Expert Advice from Bonitas Medical Fund
Bonitas – innovation, life stages and quality care

The low down on Covid-19 test protocols

As South Africa finds itself starting to move out of the second wave of a Covid-19 outbreak, over 8 million Covid tests have been carried out in the public and private sector since the start of the pandemic. The global gold standard method to diagnose Covid is the Reverse Transcription Polymerase Chain Reaction (RT-PCR) test. It is currently the most accurate way to detect SARS-CoV-2, the virus that causes Covid-19.  Will your medical aid pay for the test? According to Lee Callakoppen, Principal Officer of Bonitas Medical Fund, ‘Funding is in accordance with the Council for Medical Schemes (CMS) guidelines, all clinically appropriate and referred diagnostic testing for suspected Covid-19 cases will be funded as a Prescribed Minimum Benefit (PMB) condition.’  Bonitas pays for up to three Covid-19 diagnostic tests from risk, whether the result is positive or negative.  However, this is subject to the member or beneficiary being referred by a registered healthcare practitioner (doctor or nurse). This referral is dependent upon whether the member is showing symptoms, has been in contact with anyone who has Covid-19 and prior to hospitalisation.  It should be noted that laboratories will not normally accept walk-ins for testing and require a referral or request from a healthcare practitioner. This is to ensure that we don’t test unnecessarily and jeopardise the availability of these tests for those who really need them. ‘Despite the PCR being arguably the most accurate laboratory methods for detecting, tracking and studying the Coronavirus, there are limitations in its widespread use,’ says Callakoppen. ‘These include: Access to the test kits; the complexity of performing them; the need for specialised staff to administer them; potential global shortages; high costs; the requirement for laboratory equipment and the delayed turnaround times. For this reason, testing should only be done when it is clinically necessary.’ What about Rapid Antigen Tests Immunoassay devices that detect the SARS-CoV-2 antigen within 15-30 minutes have also been promoted as a possible solution when access to PCR tests is a challenge. An antigen – detected in the blood or any other fluid – is any substance that makes the immune system produce antibodies. Viruses and bacteria are antigens.  However, these tests are not as accurate as the PCR tests and have shown variable performance during evaluations, with sensitivities ranging from 0 to 94%. Test specificity has been high, but sensitivity has been erratic, which we need to bear in mind. Why is specificity and sensitivity critical?  Sensitivity is the percentage of true positives (e.g. 90% sensitivity = 90% of people who have the target disease will test positive). Specificity is the percentage of true negatives (e.g. 90% specificity = 90% of people who do not have the target disease will test negative). These allow you to rule conditions in or out but not definitively diagnose a condition. What does the Council for Medical Schemes (CMS) say? The CMS currently still advocates the PCR test to diagnose Covid-19. The World Health Organisation (WHO) has also previously advised that the role of these rapid antigen tests must be evaluated and are “not currently recommended for clinical diagnosis pending more evidence on test performance and operational utility”. However, the WHO has now approved the use of antigen tests (and this is the South African approach as well) as an alternative to the more expensive PCR tests. This is however, in certain defined scenarios such as testing confirmed people in communities where infections have been detected, screening of high risk groups and individuals and for contact tracing purposes. They have also provided conditional recommendations for the use of these tests such as screening at ports of entry, routine screening for employees at their place of work, schools, prior to certain urgent medical procedures, etc. The challenge with these tests is that they are most accurate in patients between 5 and 7 days after showing symptoms – therefore the timing of testing becomes critical in order to ensure accuracy of the result. What about Rapid Antibody Tests? Many countries, including South Africa, are using antibody or serology tests such as the ones offered at various drive-throughs. These can detect whether someone has previously been infected and estimate how widespread the infection is but they are not recommended for diagnosis of Covid-19.  For this reason, these are not funded by Bonitas Medical Fund as the use for these tests is limited for purposes of government surveillance and research rather than diagnosing Covid-19. If individuals want to know whether they have previously had Covid-19, for their own information, this test would be able to confirm that – but it is not used to identify whether you currently have the infection. If these tests are done too soon after the infection, they produce incorrect results as the antibodies (IgM and IgG) will not be detectable. There is also no scientific evidence that it provides any immunity to another Covid infection.  ‘What is clear is that laboratory testing plays a vital role in the diagnosis and the prevention of the spread of the virus,’ says Callakoppen. ‘Nevertheless, it is important to understand that the timing and correct use of the different types of tests is crucial to gain the best results. We reimburse up to three PCR or rapid antigen tests done in or out of hospital for our members and recommend that this protocol for testing remains, until further research is conducted and evidence provided.’

Bonitas – innovation, life stages and quality care

Pregnancy and Medical Aid

Motherhood and pregnancy are times of great anticipation and joy. Each experience is unique but what is probably high on the agenda is that you have a trouble free pregnancy, a healthy baby and then know and anticipate the cost involved for pre-natal check-ups and the birth.  ‘Choosing the right medical aid is critical in ensuring the healthcare needs of you and your loved ones are taken care of. More so, when you’re looking at expanding your family. For those who are on a medical scheme or wish to join one, here are some important points to consider when you fall pregnant,’ says Lee Callakopen, Principal Officer of Bonitas Medical Fund. When you are already a member of a medical aid scheme When should you advise your medical aid of your pregnancy? If you are already a member, you can access the out-of-hospital maternity benefits without advising your medical aid that you are pregnant. However, please ensure that your doctor uses the correct ICD-10 codes on your claim to ensure that it is processed correctly. Bonitas pays for maternity benefits in addition to savings and day-to-day benefits, which help members get the care they need during pregnancy while limiting out-of-pocket expenses. Remember that pre-authorisation is needed for the delivery of the baby, which can usually, be done from 20 weeks onwards. Pre-authorisation will help you understand the benefits you have available on your plan and ensure that you are aware of what is covered. Bonitas members can also register for the Bonitas baby bag once pre-authorisation is obtained. The baby bag is packed with of useful goodies for the baby to make parenthood a little easier. When do you advise the medical aid that your baby has been born and needs to be added onto your medical aid? For our members, the baby needs to be registered within 30 days from the date of birth to ensure there is no break in cover and that your child will be covered from the first day of life. Are there Designated Service Providers (DSPs) in terms of gynaes and hospitals for childbirth?  We strongly advise members to use DSPs to get maximum value and avoid co-payments. We agree special rates with these providers, which are covered within a member’s benefits so that they can focus on taking care of their health and wellbeing during pregnancy. What is normally covered in the maternity benefit? This differs from scheme to scheme and according to the plan you are on. Bonitas pays for up to 12 maternity consultations (paid for from a separate benefit), an amniocentesis, antenatal classes, 2x 2D ultrasounds and the delivery. In addition, there are additional benefit for newborn hearing screening tests and childhood vaccination.   Does Bonitas cover the cost of a Caesarian birth? Yes, medically necessary Caesarians are covered on all plans.  Some expectant mothers do prefer home births – is this covered? Yes the cost for a home delivery is covered.   Are all the childhood vaccinations covered by Bonitas and if so, are there any conditions attached ie where the vaccinations should be done? Vaccines are covered as per the EPI schedule on immunisation. Please note this benefit is available on specific plans. The vaccines can be done at any clinic or pharmacy. If an administration fee is charged by these providers, it will be paid from your savings or day-to-day benefits.  The vaccines covered are as follows: The Bonitas Babyline – a dedicated children’s health advice line In 2016, Bonitas introduced Babyline – a 24-hour children’s health advice line manned by paediatric trained registered nurses.  They are on the other side of the phone to assist with any parental concerns, vaccination schedules and health related issues, 24/7, 365 days of the year.  How does Babyline work? Bonitas parents, or their caregivers, simply call the Babyline number on 0860 999 121 to speak to paediatric trained nurse.  Through a series of questions asked regarding the health issue, parents will be provided with professional advice on what to do next. Depending on the symptoms, the advice might be to head straight to the ER or to see a doctor or specialist.  The nurse will advise which healthcare provider is the most appropriate, given the health issue. The services offered by the Babyline include: Home care advice Clinic/primary care/GP referral for the same day Clinic/primary care/GP referral for the following day After-hours care within the next six hours Immediate referral to the ER The Babyline service is available to members across all the Bonitas plans, for children under 3 years. Joining a medical scheme when you are already pregnant It is very common for women to apply to join a medical aid scheme when they fall pregnant. But according to the Medical Schemes Act 131 of 1998, medical aid schemes are entitled to impose a 12-month condition specific waiting period for any pre-existing medical condition, such as pregnancy. These waiting periods must be imposed for specific pre-existing conditions to protect the interests of current members of the scheme. When a waiting period is applied to pregnancy, then the pregnancy and birth will not be covered but your baby will be covered from the first day of life – if you register them on your medical aid within 30 days. This will allow you to ensure the needs of your child and the healthcare will be covered.  Bonitas has different plans and expectant mothers will be able to select the one most suitable for their needs.   Informing the medical aid of your pregnancy Prospective members need to inform their medical aid upon application or within 30 days after you complete the application. What is the policy regarding a member joining Bonitas when they are pregnant? What sort of cover can they expect, if any? The pregnancy would be considered pre-existing and therefore not covered. The baby will be covered if registered within 30 days post-delivery. What happens if someone signs up for medical aid not realising they are already pregnant? At what point is

Bonitas – innovation, life stages and quality care

What vitamins and minerals are needed during pregnancy

As an expecting mom you’ll want to do your best to make sure that your baby is as healthy as possible. What you eat is critical during this time, as everything your baby needs comes from you. Prenatal vitamins are supplements which can be taken during pregnancy which contain needed vitamins and minerals. What vitamins and minerals are essential and why?  During pregnancy your vitamin and mineral needs will change as you now have a growing baby to provide for. Your food should contain much of the vitamins and minerals needed during pregnancy, particularly if you are already following a healthy, balanced diet. Folic acid and iron are typically found in most prenatal vitamins and are essential in a healthy pregnancy. Folic acids helps to prevent neural tube defects and iron supports healthy growth, helping prevent anemia and  blood (in both mom and baby) carry oxygen Vitamin D, calcium and iodine are other important nutrients that are needed during pregnancy. Vitamin D aids in the development of the bones, teeth and nervous system, calcium helps bone and teeth development and iodine is important in brain development. Getting the correct micronutrients is important. Deficiencies can lead to complications such as hypertension and a low birth weight. However, it’s also important not to exceed the healthy amount of certain vitamins and minerals – too much vitamin A, for example, can cause birth defects. What foods should I be eating? Prenatal vitamins are a good idea to cover any nutritional gaps you may have, while they may supplement your diet they don’t replace a healthy lifestyle. Therefore, eating correctly also greatly benefits you and your growing baby. Foods you should try include in your diet are dairy products, such as milk and yogurt, as they contain extra protein and calcium, as well as probiotics. Legumes, such as lentils and soybeans are another good food to include – these contain protein, fibre and folate (which is very important during pregnancy). Sweet potatoes, high in vitamin A and fibre, are another good veggie to add to the shopping list. Eggs, broccoli, lean meat and berries are other wholesome foods you should be including in your diet. A healthy pregnancy benefits both you and your baby in the long run, not only does it ensure that you deliver a healthy baby, but helps your child throughout adulthood development.

Bonitas – innovation, life stages and quality care

Working and pregnancy – when to stop and how much is enough

As an expecting mom with a career you may be wondering when the best time would be to stop working and how you can stay comfy and productive when you are still in the workplace. Morning sickness, back pain, frequent bathroom breaks and other pregnancy related symptoms can make working as you used to a more challenging task for you. It’s important that you calculate the risks that your job could possibly have to you and your baby. For instance if you are working with chemicals, heavy metals or radiation you’ll need to either stop working or take extra precautions. Heavy lifting or labour intensive jobs and lots of travel for work are also jobs that’ll become more difficult as your pregnancy progresses. Desk work and computer work are generally regarded as safe, whereas jobs that require lots of standing will become more difficult in later pregnancy. Dealing with work and pregnancy Working can be stressful without having a growing baby in your belly. The physical and emotional changes that you experience can make meeting your body’s and workplaces’s demands a challenging task. However, some moms with healthy pregnancies are able to work almost until they go into labour, how much you can do will depend on your pregnancy. Morning sickness is something many moms have to deal with. There are ways you can help manage nausea at work. Avoiding dining areas, packing mouthwash and a toothbrush and packing in soothing lemon and ginger are all things you can do to make yourself more comfortable. Eating and drinking little and often can also help keep the nausea at bay. Be sure to dress comfortably, and try to take frequent breaks and walks, as this’ll also help you stay more comfortable. What rights am I entitled to as an expecting mom in South Africa? As a pregnant employee, you are probably wondering what rights you’re entitled to. It is a good idea to inform your employee as soon as you can, so that your employer can manage the situation as best as they can (for both of you) – they are required by law to maintain a work environment that is safe for their employees. As an expecting mom, you will be glad to hear that you’re well protected  under South African law – you may not be discriminated against or dismissed due to your pregnancy. You also have the right to four consecutive months unpaid maternity leave, anytime from four weeks before your expected birth date. Unfortunately employees are not obligated to pay you during this period, however, your job will be kept open for you until your return to work after maternity leave.

Bonitas – innovation, life stages and quality care

Travel tips during Covid-19

With the increasing number of local Covid-19 cases – over 10 000 in the past 24 hours – we need to be mindful that the pandemic is not on vacation. The statistics are worrying.  South Africans need to shake off their Covid-fatigue and get back to making informed choices about their wellbeing and adhering to the protocols: Wear a mask when you leave your home, sanitise and socially distance – if we want to flatten the second wave curve, especially over the holiday season. We have also been asked to remember the 3 Cs: Avoid crowds, confined spaces and close contact. Bonitas Medical Fund, says, ‘Internationally many countries are reinforcing lockdown rules as the cases spiral, with reports too of coronavirus symptoms changing. Some medical practitioners are also saying the second wave is even more dangerous than the first.   ‘Over the past month, within our membership community, we have seen an increase in the number of tests, the percentage of positive results, people requiring treatment and those being hospitalised. Through our free virtual consultations we have noted an increase in non-members consulting with doctors around the pandemic, with our call centre load having also increased.’ Here are some tips for travel during the festive season whether within our borders, to neighbouring states or abroad. Medical aid card Remember to carry your medical aid card and details with you.  In the case of an emergency, it will streamline the process of getting care quickly or being admitted to hospital. Bonitas also advises that you put the Covid-19 emergency hotline (0800 029 999) or call centre number (0860 002 108) into your mobile phone so it is at hand. Virtual consultations Bonitas continues to offer free virtual consultations to all South Africans – not just its members – until 31 December 2020.  If you are on holiday and concerned about your health, download the Bonitas Virtual Care App and make an appointment. The doctor will engage with you in a virtual video consultation wherever you are. The consultation includes any medical issue, Covid-19 or unrelated and advice on the most clinically appropriate steps for further care. These consults are available 24/7.  Sanitise, sanitise, sanitise Pack your own soap and sanitiser.  The hospitality industry has stringent health and safety protocols in place and most establishments have enhanced their deep cleaning regimes. However, it is still recommended that you keep your sanitiser with you always.   If you are taking a road trip, make sure you have waterless soap and sanitiser in the car and limit your pit stops without compromising on taking the necessary rest breaks. Perhaps pack a picnic, to avoid crowded fast food outlets and restaurants on the main routes. Travelling internationally Remember that if you are leaving the country and crossing a border you will need to produce proof of a negative Covid-19 test and will also complete a travel health questionnaire.  Minister of International Relations and Cooperation, Dr Naledi Pandor, has warned South Africans travelling abroad to make sure they know what the respective countries’ Covid-19 protocols are to avoid being stranded – various countries have different protocols and some have also introduced new stricter lockdown measures. She has urged travellers to familiarise themselves with the immigration and health entry requirements of the country they are visiting, as well as South Africa’s re-entry health requirement upon their return. If you are uncertain, contact the local embassy for clarification or the Department of Health. Alert your medical aid It is important that you notify your medical aid scheme ahead of any international travel. Firstly, to check what medical conditions will be covered and, secondly to activate the international medical travel cover.  Travel insurance policies Medical expenses that you might encounter when travelling in Africa or other international destinations can be prohibitively expensive.  To avoid having your holiday and finances totally ruined, look at what your current medical aid scheme offers in terms of medical travel cover and, if necessary, top this up with additional travel insurance.  Carry your policies Travel insurance policies give detailed information about what to do in an emergency situation and have international call centres to assist you. Make sure everyone in the family has these numbers handy.   The claiming process  Most medical insurance requires an invoice as well as the proof of payment or receipt in order for them to reimburse you.  Make sure you are familiar with the claim process. ‘One thing 2020 has taught us, is that life is unpredictable.  And although additional, tougher lockdown regulations were recently announced in an effort to curb the second wave of Covid-19 infections, the burden of responsibility remains with each and every one of us,’ says Bonitas.  ‘There are real concerns around the current rate of transmission, not only in South Africa but globally.  In order to minimise your risks and to stay healthy and safe these holidays we all need to do our bit and stick to the protocols.’

Bonitas – innovation, life stages and quality care

Birth injuries

You only want the best for your baby, but sometimes harm comes to them unintentionally. During the birthing process, your baby can experience harm or physical injury; this is known as a birth injury.  Birth injuries are not uncommon, sometimes they are temporary and other times they may affect your baby for a lifetime. But what exactly are birth injuries? And what causes them?  What are the chances of my baby getting injured during birth? Birth injuries range from harmless to serve, either quickly healing or causing disability throughout life. Although significant injury or death during the birth process isn’t as likely, birth injuries are not uncommon – according to the Birth Injury Guide, about 29 in 1000 babies suffer a birth injury of some kind. Why would my baby become injured during the birth process? There are several reasons why a baby can experience physical trauma during the birthing process.  When you near the end of your pregnancy your baby moves into position for delivery, sometimes babies will move into an abnormal position, such as a breech (feet first), and this can cause them injury when they are born. Other reasons why baby’s may become injured during birth is being abnormally large, the mother’s pelvis is too small, or a long and difficult labour, where the mother’s contractions aren’t strong enough to push her baby out.  What happens if my baby has a birth injury? Generally, birth injuries affect the babies head neck and shoulders, as babies are generally born head first. There are a variety of injures that your baby could stain from birth trauma, such as bruising of the scalp, broken bones or brain damage. Sometimes these injuries are temporary and other times they can last a lifetime. Your doctors and midwives will assess the damage to your baby and help you and your baby accordingly.  Sometimes babies will sustain trauma during birth, and the injury won’t be noticeable until they have started school or being missing developmental milestones, as they struggle to mentally keep up with their peers or grow at what is considered a normal rate.  Sadly most birth injuries aren’t preventable, but even so, moms whose babies experience birth injuries often feel guilty and angry, as if they are too blame. Although feeling this way is understandable,  this is not the case and if you are feeling this way after your baby has experienced a birth injury it is best to speak to a health professional and reply on your partner, friends and family for support. 

Advice from the experts
Parenting Hub

Why nutritional supplements taste so good

Taste is highly personal. Think back to the last beverage you ordered. Maybe it was tea – and you were asked if you would like it served hot, iced, sweetened or unsweetened; with lemon or milk. In general, such decisions are influenced by your culture, your location, past experiences and even by your current state of health. “Nutritional products such as Ensure® have important health benefits however the taste of the product plays a critical role in the delivery of the nutrition,” explains Monica Tortorice, a senior flavour scientist at Abbott. We all know that sometimes making healthy food taste great is not as easy as it sounds, same as balancing the nutrients consumers need with the taste they want is a process on its own. This is exactly why Abbott puts flavor, texture and aroma first in every product it makes but also ensuring that products meets the therapeutic nutritional needs of their consumers. “The more nutrient-dense a product is, the more challenging it is to make the aroma and taste appealing,” says Tortorice. “Important ingredients like HMB (also known as beta-hydroxy-beta-methylbutyrate) is found in Ensure® NutriVigor, which helps in supporting muscle health. HMB on its own doesn’t taste that great however we need to include this ingredient to provide consumers with the muscle health support they need. These are primary considerations we take in our development process.” “It’s even trickier making products for people who are ill,” says Normanella DeWille, PhD, a research fellow and product developer at Abbott. “People who have cancer often have their sense of taste impacted. Everything tastes or smells different. At Abbott it’s our job to intensify certain flavour elements and sweetness levels to ensure our nutritional supplements are enjoyed by patients whilst they get the critical nutrition they need.” Starting with the best ingredients and processing techniques Behind every one of our products is a great recipe and quality ingredients. That’s why the Abbott team first sources the best ingredients by partnering with high-quality farms and trusted suppliers. “We look at each ingredient closely for its quality and the benefits it brings to our products,” says Normanella DeWille, “For example, our years of research tells us that combining proteins from milk as well as those from plants gives our products the smoothest mouthfeel possible, which has a huge effect on overall taste and experience.” The processing of these ingredients also matters. For example, exactly how protein is extracted from milk to produce milk protein concentrate affects taste and texture. We find that milk protein concentrate is a key ingredient in a wide range of complete nutrition products including Ensure® and PediaSure®. “If the protein is extracted in a harsh manner, for example through the use of excessive heat, there can be an impact on overall taste and texture,” said DeWille. Therefore, our scientists only work with suppliers that use gentle methods of extracting that protein. Minimizing undesirable tastes If you’ve ever turned up your nose at a piece of pungent fish, you’ve smelled exactly the sort of obstacles flavour technologists are up against in making nutritional products taste great. After all, some of Abbott’s products, include fish oil for omega-3 fatty acids, which play a valuable role in overall health and healing. And while fish oil can taste and smell fishy all on its own, once it oxidizes (reacts to oxygen), that smell gets even stronger. “Fortunately, through a lot of research, we’ve been able to find an antioxidant blend that prevents fish oil from oxidizing,” says DeWille. She explains that, when combined with rosemary extract through Abbott’s pending patent on the technology, those antioxidants help scientists get fish oil into their nutritional drinks and still taste great. The end benefit; your loved ones get all the nutrition they need and a great taste.Tapping into favourite flavours around the world Once a product’s nutritional base is made, it’s up to flavour scientists to turn that base into a nutrient-laden treat, so to speak. Fortunately, Abbott scientists have been perfecting their flavour technology talents for 30 years. While some flavors are universally appealing – chocolate, strawberry and vanilla are popular worldwide, whereas some countries have their own unique flavour preferences. So how do those global tastes play out within Abbott products? For example, mushroom and chicken soup are popular flavours for Ensure® in the United Kingdom. Also, wheat and green tea are loved in China and a special saffron almond flavour is popular in India. Once Abbott identifies preferred flavours and flavour combinations, Abbott scientists are able to dig into them to determine the best way to apply them to nutritional products for that specific market. The products then provide the nutrients that children, moms and adults need daily with different flavours that make drinking the nutritional shake exciting and delicious. Ensure® NutriVigor, Similac Mom® and PediaSure® are available at major retail pharmacies and retail outlets nationwide.

Clamber Club

Empower your child

Notice your feelings when your child challenges you. We live in a different world today. What may have worked then may not be relevant today. “With the increase of mental health problems, higher occurrences of suicide amongst the tweens and teens and more depression and anxiety experienced by children it goes without saying that parents feel overwhelmed and not always on top of their game,” says Anna Rodrigues Clamber Club Expert and Play Therapist. Playing is a child’s language and can be interesting. As much as they learn from us we too can learn from them. “Children live in the moment, they live in the here and now and the time you spend with them makes a difference to their overall well being,” says Anna. “By playing with your child you are connecting on a physical level and when you start mentioning feelings, connection on an emotional level happens,” adds Anna. During play stating to your child that you are feel happy playing with him and that you are feel excited when you are jumping, dancing and crawling with him makes him feel special and important. When you smile at him, give him a hug and tickle him – you make him feel worthy in that moment. As the parent you become more attentive to your child and realise the time together is magical! There are reasons why children present with challenging behaviour. They may be looking for your attention. They may want to control you and enter into a power struggle with you or they may want you to feel sorry for them or make you feel guilty. This is the moment to notice your feelings. Scene 1: Your child refuses to feed his dog but with a bit of encouragement he gets in and does it. But on another occasion your child persists relentlessly and does not cooperate. Be conscious of your feelings. If you get irritated or annoyed your child could be looking for attention. A way to deal with this would be to reflect on content and feeling. For example: “I see you continue to play and you seem to ignore what I am asking you to do. (Reflect on the content). Perhaps you are feeling a bit tired?” Reflecting on what your child is doing or on what he may be feeling makes him feel he is being understood and this is calming for your child. “This approach may influence him to cooperate,” advises Rodrigues. Scene 2: Your child makes a noise while you and your husband are trying to watch TV. Take note of what you are feeling, you may be getting cross and a power struggle may start to form. The technique to use is to present your child with choices. For example: “You are making a noise and we can’t hear the TV. You can stay and play quietly or we can take you to your bedroom where you can play loudly.” If he continues to make a noise then take him to his bedroom and let him return when he is able to play quietly. Providing your child with choices is empowering for him as it allows him to choose. It also builds a sense of responsibility, as how he chooses to behave will determine whether he stays in his bedroom or plays besides his parents. Scene 3: You are a single parent reading a bedtime story to your 5 year old. Your child says “ Dad reads nicer stories.” You feel this is hurtful and your child may want you to feel bad or guilty because she may be angry being away from her dad. Reply by reflecting on her feelings, “I bet you wish dad were here, I feel sad for you. Maybe you can help me choose a bedtime story every night.” To recap: Your feelings Intention of your child’s challenging behaviour Technique to use You feel annoyed/irritated. Your child looking for your attention. Reflect on what your child is doing and feeling. You feel cross. Your child is looking at controlling or entering into a power struggle. Provide your child with choices. You feel hurt. Your child is wanting to take revenge or make you feel guilty. Reflect on your child’s feelings.   In managing your child’s challenging behaviour you are building his character. You want your child to have a sound moral make-up, to be able to love, be responsible and have empathy for others, to be able to solve problems, deal with failure and perform under pressure. William A Ward once said: “ The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates and the great teacher inspires” “You that you are your child’s first teacher, so be the AMAZING teacher,” says Anna.

Impaq

Bullying: What parents and schools can do

ARTICLE BY PROF RITA NIEMANN, NALIZE MARAIS, ZENDRÉ SWANEPOEL AND MONIERA MOOSA Bullying is a great concern for both parents and schools. Here we outline a number of measures that can help them both parties deal with bullying. Parents When parents notice that their child is behaving differently – not wanting to go to school, using illness as an excuse, suddenly performing poorly at school or enuresis – and suspect bullying, they need to act immediately. Firstly, they must determine where this is happing (at school, at a sports club, on social media, etc.) and who the perpetrator(s) are. Secondly, if the bullying is taking place in an organised environment such as at school or sports club, the authorities need to be informed and requested to step in. They are legally bound to protect the rights of the child. Thirdly, parents have the responsibility to equip their children to cope by: Instilling the knowledge that children must take a stand and that they have a choice in allowing someone else to victimise them. Assisting children to terminate relationships that are potentially harmful, such as blocking a person on social media. Helping them to identify bullies and the different forms of bullying. Creating a safe space for children to speak about what is happening to them. Emphasising assertive verbal communication if threatened. Building children’s self-concept. Getting the help of a psychologist, if necessary, to counsel the victim. Emphasising that respectful behaviour is always the best option and thus preventing retaliation. Fostering problem-solving and conflict resolution skills with the focus on restoring damaged relationships. Working collaboratively to solve the problem with their children so that they can feel reassured. Schools As bullying is a deliberate act to hurt someone, there must be consequences for the bully. Once teachers are aware that a bullying incident has taken place at school, the matter must be dealt with by: Asking the victim to provide the names of the perpetrator(s), as well as the names of friends of the victim, as soon as he/she has calmed down. Counselling the victim and finding out whether he/she has been injured and what effect the bullying or harassment has had on him or her. Cultivating a “no blame” approach towards bullying or harassment. Establishing punitive sanctions for both the bully and for any bystanders. Developing a bullying code of conduct/bullying policy and informing learners of this. Having designated teachers to deal with incidents of bullying. Facilitating mediation and discussions with the victim and the bully, depending on the severity of the bullying. Passing the responsibility to the bully or group of bullies to make sure that the problem is solved. Ensuring that potential bystanders understand that they have a vital role to play during bullying incidents. Letting the victims feel protected after they have reported the incident. Encouraging learners to make suggestions on how they can contribute to alleviating the negative experiences of the victim. Scheduling follow-up meetings to monitor the situation where each party has to share how things are going. Informing the parents of both the bully and the victim about the incident/s. The principal and teachers have a crucial role to play in directing learners towards becoming responsible citizens. They should create a safe and secure environment, establish a non-violent culture, and be good role models for all learners. Reference Niemann, R., Marais, N., Swanepoel, Z. & Moosa, M. 2016. Problem areas in schools In: Jacobs, M. Teaching-learning Dynamics, Johannesburg: Pearsons

Parenting Hub

SA women’s risk of ante- and postnatal depression four times greater than global average

According to the World Health Organisation, about 10% to 13% of women experience antenatal and postnatal depression globally, while in most developing countries the condition affects 20% of mothers. In stark contrast, more than 40% of South African women suffer from the condition. Shouqat Mugjenker, Mental Health Portfolio Manager for Pharma Dynamics says no woman is immune to ante- or postnatal depression, but research shows that women living in low to middle-income countries are at particularly high risk. “The high burden of postnatal depression in SA, is likely as a result of women’s exposure to a number of risk factors, which could include poverty, intimate partner violence and the threat of HIV. “Depression can affect new mothers in many different ways and can start a few months before giving birth or at any time within the first year after childbirth. It may develop suddenly or over time. Most women feel tearful and anxious within the first few weeks after giving birth, which is completely normal and commonly referred to as the ‘baby blues’, but if feelings of sadness and low mood lasts longer than two to three weeks, it might be a sign of postnatal depression. “Postnatal depression puts both the mother and baby at risk since some moms could turn to smoking, drugs or alcohol to help them cope and as a result neglect caring for their new-borns, which makes early identification and treatment essential. Suffering from postnatal depression also makes it difficult to bond with your baby, which can make babies more stress reactive and difficult to soothe. This sets in motion a dangerous cycle for both moms and babies. “Unfortunately, postnatal depression often goes undiagnosed as symptoms, such as loss of interest in life, lack of energy, increased irritability, persistent feelings of sadness, guilt and hopelessness are often dismissed or overlooked. New mothers have to deal with enormous change that range from fluctuating hormones to having to adjust both mentally and emotionally to the relentless demands of a baby. Many of the symptoms of depression such as lack of sleep, reduced or increased appetite, problems concentrating and tiredness are also associated with having a new baby in the home, which makes diagnosing even more difficult,” says Mugjenker. Several studies highlight the gap that still exist in the detection of depression in pregnant women and new mothers in SA. A number of screening tools have been tested in the country, but most are time-consuming and difficult to administer in busy, under-resourced maternal clinics. “If you’re experiencing any of these symptoms, consult your local clinic, GP or psychiatrist who will be able to confirm a diagnosis and advise on how best to manage the condition going forward. With the right help and treatment you will be able to care for yourself, other family members and your baby,” encourages Mugjenker. For more info on antenatal and postnatal depression, visit Pharma Dynamics’ Let’s Talk website: www.letstalkmh.co.za or contact their toll-free helpline on 0800 205 026, which is manned by trained counsellors who are on call from 8am to 8pm, seven days a week.

Paarl Dietitians

Coffee: Good or Bad for you?

The health effects of coffee are quite controversial. Depending on who you ask, it is either a super healthy beverage or incredibly harmful. But despite what you may have heard, there are actually plenty of good things to be said about coffee. For example, it is high in antioxidants and linked to a reduced risk of many diseases as well as improved sports performance. Some studies have even shown that coffee drinkers live longer.  The truth is… there are some important negative aspects to coffee as well (although this depends on the individual). Coffee contains caffeine, a stimulant that can cause problems in some people and contribute to anxiety and disrupt sleep.  This newsletter takes a detailed look at coffee and its health effects, examining both the pros and cons. COFFEE: THE FACTS Coffee is one of the most popular drinks worldwide, with around two billion cups being consumed in a day. With Finland drinking more coffee than any other country in the world. Coffee is a major dietary source of caffeine and has received considerable attention regarding health risks and benefits. Caffeine is a chemical compound which acts as a stimulant when consumed. Many of us are aware of the effects of caffeine on our bodies as we try to wake up in the morning, or stay awake at the end of a long day. However, for some individuals, excessive caffeine consumption (more than 2-3 cups of coffee or 200 mg of caffeine per day) can have negative consequences on their bodies including an increased risk of nonfatal myocardial infarction (heart attack). Caffeine metabolism – rate of breaking down caffeine After drinking a cup of coffee, most of the caffeine gets absorbed by the body and circulates for a few hours while slowly degrading in our body. 95% of caffeine is broken down inside the liver using an enzyme called Polymorphic Cytochrome P450 1A2 enzyme (CYP1A2). How long the caffeine stays in the body is measured by the half-life of the substance. The half-life is how long it takes for half of the caffeine ingested to be metabolized or eliminated from the body. In most healthy adults, the half-life of caffeine ranges from 2 to 4 hours. The longer the half-life (or the longer it takes for the caffeine to breakdown) the more severe the caffeine related symptoms. The half-life of caffeine as well as the way you handle caffeine and the intensity of the symptoms depend on a variety of factors such as: The amount of caffeine consumed Liver function What drugs or medications are taken at the time of caffeine intake Levels of enzymes that break down caffeine (polymorphic cytochrome P450 1A2 enzyme) Overall health status Age The majority of the population can handle moderate amounts of caffeine very well (around 400ml or 2 cups of coffee) and can enjoy its health benefits with only a few minor negative effects. However, in some cases the effects of caffeine on the body and health can be more negative than positive. The positive or negative effects of caffeine on health mainly depend on an individual’s genetic predisposition. How we react to caffeine is dependent largely on genetics & varies between individuals. GENES DETERMINE HOW COFFEE AFFECTS YOU Not everyone responds to a single cup of coffee (or other caffeinated beverage) in the same way. Depending on a person’s genetic make-up, he or she might be able to guzzle coffee right before bed or feel wired after just one cup, based on research (Java gene study).   DNA plays a big part in how much coffee we can drink, to the point that some of us should avoid or at least reduce coffee or other caffeinated drinks. There are a number of genes that determine how well we can take a caffeine hit, since they influence the rate of the breaking down of caffeine, sensitivity and tolerance to caffeine and also the rate of breaking down other harmful substances induced in the body by caffeine.  There are a few genes responsible for how efficiently we deal with caffeine in our diet: Gene CYP1A2 (Cytochrome P450 1A2) is responsible for releasing the liver enzyme that determines how quickly our bodies break down caffeine. Gene COMT (Catechol-0-Methyl Transferase) is responsible for making an enzyme which controls the breakdown of stress hormones called catecholamines. Caffeine increases the release of catecholamines.  CYP1A2 There are two variations of the CYP1A2 gene which affect how quickly a person metabolizes caffeine – one that helps metabolize caffeine faster and another that helps metabolize it slower. Those who produce less of this metabolizing enzyme (polymorphic cytochrome P450 1A2) are referred to as SLOW METABOLIZERS and then take longer to rid the body of caffeine, staying longer in the system in higher amounts and making its side effects feel more intense and prolonged. Slow metabolizers are regarded as being caffeine sensitive. These individuals usually feel the effects after drinking one or two coffees. Common caffeine sensitivity symptoms include jitteriness, increased heartbeat, nausea; sweating, dizziness, diarrhea, insomnia, headache. The other variant of the gene causes the liver to metabolize caffeine very quickly – referred to as FAST METABOLIZERS. These individuals metabolize caffeine about four times more quickly than people who are slow metabolizers. COMT The COMT gene has a number of variations – one variation causes low COMT enzyme activity. So the less active the COMT enzyme is, the bigger the concentration of catecholamines.  When caffeine is in high concentrations, there is a further increase in the release of catecholamines. High amounts of catecholamines increases the probability of damage to cells in the heart muscle resulting in an increased risk of a heart attack.  The risk of a heart attack grows if you are a slow metabolizer and have low COMT activity. SLOW CAFFEINE METABOLIZERS Slow metabolizers are caffeine sensitive, thus frequent coffee consumption are associated with health risks. The increased disease risk may be due to the fact that caffeine hangs around longer in a slow metabolizer, it has

Parenting Hub

The need-to-know about ADHD medication abuse

Attention Deficit Hyperactivity Disorder (ADHD) stimulants are prescribed by medical professionals to improve concentration, memory and motivation to complete tasks. Without treatment, ADHD symptoms (inattention, impulsivity and hyperactivity) can have an adverse impact on one’s social interactions and functioning in the school and work environment. When taken as prescribed, ADHD stimulants are safe and effective. With an accurate diagnosis and treatment plan, individuals with ADHD can face and overcome the challenges of modern life and live fulfilling lives. However, the misuse of stimulants by ADHD and non-ADHD children and adults has increased drastically over recent years. This is due to misconceptions and a lack of knowledge regarding the associated risks and potentially dangerous consequences. ADHD stimulants are commonly believed to give short bursts of enhanced concentration and academic or work performance. Reports reveal the occasional recreational use of stimulants by school children but most who misuse ADHD medication rely on it in high-pressure situations such as exams and working on big projects to improve multitasking, memory and performance. But to maintain this unsustainable level of efficiency, increased dosages and rates of use are often required. It is crucial to understand the dangers of stimulant abuse and the impact thereof on the brain. The effects and risks of ADHD stimulant abuse Research shows that ADHD is caused in part by chemical imbalances in the brain and structural differences in grey matter – a core component of the central nervous system. Grey matter is responsible for memory, executive functions, impulse control, emotions and speech. Likewise, dopamine and norepinephrine levels have an impact on concentration, memory, problem solving, decision making, motivation, impulse control, emotions and social behaviour. Prescription stimulants provide mental stimulation to harmonise chemical imbalances. It enables individuals to focus on the task at hand with enhanced concentration and energy. However, the abuse thereof can result in a lack of concentration, sleep deprivation, depression, social anxiety, an inability to communicate effectively, a fast and irregular heart rate, high body temperature, psychosis, paranoia and hallucinations. Understanding the prescribed uses of ADHD medication Modern-day school and workplace pressures are mounting. To keep up with life at breakneck speed, children and adults with or without ADHD are becoming overly reliant on coping mechanisms of all sorts, including ADHD stimulants. Explaining to a loved one with ADHD the importance of using medication as prescribed will go a long way in encouraging the responsible use of all sorts of stimulants and substances. Here’s how you can encourage a healthy understanding and appropriate use of ADHD medication.  No evaluation. No meds. A comprehensive evaluation and diagnosis by a licensed medical professional is essential before considering any form of ADHD medication. Reports show that some individuals exaggerate their symptoms to get a larger dosage to misuse or shared with non-ADHD individuals. Having an in-depth knowledge of ADHD symptoms and how it typically presents in a friend or family member will help you draw that fine line and accurately report the symptoms. Know what the fuss is about Learn all you can about the effects of ADHD stimulants on your children and adults as well as the effects and potential reasons for misuse. Equip loved ones with life management skills to rely on instead of medication when balancing academics, work and social activities. With the right practical resources, individuals with ADHD can improve their focus and organisation skills. Explain the risks of abuse Children and adults with undiagnosed ADHD often struggle with social interactions and may be more susceptible to peer pressure. The desire to fit in can be a strong incentive to misuse or share medication. Explain the impact of ADHD on the brain and the risks of misusing or sharing prescribed medication with non-ADHD individuals. Know the red flags of abuse Signs of treatment abuse can range from signs of anxiety, manic behaviour and dilated pupils to sleep deprivation and difficulty concentrating. If you suspect a loved one may be misusing, sharing or abusing stimulant medication, share your concerns with a medical professional. Living with ADHD can be challenging. There is no room for the additional dangers of stimulant abuse. The importance of an accurate diagnosis and treatment usage can’t be overstated. If you suspect that an adult loved one has ADHD, suggest this self-assessment to see if their symptoms are consistent with ADHD. For the assessment of children, consult a licensed medical professional. With a holistic treatment plan, therapy and life management skills, children and adults with ADHD can manage everyday challenges and live successful lives.

Kaboutjie

6 Simple Practices to Keep Your Child Active and Healthy

No one said that parenting would be easy, but it doesn’t have to be a struggle. Although it’s normal to worry about your kids when they’re heading off to school, you can lower those anxiety levels by preparing for the transition. You also need to accept that your child is growing, and you can’t keep him or her in a protective bubble. In fact, over protective parenting can have far worse consequences for your child, persisting into adulthood. If you’re worried about frequent infections, fatigue or low energy, learning problems, and so on, there are steps that you can take to better prepare your child for the demands and stress of schooling. Before you try to impart good habits and practices to your child, just remember that kids can be quick to call you out on your hypocrisy and double standards, so be a good role model, or learn to cheat smart and not get caught!

Parenting Hub

Play with purpose is essential for children with autism

Play is a powerful tool autistic children need to boost their development and an essential way for them to learn a range of skills. This according to Keri Delport, director of Autism Western Cape – an organisation committed to empowering individuals with autism spectrum disorders (ASD) and educating their families and communities on the disorder. Autism is a neuro-development condition that impacts the way the brain works and processes information. In South Africa more than seven thousand children are born with autism every year; this means that 160 autistic children are born in the country every week, which is roughly 23 per day. “Autistics are incredible people who open doors for other people in different ways. They are extremely honest and tend to live in the moment. They focus really well when things interest them and have terrific memories once they understand a concept. It’s for this reason that play is so important. It provides the level of physical and psychological support the child needs and helps to develop language, creativity and problem-solving skills,” she says. Delport explains that engaging in play is the start of an important cycle for autistics, forms an integral part of teaching them how to interact with other children and is “absolutely necessary” to develop their social skills and encourage independence. Play types: Explanatory play – allows children to explore the toy in its entirety and helps him/her learn  more about the world through shape, colour and texture Functional play – allows children to use the toy the way it’s designed to be used and helps to develop social skills. Sensory play – an invaluable form of play, provides children with a level of input to support their sensory modulation needs   Toy types: Teddy bears and mouthing blocks Puzzles and Lego Play dough and kinetic sand Delport says parents play a crucial role in ensuring that autistic children “play with purpose” and advise that parents introduce children to toys/games that don’t overwhelm or pressurise them in order to boost their self-confidence. “After all, as Jean Piaget said: ‘play is the work of childhood’,” she says. And to encourage a culture of play with autistics and motivate parents to allow their autistic children to engage in play, Delport says Autism Western Cape recently partnered with toy retailer Toy Kingdom to host the first ever Autism Hour in several stores around the country. During this hour, specially trained staff was at-hand to assist and interact with autistic children; and carried-out sensory demonstrations that focussed on toys that stimulate senses. Since this disorder is characterised by several marked differences including social interaction and sensory activities, stores dimmed the lights and turned-down the music to create a safe space and ensure autistics feel comfortable and welcome. “This is a pioneering initiative in South Africa and provided autistic children the space they needed to play and simply be themselves. It also served as a space where parents could come together, support each other and feel less judged. We hope to see more of these initiatives rolled-out in the country in due course, they are extremely valuable,” Delport says.

PowerPlastics Pool Covers

Child drowning – a leading cause of childhood death that is entirely preventable

Drowning remains one of the top causes of unnatural childhood death in South Africa and for every child that dies from drowning, five are left with permanent brain damage from the lack of oxygen that occurs in a near-drowning. Manufacturer of the leading child safety pool cover in SA, PowerPlastics Pool Covers, is on a drive to remind parents that drownings are entirely preventable with multiple layers of safety applied to the pool.  The PowerPlastics Solid Safety Cover and adult supervision at all times should be included in these layers of safety at all times.  The PowerPlastics Solid Safety Cover offers parental peace of mind as it completely seals off the entire pool. The PVC cover is drawn over strong aluminium batons that rest on the coping, and a tamperproof ratchet fastening system makes it impossible for a small child to access the water. Small drainage holes prevent rain or sprinkler water from collecting on the cover as just a few millimetres of water can be fatal to a curious child. The cover withstands up to 220kg and is easily deployed by two people, or it can be semi-automated for single person usage.  “For years we have been educators in pool safety for children and, with our solid safety cover, parents not only get peace of mind, the cover also allows significant savings on water, power and chemicals, unlike alternatives such as nets and fences which still leave the water exposed,” says Carolyn Idas of PowerPlastics Pool Covers.  “But a cover only saves lives if it is actually on the pool. Being lazy about re-securing a pool after use is surprisingly common. For this reason, we developed our safety cover so that it is hassle-free and does not require brute force. Next time you ‘can’t be bothered’, consider the alternative which could be a drowning due to negligence.” The PowerPlastics Solid Safety Cover is available in a range of colours, allowing it to blend into the outdoor area, or it can be custom printed with photos and graphics for a unique 3D effect.  Thermal pool covers or ‘bubble’ covers that lie directly on the water should never be considered as child safety pool covers as they do not bear weight. These covers heat the pool and save water by stopping evaporation but their purpose does not include child safety.  “As part of our education in the community, we launched TopStep, the home of pool safety, an educational website with tips and advice on preventing drownings. Aside from covering the pool, every adult in the home needs to know what a drowning in progress actually looks like as TV has created wide misconceptions around this. There is no noise or splashing nor calls for help. Drowning is quick and silent. Visit www.topstep.co.za to learn more about this.”  Even if one doesn’t have children, it is still necessary to consider safety for visitors. Families living in residential complexes with a communal pool should insist that their body corporate install a safety pool cover.  “The bottom line is that children need to be supervised around pools, and as long as the pool is covered by us and other layers of safety are in place, the likelihood of a tragedy occurring in your pool is greatly reduced.” Learn about the PowerPlastics Solid Safety Cover here or email [email protected] Practical tips for pool safety Don’t let your pool’s water levels drop. Keeping the pool topped up allows for small arms to easily grab the edge if needed.  For every two children in the pool, have one adult supervising. The more children, the more supervisors needed. Be aware that children’s pool parties are high risk events.  For larger groups, give the designated supervisor a bright hat to wear so the children know who to call for help.  Turn off fountains and water features. Not only do they waste water and power, they can cause ripples and splashing, making it harder to see when a child has encountered difficulty in the pool or has sunk to the bottom.  Ensure that every adult in the home knows CPR, including domestic workers. Never hire a baby sitter or au pair who can’t swim. Don’t let anyone who has been drinking or on sedative medication supervise children in a pool.  Don’t leave toys in or near an open pool as children will be tempted to retrieve them. Teach your child to swim fully clothed and with shoes on. If your child develops a fear of water, don’t ignore this – a child who panics is at greater risk of drowning. Never allow swimming after dark. Discourage your dogs from swimming. Children and pets in a pool are not a good mix. Never leave the pool without securing it with your PowerPlastics Solid Safety Cover. Never design / build a pool that cannot be secured for child safety.  Drowning myths Television has a lot to answer for when it comes to how drowning is portrayed and there are many myths out there. Be aware of the signs and remember that the appearance of a drowning can vary widely.  Myth #1: Drowning children will shout for help Drowning children are physiologically unable to call out. The respiratory system is designed for breathing – speech is the secondary function. Drowning children’s mouths alternately sink below and reappear above the surface but while their mouth is above the surface, they need to exhale and inhale before they sink again. There is not enough time to cry out.  Myth #2: Drowning children wave their arms to attract attention or will thrash in the water Drowning children cannot wave for help. A person who is drowning cannot perform voluntary movements such as waving or moving towards a rescuer. Envisage the surface of the water as a platform. Someone who is drowning often presses down on the surface and tries to use it as leverage to get their mouth above the water’s surface to breathe. So what the onlooker sees are arm movements that can appear

Barbara Harvey

Social/Emotional Development Starts with Dad

The good news is that according to the US Census Bureau: “Between 1960 and 2016, the percentage of children living in families with two parents decreased from 88 to 69. Of those 50.7 million children living in families with two parents, 47.7 million live with two married parents and 3.0 million live with two unmarried parents.” The bad news is while Dad’s are living with their children they are not seeming to connect with them at early ages as much as needed. I think what we need here is to begin to recognize and accept the fact that Dads are different in how they relate to infants and young children and not only accept it but celebrate it. How do Dad’s relate differently? Research shows men are different right from the beginning. * Dads hold and stare into infant faces for hours to form their bond. * Dads never pick up a child the dame way twice * Dads tend to allow children to struggle longer to acomplish a task and celebrate with children each time they overcome. * Dads are more physically stimulating in how they interact with infants. These things are not ‘bad’ just different and very important for kids. This is how they learn to relate to the world. Men are wired differently and it is this difference that allows kids to develop a sens of anticipation and excitement about life. Dad is just often more exciting to deal with than Mom. There are some women who have a hard time with this and want to protect infants from this “rough housing” not realizing this is meeting a need the infant has which can not be received any other way. Men are just naturally different with children and this builds skills in children who do not regularly relate to men have a harder time developing. Much of the truth of this lies in the trouble children have when entering school. Social/Emotional development is the most important aspect of a child succeeding in the classroom. Children cared for by stay-at-home Dads, and male ECE teachers tend to be more resilient and have a greater ability to handle stress. Thus, they do better in kindergarten where these skills are essential in leaning to manage the more demanding world of elementary school classrooms. Society has long thought that women ae more emotional than men. However, recent psychological studies have shown this is not the case. Men are far more emotional than women however, they are taught to keep a tight reign on these emotions. In fact, Dr. Emerson Eggerichs in an interview with Eric Metaxas spoke of a man in an argument can have his heart rate spike to 99 beats a minute which shows he is in warrior mode which if not controlled will cause him to physically strike. Women rarely get to this point in their emotional frustration level in an argument. As an early childhood educator I believe this is why when it come to young boys we see more aggressive tendencies until they learn to gain more control over their emotions. Knowing this explains why men are the actual social/emotional trainers, because they deal with emotions on a much more stringent level than women. Dads also tend to teach kids to think things through by walking kids through the thought process asking questions which asks kids to think through a process. Before age 5-8 when the process of myelination (nerves are coated by a sheath to keep nerve impulses to travel smoothly along nerve endings.) occurs children think out loud. Men tend to pick up on this naturally. The create a bond between Dads and kids. It is this relationship which helps Dads to: * Understand what kids are thinking and ask why * Help kids work out problems by asking open-ended questions * Get into the problem with the children and help them solve the answers So, why does this matter? Dads and their purposeful and meaningful interactions with kids help them to start off with skills, abilities, and temperaments which provide a strong foundation for thier abilities. Plugging into the role of Dad when baby is born is the best thing for kids. Mom’s who encourage Dads to coneet and stay connected are encouraging the relationships all children beed to be able to connect with the world with confidence.

Mia Von Scha

What I learned from my journey through Postnatal Depression…

I’m no stranger to depression. From as far back as I can remember I’ve had bouts of it, some severe, some just dragging out like a rainy British summer. So when I read about PND in a pregnancy book I felt sure that I would recognise it if it hit me. I didn’t. The first time I realised something was wrong I was already on my way to familicide. I was literally loosening the top of the gas bottle where my husband and baby were sleeping peacefully when it occurred to me that this was not normal. The thing is, I didn’t feel depressed. All that was going through my mind was how nice it was going to be to have a really long sleep.Depression in the past for me had always meant crying… And crying… And crying. This was different. It manifested as an underlying irritability. Everything and everyone was annoying. My temper was short and my tongue was vicious. And the layers of guilt piled up high on top of that. The morning after that realisation I called the PND help group. Even then I was fighting to stay off meds. I wanted to be a “good mother” and breast feed for as long as possible. I was told that a good mother is one who is alive to see her child grow up and bottle fed babies grow up too. Too true. And so began my journey to figure out what went wrong and how I could shift this depressive state once and for all. My first glimmer of hope came from a talk I went to by a prominent nutritionist. He spoke about research they had conducted into PND and how the vast majority of cases we’re deficient in omega 3s. This specifically affected vegans and vegetarians. I had been a vegetarian for 20 years. I put myself onto a high dose of omega 3 fish oils (yes, I had to do some soul searching and moral debating first) and I weaned myself off the anti depressants within 6 months. During this time I did further research into PND and found four pervasive factors that contribute to your chances of going down this slippery slope: The first is your perception of the birth. Well I definitely ticked that box. I saw the whole experience as the most traumatic event of my life. I had anger at the midwife for misunderstanding my needs and requests. I had anger at my husband for not having to go through it; for just getting to enjoy the good bits. I had anger at myself for being so traumatised that I was unable to bond with my baby. I had A LOT of emotional processing to do. I set out to acquire the skills to do that. I had no intention of spending years in a psychologists office rehashing the event. I wanted results, and I wanted them yesterday. Babies grow fast and there was one growing up in front of me needing me to be in my best possible state to raise her. The second is your relationship with your mother. Research shows that women with a poor relationship with their own mother have a much higher chance of having a traumatic birthing experience and a higher chance of depression post partum. Tick again. My relationship with my mother was not horrific, more like not there. Again, I set about finding the tools for letting go of the past and any lingering hurt, anger and resentment. What I found was a way not just to understand the past but to actually come to a place of gratitude for everything that has ever happened, even the stuff we label as bad. A life of gratitude is a long way from a life of depression. Number three is the instant and dramatic shift in values that you experience. It is like being kicked out of comfort zone so far that you have no idea what your comfort zone even looks like and no strength to crawl back in it if you did find it. It takes time and patience to form a new one and usually if the shift has been dramatic it means that your kids are coming out somewhere near the new top. The fourth idea I came across much later, and that is the link between depression and fantasies. All depression has its basis in an unfulfilled fantasy and nowhere is a fantasy more thrown in your face than in motherhood. The moving pictures and glossy pages that fill your pregnant world are endowed with images of doting mothers, smiling sweetly down at their breastfed babies. They are not filled with bedraggled mothers wincing in pain as their babies latch into their cracked, bleeding nipples. They show you images of happy families, their white clothes blowing in the breeze as they throw their giggling baby into the air on the beach. They don’t show you the mother who cannot leave the house for fear of leaking through the two boat-sized pads she is wearing to soak up the B-grade horror movies’ worth of blood she’s losing daily. They show you happy families snuggling in bed together doting on their newborn with their hair looking gorgeous and their make up already done. They don’t show you the unshaven husband sleeping in the couch because to his sleep deprived wife his snoring is more like a log than a straw breaking that poor camels back. We get sold a well-meaning lie. The truth is uglier and harsher, but real. And acceptance of reality is one of the cornerstones of emotional well-being. I had to face a lot of ugly messy truths, including the one where I was a less than perfect mother. And that is true. And that is ok. You see what makes me good at what I do is not that I was or ever will be the perfect parent. What makes me good at what I do

Parenting Hub

Children can burn out too!

Gone are the days when children went to school, came home, made a peanut butter sandwich and went to play with the neighbourhood kids!  Cindy Glass, Director and Co-founder of Step Up Education Centres explains “Children are naturally high-energy beings and very little thought is given to the extreme pressures and overloading of activities that our children face in the world that we find ourselves living in today! As adults, we are familiar with the challenges of physical and emotional burn-out, but we do not consider that children are prone to burn out as well.  In fact, burn out in children, if left unchecked, can lead to depression, complete apathy and a myriad of health issues.” Cindy goes on to explain that many children are being subjected to competitive and pressured activities all day, every day and at a pace that most adults would find challenging to keep up!  “Academic expectations, sports (school and clubs), cultural and religious studies, extra lessons, music, art, drama, dance…. the list goes on and on… when packed, back-to-back into the daily schedule of children can lead to overloaded children becoming exhausted and this may lead to burn out!” Parents who notice that their children are showing a combination of the following signs may want to consider that their children may be heading towards burn out-or worse-have already burned out!  A loss of motivation or desire for activities that they once enjoyed or looked forward to. Anxiety, fearfulness and panic attacks Fatigue and tearfulness, withdrawn, uncharacteristic tantrums  Feelings of dejection, making excuses or simply refusing to attend activities that they may have enjoyed before Physical illnesses, loss of appetite, nail biting Falling behind in academics or other activities Burn out is not something to be taken lightly.  Cindy gives the following tips to consider when dealing with burn out in children: Choose to be a mindful parent.  Watch, communicate, listen-with-understanding, acknowledge that something needs to change and act to help and support your child!   Honestly assess the activities and stress causers in your child’s life.  Work with your child to reduce or stop the activities that cause the greatest stress. Allow time for your children to just BE. Allow time for rest and reflection, for childish games and laughter. Teach your children the importance of listening to their bodies and making healthy choices for themselves—choices that are uplifting, enjoyable and less pressured. Be realistic in terms of how many activities your child is doing every day and every week. Watch for signs of exhaustion. Engender a relationship of non-judgemental communication with your child.  Guide, support and teach them positive coping skills (which may or may not involve a change in schedule). Choose to create balance in yours and your children’s lives. There is no advantage or positive learning that can take place from overloading a child! It is important for children to learn a variety of skills as they grow, but be aware of how much is expected of them—too much can be counter-productive! Cindy concludes by saying “Burn out in children is more prevalent that we may have allowed ourselves to consider before! It can lead to serious consequences.  As parents, it is essential that we acknowledge that children, although naturally high energy beings, can and will burn out if their lives are out of balance and the signs are left unchecked!”

STBB

Chastising Your Child: Parents Take Note

By Shereen Volks, Head of Divorce & Family Law, STBB | Smith Tabata Buchanan Boyes The question of whether parents should be allowed to chastise their children has been a heavily debated topic over the past couple of years. In terms of South African common law, parents were allowed to chastise their children, provided that such chastisement was reasonable. Parents could then raise a special defence of reasonable chastisement against assault charges arising therefrom. This principle was confirmed in the judgment of R v Janke and Janke 1913 TPD 382 and in numerous judgments thereafter. To date, no legislation has been promulgated to either regulate what constitutes reasonable chastisement or to prohibit it completely.    It has, however, been argued (after the promulgation of the interim Constitution and later the 1996 Constitution, which focusses on human rights) that chastisement constitutes an infringement on these very rights. In line with this reasoning, the promulgation of the Schools Act, Act 84 of 1996, prohibits chastisement at schools.  The recent judgment in the Gauteng High Court, YG v S 2018 (1) SACR 64 (GJ), took a stance against the defence of reasonable chastisement when it was tasked with determining whether this defence is unconstitutional. The father in this matter (the accused) was charged with assault with intention to do grievous bodily harm after he repeatedly smacked his 13-year-old son. The accused’s defence was that he was merely exercising his parental right of reasonable chastisement. The court found that even if parents’ actions fall within the scope of reasonable chastisement, there is still an element of physical violence involved and it therefore infringes on the child’s right to bodily integrity and dignity. Furthermore, allowing the defence of reasonable chastisement takes away children’s right to equal protection under the law and undermines the state’s obligation to protect children from violence. The infringement on children’s rights could not be reasonably justified and therefore the court held that the defence of reasonable chastisement is unconstitutional.  According to the court, doing away with the defence of reasonable chastisement would not result in harsh criminal sanctions being imposed on all parents found guilty of assault, as these parents should rather be sent for prevention and intervention services with the aim of promoting positive parenting.  Until this matter is dealt with in the Constitutional Court, this judgment does not have a binding effect on any court outside the jurisdiction of the Gauteng High Court. However, it will be considered when any other court is faced with answering the same question.  Contact: [email protected] 

Sherpa Kids

Sherpa Kids International now in Western Cape

Sherpa Kids – an internationally respected and trusted aftercare organisation that focuses on putting the ‘care’ back into aftercare – has successfully launched in the Western Cape. Janine Hammond, Regional Managing Director of Sherpa Kids in the Western Cape, says, “As a working mom, I know what a huge deciding factor it is when looking for schools to find a preschool or primary school that offers a good aftercare system. We saw the great work that Sherpa Kids is doing in schools in Gauteng, and around the world in places like New Zealand, the UK, and Australia, and we knew absolutely that preschools and primary schools in the Western Cape will benefit from this programme.” Sherpa Kids officially launched their before-school care, aftercare, and holiday care in South Africa in 2013. The name “Sherpa” is an homage to the mountain tribes who carefully guide climbers through difficult conditions by using their skills and knowledge in order for them to successfully reach their summit. Outsourcing aftercare is the way forward “Aftercare is often just an afterthought for SGB’s and principals who are dealing with other bigger issues. It is also often a burden to an already-exhausted, over-tasked teaching base,” says Janine. “However, just like most business owners in Cape Town know, outsourcing is fast becoming the best way to make everyone happy; protect the health and wellbeing of your staff compliment, and still keep a great brand reputation for your school by outsourcing your before-school, aftercare, and holiday care needs to the experts. This gives the teachers some breathing space, gives the parents peace of mind, and makes the children happy.” “Leaning on someone else’s expertise for aftercare allows Principals and teachers to focus on their core business,” says Janine, “while still giving children the stimulation and supervision they need. The Sherpa Kids facilitators are the ‘fresh legs’ so desperately needed after teachers have already worked a full day.” The answer to unregulated aftercare Preschool and school are tightly regulated by government, however aftercare is completely unregulated. That means, anything can happen in aftercare, and anyone can run an aftercare. “We approach aftercare differently,” says Janine. “Our people are thoroughly trained, regularly assessed, and kept accountable to international aftercare standards. This is why schools love us. Above all, they love children and want to see them thrive.” Western Cape Private and Public Schools approve In the short time since Sherpa Kids arrived in the Western Cape, both public and private schools have recruited Sherpa Kids to run their aftercare. El Shaddai Christian School and Somerset College were the first to sign up, with Hout Bay International, Elkanah House in Table View, Forres Preparatory, and Shelanti Private School quickly following. Says Kobus Stofberg, Director of Extra-Curricular Programme for Hout Bay International School, “The (holiday) programme was a great success and reports from students and parents was very positive. They offer a good, interactive programme with enough variation to keep everyone entertained and stimulated.” Not only are Principals thoroughly pleased, but parents are seeing the difference in their children too. Says Dave from the Southern Suburbs about a recent Sherpa Kids Holiday Club, “Sherpa was fantastic for our sons; and super helpful at that time of year for us.” Says Janine with a smile, “We know we’re doing something right when parents tell us their kids don’t want to leave aftercare when it’s hometime.” Going forward, Sherpa Kids Western Cape hopes to give schools a stimulating, reliable alternative to their current aftercare situation. To Contact Janine Hammond Email: [email protected] Phone:+27 72 190 2995 Web: www.sherpakids.co.za

Clamber Club

The value of sports and exercise

“Children should be playing and moving outdoors instead of sitting indoors” Says Elzanne Van Der Walt, Sports Scientist and Clamber Club Sports franchise owner. Skills learned through playing and sporting activities can contribute to the educational development of children, help children to develop physically, and can shape them to be better human beings. In this article, Elzanne gives us some valuable information and tips on the benefits of sporting for children.” “Sport can affect the development of a child’s self esteem and self-worth.” Dr Glyn Roberts  What can sporting activities do for my child? Teach key values– Participating on the playground and sports field teaches values: Honesty – through fair play and sticking to the rules of the game. Teamwork – through interaction with others, kids learn to play and work together. Respect – for yourself, others and equipment used during the games. Ability to follow rules – to listen to someone other than a parent or teacher, and to abide by the rules for the good of the team. Punctuality – being early, and ready to start when the team does. Controlling emotions – sporting games and activities can often lead to strong emotions, such as disappointment, frustration, exhilaration etc. Part of sports is learning how to control your temper and other emotions so that you can participate effectively and in the spirit of good sportsmanship. Build strong healthy bodies – Sporting activities and exercise can: Immune system– getting enough exercise strengthens the immune system, which fights infections= Heart– improves oxygen supply to the heart muscles and makes the heart more effective. Posture– improves agility, flexibility and overall posture. Lungs– strengthens the muscles used for breathing, making breathing more efficient and increasing lung capacity. Bones–  increases the bone density, making them stronger and less likely to break. Sleep– improves sleep and reduces anxiety. Concentration– increased oxygen to the brain helps to improve concentration. Develop gross motor skills: Body awareness Balance Eye hand and eye foot coordination Coordination of body sides and crossing the body midline Balls skills such as catching, throwing, and kicking Elzanne’s top SPORTING tips: Keep your children physically active– The more active kids are, the higher their skills level will be, the more valuable they will feel, and the more motivated they will be to develop new skills and take on bigger challenges. Learn broad sporting skills when young– A preschooler needs to be learning basic techniques and generalized sporting skills, and not those of a specialized sport. If young children have a broader spectrum of sport skills in general it is much easier for them to decide what sports they favor and to see what they are best at. Then at a later stage (when they are a bit older) they can specialize in whatever they are best at or like the most. Allow for competitionin the older child and learn to lose with grace – Learning to deal with competition is a huge advantage for a child in terms of life skills, and is learnt from participating in competitive sporting games. This is also healthy, but it must be presented and taught the right way. Learning to cope with winning and losing is important. Reduce stress and anxiety– Not all children can cope with stress. Sports is known to be one of the best de-stressors for a child. When we are physically active our body releases serotonin which directly contributes to our feelings of well-being. Develop muscle memory from a young age – Sporting activities require fast reflexes and skilled movements that have been practiced over and over in many different ways. If this muscle memory is there from a young age, the child feels stronger, more confident and relaxed. This improves their self-esteem and sporting ability. “Sports is the best medicine for any child’s body, mind and development” Elzanne Van Der Walt.

Crawford International

Another antibiotic winter looms unless decisive action is taken

The traditional approach to education must be revolutionised in order to ensure the best outcomes for the current generation of school children, who are increasingly being called Generation Alpha, and whose world differs materially from the world in which their Millennial parents grew up, an education expert says. “Generation Alpha represents those children who were born after 2010, who are now at the beginning stages of their school careers,” says Jenny Coetzee, career educator and founding member of the ADvTECH Group’s prestigious Crawford School La Lucia. Coetzee, currently MD of the soon to be opened Crawford International School in Kenya, has in the course of her decades-long career forged an exceptional reputation as a visionary pioneer and leader in the education space. She says each generation – whether they be Generation X, Y or Z – grew up in a world different to that of their parents and the generations before them. Just as each of these generations were exposed to unique circumstances, challenges and opportunities, so are the newest generation, whose labelling as Generation Alpha is fast gaining traction. “These children are the most connected, educated and sophisticated generation ever, so when educating, a school should provide an environment that enhances learning for these digital integrators,” she says. “These children live in an open-book environment – just a few clicks away from any information, they connect in a borderless world – across countries and cultures, and they communicate in a post-literate community where texts and tweets are brief, and where visuals and videos have the greatest impact.” She says schools should be putting special emphasis on developing critical thinking and problem-solving skills, so that students are equipped to see problems from different angles and formulate their own solutions.   “Regardless of the field they choose to enter for their careers, the ability to think, be creative and act quickly is an indispensable tool for the future, particularly in view of increasing automation and the expectation of the workplace of the future, as identified by the World Economic Forum.   “It goes without saying that technology must be embraced in today’s schools, but what is of crucial importance, is that it is effectively used to enhance pedagogy and improve learning. In order to achieve this, schools must be equipped with high speed internet and embrace the value of social platforms.”   Students must also be exposed to new technologies, such as 3D printing, drones and robotics, and schools should articulate the possibilities these new technologies create.  They must also expose students to new fields such as user experience design, and the latest schools of thinking such as design thinking modelsas a scaffold for project work.   “Just like Generation Z before them, schools looking after Generation Alpha must cultivate the spirit of entrepreneurship. Entrepreneurial thinking and leadership are imperative and entrepreneurship courses must form part of the curriculum where collaboration between subject disciplines is encouraged.”   Coetzee says it is imperative that schools nurture a global outlook, and that students are able to benefit from strong networks formed with international education bodies. And teachers must be trained in the latest strategies and teaching techniques.   “Children come to us naturally curious about their world and wanting to explore it. Their imaginations are vast and untamed, creating endless amounts of practical and impractical things. As teachers we need to continue to nurture them to develop their curiosity and imagination, as well as teach them how to apply them creatively and purposefully using technology as a tool.   “We may not know exactly what lies ahead for our students in the future, but we know what skills and tools they will need once they get there: to think critically, to work as a team, but most of all to be curious and excited about learning in this world that is so different from the world in which we were raised.”

Parenting Hub

Pregnancy: Taking care of your nutritional and financial needs

By 1Life You’ve finally taken steps to confirm the reason behind your weird cravings, unexpected emotional outbursts, the fatigue as well as all the other unusual things that have been happening to your body of late and so begins the journey towards motherhood. One moment you only had yourself to worry about, and now you’re making way for the new bundle of joy that’s growing inside of you. When you are expecting, taking care of your nutritional needs goes well beyond ‘eating for two’. Instead, there are certain nutrients that your body needs during this journey, to ensure your baby is healthy and that you keep yourself in excellent condition as well. Maryke Gallagher, a registered dietician in Cape Town and President of the Association of Diabetics in South Africa, states that from a nutritional point of view, the first 1000 days are the most important. This includes the time the baby spends in the womb, where the first 1000 days are said to set the stage for healthy brain development, growth and appropriate weight gain and building a strong immune system. Having a healthy nutritional plan is therefore vital and can also assist with protecting against chronic diseases like diabetes, heart disease and high blood pressure later in life. As a result, what you put in your body during this period is extremely important. Some crucial nutritional needs include:   Energy needs: These increase in the second and third trimester, but this does not mean you should eat for two. It means increasing the energy intake by 800-200kj per day, the equivalent of a small meal snack, like yoghurt, fruit and nuts, or a slice of rye bread with nut butter and a fruit.   Protein needs increase: Focus on eating more safe proteins, at least twice per week. Options that are generally considered safe include trout, salmon, herring, pilchards and mackerel. Plant proteins are mostly incomplete proteins. This means that legumes like lentils, chickpeas and butterbeans need to be combined with grains such as brown rice, quinoa or barley to form complete proteins. Soya beans and tofu are some of the only complete plant proteins. It is generally believed that it is safe to be vegetarian while you are pregnant if you plan carefully to eat sufficient proteins that meet the body’s demands.   Omega 3 Fatty Acids: These essential fats are important in pregnancy for healthy brain development in the baby. Fish is one such example of a good source of Omega 3 fatty acids, which you should consider before taking supplements to ensure that you are meeting your daily requirements. These type of vitamins reduce the risk of preterm birth and play a role in the visual acuity of the baby. Later in life, they play a role in the IQ and behaviour of the child. They also play a role in regulating the mood of the mother.   Total fat intake: Every cell in the body is made up of fats, and cell membranes consist of phospholipids that influence how well cells communicate with each other within the body. Plant fats are particularly valuable and include nuts, seeds, avocado, olives, olive oil, and flaxseed oil.   Micronutrients: These are essential vitamins, minerals and phytochemicals. During pregnancy, the important ones are Folic Acid, Iron, Calcium, Vitamin D, B12 and Choline. Choline plays a role in the first trimester development of the baby, in particular the brain development and formation of neural pathways. Choline is found in animal-protein-rich foods such as eggs and beef. Haricot beans, soya protein, pulses and dairy products (like milk and yoghurt) are good sources of Choline. Folic acid is found in fruits and vegetables such as leafy dark green vegetables, liver, legumes and fortified cereals.   The above is all important to keep in mind. However, your nutritional needs are in fact only one of very many aspects that you will need to consider as an expecting mom. As you enter this new life stage, your financial needs are also set to change and you will then need to start asking yourself questions about your financial plan. Things like, can you provide for the wellbeing and financial security of your child, the schools you want them to attend and if you are saving enough towards their future education. Safeguarding your assets is also an important consideration, which ensures that these will go to your child in your absence. These are the first of many aspects related to your financial planning that you will need to consider as you enter this new chapter. When starting your pre–birth financial planning, do a financial needs analysis to determine what your future financial plan should look like. Then ask yourself if your current long-term insurance provider can adjust your cover to cater for your growing family and financial needs. If they are unable to, look for a provider who can – and one who will become your partner in providing financial assurance as your family grows.

Clamber Club

Why is my child not walking?

Many parents spend the first year of their child’s life focusing on motor milestones, and are hugely relieved when their baby starts to sit, crawl and walk. The variety of baby and toddler classes and other activities on offer lead to a lot of opportunities for comparison of their child in relation to others. This often leads to parents asking themselves “why is my child not walking yet?”  “There are a few reasons why a child may not be walking at around a year,” says Paediatric Physiotherapist and Clamber Club Expert Nicole Hilburn. “The first thing to consider is when the baby started to sit, and crawl, as late sitters and crawlers will most likely walk late as well. From the start of sitting, a baby usually takes 3 – 4 months to start crawling, and another 3 months or so from crawling to walking,” adds Nicole. Babies with significant birth histories such as low birth weight, prematurity, hospital admissions or prolonged bouts of illness are more likely to be delayed due to decreased muscle strength, or imbalances between muscle groups. What factors prevent your child from walking? “An increasing number of babies are presenting with a condition called torticollis – which is where one of the muscles in the neck is tight due to position in utero, or often due to positioning postnatally in premature infants who have been in the intensive care unit for a while,” explains Nicole. Untreated, this condition leads to decreased use and stiffness of the arm and leg on the same side as the tight muscle in the neck, and may interfere with development. This condition may be present when a baby holds his head slightly to one side, and prefers looking to one side; or cannot look all the way to one side. Babies who use alternative methods of crawling such as bottom shuffling will not develop the core stability and pelvic girdle stability to support them in standing and walking, which will delay the onset of walking. These babies will also struggle to pull up to stand from the floor, due to being on their bottoms and struggling with kneeling. There are a few reasons for bum shuffling – the main reason we usually find that baby’s bum shuffle is due to resistance to tummy time – this leads to weak back muscles, weak arms, and the baby never really experimenting with pushing up off the ground. Excessive use of equipment such as seating devices, and walking rings may lead to walking delays. This is because the child is fully supported in these devices and is not using muscles or engaging postural control while in them. A baby’s temperament also contributes to how quickly he or she will start moving. A very easy-going baby may take longer than a very busy baby. A baby with sensory issues, or who is happy being stable will also take longer to walk, as gaining balance on two legs is much more difficult than being stable on all fours, and these babies may find this frightening. How can you ensure that your baby is on track to walk? Lots of floor play between the ages of 1 and 6 months – on the back and the tummy, which will strengthen the trunk muscles. If a baby looks like he/she is not going to crawl or is using an alternative method to move such as rolling or bottom shuffling, this should be corrected by a physiotherapist, in order to build up appropriate muscle strength in the trunk, shoulder girdle and pelvic girdle. Torticollis should be treated by a physiotherapist. Once a baby is pulling up to stand and cruising, the following tips can be used to promote walking:  Use a wooden wagon to push around Play in the standing position at flat surfaces such as a fridge (e.g. playing with magnets) Encourage play while standing, and give your baby something in each hand, which will encourage standing without holding on Walking with your baby while holding his hands You can also use a hula-hoop if he tends to pull down on your hands a lot – you hold one side and walk backwards and your baby holds the other side – this will give less support, and encourage him to engage his muscles more.

Skidz

Why play should be a priority in children’s development

Play is not just fun but also significant for a child’s development. It is fundamental for healthy brain development and is the way that children learn about their world. Play provides the opportunity to explore the world, learn cause and effect and derive meaning form experiences. There are many forms of play which fall within the structured or free play categories. There are 4 general types of play that we will explore, namely: physical, object, rules, and pretend play. Physical play uses the entire body. It develops and strengthens both gross and fine motor skills and keeps children active. This is often explored as free play. Climbing trees, running, pushing and pulling. It also offers social and emotional benefits as children learn to engage with others. Object play refers to the use of toys or any objects that can be used to engage play. This is great for the senses as well as creativity and problem solving. As a child learns to manipulate objects to cause a specific reaction. For instance tying a rope to a bucket and having to pull it. Games with rules such as, board games or team sports, help develop social skills as well as, language and communication skills. This is because they need to learn and communicate turn taking, sharing and empathy. Pretend play aids in a child’s understanding of the world around them. It gives them a chance to let their imagination run free. This could be in the form of acting out real-life situations or by making something up that is weird and wonderful. This is a necessary tool to use in regulation of emotions. This helps children to learn empathy as they get to play a different role than themselves. All these types of play work together to ensure that children learn and develop the physical, social and emotional skills needed for grown up life. Skidz includes all these types of play in each Clever Activity Box. The aim is to give parents the tools and resources needed to spend quality time with their kids. This time spent together is pivotal in teaching them how the world works. It helps their physical development as well as their social and emotional development. Everything a child learns is taught through play and this is what we focus on. Each Clever Activity Box comes with over 100 activities in to do at home. It also includes a fun filled curriculum for each day of the week. The ages range from birth up to 5 years. To get your Clever Activity Box and to spend quality time with your child is as easy as visiting our website www.skidz.co.za. For some more awesome and fun ideas you can also like our facebook page at www.facebook.com/skidzsa

The Headache Clinic

Hay fever headaches

A change in season also brings a change in the pollen types that are in the air and these trigger headaches directly or cause hay-fever with headaches. Sinus congestion and pressure is a secondary condition, which has also been known to trigger headaches. 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, explains “Usually hay fever is associated with spring, when airborne pollens from grasses are at their peak. October and November are peak allergy months in Cape Town, and with the Western Cape now consistently recording pollen counts of over 30 – considered extremely high – allergic people should be sure to seek help soon because there is still a long time to go.” Hay fever headaches cause a dull, deep, throbbing pain. Some of the symptoms of hay fever headaches are pressure like pain in one specific area of your face or head (for example, behind your eyes), face is tender to the touch, pain is worse with sudden movements of the head and bending forward and worse pain in the morning (because mucus has been collecting and draining all night). They are caused by an inflammation in your sinuses (air-filled cavities around your nose, eyes, and cheeks). Headaches often begin as soon as you get up in the morning, and may be better by the afternoon. Dr Shevel suggests the following to prevent or limit hay fever headaches: When the body comes in contact with an allergen, histamine and a number of other inflammatory chemicals are released as part of the body’s allergic reaction. Antihistamines work by blocking the effects of histamines, thereby reducing the symptoms of hay fever. Regular use of antihistamines throughout the pollen season is effective especially if treatment is commenced early in the season. Steroid sprays are used in more severe cases. They deliver a low dose of steroid powder through the nasal passages to control the inflammation in your nose and to help hay fever symptoms. Decongestants when used topically for short periods (less than 7 days) are effective in reducing nasal blockage and help penetration of topical steroid nasal sprays. Cortisone injections tend to be prescribed only in more severe cases where the hay fever symptoms are not controlled with other over-the-counter medications. They can’t be repeated frequently due to the possible side effects. Take note of the pollen count forecast on television or in the newspaper. Try to stay indoors if it’s a high count or on windy days after thunderstorms. Choose plants that are pollinated by birds or insects in your garden, rather than plants that release their seeds into the air. Smear petroleum jelly (like Vaseline) inside your nose to stop the pollen from touching the lining of your nose.  A simple saline (salt water) nasal douche is effective. Saline and sea water nasal sprays help flush pollen grains off the nasal mucosal and improve nasal patency. Splash your eyes often with cold water to flush out any pollen. When it is more than just a headache triggered by hay fever! If your headache persists after you have your hay fever under control, it is imperative that you undergo a multidisciplinary investigation to diagnose the specific factors behind the recurring headache. For those patients who want to have healthier alternatives to medication, there are a number of various breakthrough treatment options. These include minimally invasive arterial surgery and posture modifying technologies. In most cases it is possible to get to the bottom of the problem and resolve the pain permanently.

Clamber Club

Help your child make sense of the world around them

The importance of sensory stimulation for babies and toddlers The world is an exciting place for children, with new sights, smells and sounds at every turn. Making sense of this sensory information is known as perception, and developing this skill is a critical part of your child’s development. Without it, we would look and never see, listen but never understand. Sense making skills The more children are exposed to different sensory inputs, the more they develop their perceptual skills. “Each sense plays an important role in the development of a child’s sensory system which unlocks the key to how they learn, think and feel,” explains Liz Senior, Occupational Therapist and Founder of Clamber Club. “The role of the senses in learning cannot be overstated,” adds Kelly Westerman, Occupational Therapist and Clamber Club Toddler Milnerton Franchisee. “Parents need to have at least some understanding of what the role of each individual sense is in order to maximise the learning potential of even the simplest everyday experiences, such as bathing, sleeping, feeding and dressing.” Touch  Touch and hearing are two of the senses that develop in the womb. The sense of touch relies on receptors in the skin that tell us about heat, pressure, texture and pain. As the skin is the largest sensory organ in the body it has the greatest potential to be stimulated. These touch experiences will develop what is known as the Tactile System. Smell Receptors in the nose are responsible for receiving and perceiving smells, developing what is known as the Olfactory System. Smell is largely underrated and often ignored as it is less closely linked to physical and intellectual development. However, the sense of smell has an important role to play in our emotional stability and memory recall and should therefore not be ignored. Sight Through sight we are able to learn by visually exploring the world in which we live. We gain an understanding of the relationships between people and objects and experience light, colour and form.  It is for this reason that parents should invest as much time as possible to help their children develop their visual sense. Hearing The most common cause of speech delay in children is hearing loss; a child must be able to hear in order to learn to speak. Children who are able to hear and listen well are able to learn faster, make fewer mistakes and are less easily frustrated. Taste  Children taste everything that goes in to their mouths, and through these taste experiences they develop what is known as the Gustatory System. A child’s taste preferences may also be linked to their temperament. Very relaxed children who require a large amount of sensory input to stimulate them show a preference for strong flavours such as lemon and curry; while children who are easily overstimulated tend to show a preference for bland and salty food. Take your child on a sensory journey Even before a baby is born they begin to use their senses to discover and learn about their world. In the beginning, a new-born is forced to take in just about every single sensory input, but as children grow they are able to filter through the sensory stimuli they receive and refine their various perceptual skills. “As parents you should have an understanding of what senses may be involved in any particular activity and aim to give your children good quality sensory experiences from an early age,” suggests Westerman. This can be done by stimulating each of the senses individually and in combination with other senses. “These sensory experiences will lay important foundations for learning, movement, emotional security and survival,” she concludes.

Parenting Hub

ADHD vs Bipolar: Know the difference

Inattention, hyperactivity, impulsivity, sleeping problems, racing thoughts and moodiness. These are all typical symptoms of Attention Deficit Hyperactivity Disorder (ADHD). They are also common symptoms of bipolar disorder – a mental illness known for severe mood swings and depression. But how do you tell the difference? Studies estimate that 20% of people with ADHD will develop bipolar disorder. Conversely, 70% of people with bipolar disorder also have ADHD. The high comorbidity rate and overlap in symptoms make these two conditions difficult to distinguish and diagnose. ADHD is ten times more common and more likely to be recognised while bipolar disorder is often misdiagnosed. It is critical to know the difference and get an independent but coordinated treatment plan for both. Untreated ADHD can be challenging but living with a misdiagnosed ADHD and bipolar combination can be dangerous. However, with an accurate diagnosis, the ADHD and bipolar combination can be treated successfully. This will help patients feel more stable in mood and in their ability to live fulfilling lives in their roles as spouses, parents and employees. One fundamental difference is that ADHD mainly affects attention and behaviour while bipolar symptoms mainly affect mood. Distinctions can be drawn between the two based on mood shift triggers, the speed and duration of mood shifts, the onset and consistency of symptoms, and the individual’s sense of reality. The importance of an accurate diagnosis can’t be overstated. With a holistic and dual treatment plan, therapy and life management, individuals with both ADHD and bipolar disorder can live healthy and fulfilling lives. If you suspect that you or a loved one might have ADHD, set the record straight with this self-assessment. If you are unsure about the symptoms or suspect that bipolar disorder might be present, speak to a medical professional. For more information around the symptoms, impact and treatment of ADHD, visit MyADHD.co.za or My ADHD on Facebook.

Parenting Hub

Healthy Eating habits

 Written by: Cynthia Innes, Teacher at Junior College Preschools Sandton. A healthy lifestyle consists of various factors that contribute to healthy living, specifically eating habits, physical activity, emotional intelligence and a well-balanced activity schedule. Co-ordinating all these factors can be challenging for a child however, it is possible to achieve with guidance and a good routine. All parents face the challenge of encouraging their child to eat healthily, the trick is to create a healthy lifestyle for the entire family. Toddlers are influenced by those with whom they spend most of their time, whether it be at Preschool, at home with the nanny or parent. Children need continuous guidance to develop a healthy lifestyle, a child’s preschool years are an important time to teach children how to eat well and exercise their bodies. Parents and teachers can work together to encourage healthy eating habits and lots of physical activities. Always have healthy snacks readily available  Replace fizzy drinks and processed juices with water. Have this easily available. Have freshly cut vegetables or fruit ready to eat as a snack. A whole wheat sandwich with a fruit or veg is also a good snack between meals. Snacking regularly is beneficial to children as they have smaller stomachs and they burn energy faster. Eating healthily between meals provides their little bodies with the nutrients and hydration needed for a healthy lifestyle. Educate your child Instead of force feeding undesirable healthy foods to your children, educated them as to why it is healthy and beneficial to their bodies. Forcing your child to give into something they don’t agree with teaches them that forceful behavior from others is acceptable, this could lead to falling victim to peer-pressure situations. Reasoning and explaining why eating healthily is important, not only gives your child the power to make decisions but also develops their reasoning skills. Lead by example Children learn from their surrounding experiences, they do what you do so lead by example and they will soon follow. Having healthy snacks with your children is a great way to encourage healthy eating. Children see their parents as role models and will imitate what their parents do. Create a food schedule Creating a weekly food schedule beforehand is extremely beneficial to the cook and the family. Placing a food schedule in an area where every family member can read it will allow them to prepare themselves mentally for a meal. Explaining to toddlers what’s on the menu gives them a sense of involvement and is more likely to eat the meal.  Involving the entire family in scheduling meals for the week will encourage them to finish their meals. Introduce new foods gradually  Young children are more likely to eat new foods if you introduce tiny amounts in an attractive manner. Do not worry if they resist the first few times, keep trying without force but encourage a taste. It is natural for all of us to detest some foods, so allow your little one to do so if a few tastes have been tried. Try again a few months later, maturity brings change. Include the children in meal preparations  Allow children to help you prepare the meal. Little ones can fetch vegetables and fruit, bring you the pots and pans and help with stirring. This also develops their counting and perceptual skills. As they get older they can learn to chop, measure and mix. A child who has helped with the cooking will generally be keen to eat it Don’t be too strict As above, a taste is all you need to encourage. Serve tiny portions attractively so the child can finish and ask for more if necessary. After 20 minutes, if the child is not keen to eat, remove the food with a cheerful statement, “I see you have had enough” Do not serve alternatives or filling snacks between meals. No punishment for not eating. The more fuss you make, the more resistance you will have. Eat meals with your children, talk without TV or phones. Meals can be a family bonding time where food is celebrated and enjoyed. Physical activity for Young children Children should be actively playing, preferably outdoors on bikes, jungle gyms or just imaginative play with the toys they have. TV or tablets should be limited to a maximum of half hour daily. Lead by example and go for walks, swim, garden play ball games or take them to the gym with you. To create a healthy eating habit, the above tips need to be implemented over time and on a continuous basis for successful results.

Parenting Hub

How binge-watching TV series can wreck our immune systems

It turns out there are some surprising daily habits, such as overdosing on our favourite TV series, that can wreak havoc on the body’s ability to fight off colds and flu. Nicole Jennings, spokesperson for Pharma Dynamics – a leading provider of colds and flu medication – says the relatively new phenomenon of being able to watch an entire TV series all at once, as opposed to waiting a week, has sparked several studies that attempt to understand how binge-watching is impacting our health. She cites a paper published in the Journal of Clinical Sleep Medicine which found that people’s addiction to watching TV series can lead to chronic fatigue, which has a damaging effect on immunity. “According to the study, over half (52%) of binge-watchers viewed three to four episodes in one sitting, with an average session lasting three hours. If one considers that most of the watching occurs in the evening, that doesn’t leave much shuteye. Binge-watchers also reported more fatigue and insomnia and had 98% more chance of having poor quality sleep than those that limited their screen time. “Watching TV in a dark room for hours on end can really mess up our circadian rhythm (the cycle that regulates physiological processes) and disrupts sleep-wake cycles. The blue light emitted from TVs, PCs, laptops, smartphones and other devices can also reduce the production of melatonin (a hormone that promotes sleep). Poor sleep in general is associated with lower immune system function and a reduced number of antibodies or ‘killer cells’ that help to fight germs. Adults need between seven and nine hours of uninterrupted sleep every night in order for the immune system to function optimally. You can still enjoy watching TV, but try to avoid a binge too close to bedtime,” she recommends. Apart from lack of sleep, marathon-viewing can also exacerbate mindless eating and unhealthy snacking – both detrimental to your waistline and immunity. Research by Cornell University’s Food and Brand Lab found that action-packed shows, such as The Walking Dead for example, made participants eat twice as much (98%) than others who watched milder talk show content. Those that watched depressing shows, like the sci-fi drama, Solaris for example, also ate 55% more than participants who watched positive, upbeat programmes. According to the researchers, action and adventure shows may encourage viewers to eat more, because viewers subliminally try to keep up with the pace of the story. Stress and anxiety experienced during a show also leads to comfort-eating. Jennings points out that although it’s easier to order in pizza than pausing your show for an hour to cook a nutritious meal, junk food really upsets the immune system. “Fatty, fried foods increase bad cholesterol and can cause inflammation, leading to reduced immunity, while sugar can hinder the body’s ability to produce germ-fighting white blood cells that destroy foreign pathogens. Watching your favourite characters drink a beer or smoke a cigarette might also trigger a craving for these substances, which have been proven to lower immunity. If you’re planning to watch a TV series, rather put out cut-up fruit and vegetables or low-carb meals and healthy drinks on the table,” she suggests. Furthermore, sitting in the same position while watching hours of TV series not only contribute to deep vein thrombosis and the formation of fatal blood clots, but also increase one’s risk of respiratory tract infections (RTIs) such as a cold, sinusitis or tonsillitis, most likely as a result of lowered immune function.  A study conducted by researchers in the US found that staying physically active nearly halved the odds of catching cold viruses, and even those that did fell ill, didn’t suffer too badly. Jennings suggests that instead of sitting on the couch, TV addicts should consider watching a series on their cellphone or tablet while walking on the treadmill, stationary bike or rowing machine. “There are different ways to make the occasional marathon TV session healthier, but moderation is key,” she concludes. These findings were released as part of Pharma Dynamics’ ongoing public awareness efforts to help reduce the incidence of respiratory infections, which typically spike in winter.

Parenting Hub

Beat The Holiday Food Traps

The worst part of a holiday trip isn’t the packing before the holiday or the large crowds – it is the price your diet pays. As much as we look forward to a holiday, many of us fear enjoying it too much – and piling on the kilograms. It is no coincidence that when holidays get under way, your diet takes a nosedive. But is not just stress associated with travelling or the temptation and treats that take their toll on you. There seems to be the assumption that when you travel, you can’t eat healthily, so subsequently you don’t even make an attempt to. However, the correct foods can help ward off road rage, prevent jet lag and give you the energy to deal with your family when you finally get where you are going. You will also feel healthier, more alert, and have more fun once you reach your destination. Typical freeway fare includes fast food, microwave-ready service station options, pies, bags of chips, chocolate bars and lots of fizzy drinks. These foods are almost always full of bad fats, lots of calories and not much valuable nutrition. With a little bit of effort and willpower, you can navigate your way around the junk food and maintain your healthy diet while on a long road trip. Follow this guide to help you stay on the straight and narrow. Keep on reading to help you make the right food choices on the go. Breakfast on the run Always start your day of travelling with breakfast. Tempted to hit the Wimpy? Not so fast – beware of hidden fats and kilojoules – you also want avoid excess sugar. High carbohydrate meals e.g. restaurant or coffee shop muffins may improve your mood for a short time, but lots of sugar can also make you sleepy – which isn’t good if you are the driver. Your best bet is to look for lean protein. A protein rich breakfast can help increase the feeling of fullness and reduce cravings later in the day. Seed loaf or wholewheat toast with eggs is a good choice. Health bread or wholewheat bread contains a fraction of the kilojoules found in croissants or bagels. Rather choose ham over sausage or bacon (both are very high in artery-clogging saturated fat). Breakfast wraps are a good choice, but do avoid wraps that has words like loaded, meaty or cheesy in its name on the menu or packaging description. A common mistake people make is drinking a smoothie with their breakfast instead of drinking the smoothie as their meal. Smoothies are often high in kilojoules and high in sugar. Pick a smoothie that is made with fat-free yoghurt instead of ice cream and avoid ingredients such as fruit syrups. Skip Granola and fruit mix, despite its health reputation, granola contains more than 2000kJ (476kcal) and 30g fat per cup! It is often further loaded with dried fruit that sends the sugar content further through the roof (not to mention your blood sugar). If you do have time, it is best to prepare yummy “padkos” yourself. See below for ideas. Lunch on the go Tired of hearing…… How far yet? Now you also have to start thinking about lunch. If you weren’t organised enough to pack lunch, then it means hitting the one-stop along the freeway or the restaurant at the airport.  Options such as grilled chicken sandwiches or wraps are a good idea, as long as they’re not loaded with cheese or sauces such as mayonnaise. Caution with pre-prepared salads – they are often drenched in salad dressings loaded with kilojoules, saturated fat and salt. All the salt is sure to make you feel uncomfortable and bloated in an already cramped car or airline seat. Sushi is another healthy alternative that contains healthy fats as well as omega-3 fatty acids. If you choose a burger, try to give the chips on the side a skip. A typical serving of chips provides you with 2310kJ (550kcal) and 20g fat – this is half of the typical amount of energy most women need in a day. Snack on the road The petrol gauge’s needle is edging towards empty…… and so is your tummy! You stop at a petrol station to fill up and inside the shop you are confronted with mostly unhealthy food choices. Bypass the high sugar and fat items on the shelves and look out for healthier options. Fat free yoghurt (or low fat if there isn’t any other choice) is a healthier option which is also high in calcium and protein. Bananas are high in soluble fibre that won’t bloat you and contain magnesium that helps with headaches while driving. Be careful with nuts – limit your portion size to a small handful. Nuts are high in fat (yes, it is the healthy fat but is still high in calories). Also, be cautious with protein bars, unless you eat a brand you know and trust (approved by your dietitian). You could very easily end up with a protein bar that’s closer to a chocolate than a healthy snack. Some manufacturers jam their bars with sugar. Pack Light Packing your own travel bag of food? Then make smart choices such as the following: Packets of instant Oats (original flavour) – ask for some boiling water at your pit-stop. Alternatively, pack individual portions of Futurelife or Pronutro (original or wholewheat flavour) – just add water or milk. Homemade sandwiches, wraps, pita breads or provitas with a lean protein filling. Chicken strips, mini bobotie bites, mini quiches (made without the cream and buttery short crust pastry) – see ‘Snacks and treats for sustained energy’ for recipes and more ideas Biltong: this practically fat free protein source will keep your mouth busy and fuller for longer. Fresh fruit or fruit snacks e.g. Low GI Safari Fruit Break Bars or Just Fruit Bars (also available at the practice) for a fibre-filled way to satisfy a sweet craving. Nuts: pack 30g portions that can

Kids Eyes

Eye Allergies in Children

Eye allergies are surprisingly common in children in South Africa and unfortunately, this phenomenon appears to be on the increase. Some children will experience eye allergies as infants and young children but outgrow it as adults, while others will continue to battle with it right into adulthood. If one of the child’s biological parents suffers from some form of allergy, there’s a 40% to 50% chance that the child will have some sort of allergy as well. That probability jumps to 75% to 80% percent when both biological parents have allergies. An allergy describes the “over excited” way in which the body reacts to something in the environment which it sees as foreign. This foreign substance is called an allergen. Types of Allergens Outdoor allergens include pollens, diesel exhaust and petrol fumes. While indoor culprits encompass pet dander, dust mites, mould, and cigarette smoke. A child can come into contact with an allergen by touching it, breathing it in or eating it. The following image has been borrowed from Adam, Inc. which shows some of the various types of culprits that can cause allergic reactions in children whose body sees them as foreign. Allergic Eye Disease Symptoms In a child with allergies, the body mistakenly identifies the foreign object (seen in example above) as a serious threat, which in turn triggers a cascade of immune mediated enzymes and chemicals to be released into the body to fight off this intruder. This overzealous reaction can cause a range of symptoms from having mildly itchy eyes, to chronic scarring with resultant loss of vision. Symptoms may only occur during certain seasons such as spring when flowers start to blossom or may be present throughout the year due to continual exposure to something like house dust mites. Symptoms that occur commonly in allergic eye disease include: Itchy eyes with frequent rubbing. Increased tearing (watery eyes) Red or pink eyes. Mild swelling of the eyelids. Areas around the eye or just below the eye are also often involved. Darkened discoloration of the skin under the eye Watching Children’s Behaviour is key Children are not young adults; therefore, they cannot always describe to us what exactly is wrong. It is very helpful to carefully watch their behaviour, such as: Rubbing their eyes often. Blinking forcefully and repeatedly. Making rolling eye movements in response to the itchy sensation caused by the allergies. Allergies Are Not: Important to note is that eye allergies do not cause the following: A sticky, stringy, mucus discharge. A green or a yellow discharge Lids that are so swollen that they close the eyes. Pain or a fever. Should any of these symptomsoccur, medical attention should be sought immediately! Management of Allergies Once a diagnosis of allergic eye disease has been made by your eye specialist, there are a variety of management protocols that can be followed. The simplest of these is to avoid the possible triggers. Many allergens that cause eye allergies are difficult to identify, but there are a few general procedures that can be helpful: Keep windows closed during high pollen periods and stay indoors as much as possible when pollen counts are at their peak, usually during the midmorning and early evening, and on windy days. Avoid using window fans that can draw pollens and moulds into the house; use air-conditioning in your home and car if possible. In damp areas use a dehumidifier to control mould. Use “mite-proof” bedding covers to limit exposure to dust mites, and wash your bedding frequently, using hot water (above 40C). Wash your hands after petting any animal. In addition to avoiding triggers, your child’s eyes can be made more comfortable by using medication. Some symptoms can be controlled by using over-the-counter medication such as artificial tears, a decongestant drop and oral antihistamines. There are two important factors to be considered when taking these medications. OTC decongestant eye drops should not be used for more than two to three days. Prolonged use can create a “rebound effect” – increased swelling and redness that may last even after discontinuing the drops. OTC Antihistamine tablets may cause dry eyes and potentially worsen eye allergy symptoms. Prescribed drops include preparations such as anti-histamines, mast cell stabilisers, non-steroidal anti-inflammatories and corticosteroids. Your eye specialist will determine which combination of these treatments are the most appropriate for your child. Correct Diagnosis is Important Eye allergies can cause great discomfort and in rare cases, even vision loss. But with the correct diagnosis and treatment, the condition can be well controlled. It is always recommended to see an eye specialist for the best possible advice. References: Oxford Handbook of Ophthalmology, 2ndEdition, p. 170 American College of Allergy, Asthma and Immunology Allergy Foundation of South Africa Images: Borrowed from todaysparent.com; Adam, Inc.: Parenthub; Paediatric Associates of Franklin; Allergy & Ashtma Center of Atlanta; Eyecare Kids; allergyaustralia.com  

Parenting Hub

Talking about periods

HOW SHOULD I APPROACH THIS? Your daughters first period is a momentous event in her life, but it can also be a little confusing and anxious too. When it arrives, it’s important she feels prepared and is aware of what’s happening to her. Discuss the science Although it sounds an obvious thing to say, its worth talking her through the basics of why we have periods, how the menstrual cycle worksand the blood loss she’ll experience. We’ve got all the information you need here to help explain these things, including a Teen Handbook. If she wants to find out herself, direct her to the teen section which includes advice on all aspects of her body Help her feel prepared One of the biggest worries many girls have is starting their period when away from home or in school. Very often, wearing a pant liner on a daily basis can build her confidence as it alleviates any fear that she will be caught unaware. Its also a good idea to give her some pads to keep in her school bag just in case. Lil-lets has a mini purple rangedesigned with petite women and younger girls in mind Is there a minimum age for using tampons? There is no minimum age for using tampons or a medical reason why a girl new to her periods should not use one. However, it is often best for them to understand their flow and monthly cycle before choosing to use this form of protection. Show her products It’s easy to forget that she probably hasn’t seen what a pad looks like. Once you’ve bought a pack, show her a pad, how she should position it and how to dispose of it afterwards. This should give her the confidence to do it herself next time. If you would both rather not have this conversation directly, our Teen Handbookhas explanations of how to use pads so she can have a look in her own time. The same applies to tampons as they can be really confusing, especially as they come in both an applicator and non-applicator formats. Anything else to add? Its perfectly normal for her period to last a couple of weeks too, so again, Its worth sharing this bit of information with her so she will know what to expect. Many thanks to Lil-Lets for their insight, you can read more at https://www.lil-lets.co.za/Advice/Advice-for-parents

Munchkins

Veggies for vitality: Get your munchkins to gobble more greens

Diet – probably one of the most dreaded four-letter words in domestic history. The reason why nutrition often feels like a real burden is because our society’s concept of and relationship with food are quite rotten. As a result, there exists a confusing mess of contradicting information on what really constitutes a “healthy diet”. To pile on the pressure, you now have kids whom you love to bits and want to feed wholesome food and it’s most of the time a struggle, right? My own pursuit of answers to the much-debated topic of diet led me to a very simple (and I like to think obvious) conclusion: Eat. Real. Food.To clarify – the closer to nature, the more it will nurture. Conversely, if it is modified (processed or refined), it is best to stay away from it. A “real” diet is inevitably loaded with the substance of life: vegetables! “But my child is a fussy eater!” you say. Let me spill the beans on how you can help to fill your child’s tummy with nature’s best: Start smart The hard truth is: your child will most probably not be begging for broccoli if his palate is spoiled with “easy” foods, such as sweetened yoghurt, crackers and other refined edibles. A baby’s first foods should be freshly prepared vegetables, fruit, natural fats, proteins and whole grains rather than commercially processed baby food. Weaning foods lay the foundation for eating habits. If children won’t eat anything but white bread with cheese spread, we have to ask ourselves: Would that have happened without the option of this “meal”? Our babies have clean dietary slates – they learn to eat what we feed them. So, let them have veggies! What if it is too late for the right start? Detoxing your family from “fake” factory foods and replacing them with wholesome alternatives is a beautiful Plan B. However, it costs commitment! It will be challenging until the whole family, as well as your grocery shopping, cooking, and snacking habits, have adjusted. Cheat them to eat them If mealtimes are mostly synonymous with war, try dosing fussy eaters with vitamins, minerals and fibre by sneakily masking veggies or fruit in their food. Here are some ideas: Make smoothieswith added vegetables. You can even freeze this blend and offer it as popsicles or sorbet. Check out this recipe for a delicious green smoothie. Baked goods(made from healthy flour alternatives) are brilliant hideaways for wellbeing foods! Add grated or pureed veggies, such as carrots, baby marrows, cauliflower or pumpkin to muffins, biscuits, crumpets, breads, wraps and more. Sweeten with blended fruit like banana or dates. See these inspiring recipes for spicy pumpkin muffinsand cauli-wraps. (Google will gladly contribute many more ideas!) Hide veggies in meat recipes(like these fantastic meatballs) – add them to quiches, blend them into yummy soupsor puree them into flavoursome saucesas topping or filling for brown rice, quinoa, omelettes and more. Go on, become a master of disguise… The real deal should also appeal We should be cautious of always offering veggies in easily edible forms. When we do this, we are not accustoming children to their taste and texture and thereby not training them to be vegetable victors. That does not mean that you can’t make it less painful and more fun! Dangle a carrot in front of their noses like this: Build vegetable pictureson their plates. The internet is packed with creative ideas! Give them healthy dipslike hummus, cream cheese or mashed avocado to dunk veggies into. Gardeningis a great way to get kids excited about plant foods! Let them help and witness their greens grow. The key often lies in variety. If Fussy Fiona absolutely refuses mushrooms, give up and give celery. But try again next month. Home-grown habits The apple does not fall far from the tree when it comes to diet. In the end, what you cook and eat yourself is what your child will model. Yup, this means the pressure is on! But luckily it will pay off for your own wellbeing too. A final word of encouragement: Our survival instinct will eventually force us to eat what is available. Your child will not starve if you replace comfort foods with vegetables. May your efforts to fill the apple of your eye with good food bear much fruit! Hopefully, your tantrum-prone little eater will soon be as cool as a cucumber when there is salad for supper!

The Headache Clinic

Ponytail May Be Leading to Some Headaches

Some headache and migraine sufferers develop sensitivity of the scalp from all the pain that they experience. This means that things that normally would not cause pain or discomfort, start to cause problems. Wearing a tight ponytail would normally cause no discomfort, but in migraine sufferers who have developed a highly sensitive scalp, wearing a tight ponytail can cause discomfort and pain. It actually has a name – ‘ponytail headache syndrome’, 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. Other signs of scalp hypersensitivity may be discomfort with combing or brushing the hair, shaving, showering, or wearing glasses or earrings – things that are not normally painful. Dr Shevel says that if one does suffer from scalp hypersensitivity – the medical term is cutaneous allodynia – then treating the cause for the overload of pain signals to the brain should come first – i.e. treating the headaches. When the original source of the most significant contributor to the pain is successfully treated, the allodynia subsides along with it. At The Headache Clinic, the emphasis is upon diagnosing the original source of the pain, and then directing treatment in a focused manner at the origin of the pain. In most patients this can be achieved without the use of drugs, with their often unpleasant or harmful side-effects.  

Parenting Hub

Bedwetting: When to consult a doctor

Bedwetting is an issue that millions of families face every night. This can be very stressful for the whole family, and often the children feel embarrassed or guilty about wetting the bed.  Bedwetting can also cause anxiety when spending the night at a friend’s house or going away to a school camp. In most cases, children will grow out of bedwetting, but there are certain cases that will need medical attention. There can be numerous reasons for bedwetting. This is a problem experienced by an estimated 10% of South African children aged between 4-15 years old. In most cases, it’s linked to delays in physiological development. Children are unique, and each child develops at a different pace. It could also stem from being in a very deep sleep or a bowel issue like constipation. Bedwetting could also be caused by psychological problems that have resulted from issues at school or a change in family dynamics. Whatever the circumstances, the question remains: When should I start being concerned about bedwetting? Dr Michael Mol, Brand Ambassador for DryNites® Pyjama Pants, sheds some light on when parents should consult a healthcare professional when it comes to bedwetting and which specialist would suit the situation: “The signs that parents need to look out for when their child is bedwetting include: Signs of bladder or Kidney infection. These signs will be evident when your child cries or complains when urinating, when there is pink urine or bloodstains or when your child visits the toilet more frequently than usual If your child is over the age of 5 and cannot control their bladder When your child who in the past was able to control their bladder has begun to wet the bed and this is happening more frequently There are several healthcare professionals who can help deal with bedwetting. These specialists can also provide you with the relevant advice you need to assist both you and your child,” says Dr Michael Mol. A General Practitioner If your child is five years old or over but is still wetting the bed at night, you should consult your GP on the subject, especially if the bedwetting persists beyond seven years of age. It is also advised to consult your GP in the case of secondary enuresis (when a child starts to wet the bed again after a period of at least six consecutive months of nighttime dryness). A Pediatrician Your GP can recommend you to a pediatrician if the initial treatments are unsuccessful. A Pediatrician Urologist This specialist may be consulted only by referral from your GP or Pediatrician. Referrals will be made in the case of daytime bladder leakage which may be caused by a recurrent urinary tract infection. A Psychologist If your child is suffering because of regular bedwetting in terms of a loss of confidence, feelings of guilt or embarrassment, a tendency to isolate themselves, etc. you are advised to see a psychologist. Visible symptoms in children include depression, anxiety, hyperactivity, behavioral issues and lack of concentration. A psychologist may also be referred by your GP in cases of secondary enuresis. An appointment with a psychologist can be arranged by your GP or pediatrician. You cannot stop your child from wetting the bed. You can however help to manage their bedwetting by making them feel more comfortable. One way of doing this is to introduce them to DryNites® Pyjama Pants. DryNites® Pyjama Pants are available for boys and girls and come in two different sizes; 4-7 years and 8-15 years. These age appropriate disposable pyjama pants are super absorbent and comfortable like real underwear. They are thin enough so that children can discreetly wear them underneath their pyjamas, helping them to feel more confident and independent. For more information on DryNites® Pyjama Pants, or to ask Dr Mol a personal question or to request a free sample, visit  www.drynites.co.za.  DryNites® Pyjama Pants are currently available at selected retailers nationwide.

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