester (from week 14 to the birth) and disappears after the baby is born. A screening or finger prick blood test can be done at a clinic or pharmacy to give you a snapshot of your blood sugar levels. However, a formal diagnosis requires a blood test and sometimes this will need to be repeated. Gestational Diabetes is detected by using an oral glucose tolerance test (OGTT) or a random blood glucose test. The OGTT test is done by a nurse or doctor taking a blood sample from your vein to test the blood sugar levels. Then you will drink a glass of water mixed with glucose. An hour later you will have another blood test. Your blood glucose level should rise after you finish the sugary drink, then go back to normal, as insulin moves glucose into your cells. If it takes too long to go back to normal you could have diabetes. What the test shows The blood glucose is measured in milligrams per deciliter (mg/dL). Two hours after you finish the glucose drink, this is what your results mean: Below 140 mg/d: Normal blood sugar (7.8mmol) Between 140 and 199: impaired glucose tolerance or prediabetes (11mmol) 200 or higher: diabetes (11.1mmol) The random glucose blood test is carried out a couple of times to see if your glucose varies widely. If initially you are not diagnosed with Gestational Diabetes, the test may be repeated at around 24-28 weeks. What are the dangers? In many cases it can be controlled with a healthy diet and exercise but at least one in ten women will need their blood glucose levels controlled with medication. If your diabetes is not picked up during pregnancy it can cause risks at birth. The most prevalent is shoulder dystocia which is when the baby’s head gets stuck during the birth. This can cause: Fractures to the collarbone and arm Damage to the brachial plexus nerves. These nerves go from the spinal cord in the neck down the arm Lack of oxygen to the body (also called asphyxia). In the most severe cases, this can cause brain injury or even death It can also lead to babies being large for their gestational age which can result in birth complications How can you help yourself? By adhering to an eating programme that is healthy for you and for your baby including: Eat protein with every meal Include daily fruits and vegetables in your diet Limit or avoid processed foods Pay attention to portion sizes to avoid overeating Exercise regularly. Aim for at least 30 minutes of exercise 5 days a week. Just remember to speak to your doctor before starting any new exercises Don’t skip meals. To regulate your blood sugar levels, aim to eat a healthy snack or meal every 3 hours or so. Eating nutrient-dense foods regularly can help keep you satiated and stabilise blood sugar levels. Take your prenatal vitamins, including any probiotics, if they’re recommended by your doctor. Being diagnosed with Gestational Diabetes can be extremely stressful and dangerous to both mother and baby. It is imperative to have your blood glucose monitored during pregnancy. However, if you are tested regularly, stick to a healthy eating programme and exercise regularly,

May 6, 2021

Vaccines and the way forward

Bonitas Medical Fund, gives an update on Covid vaccines and how the Fund is positioned for the rollout to its members. Various scenarios have been presented regarding the speed of propagation of the third wave – the worst assumption is that it will be twice as fast as the second wave. The best case scenario is that the virus is 50% more transmissible than the second wave. Regardless, the urgency for the roll out of the various phases of the vaccination programme is undeniable. Unfortunately private procurement of the vaccine is currently prohibited but as procurement is opened to other entities, we will take every step to ensure we have access to vaccines for our members. We want to mitigate the risks of them contracting Covid-19 as well as getting seriously ill or dying, which is why we are working behind the scenes to ensure we are ready to roll out the vaccine to our eligible members. Medscheme (Bonitas’ administrator) is engaged and collaborating with the Department of Health (DoH), Business for SA, Board of Healthcare Funders (BHF) and various industry stakeholders in order to assist with the rollout from Phase 2. We are also in the process of requesting accreditation to set up private vaccination centres. This will ease access for our ‘at risk’ members and provide a broader footprint, including remote areas of the country. Our over 10 000 members, who are healthcare workers, have already started the vaccination programme in Phase 1. There are around 72 000 members who are classified as ‘Essential/Congregate workers’ and 185 000 high risk members who are either over 60 or have comorbidities. We intend beginning the Phase 2 rollout as soon as the vaccine is secured. The latest information on South Africa’s procurement of vaccines is that there are: 11 million doses of Johnson & Johnson (J&J) 20 million doses of Pfizer BioNTech A further 20 million doses of the J&J is being negotiated. This would be sufficient to cover the targeted 37 million adults in SA Through collaboration with one of our partners, Afrocentric Health, we will be able to administer up to 150 000 vaccinations per day. We are all familiar with the 3 Phase roll out plan as outlined by the DoH but there remains uncertainty about some definitions such as an essential worker – outlined in Phase Two: Essential workers, persons in congregate settings, persons over 60-years and persons over 18-years with comorbidities. The DoH announced from the onset that healthcare workers would be vaccinated in Phase 1. Phase 2’s priority group would include essential workers, persons in congregated settings, persons 60 years and older and persons over 18 with comorbidities. However, it has since been announced that, as a result of a shortage of the acquisition of vaccinations, these groups will be adapted in order of priority. As it stands on 8 April 2021 (subject to change), these groups include the following: Phase 2 Priority Group Definition Essential workers Teachers, police officers, miners, workers in security, retail food, funeral, banking and essential municipal and home affairs, border control and port health services Persons in congregate settings People in prisons, detention centres, shelters and care homes. In addition people working in the hospitality and tourism industry and education insititutions are also at risk Persons 60 years and older Persons older than 18 years with comorbidities Persons living with HIV, TB diabetics, chronic lung disease, cardiovascular disease, renal disease, obesity, etc What we have done is to ensure we know, upfront, who our high risk member population is and, once Phase 2 commences, we are able to ensure that all those who want to be vaccinated, will be. Together with our administrator, we have set up various processes to ensure we are able to achieve this goal to ensure peace of mind for our members.

April 14, 2021

Woman’s Health

Birth Control Side effects of birth control pills The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. If you have just started taking birth control pills you may experience a headache, dizziness, breast tenderness, nausea, breakthrough bleeding, mood changes or other side effects. Be patient, these side effects often go away after a few months. If they don’t you may want to talk to your doctor about your options. Some positive effects of taking birth control are lighter (and sometimes fewer) periods, milder menstrual cramps, and improved acne. Consult your doctor if you have questions about what type of birth control is right for you. Women’s Nutrition Unsaturated fats: the good, the bad and the uglyThe 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. There are two types of unsaturated fats, polyunsaturated fatty acids and monounsaturated fats. Polyunsaturated fats are found in most vegetable oils, flaxseeds and walnuts as well as in fatty fish such as salmon, and mackerel. Monounsaturated fats can be found in olives, avocados, hazelnuts, almonds, Brazil nuts, cashews, sesame seeds, pumpkin seeds, and olive, canola, and peanut oils. Both kinds of unsaturated fats may help lower your cholesterol and reduce your risk of heart disease. The bad fats, saturated and fatty acid fats should only be eaten on occasion. Lactose intolerant: the solution for getting your daily calcium intakeThe 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. Lactose Intolerant? Scared of not getting enough calcium? Don’t worry; you can get calcium from eating foods that don’t contain lactose. These foods contain calcium, but are dairy free: Broccoli Leafy greens Canned salmon &sardines with edible bones Almonds Oranges Pinto Beans Tofu and soymilk Calcium-fortified breads Calcium fortified juices. Risks in Women Urinary tract infectionsThe following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. If you are experiencing a burning sensation when you urinate, or feeling the need for frequent urination, leaking a little urine or cloudy, dark, smelly or bloody urine you may have a urinary tract infection. To avoid getting a urinary tract infection: Drink plenty of water to flush out bacteria Don’t hold your urine when you need to go Wipe from front to back after a bowel movement Try to urinate after having sex to wash away bacteria Do not use feminine hygiene sprays and douches, which may irritate the urethra and possibly begin a case of urinary tract infection Try vitamin C supplements which increase the acidity level of your urine which helps decrease bacteria Wear cotton panties or underwear Breast cancer prevention 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. Although you should have a mammogram and clinical breast exam every 1 to 2 years if you are 40 and older, there are ways to examine your breasts in between visits. This helps you become familiar with your breasts and breast tissue, so you are more likely to notice any changes over time. Women may start doing self-breast exams any time after the age of 20. Here are the steps: Look at your breasts in the mirror for any abnormal changes in colour, size or shape. While lying down or taking a shower use the pads of your fingers to press firmly into your breast and move your fingers in a circle around the whole breast. Check for any abnormal lumps or changes. By limiting the amount of alcohol, you drink, maintaining a healthy weight, staying physically active, and limiting the bad, saturated fats in your diet you may lower your risk of breast cancer. Heart attack warning signs and prevention The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. If you feel pressure or tightness in your chest, pain that goes from your chest into your jaw and/or left arm, or shortness of breath, you may be experiencing a heart attack. The most common symptom for both men and women is in fact tightness or pain in your chest; however, women are somewhat more likely to experience other common symptoms, specifically shortness of breath, nausea or vomiting, and back or jaw pain. Smoking, high cholesterol, high blood pressure, lack of exercise, stress and obesity are all risk factors for a heart attack. Quit smoking; exercise and maintain a healthy diet and weight to help decrease the risk. Also, talk to your doctor about whether aspirin could help reduce your personal risk of a heart attack. Aspirin may help keep your blood from forming clots that could eventually block arteries in the heart, causing a heart attack. Stroke warning signs 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. A stroke is a blood clot or a break in an artery that interrupts blood flow to part of the brain. Some symptoms of a stroke could be sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; and sudden trouble walking, dizziness or loss of balance. If these symptoms occur, get emergency medical help immediately. Act F.A.S.T if someone you know is experiencing signs and symptoms of a stroke. F. (Face) Ask the person to smile to see if one side droops.A. (Arms) Ask the person to raise both arms to see if one drifts downward.S. (Speech) Ask the person to say a sentence to see if their words are slurred and to see if they

April 9, 2021

Making your medical aid benefits last

Around 9 million South Africans are members of medical aid schemes to ensure they have access to private healthcare. As each new year begins, members start with a clean slate, with new benefits and replenished savings. However, across the industry, members often complain that their benefits seem to ‘run out’ early on in the year. If you manage your medical expenses correctly you can avoid out-of-pocket expenses and limit the possibility of running out of benefits. Here are 8 tips from Lee Callakoppen, Principal Officer of Bonitas Medical Fund, on how to stretch your medical benefits to maximise your value. 1. Use DSPs or networks Medical schemes negotiate preferential rates with providers – known as Dedicated Service Providers (DSPs) – who have partnered with them. This allows schemes to ensure that members get the best quality services at the most cost-effective rate so that benefits are optimised and the scheme at large is sustainable. Using network doctors is an invaluable tool to helping make your medical aid last longer because it means you won’t be charged more than the negotiated amount. With over 6 000 GPs, Bonitas has the largest network in South Africa 2. Ask your pharmacist Buy over-the-counter medicine to treat less serious ailments and always, where possible, use generic medicine which has the same active ingredient, strength and dosage as the original brands and are just as effective. Pharmacists are able to provide sound medical advice on problems such as rashes, colds or illnesses that are not severe, simply ask! 3. Managed Care benefits Some schemes offer programmes to help you manage severe chronic conditions such as cancer, diabetes, HIV/AIDS and back and neck problems These programmes are usually covered from the risk portion of your medical contribution and are not funded from your savings account. They help you use your benefits to maximum advantage while ensuring you receive quality care by using specific providers. Other benefits – such as maternity consultations, wellness benefits, preventative care and dentistry – are also paid from risk by some schemes. Again giving you more value for money and are in addition to your savings and day-to-day benefits. Carefully read through what your plan offers and choose wisely to make sure you find the right plan to suit your specific healthcare needs. 4. Go virtual Look out for telemedicine or virtual consultation options – which are cheaper. A doctor will engage with you in a virtual video consultation on any medical issue and advise you on the most clinically appropriate steps for further care. 5. Be aware of consulting after hours In an emergency one has no choice but be aware that after hours consultations are expensive. 6. Know the facts If you do need to be hospitalised and it’s not an emergency, ensure that the healthcare practitioner is on your medical aid’s DSP list. Talk to your doctor or specialist to find out all the facts in terms of what they will be charging and compare this to what your scheme will cover. If the difference is substantial, negotiate. Approach your doctor and ask if he/she is prepared to adjust their fee. Alternatively, you can also check if there are other healthcare providers on your scheme’s network that will charge you a better rate. You can also avoid the unwelcome surprise of a co-payment or sub-limits by: Making sure you obtain pre-authorisation Making sure the medical practitioner uses the correct ICD-10 codes Getting a quote from the doctor, hospital and anaethetist and submit it to your medical aid to see which additional costs will apply (if any), what costs will be covered and how you can avoid these. 7. PMBs If you suffer from a Prescribed Minimum Benefit (PMB) condition, understand what benefits are provided as part of PMB conditions and use the service of a DSP to ensure your claims are paid from risk rather than from your medical savings account. 8. Keep moving One of the best ways to manage your health and the associated costs, is to live a healthy lifestyle and this includes getting enough exercise. Try different exercise routines and find one that works for you. Whether it is a regular short power walk, playing tennis or soccer, riding a bike or attending a yoga or pilates class, it will be beneficial to your mental and physical wellbeing. ‘Be informed’ says Callakoppen. ‘Your health is important, as are your finances, so take the time to research and understand the medical aid plan you’ve chosen. Even if you have not changed plans your benefits and savings differ year-on-year. Make sure you read the information sent to you, including the fine print to understand the Scheme Rules fully. If in doubt, phone the call centre, your broker or financial advisor. This will go a long way in helping you know your rights and making the most of your benefits.’

April 1, 2021

15 Facts about the Covid vaccine

Although the vaccine rollout for healthcare workers has begun, myths and misinformation continue to circulate around its development, efficacy and just how the vaccine will help manage or mitigate the spread of the virus. We asked Lee Callakoppen, Principal Officer of Bonitas Medical Fund for 15 facts about the vaccine. #1. How does the Covid-19 vaccine work? The Covid-19 vaccines produce protection against the disease by developing an immune response to the SARS-Cov-2 virus. The vaccine stimulates an immune response to an antigen, a molecule found on the virus and provides a supply of ‘memory’ T- and B-lymphocytes that help fight that virus in the future. There are four types of Covid vaccines and they are all trying to achieve the same things: Immunity to the virus, reduction of symptoms if you are infected and being able to slow down or stop transmission. South Africa is currently using the Johnson & Johnson (J&J) single dose vaccine but, regardless of which vaccine you receive, you won’t reach full protection until around two weeks after the vaccination. Your immune system needs this time to develop the antibody response. #2. It is safe? Yes. The vaccine that is being used in South Africa is safe and has been given to millions of people around the world. Although it was developed very quickly to save lives, it has gone through the same rigorous processes as other vaccines. All medical products – including the Covid-19 vaccine – have to be approved by South African Health Products Regulatory Authority (SAHPRA) before they can be administered. #3. Are there any side effects? Some individuals vaccinated with the J&J vaccine have experienced temporary, mild side effects. They are similar to those experienced with other vaccines, such as soreness at the injection site, muscle pain, chills and a headache. Some also experienced fatigue and nausea. These are nothing to worry about and will disappear within a couple of days. #4. Can you be allergic to the vaccine? People who are prone to allergies should inform the healthcare personnel administering the vaccine beforehand. This, in order for them to observed and monitored for a longer period after receiving the vaccine. However, if you experience a severe allergic reaction after getting a Covid-19 vaccine, vaccination providers – or your healthcare provider – can provide care rapidly and call for emergency medical #5. Can you get Covid from the vaccine? No. None of the Covid-19 vaccines contain the live virus that causes the coronavirus. The J&J vaccine uses a harmless, modified form of the common cold virus in humans, called adenovirus. The vaccine will help your immune system fight the virus but will not infect you with it. #6. How effective is it? No vaccine is 100% effective but fortunately, the emerging data on Covid-19 vaccines have a high efficacy, at least against some of the variants. If a vaccine has 70% efficacy, it means a person vaccinated in a clinical trial is around two-thirds less likely to develop the disease than someone in the trial who didn’t receive the vaccine. Due to the severity of the virus, a 50% efficacy threshold was set for Covid-19 vaccine. #7. Am I forced to have the vaccine? No. Having the Covid-19 vaccination remains a personal choice as confirmed by President Cyril Ramaphosa. #8. Do I need the vaccine if I have already had Covid-19? Yes, the advice is that you should still be vaccinated even if you have had Covid-19 or if you have a positive antibody test. Research indicates that the natural immunity from having Covid does not last which means the best way of fighting the virus is a combination of being vaccinated and following the protocols. #9. Will I be immune after the vaccine and will this be forever? It is too soon to know how long the vaccine will last as it is still being researched. Of the people who have received the vaccine, we know that they have been protected from Covid-19 for at least 4 months. The risk of Covid-19 infection in vaccinated people cannot be completely eliminated. #10. Can you have the vaccine if you are pregnant or breast feeding? None of the vaccine trials included pregnant individuals, so direct knowledge is limited. However, the Centres for Disease Control and Prevention (CDC) as well as a number of other medical organisations agree that any of the currently authorised Covid-19 vaccines can be offered to people who are pregnant or breastfeeding. #11. Is it safe to be vaccinated if I’m living with HIV/Aids? Yes. There is some evidence that people living with HIV may be more vulnerable to developing severe Covid-19 symptoms and so getting vaccinated is even more critical if you are HIV positive. The Covid-19 vaccinations are the most powerful tools available to help prevent severe disease due to SARS-CoV-2. The vaccines are not live and are safe for people with compromised immune systems. It’s too early to tell how effective the vaccines will be at reducing transmission of Covid-19, but we do know that they are effective at preventing severe disease and death. #12. What does herd immunity mean? Herd immunity occurs when a large part of the population becomes immune to a virus, through vaccination or infection. South Africa’s Department of Health (DoH) is aiming to vaccinate 67% of the country’s population against Covid-19 – this equates to around 41 million people – to achieve herd immunity and slow down the rate of transmission of the virus. #13. How does the vaccination process work? Everyone over the age of 18 will be vaccinated in line with the Government’s Covid-19 vaccine roll out plan. You have to be registered on the national Electronic Vaccination Data System (EVDS) and then a 3-phase approach (starting with healthcare workers) is being adopted to ensure there will be enough vaccines to meet the demand. #14. Can you elaborate on the EVDS? The EVDS is based on a pre-vaccination registration and appointment system. Individuals have to

April 1, 2021

Hospital Plans vs Hospital Insurance: Knowing the difference

In times of economic pressure we all relook our monthly expenses to see where we can save on costs but having access to quality healthcare remains a priority – even more so during a global pandemic. Hospital insurance may be cheaper than medical aid hospital plans but is definitely not the same product. We asked the Principal Officer of Bonitas Medical Fund, Lee Callakoppen, to help us understand the two different products offerings. Regulation ‘Firstly, before I take you through the benefits and possible shortfalls of hospital plans as opposed to hospital insurance, it is important to point out that hospital plans are part of the offerings provided by medical aids. This means the product is regulated and overseen by the Council of Medical Schemes and in accordance with the Medical Schemes Act 131 of 1998. Hospital insurance (or medical insurance) is part of the umbrella term, health insurance and includes hospital insurance, hospital cash back plan and gap cover. Hospital insurance is not part of a medical aid but is governed by the Financial Services Board (FSB) and the Long-term and Short-term Insurance Act,’ explains Callakoppen. Medical Aid Hospital Plans A hospital plan provides you with basic, yet important medical cover. The product differs from scheme to scheme but in essence this plan is offered by a not-for profit medical scheme and will cover you in hospital for emergency and planned procedures In the case of Bonitas – you also get access to some additional benefits for wellness and preventative care The hospital plan ensures that when you are admitted into hospital for a procedure or due to an accident or illness, your expenses are covered – within the limits set by your particular plan There are 27 chronic conditions that all medical aid plans must cover, so the hospital plan also covers these which are known as Prescribed Minimum Benefits (PMBs) This type of plan does not cover you for other day-to-day medical costs like visits to the doctor, specialist or medicine It is tax deductible Hospital Insurance Hospital insurance is not a medical aid, it pays you for the time you spent in hospital but not for the treatment you receive It provides cash benefits depending on the number of days you are in hospital due to illness or an accident The insurer pays the money directly to you, you are able to use the money however you please – to pay for daily household costs or the hospital, doctor and specialist bills This often seems more attractive than a hospital plan and has a cheaper monthly premium however, the daily amount you receive is often way below the medical expenses incurred while in hospital It is governed by the Short or Long-term Insurance Acts Does not cover Prescribed Minimum Benefits (PMBs) May include Personal Accident risk cover such as disability and loss of limbs, inability to work, salary protection, death and/or funeral covers Is not tax deductible The limitations of hospital insurance It is a set amount which might not cover your hospital or medical bills, leaving you financially short and, in some cases, has a waiting period New regulations state that pay-outs are limited per insured life, per hospital stay with an annual limit Typically people buy the policy that pays less than R1 000 per day If you have one of the top plans, the daily pay-out during your stay in hospital may sound like a lot of money however, it usually falls short of actual costs charged by hospitals, doctors and specialists For example, a caesarean birth costs around R30 000. This can be much more if complications occur. Remember that hospital insurance companies are ‘for profit’ unlike medical schemes who are ‘not for profit’. The recommendation by most financial advisors is that a hospital insurance product should be used in conjunction with medical aid, or hospital plan, as income replacement rather than medical aid cover. And what is GAP cover, how does it work? Callakoppen provides an update. Minding the gap At times there may be a shortfall between what the medical scheme pays and what the hospital or specialist charges. You are responsible for paying the difference There is an insurance policy called gap cover which you can take out to pay for this shortfall The amount you receive depends on your policy but there is an overall annual limit Some gap cover policies have a waiting period for certain conditions Most people usually take gap cover together with a medical aid hospital plan It is important to know that gap cover, like hospital insurance, is an insurance ‘policy’ and is registered as Short-Term insurance policies Gap cover premiums are not tax deductable ‘There has been a growth in health insurance products over the past few years and they appear to provide medical cover, but actually don’t,’ says Callakoppen. If you choose to take out health insurance, do so as complementary to medical aid, not a substitute. ‘My advice: Shop around to find the best plan that covers your health needs and suits your pocket. A number of Low Cost Benefit Options have been introduced by Medical Schemes – these offer more affordable plans that give you peace of mind in terms of access to quality healthcare. Interrogate the benefits you receive on the plan you are considering versus the monthly contributions but, above all, never compromise on your health.’

March 18, 2021

Advice from the experts

Keeping Your Children Safe During Bath time

I’m sure many of you will agree that bath time is loads of fun for our kids. Whilst the bathroom is a fun place, it can also be a scary place with a number of dangerous hazards such as the drowning, burns and poisoning. It’s important that you are always in the bathroom with your children before, during and after bath time. Drowning is a major cause of death in children under five years. According to the Consumer Products Safety Commision in the United States, 80% of the 87 children, under five years who drown at home each year, have drowned in the bathtub. Young children are top heavy and can slip suddenly and drown in very little water. Infants and toddlers also don’t have the upper body and core strength to lift themselves up if that slip under the water. HOW TO RUN A BATH Keep your child away from the bath until the water is the right temperature. The safe temperature of bath water should be between 37oC and 38oC (36OC for a newborn). Children have thinner skin than adults so they can burn much more quickly. Even if the bath feels warm to you it may be hot to your little one. Your plumber can also set the thermostat of your geyser to a maximum of 50oC. Always fill your bath with cold water first. Your child could put his hand or foot in the water before the bath is ready and get burnt. If you have a mixer tap, run hot and cold together but start with the cold and slowly increase the amount of hot. Run cold water through the tap before your child gets into the bath to cool the tap and prevent them from getting burnt if they touch it. If you have a mixer tap, point the lever on the cold setting when you are finished running the bath to ensure the hot water does not get accidentally turned on in the bath. Do not overfill the bath. Fill the bath water to just over your little one’s knees. HOW TO HAVE A S-A-F-E BATH S: Supervision is key! Always supervise babies, toddlers and children less than six years in the bath and when you run the water. Never leave an older child to supervise. A: Arrange everything you will need for bath time in advance for e.g. towel, soap, shampoo, nappy, clean clothes and any medications.F: Feel the water with your elbow first. It should feel warm but not hot. You can also use a water thermometer. Remember to swirl the water around to ensure an even temperature with no hot pockets. E: Empty the bath as soon as bath time is over. SLIPS, TRIPS & FALLS Slips, trips and falls in the bathtub and shower are a common cause of injury in young children and according to statistics more common than tub drownings. Use a non-slip mat in the bath. If you are using a bath seat or ring, your child will still need to be supervised. A bath seat is not a safety device. These seats are actually associated with an increasing number of reported drownings. This is because the device gives parents a false sense of security and they are therefore more likely to leave their baby alone in the bath. Infants should be bathed in the bathroom basin or a smaller infant bathtub. This way they can’t roll over or ever be completely covered by the water. Wipe up any splashes before your kids get out the bath so that nobody, including you, can slip and hit their head. As your kids get older you should also teach them to remain seated in the bath and not to stand up and jump. Be sure to keep a MiniKit in your bathroom for peace of mind. Each kit contains a range of thoughtfully selected first aid items geared towards common childhood injuries. You can purchase one here: https://www.oneaid.co.za/product/minikit/ WHEN CAN YOU STOP SUPERVISING YOUR CHILD IN THE BATH? This is a difficult question to answer as children mature at different ages. Since most children who drown in bathtubs are under the age of five, the general consensus is children under the age of six should never be allowed to bath alone and even those over six should be closely monitored. Even if your child knows how to swim you should never be too far away. OTHER BATHROOM HAZARDS Toilet: luckily my daughter has never been interested in exploring the toilet bowl but I have had moms tell me how their child likes to play with the water in the toilet. Keep the toilet lids closed at all times and if your little one is particularly curious install a toilet-lid lock. Appliances: make sure any electrical appliances in the bathroom are unplugged and out of reach when your child is having a bath. Regular plug sockets may actually not be fitted in bathrooms for safety reasons so rather keep extension cords out. Medicines: many of us keep medication in the bathroom. Make sure they are all locked away, out of sight and out of reach. Dangerous items: make sure you keep cosmetics, razor blades, nail scissors, cleaning products and other dangerous items away. Don’t get distracted during bath time. Keep your phone on silent or rather keep it out of the bathroom and join in on the fun. You could also try having a shower with your child instead for some extra fun. My daughter loves this and the best part is that I manage to get cleaned up as well freeing up some time later in the evening for something else. Just make sure you get a slip-proof mat for the shower first. RESOURCES https://www.aappublications.org/news/2015/11/11/PPBath111115 https://medlineplus.gov/ency/patientinstructions/000154.htm http://www.ncbi.nlm.nih.gov/pubmed/19596735 https://pediatrics.aappublications.org/content/124/2/541.long https://pediatrics.aappublications.org/content/100/4/e1.long?utm_source=TrendMD&utm_medium=TrendMD&utm_campaign=Pediatrics_TrendMD_0

April 9, 2019

Helping your teen to have a positive body image

A happy home environment can help your child to develop an internal sense of control and a positive sense of self that will equip them to avoid eating disorders. Teen body image refers to how adolescents perceive their bodies. It includes their feelings about their body and how they take care of it, and is an essential part of adolescent development. Teen body image is also closely linked to self-esteem, largely because society and the media place so much importance on the way we look. This focus on appearance contributes to teenage body image issues and teen eating disorders. “An important challenge faced by teenagers is internal versus external locus of control,” says Linda Swanepoel, therapeutic manager and occupational therapist at Akeso Montrose Manor. “This means the extent to which a person believes they have the power over events in their lives. A person with an internal locus of control believes that they can influence events and their outcomes, while someone with an external locus of control blames outside forces for everything and seeks external approval and validation to feel good about themselves.” A healthy, confident child will learn to have an internal locus of control, but if the child is raised in a household where there is instability and chaos, and at times a lack of safety, they may learn an external locus of control. “When a child is too young to have the resources to cope they soon learn that ‘if I can help mommy and daddy to feel better, I will feel better’. As they grow older, face more stress and carry the weight of expectations, their focus turns to pleasing or impressing others, rather than developing a sense of self.” Teenagers experience increased school and societal pressures at a time when significant changes are taking place in their bodies. Thus, if they have not learned to believe in their own resources to cope with life, their focus will be on what other people expect or think of them, rather than on how they feel about themselves. “Eventually, everything they choose to do in their lives is dependent on assumptions they make about how they will be perceived by others,” Swanepoel adds. “Body image plays an important role in this too.” Why body positivity is important “Teenagers tend to see the concept of a ’middle path’ as average and boring, and Western society reinforces this all or nothing thinking. This leads to beliefs like you must have the perfect body, you must go to university and you must make money,” Swanepoel says. “This is why body positivity is important,” Swanepoel explains. “If we can get our society to be more middle path thinkers, teenagers with an external locus of control may be able to be more realistic and accepting of themselves. With less stress and pressure, it is easier to listen to your own voice and develop your own sense of self.” Body image and weight risk factors Maintaining a weight lower than your natural set point, or trying to lose weight, immediately activates “all or nothing” thinking. It takes motivation, discipline and determination to restrict food intake, so teens develop strict rules and often the rewards are external (for example, praise from others). “If you break a rule you’ve set for yourself, you feel weak and like a failure, and believe you are a greedy person,” says Swanepoel. “Greed, indulgence and selfishness are bad words in Western society, and can lead to guilt. Once the rules are broken, at risk teens tend to go off the rails and binge on forbidden foods. This may lead to secret eating rituals, comfort eating and avoidance of life, which may in turn lead to obesity.” According to Maslow’s Hierarchy of Needs, people need to meet basic needs like food, sleep, water, health and safety before they can strive for self-esteem and self-actualisation. “People who diet are depriving themselves of these needs in a drive for self-actualisation,” Swanepoel says. “They compromise their health, their relationships and their goals and aspirations as they become preoccupied by food, exercise and weight, becoming prisoners to their own habits. They end up lonely, exhausted and feeling like a failure – and they hate their bodies no matter what size they are as perfection is unattainable. This is where depression, self-harm and suicide become possibilities.” Look out for these warning signs Loss or gain of weight or fluctuating weight – often from bulimia – are the most common symptoms of eating disorder among teenagers Increased exercise and keeping busy all the time, as fear of boredom may lead to binge urges Avoiding social situations, as they have too many secrets to keep and need to stay in control Rigid thinking and ‘all or nothing’ thinking – judgemental, critical and catastrophising Isolation Spending many hours on social media Spending time preparing food and baking for others, but not eating themselves Making excuses at meal times (I’m going to work in the library, I’ll get a take away lunch) Many demands at restaurants – food rules become important (I’m gluten/lactose intolerant, I’m a vegetarian/vegan. I’m banting. No carbs, no sauce and no salad dressing) Becoming angry and defensive when help is offered Wearing baggy clothes, usually in neutral colours – black, white, grey Spending time with people who are not matched to the teenager’s personality Depression, anxiety and obsessive compulsive disorder (OCD) symptoms. How can you help? Children need to feel safe so that they can focus on self rather than feeling responsible for others. Swanepoel points out that it’s important to avoid the ‘drama triangle’ – perpetrator, victim and rescuer. “This is when one parent complains to the child about the other parent. The child will feel the need to take sides and rescue, immediately starting the external locus of control cycle. This leads to low self-esteem, which can lead to body image problems, such as restricting (trying to be perfect) or binging (as a result of avoidance). Parents need to work as a team

April 5, 2019

Pre-authorisation and payment: Do you know the difference?

Medical aid members know that pre-authorisation ahead of a medical procedure is always required but does pre-authorisation mean it’s an agreement to pay in full? No, not necessarily. This is the cause of a great deal of confusion and unhappiness from medical aid members as well as doctors and hospitals. Gerhard Van Emmenis, Principal Officer of Bonitas Medical Funds says, ‘Pre-authorisation is required for all hospital admissions, including emergencies. However, it is not an agreement to pay all the costs and expenses in full.’ Why not? Let’s take you through the Ts and Cs. Why do they differ? Most medical aid plans have varying hospital benefits according the level of cover you have chosen. Van Emmenis says, ‘All of our plans provide hospital cover for major medical events when you or your dependant is admitted to hospital. But, each plan has different hospital benefits available. We encourage you to use the healthcare providers on our network and to get pre-authorisation for your hospital stay so the providers of your treatment or procedure are paid to the full extent of what your plan offers.’ Understanding your medical aid rate of payment‘ For example’, says Van Emmenis, ‘The Bonitas Rate is the rate at which we reimburse healthcare providers. Where we pay 100% of the Bonitas Rate, this is NOT necessarily what the healthcare provider charges. They may charge 200% of your medical aid rate which means you are responsible for half the payment. Each plan has a different rate according to the premium you pay. If you visit a healthcare provider that charges the Bonitas Rate, we will pay the bill in full (provided that you have benefits available). For this reason it is important to use designated service providers with whom Bonitas has negotiated rates.’ How much will your plan cover? If it is not an emergency the best way to find out how much your medical aid will cover is by asking the hospital and medical practitioners for a detailed quote. Submit this to your medical aid to check what they will cover and how much the shortfall, if there is one, will be. Co-payments The shortfall will be in the form of a co-payment. These co-payments differ from one medical aid scheme to another, and are often higher than anticipated, mostly due to medical practitioners and hospital charging higher than the medical aid rate. Minding the gap When there is this shortfall between what the medical scheme pays and what the hospital or specialist charges, it helps if you have taken out gap cover. Even if you have a top of the range medical aid plan, it doesn’t mean there will not be ‘gaps’ between the tariffs your scheme is prepared to pay and the amount your specialist charges. GAP cover is not a medical aid product but an insurance policy taken out to reduce or eliminate co-payments. Again the amount you receive depends on your GAP policy It is important to note that Gap Cover is an insurance ‘policy’ and is regulated under the Long and Short Term Insurance Act (1998). Medical schemes, on the other hand, are overseen by the Council for Medical Schemes Act (1998) and are not for profit. Ensuring you are covered 1. Make sure you get a quote. Medical aid members are advised to not only obtain pre-authorisation but a quote from the hospital and medical practitioners prior to being admitted to hospital (if it’s not an emergency). Submit this to your medical aid to find out if there are any co-payments and if so, how much they are. 2. Find a hospital on your medical fund’s preferred network in order to ensure maximum payment 3. Make sure you fill in provide all information required for pre-authorisation correctly: Have your correct membership number and the details of the member who the request is for The date you are going into hospital and the date of the treatment or procedure The name of the doctor who will be treating the member, their telephone number and practice number The name of the hospital where you will receive treatment, their telephone number and practice number The relevant procedure and diagnosis (ICD-10) codes for the treatment (ask your doctor for these) If your request for authorisation does not include all the information listed above, your request will not be approved. If your pre-authorisation is declined the reasons for doing so will be listed on the correspondence. If it is approved, you will receive a pre-authorisation number and this will also outline the approved length of your hospital stay and the status of all codes. However remember the pre-authorisation is not a commitment to pay the full amount. 4. Gap cover If you have Gap Cover, notify them of the co-payment required prior to being admitted to hospital as there are limits to the amount they will pay. What about emergencies? Emergencies must be pre-authorised within 48 hours of going into hospital or on the first working day after a weekend or public holiday. If you don’t get pre-authorisation, your account won’t be paid by the Scheme. ‘The most important thing’, says Van Emmenis, ‘is to find out, prior to being admitted, what your medical aid will pay and what payment you are responsible for. It will save a great deal of stress when you are recovering from surgery.’

April 5, 2019

Top Choking Hazards For Babies and Toddlers

We recently went to a very popular restaurant for lunch and to my astonishment there were vending machines with gumballs and other small toys, right next to the jungle gym. This is a disaster waiting to happen! Children under 3 are at the highest risk of choking because their airways are so small. Plus, chewing and swallowing is a lot more difficult for them. They also love to put foreign objects in their mouths. There is a cylindrical tool in the US used to measure toy parts that is the same size as a young child’s throat. If a toy part fits into this cylinder it’s a choking hazard and a warning label has to appear on the toy packaging. Therefore any object smaller than 3 cm wide is a choking hazard for small children. WHAT IS A CHOKING HAZARD? Any object that can get caught in a child’s throat and block the airway is a choking hazard. TOP 10 HOUSEHOLD CHOKING HAZARDS Once your baby starts to crawl and explore, choking hazards are all of a sudden everywhere. Coins Small caps of bottles e.g. juice and water bottles Small round batteries Jewellery Buttons Toys and toy parts Balloons (uninflated or popped) Garden pebbles Nails and screws Stationary e.g. staples, paper clips and pen lids If you have older kids too, you should keep their toys separate and make sure they learn to pack their toys away. There are countless more choking hazards. You should probably get down on your knees and have a look at your child’s eye level. How many more choking hazards can you find? TOP 10 FOOD CHOKING HAZARDS Hotdogs, grapes and popcorn are the top 3 causes of choking in children under the age of 3. Young children have a hard time chewing their food since they lack the proper dentition (canines for tearing and molars for grinding). They are still trying to coordinate chewing, and as a result, often just swallow their food whole. This makes smooth, slippery, round and hard foods especially dangerous. The foods in the list below are not recommended for children under 4 years of age. The American Academy of Pediatrics (AAP) goes even further and recommends that hotdogs, grapes and popcorn not be given to children until they are at least 5 years old. If you do however want to give your children some of these foods, then cut them in such a way that you change their round shape. Hotdogs should be cut lengthwise before slicing and skins of other sausages removed. Grapes and other round fruit should be cut into quarters. Whole grapes, cherry tomatoes and other round balls of fruit (blueberries are ok for toddlers as they are soft to chew) Hot dogs and other sausages Popcorn Tough, large pieces of meat Fruit pips and stones Nuts and seeds Hard round sweets and caramels Raw vegetables, especially carrots Marshmallows Chewing gum BE CAREFUL Children can trip and choke more easily if playing and eating at the same time. Your child should not walk, run or lie down while eating. Children should not be distracted whilst eating. They must sit upright and concentrate on what they are doing. It is also not advisable to have your young child eat in their car seat whilst you’re driving. You might not even notice if they’re choking. You should always supervise your child when they are eating. It’s important that all parents and caregivers learn first aid for choking and CPR. There are many training academies that offer such courses around the country that are usually done over one day and will make you feel more confident when dealing with childhood emergencies. RESOURCES Altkorn, R. et al. (2008) Fatal and non-fatal food injuries among children (aged 0–14 years). International Journal of Pediatric Otorhinolaryngology, [online] 72 pp. 1041—1046. Available from: https://www.sciencedirect.com/science/article/pii/S0165587608001298[Accessed 24 October 2018]. CDC (2018) Choking Hazards [online]. Available from: https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/choking-hazards.html [Accessed 24 October 2018].

April 4, 2019

Are headphones damaging your hearing

If it’s too loud, you’re too old? No, more like too sensible… Headphones and earphones are the accessory of our times. They are affixed to our ears to deliver music or podcasts, to conduct telephone calls, to accompany a workout routine, or to drown out the conversation of colleagues in open-plan offices. But is all this in-ear noise safe? The answer, unfortunately, is “not really”, but you can take steps to prevent or reduce the harm of being plugged in all day. According to the World Health Organisation (WHO), up to 1.1 billion teenagers worldwide are at risk of hearing loss from unsafe use of personal audio devices, including smartphones, and exposure to damaging levels of sound at noisy entertainment venues. Of course, it’s not just teenagers who are at risk – anyone who is exposed to harmful noise levels can suffer the same hearing damage. The WHO points out that hearing loss has potentially devastating consequences for physical and mental health, education and employment. How headphones damage your hearing Sound waves travel into your ears and cause the eardrum to vibrate. This vibration is then transmitted to the inner ear via several small bones. In the inner ear, the vibrations reach the cochlea, a fluid-filled chamber that has thousands of small hairs that are moved by the vibrations. It is the movement of these hairs that enables us to hear sound. If you listen to loud sounds, the hairs move more, and if you listen to loud sounds for too long, the hairs can lose their sensitivity to vibration, or become damaged. While it is possible for the hairs to recover over time from a single instance of loud noise, repeatedly listening to sounds that are too loud and for too long can result in permanent damage and hearing loss. Preventing damage To avoid headphone-related hearing damage, the WHO strongly recommends the following: Restrict the daily use of personal audio devices to less than one hour. Limit the time spent on noisy activities by taking short listening breaks (a time when you listen to nothing). Audiologists also recommend: Turn down the volume. If you are listening through headphones and you can’t hear any of the noise around you, then your volume is too loud and is damaging your ears. Use over-the-ear headphones rather than in-ear earphones, as they increase the distance between the source of the noise and your eardrums, reducing the chance of damage. Even better, if you are listening at home or in the car, play your music or other media over a speaker, at moderate volume. If you are planning to be in a loud-noise environment, take a headphone break for most of the day so that your ears haven’t already been damaged by sound. How do I know if there’s hearing damage? If you experience any of the warning signs of hearing loss, visit a doctor or audiologist immediately, and get regular hearing check-ups so that if hearing is being lost, action can be taken. The signs of hearing loss include: the muffling of some sounds, difficulty understanding words especially when there is background noise, trouble hearing consonants, increasingly asking people to repeat themselves, needing to turn up the volume on the television, radio or device, withdrawing from conversations, or avoiding social situations. Safeguard your hearing While listening to music at loud volumes may be cool and fun and being permanently plugged into a set of phones is just the way life is, a permanent loss of hearing can affect your quality of life forever. Rather take the steps to prevent hearing damage and enjoy existing in a hearing world for as long as possible. How long to listen It’s not just volume but time spent listening to sound that is damaging to your ears. Here is a useful guide to how long you can listen to noises at certain volumes: By 1Life

April 3, 2019

SPECIAL NEEDS OR NEEDING SOMETHING SPECIAL

My children simply did not fit into the mainstream schooling system. They’re both very bright and along with that come some eccentricities that often get labelled as problems within a very structured environment where children are expected to be alike, fit within the system and not stand out or cause waves. My ten year old once explained it like this: “I’m like a puzzle piece that’s been put in the wrong box… I don’t fit anywhere. There’s no place for me.” That’s quite a tough feeling for a small child to bear. And it isn’t that there’s something wrong with her, although within that system that was exactly the message she was getting. There are many children struggling in school who don’t need to be placed in remedial classes. They need something special, but they’re not exactly special needs. They would thrive in a different environment but not that one. I have nothing against remedial education. It is fantastic in the right circumstances. But a child who is simply in the wrong place and is then moved to a remedial class where there are really special needs kids can look around and label themselves. They end up thinking there is something wrong with them. These kids will generally fly if homeschooled or placed in a good cottage school or Montessori or within the Cambridge system where they have the freedom to work at their own pace and fill in the gaps they missed by being in the wrong environment. For some, the box is simply too small to contain them. For others, it’s the noise levels. Some children are visual or kinesthetic learners and don’t respond to lectures. Most children don’t learn at the predetermined pace of the SA education system. Every child is unique – the exact reason that standardized education is failing. Nobody is standard. The trouble is if kids keep being pushed to move onto the next thing without mastering the previous stage then they end up with huge gaps in their foundational knowledge which will cause the whole structure to come crashing down at some point. That’s the point they pick up the label. Or if they learn faster than the system they get bored and restless and get labelled as ADHD or ODD (Oppositional Defiant that is, not odd – although they can be labelled as odd too!) If there is a problem with learning don’t necessarily assume that the problem is with your child. It might be. But it might not. And you are their advocate until they can stand up for themselves. You need to question and explore alternatives and not necessarily take the word of those in educational authority as fact. Only a few children really thrive within the schooling system. Most do not. Your child may genuinely be a special needs child – with Autism or dyslexia or serious processing difficulties and for these children the special needs schools and classrooms can make a huge difference to their ability to learn and develop with the appropriate assistance. But if your child is simply in need of something special – a smaller class, a more nurturing environment, a faster or slower pace, or a different style of teaching – then you need to look beyond the special needs class to any of the amazing alternatives that exist. Every child deserves to feel that there is a puzzle that they will fit in to!

March 28, 2019

MIGHT MY CHILD HAVE ADHD?

If you are wondering about the answer to this question, then it’s most likely that your child is in preschool and not primary school because by the time children are in a more formal school setting with all the demands of sitting at a desk, having a school structure etc., issues of ADHD have already started to present themselves or been diagnosed. Nearly all preschool-aged children display the core behaviours or symptoms of ADHD – inattention, distractibility, impulsivity and hyperactivity – as part of their normal development. However, as other children gradually begin to grow out of such behaviours, children with ADHD do not and this difference becomes clearer the older the child gets. So, when looking at the preschool child (three/four-year-olds), it’s easy for parents to feel confused about whether their child’s pattern of activity and behaviour is typical or whether it’s atypical. The signs and symptoms of ADHD are the same for preschoolers as they are for older children with ADHD – struggling to pay attention, getting bored and distracted quickly, being fidgety, restless or very active, having difficulty waiting and taking their turn, and engaging in risk-taking behaviour. The difference for ADHD is the degree of the symptoms. The key is to discover whether the child’s behaviour is developmentally age appropriate or not. For instance, one parent observed her child in free play at the end of the school day. She noted that her son ran around wildly and didn’t listen to the teacher’s instructions to “play safe”; when the other children were settling down after activities her son couldn’t and seemed to get more hyped up; when other children were listening to a story being read, her son was rolling around and playing with toys. Although diagnostically children with ADHD may be diagnosed as young as four years old, usually from teacher reports, assessment on the Conners Comprehensive Behavior Rating Scales™, and collateral evidence from parents, the following questions may help a parent to develop some answers. Is the behaviour I observe in my child similar to that of other children he encounters; is the behaviour I expect of my child developmentally appropriate for his/her age, do I see a pattern of behaviour when my child engages in various activities, do I see a pattern of behaviour in various settings? To be diagnosed with ADHD, a child must have a specified number of symptoms for at least six months that occur in more than one area of life, e.g. at home AND at school. However, diagnosed or not, until the age of five, medication cannot be prescribed. The best treatment plan is behavioural therapy/play therapy for the child as well as parent training to help parents understand ADHD and best manage the ADHD child so that they can function optimally at home and at school. Lorian Phillips is a clinical psychologist and has been in private practice for the last 21 years. She also parents two ADD/ADHD sons and due to her challenges with her boys, she was motivated to find more constructive ways of dealing with them. This led to her parenting her boys differently and when she saw the results of her alternative parenting style, she developed a parenting course for parents of ADD/ADHD children. The successful course has been running for the past six years. In addition, Lorian also consults with parents in her private practice to offer guidance and support in working with ADHD children. She has spoken at various schools to help teachers manage the ADHD child in the classroom and has given many talks on parenting the ADHD child including an appearance on 5FM’s Weekend Play Date where she spoke about ADHD management. You can read her parenting blog called ADHD Parenting on her Facebook page. Lorian Phillipa writes for Impaq. Impaq provides innovative and accessible education solutions.

March 27, 2019

LETTING GO OF THE PURSUIT OF HAPPINESS

Behind most things that we want, at the core of what we think we are looking for, is this one elusive word, “happiness”. We want to be happy, we want our kids to be happy, we want to be happy in our careers, we want to have happy families. Have we ever stopped to ask ourselves what happiness actually is? Do we even know what we’re asking for? And if we did, would we still want it? In order to understand happiness, we have to start by looking at the raw experience of emotion. The next time you feel any emotion, close your eyes and observe it. Imagine that you could remove the label from it and just see it in its raw state as a baby might experience it. What you’ll notice when you close your eyes is that you are instantly transported into a never-ending internal space and emotion is something that arises within this space. All that emotion is, is a movement of energy in this vast space. It may feel fast or slow, smooth or prickly, quiet or loud, distant or in-your-face. It may move upwards or downwards, be constricting or expansive, it may even have a shape or a colour. When you begin to observe your internal world, you’ll see that all emotions are simply movements of energy in this inner space, each one with a different movement, frequency or intensity. There is nothing in this movement that tells you that this is happiness or anger or sadness or boredom or excitement or anxiety or peace. There is nothing in the movement of energy that tells you that this is a ‘bad’ or a ‘good’ emotion. Each one is simply a different movement of energy once you view it without the label that you have applied to it. In fact, if you watch carefully you’ll see that without the label, it is very difficult to distinguish between boredom and peace, or between excitement and anxiety. The difference between a ‘bad’ and a ‘good’ emotion lies in the label and in the story that our minds attach to the experience. So, knowing this, then what is happiness? It is simply one movement of energy in inner space. We may experience it as smooth, quiet energy, but there is nothing in that movement that makes it better energy than one that is loud and spiky or one that is fast and expansive. What we’re saying when we say we want to always be happy is that we only want to experience one movement of energy for the rest of our lives. Like only watching one movie for the rest of your life, or listening to one song, or eating one type of food, or hanging out with only one friend. Is that really what you want? We have a variety of emotions to make life interesting, diverse, fun. There is a richness to our experience as humans because of our range of emotional energies, not in spite of them. What most people call happiness I call flatlining. What I believe we are all really looking for is fulfilment – that state of pursuing something so meaningful to you that you enjoy both the ups and downs, the highs and lows; the full range of emotional expression. That is a life worth living, that is a career worth pursuing, that is a family goal worth having, and that is what we need to be teaching our kids. Let go of the pursuit of happiness. Pursue your dreams and enjoy the roller coaster of an experience that comes with that pursuit!

March 26, 2019

Don’t Be Scared, Be Prepared

Oneaid focuses on preventing and reducing the risk of childhood injuries. Through blog posts and social media Oneaid offers you, as parents and caregivers, useful information and helpful tips on how to keep your little ones healthy and safe. OneAid by Dr Carmen Becoming a parent is one of the most challenging and liberating experiences anyone can go through. There is no amount of research, childcare books or magazines that will prepare you for parenthood. For most parents keeping their little ones safe and making sure they have few accidents as possible can be extremely stressful. It was, for this reason, Dr Carmen – mother and Doctor – created OneAid. Dr Carmen is a medical doctor with over 10 years experience in accident and emergency medicine, and is also a mom to a beautiful, baby girl. She has a Masters degree in Public Health and is passionate about disease prevention and health education. Social Media In Healthcare Almost 90% of adults have used social media to look for and share health information. Dr Carmen believes that healthcare needs to go digital and more healthcare professionals should be taking advantage of its broad reach. Social media can be an effective tool to get information to the public and promote health and safety. OneAid creates engaging fun content on social media to provide information and tips relating to various public health issues in an effort to spark up conversations to drive behaviour change and education. For a little daily advice on childhood safety issues readers can also subscribe to the OneAid newsletter. The MiniKit by Dr Carmen Cuts, scrapes and burns are common injuries to expect as our little ones gain more confidence in this world. Having a first aid kit on hand can help reduce the risk of infection or the severity of the injury. It also teaches our kids the right thing to do when they hurt themselves. Dr Carmen has designed and developed the MiniKit, a mini first aid kit geared towards common childhood injuries. This is available in two colours – red and yellow and includes first aid essentials such as plasters, burn gels, dressings and more. Plus, the MiniKit’s small size makes it fit perfectly into any nappy or handbag, so parents are always prepared, even on the go. Through its fun and colourful design, Dr Carmen hopes to get little ones engaged and involved in the first aid experience. But that’s not all. Inside each MiniKit you will find a detailed first aid pocket guide that features simple, easy to follow steps on what to do when your child has had a minor accident or fall. By following the guide’s steps, parents can take the necessary action when dealing with broken bones or burns for example, and will now know which medical materials to use. Ordering Your MiniKit Whether you are buying the MiniKit for yourself or as a baby shower gift, it’s really easy to order. All you need to do is visit the OneAid website on www.oneaid.co.za and browse through the products page. Add your products to your cart and checkout when you are done. There is no need to open up any accounts. You can also purchase the pocket guide, which can be downloaded straight onto your phone. If you buy the MiniKit this download will be available to you for free. “Accidents are just that, they happen unintentionally and unexpectedly. With the right information, we can try and reduce the incidence of these accidents.” – Dr Carmen

March 22, 2019

Do you worry about your child and cyberbullying?

As digital continues to grow and influence the day to day lives of children, and with the new school year already underway, do you find yourself worrying about the risks your children may face online, especially when it comes to cyberbullying? And do you feel that you know enough about cyberbullying – the signs, the various forms and what measures you can put in place – to not only protect your children but to be able to help them if they face this very real issue? “Despite the many benefits the digital world offers, an unfortunate challenge many parents face today is that they don’t always realise when children are being impacted by cyberbullying,” says Riaan Badenhorst, General Manager for Kaspersky Lab Africa. “This is in no way a reflection on parenting styles, but rather the result of not understanding the different types of cyberbullying that exist and with that, the proactive steps that can be put into place to help protect children from this very dangerous and growing online threat. There are many forms of cyberbullying, and getting a grip on these can assist parents in not only having a better understanding for themselves but to also educate their children on what to look out for.” Forms of cyberbullying: Exclusion – is the deliberate act of leaving someone out – like when a child is excluded from friends’ parties or activities. It can also occur when a child’s friends are having online conversations and tagging other friends but not them. Outing – involves the deliberate act of embarrassing or publicly humiliating a child or group of children, online, through the posting of private, personal, sensitive or embarrassing information, without the child’s permission to do so. Outing can happen in a variety of ways and parents should consider that even reading out aloud a child’s saved message(s) from their mobile phone can be considered a form of outing. Fraping – involves the act of someone logging into someone else’s social networking accounts and impersonating that person by posting inappropriate content, using their name. Parents are likely to be familiar with this type of bullying, as they may have personally experienced it, often in a joking manner. Unfortunately for children, however, it is more than often not a joke. Fraping can lead to repetitional damage and have serious consequences. ‘Google never forgets’ – and so anything posted online is never fully gone, even after it is deleted. Trolling – is a deliberate act of provoking a response through the use of insults or bad language on online forums and social networking sites. A troll aims to personally attack a child, in the hopes that the child becomes angry enough to act in the same way, to get a reaction – and then possibly looks to use it against the child, to get them into trouble at school or with an adult. Catfishing – is when another person steals a child’s online identity and photos, and creates new or alternative social networking profiles, for misleading purposes. A catfish is someone who wants to hide who they really are and does this through creating a fake persona, using images and information they found (and stole) online. Harassment – is sustained, constant and intentional bullying that involves abusive or threatening messages sent to a child or group of children. The messages are mostly malicious and aimed at attacking a child’s confidence and self-esteem. Continues Badenhorst; “All forms of cyberbullying should be perceived by parents/guardians of children as very dangerous and therefore requires immediate attention, as any type of cyberbullying can have massive implications to a child’s well-being.” How parents/guardians can help: Kaspersky Lab offers a few guidelines that can be followed by parents/guardians, as a means to help children deal with cyberbullying: It is important that parents/guardians are tolerant of the situation and do not ‘overreact’ leaving the child feeling scared and embarrassed. Cyberbullying can take some time to fix and so being open and talking through the issue with your child, showing support, can be beneficial in dealing with the problem. Be open and talk about cyberbullying with your children – using things like TV programmes as teachable moments around bullying and online behaviour. Ask them their views on cyberbullying and talk through these. Parents/guardians should be conversation starters on the topic – don’t wait for your child to raise the matter – look for signs of cyberbullying as the earlier the matter is picked up the faster it can be dealt with. Monitor your children’s online activities. Understand what they do on social networks, which platforms they use and who their friends are online. It’s not about ‘policing’ their behaviour, but monitoring is important. Explain to your children that they should alert you as the parent, or alert a trusted adult, if they are being cyber-bullied – that they will not be judged but can seek the right help to fix the issue. Ensure they understand that cyberbullying is not okay – and that it is better to talk up and report it so that the right help can be initiated. Do not take your child’s mobile device away or disconnect their devices from the Internet – this will only frustrate them – rather talk to them and help them with the challenge and monitor their mobile time and use, depending on their age. Educate children about basic online security rules – what can and should not be shared – and privacy guidelines. Ensure their social media pages are set on private, encourage them to only connect with people they know (friends and family) and talk to them about the types of images they share online. Make use of applications, such as Kaspersky Safe Kids, to help you manage your children’s screen time and use of certain apps. Such a solution allows you to set rules for website access, ensuring that sites with harmful content can be blocked. It also uses a GPS tracker, meaning that you can locate your children’s

March 21, 2019

Tips For Choosing The Right High Chair

Before going out and buying a high chair it’s important to know the safety requirements. A US study found that more than 9 400 children, aging three years and younger, were treated each year for high chair related injuries in emergency rooms from 2003 to 2010. That’s one child every hour! Nearly all of these injuries were as a result of a fall where the child either climbed in or out of the chair or stood in it. Majority of the injuries seen were head injuries (37%) then bumps and bruises (33%) followed by lacerations (19%). Most of us use our high chairs in the dining room or kitchen where the flooring is usually hard, so you can imagine the impact this has on a small brain. This has prompted the US to update their safety standards (unfortunately there are no available statistics for South Africa). From mid-2019 all high chairs in the US will have to have a passive crotch restraint and a three-point restraint system, which means there has to be a fixed post that sits between a child’s legs and restraints that are fixed to the high chair in three different places. They found that children were able to slip out the bottom of a high chair and hope a fixed post will prevent this. High chairs are not recommended for children younger than 6 months of age. A child is only ready for a chair once they have good head and neck control and are able to sit up on their own. If one is used too early a child could experience positional asphyxia. You may however, be able to start a little sooner with a reclining high chair. CHOOSING THE RIGHT HIGH CHAIR Framework: choose a high chair that is sturdy. Put some weight on it and see if it squeaks, deforms or moves or collapses. Gaps: make sure there are no gaps your child can slip out of. Also chair-related check for gaps that little fingers can get caught in. Harness: choose a high chair with either a three-point or five-point harness that includes a crotch strap or a post. The restraint should go over the shoulders, around the waist and if a five-point harness then between the legs. Wide base: a high chair becomes top heavy when your child is in. Choosing a chair with a wide base will make it more stable so that it does not tip easily. Wheels: if you choose a high chair with wheels, make sure they can be locked when the chair is in use. Folding locks: if the high chair folds check that the locks work well enough so that the chair cannot fall or collapse when in use. Joints: choose a high chair with metal joints. These are stronger than plastic, which can crack after time. Safety standards: make sure the high chair meets current safety standards and has been approved by an international safety authority. BOOSTER SEATS AND HOOK-ON SEATS Please be careful when you use these chairs. If not used correctly these seats can be dangerous. Hook-on seat: These chairs are mounted directly onto a table and should only be used once your baby has good head and neck control and can sit upright. The mounts must be slip resistant and because this seat carries the entire weight of your baby the table has to be strong so that it does not tip over. Booster seat: These seats are attached to normals chair by straps to raise a child’s height. They are usually used when a child has outgrown the high chair but is not quite tall enough to sit at the table unaided. They should also have straps to keep your child in the seat. KEEPING YOUR CHILD SAFE IN A HIGH CHAIR Never leave your child unsupervised when they are in a high chair. Always use the safety straps when your child sits in the chair, even if only for a few minutes. The tray is not a restraint. If the chair folds, make sure it is locked each time you set the chair up. If the chair has wheels, make sure they are locked each time you set the chair up. Never allow your child to stand in the high chair. Do not place the high chair near a counter or table. Your child may be able to push against the surface and cause the chair to tip over. Don’t allow older children to climb or play on the high chair while another child is seated in it because it could tip over. Position the high chair at its lowest possible height if this is adjustable. Make sure potential hazards such as hot food, drink and sharp cutlery are out of reach. When choosing a high chair opt for an age-appropriate one with plenty of safety features. It’s also important to check often for recalls once you have purchased your chair. High chairs are commonly recalled because of their safety issues. Recent recalls include the Skip Hop Tuo convertible high chair and the Graco Table2Table 6-in-1. You can check http://www.recalls.gov to see if your high chair has been recalled. RESOURCES https://journals.sagepub.com/doi/abs/10.1177/0009922813510599 http:// https://www.nationwidechildrens.org/newsroom/news-releases/2013/12/new-study-finds-24-children-a-day-are-treated-in-us-emergency-departments-for-high-chair-related

March 20, 2019

Cyberbullying

Bullies have always existed. However, in the digital age, the bullying we are seeing is worse than ever before. This is largely for two reasons: firstly, before we all had smartphones, a victim of bullying could go home from school and have some sort of break. Now, bullying is round the clock. Secondly, the type of content being shared is troubling as people say things behind a screen that they would never say to someone’s face. Moreover, the consequences of cyberbullying are more prevalent – in South Africa, we are seeing increased incidences of depression, anxiety and behaviour related to self-harm and even suicide as a direct result of cyberbullying. When it comes to cyberbullying, anonymity is the root of all evil – people seem to think they can get away with saying whatever they want when they hide behind the veil of online anonymity. We are seeing the worst kinds of bullying taking place on anonymous apps such as Qooh.me or through anonymous profiles created on apps such as Instagram. We are seeing a lot of naming and shaming, direct personal attacks, slut shaming, fat shaming, pressuring others to send nudes, and revenge pornography. Although terrible content is shared on anonymous platforms, the truth is that any platform can be open to abuse. Some platforms are simply better than others at removing offensive content. What to do if you are being bullied If YOU are being bullied: Tell a trusted adult (a parent, guardian or teacher). Take screenshots to keep as evidence. BLOCK the bully. If you are aware that someone else is being bullied: Don’t join in (this includes commenting and sharing harmful content) and leave a WhatsApp group that hosts abusive content. Report bullying to a trusted adult (a parent, guardian or teacher). What legal options are available if you are being bullied? If you know the identity of the bully, and the bullying is sufficiently severe to the extent that it can be said to cause you mental, emotional or psychological harm (or inspire the belief that harm could be caused), one mechanism available is to apply for a Protection Order under the Protection from Harassment Act. Almost all social media platforms have a reporting function that allows the possibility for damaging content to be removed. Finally, the Cybercrimes Bill, which will hopefully become law soon, has codified a lot of crimes relating to online activities. Specifically, its chapter on malicious communications criminalises the creation or distribution of “a data message” that incites the causing of any damage to property belonging to, or violence against, a person or group of persons which is harmful or intimate in nature, and which is distributed without the consent of the person involved. This would include a lot of content that we are loosely defining as cyberbullying.

March 20, 2019

Medical tax rebates stable after budget speech

Private medical aid members can breathe a sigh of relief after the budget speech. Treasury has been hinting for a while that they were considering reducing of the medical tax credit to fund the National Health Insurance (NHI), fortunately, it remains unchanged for the year ahead. Although it was a relief to members it was also a surprise tax sacrifice, considering the need to fund NHI. This equates to over R30 billion this year and around R35/36 billion for the coming year – a large sum indeed. It is believed the removal of tax credits would have upset too many people who are dependent on it to access private health care and are essentially being rewarded for not burdening the government health care. Before 2012, SARS deducted your medical aid contributions against your taxable income. ‘Originally,’ says Gerhard Van Emmenis, Principal Officer of Bonitas Medical Fund, ‘your medical aid contributions would be a deduction against your taxable income. However, from 2012, SARS introduced a medical credit, a ‘tax credit’ which is deducted from your overall tax liability.’ The medical tax credit consists of the following two amounts: The medical scheme fees tax credit This applies to the premiums paid by you to a registered medical scheme on behalf of yourself and your dependents. The main member, as well as the first dependant on the medical scheme, receive a monthly tax credit of R310 (for the 2018-2019 year). All additional dependants receive a monthly tax credit of R209 (for the 2018-2019 tax year). There are three categories: 1. Under 65 (without disability) 25% of the total contributions paid to the medical scheme Less (4X medical scheme fees credit) Plus qualifying medical expenses paid less 7.5% of taxable income 2. Under 65 (with a disability) 33.3% of total contributions paid to the medical scheme Less (3X medical scheme fees credit) Plus qualifying medical expenses paid 3. 65 or over (with or without disability) 33.3% of total contributions paid to the medical scheme Less (3X medical scheme fees credit) Plus qualifying medical expenses It is important to note that if your premium is a deduction from your salary or wages, your employer is obliged to use the credit system to adjust your monthly PAYE tax accordingly. If you contribute to a medical scheme independently from your employer, you will receive the tax credit on assessment when you complete your tax return. 2. The additional medical expenses tax credit This means that the overall amount of tax you need to pay at the end of the tax year is reduced. The amount of your tax rebate is made up of a percentage of all out-of-pocket expenses you have spent on qualifying medical expenses that weren’t covered by your medical scheme. This amount accumulates throughout the tax year. You will need to keep the slips for these expenses. To calculate the additional medical expenses tax credit, special formulas are used. The specific formula to use depends on your age and whether you or one or more of your dependants has a disability. The following out-of-pocket expenses qualify: Consultations, services or medications from a registered medical practitioner, arthropod, physiotherapist, dentist, chiropractor, herbalist, homoeopath, optometrist, osteopath or naturopath Admission to a registered hospital, including nursing homes Care at patient’s home by a registered nurse, nursing assistant, nursing agency or midwife Medicines prescribed by a duly registered physician (as listed above) and acquired from a duly registered pharmacist Medical expenses on services rendered or medicines supplied outside of South Africa and which are substantially similar to the services and medicines listed above Money paid towards the treatment of a physical impairment or disability (as long as it is a qualifying expense prescribed by the Commissioner). What about over-the-counter expenses It is important to note that unless these are prescribed by a registered medical practitioner and acquired by a pharmacist they don’t enjoy a tax rebate. Examples include medicines, such as cough syrups, headache tablets or vitamins. ‘Whether NHI is going to materialise or not’, says Van Emmenis, ‘The Government’s coffers need filling and the approximately 17% of the South African population on private medical should expect their medical aid tax relief to get less and less in the future.’

March 15, 2019

Review: OneAid Mini First Aid Kit

There is no doubt that we all need a good First-Aid Kit in the home, the car, your handbag…. You name it, children always seem to find scrapes and burns when you least expect it. We are absolutely in love with the MiniKit by OneAid. Developed by a mother who just happens to be a medical doctor with years of experience in the trauma room, every consideration has been made in this handy first aid kit. Firstly, it wraps up small. Small enough to fit in your handbag, diaper bag or to keep inside your motor vehicle. The kit comprises of: 2) Pairs of gloves (latex-free) (1) Hand disinfectant (2) First aid dressing (1) Conforming bandage (1) Triangular bandage (1) Sterile gauze (1) Sterile dressing pad (12) Assorted plasters (1) Burn gel (1) Burn dressing (4) cotton buds (1) Antiseptic solution (2) Antiseptic ointment (1) First aid scissors (1) Metal tweezers (1) Adhesive tape (1) Syringe (5ml) (3) Reward stickers Available in Red or Yellow Don’t miss out on this amazing first aid kit, you certainly will not be sorry! Retail price is R395 and can be purchased online at www.oneaid.co.za

March 8, 2019

Goatie Goodness – the better choice

When choosing milk, it’s not just a matter of full cream, low-fat or flavoured anymore. Sometimes an alternative is needed. But not all milks are created equal. Here’s a five-point checklist of what to look for and why Goat milk could be the ‘right’ milk choice for you and your family. Fat size Young children should drink full cream milk since they need the fat for proper development of their brains and nervous systems. Goat milk is a full cream milk and is naturally homogenized, meaning the fat molecules are naturally smaller and more easily digested. Protein Structure Milk is also a great source of high-quality protein. Protein builds, strengthens and repairs our body’s muscles, bones and blood. The protein composition of goat’ milk allows it to form a softer curd during digestion offering greater digestive health and comfort. Type of Carbohydrate Some carbohydrates, known as oligosaccharides possess “prebiotic” properties, promoting the growth of beneficial bacteria in our gut and boosting our immune system. Goat milk contains the highest amount of oligosaccharides among domestic animals and is free of added sugars Essential Vitamins & Minerals Research consistently shows that South Africans have a low intake of the minerals, calcium and potassium. Milk is a good source of calcium. Calcium is needed for strong bones and teeth. Vitamin D is essential to help increase the absorption of calcium from the gut. Check the ingredients list on the milk label for milk with Vitamin D (cholecalciferol). One glass of KABRITA Instant Full Cream Goat Milk gives you half your daily requirements for vitamin D. Better Sustainability Important environmental issues such as hygiene, animal welfare and overall quality are uppermost in the minds of the most discerning consumer and parent. All KABRITA goats’ milk is non-GMO* and is sourced from farms which follow strict guidelines in terms of animal feed and treatment. KABRITA goats’ milk is set to meet the highest international standards and goats have not been exposed to antibiotics, growth hormones or pesticides. KABRITA Instant Full Cream Goat Milk is available as an easy-to-use goat milk powder for the whole family; it’s free of added sugars and provides nutrients that support health. Why not give this unique, high-quality goat milk with its fresh and mildly sweet taste, a try? *non-genetically modified organisms Kabrita Instant Full Cream Goat Milk powder is available at Dis-Chem Pharmacy, Baby City stores and Wellness Warehouse nationwide with a price range from R170 (400g). The product range is also online at… www.dischem.co.za www.wellnesswarehouse.com www.takealot.com For more information and visit www.kabrita.co.za and follow @kabrita_sa on Facebook and Instagram. #GoatieGoodness #KabritaSA

March 8, 2019

Bonitas gives back

Members of Bonitas Medical Fund will now have access to free lifestyle vouchers as well as discounted offers on gap cover and financial services products through the Fund’s new multi-insurer platform. This is not another Loyalty programme. ‘Our members’ health has always been a priority and we strive to make healthcare as affordable as possible,’ says Gerhard van Emmenis, Principal Officer of Bonitas. ‘And while our various plans offer a host of benefits, we know that in difficult financial times money matters can add to stress levels. For this reason, we have adopted a multi-insurer platform which offers members discounted lifestyle vouchers as well as exclusive offers on gap cover and various insurance products.’ The past 12 months have been extremely difficult for consumers, impacted by the increase in VAT, the fuel levy and the resulting escalating prices. This has increased the burden placed on consumers struggling to make ends meet. ‘In 2017 a Financial Wellness Indicator revealed that 73.5% of South African households were financially unwell,’ says Van Emmenis. ‘2019 is no different. Consumers are cash strapped so being able to align with strategic partners to offer a comprehensive and tangible way to relieve the money pressure while helping them find them some ‘extra’ money, will go a long way to keeping them physically and financially healthy.’ A report published last year, which reviewed rewards programmes in South Africa, indicated that there are around 100+ existing loyalty programmes with the average consumer subscribed to about nine. ‘The economic landscape is tough to navigate and we didn’t want to add to the pressure already placed on our members by offering a loyalty programme for which they would have to pay an additional monthly fee for. Our multi-insurer platform is premised on negotiating exclusive deals to the benefit of our members. ‘They are designed to add real value aligned to member needs.’ Van Emmenis explains. In brief: These do not cost anything There are no points No levels of membership You don’t have to work for rewards The model is split in two. One: Free monthly discount lifestyle shopping vouchers to offset daily living expenses These are available from over 30 retailers and 6 000 outlets countrywide, such as Shoprite, Takealot and Edgars, as well as for airtime and data purchases and electricity. ‘The deals are aimed at the average South African, with discount vouchers for groceries, data, airtime and electricity. There are also discounts on activewear and gym membership to encourage a healthier lifestyle,’ Van Emmenis says. Two: Discounted financial service products through Medgap and Indie MedGap offers comprehensive gap cover at a discount of up to 26% exclusively for Bonitas members. Indie offers various financial products such as a funeral, critical illness or disability cover, as well as income protection at a discounted premium, together with a free investment at no extra cost. Indie will match and invest up to 110% of Bonitas’ member’s life insurance premiums, with cash drops every five years. The multi-insurer platform is supported by a new, revamped member zone to allow members to manage their medical aid 24/7, on any device. This includes submitting claims, applying for chronic medicine and viewing benefits clearly signalling a new era of medical aid has dawned.

March 2, 2019

Autism in Adults

The Adult Programme for People with Autism (APPAutism) is a registered non-profit company that aims to provide support for adults with moderate to severe Autism who are unable to independently perform the tasks required of adult life, following the principle of life-long learning, in a supported environment. Autism is a lifelong developmental disability that affects how a person communicates with and relates to, other people, and their ability to function in the world around them. It is a spectrum condition, which means that, while all people with autism share certain difficulties, their condition will affect them in different ways. The majority manifest with moderate to severe learning and behavioural disabilities and need a lifetime of specialist support. The nature of the disability is such that it requires intervention and management that is specific to the condition. There are very few centres in South Africa that cater to this need. APPAutism’s mission is to prepare adults over the age of 18 for life outside of the schooling environment, by implementing a programme of meaningful activities and interactions with the aim of developing the skills and behaviours required for these adults to be able to maximize their potential and integrate into their environments. It aims to provide a happy environment with varied activities and programmes which are individualised and where members feel they belong. The Programme The programme is highly structured. Every day includes components of daily living skills; vocational skills (at the many facilities within REEA); communication and socialisation skills; cognitive skills, and leisure and well-being activities Participants are taken twice a week to a fully operational protective workshop, where they work supervision by a job coach in order to develop their ability to work in a protective workshop environment. The programme provides for a varied and stimulating day, combining group work, individual work, and community interaction; as well as combining pre-vocational and vocational skill development, with activities that are enjoyable and fun There is a high staff to adult ratio. (One staff member per five participants. The programme is individualised as far as possible to the specific strengths of each person. Each person will have an Individual Daily Life Plan which incorporates goals/ activities related to the social, emotional, work, and familial aspects of their lives. APPA is a non-profit company. However monthly fees are charged in order to maintain the varied extent of the programme, and the high staff to student ratio. We are open from 08:00 to 15:00 daily, Monday to Friday, with an annual holiday break in December. Daily Living Activities : Aim: To develop and build self-help skills, leading to independence, in the areas of dressing, hygiene, food preparation, meal-times; housekeeping duties. Examples of activities may be: preparing food/snacks; laying the table; eating together; independent eating skills; sweeping; loading dishwasher; hanging up clothes; feeding pets; laying the table; etc Protective Workshop Activities : Aim: To identify the “best-fit” workshop/work activities that leverage both the interests and the capabilities of the adult. This may include daily workshop time either in the REEA facility or in an external facility that has been identified. Or it may include partial workshop activity time, e.g. for a couple of hours twice a week. This will depend on the ability of the individual to stay on task for long periods of time. Examples of activities may be: Sorting, packaging; compiling; assembling; office work; Working in the gardens; Part-time work at already established protective workshop centres; Dog walking; Any other work in and around the facility Leisure and Well Being: Aim: To replicate a normal, fulfilling day with balanced activities to ensure the quality of life and to maintain a healthy lifestyle. Examples of activities may be: Walking/hiking/exercising; Art lessons; Music Therapy; Watching TV/listening to movies; Restaurant/movies/ten pin bowling; “Me” time; Dancing/ ball play/soccer; Shopping Communication and Socialisation Aim: To continue to develop appropriate communication skills, and socially appropriate, adaptive behaviours, and work on diminishing socially inappropriate behaviours. These specific skills are inherent and form part of all other activities at the centre. Group socialisation sessions are held weekly led by a qualified social worker. AAC communication devices or systems are encouraged. Cognitive Aim: To continue to reinforce and build on academic skills obtained during schooling years Examples of activities may be: Numeracy and basic math’s; English and writing skills; Money skills; Computer Skills; Fine motor and gross motor development Facilities Here we have combined our own specific programme, in our own custom venue, with the facilities available at REEA. The facilities available to us include: A specific area custom designed for APPA (Adult Programme for People with Autism) A homely environment A large kitchen and laundry for life skills A fully catered dining room for lunchtime meals Large gardens Right on the border with Delta Park for walks and physical activities A medical/emergency room, staffed with a full-time nurse Horseriding facilities on the property Indoor swimming facility nearby

March 1, 2019

The link between emotional challenges and poor academic performance

Have you ever considered that your child’s struggles at school may be because of emotional challenges? The academic year, as we are already aware, hold many stressors for children. What we are not always conscious of is that a child’s emotional state can directly affect the need to perform academically. In fact, according to Kerry De Jager, Head Franchisor at Step Up Education Centres, South Africa says, “Children who are experiencing emotional challenges (pain, uncertainty, family challenges, low self-esteem and fear) are more likely to struggle with the academic demands of formal schooling.” Think of a time as an adult, for example, where you have had an emotional challenge. “It is incredibly difficult to focus on our jobs and careers when our emotional state is one of pain, blame or demotivation. As an adult we have developed the skills needed to cope with stress and anxiety and yet our emotional state sometimes hinders our ability to function in the workplace,” Kerry explains. She adds that developmentally some children are not yet ready to deal with these stresses and furthermore an emotional immature child will not have the coping skills to deal with the way their emotions make them feel. As the stresses of the year creep up on them, their emotional state will have a greater and greater impact on their ability to concentrate on their academic work. “An emotionally stable learner is able to take in and retain new information more effectively. Concentration skills are better and social relationships are a great deal more positive.” Kerry gives the following tips to parents who you have a child who is struggling at school: It is important to look at your child as a unique individual and realise that academic performance cannot be looked at in isolation. If your child has not performed as well as what you expected, try and find out why. Aim at honest non-judgemental conversations that will enable you to understand the emotional state that your child has been in during the academic year. Are they emotionally able to cope with the grade that they are in? Has it been a particularly difficult year at home? Has your child had a significant change in their lives like a new sibling or perhaps a divorce? Has there been a change in friends at school or at social clubs? All these questions may provide some insight into why they have not performed as well as you anticipated. They will also afford you an opportunity to work together to find positive solutions. Remember that everyone wants to achieve success, whether they are willing to admit it or not! It is not in their nature to want to fail. Our role as parents is to guide, support, encourage and motivate our children to rise above the challenges of life to achieve the best version of themselves! “Each child is unique and their needs all differ. If you take the time to try and understand why a child is performing the way they are, it is a huge step in the right direction. Be patient with your children as they navigate the world with you at their side!” Kerry Concludes.

February 28, 2019

Pregnancy and Migraine

Pregnancy is an exciting time for many women. Unfortunately pregnant women also suffer from headaches and migraines, and tend so self-medicate with over the counter medication. According to Dr Elliot Shevel, Medical Director of The Headache Clinic, and South Africa’s internationally recognized Migraine expert and pioneer in the field of Migraine Surgery, “Often the migraines or headaches worsen during the first trimester (the first three months of pregnancy), but don’t despair – in 70 % of women the migraines get better in the second and third trimesters. Unfortunately medication is not a good option during pregnancy, and the only pain medication that is safe is Panado or Paracetamol,” he says. “Unfortunately pregnant women who suffer from migraines with aura, (a term used to refer to warning signs of migraine such as seeing zigzag lines before the pain starts), usually don’t find relief in the second half of their pregnancy and have less chance of improvement.” Two studies show that many pregnant women rely on over the counter medication. The first study, published in the Journal of the Pakistan Medical Association, showed “a significant number of pregnant women relied on over-the-counter medication”. A descriptive cross-sectional study was conducted at Isra University Hospital in Pakistan for six months and comprised of 351 pregnant women who were interviewed face to face. Overall, 223 (63.5%) patients were using over the counter drugs before pregnancy and 128 (36.5%) had used them in a previous pregnancy. A further 133 (37.9%) were using the medications during the current pregnancy. Quite worrying is that a total of 103(77.4%) had no knowledge about the possible harmful effects of the medication they were taking. Whilst this study highlighted the frequent use of over the counter medications in pregnant women, another study, published in Headache: The Journal of Head and Face Pain, indicates most women experience automatic relief during their 2nd and 3rd trimesters. So is surgery a viable option in pregnant women? One of the most successful treatment methods for migraine is to close off the small arteries under the skin of the scalp that cause the pain (not the arteries in the brain), by means of minimally invasive surgery. Commenting on the surgery during pregnancy, Dr Shevel says, ‘We usually wouldn’t do the surgery during the first three months of the pregnancy because the drugs used in the sedation or anaesthetic may affect the fetus and cause problems. After the first trimester the operation is safe to perform, but we prefer to wait until the baby is born to avoid any possible unforeseen complications. Sometimes however, an expectant mother is just in so much pain that the operation can’t wait.” Other pressing issues Expectant mothers always have a lot of questions about headaches and migraines. Here are some answered: Will the baby be affected by the trauma and pain of my headache? No, says Shevel. “There is no evidence to indicate this, but the baby can be affected by a medication the mother is using and that is why we are saying only Panado or Paracetamol is safe.” Is there an ingredient in the pill that aggravates or makes headaches worse? The short answer is yes. “The pill contains a variety of different hormones, and changes in those hormone levels can affect the headaches. It is interesting to note however, that although they can make the headaches worse, they may also sometimes make them better – it’s impossible to predict.” What role does breastfeeding play? According to Shevel breastfeeding can also play a role. “If women breastfeed after birth the headaches usually stays away until the baby is weaned. “

February 26, 2019

How to teach the essential skill of self-awareness to your children

Life on earth is a rollercoaster ride of emotions and our reactions to these emotions. All too often, we coaster through life, unaware of our behavioral choices and even worse, unable to consider the possibility that we could have made better choices for ourselves along the way. According to Cindy Glass, Founder and Owners of Step Up Education Centres says, “Self-awareness is the first skill in emotional intelligence and it sets the precedent for the growth and development of all emotional intelligence skills. Being able to look at ourselves honestly, and without negative judgement, will enable and empower us to achieve greater success in all that we do. This, of course, applies to our children and their personal and academic learning as well.” She adds that self-awareness skills will help your children become aware of their emotions and behaviours and make better choices in all that they do. They will also experience better personal relationships as they become aware of the emotions, behaviours and choices of others. “It is important to note that self-awareness includes skills in being aware of positive and negative emotions, behaviours and choices. It is about learning to own these choices, learn from the mistakes and consider what behaviours will be best in any situation,” Cindy explains. She offers the following helpful tips to teach your child this essential life skill: Create an environment where your children are free to recognise and acknowledge their mistakes and achievements in a non-judgmental, non-frightening way. Remember that it is fear of negative consequences that often hold us back from admitting mistakes to ourselves. And yet, if we cannot own a mistake, how can we find a positive solution to fix it? Don’t allow the blame-game. Blaming others for the choices that we have made disempowers us and reduces our opportunity to grow and learn from our choices and experiences. You are your child’s first and most powerful teacher – set the example! Teach your children the power of self-awareness by being self-aware! Remember that we are all on that rollercoaster that we call life and learning is a life-long gift. Teach your children to be kind to themselves in their uniqueness and imperfections, just as you are kind toward yourself. Teach your children to recognise and honour their own talents and not to compare themselves to anyone else. We must remember that we are ALL on this journey and we all have interesting and wonderful ways in which we can choose to live our lives. Different is not less. Non-judgmental self-awareness is essential. Positive self-worth is everything! “Learning the essential skill of self-awareness will bring about more positive learning and it will go a long way in ensuring that we live happier, more fulfilled lives. Which parent would not want this for themselves and their children?” concludes Cindy.

February 22, 2019

Understanding Migraine Triggers

Migraine is a very common problem that affects about 18% of all women and 6% of all men. Studies have shown that environment, lifestyle, and diet can play a large role in how often you get migraines. Dr Elliot Shevel, Medical Director of The Headache Clinic, and South Africa’s internationally recognized Migraine expert and pioneer in the field of Migraine Surgery says that the most commonly reported migraine triggers include alcohol (especially red wine and beer), chocolate, aged cheese, cured meats, food preservatives that contain nitrates and nitrites, and monosodium glutamate (MSG). Although these are the most common, almost any food can be a trigger. Even so, only about 20% of migraine suffers have an identifiable food trigger. There is no certainty why certain foods trigger headaches, but suggested mechanisms are as follows: Chocolate 22 percent of headache sufferers identify chocolate as one of their headache triggers. But many people with migraines have increased appetite and food cravings just before their headaches start. Reaching for a chocolate bar may be the result of a migraine, rather than the cause. Alcohol Sulfites used as preservatives in red wine have been linked to migraine headaches. Alcohol in any drink causes the blood vessels in the scalp to dilate, and can also result in dehydration, both of which might be headache triggers. Alcohol is also a potent trigger for cluster headaches – otherwise known as “suicide headaches”. They are known as suicide headaches because the pain is so severe that sufferers do sometimes actually commit suicide. Caffeine Caffeine can actually help get rid of a migraine headache because caffeine works as a vasoconstrictor for some patients. In some patients it can trigger a headache or make it worse. Caffeine may be included in some migraine medications, but too much caffeine can be a headache trigger when you come down from your caffeine “high.” Cheese It is generally agreed that aged cheese is more likely to cause a headache, because it contains a substance called tyramine that forms as the proteins in cheese break down over time. The longer a cheese ages, the more tyramine it has. MSG Monosodium glutamate (MSG), which is found in soy sauce and as a food additive has been implicated in causing migraine. The interesting thing though, is that in cultures where MSG is used extensively, the percentage of migraine sufferers is the same as in other countries. Ice cream The stabbing pain you get when you eat ice cream too fast is a reaction to the cold, not the ice cream itself. An ice cream headache is more likely if you are overheated. The pain peaks in about 30 to 60 seconds. “Cold foods like ice cream may be migraine triggers for people who suffer from migraines, but for most people, the pain goes away quickly. Bananas Bananas usually don’t appear on lists of foods that are headache triggers, but they could trigger a migraine for people who are sensitive to tyramine, the same substance found in aged cheese. Preserved meats The nitrates and nitrites used as preservatives in hot dogs, bacon, and lunch meats may dilate blood vessels and trigger headaches in some people. According to Dr Shevel, studies can’t tell you if, or which foods may trigger your headaches, but many people do have food triggers and some triggers are completely obscure and uncommon. There are a few important things to remember about migraine food triggers says Shevel: Migraine attacks are often due to multiple factors. There are many non-dietary trigger factors for migraine. When you’re already stressed, not sleeping well, and not exercising, eating a food trigger may make it more likely to have a migraine attack. In this case, it is the combination of all of these different things that contribute to the migraine, and not just the one food. Your personal food triggers can be difficult to figure out. Here are some suggestions: Keep a food diary along with your headache diary, to help identify what you ate before migraine attacks. You can download a diary by clicking here Some foods can trigger a headache right away, while with other foods the headache can be delayed up to 24 hours. If you think a specific food is triggering migraine attacks, you may try to avoid that food for a month. Only limit one food at a time so that there can be no confusion as to which one affected you and monitor your symptoms to see if they improve. Be careful about trying extremely strict diets. There is a risk of avoiding foods that are not necessarily migraine triggers and you may be missing out on many important nutrients. The presence of triggers is confusing though, as they are frequently blamed for causing migraines, whereas the actual cause is some change in the body that predisposes the patient to develop migraine attacks. In other words, the patient is susceptible to developing migraine attacks – and the trigger merely sets them off. This means that if the underlying problem is diagnosed and treated, those triggers that previously set off an attack no longer do so. Obviously if the patient identifies a certain foodstuff that always triggers an attack, they should avoid it. The problem though is that many triggers, such as weather changes, stress, and hormone changes during the menstrual cycle, cannot be avoided. At The Headache Clinic, the emphasis therefore is not on identifying the triggers, but on diagnosing and treating the underlying problem. Dr Elliot Shevel, Medical Director of The Headache Clinic, and South Africa’s internationally recognized Migraine expert and pioneer in the field of Migraine Surgery, says that although migraine has many triggers, most people cannot identify their individual triggers. The best way to treat migraine therefore is not to focus upon the triggers, but upon cause, i.e. the actual physical structures that generate the pain during an attack. With the latest state-of-the-art diagnostic and Non- drug treatment techniques developed at The Headache Clinic, it is possible to prevent migraine

February 21, 2019

The Taboo Topic Of High Allergen Foods And Breastfeeding

The topic of high allergen foods being consumed while breastfeeding has been a long debated one. However, we have some interesting developments on the subject! Read on below to see why you, in fact, should be upping the ante by eating high allergen foods whilst breastfeeding. Don’t Believe Us? Believe The Science! In a study published in the Journal of Experimental Medicine today, research suggests that a mother’s diet while breastfeeding can help the baby build certain tolerances against allergic foods. Conducted by teams from Boston Children’s Hospital and Harvard Medical School, they researchers show how introducing allergic foods to your child’s digestive system from an early age actually help them build tolerance against these foods later in life. This results in them not developing full blown allergies to the foods in question. How To Introduce High Allergen Foods Into Your Diet Whilst Breastfeeding You know the good old saying, less is more? this is definitely true in this instance. When introducing the foods to your diet, do so slowly so as to not risk giving your child a reaction. For example, start with a handful of nuts a day. Go for sushi one weekend. All the while, monitor how your baby reacts to the new exposure to these foods. What Not To Do In The Process By no means should you jeopardise your own well-being. If you are highly allergic to a certain food, eating these foods will do you no good. As a result, this will definitely not benefit your baby either. Therefore, only introduce foods which you can safely eat yourself into your and your baby’s diet. Making High Allergen Foods And Breastfeeding Work In Unison From now on, do not be afraid to experiment a little with what you are eating. Who knows, it could actually benefit them highly later on in life!

February 19, 2019

Gō-Ecō WITH THE NEW KURO-Bō RANGE

KURO-Bō’s message is simple. It is now 100% easy and 100% convenient to create the best-tasting water using 100% natural filters that are kind to the environment and sustainably produced. It’s a promise! Since launching in 2017, KURO-Bō has rapidly (r)evolutionised water filtering systems in South Africa. Through their innovative use of Japanese-inspired activated charcoal (or “Binchotan”), KURO-Bō has changed the way South Africans can access purified and mineralised water, at home and on-the-go, and with zero single-use plastic. After introducing their first Gō-Ecō 1L Bottle in January 2018, KURO-Bō has extended their planet-changing range even further to make their eco-filtering technology appealing to even more active people on the gō. Those seeking a more compact bottle and volume, will welcome the new 550 ml size Gō-Ecō bottle with a sustainable bamboo lid, and a removable neoprene sleeve that doubles up as a sports-grip and insulation, keeping your KURO-Bō naturally purified water cool. Refill the Gō-Ecō bottle with tap water using the clever detoxing KURO-Bō Activated Charcoal Kōins, which have been specially designed to fit into the bottles, purifying, mineralising and pH-balancing your water while you’re active and on the move. KURO-Bō hasn’t stopped there. Frustrated by the lack of 100% plastic-free, long-lasting and effective bottle cleaners on the market, their new KURO-Bō Gō-Ecō Natural Cleaning Brush fills a real gap. The bristles are made of natural sisal, and the practical long handle is sustainable bamboo. It’s eco-friendly functional beauty in action! KURO-Bō blends elegance and style with practical functionality when it comes to naturally filtering water, but of equal importance is the message inherent in their whole range. Their new symbolic image speaks to the importance of placing care of land, water and our health – in other words, the whole of Nature – at the forefront of our awareness in whatever we do in the world. And that certainly includes how we filter our water. KURO-Bō natural water filters are fully recyclable, zero-waste and plastic-free. That’s a message they hope their Gō-Ecō bottles will carry far and wide. KURO-Bō Gō-Ecō bottles retail from R260 for the 1 litre, from R220 for the 550 ml. The bottle brush retails from R100 and a box of Koins from R180. KURO-Bō products are available in good independent health shops country-wide, in all Wellness Warehouse stores, selected Spar, Dis-Chem and @Home stores, and online at Faithful-to-Nature and Takealot, as well as directly from KURO-Bō. Please note that the 550ml bottles are available from 1st Feb and brushes are available from 1st Mar in stores (We do however, have the 550ml bottle available now, directly from our online store)

February 17, 2019

Review: KURO-Bō Natural Water Filter System

Zero-waste and plastic free… this is the life that many are trying to achieve in 2019. The KURO-Bō natural water filter system is a must purchase this year. Starting from the glass bottle to the unique filter system this product is 100% easy and 100% convenient! The bottles retail from R260 for a 1 litre bottle. Once you have your bottle which features a bamboo lid and removable sleeve, you will need to grab some KURO-Bō detoxing Activated charcoal Kōins. The process works by means of you boiling the KURO-Bō tablets for 10 minutes. You simply add the charcoal tablet to your tap water and place it in the fridge in your stylish bottle for an hour or two for the magic to start. The KURO-Bō charcoal Kōins purify, mineralise and ph balance your water while you are active on the move. They absorb toxins, bacteria and are enriched with minerals such as calcium and magnesium! For more information visit www.kuro-bo.com or visit good independent health store country wide to get your own. They are also available from Wellness Warehouse, selected Spar outlets, Dis-Chem and @Home Stores. Purchase online from Faithful-to-Nature and Takealot

February 15, 2019

Screen Addiction: parenting in the age of a digital era

No other topic could create a catastrophe of opinions, judgements, beliefs and arguments as parenting. Add technology in the mix and you’ve created world war 3. According to a survey conducted by internet security company AVG in the US, 92% of children have an online presence by the time they are 2 years old. These days’ children learn to swipe a screen before they are able to hold crayons. The digital revolution of the past 2 decades has induced a moral panic in parenting. When a child goes on Facebook, Twitter or Instagram, parents have certain unanswered questions such as: Are our kids aware of the privacy settings on social networking sites? Do they adhere to them? What kind of online games are our kids playing? Are they playing the right ones or ones that are not suitable for their age/ taste/ social-cultural backgrounds? How much digital engagement is enough and how much is too much? Though a child’s online presence allows young people access to invaluable resources and learning opportunities, it also brings about parenting challenges such as cyberbullying and filtering age-appropriate content. Parents play a vital role in teaching the children practice of “netiquette” outside of the classroom, all these require that the parent themselves be digitally literate. A digitally illiterate parent poses a risk to the privacy and safety of children. A tech naive parent may in a moment of some parental pride, post content(pictures, videos, information) of their child exposing them to the bad world of cybercrime. So we often ask ourselves which of these 2 parents is the perfect parent? Is there such a thing as correct parenting? Especially in this technologically advanced era we live in? And how much technology is too much technology? What happened to the good old days when kids played outside instead of staring into their phones and the television during their school holidays? Being a parent is hard and raising children in a digital era is even harder. Gone are the days of kids just being kids, playing hopscotch in the backyard, catching a ball in the garden or planning how they are going to build that tree house. These days playing involves Fifa and a ps4 or perhaps and X Box or candy crush. What happened to good old fashion childhood games our parents used to play? At Sugar Bay we encourage children to hold on to their childhood as much as possible, kids get to be outdoors the whole day engaging in activities such as kayaking, bmxing , rock climbing or they can choose to spend a relaxing day beading or baking amongst other things. These activities encourage kids to show their creative side, help them discover their hidden talents and passion and leaving a small room to be thinking about their phones. Like our saying goes: “What we learn in fun we never forget”. Sugar Bay is much more than a luxury holiday resort. Sugar Bay ensures the personal development and growth of a child, increase self-esteem, self-confidence and independence. Allowing campers to pick and choose from over 100 activities allows them to make decisions for themselves which encourages independence. We understand the constant need kids have of always being on their phone, but which parent wouldn’t want their child to enjoy being a child and being outdoors in the garden like they did in their good old days.

February 15, 2019

Chocolate can trigger migraines; Finds study

You should think twice before giving that someone special chocolates this Valentine’s day – it may just give them a migraine! And that’s not because they’re not in the mood; a scientific double-blind study shows chocolate can trigger migraines. The London-based study, published in Cephalalgia, the official journal of the International Headache Society, was conducted on 20 migraine sufferers. Chocolate bars were given to the subjects and bars of carob were used as a placebo. The chocolate bars caused migraine in 8 of the 20 migraine subjects while the carob bars did not induce migraine in a single sufferer. Dr Elliot Shevel, Medical Director of The Headache Clinic, and South Africa’s internationally recognized Migraine expert and pioneer in the field of Migraine Surgery, says the study clearly shows individuals who are prone to getting migraines should be careful when eating chocolates. “The reason for this is chocolate contains a chemical called phenylethylamine which is thought to trigger migraines by affecting the arteries in the scalp which are the source of the pain. Unfortunately phenylethylamine is found in the cocoa bean which is what chocolate is made from,” he says. “Carob bars, available from your local health store may drastically improve your chances of getting lucky this Valentine’s Day!” What other items can trigger migraines? Alcohol Migraine sufferers should try not to drink liquor since this can be a regular trigger of migraines. If you can’t resist, have one glass of champagne or white wine, as it is generally the dark alcoholic beverages that trigger migraines. Flowers Hay fever headaches are triggered by flowers and cause a dull, deep, throbbing pain. Some of the symptoms of hay fever headaches are pain in one specific area of your face or head (for example, behind your eyes) or the face is tender to the touch. Rather don’t buy your partner flowers if they are prone to getting migraines. Perfume People who are sensitive to fragrances and/ other odors should bear this in mind when shopping for a Valentine’s Day gift. Seek those that are fragrance free and ask a pharmacist for advice if necessary. When do I consult with a medical professional about my migraines? “People should not leave a migraine untreated,” says Dr. Shevel. “It is imperative that you undergo a multidisciplinary investigation to diagnose the specific factors behind the recurring headache. “There are a number of healthier treatment options than medication available right here in South Africa. It is possible to get to the bottom of the problem and resolve the pain permanently without medication so that you can enjoy the quality of life you deserve.” He has the guidelines for when it is possible time to consult a medical professional: • If you are unable to manage your headache on your own. • If a headache persist or if you frequently get them. • If in interferes with your day-to-day activities.

February 15, 2019

HEALTHY EATING FOR A HEALTHY PREGNANCY

There’s nothing else quite like pregnancy to sharpen your focus on your health and well-being. The journey of carrying and nurturing new life within your body is an exceptionally special time, and moms-to-be are deeply invested in doing it as well as they can. Advice will inevitably come from all quarters, and it is important to tap into expert sources that will give you peace of mind that you are on the right track. The aim of Pregnancy Awareness Week this month is to help moms access the information they need to support a healthy pregnancy and safe motherhood. The Department of Health urges pregnant South African women to access antenatal care as early as possible in their pregnancies. This provides the opportunity to understand and manage any health issues, as well as get information on important factors such as self-care and nutrition. Once the pregnancy is confirmed by a nurse at a health facility, the mother can register for MomConnect, a free cell phone-based resource for accessing pregnancy-related health information. Nazeeia Sayed, a registered dietitian and spokesperson for ADSA (Association for Dietetics in South Africa), points out that good nutrition is vital as it supports a healthier pregnancy and a healthier baby. “Pregnancy is a great opportunity to get yourself and the family into the habit of healthy eating before the new baby arrives,” she says. “You don’t need special or expensive foods. A healthy diet during pregnancy is made up of foods that we commonly encounter when grocery shopping. A variety of fruit and veg, whole grains, legumes and lentils, dairy, plant fats and lean meats, fish and eggs can all be enjoyed while you are pregnant and will provide the nutrients you need.” What nutrients should moms-to-be focus on? Following a balanced diet according to the accepted healthy eating guidelines is the optimum nutritional route to support a healthy pregnancy. Pregnancy is definitely not the time for weight loss or fad diets that focus on particular nutrients at the expense of others. Registered dietitian and ADSA spokesperson, Cath Day says, “Energy (kilojoule) restriction during pregnancy is not recommended! High protein diets which increase ketone production are also not recommended as the foetus has a limited ability to metabolize ketones. It is much healthier for you to adopt a balanced diet with a good variety.” Nutrients such as folic acid, calcium, iron and protein are all important to the developing baby; however a balanced diet will, in most cases, meet these needs. Women enrolled in the government’s antenatal care programme will receive supplements of the essential micro-nutrients; and many women choose to supplement with folic acid to prevent the risks of Spina Bifida and cleft palate. Day points out that meeting protein requirements during pregnancy is as simple as ensuring that you eat roughly six servings or between 180 g- 210 g of protein each day (size of two palms or two decks of cards). One serving equates to 30 g lean meat or fish, 1/2 cup of legumes, 15 g nuts or one egg. “These are also the best sources of iron which is needed to prevent anaemia,” she says. “By eating fruit and vegetables high in vitamin C at the same time as eggs, nuts and pulses, you can enhance iron absorption from these foods.” Focusing on a variety of healthy foods for each meal or snack, rather than the particular nutrients, is what helps to ensure you and baby get what you need. Sayed says, “Some examples of this are choosing nutrient-dense meals or snacks like an omelette with veg, a fruit and yoghurt smoothie, a salad with raw veg, nuts or lean meat; or a cooked lentil dish with green leafy veg and rice.” What should moms-to-be avoid? Smoking tops the list of what shouldn’t be going into a pregnant body. While there’s debate about whether drinking one glass of wine is safe for a growing baby, many experts and governments around the world advise a complete avoidance of alcohol during pregnancy. Pregnant women should avoid foods with a greater risk for contamination with Listeria or other bacteria or parasites, including under-cooked meat and eggs, raw fish, processed meats and unpasteurised dairy and soft cheeses. Dietitians also advise avoiding fish that may contain high levels of mercury such as swordfish, shark, tuna steaks and canned fish brands that are not tested. Caffeine intake should be limited, and rather swopped out for decaf options, with water as your best beverage of choice. Foods that are high in salt, sugar and other refined carbohydrates should be limited as they crowd out the opportunity for you to eat healthy foods which provide for your vitamin, mineral and fibre needs. They can also lead to excessive weight gain which increases your risks of developing high blood pressure issues and gestational diabetes. Reach out and get help when you need it Healthy eating during pregnancy does not have to be complicated or a minefield. It might be more challenging for moms-to-be who need to make big changes; or who are overweight or managing other health conditions. A registered dietitian can be an important ally to come up with a healthy eating plan that suits your food preferences, your budget and your lifestyle. “The big advantage of using your pregnancy as the inspiration to eat well is that you can go on to become a healthy eating role model for your precious child, instilling healthy eating habits that can last them a lifetime,” Sayed concludes. To find a registered dietitian in your area visit www.adsa.org.za.

February 14, 2019

Why we should be testing our food for nitrates and GreenTest’s top tips for summertime healthy eating

Summer is here, and the holiday season is approaching with the promise of lots of outdoor fun and relaxation time. As we start to anticipate fun in the sun, lazy afternoon cricket games on the lawn with the kids and sharing cold slices of juicy watermelon around the pool; these happy musings are imbued with the expectancy of our glowing health. However, as we all know the good health of ourselves and our loved ones can never be taken for granted. There’s ever-increasing awareness that taking responsibility for our health is multi-faceted, and latest scientific research is continually alerting us to nutritional and environmental issues that we need to get to grips with to safeguard our families. We can thank latest technology solutions that this is becoming far easier to do for ourselves. Recently launched food safety device, GreenTest shows us that taking our health into our own hands does not have to be difficult and demanding at all. The range of lightweight, easy to use, award-winning nitrate detectors empower us to make better food choices in the moment. As Lila Bruk, a registered dietitian points out, South African consumers are becoming far more conscious not just of the nutritional value of the foods we eat, but of food safety issues as well. “With lifestyle diseases on the rise, it is becoming increasingly important for consumers to be able to test their own food so that we can not only choose nourishing foods but manage our future health and well-being. The ability to test nitrate and nitrite levels in our own food is significant and empowering for South African consumers.” Why we should be testing our food for nitrates Nitrates and nitrites are naturally-occurring compounds containing nitrogen. Nitrates are essential for plant growth and occur in differing amounts in most of our plant-based foods. Nitrites are typically used as a preservative in smoked and processed meats. At low levels, nitrates which are converted into nitrites once ingested, are generally harmless in the human body. However, at high levels, nitrates and nitrites are toxic to humans and animals. Higher concentrations of nitrates in food, especially in meat cooked at high temperatures, also pose the risk of the formation of nitrosamines which have been associated with various health risks, including some cancers. The International Agency for Research on Cancer lists ingested nitrate or nitrite ‘under conditions that result in endogenous nitrosation’ as ‘probably carcinogenic to humans’ (Group 2A). Concerns about nitrate levels present in our food have been growing over the past decades because of ever-increasing use of nitrate-based fertilisers in the conventional farming sector. Nitrates and nitrates are water-soluble and also leach into the ground. It stands to reason that we are likely to be consuming way more nitrates than previous generations, and this has raised concerns that we are at risk for nitrate toxicity and the formation of carcinogenic nitrosamines. The World Health Organisation (WHO) specifies that the acceptable daily intake of nitrate is 3.65 milligrams per kilogram of body weight per day, but up until now there’s been no way for the consumer to monitor this. GreenTesting your summer fruits GreenTest devices, launched in South African by food safety company, Alvarita provide an accurate reading of the nitrate levels in 64 different kinds of commonly eaten fruits and vegetables in a matter of seconds. Some models also test the nitrate levels of meat, fish and water. “The unique rapid analysis feature provides a green, orange or red result that informs you whether you can go back for more; should moderate your intake or rather just avoid a food for the sake of your health,” says Alvarita CEO, Damian Michael. “With GreenTest the power to make truly healthy food choices is conveniently in your hands.” GreenTest’s top tips for summertime healthy eating: As the days get hotter, it’s the ideal time for cooler eating. Focus on crisp salads full of fresh ingredients; swap dollops of heavy, starchy veg for light and tasty crunchy greens, and prioritise fresh fruit and veg as the premium snack options Upscale and diversify the ubiquitous red meat braai by creating equally delicious vegetarian, chicken or fish braai options. Actively reduce your nitrate intake by substituting more yummy, quick and easy plant-based foods for hot dogs, as well as cold and smoked processed meats Tip the scales in favour of fruit and veg at every meal – or at least make sure that half your plate is covered with salads and non-starchy veg. Shifting to more and more plant-based food options is a real investment in your future health. GreenTest your fruit and veg to keep track of your daily nitrate intake Yes, it’s the holidays, but still keep the treats in perspective. It’s okay to enjoy occasional treat food without feeling guilty, after all it’s the holidays and treats abound. Who wants to feel deprived when everyone else is indulging? It’s okay to occasionally enjoy rich or sugary foods; just keep them in balance. Serve yourself smaller portions of your favourite treats and take the time to savour each bite. Mindful eating increases pleasure and satisfaction while keeping you finely attuned to your body’s real needs and comfort zone Walking on sunshine – Daily physical activity goes hand in hand with healthy food choices. The summer holiday provides plenty of opportunity to get up and moving for a minimum of 30 minutes each day. Long, sunshiny days are ideal for family bike rides, hikes and other fun physical activities

February 9, 2019

Listen Up! What’s the big deal with childhood hearing loss?

Hearing is one of the most important senses. Through hearing we learn how to communicate with others, we experience the joy of music, the excitement of laughter, the symphony of nature and the bustling sounds of the city. Hearing also protects us, it alerts us to approaching danger and keeps us connected to the outside world. According to the World Health Organization, about 466 million people have disabling hearing loss, 34 million of these are children. Hearing loss is the most prevalent birth defect and every day 17 babies are born in South Africa with some degree of hearing impairment – half of which have no known risk factors for hearing impairment. In the past, majority of children who were born with congenital hearing loss were only identified at about age 2 when they were not reaching their speech and language milestones. Research has demonstrated that children who are diagnosed with hearing loss and have the appropriate intervention by 6 months of age, will have speech and language milestones comparable to that of a normal hearing child by age three years. What are the causes of hearing loss in children? Congenital Hearing Loss This means that the hearing loss is present at birth. Congenital hearing loss is either caused by genetic or non-genetic factors. Some non-genetic factors include: Birth complications, including the presence of herpes, rubella cytomegalovirus, toxoplasmosis or another serious infection, lack of oxygen or the requirement of a blood transfusion for some reason. Premature birth. Babies that have a birth weight of less than 1.3 kilograms or that require certain life-sustaining drugs for respiration due to prematurity are at risk for hearing loss. Complications with the Rh factor in the blood A nervous system or brain disorder. The use of ototoxic medication by the mother during pregnancy. Ototoxic medications are not usually illicit substances – medications like various antiobiotics Maternal diabetes. Drug or alcohol abuse by the mother or smoking during pregnancy. Genetic hearing loss means that either the gene for hearing loss was inherited from the parents or that the child presents with a genetic illness commonly associated with hearing loss. Acquired hearing loss A child with acquired hearing loss is not born with a hearing loss but rather acquires the hearing loss due to one of many factors. Factors include: A perforated eardrum Infections like meningitis, measles, mumps or whooping cough Taking ototoxic medications A serious head injury Exposure to loud noise, causing noise-induced hearing loss Untreated or frequent otitis media (ear infections) What signs and symptoms should I look out for in my child? When a child does not turn his/her head towards a sound, especially a loud sound When a child frequently touches or pulls one or both ears When a child reacts to some but not all sounds When a child turns their head upon seeing you, but not when their name is called from outside their field of vision Does my child have difficulty following instructions Does my child ask for instructions to be repeated When a child has delayed speech and language development. If the answer to any of the following is “no”, then your child may have delayed speech and language development: Is my child using single words such as “dada” and “mama” by the age of 1? Is my child using 2-word sentences by the age of 2? Is my child using 3-word sentences by the age of 3? Is my child using understandable 4-5 word sentences by the age of 4? When should I test my child’s hearing? Most private hospitals and some government hospitals have audiologists who assess the babies hearing soon after they are born. Generally, this is an optional service so it is a great idea to opt in for the screening. The audiologists use an OAE (Oto-acoustic emissions) or an AABR (Automated Auditory Brainstem Response) machine. The test generally takes a few minutes and requires no response from your child. The Audiologist will be able to tell you if your child’s hearing is normal or if further testing is required. Even if you don’t feel like your child has a hearing loss it is important to have your child’s hearing tested once a year much like testing their eyesight! What happens if my child has a hearing loss? If your child is diagnosed with a hearing loss the Audiologist will guide you through the process. Depending on the cause, degree and configuration of the hearing impairment, the audiologist will either refer your child for further medical treatment or recommend hearing aids and perhaps a further evaluation for a cochlear implant. Your child will also require intensive speech and language therapy in order to catch up to his/her developmental milestones. The later a child is fitted with amplification the poorer the prognosis is for the child. Early intervention is of the utmost importance, we live in a an incredible time where even children with a profound hearing loss can have access to sound again and become integrated into society with ease. Be sure to contact a qualified Audiologist, if you would like to have your child’s hearing screened.

February 8, 2019

Baby’s Skin Care – What You Need to Know

It is our instinct to nourish and protect our babies. As caring mothers, we would never knowingly expose our precious babies to harmful chemicals and artificial nasties. Yet sadly these ingredients are all too common in many conventional baby toiletries. A baby’s skin is approximately three times thinner than our own skin, which means that any chemicals or irritants your baby is exposed to will absorb into their system faster and increase the risk of adverse reactions and toxicity. The most common chemical nasties Mineral oil Mineral oil is the primary ingredient in conventional baby oil products – Conventional baby oil is essentially made of mineral oil mixed with artificial fragrance, which is a nasty combination. Mineral oil is a cheap by-product of petroleum processing and acts as a “plastic wrap” on the skin, inhibiting the skin’s ability to release toxins. It is also a non-renewable and environmentally unfriendly resource. The best way to go is to treat your baby’s delicate skin with natural plant-based oils, such as our Cherish Baby Massage Oils. All our oils are made with 100% natural ingredients, organic wherever possible, and stored in amber glass bottles (kinder to the environment and will not leach chemicals into the product). Our Baby Massage Oils are made with: *Coconut oil – a superb skin moisturiser and helps to replenish and protect dry, damaged, chapped, cracked and irritated skin Sweet Almond oil – naturally rich in Vitamin E, monounsaturated fatty acids, proteins, potassium and zinc and is excellent for keeping skin soft and supple *Jojoba oil – Improves elasticity and suppleness, helping the skin remain hydrated, moisturised, soft and smooth Vitamin E oil – an excellent antioxidant that protects and repairs skin and guards against free radical damage *indicates organic ingredient We have three variants to choose from – *Lavender, *Mandarin or fragrance-free. Our products are fragranced with 100% natural essential oils, using organic oils wherever possible. Lavender and Mandarin essential oils both offer calming and relaxing properties and are great to use on little ones before bed time. For particularly sensitive babies we offer a fragrance-free version, which contains no essential oils, but still has all the goodness of the other oils. Fragrance Fragrance is added to countless products, either to create a particular smell or to mask the odour of the nasty chemicals used in production. The problem with fragrance is that it’s a catch-all term for whatever secret ingredients companies wish to add (companies are not obligated to reveal what’s included under the term “fragrance” or “parfum”). These ingredients are often coal- and petroleum-derived synthetic chemicals. The effects of fragrance are long lasting, lingering on the skin for hours, and can cause respiratory, neurological, skin, and eye damage. There is evidence that exposure to artificial fragrance chemicals as a child may lead to asthma. Unless the product you’re buying expressly states that the fragrance is derived from natural sources / essential oils, it’s probably not natural, and can have severe harmful side-effects, especially to babies. All Cherish Baby Products are scented using 100% natural essential oils, and we use organic oils wherever available. Parabens Parabens (methylparaben, ethylparaben, butylparaben, isoparapben, etc.) are a class of synthetic preservatives often used in cosmetics and skincare products to prevent bacterial and fungal growth. Parabens are hormone disruptors and can wreak havoc on oestrogen levels. Parabens are extremely common chemicals and can be found in soaps, body washes, shampoos, and moisturizers, including those marketed toward babies. Parabens are neurotoxins and are linked to skin irritation. It is best to opt for products that do not contain preservatives, such as our Cherish Baby Balm Range Our range of balms are 100% natural and free from petroleum, mineral oil, zinc oxide, phthalates and parabens. Cherish Balms will soothe and hydrate delicate skin and help treat diaper rash, cradle cap and other minor skin irritations. Formulated with specially selected moisturising oils and calming herbs to nurture and protect sensitive skin. Our balms include: *Cocoa butter – forms a protective layer on the skin and locks in moisture Coconut oil – a superb skin moisturiser and helps to replenish and protect dry, damaged, chapped, cracked and irritated skin Sweet Almond oil – naturally rich in Vitamin E, monounsaturated fatty acids, proteins, potassium and zinc and is excellent for keeping skin soft and supple Calendula oil – has antiseptic, antimicrobial and anti-inflammatory actions. It helps to speed healing and soothe irritated skin *Jojoba oil – improves elasticity and suppleness, helping the skin remain hydrated, moisturised, soft and smooth Vitamin E oil – an excellent antioxidant that protects and repairs skin and guards against free radical damage *indicates organic ingredient Our Baby Balms come in the same three variants as the Baby Massage Oils and Natural Baby Body Wash, so you can create your own nurturing set! Sodium Lauryl (Laureth) Sulfate Also known as sodium dodecyl sulfate, sodium lauryl sulfate, laurilsulfate, SDS or SLS, this ingredient is an economical surfactant that removes oil and is a foaming agent. It is commonly found in shampoo, soap, cleansers, bubble bath, toothpaste, mouthwash, body wash, and most products that foam. It is also found in industrial strength detergents and engine degreasers. It may contain 1,4-dioxane, a known carcinogen, and ethylene oxide, a chemical known to harm your nervous system. SLS has a comedogenic rating of 5, which means it has a high probability of clogging pores – it strips the skin of oils, which can cause the skin to over compensate and produce excessive sebum – not ideal in a skincare product! Our Natural Baby Body Wash range is free from SLS and other harsh chemicals, and has been especially formulated using naturally derived ingredients to be as gentle as possible on baby’s delicate skin. Our Natural Baby Body Washes come in the same three variants – Lavender, Mandarin and fragrance-free. The long-term effects of chemical additives in baby skincare products are not always known. But researchers believe our little ones are at higher risk of

February 7, 2019

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