Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Vaccine against Streptococcus Pneumoniae

The World Health Organization (WHO) stresses that although pneumonia vaccines are not effective against COVID -19, vaccinations against respiratory illnesses are highly recommended to protect your health and lowering the risk of becoming infected with any respiratory disease during this time. WHO also states that globally more children, under the age of 5, die from pneumonia than malaria, AIDS and TB combined. In SA, flu and pneumonia rank second – after intestinal infectious disease – as the leading cause of children under 5, which doesn’t make sense when vaccines are available in both the private and public healthcare sector for children and adults. Bonitas Medical Fund recommends having a flu vaccine, it is the first line of defence when it comes to protecting yourself. For those who are at risk of pneumonia, a second vaccination against Streptococcus pneumouniae is also recommended. What is pneumonia? Pneumonia is inflammation of the lungs caused by an infection. Many organisms can cause lower respiratory tract infections or pneumonia. Mixed infections with multiple viral and/or bacterial infections are common. Streptococcus pneumoniae is a bacterium known to be a common cause of bacterial pneumonia in South Africa. Pneumococcal infection may cause mild disease such as a middle ear infection or more complicated infections like pneumonia or an infection of the blood called bacteraemia. In South Africa, individuals at risk of more severe or invasive pneumococcal disease include the elderly, HIV-infected individuals and individuals with chronic medical conditions (e.g. chronic lung disease). Severe disease may require hospitalisation for treatment and may result in death. These streptococcal bacteria can spread from the nose, throat and ears of infected individuals. Pneumococcal vaccine Two pneumococcal vaccines are registered for use in adults (over 18 years of age) in South Africa: The 23-valent polysaccharide vaccine (PPV23) and the 13-valent pneumococcal conjugate vaccine (PCV13). PCV13 is also included in the South African Extended Programme of Immunisation (EPI) for childhood vaccines and is given to infants at 6 weeks, 14 weeks and 9 months. These vaccines aim to provide immunity against the types of Streptococcus pneumoniae that are most commonly associated with severe disease. According to local clinical guidelines from the South African Thoracic Society and Federation of Infectious Diseases Societies of Southern Africa, since the introduction of the PCV13 into the EPI there has been a reduction in the number of cases of pneumococcal pneumonia caused by these types of Streptococcus pneumoniae in South Africa. Who should have the vaccination? Infants routinely receive pneumococcal conjugate vaccines (PCV13) as part of the EPI for childhood disease*. The pneumococcal polysaccharide vaccine (PPSV23) is recommended for individuals who are at risk of developing severe disease*: individuals 65 years or older anyone with chronic medical conditions affecting the lung, heart or kidneys HIV-infected individuals Those with a compromised immune system due to other medical conditions (e.g. individuals with cancer) Pneumococcal vaccination during the COVID-19 pandemic The pneumococcal vaccination is not active against the novel coronavirus and will not protect you from becoming infected; it will offer protection against Streptococcus pneumoniae. However, the National Institute of Communicable Disease (NICD) states the following, ‘any intervention to lower the risk of becoming infected with any respiratory disease at this time may be of benefit. Lowering the risk of acquiring a respiratory infection, will allow for less visits to clinics and less hospital admissions, thus decreasing the burden on the health infrastructure at this time and lowering ones’ exposure to acquiring COVID-19 in the hospitals/clinics.’ Although pneumococcal vaccination does not protect against COVID-19 mild or severe disease or COVID-19 pneumonia, it could play a role in preventing secondary pneumococcal pneumonia infections in those with underlying conditions and the elderly. When to get vaccinated? If you think you may be within one of the groups at risk of severe pneumococcal disease, contact your pharmacy to check whether stock of the vaccine is available and schedule an appointment to be vaccinated. Most medical aid plans offer a free flu vaccine annually to members as well as a once off –pneumococcal vaccine for those over the age of 65. As part of the preventative care benefit this is taken from risk cover so it doesn’t deplete members’ savings. Bonitas says that despite the evidence of the efficacy of both the flu and the pneumonia vaccinations, there is not enough uptake. To address this and encourage more members to get vaccinated the Scheme runs email and SMS vaccine drives targeted at the elderly, high risk/emerging risk members as well as children. It reports that this has shown an improvement in people taking the necessarily precautions, but the Fund still believes there is a long way to go.

June 8, 2020

Coronavirus – should you still have a flu vaccine?

The flu season is officially underway and, while Coronavirus is bringing the world to a standstill, it is important to remember that flu can be deadly too. Which is why it is important to have a flu vaccine.

June 3, 2020

Making sense of the numbers – cases, co-morbidities and costs

As the number of COVID-19 infections creeps closer to 20 000, both public and private healthcare is going to be under constant pressure. The World Health Organization (WHO) says its COVID-19 data to date suggests that 80% of infections are mild or asymptomatic, 15% are severe infections, requiring oxygen and 5% are critical infections, requiring ventilation.

May 26, 2020

Supporting you through your pregnancy

Bonitas Medical Fund believes that as an expecting mom your pregnancy should be a unique and joyful experience. Through targeted support during each trimester, pregnancy education and specific related engagements – via telephone and digital channels – we aim to help you achieve this. With the new Maternity Programme we hope to improve the health of moms-to-be and, as a result, reduce possible complications.

May 19, 2020

Back pain during pregnancy and how to deal with it

Back pain is a common occurrence during pregnancy and can be frustrating to deal with. Unfortunately, if you have any pre-existing back problems you are more likely to struggle with back pain during your pregnancy. If you are suffering from back pain during your pregnancy and are wondering what you can do to help reduce it; we explain what causes it and how you can find some relief. What causes back pain during pregnancy If you are experiencing back pain during your pregnancy you are probably wondering what is the root cause of it. Generally there are two types of back pain that expecting moms deal with. Pelvic pain, which is felt in the pelvic tailbone area, and lumbar pain which is similar to any lower back pain felt when not pregnant. There are a few culprits of back pain during pregnancy. Hormones, stress, weight changes and posture are all causes of sore and uncomfortable back. During your pregnancy, your hormones change. One of them, known as relaxin, softens the joints in the pelvic region. This can directly impact on your back’s ligaments, causing you back pain. Stress can also cause your back to ache, whether you are pregnant or not. If you are worried about your job, family or pregnancy, you can find that this added anxiety can contribute to back pain. This is due to the fact that anxiety can cause muscle tension, which can then translate into back pain. Changes in weight as your baby grows and shifts in your centre of gravity can also be a cause of a sore back. If you’re already struggling with poor posture or back ache, then back pain during your pregnancy becomes far more likely. What can help relieve my back pain? Completely alleviating your back pain may not be possible, but there are things you can try that could help ease and manage your pain. Avoiding lifting heavy objects, opting for flat, supportive shoes and getting plenty of rest are all things you can try to improve your back ache. Exercises that help strengthen your glutes and abs can also help relieve back pain. Prenatal yoga and water aerobic classes are examples of gentle exercises which can help strengthen your body. However, if you are feeling cramps, experiencing vaginal bleeding, feeling feverish, numbness or sporadic pain you should consider consulting with your doctor, as these are all more than just normal pregnancy back pain symptoms.

May 18, 2020

Lifestyle diseases and Coronavirus

As the number of Covid-19 infections moves over 10 000, the health minister Zweli Mkhize has expressed concern about the huge risk group of South Africans suffering from high blood pressure, diabetes and obesity. In other words Comorbidities.

May 12, 2020

Advice from the experts

How to Talk to Kids about Death

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

October 26, 2017

5 Parenting Tips For Children With Autism

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

October 20, 2017

Brain Development in Teens

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

October 19, 2017

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

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

October 18, 2017

QUALITIES IMPORTANT FOR YOUR CHILD’S SELF ESTEEM

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

October 17, 2017

Medical Aid Made Easy

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

October 13, 2017

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

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

October 12, 2017

How to Replace Screen Time with Foundational Reading Skills

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

October 10, 2017

Cholesterol: Top foods to improve your numbers

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

October 9, 2017

Rethink Your Drink – Choose Water!

Clean and clear, refreshing and invigorating, we know instinctively that water is good for us. Yet, many of us have lost touch with water. Overwhelmed with the wide choice of what to drink, most of it sweetened with sugar, we’ve somehow left the simple, but profound goodness of water behind. National Nutrition Week 2017, running from 9 to 15 October and, with its theme “Rethink your drink – choose water”, aims to help us rethink when it comes to water and get into the habit of making water our beverage choice each day. Water contains no kilojoules and hydrates. It is essential for health and is the best choice to quench thirst. What the campaign highlights is that when we are not drinking water, we are probably choosing a sugar-sweetened drink which spikes our daily kilojoule intake, degrades our diet, and leads to weight gain and the onset of non-communicable diseases such as type 2 diabetes, heart disease and dental caries. “The prevalence of obesity and non-communicable diseases in the country is alarming,” says Rebone Ntsie, Director: Nutrition, of the National Department of Health). “The South African Demographic and Health Survey conducted in 2016 found that the prevalence of overweight was 13.3% among children 0 – 5 years of age. About 67.6% and 31.3% of South African women and men respectively are overweight and obese. These findings show that overweight and obesity among children and adults have increased from earlier surveys. Replacing sugary drinks with water can help.” Professor Pamela Naidoo, CEO of the Heart and Stroke Foundation South Africa (HSFSA)warns that the risk of coronary heart disease and ischaemic stroke rises with an increase in body weight. “There is also a clear link between sugary drink consumption and heart disease,” she says. “Indicators of heart disease such as blood lipids and uric acid also increase with an increase in consumption of sugary drinks.” Daily consumption of two or more sugary drinks has been found to increase the risk of developing diabetes by at least 24% compared to consuming less than one sugary drink per month. According to Statistics South Africa, diabetes was the second leading underlying cause of death in the country in 2015, accounting for 5.4% deaths and the leading cause of death in females (7.1%). On average, commercially produced sugary drinks contain the following amounts of sugar per 500 ml serving (2 average-sized cups/glasses): Sweetened fizzy drinks: 13 – 17 teaspoons Energy drinks: 13½ to 15 teaspoons Fruit juice: 12 – 16 teaspoons Sweetened milk or yoghurt-based drinks: 7 – 13½ teaspoons Sweetened iced tea: 8 – 10½ teaspoons Sports drinks: 4½ – 12 teaspoons Sweetened drinks, such as sweetened flavoured water, vitamin enriched water and coconut water: 4 – 8 teaspoons of water The World Health Organization (WHO) recommends that the intake of free sugars, i.e. sugars added by the manufacturer, cook or consumer or sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates, should be less than 10% of the total daily energy intake for adults and children and less than 5% for further health benefits. “This means that the maximum intake of free sugars from food and beverages per day for adult men and adolescents (14 – 18 years) should not be more than 12 teaspoons, and for adult women and children 5 – 13 years, not more than 9 teaspoons”, says Nicole Lubasinski, President of the Association for Dietetics in South Africa (ADSA).“To achieve more health benefits, the number of teaspoons of sugar from food and beverages per day for adult men and adolescents (14 – 18 years) should not be more than 6 teaspoons, and for adult women and children 5 – 13 years, not more than 5 teaspoons”. Some sugary drinks have a nutrition information label, this will indicate how much of the carbohydrate in the drink is found as sugar”, says Carol Browne of the Nutrition Society of South Africa (NSSA). “Sugar is one of the primary ingredients in drinks, and so it will be listed high up on the list of ingredients. In milk based drinks some of the sugar will be the sugar from milk, and this is not classified as a ‘free sugar’. In these products the total sugar content on nutrition information label should be considered with the ingredient list.” “It makes good sense to replace sugary drinks with lots of clean safe water”, says Rebone Ntsie. “Drinking lots of clean and safe water is essential for one’s health. Besides keeping you hydrated, it helps with digestion, regulate your body temperature, and to lubricate your joints. Furthermore, tap water is cheaper than any other drinks.” “There are several ways to increase your intake of water”, says Abigail Courtenay, registered dietitian and spokesperson for ADSA. “Make sure you always carry water with you; set reminders on your cell phone or notes at your desk every hour; drink water with meals; before and after exercising; and send a bottle of water with your child to school every day. You can also add fresh slices of lemon, cucumber, mint leaves, lime or fresh fruit to your water or unsweetened rooibos or herbal teas to add more flavour.” On Wednesday, the 11th of October, ADSA (@ADSA_RD) will be hosting a Twitter Talk from 13h00 to 14h00 where dieticians and National Nutrition Week partners will be providing information, tips, ideas and advice on choosing water as the beverage of choice instead of drinking sugary drinks. Join the conversation live on Twitter, and follow the @ADSA_RD handle to get great ideas and tips. The Department of Health in the various provinces will also celebrate National Nutrition Week during the month of October. For more information on National Nutrition Week 2017, visit the website: http://www.nutritionweek.co.za/ National Nutrition Week Partners: The National Department of Health: www.health.gov.za The Association for Dietetics in South Africa (ADSA): www.adsa.org.za The Nutrition Society of Southern Africa (NSSA): www.nutritionsociety.co.za The Heart and Stroke Foundation South Africa (HSFSA): www.heartfoundation.co.za Consumer Education Project Milk South Africa: www.rediscoverdairy.co.za

October 6, 2017

Genetic Testing & Nutrition

Ever wondered why nutrition studies demonstrate so many conflicting results or why some people respond to one type of diet and others don’t? It might be because of us. Well, because of our different genes. Just about everybody benefits from a diet consisting mostly of whole, fresh foods. But when it comes to fine tuning for sport performance, weight loss or optimum health – our needs and reactions to specific foods might differ. And this difference likely depends on genetic variation. Humans are 99.5% the same, yet that 0.5% difference matters. This specific question led to the emerging science of genetic testing, called nutritional genomics (a.k.a. nutrigenomics) – the study of interactions between genes and diet. WHY TEST YOUR DNA? Your ability to lose weight and predisposition to specific illnesses all depend on how your genes interact with your environment. For instance, your genes may suggest that you’ll grow to somewhere between 1.65m to 1.7m. But your actual height is an interaction between genes and environment. If you grow up malnourished, you won’t reach 1.7m. What we eat early in life (and what our moms eat while they’re pregnant) can affect our genes and regulate our traits – including development of diseases, even decades later. Our genes can be influenced by all kinds of things, such as: Nutrient deficiencies or excesses (especially at crucial developmental stages) Dietary components (omega-3 fats, phytoestrogens, cruciferous vegetables, folate, to name a few) Sunlight and vitamin D Toxins (such as industrial chemicals, pesticides, heavy metals) Bacteria and viruses Exercise Alcohol and other drugs Circadian rhythms (such as sleep, shift work, travel across time zones) A host of other factors we probably don’t even know yet. It sounds a little scary…… but while we can’t control our genes themselves, WE CAN CONTROL HOW OUR GENES ARE EXPRESSED – whether they’re likely to get “switched on” or off. Genetic expression is strongly shaped by our environment, over which we DO have some power. So, if we know more about our genetic defects (called genetic variants), we might be able to adjust our lifestyle or environment in order to be healthier and prevent some illnesses. For example, some gene variants can tell us how your body metabolize certain foods. Others can tell us whether or not carcinogens in cooked meats will influence the development of colon cancer. And others can predict inflammatory response and predict DNA repair. Genetic testing may also be useful in exercise prescriptions. Specific genes have been identified with athletic potential and performance. If we know more about our own unique risk factors, we might be more likely to make healthier choices – choices that could impact our genetic expression HOW GENETIC TESTING WORKS It is as simple as 1-2-3! Do a cheek swab DNA testing is easy and painless, by taking a cheek swab sample (like they do in Crime Scene Investigations on TV) and then sending the sample back to the DNAlysis laboratory for analysis. Here they use modern technology to analyse a person’s sample in order to identify genetic variants and study the relationship between individual genes and diet – thereby gaining intimate knowledge about physiological processes that may not function optimally. Unlock your results DNA reports are generated that allows an individual to understand how their genes affect the way he or she respond to the environment e.g. the foods they consume or toxins they are exposed to. Optimise your diet and training plan DNA reports are used to refine your nutrition and exercise plan to manage your weight and health. Providing you with a diet plan tailored to your genes (be it low carb or low fat) and insight into optimal exercise intensity for weight loss. However, some people have the gene where physical activity does not help them lose weight! Certain genetic variants can shape possible behaviour traits such as impulsive tendencies and addictions. Knowing, for instance, that you’re probably constantly looking for a reward can help you understand why you might be more drawn to an exciting sport or tasty snack. And help you work with your dietitian and trainer to find nutritional, exercise and behavioural strategies that work for you. INSIGHT INTO THE DIFFERENT DNA TESTS DNA DIET DNA DIET tests a number of well-researched gene variations that impact metabolism, absorption and storage of fats and carbohydrates, as well as eating behaviour. It provides insight into how our bodies respond to different types of foods, it may also have a powerful influence on what we like to eat (bitter vegetables or sweets) as well as why some people get fat and others stay thin. Some gene variants affect appetite and satiety. Others appear to influence how efficiently people burn fat for energy. The DNA DIET report provides additional insight into how each individual reacts to carbohydrates, saturated fats and intensity of exercise, allowing a trained Nutrigenomic practitioner to further personalise your eating plan to suit your needs. DNA Diet tests some of the following genes involved in key metabolic processes: Obesity risk / insulin resistance Binge eating Carbohydrates metabolism Fat absorption DNA HEALTH DNA HEALTH tests for 36 gene variants that are known to have a significant effect on health and susceptibility to chronic diseases. DNA Health reports on genes involved in the following areas: Cholesterol metabolism and risk for heart disease Bone Health & risk for osteoporosis Vitamin B Metabolism and risk for cancer Inflammation and oxidative Stress Detoxification Insulin sensitivity/resistance and risk for diabetes Food Responsiveness, including Lactose intolerance, Caffeine processing, Salt sensitivity and blood pressure & Iron overload disorders DNA SPORT DNA SPORT tests genetic variants that influence injury risk, recovery, as well as power and endurance performance. Results provide insight into various biological areas that impact training responsiveness and sporting performance, optimal exercise selection, and injury and recovery strategies. The test is suitable for the elite performance athlete as well as the recreational athlete looking to maximize their fitness potential and reach peak levels of conditioning. DNA Sport reports on the following

October 2, 2017

MYTH BUSTERS BABY SLEEP EDITION

Keeping your baby up longer at night/between naps will encourage her to fall asleep faster and sleep better. This is definitely a myth. Keeping your baby up longer at night/between naps will result in an overtired child. An overtired child will be fussy, cranky, have trouble feeding and take much longer to settle into sleep. They will also be more likely to wake during the night and earlier in the mornings, and will only have very short naps the following day. Your baby will sleep through the night when she is three months of age. It is possible, if you have set the foundations for healthy sleep skills early and your child is developing good self-soothing strategies. In this instance, you can usually expect babies to start sleeping through the night between three and six months of age (providing they are healthy and developing well). However children that still rely on “props” to fall asleep, such as feeding/rocking/patting, etc. will more than likely continue to wake through the night. This is because they have never learned the ability to put themselves to sleep so they are unable to consolidate sleep cycles through the night. They will often rouse after a sleep cycle and instead of using their own skills to return quickly to sleep they will cry out for their “prop” before they are able to go back to sleep. Letting your baby fall asleep while being held is a bad thing; you should never wake a sleeping baby. It is very difficult to always put your baby in their cot/bassinet while awake and allow them to use their own skills to fall asleep when they are newborns, as they need to sleep often. Parents will sometimes be out and about and need to put their baby to sleep in the pram/car or carrier. However it is important to be respectful of your child’s sleep needs and whenever possible give them the opportunity to attempt to fall asleep in their cot/bassinet. This is the place where they are going to get the best quality sleep. Remember how challenging and disturbed your own sleep is if you have to sleep in the car, or even when staying in a hotel room as opposed to your own bed at home. If you always let your baby fall asleep in your arms they are never going to develop their own self-soothing skills. Just remember that as your child grows, they get heavier and while you may find it easy to rock a newborn to sleep in your arms it will not be as easy to do this with your one, two or even three year old. It is never enjoyable to have to wake a sleeping baby, and the only reason I would suggest doing this would be to preserve a bedtime. As children get older their sleep needs change and sometimes too much daytime sleep (for an older baby or child) can have a negative effect on bedtime and sleeping through the night. However the opposite is also true and over-tiredness will also negatively impact night time sleep so it’s best to err on the side of more sleep as opposed to less. Daytime naps aren’t always needed. Most children will usually drop their daytime nap around three or four years of age (providing they are getting their 11-12hrs of night time sleep). However, it is possible that children as young as 2 ½ years of age drop their daytime naps. Before this age, a daytime nap or naps are very important to prevent over-tiredness and recharge their little bodies for the remainder of the day. Filling your baby up by putting infant cereal in her bottle will help her sleep. This is a myth. For very young babies, the length of time for which they are able to sleep is largely determined by how quickly their little bellies empty after a feed. However, as your baby reaches the three to six month age, it is healthy sleep habits and good self-soothing skills (that can be introduced gently from birth) that will help your baby sleep for longer periods. It is always very important to ensure your baby is well fed and developing properly, but the addition of good nutrition throughout the entire day is more important than adding infant cereal to their bedtime bottle.

September 28, 2017

Umbilical Cord Care

Becoming a new mom is filled with so many fun, exciting and sometimes nerve-wracking moments. There are also many things that you need to look out for and make sure you are doing correctly for your little one as a new mom. One of these, often very daunting things, is caring for your baby’s umbilical cord. Huggies® expert, Lynn Bluff, registered nurse, midwife and childbirth educator, sheds some light on this subject. How long does it take for a newborn’s belly button to heal? Babies in the womb receive nourishment and oxygen through the placenta, which is attached to the inner wall of the mother’s uterus. The placenta is connected to the baby by the umbilical cord, which attaches to the baby through an opening in the baby’s tummy. After your baby is born, the umbilical cord is clamped and cut close to your baby’s body, approximately 5-6cm long. It’s a painless procedure, and it leaves an umbilical stump attached to your baby’s belly button. The stump will dry up and drop off in about 7 to 21 days. When the stump falls off, you may notice a little blood on the diaper – don’t worry, this is normal. Sometimes, after the stump falls off, there may also be a little oozing of clear or yellow fluid. Cleaning the cord stump To clean your baby’s umbilical cord, you can apply surgical spirits to an ear bud or piece of cotton wool. Another option is to use sterile/cooled boiled water and gently clean the entire umbilical cord. The most important area to clean is where the cord is attached to the baby’s tummy. Your baby may cry when you do this, not because it is painful but rather the spirits feel very cold against their tummy area. It is not painful to clean as there are no nerve endings in the cord. It is very important, to not put anything on the cord. Some cultures put dung on the cord and this is very dangerous as it can lead to neonatal tetanus, a disease that is often fatal for the baby. Do not even apply any creams or powders. Just clean it well and let it dry. Over a week or so the cord will become drier and drier and eventually drop off. The drier the cord the sooner it will fall off. Tips to keep your baby’s cord clean A baby’s umbilical cord can easily become infected if not cared for properly. That’s why Huggies® developed Huggies® Preemie nappies and New Baby Size 0 nappies with an innovative umbilical cord cut-out. These Huggies® nappies make cord care easier for moms as they help prevent infection by allowing the umbilical cord to stay clean and dry, which is absolutely essential. But, it is still important to clean your baby’s umbilical cord after every nappy change and bath. Signs of umbilical cord infection Infections are rare, but consult your pediatrician if: Your baby cries when you touch the cord or the skin next to it The skin around the base of the cord is red The stump smells foul or has a yellowish discharge Also call the doctor if the stump bleeds continuously, as this may be a sign of a bleeding disorder. Becoming a new mom is filled with so much joy and a few challenges. Huggies® would like to encourage you as a new mom to be a little easy on yourself during this process. Both you and baby are learning together and this takes time but you will get the hang of it all. Huggies® is there for you every step of your nappy journey, baby gets its first hug from mom and its second hug from Huggies®.

September 25, 2017

Bedwetting Myths Debunked by Dr Michael Mol

Bedwetting is a common occurrence in many South African households. Research has shown that up to 25% of children at the age of 4 and an estimated 10% of South African children aged between 4-15 years old experience bedwetting. Even though bedwetting is common, it is not often spoken about openly due to feelings of embarrassment. This embarrassment and lack of communication has contributed to a number of myths surrounding bedwetting coming to light. Dr Michael Mol, Brand Ambassador for DryNites® Pyjama Pants, debunks seven common myths below, in the hopes of helping parents support their children affected by bedwetting. Myth 1: Bedwetting is caused by drinking too much fluids before bedtime This is not true. The medical term for bedwetting is Nocturnal Enuresis, which is summarised as the involuntary discharge of urine after the age at which bladder control should have been established. The word to take note of is involuntary, which means that the child does not know that they are wetting the bed. There can be numerous reasons for bedwetting. In most cases, it’s linked to delays in physiological development, children are unique and each child develops at a different pace. It could also stem from being in a very deep sleep or a bowel issue like constipation. It is suggested that you limit your child’s intake of sugary or caffeinated drinks a couple of hours before bedtime but they should always be allowed to drink water as this doesn’t affect whether or not your child will wet the bed. Myth 2: Using an absorbent product enables bedwetting Bedwetting products, such as DryNites® Pyjama Pants, have been shown to improve sleep quality, boost confidence and reduce stress (which can be a causational factor in bedwetting), as it makes wetting the bed less of a big deal. DryNites® Pyjama Pants will also give your child some control over the situation, especially if they have reached sleep over age. Myth 3: If your child is properly toilet trained, they shouldn’t be wetting the bed If your child wets the bed it doesn’t mean that they haven’t been properly toilet trained. Urine control during the day is completely different to what goes on when your child is sleeping. In most cases it will rectify itself in time and is nothing to worry about. Never blame yourself or think that you didn’t finish the job properly when you were taking them through the toilet training phase. Your child could be a star bathroom goer while they’re awake, but it is nobody’s fault if they wet the bed while they’re asleep. Myth 4: Children wet the bed when they are lazy to go to the bathroom This is false and, if believed, could lead parents to blame their child for wetting the bed, which will only exacerbate the problem. There are several reasons why your child may be wetting the bed. These are the most common problems associated with bedwetting: Delay in bladder reflex development, meaning your child’s bladder is not signalling the brain to wake up Their body may not be producing enough anti-diuretic hormone, which slows down urine production at night, so we don’t have to wake up as much A delay in bladder development can result in lower bladder capacity Myth 5: Punishing your child for wetting the bed will help their progress Remember that your child has no control over the situation and probably feels incredibly bad about it. Being punished for something they can’t help will only cause self-esteem to decrease and stress to increase. Many parents go the opposite way and try star charts or reward systems for dry nights. The best thing a parent can do for their child in this situation is to remain calm and supportive while helping their child to manage their bedwetting. Understanding the problem goes a long way in terms of maintaining your child’s confidence levels. Myth 6: Bedwetting is a sign of psychological problems or anti-social tendencies There is no evidence suggesting that primary bedwetting has anything to do with psychological issues. It is true that if your child begins wetting the bed after a period of six months or more of being dry at night (secondary bedwetting), it could be due to stress or an emotional issue, such as grief. If this is the case then you should talk to your child about what’s on their mind and flag the issue with your GP, play therapist or psychologist. Myth 7: Waking your child in the middle of the night for a bathroom visit will end bedwetting It is common practice for parents to wake their children in the middle of the night and encourage them to use the bathroom to prevent bedwetting. This is often referred to as ‘lifting’ and can seem like a good strategy if it helps keep the sheets dry. The reality is that this will not improve your child’s bladder control and could frustrate them, especially if they don’t need to urinate when you wake them up. If your child is over five years old it may also cause them to feel discouraged which will have a negative effect on their self-esteem. For more information on DryNites® Pyjama Pants, or to ask Dr Mol a personal question or to request a free sample, visit www.drynites.co.za. DryNites® Pyjama Pants are currently available nationwide. About DryNites® Pyjama Pants DryNites® Pyjama Pants are a discreet, comfortable and absorbent form of bedtime protection. They can be worn under pyjamas or a nighty and come in designs suitable for age and gender to make them look and feel just like underwear. DryNites® Pyjama Pants are available for Boys and Girls and come in two sizes, 4-7 years and 8-15 years. These products have trusted absorbency and leakage protection to ensure a good night’s rest. And because they’re discreet and underwear-like, children can feel more confident and independent at bedtime, either at home or on nights away. Waterproof mattress protectors and sheets can be uncomfortable and indiscreet. DryNites® Pyjama Pants allow your child to sleep on their usual sheets to ensure that

September 11, 2017

Stem Cell Myths – Busted

The term stem cell gleans different reactions from people both in the medical community and the wider public. Still an emerging science, but with immense possibilities, stem cell research is shrouded in many myths and misconceptions. Cryo-Save has taken on the top myths and clarifies facts regarding this fast-growing medical treatment. Myth 1 – Stem cell storage is costly Stem cell storage is available to anyone who would like to store their baby’s umbilical cord stem cells. Cryo-Save has multiple cost options and interest-free payment plans to store cord blood and tissue. Myth 2 – All stem cells are the same When you hear “stem cells”, you may not know exactly what these are or conjure up images of a certain cloned sheep. In reality, stem cells are the body’s internal repair system. It continuously replaces dead or diseased cells with new, healthy cells to ensure normal function of the body. We differentiate between embryonic stem cells and adult stem cells. Embryonic stem cells are powerful because they are pluripotent and can develop into any type of cell in your body. But they’re often controversial because of their origin and is not part of the stem cell storage services offered by Cryo-Save. Multi-potent or adult stem cells are found throughout the body and they form only certain tissue cells, maintaining your body’s organs as you age, e.g. blood forming stem cells and mesenchymal stem cells. BLOOD FORMING STEM CELLS produce new and healthy red blood cells, white blood cells and platelets continuously, to ensure normal function of the blood and immune system, (like a factory producing new cars every day). RED BLOOD CELLS are responsible to carry oxygen to all parts of the body. WHITE BLOOD CELLS are the soldiers in our blood and fight off all foreign invaders like bacteria etc. PLATELETS form clots to prevent excessive bleeding. Researchers have successfully used umbilical cord stem cells (taken from a new-born’s cord blood), to treat leukaemia and other blood disorders since 1998. Stem cells from a baby’s umbilical cord are considered adult stem cells and these precious cells, if not cryopreserved, are discarded as medical waste in many instances. Therefore, these cells are free of controversy and acceptable to most cultures and religions. Myth 3 – Umbilical cord stem cells can only be used for your baby Your baby’s umbilical cord stem cells are a 100% perfect match for your baby and biological parents’ stem cells will be at least a half match. There is a 25% probability of matching siblings, and unlike bone marrow transplants you don’t have to have a perfect match in transplants when making use of cord blood stem cells. Myth 4 – I didn’t store my first child’s stem cells so there is no point in storing for the second child 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 cells are your own, and sometimes they will come from a donor. Cord blood contains powerful stem cells, and fact is that if your baby becomes ill in the future you may be able to use these cells as treatment. One of the contributing factors is that partially matched cord blood stem cells can be used for transplantation, increasing the chances of finding a suitable match. Today, umbilical cord blood stem cells are used in more than a third of all blood stem cell transplants in the world. 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 but also other members of the family. Myth 5 – Stem cell storage is only available overseas 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 Africa, Cryo-Save has stored more than 310 000 samples. 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 facility complies with the highest international standards and importantly complies to the coveted AABB accreditation standards. AABB, formerly known as the American Association of Blood Banks, is an international non-profit association, representing individuals and institutions involved in the field of transfusion medicine and cellular therapies. Accreditation by the association follows an intensive on-site assessment by specially trained assessors who established that the level of technical and administrative performance within the facility meets or exceeds the standards set by the Association. AABB’s Accreditation programme (recognised by the International Society for Quality in Healthcare – ISQUA) contributes to quality and safety of collection, processing, testing, distributing and administration of stem cells. Myth 6 – Mixed race parents can’t store stem cells On average, the chances of finding a perfectly matching blood stem cell donor for allogeneic transplant, are only 1 in 100 000. These odds are significantly worse for people from a mixed descent. However, despite its diverse ethnic make-up, South Africa (nor the rest of the continent) has no public cord blood stem cell bank, which makes the likelihood of finding a matching donor even more challenging. Should a child from mixed descent be diagnosed with a blood-related cancer or disorder, the search for a possible stem cell match can be debilitating to a family’s finances and hope for recovery. Therefore, Cryo-Save encourages mixed race families to store their babies’ stem cells. Myth 7 – Stem cell banking is only for families with a history of cancer The myth is deceptive and dangerous. The uses of cord blood stem cells have extended far beyond treatments for cancer. Researchers have invigorated the field of regenerative

September 4, 2017

Stimulating Language and Listening Skills

Language is considered a verbal behaviour which is learned by means of the environment. A parent / caregiver and other significant adults in a child’s life provide modelling and reinforcement of these learned language structures and of speech (Allyn & Bacon, 2001). The caregiving environment is therefore extremely important to the child’s development. Early in a child’s life, as they start pointing to objects, parents often automatically label these objects and thus form the beginning of the child’s vocabulary acquisition. Once the child has some words, he might point and say “ball” and the parents would say “yes, that is a ball. A red ball. Do you want the ball?” The parent is thus modelling the sentence construction and the combination of words into a sentence, as well as reinforcing what the child is saying each time. Listening skills and auditory processing skills involve processing information through our hearing, memorising this information, and processing and reasoning the details to provide an output. These skills also include awareness of sounds in words (e.g. rhyme, sounding out words: c-a-t) which are crucial for later reading and writing. It seems that with the advances in technology, this generation of children are being more and more exposed to visual input such as televisions, iPad’s and smart phones, potentially reducing the necessity of the use of their auditory skills; The skills so crucial for many activities of daily life. The following ideas for activities may be used in order to stimulate your child’s language and listening skills: Make language a part of your daily routine. During bath time and dressing, name the parts of the body and your child’s clothes. During cooking, name the ingredients and make use of short phrases, such as “put it in the bowl.” and different actions e.g. “stir,” “pour,” “crack the egg.” Although your child may only learn to produce rhyming words later in their pre-school years, nursery rhymes are a fantastic way to teach rhyming incidentally. Playing games such as “I spy with my little eye” assists in your child’s listening, auditory memory and reasoning skills, as well as, creating awareness of the initial sound in a word. Playing “I am going on a picnic, and I’m going to bring…” assists in developing your child’s auditory memory skills. These are crucial for recall of details for following instructions and other important tasks. On a daily basis, your child should be provided with instructions that should be followed. These can even be silly instructions for example, “Take the spoon and put it on your head and walk to the door.” You may take turns giving each other instructions. This also gives your child a chance to express themselves and verbalise steps to be followed. Try to lengthen the complexity of the instructions, for example, if your child is able to cope with 3 details in the instruction move to 4 details (e.g.. draw a red circle under the square) or 4 steps (e.g. colour the girl’s hair in brown, draw grey eyes and then give her a mouth and nose). Identification of common labels such as Coke, Mac Donald’s, Pick ’n Pay, is an early pre-reading skill. This teaches children that symbols are associated with a meaning. Reading is such an important part of your child’s learning, language and development. From infancy, your child will learn the vocabulary and language structures, as well as early pre-reading skills such as holding a book, turning pages and that reading occurs from left to right (in English). This is crucial for language development and later reading skills. Furthermore, the love of books and of reading is an immeasurable asset. Ultimately, it seems that we need to go back to our roots and learn to enjoy and apply some of the games of our youth and our parent’s youth. For more information and ideas on how to aid in your child’s development, look at the SkidZ Clever Activity Box program. It is filled with age appropriate activities for language and listening skills as well as other areas of development. The program provides an option of a daily curriculum which includes activities for everyday of the week. The SkidZ program is not only comprehensive but provides hours of fun for little ones. For more information on the SkidZ Clever Activity Boxes visit their website at www.skidz.co.za Written by: Jemma Roets – Speech- Language Therapist and Audiologist Jemma Roets qualified as a Speech-language therapist and Audiologist at the University of Pretoria in 2007. She later completed her Masters degree in Early Childhood Intervention, specialising in severe disabilities, in 2013, at the University of Pretoria.

August 31, 2017

Healthy Coping Skills For Teens

Let’s face it, we all need to learn healthy coping skills, but adolescence is a particularly stressful time, when making healthy choices is so important. With hormones raging, peer pressure at its peak, sometimes overwhelming high school stress caused by erratic relationships and high expectations, conflict with parents and a driving desire to explore their world and express themselves, teens are at risk of going off the deep end. They learn coping skills from us parents, but often we have developed our own bad habits, like reaching for a glass of wine, a cigarette or unhealthy foods when we’re stressed or totally losing our cool in the traffic. Here are some better coping mechanisms for them to practice until they become healthy life habits: Work on building self esteem. This is the foundation on which they will build their blossoming selves. They need to spend time alone to know themselves – their strengths and vulnerabilities, their talents and unique qualities. Making a list of 10 positive qualities about themselves and reviewing it every day can help start each day on a positive note. Using positive affirmations and filling their heads with inspirational words helps. There are fabulous stories of people who have succeeded against all odds. Taking the power out of negative words like “fat” (fabulous, amazing, tenacious) can help to stop them from feeling emotionally hurt. Joining a sport or creative activity they enjoy and are good at can really help them to feel better about themselves. It’s also important for them to associate with positive, supportive people who uplift and believe in them. Girls are especially vulnerable to falling into the trap of losing themselves in an attempt to fit in with a group perceived to be popular. Having a happy outlook goes a long way towards winning over their peers and it helps to be grateful for what they have rather than focusing on what they don’t have. Take responsibility. Teens need to learn to take responsibility for their own life – for the good and bad decisions they make. They shouldn’t beat themselves up over mistakes – just learn from them, apologise where necessary and don’t keep repeating the same mistakes. They must understand that some of the most successful people on this planet had to fail many times before they succeeded e.g. JK Rowling, who was turned down hundreds of times before her Harry Potter books were accepted by a publisher. Parents should reiterate that “failing” is how we learn so actually, there is no such thing as failure – only results – which they may like or not like. Fear is usually generated by the unknown but they shouldn’t let this hold them back – unless they try, they will never know what they might accomplish. Take control of their life. Teens need to learn that although they can’t always control what happens to them, they always have a choice as to how they respond. Being right and always winning is not nearly as important as doing the right thing. Even if they’re handling difficult circumstances, blaming other people doesn’t help – that just gets them stuck in the drama of the moment. Instead, looking at how to resolve the situation will be a lot more helpful in moving them in the right direction. If they want things to change, they have to change their actions. Doing the same thing over and over will give them the same results. They should not accept limiting beliefs about themselves, e.g. “I’m hopeless at maths”. Everyone has different strengths and it may just be that they learn differently and need someone to explain concepts in a way they can grasp. They should think BIG! The power of the mind is unlimited and what the mind can conceive and truly believe, it can achieve. Set goals. Teens must learn how to set goals and take small steps towards achieving them. There’s a saying: if you aim at nothing, you will achieve it every time! Goals are like ship rudders – they set the direction in which our lives move. A great goal setting method is for them to: Brainstorm all areas of their life – include school, personal, hobbies/interests, sports, etc. Write them all down. Some examples could be health/fitness, self-confidence, friendships, family, prioritising skills, organisation skills, etc. Make a chart with 3 columns – Yes, No, Maybe. Put everything they wrote down under the columns. Yes = areas they really need to work on right now. No = Areas they think are okay right now. Maybe = Areas they could work on but there is no urgency right now. Get it down to 3 goals in the Yes column. If they have more than three items, they should think about which three are the most important for them to work on right now. Move the others over to the Maybe column. These 3 Yes goals are their primary Those in the Maybe column are their secondary goals. Look at each goal and think about what they would like to achieve in 3 months. Imagine how it would look and feel to achieve this – make it real. Write down a goal statement for each goal. It must be inspiring and visionary, challenging and achievable, measurable (there should be a time limit), clear and focused. E.g. In 12 weeks I want to feel fitter and more energetic by running 5km three times a week. Now change the wording to make each goal inspiring. They need to look at it and feel really excited and motivated by it. E.g. “Wow, look at me now!” They can get ideas by looking up company slogans – e.g. Nike “Just Do it!” It will help to create a vision board and pin up photos of people who inspire them, sayings that motivate them, etc. Now set actions for each goal, with due dates. It helps to do this on a weekly basis. They need to keep setting different actions as they

August 28, 2017

Introducing Solids to your baby- a comprehensive guide

You may have fluctuating emotions when it comes to introducing solids. You may eagerly wait that first mouthful and be pinning a lot of hope on solids getting your baby to sleep better, while at the same time feel sad as the realization dawns that your baby is growing up. Many mistruths and myths surround when to start solids, for example: It is not true that you must start solids as soon as your baby has doubled her birth weight or when she is drinking more than 1 litre of milk a day. Nor does it mean that your baby is hungry because she has her hands in her mouth all the time at 4 months of age. Furthermore, introducing solids will not guarantee that your baby will sleep through the night. When solids are introduced too early, that is before 17 weeks of age, the immaturity of your baby’s digestive and immune system may increase her risk of developing an allergy. The exact ‘right’ age for your baby to begin eating solids will depend on two main factors: physical and emotional. Your baby needs to be both physically ready for food as well as emotionally ready. You will also have a sense whether or not your baby is ready to eat solids. Learn to trust this intuitive side of being a parent. Physical factors indicating your baby is ready for solids: Between four and six months old Can hold her head up Sits comfortably with support No longer satisfied with her normal milk feeds even if volume is at an age appropriate level Is unsettled between feeds during the day and is decreasing the time between feeds to 3 hours or less Demands more frequent milk feeds at night or suddenly start waking closer to midnight again Weight gain may have slowed down The tongue – thrust reflex diminishes Emotional factors Starts to show an interest in foods Watches you eat – social eating Turns her head towards you while you are eating Mirrors your mouth movements by opening her mouth in response to your eating Shows excitement when watching others eat By 6 months it is critical to start introducing solids even if some of the physical or emotional factors are not obviously present. Babies are born with a store of nutrients. These are normally adequate for the first few months of life. Iron is an example of this. After the first 4-6 months your baby’s iron stores begin to deplete. Furthermore, milk is no longer an adequate sole source of iron and so you need to give your baby additional iron rich foods. Foods to try between 4 – 6 months: First veggies: baby marrow, gem squash, sweet potato Orange vegetables: butternut, carrots, pumpkin, sweet potato, Hubbard squash, potato Green veggie mix – spinach, baby marrow, gem squash, peas, beans Fruits: Apples, pears, peaches, prunes, papino, avocado, banana, mango, melon Quinoa porridge Maize cereal Maltabella porridge If you have introduced solids closer to 4 months then you will be able to introduce some protein foods just prior to 6 months. A good time of day Introduce the first solid meal at a time of day when your baby is happily awake, in the calm alert state. Choose a time of day when you are not stressed. The early evening is not always the most relaxed time in a household, especially if you have a busy toddler under foot. A good time is in the morning about half an hour after a milk feed and during ‘play time’. Making the first food experiences fun and stimulating will set the tone for many happy feeding times. Week 1: Day 1: gem squash, baby marrow and sweet potato (green veggie) mix. Steam or bake the above. Liquidize with additional water if necessary. In the beginning blend or mash the food. Freeze in freezer containers in 3tsp quantities. Day 1 – 3: Give 1 – 3tsp green veggie mix at midday at a happy awake time. Day 4 – 7: Introduce a second veg group ; orange veggies: hubbard squash/butternut, carrots and parsnips/orange sweet potato mix. Give 1-3tsp orange veggie mix at midday and alternate with green veggie mix Optional Tactile: allow your baby to touch and feel a veggie that you have left over from the night before while feeding the solid mix Week 2 Day 1-7: Introduce a second meal at another happy time: Eg: Meal 1 orange veggie mix 1-3tsp Meal 2 green veggie mix 1-3 tsp Optional Tactile: allow your baby to touch and feel a veggie that you have left over from the night before while feeding the solid mix Week 3 Introduce a third meal of fruit Choose: apple, pear, mango, peach, guava, prune, avocado, paw paw (in season fruit) you can mix 1-3 fruits together or give individually Meal 1: fruit mix 1-3 tsp Meal 2: Green or orange veggie mix 1-3tsp Meal 3: Green or orange veggie mix 1-3tsp Optional Tactile: allow your baby to touch and feel a veggie that you have left over from the night before, while feeding the solid mix Week 4 Introduce porridge Introduce a grain food: Ideally cook from scratch like oats, quinoa, millet, spelt, maltabella, maize porridge. If you need to use baby cereal choose one that is not full of sugar, soya, cows milk protein or other additives . Soak 2 TBSP oats/quinoa/millet/spelt and 4tbsp water, cook in micro and make sure runny. Then liquidize and can also freeze Day 1 – 7 By now your routine will look something like this: Am: milk feed Breakfast: 2 – 3tsp porridge + 1-3tsp fruit puree. Mid Am feed: milk feed Lunch: 2-6tsp orange or green veggie mix Mid avie feed: milk feed Supper: 2-6tsp orange or green veggie mix Bedtime: milk feed 1-2 night milk feeds

August 25, 2017

Your Child’s Hearing

Hearing is an essential part of development as it enables babies to take in information about the world around them. It stimulates brain development and is critical for language development. For this reason, it is vital to identify and address hearing difficulties as early as possible. By the 16th week of pregnancy, the tiny bones in the baby’s ears begin to develop. By the 20th week of pregnancy, the baby begins to respond to sounds. Loud sounds may even make the baby startle or move about. By the 25th week of pregnancy, the auditory system becomes fully functional. At this point the baby is able to hear your voice when you are speaking or singing. Studies have shown that after birth, babies are able to recognize songs that were sung to them while in the womb. Unlike the visual system where actual visual experience begins after birth, the auditory system requires auditory experience with voice and language, music and meaningful environmental sounds during the last 10 to 12 weeks of fetal life. A child is born with a mind that is open and ready to receive information through all five senses. The more information the mind receives, the better the child is able to understand and participate in the world around them. All five senses are tools for learning and communicating. However, the sense of hearing is the most critical for speech and language development. It is difficult to define “normal” hearing development when speaking about human beings as each individual develops in their own way and at their own pace. However, over the years, several researchers have been able to compile a guideline for general milestones for hearing development: A Guideline for Hearing Developmental Milestones Birth At birth, babies are able to exhibit a startle reflex in response to sudden loud noises. This means that they will stiffen, quiver, blink, fan out their fingers and toes, or cry as a response. They are often sensitive to a wide range of sounds, including intonation and rhythmic cues. At birth, babies are able to recognize their mother’s voice and often prefer the sound of their mother’s voice. Sounds of different pitches have different effects on the infant. Low frequency sounds and rhythmic sounds have a calming effect. Higher frequency sounds result in a more violent reaction. You may note an increase or decrease in sucking in response to sound. Three Months At three months of age, babies are more aware of human speech and will begin to attend to voices. They will also start to show excitement for familiar sounds such as approaching footsteps, running bath water, etc. At this age, babies tend to awaken or quiet to the sound of their mother’s voice and will vocally respond to their mother’s voice. They begin to imitate noises as they hear them e.g. ooh, baba. Most importantly, at this stage, babies begin to localize sound by means of turning their eyes toward the general sound source. This is a great time to introduce sound-making toys; as they begin to enjoy such sounds and will listen to bells and other sound-making toys near them. Four Months By four months of age babies start localizing sound by turning their head toward the general source of sound and they will actively search for human voices. Five Months At 5 months of age, babies are able to localize sound more specifically. They distinguish between friendly and angry voices and react appropriately. They will stop crying or coo is response to music and become very interested in human voices. At this point, they are able to discriminate between sounds of strangers and familiar people. Six Months By 6 months of age, babies specifically locate sound from any direction, such as the bell that is rung out of sight (downward localization develops before upward localization). They will respond to human speech by smiling or vocalizing and will turn immediately to their mother’s voice across the room. They may show evidence of response to different emotional tones in their mother’s voice. Their association of hearing with sound production is now evident, in that they repeat selected sounds that they have heard. Eight Months At 8 months of age it is expected for the baby to turn his head and shoulders toward familiar sounds, even when he cannot see what is happening. They begin to understand sounds and words in context e.g. responding to a telephone ringing, a human voice, his own name, “no-no,” “bye-bye“. It is at this point that they begin to enjoy games like pat-a-cake and peek-a-boo. They may respond with raised arms when their mother says, “Come up” and reaches toward the child. One Year At one year of age it is expected that the child will babble in response to human voice. His sound imitations indicate that he can hear the sounds and match them with his own sound production. He will enjoy various sounds like jingles and rhymes and show interest in environmental sounds that may even be beyond his immediate surroundings. The child will respond to simple commands (at first, only when the command is accompanied by a gesture), such as giving a toy on request or going somewhere as directed. At this age, it is expected that the child understands an assortment of action words (verbs) such as “drink“, “go“, “come“, “give“, as well as some simple directions such as “wave bye bye.” No real understanding of questions is shown at this point. Two Years By two years of age several hearing and communication skills have developed: Shows interest in the sounds of radio or TV commercials. Listens to reason of language. Listens to simple stories. Responds to command, “Show me the —.” Understands and answers simple “wh” questions, e.g. “Where is your –?” Responds to yes/no questions by shaking or nodding head. Waits in response to “just a minute.” Identifies five body parts. Understands family names by selecting appropriate pictures. Understands the phrase, “have sweets after lunch” Carries out 4

August 24, 2017

Struggling with a teething baby?

It’s 3 ‘o clock in the morning and your baby just won’t settle down. She’s been crying non-stop for the last couple of hours and after checking that’s she’s dry, fed and not in any way uncomfortable, you still can’t figure out what’s wrong with her. Surely it can’t be that she’s teething? She’s still so tiny! But yes, it’s possible – teething can begin as early as three months and continue until a child’s third birthday. Between the ages of four and seven months, you’ll notice your baby’s first tooth pushing through the gum line. The first teeth to appear usually are the two bottom front teeth, also known as the central incisors. Four to eight weeks later the four front upper teeth (central and lateral incisors), appear and about a month later, the lower lateral incisors (the two teeth flanking the bottom front teeth) will appear. In some rare cases, babies are born with one or two teeth or have a tooth emerge within the first few weeks of life. Unless these teeth interfere with feeding or are loose enough (as they sometimes are) to pose a choking risk, this should not be cause for concern. As your baby begins teething, she might drool more and you’ll notice that she wants to chew on things. Fortunately for mom, some babies find teething completely painless and their teeth seem to suddenly appear out of nowhere! However, others may experience brief periods of irritability, and some may seem cranky for weeks, with bouts of “unexplained” crying and disrupted sleeping and eating patterns. And you guessed it – that’s when you find yourself at 3 o’clock in the morning trying to calm a crying baby! For the most part, teething can be uncomfortable, but if your baby seems very irritable, talk to your doctor. Although tender and swollen gums could cause your baby’s temperature to be a little higher than normal, teething doesn’t usually cause high fever or diarrhoea. If your baby does develop a fever during the teething phase, it’s probably due to something else and you should contact your doctor. It has been said that teething symptoms are signs of physical stress which can lower your baby’s resistance to infectious agents that under normal circumstances would not produce illness. The same germs that live in a baby’s intestines and cause no ill effects, at other times could produce ear-aches, congestion, or other low-grade infections when your baby is teething. As parents look more towards natural healing, we have found Baltic Amber, which is a fossilised resin, can provide relief. There are many gum soothing medications and remedies on the market and you should consult your pharmacist, local clinic or paediatrician to find a solution that best suits your baby’s needs. Stages of teething : 6 to 7 months – Incisors (situated 2 central bottom & 2 central top teeth) 7 to 9 months- Two more incisors (situated top & bottom; making four top & four bottom teeth in all) 10 to 14 months – First molars (double teeth for chewing) 15 to 18 months – Canines (pointed teeth or fangs) 2 to 3 years – Second molars (second set of double teeth at the back)

August 23, 2017

How Heart Healthy is your Family?

Heart disease or medically referred to as cardiovascular disease refers to any disease of the heart and blood vessels. The most common ones are diseases of the heart muscle, stroke, heart attacks, heart failure as well as heart disease caused by high blood pressure. If you suffer from any of the above-mentioned conditions or presents with a family history – it is extremely important to know YOUR risk of suffering a heart attack or stroke. Making the right dietary and lifestyle changes can improve your heart health and alter the statistics. Did you know? One South African suffers a heart attack or stroke every 4 minutes and one South African dies due to cardiovascular disease (CVD) every 8 minutes. CVD kills 200 people in South Africa daily, which is about the amount of 13 mini bus loads per day! For every woman that dies of CVD, 2 men will die. Over the past few years more and more ‘young’ people are diagnosed with CVD. Early deaths caused by CVD in people of working age (35-65) are expected to increase by 41% by 2030. Scary statistics you might think….but I’m too young or I don’t have a family history of heart disease and therefor are not at risk. Well stop right there – let’s put your heart under the magnifying glass and investigate your disease risk. Why should I look at my risk factors? Risk factors are those habits or conditions that make you more likely to develop cardiovascular disease. Cardio vascular risk factors may also increase the chances that an existing heart disease (like high cholesterol) can get worse and cause a heart attack. In people who presents with more than one risk factor the chance of suffering a heart attack or stroke increase exponentially with each additional risk factor. What this means, for instance is if someone presents with 3 cardiovascular disease risk factors their risk of heart disease is not 3 + 3 + 3 = 9 but actually 3 x 3 x 3 = 27. Therefore, for each risk factor that you are able to control or change, you can also exponentially decrease your risk of heart disease. Certain risk factors like age, gender and family history we are unable to change but others we can alter. More than 56% of all South Africans (between the age of 15 and 64 years) have at least one risk factor they are able to change. What is my risk of heart disease? You can see how healthy your heart is by doing the heart health quiz in this newsletter. Complete the quiz and tally up your total points. The more points you have, the more risk factors are present and the higher your risk of having a heart attack or stroke. Heart Health Quiz: If you are male and above the age of 55 give yourself 1 point or if you’re female and going through menopause give yourself 2 points. If you have immediate family (siblings or parents) that are diagnosed with heart disease problems such as stroke, cholesterol, high blood pressure, or heart attack add 2 points. If anyone in your immediate family had an early heart attack, father or brother before age 55 and mother and sister before age of 65, add 1 more point. If any family, not immediate family (uncles, aunts, grandparents) presents with any heart disease problems such as stroke, cholesterol, high blood pressure or had a heart attack add 1 point Measure your weight, height and calculate your Body mass index (BMI) by dividing your weight (kg) with your height (in metres) squared e.g. BMI= kg ÷ m2. A BMI less than 18.5 add 1 point, BMI 18.9 – 24.9 add 0 points, BMI 24.9 – 29.9 add 1 point, BMI more than 30 add 2 points. If you don’t know your weight, add 1 point. With a measuring tape, measure your waist circumference. If you are male with circumference of more than 102 cm and female more than 88cm add 2 points. For circumference of men 94 – 102 cm and women 80 – 88cm, add 1 point. For waist circumferences unknown, add 1 point. How often do you exercise? Not doing any exercise add 3 points Exercise equal to or less than 3 times per week for less than 30 minutes per session, add 2 points Exercising at a very low intensity (slow walking) for less or at least 30 minutes, 5 times a week add 1 point Exercise for 30 minutes or more, 5 times per week at a moderate or high intensity (sweating and heart rate increased) subtract 1 point Exercise for 60 minutes or more, 5 times per week at a moderate or high intensity (sweating and heart rate increased) subtract 2 points Smoking: social smoking add 1 point, smoking more than 1 cigarette per day add 2 points, smoke pipe or cigars add 1 point, if you are daily exposed to second hand smoke (living with a smoker) add 1 point. Alcohol: female and consuming more than 1 drink per day add 1 point, male and consuming more than 2 drinks per day add 1 point, if you binge drink on occasions add 1 point (if above two questions applicable, add an additional point). Stress levels: Struggling to fall asleep at night, add 1 point, under stress at work or home, add 1 point. When looking at dietary habits, add points accordingly: Consuming take-ways or ready to eat meals more than once a week add 1 point Consuming 2 or more portions of chocolate, cake, pudding, sweets per week add 1 point Using full cream dairy products add 1 point Skipping meals add 1 point Eating ribs, polony, viennas, sausage or salami more than twice a week add 1 point Eating less than 1 fruit per day add 1 point Eating less than 1 cup cooked vegetables or raw salad per day add 1 point Consuming less than 1 cup legumes (peas, lentils, corn) x 1

August 22, 2017

HELP – BREASTFEEDING DOESN’T COME NATURALLY FOR ME

Many people may argue the fact that breast feeding should be the most natural thing in the world. So, what’s wrong with you if you find the whole breast feeding thing really hard? Indeed it is a very natural and easy thing for most new mothers, but for some, it is an incredibly stressful and traumatic part of mothering. We all know the benefits of breastfeeding such as: Breastfeeding until six months helps prevent allergies later on in baby’s life Breast milk is always the right temperature and is easily digested Breastfed babies seldom have problems with constipation or diarrhoea Breast milk doesn’t cost anything! Breast milk contains antibodies to boost her immune system Breast milk perfectly meets your baby’s nutritional needs Most first time mothers would really like to give breast feeding their best shot, but many factors can occur in the early days that can really thwart any of the best intentions she may have to breast feed. Sleep deprivation, cracked and bleeding nipples and a crying baby can all add up to a miserable and emotional mom, a stressed out dad and the idea of a pain free feed by bottle feeding is all too tempting. Let’s take a look at the issues that might make breast feeding in the early days really difficult. Engorged and swollen breasts: This typically happens around day 4 after delivery (slightly longer after a caesarian birth). Most new moms are usually at home by now and do not have the support and care of the nursing staff in the maternity units to help them through this difficult time. Your breasts will become full and heavy, and excruciatingly tender to the touch. In some instances, they become rock hard, hot and sore. This is what is commonly known as “milk coming in”. It usually settles after around 72 hours. Feed your baby on demand, as normal, and don’t be tempted to express your breasts to make them emptier and softer – all you will do is encourage more milk to be produced! Place cabbage leaves in your bra (they really do work), rub arnica cream or oil onto your sore and swollen breasts, and take an anti-inflammatory medication to help with the pain and swelling (ask your pharmacist, clinic sister or doctor to recommend one that is safe for breast feeding). Applying ice packs also helps with the pain and inflammation. Persevere, it will get better – just give it some time, and don’t expect your breasts to settle down for at least a few days. Blocked milk ducts or mastitis: Blocked milk ducts commonly occur, especially in the first few days after your milk has come in and your breasts are feeling swollen and sore. You can usually feel the actual spot where the blockage is, because it is sore, and if you look, you may see a red and inflamed area. This is more prevalent before a feed when your breasts are full, and feeding usually gives you some relief. You may also feel a bit feverish and have a headache. Gently massage the tender and red area with some arnica oil or cream, and apply heat to the area after you have finished feeding. Taking Anti-inflammatory medication also helps. In some instances your doctor may prescribe anti-biotics. Keep a close watch on the affected area, as it may develop into a breast abscess if the blockage is not released. If the red and tender area does not lessen after a feed, and if the entire area does not settle down within a few days, and you are feeling feverish and unwell, it is best to seek medical advice in case you have a breast abscess, which will need to be surgically drained. Cracked and bleeding nipples; This is a common reason for throwing in the towel with breast feeding due to excessive pain and discomfort with feeding. The most frequent cause of cracked nipples is incorrect latching of the baby’s mouth onto the nipple. Make sure that your baby is latched onto the breast correctly, with both top and bottom lip in a snug seal around your nipple. Your pain level will indicate to you if your baby is latched correctly or not! To release the suction on your breast so that you can take your nipple out of his mouth, insert your finger into the corner of his mouth and gently withdraw your nipple from his mouth, and retry to latch him successfully. Using a nipple shield (available from your pharmacy or baby shop) during feeding gives cracked and bleeding nipples time to heal . Speak to your clinic sister or doctor to recommend a nipple cream to assist with healing. Exposing your nipples to some sunlight also helps to hasten healing (easier said than done!). Expressing breast milk and offering it to your baby from a spoon or a bottle is also a way to let your nipples heal whilst continuing to breast feed. Not enough milk: Don’t listen to old wives tales about your milk being too strong or too weak. It is not the quality of the milk that makes the difference, it is the quantity. If your baby is unsettled after feeds and appears hungry all the time, get her weighed frequently to ensure that she is growing adequately. If your baby is gaining weight, having at least 6 wet nappies a day, and is relatively happy in between feeds which may be very frequent in the early days, lengthening to a few hours after a few weeks; then you can rest assured that you have enough milk. Your stress and anxiety, a poor diet and inadequate fluid intake all play a part in hampering breast milk production. Make sure you are eating enough protein (you need to increase your protein intake three fold whilst breast feeding), drinking at least a litre of fluid a day and that feeding times are relaxed and calm. The main hormone that ensures adequate milk production

August 2, 2017

Anger in Children: When is it a Problem?

Anger is a normal emotion that every happy healthy adult and child has to deal with from time to time. When does expressing anger become a problem? Children go through different stages with their age that affect the way they deal with anger. Anger is usually not a root emotion, but a term that may cover feelings ranging from embarrassment, frustration, loneliness to guilt. A newborn baby expresses their “anger” or frustration over being hungry, tired or uncomfortable by screaming and crying. A two-year-old may throw tantrums that include rolling around on the floor or trying to hit the parent, sibling or even their pet. As a child gets older, hopefully proper responses to anger have been modelled for them and they can learn to express their anger more appropriately. Anger becomes a problem when it causes negative, aggressive behaviour, gets out of control and when the root cause of the problem isn’t being dealt with. For instance, often children with undiagnosed learning disabilities will have frequent angry outbursts. They may be feeling frustrated because they are struggling to learn and it may feel like the world is closing in on them when parents or teachers suggest that they aren’t trying hard enough or doing their best. Because the child isn’t able to deal with the real issue, they become angry over small incidents that would normally be insignificant. This helps them to avoid feeling “stupid” or incapable. Once the problem is discovered and the child gets the help, support and proper discipline that is needed, the angry outbursts become less frequent or disappear altogether. It is important that children learn how to express their emotions in a healthy and constructive manner. A child should never be told that their feelings are wrong, though they may need reminding if their behaviour is wrong. For instance you might say, “Johnny, I understand that you are angry about your brother breaking your toy, that wasn’t fair, but it is not okay to hit when you are angry.” The child needs to know that his feelings are validated and should also be given some ideas about how to handle the situation better the next time they are in a similar position. Anger is a normal emotion for people of all ages, including children. Good communication and modelling good behaviour are two of the best ways to help children learn to deal with anger. Taking the time to praise your child whenever he or she does anything that is positive can also help them understand what it expected and feel good about doing what is right. Take the time to check yourself to see if you spend too much time being negative or angry and find ways to be more positive. If the parents in the home aren’t dealing with anger appropriately, they can’t expect the child to. Be willing to admit when you are wrong and apologise to your child, teaching them to do the same. If you suspect that your child has a serious anger problem, it may be time to get some additional help and guidance. Written by: Ray Subs Ray Subs is a public relations consultant working to promote the Help Your Child with Anger Blog.

July 30, 2017

SIDS Explained

One of the scariest things for all parents is the reality of Sudden Infant Death Syndrome (SIDS). SIDS is the unexplained, unexpected death of a baby who is less than one year old. Because it usually occurs when the infant is sleeping, it is sometimes called “cot death”. What catapults SIDS into pole position in the realm of fear, is that it is unfortunately the leading cause of death in babies under the age of 1 year. What you need to know about SIDS: It is a very real thing! It’s unwise to assume that “it will never happen to me”, as approximately 2500 babies die from SIDS annually in the USA. The primary age group that suffers from SIDS are babies aged between 4 and 6 months. The syndrome affects more boys than girls. SIDS occurs more frequently in cold or inclement weather. Steps to ensure that your child is safe: A safe sleep environment is fundamentally important: Make sure nothing covers the baby’s head. Use a firm sleep surface, such as a mattress in a safety-approved crib, covered with a fitted sheet. Do not use pillows, blankets, sheepskins, or crib-bumpers anywhere in your baby’s sleep area. Keep soft objects, toys and loose bedding safely stored away from your baby’s sleep area. Positioning: Always place your baby on his or her back to sleep, for naps as well as at night. While some parents are concerned that a baby sleeping on its back is more likely to choke on vomit or spit-up, according to the American Academy of Paediatrics (AAP), lying on the back does not increase this risk. Babies normally cough up or swallow fluids on their own with no choking problems. Note: Parents of babies who have been diagnosed with Gastroesophageal Reflux Disease (GERD) or certain upper airway problems should consult their doctors about back sleeping. In some cases, stomach sleeping is recommended, but this should always be at the recommendation of the child’s physician. Make sure that your baby’s airway is not obstructed. This means that your baby should never have his/her chin on his chest. This occurs in car seats, slings, and even while breastfeeding. Keep in mind that your child breathes primarily through his/her nose and this needs to be open and unobstructed. A baby’s head is heavy. Until your little one displays good neck control, it is important to ensure that it is always well supported. How can I reduce the risk of SIDS for my child? Never EVER smoke during pregnancy or expose your child to smoke thereafter. Conform to the required and recommended health care during pregnancy. Breastfeed your baby. Ensure your baby sleeps in a room with a comfortable temperature (not exceeding 23 degrees Celsius) during sleep. Give your baby plenty of tummy-time when he/she is awake and when someone responsible is watching. Where should my baby sleep? Whether parents should co-sleep or not is heavily debated topic. Studies have proven that co-sleeping increases the risk of SIDS. In many cases, infant death associated with co-sleeping is not the result of SIDS, but rather of accidental asphyxiation. Babies can suffocate if a parent changes sleep positions and accidently blocks the baby’s airway. Infants who sleep face-to-face with a parent are more susceptible to inhaling the carbon dioxide that the parent exhales. Soft, fluffy bedding can also suffocate an infant. If you do want to co-sleep, Good Night HIGHLY recommends safe co-sleeping options such as a crib extension to the bed.

July 26, 2017

D-I-V-O-R-C-E

MBI Attorneys, share advice on the subject of divorce and reveal this law firms unique approach. How often as parents have we all used spelling a word out as a device to prevent our children from understanding what we are talking about? The hit country and western song of the above name goes a long way towards exposing the complexities and pain attached to divorce. “The spelling out loud of ‘divorce’ by singer Tammy Wynette was certainly a parody but also a soulful rendition of the tale of a parent using an age old ruse in order to spare her child from hearing the dreaded word,” says Beverly Brown, senior partner and co-founder of MBI Attorneys. The song is a divorcee’s perspective on the pending collapse of the marriage. Although written from the woman’s angle it aptly represents either side of the gender coin in the divorce stakes with both parties trying to protect the children caught in the middle and yet get off the battlefield with as few wounds as possible. “I thought it would never happen to me, is a phrase I have heard many times in consultation with clients grappling with this life changing decision and seeking guidance on how to proceed. “Indeed in many instances over the seventeen years I have been practicing as a family law attorney, I have consulted with clients who have not yet finalised that decision in their minds and who desperately seek insight into the impact it would have on their family, their lives and their financial future,” she adds. Beverly says there are a myriad of reasons why people can move to considering divorce. “Some are what would be considered obvious – infidelity; physical or verbal abuse; drug or alcohol addiction. Financial pressure is high on the list and places immense stress on a marriage. In fact studies show that in times of recession divorce statistics rocket skywards. “Other reasons can be of a more subtle nature with insidious changes in a relationship taking place over time with one party changing to an extent that the other can no longer tolerate. This eventually leads to the realisation that living apart is probably the only decision if both partners are to provide a happy environment for their children and themselves,” says Beverly. The harsh reality. Chantelle Martins, partner, MBI attorneys, adds that the implications of this harsh reality are immense. “The financial impact of having to sustain two households from the same income that to date has often barely managed to sustain one, is only one consideration. “There are also the emotional implications – everyone is wounded and egos are dented but the latter needs to be put aside where children are concerned. Attorneys don’t usually look at the wellness aspect of a pending divorce but this is essential and fundamental to how MBI approaches divorce. The emotional or social implications can include loss of friendships; anxiety and even depression which in turn holds implications for the entire family unit,” notes Chantelle. So, what to do when the decision is taken? Beverly advises that the first thing to do is to take responsibility for the choice of attorney. “You can go to a lawyer for a legal solution but be aware that this may not be a practical solution for your family. “What you need is an attorney who will support you whilst driving the process in your best interest. Selecting an attorney is easy – find one who truly understands your particular situation. In short – the lawyer must ‘get it’. If they don’t ‘get it’ – walk on – they are not right for you. You need an attorney who truly understands the reality of the immense trauma you are suffering which often includes living on enemy territory,” says Beverly. MBI takes the approach of empowering our clients with knowledge and understanding of the legal process and the available options. Chantelle explains: “In collaboration with the client we prepare a carefully considered strategy which aims to put the client back in control of their lives. This translates into dignity and respect for clients at a time in their lives when many, if not all, are overwhelmed by events. “The mantra of this practice is founded on three key values: Know your client Know your client and above all – Know your client! “This is critical in terms of the first step in divorce – which is the issuing of the summons. Where children are involved this is a strategic move involving immense sensitivities that must be taken into account. “In hostile situations we assist clients by calculating the impact of actions on the entire family unit. We strive to guide clients and their families to understand that despite the fact that times are tough and even sad for them, this is how they will deal with it and get through it,” notes Chantelle. “A divorce is like an amputation: you survive it, but there’s less of you.” This is a quote from author Margaret Atwood but according to Beverly it does not have to be like that. “A strong support network of friends and family is crucial. But it must be the right support in the shape of people who are capable of making a paradigm shift and putting themselves in your shoes, as opposed to offering solace based on their personal history or disappointments. “There is no doubt that divorce is a lonely journey so we encourage clients to establish a support network but to be discerning about who they discuss the fine details with and to be wary about taking advice from others working through their own emotional scar tissue.” Beverly says Resilience is crucial. “Finding reserves will be difficult but knowing that you are part of the solution to this life problem and working hand in hand with your legal team brings confidence.” Learn what resources your legal team has available, if any. What is meant by that? “In the foregoing I have outlined

July 20, 2017

Four Ways That Parents Can De-Stress

I watched 3 little children in a store yesterday as they chipped away at their mother’s sense of calmness. One child asked her questions, another one spoke loudly over the other two, and the third must have been over tired as she whined and kept hitting the other two children in the shopping cart. Mom finally succumbed to the stress and snapped at them to STOP THE NOISE. It did nothing to quell the chaos. I remember the moments of stress while raising my own 3 children. The noise and the chatter would sometimes get to me easily. I had to learn how to calm myself so that I did not take out my stress on the three little kids who just wanted to be heard and who felt like they were fighting for my attention in competition with their siblings. On a recent episode of my television show Creating Cooperative Kids, I interviewed a parent time and stress management coach who offered tips for parents. Virginia Ann Griffiths (we-leap.com) said the number one thing that parents can do anywhere to calm down is to breathe intentionally. What she meant by this is to breathe deeply to get oxygen to our brain so we will have the power to remain calm in moments of chaos. Here are more tips for parents for distressing. Intentional Breathing. Close your eyes for just a moment and slowly pull in a series of deep breaths through your nose. Feel the air going into your lungs and imagine that you can see the air filling your lungs. Hold it just of a second and then breathe out through your mouth. Just a couple of deep breaths can help you calm down and think clearly before reacting. Quiet Toys. Keep small quiet toys in your purse to give to the kids when they begin to act up. They are likely to create temporary distractions that will give you a few moments of silence to calm yourself. Although many parents hand their child their cell phone or a tablet, avoid this solution. Small media devices are not healthy alternatives for small children. Engage Them in Your Shopping. If you’re out shopping with your children, create a list of items that you’re looking for and get them to help you locate them. Be sure to set up rules in advance before entering the store (such as remaining in the shopping cart and what you are not willing to buy) and get them involved in the adventure. For younger children, cut out and provide for them, pictures of items to find as a way of helping. Take Care of Yourself. Make it a priority to take time out for you whenever you can. Make use of family members and friends who can take the kids for short periods of time so you can have time to yourself. Other matters that seem to be urgent can take over the little time you have away from the kids, but don’t let it. Schedule in time to take care of yourself physically, spiritually, socially and emotionally.

July 20, 2017

Grieving with children

I’ve done a fair bit of grief counselling over my time since internship until now and one thing has always struck me as a significant reflection after each such session: We are often so unprepared to deal with death, especially the first time around and even more so when it strikes without advanced warning. This thing that is a part of our lives and the life of every other human being and living, breathing organism so often hits us so hard. Objectively speaking, it really shouldn’t seem as scary as it is, given that it as much a part of our cycle as is first being born, facing puberty, adulthood, mid-life and eventually old age. Then again, don’t each of those stages come with their own traumatic consequences, sometimes hitting harder than grief ever will? So, how do people cope more peacefully or less chaotically in any traumatic event? Resilience and preparedness are the two main factors that play a role. How much did you know about what happened and how “tough” were you to it? If you look at people who have endured the loss of a close loved one, often their grief process is less severe the second time around. This is because they have been through this and have some of the requisite coping skills from before. So, how do we prepare or help those we care for most, with one of the hardest matters they’ll ever face? So much depends on their age and their ability to conceptualise the loss they are faced with, as such there is not necessarily a “one size fits all” approach, although there are a few pointers listed below that may help along the way: For children of any age, it’s worth focussing on the following: Pay attention to them, remind them of their importance, and validate their opinions, thoughts, and feelings. Be patient and open minded. Allow them to grieve in their own way, as this is their own unique process. Have time to sit with them, listen and answer their questions, as there will be many. Reassure them the circumstances of to the death were extreme and it is unlikely other adults in their lives will die any time soon (unless this is untrue). Let them know that a range of different emotions are normal and that they’re likely to feel all sorts of things like anger and confusion. Validate their feelings and do not minimise them with expressions like “It’ll all be over soon”. Check in with other adults involved in their life to make sure they are doing as ok as can be expected, or that they are not showing more extreme signs of grief away from the home. Stay in touch with school, mentors, coaches etc. For those who find it still difficult to discuss loss with their children, here’s a short list of books that can help with the process, depending on the type of loss encountered. Krasny-Brown, L. and M. Brown: When Dinosaurs Die Thomas, P.: I Miss You: A first look at death Clifton, L.: Everett Anderson’s Goodbye Holmes, M.: Molly’s Mom Died and Sam’s Dad Died Vigna, J.: Saying Goodbye to Daddy Old, W.: Stacy Had a Little Sister Cohen, J.: I Had a Friend Named Peter Coleman, P.: Where the Balloons Go DePaola, T.: Nana Upstairs and Nana Downstairs Thomas, J.: Saying Goodbye to Grandma

July 19, 2017

Smoking causes permanent harm to babies, both before and after they are born

Mothers who smoke during or after pregnancy not only affect their own health, but they can also cause permanent harm to their babies. As we observe Anti-Tobacco Campaign Month, it is our collective responsibility to educate and support mothers to both limit the harm that their smoking may cause to their children and to stop smoking altogether. “There is no doubt that smoking during pregnancy can harm your unborn child. Tobacco use during pregnancy has been conclusively linked to increased chance of miscarriage, premature birth and low birth weight,” says Dr Mhleli Masango, Medical Director of the South African Breastmilk Reserve (SABR). “It also increases the chance of Sudden Infant Death Syndrome (SIDS) and birth defects like cleft palates,” she continued. * Many mothers stop smoking during pregnancy but then resume once their baby is born. However, dozens of scientific studies have shown that exposure to even small amounts of cigarette smoke or nicotine in your breastmilk can significantly harm your baby. ** “Children of smokers are far more prone to pneumonia, asthma, ear infections, bronchitis, sinus infections, eye irritation, and croup. They are also more likely to suffer from colic, and visit their doctors three times more than children of non-smokers,” explains Masango. “Perhaps worst of all, children whose parents smoke are more likely to become smokers themselves,” she said. ** The only guaranteed way to prevent this harm is to stop smoking, but mothers who are unable to quit can limit the harm by smoking outside, away from their babies, and by ensuring that no one else smokes near their babies. They can also smoke immediately after breastfeeding to cut down on the amount of nicotine in their milk. It takes 95 minutes for half of the nicotine to be eliminated from your body, so mothers should wait as long as possible between smoking and nursing. “Mothers who struggle to quit smoking should not stop breastfeeding. The benefits of breastfeeding outweigh any harm caused by smoking,” says Masango. “Breastfeeding actually counteracts some of the effects of smoking but the best solution is still to quit completely.” ** Unfortunately, even with these preventative measures, smoking makes it harder to breastfeed. Smoking has been conclusively linked to earlier weaning, with the heaviest smokers tending to wean the earliest. It also lowers milk production and interferes with the flow of milk while nursing. South African law recognises the dangers of smoking and is making it increasingly difficult to smoke near other people. For example, it is now illegal to smoke in any car, including your own, if one of the passengers is under 12 years old. It’s also illegal to smoke on the premises (including outside of buildings) of any properties used for commercial childcare activities, schooling or tutoring. *** Smoking is no longer allowed outside of designated areas in any public buildings, including all restaurants, bars and other businesses. This even includes smoking in partially enclosed areas like balconies and parking areas. The fines for both smokers and property owners are steep. “While it’s not currently illegal to smoke while pregnant, we should expect the laws to continue to tighten,” says Masango. “Smoking is increasingly seen as both anti-social and unacceptable. We recognise that quitting can be difficult, but during Anti-Tobacco Campaign Month we urge all parents to make a concerted effort to become smoke free.” For more information about breastfeeding, pregnancy and childhood health please visit www.sabr.org.za or call 011 482 1920 or e-mail: info@sabr.org.za.

July 18, 2017

Nutritious Knock-Ons

When it comes to mothering styles, I’m more like Bridget Jones than Gisele Bundchen. I don’t work on a balanced meal plan for the week, and I don’t make achingly beautiful organic moss and bark collages with my kiddo. Rather, I’m the mom who makes it to 5pm (with the morning’s oatmeal still in my hair) and realises that the piece of fish I set aside for my 18-month-old son’s dinner has mysteriously disappeared from the fridge, so I have to cobble something nutritious together in half an hour while said kiddo takes apart the Tupperware cupboard for the fourth time since he woke from his nap. Right. Even though I’m something of a hot mess come dinnertime, I still care deeply for my little boy, and, obviously, I want to give him the very best start in life. It’s a mom thing. Even though we chug back an illicit bag of cheese curls in times of stress, we don’t want our kids to develop the same bad habits. Considering that we’re the ones who control what they eat, it’s good to know that we actually can influence their behaviour positively, by giving them the right kinds of food. What does this entail? Simply put, a whole bag of common sense and a dash of science. Some things, when eaten excessively by kids, affect blood sugar and serotonin levels, and can result in anything from short-term hyperactivity to full-on diabetes. Sugar and salts are the main culprits, with processed carbs, artificial flavourings and colourings hot on their heels. Check out this informative article on the impact of nutrition on development. The good news is that in our roles as Supreme Rulers of the Food Groups and All Things Delicious, we can help our little ones develop a preference for the good stuff. We can do this simply by exposing them to more of the good stuff and less of the harmful additives that have somehow weaselled their way into our everyday diets. More good news is that by encouraging them to experience natural flavours and textures, we can help them to develop discerning palates, which they’ll likely take on into adulthood. It’s logical if you think about it. The flavour concepts our little ones have relate directly to the food we give them. This means that even though we might turn our noses up at steamed carrots unless they’re liberally doused in salt and melted butter, maybe a piquant cheese sauce, our tots are blank slates. Beyond Taste From my own experience, I know that the food my son takes in definitely has an effect on his behaviour. I’m not just talking about how sugary things make him all revved up. I also mean that when I buckle like a cheap belt and feed him a convenience meal for dinner, he’ll gobble it down, but his normally peaceful journey to bedtime becomes an exercise in desperately wrangling a fully-fledged were-child (also see how food affects behaviour). If we ask Science, we’ll discover that the pre-packaged meal might not seem sugary, it might even have a wholesome name like “Hearty Homemade Lasagne”, but it’s most likely packed with processed carbs and additives. The body processes this junk quickly, and gets hungry again pretty fast. Hence the term “empty carbs”. Also, the flavour enhancing additives that make him gulp his food down so eagerly are pretty much just refined sugar. Hope for Harassed Moms Ok, so it’s good to know the facts, but what can you do when you’re having one of those days/weeks/years when you can barely make it to dinnertime without something exploding? Not everyone has a full-time nanny, or hands-on Grandma down the road; sometimes you’re all you’ve got. If you’re like me, and need to a little help to insert a healthy meal into your little angel at dinnertime, here’s the cheat sheet: Balancing act – A good balance between protein and carbohydrates will keep him fuller for longer. Better sleep for the whole family! Good carbs – You want your carbs to be lower in sugar and higher in fibre. Generally speaking, if you have to peel, wash or chew it yourself, it’s a keeper. Snack happy – Morning snacks pave the way for eating behaviour later in the day. Avo on whole-wheat toast keeps the toddler engine running optimally, but sugary bites create were-children. Breaking Bad – Avoid flavoured breakfast cereals that can encourage sweet expectations, and go for oatmeal with cinnamon and an ooze of honey. Or better yet, eggs. Eggs forever! When my day has rapidly spitballed into mismanaged chaos, my emergency go-to options include: a nourishing smoothie (with avocado and baby spinach in it, making sure not to add too much fruit); some shiritaki noodles with pesto, chicken and broccoli (fortunately my boy loves his broc, so I always know if he sees that first he’s more likely to eat the whole meal); or breakfast for dinner: poached eggs on a bed of rocket, with bacon, and a side of avocado and tomato. Straight Talk While it’s possible to course correct at dinnertime, it’s much easier to lay a good foundation in the morning, because our dietary decisions have knock-on effects. In my family, we aim for a good start, so breakfast is either oatmeal, or some kind of eggy dish. Omelettes, sunny-side ups or these 3-ingredient banana flapjacks (see finger foods and snacks for toothless tots) – it depends on how creative my husband is feeling. He’s the Breakfast Guru. Sometimes though, I resort to Oatees and plain yogurt. While I do add blueberries, my boy delights in chomping the fruit and delicately spitting it back into my hand. The cereals, however, he throws back with gusto. It’s on these days that I can expect a mid-morning crash and a dishearteningly short nap. The knock-on from there is that he’s awake from 11.30/12ish, right through to bedtime. Yep. You can imagine the horror. I can’t pretend to win points for nutrition

July 15, 2017

Ban the baby blues

Around 20% of new mothers experience ‘the blues’ or postnatal depression, and almost all new moms at some stage in the first month or two have weepy sessions. The changes to the body both during pregnancy and afterwards are huge, but here again with the correct nutrition during and after pregnancy, you can get around many of the causative factors of the blues. Important DIY deficiency symptom tests The blues can be caused by several things, but a lack of three main ones are noted: zinc, Vitamin B6 and essential fatty acids (notably Omega-3s from fish oil). Take these three little tests to see whether you are deficient in any three nutrients. TEST 1 Are there white marks on your finger nails? Do you have stretch-marks? Is your appetite poor? Is your sense of taste and smell poor? If you answered YES to the first two and any others, you may have a zinc deficiency at this time. The worse it is, the more symptoms you will have. Zinc is such an important nutrient, and one many people are deficient in anyway, but particularly after giving birth. If you are deficient, supplement a zinc tablet of 15-22mg a day twice a day until you start to notice you are feeling better, then take just one tablet a day. TEST 2 Do you have pain and stiffness in arms and/or hands? Have you got painful ‘knots’ on the last joint of your fingers? Do you get headaches? Do you suffer from: Bad breath, dizziness, extreme nervousness? Burning pain and/or abdominal cramps? Lethargy? Dizziness? Swollen ankles? An itching red rash around genitals? Sore lips, mouth and tongue? Lots of dandruff? Do you take Theophylline for asthma? Once again the more ‘YES’ answers here, the more your need for Vitamin B6 is obvious. A good starting point is to take a quality brand B-complex supplement. Find one which has around 50mg of each B vitamin, as B vitamins work best together. Too much of one B vitamin for too long ends up depleting the others, so take a complex to avoid this happening. Check that you get about 50mg of Vitamin B6 in this supplement, otherwise if not sufficient, add a good Vitamin b6 in addition to this Vitamin B complex. TEST 3 Is your skin very dry? Do you have stretch-marks? Do you have extremely dry hair? Is there a ‘goosebump’ rash on the upper arms and/or upper thighs? Do you sometimes experience excessive thirst? Do you experience frequent urination? Do you have attention problems? Are you depressed/anxious? If you answered YES to these you are likely to be deficient in Omega-3 essental fatty acids, and a good fish oil supplement which is ultra-refined (mercury-free) will help to restore you to your old self. A supplement is strongly recommended, even though fish is the source of these helpful fatty acids, and we should be eating fish regularly as part of a healthy diet. However, we just don’t get enough of what we need anymore unless we take good quality supplements and this is no exception. Super nutrients for super milk production then are going to include foods rich in these ingredients to ensure that you are covering all those nutrients. In effect, eating a diet rich in wholegrains, fibre, vegetables, healthy fats, ‘clean’ protein free of hormones and antibiotics, together with plenty of purified water will be best for any new mom. Essential nutrients As can be seen from the above three tests, Vitamins B6, zinc and healthy fats are pivotal at this time. But they are not the only ones you should be concerned with. By taking a specialised pregnancy or prenatal supplement, you will be getting all the important nutrients needed for yourself and your baby at this time. If you find from the above tests that you are still short in Vitamin B6 and zinc, these needs to be added. Omega-3 essential fatty acids from fish oil are always needed, whether you are showing a deficiency or not. Food sources of these nutrients: Good sources of Vitamin B6 are fish, bananas, chicken, pork, wholegrains and dried beans. Good sources of zinc include pumpkin seeds, beef, lamb, turkey, chicken, salmon, wholegrain cereals, brown rice, wholewheat bread, potatoes and yoghurt. Good sources of Omega-3 essential fatty acids cannot be eaten successfully other than from a seafood source. Eating fatty fish is good, and fish oil supplements from a purified supplement is an excellent source of pure bio-available EPA and DHA. As seen earlier, flaxseed oil is not a substitute in this instance as the conversion rate is virtually non-existent. We advise against krill oil mainly for humane reasons, as this is the bottom of the food chain, and the food of penguins and whales. Studies are showing that their food source is now under threat due to over-harvesting of the drill in the oceans. We get plenty of Omega-6 fatty acids from a diet high in plants, lean meats, nuts and seeds – so there really is no need to supplement this unless you show a serious deficiency.

July 15, 2017

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