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

Elective surgeries – the disruption, the trends and back to business unusual

On 9 September, South Africa recorded 1990 new cases of the pandemic in 24 hours. The country has now slipped to the eighth worst affected nation in the world in terms of the number of Covid-19 infections. In spite of this elective surgery has been given the green light and its back to business – albeit with strict protocols in place to safeguard staff as well as patients.  Almost five months ago elective surgeries came to a standstill. This was reflected in claiming patterns in the private healthcare sector during lockdown – a disruption of the norm globally.  In South Africa, elective surgery in both the private and public healthcare space and specialists’ visits are just two of the areas which have been affected by Covid-19. The link between the two is clear: Fewer specialists’ visits mean fewer referrals for surgery.  So what exactly is elective surgery? The term can be ambiguous. It does not mean, as the name implies, that the surgery is optional but rather that it doesn’t need to be performed immediately. It can be scheduled at the patient’s and surgeon’s convenience. Some of these surgeries are necessary to prolong life, for example an angioplasty or, as in most cases, improve the quality of life. In brief, elective surgery is ‘A planned, non-emergency surgical procedure.’  Elective surgeries dropped by over half According to Lee Callakoppen, Principal Officer of Bonitas Medical Fund, ‘there has been a 60% reduction in hospital authorisation requests compared to 2019. A study release in March predicted that an estimated 28.4 million elective surgeries worldwide, would be cancelled during the 12 weeks of peak disruption due to the global pandemic. This has been a similar experience to other industry role players and is predominantly due to a combination of member fears related to Covid-19, lockdown and provider caution.’  Surgeries delayed not cancelled The postponement of surgeries was done to prevent patients taking up hospital beds and to avoid unnecessarily exposure to the virus – a strategy that worked well to flatten the curve.  Surgeries were delayed based on provider discretion and subsequent patient engagement. Callakoppen says, ‘Providers are best placed to make these clinical decisions in the interests of their patients. If the procedures were emergencies or urgently required to enable member quality of life, those would have proceeded.’  The public sector too experienced backlogs in terms of elective surgeries. Examples are procedures including but not limited to, cataracts, orthopaedic surgeries, scopes, caesarean sections, tonsillectomies and adenoidectomies. BHF cautioned funders In July, The Board of Healthcare Funders (BHF) and its members in the healthcare funding space requested members of medical schemes to proceed with caution in scheduling elective surgical procedures. Dr Rajesh Patel, Head of Benefit and Risk at the BHF, said, ‘While the relaxation of the lockdown restrictions is good news for people, the country and the economy at large, we are still in the eye of the storm.’ The way forward? ‘As we move toward Level one, elective surgeries are almost back to normal,’ says Callakoppen. ‘It’s time to address the backlog of surgeries not considered emergency during lockdown. These include slow-growing cancers, orthopaedic and spine surgeries, airway surgeries, surgeries for non-cancerous tumours as well heart surgeries. We caution against a rush of elective surgeries though. Any surgery has an impact on the immune system which means the patient has a greater risk of contracting Covid-19 and developing complications from it. ‘It must further be noted that in some instances surgery is often recommended by specialists as one of the key courses of action. But we have noted that managed care protocols, in many instances, improve clinical outcomes with lower risk to the patient. One such example of this is spinal surgery, which is often unsuccessful. From a Bonitas perspective, we have noted that in the back and neck programme which enforces functional rehabilitation has been far more effective for our members. In addition, the risk to the member is significantly lower.’ Bonitas recommends the following is taken into account:  That elective surgeries should only be resumed in instances where not having the procedure will severely impact the members’ health and quality of life  That the current state of a patient’s healthcare is assessed –  individuals with chronic conditions such as diabetes, asthma HIV/AIDS and hypertension, are at high-risk of developing Covid-19 complications The patient’s age is taken into consideration (older individuals are identified as one of the most vulnerable groups) The impact of waiting on the patient’s healthcare outcomes (for example, is it essential that the surgery takes place now or can it safely be deferred for a few months) Alternative care protocols – in some cases surgery, which should be a last resort, is prescribed without considering other treatment protocols such as rehabilitation. The most common examples of this include back and spine procedures, elective c-sections as well hip and knee replacements The use of day hospitals and clinics,  where possible, to limit the possible chance of infection We may have flattened the curve but we are by no means out of the woods. Current Covid-19 cases in South Africa prove that.  What is happening in hospitals? ‘Surgeries are being resumed responsibly with due collaboration and consideration exercised between the surgeon, the patient and hospital staff,’ says Callakoppen. Where there are capacity constraints, surgeries will be classified in terms of priority at the various hospitals. Pre-operative screening will continue. Facilities will continue to utilise separate zones for Covid-19 positive patients, Persons Under Investigation (PUI) and those for whom the status is unknown at the point of admission. Surgeries will be carefully planned and scheduled. Specialist visits on the up ‘Consultations are starting to increase once again but providers in general are likely to remain prudent. However we urge people who have not had their necessary annual check-ups, particularly our high risk members, to consult with their doctors. There may be members who have put these consultations on hold and are now more comfortable to visit a specialist. But care coordination

September 11, 2020
Bonitas – innovation, life stages and quality care

Physical touch & newborns – why is this so important

The birth of your baby is a beautiful and special moment in both of your lives. You may be wondering about your newborn’s senses, while they are born with all necessary senses, some are less precise than others and develop as your baby grows. Physical touch is an important aspect of your child’s growth, coming from your womb, where they are tightly cocooned in your womb. Skin to skin contact offers benefits to both you and your baby, and touch is one of the senses that can help comfort your baby, making them feel more secure and helping strengthen the bond between the two of you. Why is touch important? Touch enables your baby to learn more about the world, bond with their mother and learn communication skills, as touch and body language will be the first way that you can ‘speak’ to one another. Breastfeeding is an important part of this, as your baby then spends time in her mother’s arms. The benefits of touch goes beyond the physical. Contact between mom and baby has been shown to lower cortisol levels, which in turn benefits the functioning of the immune system.  Children that are deprived of touch can be more aggressive with other conduct disorder problems. What is swaddling? Coming from a tightly packed womb, you’ll find that your baby is comforted by touch and close cuddles. Swaddling your baby in a blanket is also another technique that you can use on young babies to help them feel more secure, as it stops them from upsetting themselves from their own startle reflex. It’s important that your newborn finds their new world a comfortable and soothing place. Swaddling is an old technique, and beyond helping your little one feel safe and secure, your baby is likely to sleep better and will be kept nice and cosy in their blanket. If you decide to swaddle your baby it’s best to do so from birth, as opposed to introducing it when they are older as this can increase the risk of Sudden Infant Death Syndrome. Using the proper techniques when swaddling is also important, as incorrect wrapping can lead to issues.

September 8, 2020
Bonitas – innovation, life stages and quality care

How does my diet affect my pregnancy?

A healthy diet is always important, but during pregnancy you are eating for both you and your baby so it’s critical that you remain healthy. Eating poorly during pregnancy can have a long term impact on your baby’s health growing up. So that being said, what foods should you be eating during pregnancy? If you eat healthily already you won’t need to go onto a special diet during pregnancy, but it’s important to get the right nutrients for you and your baby through a balanced diet. Don’t be alarmed if you find yourself hungrier than usual, but even if you are expecting twins you won’t need to eat for two. It is also important to note that weight gain during pregnancy is normal, so don’t be alarmed by this. Eating schedules differ between moms, however, it is generally recommended that you eat smaller amounts more frequently when pregnant, especially if you are struggling with morning sickness. What to eat when you’re expecting Fruit and veggies are your friend during pregnancy. Providing much needed vitamins and minerals, as well as fibre which helps with digestion and keeps you feeling fuller for longer. Protein is another important nutrient, and you should try to include it in your diet everyday as it helps your baby grow strong. Sources of protein include nuts, beans, pulses, eggs, lean meat and fish. However, raw, cured and uncooked meat are all risky to consume during pregnancy as they can cause toxoplasmosis. Another important source of energy is carbohydrates, specifically whole grains. They contain vitamin B, fibre and iron, which are all important for the baby’s growth and staying healthy. These include oatmeal, wholewheat pasta and bread, potatoes and maize. If you are suffering from morning sickness, these blander foods fill you and can be eaten little and often.  Foods that are rich in calcium should also be eaten regularly. Dairy foods, such as milk, cheese and yogurt are all options containing calcium as well as protein and vitamin D. That being said, some cheeses (such as soft cheese like brie) should be avoided as they can contain harmful (although rare) listeria bacteria. What foods should be avoided during pregnancy There are certain foods that you should take care to avoid during pregnancy. As mentioned, rare meats and certain cheeses should be avoided. Liver and raw fish (i.e sushi) are also on the to-avoid list. Consuming too much caffeine can also affect the baby negatively. Coffee is the obvious drink to avoid, but be aware that soft drinks, green tea, certain energy drinks and chocolate all contain caffeine.

September 1, 2020
Bonitas – innovation, life stages and quality care

Stimulating your baby’s senses

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

August 17, 2020
Bonitas – innovation, life stages and quality care

Cancelling your medical aid should be a last resort

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

August 13, 2020
Bonitas – innovation, life stages and quality care

Collaboration addresses the challenges of COVID-19

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

August 7, 2020
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Advice from the experts
Kath Megaw

Eating During Pregnancy

When you discover you are pregnant for the first time – your whole world shifts. Up to this point decisions you made with regards to your eating only had a direct effect on your body. Suddenly what you eat affects your unborn baby in more ways than we even realized. Benefit 1: A good balanced nutritious diet will have all the necessary nutrients to allow for optimal growth of your little one! Keep it simple but healthy. You need to eat foods from all the food groups. Avoid fad dieting while pregnant as you will miss out on some essential nutrients. You need a range of fresh fruit and vegetables as this gives you the vitamins and minerals you and your baby need. Lutein is an anti oxidant found in green leafy vegetables and is very good for your babies immune system and brain development. Carotene is found in orange veggies and is very healthy for your babies eye and skin health. A healthy skin may be protective for your baby against allergies later on in life. Aim to eat at least five servings a day. Protein foods like meats, eggs, milk, nuts etc are very important for muscle development and for keeping your placenta well nourished with a healthy blood flow. Some pre term deliveries may result from a placenta that has ‘dried’ up too soon. So aim to eat at least 4 portions (palm size) daily. If you are struggling with nausea in these early days then it may be helpful to get a good supplement that you can take to ensure you meet you protein needs. Starch foods like rice, pasta, wholegrain breads and cereals are very important for energy for you and your baby and also for fibre. Like fruit the fibre in these whole grain products ensure that you stay regular when drunken with adequate water. Have 3 -4 servings of healthy low GI starch daily and at least 1.5L water through out the day. Fats like avocado, linseeds, flaxseeds, olives etc are important to provide the essential fatty acids necessary for you the mom to retain brain cells and for your little one to create new healthy brain cells. Aim to have 4 fat servings per day (1 tsp/serving or ¼ avocado). Benefit 2: A lot of ongoing research is looking at the moms diet and including high risk allergen foods and initially the thinking was that we should avoid allergens during pregnancy however this has not shown to be beneficial and may even be more harmful. The recommendations now are to include all allergen foods as long as you are not allergic to one of them. So avoid all foods except those you are allergic to. Benefit 3: Some very interesting and current research is going on at the moment around fussy eating and when foods were introduced to babies and its affect on fussy eating behaviour. We know that babies swallow amniotic fluid and we know that babies can taste tastes in the amniotic fluid. So there is some research looking at the variety of vegetables eaten by a mom and then acceptance of theses vegetables later. So in summary if you want your little one to eat his veggies it may all start in the womb!!!!

February 8, 2018
Kaboutjie

8 Awesome Benefits of Pregnancy Massage

Massage is not just about it feeling good, it actually comes with many health benefits that you may not be aware of. Having a massage while you are pregnant can actually help to lessen some of the unpleasant pregnancy symptoms you may be suffering with as well as be a lovely way to unwind and relax. I had a pregnancy massage when I was 6 months pregnant and on my honeymoon. I really struggled with my first pregnancy and it was amazing to have that massage. The strangest thing though is that I felt the most amazing sensation of stress relief when the area in the crook of my elbow was massaged on the one side. When you are pregnant your body goes through some incredible changes and a massage can really help your body and your mind to cope better. If you are pregnant it is really important to highlight that you need to see a massage therapist that is qualified in prenatal massage. 1 Increased Blood Circulation This will bring more oxygen to mother and the baby, stimulating the lymphatic system. This will result in a stronger immune system and help to reduce toxins in the body. Increased blood circulation will also result in your baby getting better nourishment. An added bonus is that increase blood circulation will help prevent varicose veins from forming which is common during pregnancy 2 Massage Helps To Relieve Lower Back Pain Lower back pain is a common pregnancy symptom that can be caused by the hormone relaxin that causes ligaments that support the spine to relax. This can cause instability and pain. Pregnancy massage improves lower back pain through improving the lumbosacral tilt that occurs during pregnancy. 3 Relieves Depression and Anxiety In case you didn’t know, it is actually very common for postnatal depression to start during the third trimester of pregnancy instead of when you expect it to start (after your baby is born). Massage helps to stabilize hormone levels which can relieve anxiety and depression. Massage also releases endorphins that soothe and relax the mother. 4 Improved Sleep Any woman that has been pregnant knows how hard it can be to really relax and sleep well while pregnant. Due to massage relaxing the nervous system and extra feel good hormones moms to be will sleep better. In addition to the mom being more relaxed the other benefits of massage such as back pain relief will also make the mother more comfortable which will help her sleep better. 5 Decreased Swelling Edema, which is the swelling of joints during pregnancy, is caused by decreased circulation while pregnant as well as the increased pressure on major blood vessels. Having a pregnancy massage can greatly reduce edema by improving circulation and reducing the fluid collected in swollen joints. 6 Reduced Muscle Pain and Headaches During pregnancy your body changes and your center of gravity moves. In addition to this there is quite a bit of extra weight placed on muscles and joints. All these changes result in your muscles taking strain and can also result in headaches. Pregnancy massage can help to relieve this pain and to reduce any headaches if you are suffering from them. Pregnancy massage will also help you to keep better posture which will also in turn help to reduce muscle strains and pains. 7 Reduces Common Discomforts During Pregnancy Along with all the above benefits having a pregnancy massage can also help with lessening numerous other common pregnancy symptoms such as sciatica, heart burn, constipation, carpal tunnel syndrome, leg cramps and much more. 8 Prepares Your Body For Labor and Birth Studies has shown that women that have pregnancy massages have less complications during birth as well as fewer postpartum complications. These women reportedly had shorter hospital stays, shorter labors and less incidence of post natal depression.

February 7, 2018
Parenting Hub

Childbirth education for an empowered birth

‘Empowering Birth’ is the theme of Pregnancy Education Month in February 2018, when childbirth educators, Bio-Oil and hospitals nationwide will be highlighting how education empowers expectant parents and helps create a better birth experience. For more details visit www.pregnancyeducation.co.za. Birth is the most natural process on earth and yet studies have shown that one in every four women describes her birth as traumatic, one in every five to 10 meets the criteria for post-traumatic stress disorder and one in three or four has postpartum mood disorder. Studies have also found that women who fear childbirth experience longer labour and were more likely to need an emergency caesarean than those who did not. ‘There is a link between a lack of knowledge, fear and the experience of childbirth,’ says Lynne Bluff, national co-ordinator for the Childbirth Educators Professional Forum (CBEPF), which is partnering with Bio-Oil and hospitals nationally for Pregnancy Education Month 2018. With the theme ‘Empowering Birth’, the campaign highlights how pregnancy education empowers expectant parents and helps create a better birth experience. ‘It is so important that parents are comprehensively informed about birthing options safest for the mother and infant in the event of a low-risk, normal pregnancy,’ says Professor Suzanne Delport, neonatologist. Good childbirth classes, says Bluff, will equip parents with knowledge about all available childbirth options and the pros and cons of each, practical tips and techniques for the birth and after it, and the confidence that comes from knowing what to expect and how to cope. Ideally childbirth educators are nurses and midwives, as well as being parents themselves, who can prepare expectant parents for every aspect of childbirth and instil faith in their own ability and strength to give birth. ‘We believe that when parents are informed, any type of birth, from homebirth to caesarean, can be an empowering one. It shifts from a potentially overwhelming experience to one that is fulfilling, positive and, ultimately, beneficial to mother and child,’ says Anna Guerin of Bio-Oil. ‘There is simply no substitute for evidence-based information provided by qualified and experienced professionals. With quality childbirth education, parents are empowered and properly prepared in a warm and supportive way,’ says Bluff, who is also a registered nurse and midwife. “Although childbirth is one of life’s most significant milestones many parents are simply ignorant of the facts vital to decision making,” says Bluff. For example, many parents are not aware that when a baby passes through the birth canal, he or she picks up a multitude of micro-organisms that will benefit their health and guard against chronic illness for the rest of their life; or that there are a number of caesarean options available, some more friendly to mother and baby than others. And most of us know little of the interplay of birthing hormones that click in, one step at a time, to pave the way for birth, help manage pain and stress and give us the feeling of joy when seeing baby for the first time. To find out more about childbirth education, Pregnancy Education Month activities or to find a childbirth educator in your area, visit www.pregnancyeducation.co.za. #PregnancyEducationMonth #EmpoweringBirth

February 2, 2018
Amanda Marele

Surviving a Heterotypic Miscarriage

I had a heterotypic miscarriage and it was painful. Heterotypic pregnancy is when one is carrying twins, the one foetus grows in the uterus and another in the tube. It is rare in natural conception to have a heterotypic pregnancy, research estimates that 1 in 30,000 pregnancies are heterotypic pregnancies. I lost my first child on Christmas day. I had just finished preparing Christmas lunch and was taking a bath when I started vomiting, felt what the doctor later called ‘acute abdominal pain’. My 10year old son had to help me out of the bath, assist me while I was getting dressed (my mother, my husband and my nieces had gone to get some last-minute necessities for the lunch). My son called his dad who came rushing and took me to the hospital. At the ER, the doctor attending did a pregnancy test and the results were positive, she then told me that I was showing signs of an ectopic pregnancy. She wrote her diagnosis on my medical file and I was wheeled to the ward. When the gynaecologist arrived, he did a sonar and reconfirmed that I was indeed pregnant but that the pregnancy was in the womb and not an ectopic pregnancy. He then ordered the nurse to run some tests and in the morning told me that my oestrogen levels were higher than normal which meant that I was pregnant, however my oestrogen levels were lower than the previous day which meant that I was having a miscarriage. He further explained that I would undergo a ‘minor procedure’ i.e. evacuation of the womb. December 26, 2016, I went for evacuation of the womb. I did not feel better, I was still bloated, I still could not do much, I was in pain. 10 January 2017: I was back in the hospital and the diagnosis, ruptured ectopic. At 3 am that morning I felt so much pain, it felt like period pains, at the same time I was freezing cold and sweating at the same time. I woke my husband up and asked him to call someone to take us to the hospital (he panics so I’d not have made to the hospital). I told him that I was feeling faint and the next thing I remember is being carried out of the house to the car; by this time, I was vomiting and without energy. I woke up in the ER briefly and the next thing I remember is waking up in ICU, surrounded by doctors and nurses who looked very concerned. Now when nurses get concerned and curious, then I know something is not good. “My dear can you hear me?” one of the nurses asked, I nodded. As she put lip balm on my lips she said “You look much better than you did last night…” she then told me that my doctor was on his way and he will discuss a few things with me. My doctor arrived he looked at my medical file and when the nurse asked what the diagnosis was, he simply showed her the file. When my husband asked him what the diagnosis was, he said; “Don’t worry about that now, let’s take care of your wife’s health.” I went to the theatre for a laparoscopy. In the surgery, three fairly small incisions were made, two in my tummy and one in the navel; and because my tubes were ruptured, the fallopian tube containing the pregnancy was surgically removed. Upon my return to the ward, my doctor seemed to be concerned about something, he asked the nurse how much was ordered and the nurse replied “two”. “No no! We need five at least and we need it within the next hour” my doctor said. Moments later blood was delivered, the nurse explained to me that I had lost blood. “It happens with ruptured ectopic pregnancies, so now your heart is pumping faster, trying to compensate for the blood loss and is beating at twice the normal rate. You need at least five blood ”. The nurse had been coming to my bedside at least three times a day just to see how I am and explain to me what the next steps would be. Some struggles after the surgery: I went through physio therapy, to learn to walk and move I was constipated for about two weeks I was on schedule 5 pain medication for weeks I had no appetite I could not play my children or sleep because the pain was unbearable A week after I was discharged from the hospital, I went for a check-up and the doctor told me that I had had a Heterotypic pregnancy. He apologised for not seeing the issue when I’d come in on Christmas day. It only hit me as I set at home counting that in September 2017 I could have been a mother to twins, that I had to be at death’s door to get a proper diagnosis. My doctor apologised and told me that he did not know which of my tubes were removed, to this day I do not know. Perhaps mommies will learn to ask their doctors to not only check the womb but the tubes as well, to avoid or diagnose what may be missed. To my unborn children, I’d have loved you, as I do now

February 1, 2018
Parenting Hub

Play is crucial for early child development

Only 29 percent of South African children have access to safe, child-appropriate play areas in their communities, this according UNICEF, but a local organisation – Play Africa is championing for this change countrywide. Gretchen Wilson-Prangley, CEO of Play Africa – a social enterprise organisation driving inclusive public learning for the country’s most vulnerable says play is “exceedingly important” for children of all ages and an integral part of early learning and healthy social development. “Neuroscience has confirmed that the first few years of a child’s life is crucial for early learning. And play forms part of early learning and is far more valuable than we realise,” she says. Wilson-Prangley says play sparks imagination, enhances creativity and problem solving capacities, promotes teamwork and helps to instil empathy and compassion for others. “I believe in the importance of helping to advance children’s basic rights and this includes the right to play,” she says. And since many South African children lack toys and other learning materials that can help stimulate a range of child-initiated, open-ended activities which bolster cognitive, physical, social and emotional development, Wilson-Prangley explains that her organisation seeks to promote one single message – there is no cost to play. Their workshops encourage parents and children to make use of everyday materials when playing. “We demonstrate just how to transform everyday items into play materials using the imagination. Few people know that you’re able to make a robot or a rocket ship using clean milk containers, or a car out of empty loo paper rolls. What’s important is the process and the imagination and creativity it stimulates,” she says. Further, she says play is a “good way to engage” and helps children make use of their imagination; she also describes it as “pleasurable and enjoyable”. “Playing overall gives children an opportunity to stretch their thinking and imagination, it also invites repeated active engagement which is highly beneficial for children of all ages,” Wilson-Prangley says.  

January 19, 2018
Bonitas – innovation, life stages and quality care

Bonitas Talks Babies

When do advise your medical aid that you are pregnant? If you are a prospective member, you need to do so upon application or within 30 days after the completion of your application. If you are already a member with no waiting periods, you can access the out-of-hospital maternity benefits without advising the medical aid that you are pregnant. However, you need to obtain pre-authorisation for the delivery of the baby, which can be done from 20 weeks onwards. Are there waiting periods? Waiting periods may apply to members who join a medical aid while already pregnant. If you join while you are pregnant the pregnancy will not be covered. When do you advise the medical aid that the baby is born and needs to be added onto your medical aid The baby needs to be registered within 30 days from the date of birth to ensure there is no break in cover and your child will be covered from the first day of life. Are there any things you need to know or be cautious about when pregnant regarding medical aid so that you do not find yourself out of pocket We advise members to use doctors and hospitals on the network to avoid out of pocket payments. Bonitas offers a wide range of maternity benefits which includes cover for consultations, amniocentesis and scans as well. These benefits are in addition to savings to give members more value for money. Bonitas advises that any false information or non-disclosure of any material information provided upon application will result in the membership being declared null and void. In addition Bonitas Medical Fund offers 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, or health related issues, 24/7, 365 days of the year. How does it work? Bonitas parents, or their caregivers, simply call the Babyline number on 0860 999 121 to reach a 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. Sharing our content with parents you know will go a long way to making us smile for the day 

January 17, 2018
Parenting Hub

Children get stressed too!

It’s a new school year! It’s exam time! Both of these occurrences during your child’s school life come with their own level of stress – for your child. When your child starts a new school year, or begins exams parents often focus on the stress that they themselves are feeling, rather than taking into account that their child is feeling the pressure as well. “Children don’t deal with stress, or show stress the same way that adults do, and often parents can over-look these clues,” says Carla Yssel, brand manager for Linctagon®. “When children are stressed they are not sure how to deal with it, and this can often manifest itself in a complete change of behaviour – being moody, crying, withdrawing from activities, and even complaining of stomach aches and headaches. Parents need to be on the lookout for these types of behavioural changes when big events in their child’s life occur, such as starting school, or tackling exams.” Although, some stress can be a positive as it can motivate your child to overcome what is worrying them, being over-stressed can cause illnesses. The stress hormone corticosteroid suppresses the immune system, and results in your child getting a cold or even the flu. “We are often consumed with whether our children have the correct stationery, or have prepared enough for their exam, that we forget to actually take care of them,” says Yssel. Yssel provides 5 tips on how to look after your child during stressful times: Be prepared in advance: Make sure that your child has everything they need long before school starts, and gets through all their studying with enough time to revise before an exam. This will give your child the peace-of-mind they require to overcome any stress they may be feeling. Get enough sleep: A good sleep is sure to improve your child’s concentration, and also allow them to feel ready to take on the new day with confidence and a clear mind. Talk to your child: Your child needs to know that you support them, and that you understand what they are going through. Talk to them about what they can expect on their first day of a new school term or year, or that no matter how they do in their exam you will support them through it all. Give them the edge: When your child starts to feel a cold or the flu coming on, give them Linctagon® Effervescent (which can be used from age 12) or Linctagon® Effervescent Junior (can be used from the age of 1) to help get over colds. Linctagon® effervescent and Linctagon® effervescent Junior contain the active ingredient Pelargonium sidoides and with its active support can shorten the duration of the common cold as well as reduce the severity of symptoms with the added Vitamins A and C, anti-inflammatory MSM and immunity enhancer Zinc (Alt Med Review, 2007). This will allow your child the opportunity to get back to what really matters; quicker than usual (Lizogub et al, 2007), and it is suitable for children and adults who are diabetic. Take time out to laugh: Just because your child is writing exams, or getting ready to go back to school it doesn’t mean that all fun needs to end! Laugh with your child; let them forget what they are stressed about, and just have a moment to breathe. Sharing our content with parents you know will go a long way to making us smile for the day 

January 10, 2018
Parenting Hub

Will you bank them, or bin them? Wise up on stem cells before it’s too late.

Becoming a parent is fraught with responsibilities. Prospective parents should know the facts about the life-saving abilities of umbilical cord stem cells so that they can make informed decisions for their families. Stem cells should be called master cells as they can replicate, regenerate and differentiate themselves into any one of 200 different specialised cells in the body, and are used to treat over 80 potentially life-threatening blood related diseases including leukaemia, lymphoma and bone marrow failures. Blood stem cell transplantation, using stem blood cells from sources such as bone marrow, has been performed for more than 50 years, with more than one million blood stem cell transplants across the world playing an important role in the treatment of bone marrow failures, blood cancers, blood disorders, metabolic diseases, immune deficiencies and autoimmune diseases. Cryo-Save South Africa has listed the top 10 most noteworthy facts about stem cells that you need to know: Stem cells are your body’s internal repair system Stem cells continuously replace dead or diseases cells with healthy ones to maintain a normal functioning body. They fall into two major groups; pluripotent and multipotent stem cells. Pluripotent stem cells are powerful, meaning they can develop into any type of cell in your body. However, these cells are still fraught with ethical controversy. Multipotent stem cells, also called adult stem cells, can develop certain tissue cells to maintain your body’s organs as you age, such as blood-forming stem cells. Blood-forming stem cells produce new and healthy red blood cells to carry oxygen to all parts of our body; white blood cells to fight bacteria; and platelets which form clots to pervert excessive bleeding. Best time to collect stem cells is at birth  Stem cells age as we age, so the best time to collect blood stem cells is at birth. These cells have not been exposed to pollution and poor lifestyle choices and can therefore offer greater therapeutic possibilities and better transplant outcomes. Stem cells from umbilical cord blood don’t need to be a 100% match for transplants Although your baby’s umbilical cord blood stem cells are a 100% perfect match for own use, there is a 25% probability for a 100% match for siblings. However, unlike bone marrow transplants, you often don’t need a 100% match using cord blood stem cells, which means the probability of finding a suitable donor is so much greater. Stem cell storage is not that costly Stem cell storage is available to anyone who wishes to store their baby’s umbilical cord stem cells. Cryo-Save offers multiple cost options and interest-free payment plans from as little as R273.00 per month to store cord blood and R350.00 per month for storing both cord blood and tissue. Mixed ethnicity parents should store stem cells The chances of finding a perfect matching blood stem cell donor for an allogeneic (matching donor) transplant are only 1:1,00,000, but the odds are much lower for anyone from a mixed-race family Despite its diverse ethnic make-up, Africa has no public cord blood stem cell bank, which makes the likelihood of finding a matching donor even more challenging. Therefore, Cryo-Save encourages mixed race families to store their babies’ stem cells. Banking stem cells is not just for families with a history of cancer Many people don’t realise that stem cells now play a part in the treatment of over 80 blood diseases and conditions. Every day we are seeing more diseases developing, and more clinical trials are taking place to identify treatments of many of these diseases. Some of the most promising research is being done to use children’s’ own umbilical cord blood stem cells in the treatment of cerebral palsy and autism. Additionally, statistics show that more than 90% of cancers develop due to lifestyle factors, not genetics, and that the incidence of cancer is increasing. Stem cell collection is a safe medical procedure Collecting stem cells from an umbilical cord is quick, painless and non-invasive, posing no medical risk to mother or baby. It is only after the clamping that the blood and tissue are collected from the umbilical cord for stem cell processing. Stem cell banking is possible with any type of birth Cord blood and cord tissue collections can be performed at both vaginal and caesarean deliveries. Immediately following the birth but before the placenta is delivered, the healthcare provider collects the cord blood from the baby’s umbilical cord. You can store your second child’s stem cells if you didn’t store for your first child Today, umbilical cord stem cells are used in more than a third of blood stem cell transplants around the world. Siblings have a 25% chance of being a perfect match. But because cord blood stem cells do not require a perfect match for transplant, the likelihood that siblings will be a match is much higher. Therefore, storing your second child’s stem cells has the possibility, depending on the degree of matching, to treat your first child should a stem cell transplant be required and may also be used for other immediate family members. Stem cell storage is available in South Africa Cryo-Save has been storing umbilical cord stem cells for families all over the world since 2000. It is the leading family stem cell bank in Europe and ranked fifth most influential cord blood bank in the world by Bio Informant. Cryo-Save South Africa offers both local and international storage options in either Pretoria or Europe for both cord blood and cord tissue. This local laboratory complies with the highest international standards and importantly complies to the coveted American Association of Blood Banks accreditation standards. Just as some people need organ transplants to treat or cure diseases, blood stem cells can be transplanted too. If the blood forming stem cells in our bodies cannot produce healthy cells or stop producing cells completely, we cannot function normally and our stem cells will have to be REPLACED with healthy ones that can be found in the bone marrow or umbilical cord blood. Sometimes these stem

December 18, 2017
Mia Von Scha

Holiday Blue’s

December: Time for festive lights and great food and fun with the family and holidays and presents and singing and cheer and… suicide. What?! Yes, despite the festivities, this is the time where depression and suicide are most prevalent. All the pressure to have a good time and the fantasy of how perfect it is going to be can be downright miserable, and if you’re already prone towards depression can really take you down the spiral. Depression is a whole body-mind phenomenon, and so there are many things that you can focus on and shift in your life to both prevent and treat depression. Of course, if you’ve already gone so far down into hell that you can’t even imagine implementing these things then you need to get some help, but my xmas wish for you is that you take note of these things before you disappear down the rabbit hole. This is a summary of my full depression checklist that I use myself to give myself a leg-up when I need it. Check in with yourself regularly and make sure that you have these basics in place: EXERCISE/MOVEMENT: This is the single most effective and most underutilized treatment for depression. Get up off the couch! DIET: The key things here (other than good all round nutrition) are Omega 3’s, probiotics, magnesium, Vitamin D and the B Vitamins and water. Make sure you’re getting these in your diet, or supplement. ILLNESS: Make sure your depression isn’t a remnant of a previous illness. Allow yourself time for recovery. ENERGY LEVELS: Take a break. Get enough sleep! STRESS LEVELS: Breathe, breathe, breathe. HORMONES: Don’t confuse your life falling apart with a bout of PMS. APPEARANCE: Look after yourself – treat yourself to a manicure, a new outfit, a homemade facemask. PURPOSE: Do something every day that moves your soul. BOREDOM: Sign up for an online course, go to an interesting talk, read a good book. DAILY GRIND: Add some fun into your week and prioritise. GOALS: Take some baby steps towards something meaningful to you. TRAUMA: Find the growth points in what you have been through or get some help to work through your past. SEASONAL: Brainstorm some fun ways to make the season more bearable for you. SOCIO-POLITICAL: Stop watching / listening to the news. Change the subject. Don’t get drawn into other people’s fears and negativity. CLUTTER: Do some Spring (Summer) cleaning. Start with a small area or just one drawer. MUSIC: Switch from Leonard Cohen to The Beatles! TOXINS: Clear out harmful chemicals from your home and life. CONNECTION: Reach out to a friend who really cares and is open to listening. FUN: Find enjoyable things to do with your family other than just day-to-day necessities. TIME: Get rid of irrelevant time wasters and see what in your life can be delegated to somebody else. WORRIES: Take action on niggling worries. ASSUMPTIONS: Question the things you are thinking (eg the mess in the house means nobody cares about me)… always ask: “Is this really true?” PERFECTIONISM: Let it go. You are enough (write this on your mirror now!) FANTASY: Let go of how you think life “should” look and appreciate it as it is. Find 3 things right now to be grateful for. Do this daily. DEPRESSION IS BAD: Depression is there to help you to grow, to reprioritize your life, and to get on track living your purpose. Question the idea that it is bad and see if you can gently welcome it in and allow it to change you! Life is not always going to be happy-go-lucky, and just because the festive season swings around at this time of your does not mean that your mood will too. Let go of the pressure to be joyous and filled with fun and allow yourself to be as you are. Take tiny steps towards addressing the things in the list above – just start with whatever you can manage and see how little changes over time amount to massive shifts. This festive season, be real, be safe and look after your whole self.

December 14, 2017
Barbara Harvey

How to be sure your child has a positive inner voice

In 2004, I started reading Dr. Phil McGraw’s book Self-Matters it is the first place I heard of and learned about the concept of elf-talk or the inner voice. I love the way he explained it. What I took away from it was the concept of a quietly running tape which urns underneath all the other voices in your life and this voice is the one where people live from. It is based on all the things you heard as a child not only about yourself but about the way life works in general these are the voices primarily of your parents. Therefore, it is what we hear our parents say about us and life that creates the foundations of our inner voice. As a parent coach, this caused me to step back and examine my whole concept of what it means to be an effective parent. I have concluded that effective parents have several things in common when it comes to creating a positive inner voice for themselves first and as a result for their children. I have found this can help even if their children go differing messages early if parents are willing to communicate these inner changes with their kids. Authenticity Examination of own Inner Voice Recognition of Values and Self Positive Parenting Authenticity is defined as living a life true to yourself. I believe authenticity is about aligning your life so the following parts of you are congruent. Beliefs Thoughts Feelings Words Actions As I was reading Dr. Phil’s book it began to occur to me I had no real idea what my self-talk was and how it was shaping my life. I began to wonder if other people felt the same way. At the time, I was working with a group of moms and I began to talk with them about what I was reading and how it was affecting my life and I wondered what they thought. It was amazing every woman in the group of 12 shared the same feeling. Exploring your own self-talk-taking the time to stop and get your mind and surroundings as quiet as possible while thinking about a decision. Finding out what our own inner voice was saying and deciding about whether this is what we wanted for our lives. We began to think about and create a space where we could be open and vulnerable with one another about how do develop our own self-talk. As we did so something interesting started to happen, the kids started to respond differently to how we interacted with them. Upon reflection, we recognized in developing our own connection with our inner voice it causes significant changes in our outer voice as well. This is where I began to realize that authenticity is the true foundation of parenting. I call authenticity living a life based on what I truly believe, and let that be the basis from which I think, say, feel, and act. Bringing my life into congruence. This causes me to be clearer on what I want and what I expect. Living an authentic life is not easy. If you want to learn more about it. I wrote a post for Inspire Me Today which gives a short post on how to start. Exploring your values and goals-Being authentic is primarily about exploring who you are and what you want in your life. I have created a list of ten questions I ask every client today. You can use them to help you think not only about the values you consider important. But, also why they are important to you. 1. What is the most important thing in your life? 2. What is your biggest dream? 3. Who are the most important people in your life and why? 4. If you could do anything in the world for your work life, what would it be? 5. If you could do anything in your personal life what would it be? 6. What do you spend the most time doing? 7. In one to three sentences write down what you would want people to say about you after you die. Are you living in a way in which people would say that? 8. What are your most important roles in life? Why? (I.e. mother, father, sister, friend) 9. What would you say living a spiritual life is to you? 10. If you could sit down to dinner with three important people in your life dead or alive and have; what three people would you ask> What would you ask them? These questions get down to the core of your belief system and therefore get to the heart of what your inner voice is saying to you. It was not until I came up with this list and answered the questions myself that I began to really define what my life was about and why. It was this understanding which gave me the courage to strike out on my own and start a nonprofit organization based on effective parenting. I firmly agree with Dr. Phil when he says, “you can’t lead where you haven’t been”. We adults need to know, understand, and adjust our own inner voice to be a positive one before we can ever get our children’s inner voice to be positive. This is because it is our voice which forms the foundation for the future inner voice of our kids. If we are not positive, they will not be either. How we answer the above 10 questions will help to know what you value and why. Once we know this we can then step back and examine how we feel about things and weigh what we think, say, and do based on these insights. Here is how we change our voice. Know our values and why we think they are important. Based on these values create positive statements to replace the negative ones which may come up. When making decisions listen to our inner voice for any negative feedback.

November 21, 2017
Parenting Hub

Spectacles can mean the difference between success and failure for an underprivileged learner

Sight is something most people take for granted, yet at least 239 million children around the world suffer from impaired vision that could be corrected by spectacles. Since 80% of all learning occurs through vision, children who cannot afford spectacles are at a major disadvantage in education environments, which can lead to lower earning potential later in their lives.* As we observe World Sight Day on 12 October, the Adopt-a-School Foundation (AAS) encourages partners in the private sector, civil society, and government to support its efforts to address the issue of impaired vision that affects millions of underprivileged learners in South Africa. AAS first encountered this issue six years ago in Bodibe, a small village nestled in the rural part of the North West province, when they were conducting educator development programmes in 11 schools in the community.  Educators shared their frustrations with AAS, saying that many children were being disruptive and unable to concentrate. When AAS investigated the matter, they decided to test the learners’ eyesight, and found that more than half of the children had vision problems. “At AAS we use a unique Whole School Development (WSD) approach to school development,” says Banyana Mohajane, Head of Skills and Social Development at AAS.“Rather than tackle an individual issue, WSD works to improve the school holistically by focussing on the academic, infrastructural, social, and security environment in which a school operates. This includes issues such as learner health and well-being, and includes eyesight testing,” she continues. “Most children in our adopted schools have never had their eyes tested,” explains Mohajane. “Through the introduction of mobile eyesight testing clinics, we have found that up to 15% of these learners have vision problems, which could lead to poor academic performance,” she continues. The benefits of treating impaired vision are immediate and clear. Research by the World Economic Forum has found that simply correcting the vision of primary school students is equivalent to another six months of additional schooling in terms of test scores. There is also strong evidence that the provision of spectacles leads to higher earnings, and can lead to increases in GDP.* “Over the last six years we have partnered with optometrists to conduct nearly 60 000 eyesight tests. We have donated 2 697 pairs of spectacles to learners in need and have referred the more serious cases to specialists and the Department of Health,” continues Mohajane. “Together with our partners, we hope to test the eyesight of many more school children across South Africa,” she concludes. For more information on Adopt-a-School or to contribute to this programme, visit the Foundation’s website at www.adoptaschool.org.za,  email info@adoptaschool.co.za or call 011 592 6430.

November 21, 2017
The Headache Clinic

No more headaches about exams

Examinations are stressful enough for learners and students, without them having to worry about headaches and migraines. Unfortunately it has become an ordinary occurrence for students and many of them feel helpless when dealing with this problem. They can feel so overwhelmed that they completely forget about the effects this is having on their health. Dr Elliot Shevel, South Africa’s pioneer in the field of migraine surgery and the medical director of The Headache Clinic, says headaches and migraines can have adverse effects on the performance of students and suggests the following measures: Be aware of your posture when studying as this can result in a tension headache. Use a good chair that supports your back and that gives the ideal posture. Visit www.headacheclinic.co.za to get a free copy of the Ideal Computer Posture. Learn the right stretching exercises to stretch the muscles of your head, face, neck and jaw. Finding out what triggers your headaches by keeping a diary. Each time you suffer from a headache, make a note about the warning signs, triggers and severity. If you can discover some of your personal triggers, you may be able to avoid future headaches. This diary is important as it will give your medical professional an accurate history of your headaches. Dietary migraine is a common affliction. These are usually triggered by foods that assist with energy such as chocolate. Chocolate raises the blood sugar levels quickly and then allows it to drop quickly again. Low GI (Glycaemic Index) foods give a more even blood sugar level. Use the nutritional facts label to help choose healthy foods when shopping. A dietary trigger diary is available on www.headacheclinic.co.za under “Free Assistance”. Beware of Medication-Overuse Headache (MOH). Medication is only appropriate for someone who suffers a few times a month. According to the International Headache Society, if you are taking medication more than twice a week you are at risk of developing MOH. This means that the drugs you are taking will cause the migraine to become more severe and more frequent over time. Dehydration is a common trigger, adequate intake of fluid throughout the day to prevent headaches. The human brain is more than 75% water, and it is very sensitive to the amount of water available to it. When the brain detects that the water supply is too low, it begins to produce histamines. “If the problem persists, it is imperative that you get an accurate diagnosis” says Shevel. “There are a number of treatment options that can be investigated. The longer the headache persists, the more damage will be done. One must get to the bottom of the problem and resolve the pain permanently.”

November 17, 2017
Parenting Hub

How to fix a broken diet?

Are you not getting the results you wanted or your diet plan stopped working? Every diet and exercise system is going to stop working at some point. No matter how great it seems initially, that diet will break. And when it does, your next step is crucial. In this newsletter we’ll be discussing the main strategies to fix a “broken diet” and start eating better. DON’T REALISE YOUR DIET IS BAD In my many years as a dietitian, I came well aware that we humans generally suck at realising what we’re eating. For one, we typically tend to remember the “good things” we do – how we turned down the rusks as they were going round the office last Friday, or how we managed to go a whole week without alcohol. And when we do something “bad” we’re really good at justifying it. “It was so-and-so’s birthday, “or “Yes, I did have that slice of cake, but my friend had 2 slices, so I’m not as bad as her,“  are common reasons I hear for making poor dietary choices. In fact, we’re so bad, that a study from the New England Journal of Medicine found that obese subjects underreported their food intake by an average of 47%, and overestimated the amount of calories burned from exercise by 51%. What does this mean? It means that we think we are eating a lot less than we are, and that we think the exercise we are doing is burning far more calories than it really is. End result – we make little progress and become disheartened with the results. STEP 1: GET TRACKING – KEEP A FOOD DIARY I am a huge fan of food logs. For a start, it gets a person thinking about exactly what they’re eating. Mindless eating is a big problem for many. Writing down everything one eat and drink, over a 2-week period, gets you off to a great start in identifying possible problem areas and underlying nutritional deficiencies. STEP 2: IDENTIFY AND CORRECT NUTRITIONAL DEFICIENCIES Most people think they need a complete diet and exercise make-over. “I have to cut out sugar… and dairy… and carbs… and saturated fat. Plus I have to eat more protein… more healthy fats… and more vegetables. I have to start drinking lots of water too. And exercise… maybe a 6 am boot camp… yeah.” I don’t know about you, but I get exhausted just thinking about changing all this, all at once and often people set themselves up for failure. Let’s call it the “Mission Impossible” approach. Often, people struggle with how they look and feel because their physiology doesn’t work the way it should. This can be hormonal imbalances, but it’s more often dietary deficiency: not getting the right nutrients, in the right amounts, to feel your best and get the best results. Dietary deficiencies are more common than you think A study published in the Journal of the International Society of Sports Nutrition showed that it’s really hard to get all the essential vitamins and minerals from food alone. Of the individual diets that were studied – every single diet was deficient in at least three nutrients. Some diets were missing up to fifteen nutrients! The most common deficiencies included vitamin D, zinc, calcium and some of the B-vitamins. The most common deficiencies I see at Paarl Dietitians are water (low-level dehydration), vitamins and minerals, protein (particularly in women and in men with low appetites), essential fats e.g. omega-3 fatty acids (95% of the population is deficient here), vitamin D, iron and B-vitamins. Bottom line: Dietary deficiencies are very common. Chances are you’ve got one, no matter how good you think your diet is. That’s a problem because when you’re deficient in key nutrients, your physiology doesn’t work properly. And when your body doesn’t work as it should, you feel rotten. Energy levels, appetite, strength, endurance, and mood all rely on getting enough of these essential nutrients. When you don’t get them, things break down. Correcting deficiencies Analysing a food log and blood testing can uncover specific nutrient deficiencies that can be corrected by means of dietary adaptations and nutritional supplementation. As soon as we get the nutrients we need, we thrive. Once we’re getting all the essential nutrients necessary for proper functioning we can move on to bigger issues. These include adjusting food amount (what some call calorie intake) and food type (which includes diet composition or the distribution of protein, carbohydrates and fats). STEP 3: DO NOT EXCEED YOUR METABOLIC RATE For our body to function normally, it needs a constant supply of energy and a variety of nutrients. The amount of energy or number of caloriesyour body uses to carry out these basic functions is known as your basal metabolic rate (BMR) — what you might call metabolism. Thus the metabolic rate is the rate at which the body burns calories. So how much should one eat? The problem comes in when energy is taken in excessive amounts. Too much energy and the body will store the excess as fat and you will gain weight. In other words, if your body uses 1500 kcal to maintain weight, you need to take in at least 500 – 1000 kcal less to lose ½ kg – 1kg per week, therefore a 1000 kcal diet plan. Our practice assess metabolic rate and an individual’s eating plan are devised according to the person’s metabolic rate. By knowing your metabolic rate, we are able to provide correct food amounts and portion sizes to ensure long term weight loss. The secret lies in calorie and portion control. Remember the success of weight loss is an individual approach. Don’t count calories, Be Calorie-Conscious Calorie counting can be very exhausting, time-consuming, confusing and incorrect! Plus this approach just doesn’t suit everyone’s’ lifestyle. Being ‘calorie-conscious’ is a much better approach. The term ‘calorie-conscious’ is a great one, and can often be a real eye-opener. I like to go over an individual’s food diary and pick

November 17, 2017
Parenting Hub

Some games are good for cognitive development – experts say

Certain toys and games play an integral part in a child’s cognitive development and one of the best ways to nurture a young brain is through play – it challenges thinking and the ability to process information. The body as an “architect of the brain” Parenting expert Nikki Bush explains that the body is an “architect of the brain” during childhood and in order to best understand the world around them, children need to be exposed to a range of scenarios to ensure the brain remains stimulated. She says that school, home and the outdoor environments are important; and so are toys and games with educational value, like Lego, and arts and crafts.  Engaging in conversation with both adults and children is also a “big advantage” and encourages interaction and open communication. Different stages; different needs “Children go through different stages of development that all play a role in their ultimate cognitive development. Different environments, different people and different toys with value help to stimulate the young mind and assists children to interpret new information accurately,” Bush says. And a young brain learns easily, she explains that during childhood the brain is “extremely plastic and elastic” and with the result, learning is much easier for young children than older people. “Ever hear the saying that a child’s brain is like a sponge? That’s because it’s 100 percent correct, much learning happens when they’re young as they’re able to absorb information and understand things quite easily,” she says. Phases of learning: Concrete Semi-concrete Abstract   The concrete learning phase is most important, Bush says no images on screens or in a book can substitute the real thing, “real trumps everything in early learning”. The Child Development Team at Toy Kingdom South Africa says stocking toys that are good for cognitive development is high on its priority list. The range of Hape products, along with Lego are just few developmental toys on the store’s shelves. “Children thrive on three-dimensional learning. And the concrete phase allows a child to interact with a real object with their bodies. They are able to feel that an apple is round, see its colour, taste and smell it,” she says. Bush says children should be able to internalise and experience with their bodies for an ultimate memorable learning experience.

November 14, 2017
Parenting Hub

Your child is sick, and you feel guilty. Why?

There is nothing worse than when your child is sick. As a parent, you feel the need to do everything in your power to take care of your child. “But, the truth is, although you can do everything in your power to try and prevent your child from getting sick, or getting hurt, these things happen,” says Carla Yssel, brand manager for Linctagon®, “and mommy guilt is a real thing.” We don’t account for the guilt that a parent feels when their child is sick. “Mommy guilt, and daddy guilt are real emotions that almost all parents feel – it’s the feeling that you haven’t done enough to protect your child from anything and everything,” says Yssel. Yssel says parents need to give themselves a break and she gives them following advice: At night instead of looking at all the things that went wrong during the day, congratulate yourself on the things that you did right. This will enable you to see that you did succeed during the day and not everything is as bad as it may seem. Give yourself a break. Remove yourself from the guilt for a little bit – go for a cup of coffee, meet a friend for dinner – remember who you are as a person and not only as a parent. This will give you a break, and when you return you will be able to focus more on your children. Be prepared (as much as you can be). When it comes to children things can tend to go a different direction than expected, and you need to have the basics covered in case they do. Keeping a stocked first aid kit including band aids, and antiseptic ointment are a must. Children get sick – deal with it. Your child is not sick because you have to work, or because you gave them fish fingers one night for dinner instead of vegetables. Your child is sick because that is what happens. Linctagon® boasts a full range of medicines to help deal with any aspect of the common cold or flu, and Linctagon® Effervescent Junior can help children get over colds quicker than usual. It contains the active ingredient Pelargonium sidoidesand through its active support can shorten the duration of the common cold as well as reduce the severity of symptoms. It also contains added vitamins A and C, anti-inflammatory MSM and immunity enhancer Zinc.

November 9, 2017
Parenting Hub

Breastfeeding can help prevent both breast cancer and childhood cancer

One in every 20 women in Southern Africa will develop breast cancer at some point in their lives.* As we observe Breast Cancer Awareness Month in October, the South African Breastmilk Reserve (SABR) urges women to take action to reduce their risk of developing breast cancer. “Many women understand the basics of breast cancer prevention, for example getting enough exercise, maintaining a healthy weight, and eating properly,” says Professor Suzanne Delport, breastfeeding activist and Medical Director of the South African Breastmilk Reserve (SABR). “Few realise that breastfeeding your child for at least a year significantly lowers the chance of contracting breast cancer later in life,” she continues. While breastfeeding, the mother and infant are benefited simultaneously. Breastfeeding also improves long term outcomes for both mother and infant long after cessation, particularly outcomes related to cancer. A long period, six to twelve months, of breastfeeding: Decreases the risk of invasive breast cancer by 7%. This percentage translates into the annual prevention of 20 000 breast cancer deaths globally. Decreases the risk of ovarian cancer by 18%. Has long term beneficial effects on the health, nutrition, and the intellectual development of a child. Greatly reduces the risks of obesity and both type 1 and 2 diabetes in a child.**** Clinical studies have proven that producing breast milk tends to inhibit cells from “misbehaving” and becoming cancerous. Many women have fewer menstrual cycles while breastfeeding, which in turn lowers their oestrogen levels, which are a major cause of breast cancer. Women also tend to lead healthier lives while breastfeeding, and will often stop smoking and drinking alcohol while they are nursing.** Breastfeeding also reduces the chances of your child developing childhood cancers. A recent study found that babies who were breastfed for at least six months appeared to have a 19% lower risk of childhood leukaemia compared to children who were never breastfed or were breastfed for a shorter period.*** “Of course, breastfeeding is just one factor in combatting breast cancer. Women should take as many precautions as possible to reduce their risk,” says Delport. “It’s vital that every woman in South Africa learns how to conduct breast exams on themselves and commit to having regular mammograms. Smoking is also a huge contributor, and quitting this habit can reduce your risk of all cancers enormously,” she continues. Some women develop breast cancer before they have children, or even while they have a young child of breastfeeding age. “A breast cancer diagnosis doesn’t necessarily mean that you won’t be able to breastfeed,” says Delport. “Many breast cancer survivors go on to successfully nurse their infants. It’s important to explore all the options with your doctor, and not to give up hope,” she continues. “Human milk banks exist, in part, to help those mothers who are unable to breastfeed at all,” explains Delport. “So even if you’ve had a double mastectomy, you’ll still be able to feed your child with nature’s perfect baby food,” she concludes. To get involved and alleviate the challenges faced by the South African Breastmilk Reserve (SABR), including the low breastfeeding rates in South Africa, sourcing donor mothers, and funding for the operation of the milk banks, please visit www.sabr.org.za or call 011 482 1920 or e-mail: info@sabr.org.za.

November 9, 2017
Parenting Hub

Drink Rooibos Tea to Improve Concentration During Exams

Coffee and energy drinks are usually the go-to beverages for high school learners and students to help them cram for finals during the stressful months of October and November, but science suggests they drink rooibos tea as an alternative to help them stay on top of their “A” game. Several studies point to rooibos tea’s ability to protect healthy cells from damage caused by free radicals and that its high level of antioxidants could reduce the effects of oxidative stress, which learners and students typically experience in the lead up to and during end-of-year exams. Adele du Toit, spokesperson for the SA Rooibos Council explains that the brain appears to be especially susceptible to excessive oxidative stress, because of its high demand for oxygen. “Dietary antioxidants, like the polyphenolic compounds found in rooibos, have been shown to protect neurons against a variety of neurodegenerative conditions. Reactive oxygen species (ROS) or more commonly referred to as ‘free radicals caused’ by poor nutrition, cigarette smoke, excessive alcohol intake, pollution, among other factors, are harmful elements that trigger oxidation (disruption of a living cell) in the body and brain. The stress hormone, cortisol, which is elevated during exam time, increases inflammation, and further intensifies free radical production. “When these free radicals cause oxidation in the body, they damage the healthy cells which could hinder one’s ability to learn and retain information. Rooibos counters this impact by reducing the effect of oxidative by-products in neural pathways thereby stimulating concentration and focus. “Unlike coffee, which could give you the jitters followed by a crash, rooibos tea is a cleaner-burning and longer-lasting fuel for the body since it doesn’t contain any caffeine or tannin. An added bonus is that it also relieves tension and headaches,” she remarks. While consuming small amounts of caffeine daily is not harmful, drinking too much, such as during exam time, could prove dangerous and lead to a physical dependence since it is highly addictive. The temporary boost of energy it gives you, may also keep you awake for longer than is needed, which could lead to unwanted fatigue on exam day. Du Toit recommends six cups of rooibos tea a day for optimal replenishing of critical antioxidants. “Rooibos tea has no side-effects and contains some of the strongest and most unique antioxidants in the plant kingdom, including aspalathin and nothofagin. Students should make the most of this natural energy drink, which is tasty, affordable and can be enjoyed hot or cold.” Here’s a few fun twists on rooibos tea to get you through your finals: Basic rooibos iced tea: One litre of Rooibos tea using four to six teabags Sweeten the tea with honey to taste and leave it in the fridge to cool overnight Experiment with this basic iced tea, by adding mint, lemon, orange, granadilla, mango or apple, or a combination of flavours until you find one that you love. Juiced or squeezed fresh fruit usually delivers the best results, but you can also use honey and preservative-free fruit juice. Mixing it with cold rooibos will make it go further and keeping a jug of it in the fridge should mean you don’t have to keep buying juice. Rooibos can be kept in the fridge for up to two weeks without spoiling. Rooibos and berry iced tea: 8 rooibos tea bags or flavoured rooibos of your choice 1 cinnamon stick 4 whole cloves 6 thin slices ginger 4 cups (1 litre) boiling water 4 cups (1 litre) 100% berry juice, chilled Lemon juice to taste Place tea bags, spices and ginger in a large glass jug and pour over boiling water. Stir well and allow to cool for about two hours. Remove tea bags, ginger and spices. Add berry juice to the tea and season with lemon juice to taste. Enjoy cold with ice and mint leaves, fruit and lemon. Rooibos ice-lollies: By pouring some Rooibos iced tea into popsicle containers or ice-cube trays and freezing it, you can also enjoy it as a refreshing treat when you get the munchies while you’re studying. For more info about the health benefits of rooibos, visit www.sarooibos.co.za

November 9, 2017
Parenting Hub

Exams: Study Time vs Screen Time – Striking the Balance

Helping children to build a healthy relationship with technology, and knowing how much of what is enough, is challenging for parents under the best of circumstances. Exam time however throws a whole new spanner in the works, an education expert warns. “While some parents might want to introduce new house rules or impose a total ban on screen time during important periods such as exams, that approach could be counter-productive,” says Nola Payne, Head of Faculty: Information and Communications Technology at The Independent Institute of Education, SA’s largest private higher education provider. “However it is necessary to review and agree on how devices and especially social media will be used during this period,” she says, “and parents and guardians should play an active role in assisting young people to strike the right balance.” Payne warns that parents will face a lot of resistance if they implement a total ban on social media interaction, which will not be conducive to a positive studying environment.  “Matric and other exams are already very stressful, and social media can help learners and students unwind and let off steam by sharing their concerns, clearing up study material confusion and encouraging each other. “A better approach would be to rather restrict social media during focussed 1-2 hour study sessions so concentration is not interrupted, and allow it during breaks – preferably away from the desk – in conjunction with a healthy snack and some fresh air.” Payne says that in general, parents should assist their children to build a healthy relationship with technology from an early age, noting that technology has become an integral part of children’s lives. “While there are of course dangers and concerns, technology has also brought many advantages and opportunities. Our children need to build a set of skills – hard skills and common sense ones – around technology as it will always be a huge part of their lives, whether when researching school work, investigating higher education options or searching for career opportunities, or whether for entertainment or engaging with social media contacts.” She says that approaching technology positively and pragmatically right from the start can help families engage better. “It can improve their resourcefulness, open up new avenues for learning and help them better understand how to manage social interactions. Parents need to be honest about their own concerns and should support and mentor their children by creating the right environment in the online world, as they would in the offline world. “Encourage the learning, whether it is online or offline, but set boundaries and time limits on digital engagement, study methods (which should also include pen and paper and not just digital learning) and also digital social interactions during exam time. There are thousands of mobile apps and software applications that support learning in a fun and constructive way, and that can ensure that study time is in fact study time, and not Facebook time in disguise.” Payne says there are 4 simple things parents can do to ensure healthy technology habits for life: Create and schedule fun offline activities and spaces where the family can interact without technology. Spend time with your younger children sharing your “tech time”. You can sit with them and create study notes or play an educational game together. This form of interaction can open up interesting discussions, in a natural way, and not feel like it is a forced conversation. The interest you show in your young child’s technology interactions will build a feeling of trust between yourselves and technology will be seen as a constructive tool for learning. Respect your children’s privacy. This could be as simple as asking for their permission before you share and tag pictures of them online. If they don’t want you to do it, then respect their wishes. Set boundaries (which the adults need to adhere to as well), for instance not interacting with technology during dinner or if someone is talking to you. “Parents need to embrace our changed world and work with their children to encourage a balance between technology and the physical world,” says Payne.

November 6, 2017
Edublox - Reading & Learning Clinic

Is our knowledge about dyslexia dated? What is the contemporary view?

“According to popular belief, dyslexia is a brain disorder which causes otherwise smart and intelligent children to struggle with reading, spelling and writing,” explains Susan du Plessis, Director of Educational Programmes at Edublox. “The problem is that a lack of education about dyslexia has caused many myths that discourage parents the moment they hear of the dreaded word.” The term ‘dyslexia’ originated in 1884 and was coined by the German ophthalmologist, Rudolf Berlin. It comes from the Greek words ‘dys’ meaning ill or difficult and ‘lexis’ meaning word. Since then, researchers across a variety of disciplines have tried to understand the causes and possible solutions for the problem. “Instead of viewing the collective research in its entirety, we tend to catch bits and pieces. Some of our beliefs about it date back to times before modern-day technology and research revealed the good news about dyslexia,” Susan continues. In a nutshell, some of these misguided beliefs include: The brain of dyslexics differs from poor readers with low IQs; These brain differences are the cause of dyslexia; A host of famous individuals such as Albert Einstein, Walt Disney and Hans Christian Andersen were dyslexic; There is no remedy for dyslexia. One source states it quite bluntly: “Dyslexia is like alcoholism, it can never be cured.” * Susan explains that contemporary research sheds doubt on some of these old beliefs. With the rise of modern fMRI-scanning technology which allowed neuroscientists to explore the human brain in more depth than ever before, old myths about dyslexia have been debunked. Neuroplasticity is a field of study that is significantly influencing the grasp that we have on dyslexia. According to research conducted in this field, the human brain has the ability reorganise itself by forming new connections throughout a person’s life. The findings from a variety of recent studies contradict earlier beliefs in the following ways: Using brain imaging scans, neuroscientist John D. E. Gabrieli at the Massachusetts Institute of Technology found that there was no difference between the way poor readers with or without dyslexia think while reading. ** In a study, published online in the Journal of Neuroscience, researchers analysed the brains of children with dyslexia and compared them with two other groups of children: an age-matched group without dyslexia and a group of younger children who had the same reading level as the children with dyslexia. Although the children with dyslexia had less grey matter than age-matched children without dyslexia, they had the same amount of grey matter as the younger children at the same reading level. Lead author Anthony Krafnick said this suggests that the brain differences appear to be a consequence of reading experience and not a cause of dyslexia. *** Studies of the biographies of Einstein, Disney and Andersen and many other “famous dyslexics” reveal little resemblance with individuals who are currently labelled dyslexic. For example, Einstein was reading Darwin’s writings at age thirteen. “The myth of these ‘famous dyslexics’ has been perpetuated by advocacy groups over many years to keep dyslexia in the lime light,” says Susan.“The problem is that myths like these distract from the scientific study of the field and subtly hints that it can only be okay to have dyslexia if a string of famous people also struggled with it, while that is not the case.” The belief that dyslexia cannot be overcome is deeply rooted in the theory that the brain cannot change. Today we know that the human brain is a powerhouse. New connections can form and the internal structure of the existing connection can change. Susan has been extensively involved in research on the subject of reading difficulties over the last 25 years, and has made a few observations that may give South African parents hope. “At Edublox, we believe that dyslexia is not a DISability but simply an INability. While there are other causes, the most common cause of dyslexia is that the foundational skills of reading and spelling have not been mastered properly. Massive strides can be made when children’s cognitive deficits are addressed, and have seen we have seen amazing results with this approach.” Javier Guardiola, author of the research paper, ‘The evolution of research on dyslexia’ applauds contemporary research and how it has contributed to our understanding of the subject. “Dyslexia is currently an interdisciplinary field of study, involving disciplines as varied as education and neurobiology. Researchers hope that the answers to this complex learning disability lie in the intersection of all these disciplines,” he writes. **** “To create awareness about dyslexia, we need to keep abreast of the latest research and what this means for our children. As parents, we need to keep looking for solutions and support systems that will help us tackle the symptoms associated with dyslexia. And the good news is there has never been a better time in the history of the field,” concludes Susan.

November 3, 2017
Parenting Hub

When to supplement your child’s diet

Children come in all shapes and sizes. But if you’re noticing that your child is shorter than her friends at school, it’s natural to wonder, “is my child growing normally?” Most children take well to eating solids for the very first time. Being naturally inquisitive, children will try a variety of gloopy and colourful tastes and textures. Unfortunately, as babies become toddlers, their tastes in foods begin to change dramatically. As parents, this period may be particularly stressful leaving you worried about whether or not your child’s diet adequately meets their growing needs. This is a greater concern if your child is growing more slowly than their peers. Therefore, it is important to know what the ‘norm’ is when it comes to your child’s growth and development. Registered dietitian Abigail Courtenay has answered a few questions commonly asked by moms. What are the consequences of undernutrition/ underweight¹ ²: Being underweight interferes with optimal growth and development as it is often related to nutrient deficiencies. Specific nutrients are required to support your child’s cognitive health, immunity and physical development. What are the causes for slow growth? There are many factors that could lead to slow growth namely: Poor appetite (this may also occur in healthy children) Acute or chronic illness Restrictive eating due to illness (like allergies) or misinformation Poor absorption (e.g. coeliac disease) Chewing or swallowing difficulties (e.g. children with cerebral palsy) What is considered normal eating behaviour? You can safely assume that children gaining weight appropriately according to their growth chart are getting enough to eat (even if you believe they should be eating more). Children from the ages of 3-5 years have demonstrated the ability to self-regulate their energy intake. Your child’s appetite will depend on a variety of factors such as level of tiredness, activity levels and growth spurts. Some children experience what is known as a food ‘jag’. This is when a child gets fixated on a certain type of food or food group and refuses all other foods. It is not clear how long these food jags last but often a child’s overall nutritional status is not affected by them. ¹ What can I do to help my child enjoy food more¹? Offer a variety of nutritious foods Repeat exposure to foods (sometimes it can take up to 15 repeated exposures before a food is liked/ tolerated) Scheduled meal and snack times (this makes eating a routine and assists in managing your child’s nutritional needs) Provide more frequent but smaller meals Be your child’s role model for healthy eating (i.e. eat healthy foods yourself!) Remove distractions at mealtimes (i.e. TV, tablets and phones) What should I avoid doing¹? Don’t force or pressurise your child to eat Don’t prepare separate or special meals for your child Don’t give rewards for trying new foods Why shouldn’t I force or pressurise my child to eat? Pressuring young children to eat may cause overeating, which may lead to excessive weight gain, or may cause them to actually eat even less as a result of the stress. Either way, pressuring children to eat may upset your child’s natural appetite control system, resulting in them ignoring their internal hunger and satiety cues. ¹ When should I consider supplementation (in the form of a nutritional drink)? If you are concerned about your child’s diet, observe slow growth patterns, or if your child is falling behind in height and weight, this could be a good opportunity to introduce a drink-type nutritional supplementation*. Drinks are often well tolerated by most children and can be made into fun and tasty snacks using a variety of flavours like hot chocolate or fruit puree. Drinks are preferential because they are easier to consume in-between meals, more than food, and may be more acceptable and manageable to a child. * PediaSure® is a tasty and convenient nutritional drink that can be used to supplement a child’s diet during these times. By giving two glasses of PediaSure® to your little one (as an early intervention) per day, you can support their nutritional status, promote healthy growth and normal development. ³ References and notes: Practice-based Evidence in Nutrition: Toddler and Preschool Nutrition – Influences on Appetite and Eating Behaviour. Key Practice Points. Last Updated: 2016-04-01. Mahan KL, Escott-Stump S. Krause’s Food and Nutrition Therapy. 12th edition. Philadelphia: Elsevier/Saunders Publishing. Huynh DTT, Estorninos E, Capeding RZ, et al. Longitudinal growth and health outcomes in nutritionally as-risk children who received long-term nutritional intervention. J Hum Nutr Diet. 2015; doi: 10.1111/jhn.12306: 1-13.

November 3, 2017
Kaboutjie

7 Things every mom should know about trampolines

We know that moms, always being the cautious ones, often feel skeptical about trampolines and the prospect of their kid bouncing on one. Much of it is due to unfounded rumors or exaggerations. It’s only unfortunate that the benefits of trampolines don’t get passed around as often… to the detriment of everyone involved. Let’s clear up some of the misconceptions and find out why moms all over America have taken to trampolines and enjoy bouncing with their kids! 1 Trampolines Are Very Safe Compared to the trampolines of yesteryear, most of the trampolines on the market now come equipped with a plethora of safety features to minimize the risk of any accidents. Almost all trampolines come equipped with an enclosure and generous safety padding to ensure maximum safety. An overwhelming majority of trampolines we’ve tested meet the minimum safety requirements. Safety is also enhanced if you abide by the recommendations, which state that only children above 6 should bounce on the trampoline. Also, never let more than one child bounce. Most of the accidents happen when jumpers collide with one another mid-air, not when someone falls off (which the enclosure prevents anyways). Our extensive database of trampoline reviews  can help you make the optimal purchase decisions and we put special emphasis on the trampolines’ safety features. As you’ll see, these trampolines are in no way like those old beaters without a safety net or even stable legs! 2 You Can Keep an Eye on Your Kid If you had a trampoline, where’d you put it? In your back yard, of course. And where would your kid play? In the back yard, as well, bouncing on the trampoline! This way, your child will always be near you and you can easily see what they’re doing. There is no risk of them running around the neighborhood unsupervised. You can simply relax on your patio and be safe knowing where your child is at any time, instead of not knowing where your child is and calling all the moms in the area sick with worry. 3 It’s Healthy for Your Kids… Trampolines are an excellent way for your children to exercise. Think about it – these days most of the kids are glued to their phones or computers and won’t do anything outside. And even if they do, parents feel uneasy as the neighborhoods of today are not what they used to be. Luckily, trampolines solve both issues. It’s in your back yard and the kids can be active. Bouncing on a trampoline burns 60% more calories than jogging, according to a NASA study. It is a low impact exercise, meaning it doesn’t strain the joints and ligaments the way running does. The forces are much more evenly distributed all over the body, thus eliminating knee and foot pain common when jogging. Exercising on a trampoline is a great way of maintaining healthy body weight and fighting the obesity epidemic. They are especially good if your children don’t have a semblance of athletic prowess nor any inclination to do something about it. Instead of nagging and urging them to exercise, they will happily bounce on the trampoline, as they will view it as a fun game instead of a boring exercise. They’ll be none the wiser and won’t ever get the wind of your devilish scheme! 4 … And You And by that, we don’t mean only in a physical way. Any benefits already stated (and much more that we had to left out) also apply to adults. But the benefits aren’t only physical. Yes, trampolines are a great way of reducing stress and unwinding after a particularly tough day at work. And yes, they will help you keep trim and slim, strengthen your bones and your lymphatic system. But they will also let you bond with your kid better – by being near them – and your partner as well. The children will be more tired and will go to bed earlier, thus saving you a lot of frustration and arguing with your spouse – a sight too often seen in homes all around the country. 5 You’ll Be the Coolest Mom Enough with the health talk – now it’s vanity time! Seriously, we all want for our kids to have the best we can provide. It can be disheartening to hear that your kid wants to play elsewhere because their friend has that cool toy that their parents bought them. Why not bring out the big guns? With a trampoline, your kid, and as a consequence, you, will become the coolest folks in the neighborhood – and everyone will flock to your back yard (if you so desire, of course). It can be a boon for your kid’s social life, and who knows – a nice opportunity to catch up with your neighbors as well! 6 They won’t break the bank People often have a misconception that trampolines are something ridiculously expensive and only the richest people can afford it. While trampolines that cost a king’s ransom certainly exist, even a modest budget will go a long way. There are a lot of trampolines that are both affordable and well-made. As little as $300 can get you a fair, decently-sized trampoline of about 14ft with all the usual safety features that make trampolining a worry-free exercise. However, not all trampolines are the same. To help you separate the wheat from the chaff, our handy review database will do all the work for you! 7 They Liven Up the Back Yard Trampolines need not look ugly and drab. There is a plenty of models that look fresh and sharp. A nice trampoline is a great way to improve the look of your back yard, especially if there is a lot of empty, unused space. They come in various sizes and shapes, and if you prefer rectangular over oval or round trampolines, there is plenty of choice. Now that you see that trampolines are loads of fun for everyone involved, it’s time

October 30, 2017
Barbara Harvey

How to Talk to Kids about Death

Let’s just get it out there: nobody really wants to talk to kids about death. Death is a part of life none of us really want to deal with, and helping children deal with grief can be really difficult,  as a parent. So, how does a help when your child has suffered a loss? First, deal with your own grief and sadness. Remember, we are the models for kids. How we deal with death and grief is how they will deal with it. We must determine how we feel about death and dying, preferably before we have to help children deal with it. Talking to kids about death is important, but we can’t do it until we have had a conversation with ourselves. Questions to ask yourself about death and grief: What do I feel about my own mortality? How did I handle my last bout with grief and sadness? What do I believe about the afterlife? What do I want to teach kids to believe? What do my employers believe, and how can I support them in dealing with grief and sadness? What do I want to tell the children about remembering the (person or pet) we need to say goodbye to? Could I benefit from group or individual grief counseling? I suggest that, as you think and talk about these questions with your loved ones, you keep a journal. Doing so will allow you to revisit your decisions and not have to rely on your memory. Organize everything you think of as associated with grief in one spot, so it is easy to grab and use. Once this is done, you will be more relaxed and less stressed, should something inevitable happen. Now that you have thought about your position on death and grief, you are better prepared to help the children. General Tips for Helping Kids after a Death There are several things you can do to support children during times of grief and sadness. Communicate. Talk about your feelings and theirs, read books for kids about death, grief and sadness together. Give the children words they can use to discuss their feelings. Be physically affectionate. On purpose, give more hugs, and let children be close while reading, watching TV or movies, or playing games. Be active. Provide a variety of activities for children to get involved in. Children need physical and mental distraction, and trying new activities in addition to their favorites may help them to move on. Pay attention. Pay close attention to how the child seems to be processing through their feelings of grief. Consider grief counseling. Discuss any plans for children to attend a children’s grief support group. Grief counseling is vital if the child experiences the loss of a parent. One important thing to keep in mind when n children experience a death is that children are naturally egocentric, which means that – right or wrong – they believe they are linked to everything that happens. It is a safe bet  the child somehow blames himself or herself for the death. For example, a child may think: “I did not finish my vegetables and that is why my dog, Scooter, died.” When talking to kids about death, emphasize that death is part of life and that no one is to blame, but that the child especially is not at fault. How you handle your approach to death and grief will largely depend on the age of the children.  If a child’s grieving behaviors last for more than three months, it is time to speak with the child’s pediatrician about intensive specialists for children’s grief counseling. Talking to Kids about Death: Birth to Age Three Many people make the mistake of thinking of children and grief as incompatible at this age; people believe that infants and toddlers do not have emotions like the adults. This is not true. Babies can and do feel grief and sadness, especially if the loss is of a parent or caregiver. Infants and young children who are sad, stressed and showing signs of grief may begin to: Show signs of lethargy Complain of frequent tummy aches Become cranky and clingy Take a developmental step backwards, such as a potty trained child having more accidents, or a child’s talk reverting to babble or baby talk. Book suggestions: Are You Sad, Little Bear?: A Book About Learning to Say Goodbye by Rachel Rivett What Happens When We Die? by Carolyn Nystrom These two books about children and grief can help to give you the words to use to talk to kids about death, as well as the basic concepts to help advance the child’s understanding of death. Talking to Kids about Death: Ages Three to Five Children of this age tend to exhibit their grief in a variety of ways, especially depending on the child’s maturity. Do not assume the child will grieve by being sad – instead, remember that the stages of grief include anger, denial, and bargaining. Children of this age may rebel, use their imagination in new ways and to the extreme, or attempt to make “deals” more than before. Responsibilities for adults may be less about talking to preschool-aged kids about death, and more about listening to them. Kids of this age experiencing grief tend to: Be crankier than before the loss Cry more easily than before the loss Seek out more comfort than before the loss Revert to a previous developmental stage Display some personality change. Usually a shy, quiet child becomes loud and belligerent, or an animated child becomes more reserved. Book Suggestions: Always and Forever by Alan Durant. The Purple Balloon by Chris Raschka These books are age-appropriate to help children actively discuss their grief, while showing them that other people experience death and have empathy for their feelings. Talking to Kids about Death: School Age (Kindergarten-5th Grade) Children this age are still egocentric and can blame themselves for illness, tragedy, or death. However, the older a child gets, the better he or she understands the differences between cause and effect. Grief counseling can be

October 26, 2017
Kaboutjie

5 Parenting Tips For Children With Autism

When autism is diagnosed early the long term outcome is almost always better since you can start behavioral therapy early on. Being a parent is a demanding task that requires a lot of effort. If you have a special needs child then you will find parenting even more challenging. No parent is prepared when they find out that their child has autism and it may seem completely overwhelming, however there are some steps that you can take that will help you to cope easier and help you to assist your child better. Here are some simple parenting tips for children with autism: 1 Structure, Routine & Safety All children need structure, routine and safety but children with autism need it even more so. An autistic child will struggle to apply things learnt in one setting to another, so it will be important to find out what your child is learning at school and in therapy so that you can also apply those things at home. Consistency also needs to be applied to the way you deal with your child’s challenging behavior and interact with your child. Try and keep your daily routine the same as far as possible, so therapy times, meal times, play time and bedtime should be the same as far as possible. There will be times that you will need to break your schedule, so when this happens let your child know in plenty of time and help your child prepare for the change. While it may seem easier to keep your child at home due to unpredictable behavior it is important for your child to learn how to deal with the outside world too. Choose some regular errands that you do with your child such as grocery shopping so that your child can get accustomed to doing it on a regular basis. This should be included in your schedule and over time it will get easier and you child will become better adjusted. It is a great idea to set up a safe zone for your child in your home. This space should be a quiet area where your child can be comfortable, relax and feel safe. You can mark this space out clearly for your child. Keep in mind that your child has sensory sensitivities. This means that your child is super sensitive to sound, light, touch, smells and movements. Take this into account when you create this safe zone. This is going to be the place for your child to get away from it all and be safe. 2 Put Emphasis On Play Play is important for all children, as well as children with autism. In fact it may be even more important since your child will be doing a lot of therapeutic activities. Try and keep play as fun as possible, focusing on things that will bring your child out of his or her shell. Keep in mind that verbal skills is not your child’s forte so try and get some non-verbal activities that you can do together too so that your child can relax and not feel too much pressure. Remember to keep play fun rather than therapeutic. Make sure that you put loads of play time on your schedule and try to make it at a time that your child is most alert. 3 Positive Parenting Positive parenting is important for all children, but even more with special needs children. It is important to be patient and accept your child at whatever stage he or she is at. Focusing on the positive behaviors in your child with praise and rewards will go a long way. Be very specific when you praise your child so he or she knows exactly what it is that has been achieved. Find ways to reward your child for positive behavior that will reinforce your praise. Your child will regularly have tantrums and difficulty controlling his or her negative behaviors. Try to be patient and not to let this affect you, rather keep focused on figuring out what the trigger is for this behavior. Your autistic child will have more difficulty communicating and this can be a huge source of frustration for your child. Try and learn your child’s non-verbal cues. 4 Figure Out What Works There is no one thing that will work for all autistic children. Your child will have his or her own unique triggers and ways of communication. Since your autistic child will struggle with verbal communication you will need to pay special attention to your child’s non-verbal communication. Learning about autism and specifically about your own child is key here. You will need to try out different things to find out what really works for you and your child. Trust your instincts and try to be patient with yourself and your child. There are so many different types of approaches to treating autism so if you try one type of therapy and it doesn’t work don’t let if get you down. Keep trying until you find the unique plan that works best in your unique circumstances. 5 Get Support Looking after yourself is essential so that you are emotionally, physically and spiritually strong enough to look after your child. While you may feel that taking some time off from your child is selfish and that it is your responsibility you do need the time off to look after yourself. Get a family member to look after your child regularly or a carer so you can rest a bit. Joining a support group for ASD will help you immensely since you will be able to meet other families that are dealing with the same things you are. You will be able to get advice from other people that are facing the same challenges as well as get emotional support when things get tough. Dealing with a special needs child can take its toll on you emotionally, so you (or your parter) may suffer from depression, stress or anxiety. Consider getting counseling for yourself,

October 20, 2017
Barbara Harvey

Brain Development in Teens

When we look at the average 13-15 year old today it is often hard to remember they are not as old as they look. When I was 13, I looked like a grow woman if you looked at me from the neck  down. I have always been admired by older men. However, just because teens look so mature their brains are far from it. Looking back I can see how I thought I was so mature, but I was always getting in trouble for spouting off at the mouth. I wish my Mom had known about brain development I may have not been grounded near as much. She might have cut me some slack had she known, I was not yet capable of thinking about what I was thinking. It turns out the teen brain is vastly different from the adult brain. In fact we do not even think from the same part of the brain as a teen. Adults think primarily from the part of the brain called the frontal cortex. Teens ten to use more of the central area of the brain called the pre-frontal cortex. This is the part of the brain which is reckless, laid back, and full of angst.  Describe anyone you know. The teen brain is also different in that it has literally thousands of connections called neuro-connectors. As a matter of fact it is these connectors which prevent the teen brain from being able to use the frontal lobe. As we spoke about last week the pituitary plays a large part in physical development. Part of what this gland does is to cue the brain to start changing a child’s brain into a more mature brain. Thus, the brain begins to develop these neuro-connectors in order to begin the restructuring process. So, much of what is going on in puberty. It turns out the process is a lot more complicated than most of us thought. This week your exercise is to read two articles about the brain development of teens. This article from the Wall Street Journal breaks things down by age. Remember every child is different. Depending on the skills they acquired in childhood some things may be different with your child. However, children will at one point or another hit all the staged described. This article in Science News for Students this article is an easier read. I suggest you read it with your teen and discuss the article. Knowledge is power. Reading and having this discussion will not only give you something to share. It will give you both greater knowledge in what is going on beneath the surface.

October 19, 2017
Parenting Hub

Is genetic insight the greatest gift you can give your child?

From the time you first hold your child in your arms, you’ll do everything you can to protect them – and that includes shielding them from a range of illnesses. You’ll spend the first few years as a parent trying to find treatment that works best for your offspring when they’re sick, based on recommendations from your paediatrician. But what if you could empower your specialist with deeper insights to inform your child’s treatment? New advances in pharmacogenomics give parents access to an uninvasive DNA test that yields critical insights into how their offspring metabolise medication. And it’s likely the most important gift they’ll ever give. Just for your child Your child’s genetic make-up determines how they respond to medication – what dose they need and the side effects they’ll experience. Medication therapy in children is a complex issue with limited information. Research shows only 25% of approved medications are suitable for pediatric use. Most is researched and labelled for use in adults. As a result, many indications and dosages are based on trial and error instead of proven studies. Adults vs children Child psychiatrist, Dr Sarvani Pather says every child’s DNA holds the key to the enzymes they produce, which is how they metabolise medicine. Some children may have a genetic variation that creates overactive enzymes and makes them ultra-rapid metabolisers of an ingredient. Others might metabolise medication far less expediently or intensively. “One working example is in the case of a common painkiller, such as codeine, which is present in many cough and cold medications. For ultra-rapid metabolisers, an inappropriate dose means codeine is converted into morphine which can have negative side effects,” says Pather. “These include sleepiness to the point of difficulty waking up your child, blueness around lips or mouth, confusion and interrupted sleep. For children who don’t metabolise medication as well, they won’t find pain relief and may be traumatised as a result.” Tonsil and adenoid surgery are routine procedures for children – it’s thus critical, at this stage of their lives, to understand how they’re going to metabolise the medications they’re given. Safe and effective treatment for the future A simple cheek swab is the first step in unlocking your child’s DNA – and towards better treatment. As a parent, you can now access and order the mygeneRx test online, have it delivered to your door and conduct the test with your child. No needles and no hospitals. It means better control of the medicine your child needs, informing the best health decisions throughout the lifespan. As medication and treatment becomes increasingly personalised, it’s the greatest gift you can give your child. To speak to an expert about genetic testing for your child – and the power of pharmacogenomics for personalised medicine, visit www.mygenerx.co.za.

October 18, 2017
Raising Kids Positively

QUALITIES IMPORTANT FOR YOUR CHILD’S SELF ESTEEM

Searching for some easy ways to help your kids feel good about themselves? A practical way to build their self-esteem is to focus on just four qualities. Belonging is about meaningful connections with others. Kids, who feel they belong, feel safer, self-assured and better at managing challenges. This is why when friends exclude them it really hurts.  By helping them to adjust to new environments; encouraging healthy friendships and building family values, you boost their sense of belonging. Tips Set up play dates and activities where they can learn to cooperate Encourage team sports/group activities In new places and situations help them feel that they belong Do fun things together as a family Mastery  is the ability to achieve a skill / feel competent at something.  Kids love to be noticed whenever they get something right without your help. This is why your four-year-old melts down when you take over for them. Babies don’t give up on walking after falling down once or twice.  As parents we need to step back a little, motivating them to keep trying, while encouraging them to achieve things by themselves. Tips Be encouraging when they are trying/showing you a new skill Avoid taking over when they’re struggling (rather encourage finding other ways ) Always comment on their efforts Independence is about being your own person – making decisions, problem solving and taking responsibility.  When kids are given chances to manage themselves and become inwardly directed, their confidence soars.   Remember over time, school and sport demands increase and kids are expected to manage without your help, relying on their own inner qualities and resources. Tips Do less for them, and more with them (i.e. stand by while supporting with words) Don’t always give solutions – rather encourage them to think Offer choices – it builds independence Encourage decision-making-  without telling them what you would do Involve them in simple household chores from an early age  – it builds independence, responsibility and self-discipline. If you’re in doubt as to whether they can do something without your help, give it a try.  Use words to guide them, while standing by and commenting on how well they’re tackling the task. Although they may want you to help, if you keep encouraging and only help with words, they’ll soon believe in themselves too. Generosity is about giving to others without expecting anything back. In helping others, kids feel good about themselves.   Where children have plenty of opportunities and positive encouragement to be generous, they naturally become more helpful and caring, and compassionate towards others.  Remember they’re learning by seeing what you do. With a little bit of effort, any selfish habits can be unlearned, and our kids can become far more helpful, kind and generous than we can imagine.  Lead the way and let them follow. Tips  Be caring – share hugs and smiles Encourage gift making, giving and donating used clothes/toys Create a “gratitude jar” – let them write down what they feel most grateful for daily and put it in the jar The wonderful parenting joy about strengthening these qualities (adapted from the Circle of Courage Model) is that it with a little bit of focus and effort we can build lifelong self-esteem in our children. Written by Carol Surya, author of ParentMagic – raising kids positively.

October 17, 2017
Bonitas – innovation, life stages and quality care

Medical Aid Made Easy

Access to good healthcare remains a concern for most South Africans and choosing a medical aid to suit your financial status and needs, can be very confusing. Not surprising considering that, according to the Council of Medical Schemes, there are 83 medical aids operating in South Africa. Added to the mix is the recent announcement by the Minister of Health of the proposed National Health Insurance (NHI) scheme. With all the options offered by medical schemes, which include everything from comprehensive cover to a simple hospital plan, how do you make a choice? Gerhard Van Emmenis, Principal Officer of Bonitas Medical Fund, provides some pointers to help make the decision easier. He cautions, however, that due diligence and some homework is required ahead of making a final decision. Your needs The most important factor is to know what you and your family need in terms of cover and what suits you best: Reflect on your family’s health history to gauge the number of visits you make to the doctor and the cost of medication Whether anyone has a chronic condition or needs to see a specialist How much you spent – or need to spend –  on dental or eye care If you already have a medical plan check what was covered, how much your co-payments (if any) were and whether your savings for the year were adequate. Your budget Once you have an idea of what you might need for the year ahead in terms of healthcare, then it’s time to look at your budget.  What can you comfortably afford to spend to get the medical cover you need? (The rule of thumb is contributions should not exceed 10% of your monthly income). ‘Once you have these two scenarios then it’s time to compare the various plans and see which best matches your needs and budget,’ says Van Emmenis. The benefits Benefits vary from plan to plan so check what is covered by the one you are considering and look at whether it offers supplementary benefits which can potentially save significant day-to-date expenses. These could include anything from wellness screenings (blood pressure, cholesterol, blood sugar and BMI measurements) through to maternity benefits, flu vaccinations, mammograms, pap smears and HIV tests. All of these are costly if you have to pay for them yourself. In terms of the Medical Schemes Act, there are 26 common chronic illnesses, known as Prescribed Minimum Benefits (PMBs), which all options on all schemes are required to cover for medication and treatment. What are savings? One of the most misunderstood elements of medical plans is how the day-to-day benefits work. ‘Medical savings are a fixed amount that the medical scheme gives you at the beginning of the year,’ explains Van Emmenis. ‘You can use your savings for daily out-of-hospital medical expenses, such as GP and specialist consultations and over the counter medicine. It is imperative that members use their savings and day-to-day benefits wisely to get maximum value for money.’ How can to make the most of savings? Always use partner networks Medical schemes negotiate preferential rates with these partners. This means if you use a network hospital, doctor or pharmacy you will not be charged more than the rate agreed with the scheme. This will also help you to avoid co-payments, deductibles and additional out-of-pocket expenses. Find a GP on your medical aid’s network Using network doctors is an invaluable tool to make your medical aid last longer. It means that doctors can’t charge you more than a specific amount. At present, Bonitas Medical Fund has the largest network of GPs in South Africa – with over 5 500 doctors. Register all chronic diseases If you’re on regular medication to treat a chronic illness (such as Diabetes, hypertension or hypothyroidism) you could qualify for chronic medication benefits. This means that your medical scheme pays for it out of the risk portion of your medical aid and not your medical savings account. All you need to do is register your condition as chronic. Make use of preferred providers Medical schemes often have providers that are contracted to them. Members are then given better rates for specific benefits. For example, Bonitas has contracted the services of DENIS for dental benefits. Use formulary meds All medical schemes have a list of medication they cover called a formulary. Another way to avoid co-payments and out-of-pocket expenses is to ensure your doctor treats you with medication listed on your plans specific formulary. Where applicable, you can also use a Designated Service Provider to obtain your medicine and stretch your benefits even further. Managed care benefits Some schemes offer preventative care benefits, which are paid from the risk portion of your medical scheme and are not funded from your savings account. This includes Oncology, HIV and Diabetes management programmes. Ask your pharmacist Pharmacists too can provide sound medical advice on problems such as rashes, colds or illnesses that are not severe. Buy over-the-counter medicine to treat less serious ailments and consider using generic medicine which is cheaper but effective. What is Gap Cover? Gap cover is an insurance policy you can take out to help pay for the shortfall between what your medical scheme pays and what the hospital or specialist might charge. The amount paid out depends on your policy but most people usually combine Gap Cover with a hospital plan. It is important that note that Gap Cover is not offered by medical schemes and is a separate health insurance product. As of 1 April this year, the same requirements for a medical scheme have been introduced including a waiting period of between 3 and 12 months for certain conditions and payout limit of R150 000 a year for each person. And a hospital plan? This provides you with basic, yet important medical cover and essentially covers all your required in-hospital procedures and check-ups, including the 27 chronic conditions (or PMBs). However, a hospital plan does not provide cover for day-to-day doctors’ visits, prescribed medications, chronic medication

October 13, 2017
Parenting Hub

Cost free stem cell storage programme gives hope to South African families affected by life-threatening blood disorders

Storing umbilical cord blood stem cells at birth could prove to be a live-saving investment for the child, or a sibling, diagnosed with a life-threatening blood disorder, treatable by a stem cell transplant. However, not everyone chooses to bank their baby’s cord blood stem cells. Cryo-Save South Africa, a private cord blood stem cell bank located in Pretoria, has recognised the plighn t of families who have a child with a blood disorder that can be treated with a stem cell transplant. It provides hope to families affected by leukaemia, other forms of blood cancers, and blood disorders such as sickle cell disease, through its Cost-Free Donation Programme. Three years ago, South Africans Charlene and Ralph Subbarayan’s first-born son, then aged five, was diagnosed with leukaemia. He was frequently hospitalised and only recently completed his treatment. During this time, although unplanned and a wonderful surprise, Charlene fell pregnant with their second child. Both parents became extremely concerned as to whether their unborn child may also develop cancer in future. “My husband and I began frantically researching cancer and it was on a visit to my gynaecologist that I picked up a Cryo-Save pamphlet right there in the waiting room. After reading, I immediately called the Cryo-Save’s Information Hub, who were more than willing to help us out – and for free!” explains Charlene. To give hope to families in need, the Cryo-Save Cost-Free Donation Program is specifically designed to offer families affected by diseases that can be treated with blood stem cells, the opportunity to store the cord blood stem cells of their expected new-born child to potentially treat a sibling who has been diagnosed with a blood disorder To qualify for the Cost-Free Donation Programme, a sibling of the unborn child must have been diagnosed with a disease that is currently treatable with umbilical cord blood stem cells (an FDA approved indication for transplantation) and must be being treated by a medical specialist (oncologist/haematologist), who agrees that the stem cells could be used for treatment. If eligible, Cryo-Save will enrol the family into the Cost-Free Donation Program, provide the cord blood collection kit, and process and store (cryo-preserve) the new-born’s cord blood sample without any cost to the family. “Storing my second child’s stem cells with Cryo-Save was such a phenomenal experience! I’m glad I did it. Stem cells are used to treat and cure several diseases and not just cancer. I would advise any parent who would like to store their child’s stem cells to definitely go for it, it is a must. Use our family as an example. My child, who was diagnosed with leukaemia three years ago, will be turning nine on the 14th of December. I am so grateful to have beautiful healthy children, I love my boys and I wouldn’t give up my stem cell storage experience for anything,” concludes Mrs Subbarayan. Blood-forming stem cells are able to be collected not only from umbilical cord blood but also directly from bone marrow and from circulating blood. These stem cells have been used to treat more than 80 types of diseases ranging from blood cancers, metabolic diseases, bone marrow failure syndromes, to other blood and immune deficiency disorders. Stem cells found in the blood of a baby’s umbilical cord and placenta are usually discarded at the time of birth, as both the cord and placenta are discarded as medical waste. Prospective mothers and fathers should consider the potentially life-saving investment they could make and the benefits of storing cord blood and cord tissue stem cells well in advance of giving birth. Nothing in life is certain, but if we knew we could do something to help our children, why wouldn’t we? It is for this reason that Cryo-Save enables access to umbilical cord blood stem cell storage. Visit www.cryosave.co.za for more information on stem cell collection and storage.

October 12, 2017
Advtech Group

How to Replace Screen Time with Foundational Reading Skills

Most parents are very aware that too much screen time for young children isn’t a good thing, but many are just as uncertain about what exactly the problem is and, importantly, how time can be more constructively spent without it becoming an additional daily burden adding to the stress of the adults. “Taking the guesswork out of quality family interaction, which also assists in the development of the child, is half the battle won,” says Barbara Eaton, Academic Development Advisor for the Pre-Primary Schools Division at ADvTECH, Africa’s largest private education provider. Eaton says parents who rely on some screen time to get a bit of a breather shouldn’t feel guilty, but adds that they should ensure they also spend time every day connecting with their children through activities. Activities, which are both fun and will aid the cementing of the skills they will require for reading success in future, can be woven into the daily routine. “We are constantly researching improved methods of teaching foundational reading skills from Grade 000,” says Eaton. “Research into the reading brain indicates that 40% of children learn to read easily, but 40% of children are at risk and 20% at severe risk. Over twenty thousand studies of children failing at reading in the USA indicated that the bottom 40% of readers lack phonemic awareness, which is the ability to hear, identify and manipulate individual phonemes – the smallest unit of sound in the spoken word.” Eaton says the human brain is wired for developing spoken language which is why, with good personal interaction, babies develop speech from an early age without intentional teaching. “But there is no automatic brain wiring for reading and spelling, so all aspects of these skills need to be taught systematically and explicitly. Modern life has increasingly seen young children spend significant amounts of time in front of screens, which focus their brains on visual more than auditory content. “The major problem with screen time is that much of the spoken content of what they watch is too fast and often indistinct, making them less likely to concentrate on it. This has impacted on the development of accurate listening skills.” This all sounds quite negative, but the good news is that brain repair and the re-routing and development of neurons are possible and that with correct teaching, the children who would have learned to read easily will read at a higher level while the ‘at risk’ children will be able to read well. So how can parents help their children? 1 – BY TALKING AND LISTENING “In these days of digital media, we are talking less to each other and much of the communication taking place is instructive: ‘It’s time to bath. Pick up your clothes” etc. Instead, try to focus on generating discussions, for instance talk about the highs and lows of your day; introduce topics such as, ‘if you could do anything you wanted, what would it be and why’, ‘tell us about the best thing you saw today’.” Eaton says it is important to ask open-ended questions (which don’t have a yes or no response), to elicit full answers. Dads are especially good at this! 2 – BY READING TO THEIR CHILD Read both fiction and factual books from a very young age and join the library to give a wider choice. Choose quality stories that link to your child’s interests, not just Disney ones, Eaton advises. “Let your child see you reading books and magazines. When you read a menu, shopping list, or road sign, involve your child and discuss how wonderful it is to be able to read and understand the information around you.” 3 – BY SINGING AND RECITING Sing songs, recite rhymes together and read poems. “Rhyming is such an important pre-reading skill, but fewer and fewer children learn any rhymes at home. Nursery rhymes are basically historical nonsense but children love them and they are easy to memorise,” Eaton says. 4 – PLAY WITH WORDS Play with compound words – breaking popcorn into pop and corn, fishtank into fish and tank etc. They make good car games, and make a walk to the shops shorter and more fun. I Spy is another fun favourite but use the sound at the beginning of the word, not the name of the letter. Cat starts with ‘c’ not CEE. Eaton says activities as listed above should be fun for adults and child, and should not become another chore for parents, but rather an easy, entertaining way to connect as they go through their usual routine in the morning and the evening. Additionally, to build solid listening skills, parents should not repeat instructions and comments, as this programmes a child not to listen the first time. “Parents should make eye contact (lower the phone!),  and pay attention to what their child is saying so that they model the desired listening behaviour. Above all, be excited about your child’s developing language and literacy skills. “Investing quality time in your children can be achieved by including them in daily routines. Complementing this time with activities such as the above can make a tremendous impact on setting a child on the path to their own personal academic excellence,” she says.

October 10, 2017
Paarl Dietitians

Cholesterol: Top foods to improve your numbers

If your diet gave you high cholesterol, it can lower it, too! It’s easy to eat your way to an alarmingly high cholesterol level. The reverse is true, too — changing what you eat can lower your cholesterol and improve the armada of fats floating through your bloodstream. Different foods lower cholesterol in various ways. Here are the top foods to lower your cholesterol and protect your heart. IN WITH THE GOOD Soluble fibre Soluble fibre binds cholesterol in the digestive system and drags them out of the body before they get into circulation. This type of fibre reduces LDL cholesterol levels more than a diet low in saturated or trans fats alone. Five to 10 grams of soluble fibre a day reduces LDL cholesterol by 5%.  Barley, sweet potatoes, peas, carrots and beans are great sources of soluble fibre. They also take a while for the body to digest, meaning you feel full for longer after a meal. Bananas, apples, strawberries, prunes, citrus fruits are rich in pectin, a type of soluble fibre that also lowers LDL cholesterol. Omega-3 containing fish Eating fatty fish e.g. mackerel, trout, sardines, pilchards, snoek, salmon – two to three times a week can lower LDL cholesterol in two ways: by replacing meat, which has LDL-boosting saturated fats, and by delivering LDL-lowering omega-3 fats. Omega-3s can reduce blood pressure, risk of blood clots and triglycerides (fat in the blood that increases cholesterol) in the bloodstream and also protect the heart by helping prevent the onset of abnormal heart rhythms. In people who have already had heart attacks, fish oil — or omega-3 fatty acids — may reduce the risk of sudden death. Seeds Flax seeds have been shown in several meta-analyses to reduce total cholesterol and LDL cholesterol by 5–15%, reduce Lipoprotein (a) by 14% and triglycerides by up to 36%. Flax seeds are anti-inflammatory; it is a source of fibre, lignins as well as phytoestrogens that further protects against heart disease. The dose required for these effects is between 14 to 40 grams of flax seed per day. Important to note is that these health properties do not apply to flax seed oil. Chia seeds at a dose of 25 g per day is also good for cholesterol lowering. Sesame seeds at 40 g per day reduces LDL cholesterol by 9%. Unsaturated fats or plant fats A number of studies shows that eating nuts and avocados is good for the heart. Rich in mono (MUFA) – and polyunsaturated (PUFA) fatty acids, both can lower LDL cholesterol and they have additional nutrients that protect the heart in other ways. All nuts are high in calories, so a small handful will do. Make sure the nuts you eat aren’t salted or coated with sugar. To avoid eating too many nuts and gaining weight, replace foods high in saturated fat with nuts. For example, instead of using cheese, meat or croutons in your salad, add a handful of walnuts, cashews or almonds. Another good source of MUFAs is olive-, canola- and avocado oil. Try using these oils in place of other fats in your diet to get its heart-healthy benefits. Add it to a marinade or mix it with vinegar as a salad dressing. Both avocados and these oils are high in calories, so don’t eat more than the recommended amount (as indicated by your dietitian). Soy  Eating soybeans and foods made from them, like tofu, soy mince, soy yoghurt and soy milk, was once touted as a powerful way to lower cholesterol. Analyses show that the effect is more modest — consuming 25 grams of soy protein a day (300g of tofu or 2 ½ cups of soy milk) can lower LDL cholesterol by 5 percent. Sterols and stanols Foods are usually fortified with sterols and stanols and these plant compounds interfere with the body’s ability to absorb cholesterol from food. Some margarines and yogurt drinks come with added plant sterols and can help reduce LDL cholesterol by 5 to 15 percent. However, for most people, it is not possible to achieve the optimum intake of 2g per day from foods. For example, the recommended daily dose can be obtained by using 25g (5tsp) Flora PRO.ACTIV spread per day that could be detrimental if you are watching your weight. Fortunately, there are also supplements available that are worth trying. Pomegranate Pomegranate is a potent antioxidant that lowers oxidation of LDL cholesterol. Consuming 250ml of pure pomegranate juice per day or one to two cups of pomegranate seeds is recommended. OUT WITH THE BAD Harmful LDL cholesterol creeps upward and protective HDL cholesterol drifts downward largely because of diet and other lifestyle choices. Genes play a role, too — some people are genetically programmed to respond more readily to what they eat — but genes aren’t something you can change. Here are things you can change. Saturated fats Typical sources of saturated fat include animal products, such as red meat, whole-fat dairy products, eggs, and also a few vegetable oils, such as palm oil, coconut oil, and cocoa butter. Saturated fat can increase your levels of “bad” LDL cholesterol. But it has some benefits, too — it lowers triglycerides and nudges up levels of “good” HDL cholesterol. The role of saturated fat in heart disease is currently under debate. For now, it’s best to be sensible and manage your intake of saturated-fat-rich foods. Refined carbohydrates Increased refined carbohydrate intake may be more important in having a detrimental effect on cholesterol levels than saturated fats. Refined carbohydrates have adverse effects on insulin resistance, LDL and HDL cholesterol as well as triglycerides levels, thus contributing to coronary heart disease risk more than saturated fats. Trans and hydrogenated fats The right amount of these fats are zero! Trans fats are a by-product of the chemical reaction that turns liquid vegetable oil into solid margarine or shortening and that prevents liquid vegetable oils from turning rancid. These fats, often found in shore-bought cookies, doughnuts, crackers, cakes, pies have no

October 9, 2017
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