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

Bonitas takes the edge off contribution increases

Financially solid, younger new members, two new plans, virtual healthcare and a renewed focus on Managed Care for chronic diseases are just a few of the insights from the Bonitas 2021 product launch. But it is the annual contribution increases which are highly anticipated and the moment of truth for all medical schemes.   Lee Callakoppen, Principal Officer of Bonitas Medical Fund announced an unprecedented 0% increase on its BonFit Select plan and a weighted increase of 4.6% across all plans. The highest increase is 7.1%. ‘Members on our growth options, which contribute to 91% of business, will only experience an increase on 3.9%. I think, looking at the pricing and the benefit richness we offer in comparison to the market, the changes for 2021 will be well received.’ He says, ‘The guidelines received from the Council for Medical Schemes (CMS), clearly highlighted that medical schemes should limit contribution increases as far as possible. We crunched numbers and worked tirelessly to find the sweet-spot between sustainability and ensuring affordability. Not an easy task, especially in a weakened economy. We took a responsible stance, with a long-term view, to ensure that our members wouldn’t have to pay the price of a low increase for 2021 in the coming years. One of our core considerations was finding ways to ensure members could get access to full healthcare cover and avoid out-of-pocket expenses and co-payments.’  Pricing and technology Seven of our current options are priced between R1 500 and R3 000 which is where the medical scheme market is experiencing growth currently. Member behaviour has changed significantly and demand is for innovation, accessibility and technology. This has the benefit of attracting, a younger, target audience and driving sustainability. We can’t talk about 2020 without mentioning Covid-19. Key trends that emerged from a medical schemes perspective were: Changes to benefit structures and PMBs  Lower than anticipated investment income as markets slumped Changes in claiming patterns in terms of seasonality and volume, due to the lockdown measures that came into effect And a Consumer Price Index that was lower than previous years which is expected to be at around 3.9% in 2021  In an industry like ours, it’s challenging to be different – to innovate, disrupt…to be better. But not impossible. The Fund needed to make short-term decisions with the long-term view and sustainability in mind.  One of the highlights over the past few years, has been the introduction of four Efficiency Discounted Options (EDOs).  Plans whereby members use network healthcare providers and pay around 15% less for the same benefits. The EDOs cover over 74 000 lives and the principal members who join are around 10 years younger than the average Bonitas member. 2021 – changes, contribution increases and enhancements Over the past five years, we have proactively driven innovative product design, actuarial modelling and constant engagement with various stakeholders. We believe we offer the ultimate split risk solution, with a comprehensive product range and diversified membership base.  To stay at the forefront of innovation we have introduced:  Edge – a new category driven by technology, intelligence and innovation, with two plans called BonStart and BonStart Plus. These are designed for economically active singles or couples, living in the larger metros. The plans include access to: A private hospital network and full cover for emergencies; PMB chronic medicine; excellent day-to-day benefits including unlimited GP consultations; layers of virtual care, dental and optical benefits; preventative care; wellness screenings; contraceptives and more.  The cost: R1 452 and R1 731 respectively for the principal member. Managed Care One of the leading trends worldwide is the rise in non-communicable diseases, such as diabetes, high blood pressure and oncology. In fact, during this global pandemic, the impact lifestyle diseases and comorbidities had on Covid-19 patients was put in the spotlight. 20% of our members have multiple comorbidities which means, even without the pandemic, we need a stronger focus on preventing and managing lifestyle behaviours. Poor diet, smoking and lack of exercise are the three lifestyle factors that contribute to over 80% of chronic conditions.   Managed Care continues to be a focus to empower members to take charge of their health and support them along the way.   Home-based care During Covid-19, home-based care received renewed interest and focus. This dovetails with our strategy to move more care to the home and out of hospital. As an example, post-surgery or mild pneumonia, treatment can be effectively provided at home through the assistance of nurses. Not only is home-based care a cost effective delivery of care but it also promotes healing. Studies show that patients recover faster in their comfort of their own home. Day hospitals We believe the use of day hospitals and clinics should be encouraged, where possible. Some procedures such as cataract surgery, circumcisions and scopes are better suited to be performed in day hospitals or clinics versus larger hospitals.  There is minimum disruption to members, speedier recovery times, less risk of infection and day hospital are also a more cost effective alternative. Technology  One of the key learnings has been adapting to a new way of working – with virtual technology at the forefront.  The WhatsApp channel we introduced has the most room for potential. This platform is convenient for members and allows them to manage their medical aid through live chats.  Virtual Care There was a positive response to the launch of the new Bonitas Member Mobile App and free virtual care for all South Africans. This provided access to GP consultations for a range of conditions, including Covid-19, as well as free delivery for chronic medicine.  At the heart of the model is the GP. This aligns to our care coordination initiatives, ensuring members receive the right level of care and support in managing their conditions. It allows access to a virtual nurse, advice in an emergency, auxiliary and home- based care, ensuring members have comprehensive support for any condition, in any circumstance, through our virtual based model. We’re pleased to announce that this model is unique and

September 23, 2020
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
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Advice from the experts
Kaboutjie

The benefits of yoga for pregnant woman

Introduction Unknowingly, many of you are transforming from a woman into a mother and you have all the privilege to give birth and to nurture. At this stage, pleasure and pain merge into this cosmic experience of creation, and you can think of nothing, but your little precious baby. This world will soon be your baby’s playground, a place that he/she can grow into his/her own unique characteristic. But for now, the child is starting experience the world through us, therefore, we need to prepare all of the best things to welcome them. Therefore, I would like to share my experience with yoga during my pregnancy which can help any moms stay fit as well as deliver healthy and happy babies. What Yoga Can Help Women in Pregnancy For me, pregnancy and bringing a child into the world is regarded as the unique experience, but it is also a time of immense change of excitement, joy, anticipation, nervousness as well as other fluctuating emotions. As a consequence, practicing yoga is extremely beneficial for pregnant women for many reasons that I will show you now. Nevertheless, you still need to consult with your doctor before taking it up so as to make sure that you will not suffer from any pregnancy-related complications. When I was pregnant for the first time a few years ago, many people advised that I should enhance strength for my lower and upper body in order to endure the additional weight as well as adapt to such adjustment in balance. Thus, I started coming to yoga and surprisingly, this routine deals with the actual birthing muscles which are utilized during the birth process including my lower back, pelvis muscles along with the hip. Furthermore, during my pregnancy, I had to put up with back pain as my tummy size increased dramatically. As a result, pain-busting moves in yoga did a great job in supporting my waist and then my lower back. Moreover, owing to the increase in my weight and the change in my body shape, I felt wobbly, so that some balancing exercises in yoga can help me to get familiar with my changing center of gravity. Going to the next point, I used to go through a depressed period when having my first baby and prenatal yoga can help me release endorphins in my system. Thanks to this incredible exercise, I can get into happy positive state of mind, avoid the morning sickness as well as keep me active the whole day. Therefore, do not hesitate anymore since you have to try this and you can totally achieve all of these great things like me. In addition, you and your baby are so intrinsically connected that when there is any toxicity in your body or any stress, all of them will go straight to the baby. Therefore, practicing yoga can help moms to live more purposely and efficiently. I used to have doubts in these benefits when first inviting to yoga, but now, I have to admit that it is exceptionally suitable for any pregnant woman. Before, I believed that sleeping is the the best way of rest but I have changed my mind after coming to a yoga class. You will be surprised to know that the relaxation pose that comes at the end of any yoga classes is useful for your rest. I am sure that many women do not believe at this moment, but you need to take my advice and see the magic in the end. Last but not least, I recommend that taking part in yoga classes is the cheapest method to meet moms who are going through the same process as you. After some classes, I have made a lot of good friends and until now, we still meet each other with our children at the weekends. We can share the difficulties as well as some tips to take better care of our precious children. Conclusion As you know, pregnancy is one of the most powerful and tough times in a woman’s life. Therefore, prenatal yoga really trains the woman’s mind and body to be able to give birth consciously. After reading this article, why don’t you join a yoga class right now and if you have any confusion, please feel free to contact me anytime. Emma Baster is the editor of Eruditemommy.com. She understands deeply about the difficulties of pregnant women and mothers. Therefore, she built this blog to share her knowledge about nutrition, taking care of children, mommies’ health. Better care for families is everything she wishes to convey in this blog. Follow Emma on Twitter @EruditeMommy

March 15, 2018
The South African Depression and Anxiety Group

The common myths & FAQ’s when talking about Teen Suicide

The South African Depression and Anxiety Group (SADAG) is highlighting Teen Suicide Prevention Week (11-18 February) to help parents, teachers and loved ones with tips and information to talk about Teen Depression and Suicide Prevention to their teens. 1 in 4 South African teens have attempted suicide, talking to teens about depression and suicide can help prevent them from taking their life. Most people are too scared to talk about the topic, or if they do they don’t know what to say. “For many teenagers adolescence is a transition into a different stage of life of the beginning of living itself, however unfortunately for some it can also be the end of their life altogether. Teen suicides are real and rob many young people of a future and our society of a future. Let us speak about teen suicide today so that we may never have too again in the future.” Says Clinical Psychologist, Zamo Mbele. Remember that people who are thinking about suicide feel alone and isolated, and often feel like no one understands how they feel. Changes in life may be upsetting and they may want to escape a difficult problem or situation, or get relief from terrible stress. You may know if your friend or loved one is going through a tough time. Here are some common myths and facts about Teen Suicide: death in the family – can cause depression. If you are worried about someone you care about, encourage them to tell their parents, see a doctor, counsellor, or teacher – you can even go with them so you know they get there, and they know you are there to support them. The most important thing is that they speak to someone and get help. If you are worried about your teen or friend who may be depressed or suicidal, contact a counsellor at SADAG 0800 567 567 or 0800 12 13 14 or visit www.sadag.org . We can provide free telephonic counselling, info and referrals to resources throughout South Africa.

March 14, 2018
AmnioPad

What is PROM and is it a Cause for Concern in Pregnancy?

Pregnancy is one of the most beautiful miracles of nature, to have a human being formed inside us. This is a time filled with excitement and joy, but can also be overwhelming as we are expected to know everything there is to know about pregnancy, what is normal and what is not, what is cause for concern versus what is not and overall what to expect. This article is meant to give more information about PROM (Prelabor rupture of membranes); how common it is, what some of the associated risks are, and what we need to do in case we suspect PROM. How common is PROM? PROM (prelabor rupture of membranes) is very common in pregnancy, in fact, it is estimated that between 20%-30% of pregnancies are affected by PROM, but frequencies of up to 40% have been reported 1.  PROM occurs when the amniotic sac ruptures and amniotic fluid starts to leak. What is this Amniotic fluid (water)? Amniotic fluid plays a very important role in supporting the fetus during pregnancy. The mother’s body produces amniotic fluid as soon as 2 weeks after conception. The most important role of the amniotic fluid is to protect the baby against physical shocks from outside. It also helps the fetus to move around in the womb, consequently, allowing the fetus to develop his muscles. Maintaining a constant temperature – The amniotic fluid is typically 1 degree Celsius higher than the mother’s body temperature. This helps the fetus to maintain his body temperature. At full gestational age, SROM (spontaneous rupture of membranes) occurs, which usually occurs after labor pains commence and is a normal part of the labor process. However, sometimes PROM occurs, and this could lead to complications. Complications associated with PROM: PROM is defined as the rupture of membranes (amniotic sac) and leakage of amniotic fluid before labor begins. This can happen after 37 weeks of gestation. If the rupture of membranes happens prior to 37 weeks of gestation, the condition is termed PPROM (preterm premature rupture of membranes)2. It is important to be able to identify PROM as sometimes it is a gush of water that comes out which is obvious, and sometimes it is a gradual continuous leakage which is not very obvious, and can thus be mistaken for urine. Diagnosing PROM is very important for proper management of the pregnancy and delayed diagnosis could lead to complications for both mother and baby.  The two direct and most important complications of PROM are: Chorioamnionitis, which is an acute inflammation of the membranes & chorion of placenta, from ascending polymicrobial bacterial infection due to ruptured membranes and Preterm delivery (PTD)1 These complications could lead to neonatal respiratory distress syndrome (RDS), foetal distress, neonatal sepsis, congenital infections like pneumonia and intraventricular haemorrhage (IVH) and increased neonatal deaths1. According to an article in the South African Medical Journal, deaths due to prematurity had patient associated avoidable factors in 30% of the cases. The top 5 factors were: Inappropriate response to rupture of membranes. Delay in seeking medical attention during labor. Non-initiation of antenatal care. Booking late in pregnancy. Infrequent visits to antenatal clinics3 Diagnosis of PROM is important and facilitates the commencement of appropriate therapy and could lead to reduction in complications. PROM often occurs when the pregnant woman is not in a healthcare environment. For this reason, it becomes very important to identify and know when it is PROM, in order to seek medical care and thus reduce the associated risks. When the rupture of membranes occurs or the water breaks, there is usually a gush of fluid that comes out; this is the obvious sign of PROM. The challenge becomes when this classic gush of fluid doesn’t occur, and only a gradual continual leak occurs; in this case how do you know if it is amniotic fluid or just a urine leak which is common in pregnancy? The AMNIOPADTM is a self test kit used to test for leakage of amniotic fluid (water breaking) during pregnancy. The test comes in the form of a panty liner; it’s highly effective, easy to use, results are easy to interpret, and is the only test available in South Africa that can be used at home. This easy-to-use home test kit allows you to detect probable leakage of amniotic fluid whenever you encounter unidentified wetness, or among women with a history of premature membrane rupture. AMNIOPADTM panty liner changes colour when it comes into contact with fluid of pH levels greater than or equal to 6.5. Amniotic fluid pH levels are greater than 6.5.   How to use: Simply attach the special AMNIOPADTM panty liner to your underwear and get on with your day. When you feel a fluid leak, check for a colour change on the yellow background. The pad colour change can be partial or complete (any intensity, shape, size or location). Note: a colour change appears within 10 minutes following a fluid leak. If there is a colour change to blue or green, amniotic fluid may be leaking from your uterus, or you may have a vaginal infection. You should consult your physician or go to the hospital without delay. If the panty liner remains yellow or turns yellow after 10 minutes, the fluid leak is probably urine, which is common during pregnancy. If you continue to experience vaginal wetness, apply a new panty liner and repeat the test. Any minimal amount of amniotic fluid leakage which can be sensed as wetness by the user will create a visible blue or green stain. For further diagnosis and medical care, report the results to your physician. AMNIOPADTM panty liners are recommended for screening either high-risk or normal pregnancies. Leaking amniotic fluid increases the risk of infection to both mother and foetus and early detection can help to: Prevent complications or premature birth. Identify a possible membrane rupture, especially after amniocentesis. Confirm that your water has broken so that you arrive at the hospital in time for a safe delivery. READING YOUR

March 12, 2018
Parenting Hub

Experts Weigh In on Pregnancy and Nutrition in SA

Good nutrition before and during pregnancy may influence the pregnancy, the delivery and the health of mother and child later on. What you eat now will help your baby to grow healthily and give them the best start in life and help you to feel your best. We asked registered dietitians and ADSA (Association for Dietetics in South Africa) spokespeople to provide their top tips for healthy eating during pregnancy. Does eating for two mean doubling up your portions? “Additional energy is needed during pregnancy to support the growth demands of your baby, however the saying ‘eating for two’ has been taken out of context,” says Cath Day, Registered Dietitian. “During the first trimester, you don’t need any additional energy. This means that if you were maintaining a healthy weight before you became pregnant, you can continue eating the same amount.  It is only in your second and third trimester that you need to eat a little more.” But, how much more? The professional advice from a dietitian is that an expectant mom who is at a healthy weight should take in an extra 350 kCal / 1470 kJ per day in her second trimester.  This would be the equivalent to eating an extra half a cup of fruit or one tennis ball-sized fruit, a 175 ml of plain low fat yoghurt, two wholewheat crackers, two teaspoons peanut butter without added sugar and salt, and a 30 gram portion of a medium fat cheese. In the third trimester, the recommended additional intake rises to just 460 kCal / 1930 kJ per day, and that would be equivalent to eating an extra one cup of fruit or two tennis ball-sized fruits, 175 ml plain low fat yoghurt, four wholewheat crackers with the same two teaspoons peanut butter without added sugar and salt, and a 30 gram portion of a medium fat cheese. What should you do if you are overweight and pregnant? Overweight and obesity can present health challenges during pregnancy, so health professionals do advise that women should get to a healthy weight before they fall pregnant.  However, in South Africa where women’s rates of overweight and obesity are high, less than ideal conditions for pregnancy need to be managed. “Pregnancy is not the time to think about dieting and weight loss,” says ADSA spokesperson and Registered Dietitian, Nazeeia Sayed, “An overweight pregnant woman should focus on the healthy eating of a variety of nutritious foods, and her weight gain needs to be monitored at her ante-natal check-ups.  She should also focus on light exercise such as walking.” Day also points out that: “Overweight and obese pregnant women would benefit from seeing a registered dietitian who can assist them with an eating plan which will support baby’s growth and ensure that they gain weight within healthy parameters.” How can you eat healthily on a budget?  Day has some sensible tips: Eat fruits and vegetables which are in season and more affordable Get your family members and neighbours to shop with you for bulk fruits and vegetables that are more cost-effective Start a vegetable garden using water-saving ideas at home or in your community. NGOs such as Soil for Life and many more help households and communities to sustainably increase their access to fruits and vegetables Spend less money on fizzy cold drinks, junk food and take-aways, and use what you save to buy seasonal fruits and vegetables instead You can save money by reducing your meat intake by half and instead use beans, split peas and lentils to bulk up your favourite meat dishes. These legumes are a more affordable, healthy vegetable protein source that also include the B-vitamins and folic acid Buy frozen vegetables when they are on promotion – they contain as much or even more nutrients than vegetables which have been on the shelf for an extended period of time What can pregnant women who can’t afford supplements eat to get the micro-nutrients important to pregnancy? Pregnant women and those planning on falling pregnant should take a supplement of iron and folic acid, as these are essential nutrients needed for a healthy pregnancy. Sayed points out that it is important for all pregnant women to know that they have access to the State ante-natal services because supplements such as folic acid, iron and calcium are included in their free healthcare. Day also adds that there are many affordable food sources that provide these nutrients that are vital to a baby’s healthy development.  “For instance,” she says “Green leafy vegetables such as spinach, morogo and legumes such as beans, split peas and lentils are good sources of folic acid and iron.  You can also find staples such as maize meal and brown bread that are fortified with folic acid and iron.  Amasi and milk provide calcium. Tinned sardines and pilchards provide calcium and iron, and chicken livers are another good source of iron.” How can you use your pregnancy to develop healthier habits? Pregnancy is a time when your health and the health of your developing baby is an absolute priority.   Day says that it is not only what you consume but also what you do not consume that counts.  “Don’t drink alcohol when you are pregnant. All forms of alcohol could be harmful to your baby and the safest choice for your unborn baby is not to drink any alcohol at all when you are pregnant.” Sayed concludes: “Pregnancy is not a state of ill health but a time to be enjoyed, and it can help you to develop life-long healthy eating patterns that you sustain as you become a role model for the new addition to your family!”

March 12, 2018
Dr Tamara Jaye

Oral Allergy Syndrome – are allergies leaving a bad taste in your mouth?

Does your teenager suffer from hay fever?   Does he complain that certain fruits or nuts make his whole mouth feel itchy, his tongue swollen or his throat scratchy? Does this  mouth discomfort only last for a few minutes and then resolve on its own, often not requiring treatment? Is this reaction confined to his mouth without any associated chest problems such as wheezing, or a skin rash, or diarrhoea and vomiting? Then perhaps your teenager suffers from a condition called Oral Allergy Syndrome (OAS) OAS, commonly known as Pollen-Food Syndrome, is an allergic condition that occurs generally in older children, teenagers or adults.  OAS sufferers have hay fever, experiencing a runny nose and itchy watery eyes when exposed to certain pollens. The body sees the allergen -the pollen –  as harmful and mounts a heightened, inappropriate response resulting in this picture of nasal congestion. People with OAS  complain that certain fruits and nuts cause them discomfort in their mouths such as itchiness of their tongues or a scratchy sensation in their throats. The allergy is due to local contact with the offending fruit or nut resulting in only the mouth being affected. These two seemingly unrelated symptoms, the hay fever from pollen, and the mouth itchiness from fruit, are linked due to the fact that fruits, nuts and pollens share similar proteins which cause allergic reactions. This means that a person with a rye grass allergy may experience a tingling palate when eating watermelon. Or someone allergic to birch pollen may complain that apples and pears give him a scratchy throat. It therefore makes sense that OAS is generally more prominent during pollen season. How can a diagnosis of OAS be made? A careful history should be taken showing the typical symptoms – the hay fever as well as the mouth itch following eating certain fruits. The offending fruit or nut can be given in the rooms under supervision – an oral food challenge – to observe the symptoms. Skin prick tests to pollens can be done. This means that drops of diluted allergens are placed on the arm and then pricked with a lancet to see if there is a reaction. A positive result causes a mosquito-bite type of lesion within a few minutes. In OAS these will most likely show a positive result to certain pollens. Skin prick tests using fresh fruit can also be done and may cause a reaction too. OAS symptoms may improve if certain fruits are cooked. Interestingly, cooked food doesn’t cause a reaction as the heating process distorts the protein and the body doesn’t recognize it as an allergen. Peeling fruits may reduce the allergen content of the fruit too.  For local mouth reactions, an anti histamine will help as well as rinsing with water after eating. Treatment of the allergic rhinitis definitely reduces symptoms in OAS. This includes taking an anti histamine and a steroid nose spray prescribed by your doctor. Long term treatment for allergic rhinitis may include immunotherapy. This is treatment in the form of drops that are put under the tongue daily for up to 3 years. This results in the immune system actually changing so it no longer see the specific pollen as harmful, and essentially eradicates the allergy. If you would like to take away the itch from your litchi-eating experience, then consult your allergy doctor!

March 8, 2018
Kaboutjie

7 Ways to keep your children off drugs

Children are the most vulnerable during their growing years and will always have their curiosity spiked by anything new. The same applies to the usual attractions of alcohol, cigarettes and drugs. Keeping them away from drugs is really important as this is a decision which can change the course of their whole life. The warnings have to be given to children in such a way that they really understand the repercussions of drug usage. Here are some parenting tips when it comes to keeping your children away from the danger of drug abuse for their own betterment. Be the Perfect Role Model Hypocrisy rarely works in such a situation. Advising your children while doing drugs yourself is never going to achieve the required objective. Children usually observe a lot and the same applies to the habits of their parents, whom they may see as their role models. This makes it really important to maintain a clean image and stay clean at least for the sake of your children. Only then will they be fully convinced by your words and stay away from drugs. Do the Talk It is important to sit down and talk about the effects of drug usage to your children. Assuming that your child will not be affected by drugs and feeling that there would have been enough information regarding the issue from schools is not very realistic. Give them all that they need to know about drug usage to make sure that the dangers are understood clearly. Make it as simple as required for them to fully grasp the consequences of any actions that they take. Use the Friendly Gesture When exposing children to such a sensitive issue, it should be done in a realistic way. Giving them a clear picture in the friendliest way should be done, rather than using harsh and threatening tones. The way the message was delivered will also highly impact how children react to any unsupervised situation. Showing that you have placed utmost trust on them can alter how they resist any peer pressure or temptations. Point Out Real-Life Examples There are many people who have become slaves to drugs and will do anything to get their next fix. Pointing out the deep slip that their life has taken works more effectively than all the lectures that you have planned on the subject of drug education. Children today, believe what they see. The same applies to this situation too. By showing them actual people whose lives have been drastically affected by drug usage, you can make sure that you have instilled the right fear in their minds of being exposed to drugs. Keep an Eye on Their Gang Peer pressutre seems to be one of the most common reasons for children to try drugs. This makes it important for parents to keep an eye on the people that their children hang out with. Getting to know their best friends, the people they party with and the things that they usually do with their friends is not only a way to bond better but also a precaution to make sure that they stay safe. Spend More Time Together As time passes, the distance can increase between you and your children. This is quite natural as they seem to develop their own interests and friends. However, it is important for you to keep them close by making sure that they can come to you for any matter. Encourage them to get a hobby which will keep them engaged and maybe opt for something which can be done together. This will help them be distracted from other unwanted distractions and also help you keep your relationship strong. Provide A Stress-Free Environment During this age, children are exposed to a lot of changes and are quite confused about themselves and their surroundings. If a violent or disturbed situation prevails in their environment persistently, children may look for other ways to manage the mental breakdown that they are being exposed to. This is why parents should try keeping the home a place where their children can be happy, in spite of any issues that they may be facing. Children are incapable of fully understanding the consequences of the actions that they may try out. It is the parents’ duty to ensure proper education on the subject for their kids to be safe out of harm’s way.

March 7, 2018
Parenting Hub

Weight isn’t the only thing you’ll be shedding after having a baby

Everything FINALLY seems to be settling down a few months after welcoming your new baby – she is in (somewhat of) a routine, her sleeping patterns are getting better and you have even managed to get more done this week. Just when things are coming together your hair starts to fall out! The average person loses around 100 hairs a day to make way for the newer hairs to come through. Most of the hair on your head is still growing, while around 10% is in a resting phase and will soon fall out.  When you are pregnant this natural hair shedding ceases to happen, which is why an expectant mother is able to proudly display her shiny locks “Many new mothers aren’t aware of the amount of hair shedding that can take place after having a baby, and it can come as quite a nasty shock when they see how much of their hair is left behind in the shower. This noticeable hair shedding is caused by dropping estrogen levels and a lot more follicles entering their resting stages” says Nomfundo Majozi, Vigro® brand manager. To start the process of getting your hair back to its original glory the active ingredients in Vigro® can help reduce non-genetic hair thinning. These active ingredients can assist the scalp with non-genetic hair thinning by cleaning and opening the hair shaft preparing the scalp for penetration of the actives, as well as assisting hair follicles to reduce hair thinning through the active ingredient Follicusan™ (topical products). ** The Vigro® 3-Step System also provides a combination of vitamins and minerals needed for healthy hair growth. Consult your doctor before using Vigro® capsules during pregnancy or breastfeeding. * *Efficacy of support may vary between users. Consult a medical practitioner for a diagnosis or if symptoms persist. Use as indicated. Vigro®3-Step System is not indicated for genetic hair loss.

March 6, 2018
Kaboutjie

What can be done about night terrors

Night terrors can be very stressful and frightening. When a child has a night terror he/ she is so deep into the dream, he cannot hear the person trying to wake him, even though the child may look at you and seem to be awake. Often a child may cry out, ask for help, thrash, kick, and scream — but cannot be comforted. Make your child’s room safe to try to prevent him from being injured during an episode. Eliminate all sources of sleep disturbance, such as caffeine, sugar, and high-energy activities before bed. Maintain a consistent bedtime routine and wake-up time. Unfortunately, there is not much you can do to help your child during the actual episode except to make sure he is safe. Just take comfort in the fact that the night terror is short-lived. If your child has night terrors, you can try to interrupt his/her sleep in order to prevent one. Here is how to do it: First, note how many minutes the night terror occurs from your child’s bedtime. Then, awaken your child 15 minutes before the expected night terror, and keep her awake and out of bed for five minutes. You may want to take your child to the bathroom to see if he/ she will urinate. Continue this routine for a week. Have you had any experience with night terrors? What helped?

March 3, 2018
AmnioPad

Hey Ladies are you feeling Wet down there? No need to worry …….

Most women at some stage in their lifetime will experience some form of vaginal discharge. The discharge may be normal or have a vaginal infection, characterized by discharge, itching, or odor. Vaginal infections are one of the top 25 reasons for women to consult doctors in the USA. The 3 most common types of vaginal infections (vaginitis) include: Bacterial Vaginosis, Trichomoniasis and Candidiasis, and these may or may not be associated with cervical infection1. The key to proper treatment of vaginitis is proper diagnosis. Bacterial vaginosis (BV) Bacterial Vaginosis is a vaginal infection that occurs when the balance of bacteria in the vagina is altered. It is a common condition affecting millions of women. Bacterial Vaginosis is characterized by the following symptoms: Increased vaginal pH to level of above 4.5. Thin homogeneous vaginal discharge – watery discharge (up to 50% of pts). Positive amine test – fishy odor (In pts with no discharge, the fishy odour may be more noticeable after sex or menstruation). Nearly 50% of pts with BV do not have symptoms and don’t know they have BV. Although the syndrome is curable with standard drugs, recurrence rates are high. Because many patients are asymptomatic (do not experience any symptoms), recurrence is difficult to differentiate from treatment failure. BV is associated with serious complications such as: Premature delivery Infections after abortion or hysterectomy and After placement of an IUD, increase in development of PID (pelvic inflammatory disease) and endometriosis, Inflammation of uterus / womb and fallopian tubes  Bacterial vaginosis is not a sexually transmitted infection; however, it is associated with the transmission of sexually transmitted infections (STIs) including HIV/AIDS.  Various diagnostic methods are available to identify the abnormal vaginal discharge. Clinical laboratory testing can identify the cause of vaginitis in most women OR BV can be diagnosed by the use of clinical criteria (i.e., Amsel’s Diagnostic Criteria considered the gold standard laboratory method for diagnosing BV) Clinical criteria require three of the following symptoms or signs: Homogeneous, thin, white discharge that smoothly coats the vaginal walls; Clue cells on microscopic examination; pH of vaginal fluid > 4.5; or a fishy odor of vaginal discharge before or after addition of 10% KOH (i.e., the whiff test). BV can be treated with over the counter medication or by prescription medication. Proper clinical evaluation is recommended to ensure proper treatment. Trichomoniasis  Trichomoniasis is the most prevalent  non-viral sexually transmitted infection. Trichomonal infections are asymptomatic in as many as 50% of male and female patients. The signs and symptoms of Trichomoniasis are: More extensive inflammation Erosion of the epithelial lining that is associated with burning, itching, and pain during urination Smelly or typically foamy discharge Yellow or gray-green discharge. Increased vaginal pH to levels above 4.5 Trichomoniasis should be treated by a clinician and not by over the counter medication. The sexual partner must also be treated in order to avoid reinfection. Candidiasis It is said that approximately 75% of women will experience at least one episode of Candidiasis in their lifetime. Candidiasis, otherwise commonly known as Candida is not a sexually transmitted infection and is usually caused by an overgrowth of the yeast that is normally present in the vagina. Some of the signs and symptoms of candidiasis are: Vulvovaginal irritation and / or soreness Whitish, cheesy discharge The pH levels of the vagina remains normal <4.5 With the availability of alternative therapies and over-the-counter medications for candidiasis, many women with symptoms seek these products before an evaluation by a medical provider. Obtaining a medical history alone has been shown to be insufficient for accurate diagnosis of vaginitis and can lead to the inappropriate administration of medication2. This makes it important for women to have a tool they can use either at home or at their Drs room to determine the cause of their vaginitis and treat correctly. Coincido offers the only rapid test on the market that can be used either by women at home or by healthcare professionals to monitor vaginal pH and assist in determining the cause of vaginitis:   Result interpretation (considered as part of the clinical evaluation): Positive result (blue, green) consider BV or Trichomonas infections. Negative result  (yellow) consider yeast infection The SwabEze is comprised of a vaginal swab with a polyester tip. The swab tip changes color when it comes in contact with vaginal secretions presenting elevated pH  (abnormal acidity) or low buffer capacity (watery discharge). A change of color from pale yellow to green or blue (even if only part of the tip change color) is easy to identify, considered as positive reading No color scale needed to interpret results. The Swabeze gives you piece of mind and guidance with appropriate treatment of vaginitis. By using the Swabeze at home you can avoid embarrassing questions when seeking treatment at the pharmacy. The Swabeze is also available in Australia, USA, New Zealand, UK and many other international markets. For more information on how to order the Swabeze for monitoring vaginal pH you can visit: www.coincido.co.za or call 011 589 989 MANAGEMENT OF VAGINAL DISCHARGE A AHOOSEN  CME February 2004 Vol.22 No.2 Page last reviewed: June 4, 2015 Content source: Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention

February 27, 2018
Paarl Dietitians

Nutrition in pregnancy: Giving your baby the healthiest possible start

With so many myths out there about diet and pregnancy, no wonder new mothers-to-be feel confused about the do’s and don’ts of their own diets. To eat appropriately is the one thing a mother have a lot of control over, and wants to get 100% right, but is so afraid of getting it wrong. We are regularly told that our weight, nutritional status and health during pregnancy and breastfeeding have effect on a baby’s risk of developing disease in future, birth risks, the baby’s health and growth both in the uterus and after birth. Scary as it may sound, with the right dietary advice and support it can actually be quite easy to get your diet right with a few easy tips. Keep reading. Will my pregnancy cravings influence my child’s eating habits?  Want your child to love veggies? Start early. Very early! New research shows that WHAT a woman eats during pregnancy not only nourishes her baby in the womb, but can influence a baby’s palate and food memories before he/she is born. The study found that a mother’s diet shapes her baby’s food preferences and acceptance later in life. Flavour perception develops as early as in the unborn infant and taste and smell continues to develop once they are born. In the womb, a fetus is surrounded and nourished on amniotic fluids, which is filled with the flavours of what the mom has eaten in the last few hours. The fetus starts to swallow large amounts of amniotic fluid from about 12 week’s gestation. By the time a women reaches her third trimester the fetus’s brain starts to communicate with the taste and smell receptors – for the baby to start to associate with certain flavours and odours in the amniotic fluid. A baby therefore already starts to build a memory bank of tastes and flavours during pregnancy. Amniotic fluid is therefore the first food for the baby to feast on and contains protein, sugars, fat and different flavours of the food that the mother eats. The fetus can detect these tastes and flavours – forming memories of these flavours and will prefer flavours that were previously experienced in the amniotic fluid. It was shown that if mothers who consumed carrot, anise or garlic flavoured food during pregnancy, their infants would be more accepting to flavours later in life. The flavour learning continues when infants experience the flavours of mother’s diet transmitted in breast milk, especially flavours such as anise, garlic, carrot, mint, vanilla. When babies start solids they showed greater liking for and acceptance of flavours to which they had early exposure. This means you can teach your baby to like broccoli from an early age! This varied experiences with food flavours increase food acceptance and may help explain why children who are breastfed are less picky during childhood. Formula tastes the same day-in and day-out. If you plan to formula feed your infant, and worry about the lack of variants in flavours just make sure you introduce your baby to the largest variety of solid  food and flavours early on in the weaning period. To conclude, if you want your children to eat a healthy diet (e.g. their broccoli) or more adventurous diet, you should expose them to all the right, healthy flavours early on. Will WHAT I eat during pregnancy affect what diseases my child may have in later life? There are some studies that show that the mother’s diet may affect whether children have the risk for developing diabetes, heart disease, obesity or high blood pressure later in life. During the war, when pregnant women were exposed to very little food, especially in the first trimester, their children were more likely to be born heavier, taller and develop heart disease in adulthood. Some studies suggest that when an expectant mother has too little protein and too many carbohydrates in her diet, the child may have a risk of high blood pressure later in life. This also applies to when you do not supplement your diet with the recommended vitamin and mineral supplements e.g. folic acid, iron calcium and vitamin D. “Over nutrition” during pregnancy also has detrimental effects and may cause the fetus to grow faster than the fetus’s organs and can lead to liver, heart and kidney disease in adulthood. There is also a suggestion in research that if your diet is rich in omega 3 fatty acids (mainly available in oily fish and seeds) during pregnancy it can protect the baby against ailments such as high blood pressure and heart disease in adult life. Should I avoid certain foods during pregnancy to prevent my child from having food allergies? Many scientific studies have been done to investigate whether mothers who avoid certain foods in the diet during pregnancy can control the presence of allergies and eczema in their babies once they are born. They all concluded that babies might or might not present with food allergies and eczema, regardless of the mother’s diet, especially when there is a strong family history of food allergies. They also concluded that avoiding certain food in the pregnant mother’s diet have shown to affect the mother and the baby’s nutritional status. Both may run the risk of missing out on essential vitamin and minerals contributing to an inadequate nutritional intake and is therefore not recommended. You can actually do more harm than good by avoiding anything in the diet for instance nuts, fish, eggs, milk, citrus fruits to prevent allergies in your baby. If you as expectant mother do suffer from food allergies and need to avoid certain foods it would be of benefit to consult a dietitian who would be able to provide you with a nutritionally balanced diet and ensure both you and your baby get all the nutrients you require. Super foods for pregnancy Eggs: It contains choline that helps to reduce the risk of neural tube defects, such as spina bifida. In addition, studies suggest that choline is key to the

February 22, 2018
South African Association of Audiologists

Hearing in the young child

Hearing ability is crucial for development of speech and language in the young child. In South Africa especially, hearing loss in children often goes undetected until the child has passed the critical period of language and speech development. The hearing loss is usually only picked up when the child is about to enter school and has no little communication skills.  Even a mild hearing loss can inhibit a child’s ability to development communication and language skills severely! Late detection has detrimental problems on the child’s mental, cognitive, developmental and social aspects of life. The key to avoid late detection is awareness of the fatal implications of undetected hearing loss and the signs and symptoms that parents and care giver should look out for in a child’s early life. There are many factors that put a child at risk for hearing loss. These factors can be categorized into: hearing loss that is present at birth (congenital) or hearing loss that developed after birth (acquired hearing loss).  Parents and caregivers should be vigilant if the following risk factors are identified: Indicators for a high risk of hearing loss present at birth (Congenital Hearing loss) Family history of permanent hearing loss in childhood Maternal infections during pregnancy or delivery these include: Toxoplasmosis, Syphilis, HIV, Hepatitis B, Rubella, CMV, Herpes simplex. Physical problems of the head, face, ears, or neck (cleft lip/palate, ear pits/tags, atresia) Ototoxic medications given in the neonatal period Born with any Syndrome associated with hearing loss (Pendred, Usher, Waardenburg, neurofibromatosis) Admission to a neonatal intensive care unit greater than 5 days Prematurity (< 37 weeks) Hyperbilirubinemia Low Agar score (0-3) Disorder of the brain or nervous system Indicators for a high risk for acquired hearing loss after birth: Childhood diseases such as mumps or measles Untreated middle ear infections Perforated eardrum Excessive loud noise such as gunshots, fireworks or loud music Severe injury to the head Ototoxic medication Otitis media / Ear infections (explained later in article) With these risk factors there are also many signs and symptoms that parents and caregivers can look out for: Child isn’t startled by loud sounds Child is inattentive during interactions Doesn’t respond to parents voice Doesn’t make babble sounds Doesn’t imitate sounds or words like ”bye-bye”, “mama” Fails to respond to their name Fails to turn his/her head to a sound source Fails to follow simple instructions With these signs and symptoms it is also important for parents and caregivers to take note of speech and development milestones from 12 – 36 months which are related to receptive language ( ability to understand words and speech) and expressive language ( ability to use speech and gestures to make meaningful communication) Age groups Receptive Language Expressive Language 12 – 24 months Recognize names of family members and familiar objects Use hand gestures to signal something such as finger pointing to toys Understand simple phrases e.g. ‘give me’ , ‘no’, ‘ all gone’ Make one-two syllable sounds that stands for something they want e.g. ‘nana’ for a bottle By 18months know names of body parts , objects and places By 18 months – use of made up language- mixture of made up and understandable words Follow simples instructions like ‘ put the ball down’ or ‘come to mommy’ Between 1-2 years old has a vocabulary of at least 20-50 words which are understood by family members 24-36 Months Know and point to at least  7 body parts Tend to start speaking a lot and questioning surroundings and environment  Follow simple requests like ‘ pick up the shoes’ Use pronouns such as ‘ me, you, yours’ but often get it mixed up Understand questions and points to pictures when asked what it is e.g. where is the rabbit or show me the balloon Make simple phrases such as ‘ want more food’ or ‘ no sleep time’   By age 3 should have 150-200 words in vocabulary and stranger should be able to comprehend their speech   Another major risk factor that parents should be on alert for is Otitis Media with Effusion (OME) or better known as ‘glue ear’. It is described as build-up of non-infected fluid in the middle ear. OME is common among children between 6 months and 3 years of age. The fluid could sometimes resolve itself however if OME is left untreated or last more than 6 days it can to fluid becoming infected and causes a temporary decrease in hearing. OME can sometimes go undetected   due to the lack of obvious or acute symptoms. OME is usually caused by a poor functioning Eustachian tube (ET), this tube is a link between the middle ear and the throat.  The ET helps us to equalize the pressure between the air around you and the middle ear. When the ET doesn’t function correctly it stops normal drainage from the middle ear causing an accumulation of fluid behind the child’s eardrum The following are also risk factors for your child developing OME: Drinking from a bottle while lying on their back- this causes milk to seep into child’s ears Developing a common cold 2nd hand smoke Not breastfeeding Craniofacial abnormalities ( cleft palate , cleft lip ) OME can be very subtle and sometimes hard to detect however your child may show the following signs: Continued tagging of ear Hearing difficulties Loss of balance Delayed speech development The only way to correctly diagnose an OME is to visit an Audiologist. The Audiologist will perform a Tympanometry test. This test will reveal findings of the status of the middle ear, giving information about any fluid present in the ear, mobility of the middle ear and volume of fluid in the ear. Tympanograms can be read off graphs and normative data of pressure and volume, the Audiologist can make a diagnosis from any abnormalities in the results. If a fluid build-up in the middle ear is detected it should be monitored to determine whether it clears up by itself. Should the fluid build-up not

February 22, 2018
Raising Kids Positively

Words can make or break

What you say, and how you say it Your words, (and how you say them), are being absorbed by your kids all the time.  Neuroscientist, Louis Cozolino, tells us that the amygdala (that part of our brain that is activated in fear situations) pays special attention to anger signals, while positive, warm encouragement increases serotonin (a feel-good hormone). This means that simply through words (and how we say them), we literally have the power to change everything! Words can build your child up, or break him down.  It takes much more effort to undo the negative effects of our words, than it does to start speaking positively. So why not give positivity a go. Remember : young children take words literally – their logic and reasoning isn’t well developed yet kids take things personally and misinterpret  – often making wrong assumptions they believe what we tell them – adults are powerful, be careful of sarcasm they remember negative comments easily – in comparison to praise children become what you tell them  – be encouraging and speak “as if” they’re already co-operating (e.g. “nice listening”) “yes” motivates – “no” makes kids defensive (e.g. “Yes, you can have that after supper”) Speaking consciously is an ongoing learning in self-awareness.  Yet words can change lives, so be patient with yourself and watch how your new way of talking easily wins their co-operation and starts to change how they view themselves.  

February 21, 2018
Paarl Dietitians

Alcohol Myth Buster

How much alcohol is recommended for a person (women) a day? For many people drinking alcohol is a pleasant social activity. Alcohol has long been an integral part of celebrations and other happy social gatherings for centuries. However, it should be done in moderation. The South African Heart Association recommends a maximum of 2 drinks per day for males and 1 drink per day for females. The South African Food-Based Dietary Guidelines (FBDG) recommends that if you drink alcohol, drink sensibly and define low risk drinking as no more than 4 units of alcohol per day for men and no more than 2 units for women, with at least 2 alcohol-free days per week. However, people who do not drink alcohol are not advised to start drinking in an attempt to gain any health benefits. Many experts are of opinion that this recommendation is still too high and should be changed. New international guidelines (UK Chief Medical Officers’ Low risk drinking guidelines, August 2016) for both men and women to keep health risks from alcohol to a low level – is safest not to drink more than 14 units a week – equivalent to six glasses (175ml) of wine or fourteen (25ml) shots of spirits per week. Ideally women should be having up to a maximum of 1 drink per day. An additional recommendation is not to ‘save up’ the 14 units for 1 or 2 days, but to spread them over 3 or more days. People who have 1 or 2 heavy drinking sessions each week increase the risk of death from long term illnesses, accidents and injuries. A good way to reduce alcohol intake is to have several alcohol free days a week. These new guidelines for alcohol consumption, warn that drinking any level of alcohol carries a health risk for anyone and increases the risk of a range of cancers and liver disease. This is supported by a new review from the Committee on Carcinogenicity (CoC) on alcohol and cancer risk. The guidelines for pregnant women have also been updated to clarify that no level of alcohol is safe to drink in pregnancy. The previous advice for pregnant women to limit themselves to no more than 1 to 2 units of alcohol once or twice per week has been removed to provide greater clarity as a precaution. Although the risk of harm to the baby is low if they have drunk small amounts of alcohol before becoming aware of the pregnancy, there is no ‘safe’ level of alcohol to drink when you are pregnant. So what does 1 unit of alcohol look like? 218ml cider or 76ml wine or 25ml whiskey or 250ml beer or 250ml alcopop. What type of alcohol is the best option for a person? Individual reactions to alcohol vary, and are influenced by many factors, such as age, gender, race or ethnicity, physical condition (e.g. weight, fitness level), amount of food consumed before drinking, how quickly the alcohol was consumed, use of drugs or prescription medicines and family history of alcohol problems. The intensity of the effect of alcohol on the body is directly related to the amount consumed and how fast the alcohol was consumed. For example one 340ml beer has about the same amount of alcohol as one 150ml glass of wine. The faster you drink the higher blood alcohol levels. There are some similarities in how alcohol affects men and women, but there are differences too. If a woman and a man drink the same amount, the woman’s blood alcohol level will almost always be higher than the man’s. There are several reasons for this…. Women tend to be smaller than men. That means, the same amount of alcohol is going into a smaller body. Even if a woman is the same weight as a man, she will have a higher blood alcohol level if she drinks the same amount as that man. Alcohol is held in the body in body water, not in body fat. Women generally have a higher proportion of body fat than men, so have less body water. That means the alcohol is more concentrated. Other factors have also been reported that can make women more sensitive to alcohol, such as enzyme differences. So to answer the question….. It is the amount of alcohol consumed that affects a person most, not the type of alcoholic drink. Does alcohol make ones blood glucose drop? If yes, what does it mean? Yes, alcohol affects blood glucose levels each time it’s consumed, regardless of the frequency of consumption. The primary hormones involved in maintaining a healthy blood glucose level are insulin and glucagon. Normally, when your blood sugar begins to drop, your body can respond by making more blood sugar or burning up stored sugar. And when your blood sugar begins to rise, additional insulin is secreted to bring your levels back to a healthy range. When a person drinks alcohol, it is considered a poison or toxin by the body and the body channels all energy into expelling it. This means that other processes are interrupted – including the production of glucose and the hormones needed to regulate healthy blood glucose levels. Alcohol consumption causes an increase in insulin secretion, which leads to low blood sugar (otherwise known as hypoglycaemia). It can also impair the hormonal response that would normally rectify the low blood sugar. This causes light headedness and fatigue, and is also responsible for a host of longer-term alcohol-related health problems Should one eat in between the drinking? Yes, to prevent your blood glucose levels from dropping to low. We know eating is cheating, but you will be cheating your body and depriving it from much needed glucose and nutrients as well. Is it important to eat before drinking alcohol? If so, why? And what should one eat? Eating limits the effects of the alcohol. Research has shown that alcohol consumption increases insulin secretion, causing low blood sugar (hypoglycemia). Drinking as little as 60ml of alcohol on an empty

February 21, 2018
Parenting Hub

Chiropractic care for mothers during and after pregnancy

Chiropractic has typically included the care of pregnant patients to insure a comfortable pregnancy and to help facilitate in an uncomplicated labour and delivery process. Low back pain is often described as an inevitable complication of pregnancy.  It has been reported that approximately 50 % of all pregnant women experience back pain during their pregnancy and 50 % to 75 % of women experience back pain during labour. However, only 21% of pregnant women with back pain seek consultation with medical practitioners. Therefore, it is important to have a look at some possible causes of low back pain during pregnancy. Biomechanical changes and stress to the neuro-musculoskeletal system are present during and immediately after pregnancy. Adaptations of the body structurally may be a contributory source of low back pain throughout the gestation period. As the foetus develops, its weight is projected forward and the lumbar lordosis is increased, placing extra stress on the intervertebral discs and joints of the spine. Spinal dysfunction related to the change in the load distributions are a factor in back pain. Hormonally an increase in circulating progesterone, estrogen, and relaxin (especially in the third trimester) cause hypermobility in the pelvis and a decrease in spinal stabilization. Physically strenuous work and previous low back pain are factors that may also be associated with an increased risk of developing low back pain during pregnancy. Common treatment techniques that chiropractors utilize include gentle myofascial relaxation of specific muscles, which can greatly aide in the reduction of pain and tension. Also, improving the strength of the core muscles is thought to prevent some of the typical postural alterations.  Release of muscle spasm can be quite beneficial in relieving suboccipital headaches, cervicothoracic pain, thoracic outlet syndrome symptoms, or myofascial pain syndromes. Chiropractors can also help the pregnant patient manage an exercise routine compatible for her changing body throughout pregnancy. Research shows that approximately 75% of pregnant patients who received chiropractic care during their pregnancies stated that they found relief from pain. After delivery, the ligaments in the body are tightening up to help bring the joints back together, this process can take up to 8 months. Rehabilitative exercises should be used for weakened back and abdominal muscles.  Regular chiropractic care is valuable during the post-partum recovery phase and is beneficial in assisting proper restoration of normal spinal biomechanics. SOURCES: Borggren, C.L. (2007). Pregnancy and Chiropractic: A Narrative Review of the Literature. Journal of Chiropractic Medicine. 6(2) p 70-74.

February 16, 2018
Mia Von Scha

Should We Be Giving Our Teens Condoms?

I don’t think there is a parent on the planet who wouldn’t cringe at the thought of their 12 year old having sex. And so when, last year, our education department proposed to hand out condoms to kids aged 12 and up, without any parental consent needed, it made many parents feel a little uneasy. It is understandable that a lot of people oppose this idea, regardless of the thought processes behind it. And yet, just because kids having sex makes us uncomfortable does not mean that it isn’t happening. And I’m not just talking about lower class, uneducated youth either. Just last year there was a case in a very wealthy neighbourhood where a family tried to immigrate to Oz and on doing their final medicals discovered that their 11 year-old daughter was HIV positive. It turns out she and a group of her friends were having sex with the security guards in the complex where they lived. We like to assume it isn’t happening and if it is happening it isn’t in our neighbourhoods or our schools or with our children. We have to get our heads out of the sand. Teen pregnancies are on the increase in South Africa and we have one of the highest HIV rates in the world. Teenagers are sexual by their very nature and by making sex taboo or keeping it as an unspoken in our homes and schools, we are not helping them to deal with the very real pressures and dangers that they are going to face in the real world. I applaud this move by the education department. Around the world there is evidence that having more open, relaxed conversations with teens about sex, by supplying them with contraceptives and helping them to understand how and why to use them, and giving them the opportunity to explore their sexuality safely reduces teen pregnancies, sexually transmitted diseases and abortions. This completely contradicts the fears that most parents have that if they start handing condoms out to kids that there is going to be more teen sex and all the issues that go along with that. Nobody is running around encouraging children to get it on with each other. The department of education is simply looking at the facts and taking action. And the fact is… Kids are going to have sex whether we talk about it or not. Kids are going to have sex whether we want them to or not. Kids are going to have sex whether we educate them on it or not. Kids are going to have sex whether we supply them with condoms or not. Let’s do the right thing and make sure that if they have sex they are able to do this safely and that they understand the risks involved. Let us give our children both condoms and the education that goes along with that. An educated, aware child has a greater chance of survival than one who is kept in the dark. Handing a child a condom does not ensure that they are going to have sex. But not making condoms available ensures that if they do have sex the consequences are much more likely to be tragic. Let’s keep pregnancies for the adults!

February 16, 2018
Teddys Inc Ltd

WHY IS IT IMPORTANT FOR YOU TO UNDERSTAND YOUR CHILD’S EMOTIONS?

Emotions… we all have them and there is no denying them as we are all born with them.  Emotions are wonderful things to have, that is when they make us feel good.  But, when they make us feel bad, they can potentially send us into a flat spin.  Especially if it is your child who is feeling yukky and you have no idea what to do about it. So what are emotions and what does it mean when your child is throwing a tantrum, sulking, hitting other children, feeling sad or distressed.  Emotions are the energy of feelings and feelings are based on what we think, especially about what we think about ourselves and the situations we are in.  Let me explain, if you think there is something wrong with you, you will feel bad about yourself.  Your actions will demonstrate how you are feeling and will be expressed from a place of anger or sadness or even depression.  Another example is, if your child thinks they are not important, that you are too busy to spend any time with them.  This may lead them to feel neglected or isolated which will come across again as sadness or resentment or any other kind of ‘negative’ type of emotion.  The behaviour from this can manifest in a few ways.  Tantrums, being ‘naughty’, ill-behaved or any kind of behaviour that is displayed to seek attention.  The reason for this ‘bad behaviour’ is that children would rather get any attention, including being punished than have no attention at all. Emotions need to be viewed as a guidance system, your very own inbuilt GPS as emotion is what brings our attention to what is going on on a deeper level.  A child does not have the ability or emotional literacy to express that they feeling are neglected, especially younger children, hence the reason that they demonstrate it with their emotions.  However, this does not only apply to young children, but to older children and adults as well. Our emotions also cause a chemical reaction in the body.  When we feel love, endorphins like serotonin and oxytocin are released into the body.  These chemicals make us feel content and peaceful and happy.  When we feel frustrated, resentful or fearful, cortisol and adrenaline are released into the body which makes us feel stressed, angry and aggressive. However, not only are our emotions affected by how we feel or think, they are also affected by our environment.  What we eat, what is going on at school, what is going on at home, all has an affect on our emotions and ultimately our behaviour.  When we eat processed food or food that contains chemicals like preservatives, colourants and artificial sweeteners, the body sees these as toxic or as poisons and tries to rid itself of it as quickly as possible.  The behaviour that results from this is hyper activity, over activity or anxiety.  Too much sugar has the same affect.  In some cases sugar actually causes people to feel tired and lethargic. Especially when a person’s diet is not balanced and you are not getting enough protein, veg and healthy fats to balance it all out.  Other chemicals that affect emotions and behaviour are the chemicals we inhale, like smoke, fumes, perfumes and household chemicals.   All of these have an affect on the body’s chemical reaction which then affects emotions and energy. Other factors that affect a child’s emotions, are other people’s emotions.  Emotions are incredibly contagious.  If parents are stressed, worried, anxious or if they bicker and fight a lot, this will be transferred to your child and they will feel what you are feeling.  This can be incredibly stressful for a child because they will have no idea what to do with it and often their behaviour once again will be affected.  The same thing will happen if their teacher if stressed out or if the children in your child’s class are stressed and more so if there is bullying going on at school. I’m sure you can now appreciate why it’s so important to understand emotions so that you can help your child, and yourself, to deal with them.  Unresolved emotions can cause incredible distress, anxiety and stress and the quicker you learn how to identify and ope with them, the better it is for everyone. If you want some help understanding emotions, then do join our free support group for parents and teachers on Facebook which you can find here 

February 14, 2018
The Headache Clinic

Pregnancy and Migraines

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

February 14, 2018
Parenting Hub

Headaches associated with impaired learning ability and negative mood

Research has shown that headaches can have many adverse effects on our lives: from diminished concentration in class or at work to irritability in general. There have, however, been few studies on the effect on learning ability and mood. Two recent studies filled this gap and found that tension-type headaches are associated with negative mood and impaired learning ability. Both studies were summarised in Frontiers of Neurology and both involved one group of participants completing a battery of tasks when they had a tension-type headache and again when they had no headache. Another group (the control group) was headache free on both occasions. In the “no headache” condition, the participants had not reported a headache for 24 hours prior to the assessment. In the first study, 12 participants (6 with tension-type headache and 6 in the control group) completed a computerised battery measuring mood and aspects of learning ability. In the second study, 22 participants (7 tension-type headaches, 5 after tension-type headaches and 10 people from the control group) completed mood and learning tasks. In the first study, having a headache was associated with an increase in negative mood both before and after the tasks. Three performance tasks showed impairments when the participants had headaches: logical reasoning was slower and less accurate and retrieval from memory was slower. According to Dr Elliot Shevel, South Africa’s pioneer in the field of migraine surgery and the medical director of The Headache Clinic, results from the studies confirmed the increase in negative mood when a person has a tension-type headache, as well as impaired learning ability. “The results confirmed impairments in the logical reasoning, and also showed that those with a tension-type headache were more easily distracted and experienced irritability. Effects did not continue after the headache had gone.” These findings can have an impact on the performance of students and workers, as well as their relationships with colleagues and team members. “Negative mood and impaired learning ability adversely affect the quality of work,” says Dr. Shevel. “It is important to take note of these effects that reduce quality of life and ensure early diagnosis and effective treatment takes place.”

February 13, 2018
Parenting Hub

SA Children more at risk from sunburn at school

Copious amounts of sunscreen are sold each summer holiday in an effort to protect, in particular, children’s skin from both the damaging ultra-violet (UVA and UVB) rays of the harsh South African sun, but when kids go back to school, this dogged persistence seems to wane. Millions of school learners have gone back to schools around the country – many of which have inadequate or no sun protection policies in place, leaving children exposed to sunburn. Even though there is more public awareness around sun protection, it doesn’t appear to be a top priority at the majority of SA schools since other pressing issues such as nutrition and violence seems to have taken precedence. However, interventions at school level are critical in curtailing SA’s high incidence rates of skin cancer and should receive more attention. Local research studies have shown that sunburn in children significantly increases the risk of developing skin cancer and melanomas – the deadliest form of skin cancer – later in life. It is therefore vital that children are protected from the sun not only when at the beach or the swimming pool, but at school as well. In South Africa, skin cancer remains the most common cancer with about 20 000 reported cases and 700 deaths a year, making it a significant health problem. According to CANSA, the most of a person’s lifetime exposure to the sun occurs before the age of 18, which makes sun-safe policies an absolute must at pre-schools, primary schools and high schools. As in Australia – where skin cancer rates are amongst the highest in the world – SA schools across the board should adopt similar sun-smart policies. Some of these interventions include learners having to wear a broadbrimmed hat as part of their school uniform. If no hat is worn, learners may not play outside; plenty of shade is also provided on the playground via trees or structures; the use of sunscreen is encouraged and time is allowed for application, and during outdoor athletic or sporting events, ample provision is made for shade to avoid sunburn. In addition to these measures, scientific studies have validated the health properties of Rooibos on skin, which may assist with various skin ailments including the prevention of the development of cancer. Thus, parents whose children have been badly sunburnt may be able to turn to Rooibos for help. Dr Tandeka Magcwebeba, a post-doctoral fellow at Stellenbosch University, who has done extensive research on the anti-cancer properties of Rooibos on the skin, says the topical application of Rooibos may offer protection against the early stages of cancer development in the skin. Dr Magcwebeba says, once the anti-cancer properties of Rooibos has been fully characterised, this herbal tea may be one of the agents that could protect children’s skin from some of the damage caused by the sun’s harmful rays. “Once the skin has been exposed to the sun’s UV rays, Rooibos extracts have the ability to remove precancerous damaged cells and also block the onset of inflammation. It does so by stopping the multiplication of cancerous cells and removing these cells through programmed cell death – in other words, prompting the cells to commit suicide. “It’s the abundance of polyphenols (antioxidants) – natural compounds found in Rooibos – which gives its restorative power,” explains Dr Magcwebeba. “These compounds are linked to the prevention of various chronic disorders, including skin cancer. However, it is important to note that preliminary findings show that Rooibos extracts are more effective during the early stages of skin cancer development as they are able to facilitate the removal of UVB damaged cells thereby delaying their progression into a tumour.” If your child does end up with nasty sunburn, anecdotal evidence indicates that soaking him/her in a lukewarm bath of rooibos tea two to three times a day, could help reduce inflammation, which is likely due to the tea’s anti-inflammatory properties. This, in combination with the abundance of antioxidants present in Rooibos tea will help to naturally accelerate the healing of the skin. It is still uncertain how much rooibos extract is needed to prevent the development of skin cancer, but according to science, children (and adults) who spend a lot of time in the sun may benefit from using cosmetics, sunscreen and after-sun skincare products containing Rooibos extract. For more information on rooibos’ healing potential, visit www.sarooibos.co.za

February 12, 2018
Kath Megaw

The benefits of eating well 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 J 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 12, 2018
Maritza Breitenbach

The Effects of Pregnancy on our Intimate Bits

The miracle of pregnancy is universal and timeless, and even though we are, by divine design, capable of going through this process, it does have a pronounced effect on our bodies and our sexuality. During this event, higher levels of progesterone cause drowsiness while the increased estrogen lifts our mood, making us more radiant than ever. As our bodies gradually grow larger, we may suffer from stormy hormonal changes. Suddenly we have irrepressible cravings and our sense of smell becomes acute; we have whimsical shifts in preferences and aversions, and if exposed to the sun, we may even acquire a pigmented ‘moustache’ and brown patches on our cheeks. During the fourth month of pregnancy, our intimate bits also start changing – it becomes puffy and enlarged, and the colour of the labia deepens considerably. Both the increased blood supply to the vagina and the increased pressure on it create a permanent state of gentle sexual arousal, leaving us moist and more conscious of our lady parts. The thin line that runs between our pubic patch to our navels also becomes more pronounced. The most common long-term problem associated with pregnancy and childbirth include urinary incontinence and pelvic organ prolapse. During pregnancy, the weight of the baby, the ‘water’ and the placenta put a twenty-times-heavier-than-normal strain on the pelvic floor, and this often leads to urinary incontinence during the last trimester. Vacuum extraction, forceps delivery, an episiotomy, lying on the back, and applying fundal pressure (pressing on the abdomen to help move the baby out) are all factors that increase pelvic injury risk during vaginal birth. Even by opting for a caesarian section we are not exempted from pelvic injury risk; in fact, this procedure inceases the risk of maternal death by sixteen-fold, and it increases the risk of having to have a hysterectomy by ten times. The pelvic floor consists of a complex, multilayered group of muscles, tissues and nerve endings that creates a hammock between the pubic bone and the base of our spinal cord and supports a number of organs including the bladder, rectum, uterus, urethra, vagina and anus. The pelvic floor seems to be the ‘headmistress’ that has all our lady parts neatly secured in her firm hand. She has the huge task of coordinating, directing and protecting all of our beneath-the-belt bits, and she plays a valuable role in our womanly health. We should be well aware of her strengths and shortcomings. The best and safest way to protect ourselves from pelvic floor impairment is Kegel exercises. The importance of these exercises cannot be overemphasized; they play a vital role in the prevention and treatment of pelvic-floor disorders. Work those muscles daily to keep them strong, elastic and toned.

February 9, 2018
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
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