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

Free Flu Vaccines

Annually, seasonal influenza (flu) kills around 11 500 people in South Africa. Which is why Bonitas Medical Fund offers flu vaccines annually at no cost – to every member and beneficiary. The Fund has announced that the cost of administering the flu vaccine – as well as other vaccines covered from the risk benefit – will also be covered or subsidised for its members. Flu vaccines have been shown to reduce the risk of contracting flu, becoming seriously ill if you do, being hospitalised and even death. Flu vaccinations are also an important conservation measure for scarce health care resources, which remain a concern during the ongoing the Covid-19 pandemic. According to Principal Officer of Bonitas, Lee Callakoppen, the World Health Organization (WHO) has also recommended that high risk groups consider having the flu vaccination in 2021, particularly because of Covid-19. ‘As part of our preventative care benefit, we offer free flu vaccinations annually to our members to help maintain their health and immunity.  ‘Due to the unique circumstances created by the pandemic and our members being financially constrained, we have negotiated with our network of over 60 pharmacy groups – which include Dischem, Clicks and PnP – to cover cost of the flu administration fee, capped at R50. However, should a provider charge more than R50, the shortfall will be for the member’s account.’ He says the Scheme is financially stable and sound and has set aside funds to cover the flu vaccine – estimating around 40 000 doses will be utilised during the 2021 season – along with the administration costs.  Although the flu vaccination is free to all members, the Scheme (guided by WHO and the Department of Health) highly recommends that the following groups consider being vaccinated: Healthcare workers Individuals over the age of 65 years  People with comorbidities like heart disease, diabetes or lung disease  Pregnant women  People living with HIV and AIDS  ‘We believe the best and first form of defence against flu is the vaccine,’ says Callakoppen. ‘And we suggest people get vaccinated soon, ahead of the flu season – which traditionally runs from May to August because the protective antibodies take about two weeks to develop. However, we know that protocols in place for Covid-19 such as social distancing, wearing a mask, handwashing and sanitisation will also go a long way in protecting against us against getting flu.’ In addition to the free flu vaccination and as part of the preventative care benefit, Bonitas also covers the costs of a pneumococcal vaccine for beneficiaries over the age of 65 years once every 5 years and childhood immunisation, this includes the vaccine admin fee. 

Bonitas – innovation, life stages and quality care

Gestational Diabetes: Reasons, risks and recovery

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

Bonitas – innovation, life stages and quality care

Vaccines and the way forward

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

Bonitas – innovation, life stages and quality care

Woman’s Health

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

Bonitas – innovation, life stages and quality care

Making your medical aid benefits last

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

Bonitas – innovation, life stages and quality care

15 Facts about the Covid vaccine

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

Advice from the experts
Breastpumps and Beyond

How to prepare yourself emotionally for when your child starts eating solids

Eating solids is a huge milestone in the life of your child! It is also a milestone for all moms who have breastfed their little ones up until that point. Letting go of the intimacy of feeding times can be an incredibly difficult journey for a woman. Therefore, know how to cope with this by reading on below now. We have a few suggestions to help you emotionally face the transition from liquids to solids in your little one’s life. Don’t Say Goodbye Just Yet Even though your child should be able to start eating solids from around the four month mark, this doesn’t mean you need to say goodbye to breastfeeding just yet. Luckily, you will be able to still breastfeed for as long as you see fit. Breastfeeding experts suggest you should aim to breastfeed your child for two years. From between four to six months, you will be able to introduce them to a more solid diet but continued breastfeeds are strongly supported.  How To Cope When Eating Solids Are Enough For Your Little One Ending a breastfeeding journey can be a mixed bag of emotions. Many women have been known to go through a myriad of emotions in the space of a day! Some of the most common emotions you will experience are as follows: Relief: some moms may experience a sense of relief at the thought of ending their breastfeeding journey. This doesn’t suggest that they loathed the time spent with their child, but rather, that they look forward to enjoying a carefree diet once more! for whatever reason, some women feel a profound sense of relief at the thought, and this should not be belittled. Guilt: in the same right, guilt will rear its ugly head in the emotional trio. Moms will feel guilty for being relieved at the thought of ending this journey. In the same right, some women will feel guilty in that they don’t know if it is the right time for their child. Whichever way you experience it, note that guilt will probably surface during this time. Sadness: naturally, sadness will come into play. Breastfeeding is a hugely emotional and sentimental journey between mother and child. It also plays a huge role in the formative years of a child’s life. Naturally, saying goodbye to this practice will pull on the old heart strings. Putting Your Emotions Into Perspective The best thing to do for yourself is allow yourself to go through the motions of any feeling which pops up during this time. Another wonderful way to ensure you don’t lose any connection to your child is to set time aside daily for skin to skin hugs. Perhaps begin to schedule these in the times you would’ve usually spent breastfeeding. This will ensure you never miss out on the intimacy you shared with your child before. 

The Headache Clinic

Bad Posture may lead to headaches

There are many different medications, surgeries and interventions to treat headaches, but a new study reveals an effective way to treat primary headaches might be at your fingertips – neck stretching. By performing simple neck stretching exercises that stubborn and painful headache might just disappear.  The study, published in Workplace Health and Safety, examined the effects of a neck stretching exercise intervention on nurses’ primary headaches. It used a pretest and posttest two-group design with a total of 60 female staff nurses employed by a medical center in Taiwan.  Participants in the experimental group (a total of 30 patients) practiced neck stretching exercises while experiencing headaches. The participants in the control group (the other 30 patients) managed their headaches as they would usually do.  According to Dr. Elliot Shevel, Medical Director of The Headache Clinic, and South Africa’s internationally recognized Migraine expert and pioneer in the field of Migraine Surgery, a structured questionnaire was used to collect data on headache intensity at baseline, and at 30 minutes and 1 hour after intervention.  “Decrease in headache intensity of the experimental group was significantly larger than that of the control group,” says Shevel. “The conclusion was that neck stretching exercises is an effective method for treating primary headaches.” What exercises can you do?  By simply doing some physiotherapy exercises at the office or in the comfort of your own home, you can treat your own headaches, says Shevel.  The Headache Clinic’s in-house Physiotherapist Urvashi Chiba has put together a short demonstration video with practical advice and exercise demonstration. Please click here.  Things to remember when doing neck stretching: Do the neck stretches two to three times per day. Stretches are more effective and comfortable when the muscle is warm. Ideally it can be done in the shower, after a bath or after heating the muscles with a heat pack.  Do not pull too hard; a gentle pulling sensation should be felt. The stretch should be gentle and should not cause you pain Take regular breaks from the computer or seated position.  Maintain correct seated position in front of your computer or desk. Correct computer posture Maintain correct seated position whilst driving. Correct driving posture Avoid awkward positions, especially for extended periods of time. Common awkward positions Slouching in a chair Sticking your bottom out Standing with a flat back Leaning on one leg Hunched back and ‘text neck’ (from hunching over while texting) Poking your chin by sitting too low in front of your screen Rounded shoulders Cradling your phone between head and shoulder

Kaboutjie

12 Breastfeeding Super Foods

Moms that are breastfeeding must consider which foods they can include in their daily diet. All foods or drinks that are consumed in large quantities can pass through the breast milk to your baby’s system and can as a result have a negative effect on your baby’s health or overall well-being. There are a few helpful tips to consider for milk supply when nursing your infant: Make sure that you include a well-balanced eating plan and consume a variety of foods to provide your baby with different kinds of vitamins, minerals and nutrients that is vital for healthy growth. *Foods that should be avoided or consumed in moderation are:Caffeine, fish, chocolate, parsley, peppermint, alcohol, citrus, dairy, peanuts, gassy vegetables (such as cabbage) and spicy foods. Always be vigilant by watching your baby’s reactions after you’ve eaten certain foods that could have an undesirable effect on your baby. If you are unsure or have any health concerns with regards to certain food items, always check with your pediatrician to be on the safe side. Another great way to promote milk supply is pumping to induce lactation. The best method for increasing milk supply is by stimulating the nipples whether it is by pumping or putting baby to your breast. If you aren’t stimulating the breasts regularly, no supplement or food is going to help you increase your milk supply. When pumping frequently, the aim is to remove more milk from breasts and increasing the frequency of breast emptying. Adding pumping sessions in between or after nursing sessions can be very beneficial when you’re looking to induce lactation, therefore increasing your milk flow and upping your milk supply. Have a look at these 12 breastfeeding superfoods to promote lactation: Oatmeal A good choice for comfort food which is easy to prepare. Oatmeal is a rich source of iron which is vital for Moms that are experiencing post-pregnancy anemia. Oatmeal helps to increase red blood cell count in blood which can lead to increased breast milk production. Another great benefit is stimulating the production of Pitocin which is a key hormone when it comes to producing breast milk. Water Drinking enough water is vital when you are breast feeding. For your body to function properly and to promote milk supply (water forms the basis of breast milk), you must drink enough water to make up for the fluids lost when you’re sweating as well as producing enough milk to quench your baby’s thirst. Green Papaya Women across Asia often consume unripe papaya which is a great galactagogue (food that increases breast milk). Green papaya helps promoting the production of oxytocin which in turn increases milk production. Garlic One of the best food choices for increasing milk supply in breastfeeding mothers is garlic. A great way to add an extra layer of flavouring to your dishes plus garlic has an array of health benefits, including providing relief for babies suffering from colic. Drinking garlic pills is a great option for ladies that don’t enjoy the after taste of garlic. These pills provide the same benefits as garlic without the lingering after taste. Fennel Fennel has similar properties as estrogen, therefore fennel or fennel seeds are ideal for promoting lactation. Another great option is making use of fennel essential oil, but it’s important to keep in mind that long-term use can affect the urinary tract, therefore it’s best to use it for up to seven to ten days at a time and no more. Fenugreek seeds Fenugreek is one of the most popular and safest herbs used for milk supply since biblical times, as it stimulates the secretion of human growth hormone. It can be boiled in tea or you can buy them in capsule form. Many cultures also use Fenugreek as a herb or spice in food to treat medical conditions. Other benefits include, slowing the digestive tract as well as stabilizing blood sugar levels. Nuts Almonds, cashews and macadamia nuts contain monounsaturated fats which increase the richness of your milk. They need to be eaten raw (not roasted and salted) and you can enjoy up to three servings a day. Grains or Legumes Brown rice, lentils, millet and barley are excellent examples of grains or legumes that promote milk supply as well as stabilizing blood sugar levels. Spinach Spinach is a great source of calcium, iron, Vitamin K, A and folic acid. Folic acid is vital for women who are breastfeeding. Dark leafy greens contain phytoestrogens which promote lactation and breast tissue health. But to avoid any food-borne illness, make sure you boil it before consumption. You can also add it to salads but ensure that you’ve rinse it properly beforehand. Carrots Carrots are rich in Vitamin A which is great for assisting with baby’s growth and they are also believed to assist with lactation. Sesame seeds Not only are they delicious, but they are high in calcium and polyunsaturated fat, making them a very nutritious choice. They are also known as lactogenic food which means they help to increase breast milk production. Asparagus Asparagus is one of the must-have food items for nursing mothers because it is rich in fibre, high in Vitamin A and K and helps stimulating the hormones that are essential for nursing moms when it comes to lactation. Conclusion: Every lactating Mom who is breastfeeding, will have questions about what to eat and what to avoid when producing and providing the necessary quantity of breast milk that is also nutritious. Certain food items, known as galactagogue specifically assist with lactation, boost milk production and provide essential vitamins, minerals and nutrients to your baby when nursing. Remember to stay hydrated and ensure that you are taking in enough fluids when breastfeeding. Now that you know which foods can promote lactation and increase the production of milk supply, you can add them to your daily diet and provide your baby with the best possible breast milk that he/she needs to stay healthy and have a full tummy. Read Also:

The Headache Clinic

Summer fun without the headache

Summer is the season most South Africans look forward to for its long, lazy weekends and holidays full of braais, swimming, sports, and picnics. Relaxing in the sun are highpoints in the year for most of us. However, mixed with some tension and frustrations and the mix of breaking your routine, eating and drinking differently, staying up late and having too much sun can all lead to headaches.  According to a study published in Neurology the official journal of the European Neurological Society, your headache risk jumps 8% each time the temperature climbs nine degrees. Heat may make the blood vessels in your skull expand and press up against surrounding nerve endings, creating a very sensitive situation.  As a result, even normal blood flow can feel like a jackhammer drilling through your cranium, says Dr Elliot Shevel, South Africa’s pioneer in the field of migraine surgery and the medical director of The Headache Clinic. Headaches are people’s number one physical woe, but you don’t have to live with the pain. You can stop the throbbing and get back to the beach. Eat healthy meals Eat balanced meals three times a day with healthy snacks in between to make sure your body gets the nutrients and energy it needs. Hypoglycaemia (low blood sugar) can also trigger headaches in many people. If a meal with high sugar content is eaten, it can cause a rapid rise in blood sugar levels followed by a fast drop that may trigger a headache. Eating a meal with low sugar content may prevent the onset of a headache during the day. Call us on 011 484 0933 for a list of foods which have a low glycemic index. Remember that skipping meals is a sure-fire trigger for headaches. Eat in moderation and enjoy your meals. Beware of too much sun It’s not only the heat, but bright sunlight will often also trigger headaches. Many headache and migraine sufferers are sensitive to bright light and they should avoid it when they have a headache. It is wise to wear sunglasses for protection. Polarized lenses are recommended, as they are effective in cutting out glare. A suitable hat may also be helpful.  Get enough sleep A recent study published in the Journal of Clinical Sleep Medicine, tested 32 women with tension-type headache. The investigators studied self-report data on headache triggers, pain interference with sleep, and self-management strategies for pain.  81% reported that going to sleep was the most frequently used self-management strategy, and this group also rated going to sleep as the most effective strategy. So don’t lose out on sleep this winter. Fatigue is a major trigger of headaches as well, aim to sleep seven or eight hours a night. Stay active Taking part in physical activities are not only great fun, but also an important part of a healthy lifestyle. Take up some form of everyday physical activity that will help you stay healthy. Learn the right stretching exercises to stretch the muscles of the head, face, neck and jaw. Stretching should be gentle and soothing, not agonizingly painful. For a free copy of exercises, contact The Headache Clinic on 011 484 093. These exercises will help you to stretch the neck and jaw muscles carefully and will give results. Steer clear of stress Summer can be a very stressful time for most, thanks to large family gatherings over the festive season and stress is a major headache trigger. The research conducted by the World Health Organization has shown that 80 % of headaches are caused by muscle tension, which is triggered by stress. Headache and migraine sufferers should try plan ahead of time for big family get-togethers and holidays to avoid tension headaches. Try to avoid last minute gift shopping, ensure your car is serviced before travelling, delegate chores to family members, and make travel reservations well in advance. Keep your fluid intake up The human brain is more than 75% water, and it is very sensitive to the amount of water available to it. When the brain detects that the water supply is too low, it begins to produce histamines. This is essentially a process of water rationing and conservation, in order to safeguard the brain in case the water shortage continues for a long period of time. The histamines directly cause pain and fatigue, in other words a headache and the low energy that usually accompanies it. It is best to drink plain water, as many carbonated soft drinks contain substances that can also trigger headaches. Substances that headache sufferers should avoid include common ingredients in soft drinks such as caffeine. When to see a doctor It is crucial that if your headaches persist, you should get to the root of the problem. The longer the headache persists, the more damage will be done to the underlying structures. A “multidisciplinary” assessment will need to be done. There are so many different structures in the head, face and neck, all of which can be involved in the migraine process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. Which structures are causing the pain and generating the pain signals is the million dollar question.  For those patients who want to have healthier alternatives to medication, there are a number of non-drug breakthrough treatment options. These include bloodless “surgery”, minimally evasive arterial surgery, posture modifying technologies, Botox and trigger point therapy to name but a few. In most cases it is possible to get to the bottom of the problem and resolve the pain permanently. 

Parenting Hub

Understanding the effect of alcoholism on children

An Open Letter To My Teacher Dear Teacher, I think it’s time I told you why I have been acting out at school and crying sometimes. I think you know that something is wrong, because you keep asking me, “What’s the matter?” The reason I haven’t told you before is that I can’t talk to you in the hallway with all the other kids staring at me—and until now, I didn’t feel like I could talk to anybody about it. I’m worried about my schoolwork. I keep getting in trouble for not doing my homework, and not listening in class. Sometimes I am so scared that I just get mad at everybody. I don’t mean to yell. I just feel like everyone is picking on me at home and at school. You see, my dad has a drinking problem. It’s called “alcoholism.” It means that he can’t control his drinking. He comes home some nights really drunk and yells at all of us. Then Mom yells back at him for being drunk and spending all the money. Sometimes he hits her, or my sister and me for no reason, just because he is drunk. Sometimes my sister and I are so scared that we hide in our room. I used to hate my mom and dad for all that – Mom for yelling at Dad and making him even madder, and Dad for his drinking. I don’t hate them anymore because I found out why they were like that. One day a lady came and talked to my mom, and I listened, too. She was the one who explained to us what alcoholism is. I learned that my dad was not horrible, just sick. He has a disease called alcoholism. She told us that when there is someone in the house with a drinking problem, the whole family gets hurt by it. She also told my mom about Al-Anon. That is where families and friends of problem drinkers go to understand the disease of alcoholism and how they can stop being so scared and mad all the time. Now Mom goes to Al-Anon. It works, too. Mom doesn’t scream at Dad or us as much anymore. I go to Alateen, that’s for kids affected by someone else’s drinking. Sometimes we have friends that drink too. Now I understand, and it feels good not to be the only one with my kind of problem. I think that teachers should know about alcoholism, because then they would understand kids like me. If you know of any kids who might have a problem with a drinking parent or a drinking friend, you could tell them where they can get help. It really helped me.  Your Student ____________________________ For nearly 70 years, Al-Anon Family Groups, globally, has helped the families who live with the disease of alcoholism. The disease of alcoholism in a family member or friend affects children and teenagers in many ways that impact on their behaviour and ultimately, their school work.  Frequently, students and educators do not realise that a relationship with an alcoholic could be a factor in poor performance, disruptive behaviour and other problems. Alateen helps young people understand how alcoholism affects the lives of all who are associated with a problem drinker. It especially effective for children in the Teens & Teens age group Alateen in South Africa We have learned that learners are very cautious about attending Alateen meetings at their schools.  In some areas Alateen meetings are held in the evenings in a nearby church hall, community centre or somewhere secure. Parents/guardians must give written permission for Alateen attendance. Alateen South Africa has groups across the country.  A list of Alateen meetings may be found on our websites: http://www.alanon.org.za/meetings/ http://www.alanongauteng.co.za/ Teen Corner (Alateen) [email protected] — 24 hr Helpline – 0861 25 66 66 Literature & more information is available.  Just call us.  

The Headache Clinic

Preparation tips for parents on back to school headaches

It’s back to school time again. Parents know this time of year all too well. There are school clothes and supplies to be purchased, class and bus schedules to review, and seemingly countless other details to deal with.  For children who get headaches, this time of year means anxiety, stress, and chronic head pain. The research conducted by the World Health Organization has shown that 80 % of headaches are caused by muscle tension, which is triggered by stress.  “In order to start the school year off right, you need to have a headache strategy” says Dr Elliot Shevel, South Africa’s pioneer in the field of migraine surgery and the medical director of The Headache Clinic. He advises parents to take note of the following: Install a blue light filter on devices If your child uses a computer, tablet or mobile phone for many of their school activities and leisure, installing a blue light filter on each device is recommended to reduce muscle stress of the eyes which contributes to headaches and migraines. Blue light filters also block out the light that contributes to insomnia and poor sleeping. Lack of sleep is also a trigger for headaches and migraines so every member of the family should have blue light filters on their devices too. Choosing the correct backpack/ posture related headache Choosing a backpack with wide, padded shoulder straps and padded back. Pack light and organize the backpack to use all of its compartments. Pack heavier items closest to the center of the back. The backpack should never weigh more than 10 to 20 percent of your child’s body weight. Always use both shoulder straps as slinging a backpack over one shoulder can strain muscles and lead to muscle tension headache. Consider a rolling backpack; this type of backpack may be a good choice for students who must tote a heavy load. Remember that rolling backpacks still must be carried up stairs. Nutritional lunch boxes/ dietary related headache Nutritious home packed lunches start in the supermarket; use the nutritional facts label to help choose healthy foods. Compare nutrient levels for similar foods. Select those lower in fat, sodium and sugar. Dietary headache is a common affliction. These are usually triggered by foods that assist with energy such as chocolate. Instead of giving your child a chocolate as a sweet treat rather include a fruit. Fruits make a sweet and nutritious contribution to lunch. They are generally rich in vitamin A, vitamin C, fiber and water. Take note of which foods trigger headaches for your child by keeping a diary and avoid these foods. A Dietary Trigger Diary is available on this link free of charge to assist you. Remember to remind your child to eat their lunch as skipping meals is a surefire trigger for headaches. Teach them to eat in moderation and enjoy their meals. Ponytails, braids, weaves, tight hats or headbands  The scalps of headache sufferers are far more sensitive than people who are not susceptible so be mindful of your child’s hairstyle to ensure that it is not contributing to their headache pain. Pulling hair tight can often cause discomfort but this will be relieved as soon as the pull on the hair is relaxed or released. Remember to pack a fruit juice/ dehydration headache Dehydration is a common trigger, adequate intake of fluid throughout the day to prevent headaches. Select 100% fruit juice, not just any soda drinks. Soda drinks contain mostly caffeine and sugar and are low in nutrients. Caffeine has been known to trigger headaches in children and it is also highly addictive. A better choice is 100% fruit juice or water. First day stress headache Having your child feel anxious and stressed on the first day is a surefire way to trigger a headache. Remind your child that he/she is not the only student who is a bit uneasy about the first day of school. Teachers also know that students are anxious and will make an effort to make sure everyone feels as comfortable as possible. Point out the positive aspect of school, such as it being fun and them getting a chance to make new friends. If you feel it appropriate, drive your child to school and pick them up after on the first day. Taking part in sports/ stretching exercises Parent should encourage their children to take part in physical activities at school as these are not only great fun, but also an important part of playing and learning. It is also vital for healthy growth and development. Persuading those children who don’t enjoy organized sport to take up some other form of everyday physical activity will help them stay healthy. Teach your children the right stretching exercises to stretch the muscles of the head, face, neck and jaw. Stretching should be gentle and soothing, not agonizingly painful. Get your children to stretch their neck and jaw muscles carefully and this will give results. For a free copy of the exercises, contact The Headache Clinic on 011 484 0933. These will help them to stretch the neck and jaw muscles carefully, this will give results. When to consult a medical professional If your child’s headache persists, it is imperative that you undergo a multidisciplinary investigation to diagnose the specific factors behind the recurring headache. There are a number of healthier treatment options to medication available right here in South Africa. It is possible to get to the bottom of the problem and resolve the pain permanently without medication so that your child can enjoy the quality of life they deserve. For more information go to www.theheadacheclinic.net alternatively contact The Headache Clinic hotline on 011 484 0933.  

Speech and Audio Inc

Is my child talking the talk?

  Learning to communicate effectively is a complicated process, involving multiple skills that develop concurrently. A child’s speech and language skills develop as they grow from infancy to school age. This development should follow suggested timelines and patterns. When it doesn’t, this can be a worry for parents and is cause for a professional evaluation by a speech-language pathologist. Often, these difficulties can be treated with speech and/or language therapy. Normal speech might seem effortless, but it’s actually a complex process that needs precise timing, and nerve and muscle control. When we speak, we must coordinate many muscles from various body parts and systems, including the larynx, which contains the vocal cords; the teeth, lips, tongue, and mouth; and the respiratory system. The ability to understand language and produce speech is coordinated by the brain.  A number of events must occur for us to speak. The brain MUST:  Want to communicate an idea to someone else  Send the idea to the mouth Tell the mouth which words to say and which sounds make up those words Incorporate patterns and accented syllables (to avoid sounding like a robot) Send the signals to the muscles that control the tongue, lips, and jaw   Language is what we speak, write, read, and understand. Language is also communicating through gestures (body language or sign language). There are two distinct areas of language: receptive (what we hear and understand from others’ speech or gestures) and expressive (the words we use to create messages others will understand).  In order for children to begin using and understanding spoken language, they must:  Hear well enough to distinguish one word from another Have someone model what words mean and how to put sentences together  Hear intonation patterns, accents, and sentence patterns Have the intellectual capability to process what words and sentences mean, store the information, and recall words and sentences heard previously when communicating an idea to someone else Have the physical capability to speak in order for others to hear and understand the words they are saying Have a social need and interest in using words to communicate with others  Have another person to positively reinforce their attempts at communication   Language Disorders483 AGE RED FLAG Birth & Up • does not smile/interact with others 4 – 7 months • does not babble (“bababa”) 7 – 12 months • very few sounds or gestures (pointing) 7 months – 2 years • poor comprehension of what others say 1 1/2 – 2 years • speech is difficult for listeners to understand 1 1/2 – 3 years • does not combine words into sentences 2 – 3 years • difficulty talking to and playing with peers 2 1/2 – 3 years • difficulty with early literacy and writing skills Speech Sound Disorders AGE RED FLAG 1 – 2 years • incorrect production of early sounds /p,b,m,h,w/ in words 2 – 3 years • incorrect production of /k,g,f,t,d,n/ in words 2 – 3 years • speech is unclear, even to familiar listeners Stuttering Disorders AGE RED FLAG 2 1/2 – 3 years • difficulty producing sounds or words 2 1/2 – 3 years • repeats the first sound of words (b-b-b-baby for “baby”) 2 1/2 – 3 years • frequent pauses of silence when talking 2 1/2 – 3 years • stretching sounds out while talking (sssss-silly for “silly”) Voice Disorders AGE RED FLAG any age • hoarse- or breathy-sounding voice any age • nasal quality to voice Hearing Problems AGE RED FLAG birth – 1 year • poor attention to sounds in the environment 7 months – 1 year • does not respond when name is called 1 – 2 years • difficulty following simple directions birth – 3 years • delays in speech and/or language development any age • scratching or pulling at ears school-age • limited academic progress, especially math and/or reading school-age • social isolation and unhappiness at school school-age • discomfort in ears after exposure to loud noise     Encouraging good communication Parents play the most important role in building communication skills in their children. Children develop communication habits by the way they see parents interacting with others. Parents who listen and speak with patience, interest, and attention prove to be the best teachers of listening and give their children the greatest audience in the world. Listening Skills Listening is a learned skill and an essential part of the communication exchange with your child. It is important to model good listening skills when your child is communicating via verbal messages (questions, requests) or nonverbal ones (actions or non-actions). You will be setting a good example for your children, and help them to become active listeners. Active listening is the central component of communication. When parents are active listeners, other people may describe them as having good intuition and as being “tuned in” to their children. The process of active listening will help your child understand feelings and be less afraid of the negative ones. It will also allow them the opportunity to talk about and solve their own problems as well as gain more control over behaviour and emotions. To become an active listener: Set aside time to listen and block out distractions as much as possible. Encourage your child to talk directly to you so you may model the habits of good listening. Some parents and children find they can communicate best just before bedtime or when they share an evening snack. Maintain eye contact while your child talks. When your child speaks to you, show that you are genuinely interested in their thoughts and feelings. Listen to, summarise, and repeat back to your child the message you are hearing. Watch for your child’s nonverbal cues including facial expressions, posture, energy level, or changes in behaviour patterns. The underlying messages may include the feelings, fears, and concerns of your child such as being scared… sad…angry…happy. Accept and show respect for what your child is expressing, even if it does not coincide with your

Parenting Hub

What to do if your teenager is depressed

Growing up can be an emotional rollercoaster, during which a young person has to contend with many high and lows, from school and friendships to puberty and their sexuality. If you have noticed that your teenager seems to be experiencing more lows than highs, and these lows are happening more and more frequently, this may be a sign that they are struggling with depression. It can be distressing to watch your teenager feel constantly sad and low. However, it’s important to know that you’re not alone, and the most important step you can take to help is to seek help.  Here, we provide information on the symptoms of depression in teenagers to look out for, as well as guidance on the ways that you can support them. What does depression feel like for your teenager? Whilst it’s normal to feel sad occasionally, the intense and overwhelming low moods that depression causes can stop your teenager from getting pleasure from things they usually enjoy. This all-encompassing sadness can also prevent them from being able to function and perform daily tasks. We have outlined what depression actually feels like for a teenager to help you understand what they may be going through: For young people, depression can feel like they have a sieve in their head, which washes away all positive reinforcements and keeps hold of all negativity, which they focus on and magnify A teenager may feel like they are wearing a mask in front of friends. They will put on this brave face to cover up how they really feel, as they believe that they will be a burden if they show their real mood. This mask can be exhausting to wear, so by the time they come home they often can’t keep it up, meaning that you are likely to see the true picture Many young people describe depression as being tortured in their head. Anything that they hear gets turned into something negative, and even if they are told by a specialist that their depression is treatable, they believe that they’re the only one that can’t get better Signs of depression in children If you are becoming increasingly worried about your teenager, we have outlined common symptoms that they may be experiencing and warning signs for you to look out for:  Psychological symptoms: Persistent sadness, or low mood  Anger and irritability Crying more than usual Being highly sensitive to bad news or rejection Feeling worthless or guilty Low self-esteem Poor concentration Indecisiveness Feeling empty or numb Self-harming Suicidal thoughts Drugs or alcohol abuse Social symptoms: Social withdrawal Lacking interest in activities they once enjoyed Poor performance and behaviour at school or college Physical symptoms: Insomnia, or sleeping more than usual Frequent headaches and stomach aches Eating more or less than usual Unexplained digestive problems Exhaustion Lethargy Restlessness I think my teenager is depressed – what are the next steps? Talk to your child If you’re worried, sit down with your child and calmly explain that you’re concerned because they don’t seem to be themselves lately. If they’re willing to open up to you, try to find out how they are feeling and what is troubling them, and let them know that you’re always there to talk. If your teenager doesn’t want to talk to you, encourage them to speak to someone else they trust, such as another parent or a teacher.  Take them seriously  If you haven’t experienced depression yourself, it can be difficult to understand what your teenager is going through. Something that doesn’t seem to be a problem to you could be a major issue for your child, which is why it’s important to take them seriously and avoid being judgemental or critical.  Be open and listen If your teenager wants to talk to you about their problems, it’s important to be open with them and listen to what they have to say. This lets them know it’s OK to talk about how they’re feeling, and they’re not alone.  Learn the symptoms By familiarising yourself with the symptoms of teenage depression, not only will this help you to empathise with your child, but will also mean that you are able to spot when they’re going through a particularly difficult time. It can also help you to manage expectations, and understand that it’s possible that things may get worse for your teenager before they get better. Reduce risks Give them the phone numbers for charities such as LifeLine, and encourage them to call if they ever need to. You could also give them useful apps to look at such as Headspace or Mindspot. If they have thoughts about harming themselves, ask them to share those thoughts with you in a way that they feel comfortable with, so you can help keep them safe. They could write their thoughts down, send them in a text message or email, or talk to you about them when they’re feeling calm and perhaps distracted with an activity.  Things you can do to reduce risks include locking away any medication and asking the young person what websites they are accessing online, and talking through whether these are really helpful to them or not.  It’s also important to establish the best way that you, as a parent, can support your teenager. Ask them what you can do to help; they may just want hugs, a distraction such as watching a film with you or not to be left alone at night time.  Seek help It’s crucial to seek professional help if you think your child is struggling with depression. This will ensure that they receive the support they need to prevent their depression from becoming worse. Make an appointment to see your GP; they will be able to recommend next steps.  Also, reassure your teenager that depression is treatable and advise them that it would be worth taking them to a doctor to find out if they have depression, and if so, to get them the right support. Dr Hayley van Zwanenberg

Disabled Parents

Give Your Special Needs Child the Best Future Possible

When you’re told that your child will be born with a mental or physical disability, the news can be crushing and leave you with many doubts. Will you be able to provide for them? Will their childhood be as full of joy as the other kids? Will you have the stamina to carry on when the going gets tough? The answers are yes, yes, and yes. Though you’re facing the greatest challenge of your life, you can see it through with plenty of love and the right preparation. Here are some things to do before your baby arrives in this world. Research Their Disability How you get ready mentally, physically, and financially depends on the nature of your child’s disability and what obstacles they will face growing up. A good place to start your inquiries is Parent to Parent USA. Not only will you find a treasure trove of information on conditions ranging from blindness to mobility impairment to Down syndrome, this organization will put you in contact with other parents who have already faced the same challenges. Look Into Financial Aid Read up on the Individuals With Disabilities Education Act, or IDEA, which is a federal law that guarantees your child access to early intervention, special education, and related services from birth until adulthood. These include therapy sessions either at home or in the community to aid in the development of motor, cognitive, and communication skills needed to thrive during their infant and toddler years. Grants are available through agencies in each state. Find Support From Nonprofits There are also a number of charity organizations that are ready to step in and offer assistance when federal aid is insufficient. Many of these are devoted to children suffering from specific conditions such as autism, while others, like the Legacy of Hope, offer access to exciting activities outside of education such as art classes, music lessons, and even horseback riding, helping to ensure a well rounded and enjoyable childhood. Begin Navigating Health Insurance Thanks to recent health care reforms, insurers cannot deny coverage to children under the age of 19 based on pre-existing conditions including disabilities, according to the experts at Allied Wealth Partners, adding that you have 30 days after the birth of your child to add them to your health plan. Speak with your insurer to find out which physicians and providers are in-network to reduce out-of-pocket expenses. Depending on your income, you may also qualify for Medicaid or Supplemental Security Income. Set Up an Emergency Fund There will be items that you have to pay for yourself. Luckily, more and more states are offering residents as well as non-residents the opportunity to open a tax-advantaged ABLE account for any disabled person under the age of 26, with contributions limited to $14,000 per beneficiary per year, according to finance magazine Kiplinger. This money can be withdrawn tax-free and used to cover medical treatment and other expenses. Prepare Your Home You’ll need to make some modifications to ensure that your child is safe and can move around comfortably. If they’ll be confined to a wheelchair, then begin your research into options for improved accessibility, such as wheelchair ramps, which cost $1,604 on average. Other renovations include grab rails in the bathroom as well as a roll-in shower to make washing up easier at the end of the day. Contact local professionals to get an estimate in your area. Take Care of Yourself Giving your child the support and attention they deserve is impossible if you are tired and strung out. Begin a regimen of self-care now to ensure you’re in the best possible condition when the parenting begins. That, above all, means a balanced diet, plenty of exercise, and a good night’s rest, as well as techniques for relieving stress such as meditation or yoga. There’s a lot of work to be done, but rest assured that there are ways to overcome the obstacles that you and your child face. It just takes love and courage, and you’ve got both in spades. 

Parenting Hub

SUNUMBRA P – Embrace the sunshine

Sunumbra P is a Natural Sunscreen with Organic Ingredients and a core purpose to make a difference inpeople’s lives as well as the environment by embracing the sunshine. Don’t damage your skin with chemicals to avoid getting sunburnt. Zinc Oxide, as a mineral sunscreen, is 100% natural, provides a high level protection for both UVA and UVB, plus has excellent healing qualities. Three of the great Sunumbra P sunscreens available: Sunumbra P Sport SPF 40+ (RSP: R265.00) Sunumbra sport is a natural sunscreen containing organic ingredients that is specially formulated for the active outdoors person Sunumbra sport is a natural sunscreen containing organic ingredients that is specially formulated for the active outdoors person to ensure… 5 Star rating (UVA) SPF40+ (UVB) Fully certified ISO/COLIPA for UVA & UVB Water resistant 40 minutes High protection Broad Spectrum Sunumbra P Sunkids SPF 40 (RSP : R299.00) •Protects against UVA and UVB light at the highest level•Contains natural, organic, photo-protective botanicals •Contains the powerful anti-radiation properties of zinc oxide •No harmful chemicals •Dermatologically tested and approved •Specially formulated for children and people with sensitive skin•A tinted sunscreen using natural botanicals containing pigments•Tested on human skin only, not animals •PH in balance with children’s skin •Can be used by anyone with a dietary or environmental concern Sunumbra P SPF 30+ (RSP : R299.99)Natural sunscreen ● Organic ingredients ● SPF 30+ (UVB) ● 5 ***** UVA rating (highest level) ● Free of Parabens ● 100% Free of harmful Chemicals ● A tinted sunscreen using natural botanicals containing pigments● Not tested on Animals ● No Animal derivatives ● Water resistant ● Developed, Formulated and manufactured in South Africa Tip: As this is a tinted sunscreen, any clothing stains that may result from the natural oils can be removed by simply applying dish washing liquid directly to the stain (because regular laundry detergent does not contain oil-removing properties), then launder as normal. Why you should choose and natural sunscreen? Natural and organic preservatives do not damage your health. Commonly used Parabens are endocrine disruptors mimicking estrogen, upsetting hormone balance, plus are carcinogenic. No Petrochemicals or Mineral oils: they clog up skin pores, trap toxins, slow skin cell growth, disrupt normal hormonal functions, rob bones and the nervous system of magnesium, can be estrogenic, plus absorb oil soluble vitamins A, D, E and K from you and then excrete them. Natural Colorants are non-toxic – vs toxic Synthetic ones Natural organic ingredients smell delightful. Added Fragrance can be toxic. Avoid unnatural Polymers for Water Resistance, which coat the skin and prevent it breathing Many Organic plant extracts provide Anti-oxidants, which protect against free radical damage and atmospheric toxins, eliminate chemical reactions, and repair skin cells. Direct benefit from every ingredient. No fillers are required to counteract negative reactions to chemicals. Reverse sun damage. Switching from toxic chemical sunscreens to non-toxic sunscreens with added organic ingredients, you can possibly reverse some existing sun damage What chemicals to avoid and what are their potential health risks: Octinoxate (Octyl Methoxycinnamate): gender bending (estrogenic) Oxybenzone (Benzophenone-3): allergic reactions and hormone disrupting. Avobenzone (Butyl Methoxydibenzoylmethane): becomes toxic in sunlight! Octocrylene: potentially carcinogenic! Homosalate: Hormone disruptor; forms toxic metabolites Padimate O (Octyl Dimethyl Paba / Paba Ester): releases free radicals; damages DNA; estrogenic and allergic reactions. Ensulizole (Phenylbenzimidazole Sulfonic Acid: potentially carcinogenic! Mexoryl SX: Degrades 40% in sunlight, produces reactive oxygen species. Octyl Salicyclate: penetration enhancer; allows other chemicals into blood. Benzophenone (Sulisobenzone): irritates skin & eyes. Penetration enhancer. Avoid toxic cosmetic ingredients. A healthy lifestyle is vital to combat toxins from modern industries. Choose cosmetics with healthy ingredients and avoid these toxic ones: Sodium Laurel, Lauryl Sulfate, or Sodium Laurel Sulfate: Combined with other chemicals this becomesNitrosamine, a powerful carcinogen, which penetrates the skin’s moisture barrier, allowing chemicals in.PEG (Polyethylene Glycol), Polysorbates, or Ethoxyylate alcohol: all contain dioxane, which is carcinogenic and probably one of the most potent toxins known to man. Propylene Glycol: can cause dermatitis, kidney or liver abnormalities, skin growth prevention, or just plain irritation. Phenol Carbolic Acid: Can cause circulatory collapse, paralysis, convulsions, coma, and even death from respiratory failure. Acrylamide: Can cause breast cancer Toluene (Benzoic; Benzyl or Butylated Hydroxtoluene): can cause anaemia, low blood cell count, liver and kidney damage and birth defects.

Bonitas – innovation, life stages and quality care

Medical aid unpacked

When it comes to medical aid, affordability is usually the biggest consideration.  However, monthly premiums should be weighed and balanced against the actual benefits and healthcare coverage being offered in order to make an informed decision.  The biggest question around medical aid costs is why healthcare inflation is rising at such an alarming rate and how schemes deal with this. ‘Currently, medical inflation is outpacing general economic inflation by between 3 and 4%,’ says Gerhard van Emmenis, Principal Officer of Bonitas Medical Fund.  ‘And while the jury’s still out in the form of the Health Market Inquiry into the private healthcare sector, fingers are being pointed at all role players from private hospitals and specialists to medical schemes.  However, you need to remember that the former are all about the bottom line, while medical schemes are not-for-profit.’ Consumers, unable to make Rands or sense of the many plans available and what they’re actually offering, are often tempted to migrate to what is perceived as a more affordable plan, but with less coverage.  ‘Comparing the average percentage increase in isolation is not an indicator of the value of the healthcare being provided,’ says Van Emmenis ‘We urge consumers to compare monthly contributions with the benefits to ensure they are getting the cover they need.’ He maintains that simply comparing the average percentage increase announced by the various schemes is not a litmus test for value for money, since it does not take into account the basis on which the increase applies.  Here is a simple maths example:  Two schemes offer the same benefits however, Scheme A costs R1 000 pm while Scheme B costs R1 100pm. If Scheme A announces a 10% increase  (R1 100pm) and Scheme B announces a 7% increase (R1 177) but neither change or increase the benefits, then Scheme A is still providing the same benefits, at a lower cost, even though it announced a higher contribution increase.  ‘That’s why it’s important to compare the actual benefits and contributions rather than only looking at the percentage increase,’ says Van Emmenis. This is where a Broker can be invaluable. While consumers are becoming more savvy and educated on the inner workings of the medical scheme industry there is confusion. Brokers assist consumers by making informed recommendations that take into account their specific needs. They also play a vital role in education around the offerings, how to maximise your benefits, how to benefit from Managed Care, both financially and in terms of quality of life, various healthcare terminology and assisting members with claims. Van Emmenis explains that schemes with a growing membership base will require additional loadings in the monthly contributions to increase the reserves in order to meet the statutory solvency requirement of 25%. ‘This is a legislative requirement and does not imply the scheme is performing poorly – in fact the opposite is true in this context,’ he says. According to data released by the Council for Medical Schemes (CMS), the market has not been successful in attracting young, healthy people who are less prone to chronic health conditions like diabetes or hypertension: Lifestyle diseases that adversely effect of the pool of contributions. The increasing age of beneficiaries is also a huge concern. The CMS reported that the industry average beneficiary age increased from 31.9 years in 2013 to 32.5 years in 2016. The pensioner ratio increased slightly to 7.9%, with a general rise in the ratio for both males and females.  Schemes with an ageing membership base generally experience increased claims costs, in excess of inflation, due to the higher use of benefits. ‘We have seen around a 2% increase in claims by members annually as they age,’ says Van Emmenis.  ‘In addition, all chronic conditions, except Type 1 Diabetes, have shown an upswing, ‘says Van Emmenis. ‘These conditions are PMBs that need to be paid in full by all schemes. So, although the regulation is well intended, it is without doubt one of the factors driving up the cost of healthcare. At the same time, there have been particularly steep increases in the cost of specialists and hospitals, which together account for more than 61% of total claims paid.’ Runaway healthcare costs are difficult to contain because of a myriad of contributing factors.  Most rooted deeply in a complex health system where much of what happens is beyond the influence of the schemes. Take for example the over-regulation in the form of exclusion from collective bargaining by the Competition Commission. This leaves schemes with no option but to negotiate individually with service providers, blocking the development of a more efficient and cost-effective healthcare sector.  Open enrolment also impacts costs as schemes have to accept anyone who wishes to join, regardless of their health status, which does maximum damage to risk equalisation.  So what is the best approach for medical schemes going forward? Van Emmenis says that schemes need to continue to explore and implement cost containment strategies and offer value for money to members. ‘Access to quality healthcare remains a concern and priority for the majority of South Africans. Our mandate has always been to provide quality healthcare at affordable prices and this will continue.’

Parenting Hub

Food’s influence on childhood behaviour and learning

Worldwide, allergies are on the rise, and in South Africa a staggering 40% of sufferers are children, according to the Allergy Foundation of South Africa – affecting quality of life and learning potential. The problem, and solution, to common allergy symptoms, says world-renowned nutrition expert Patrick Holford, is diet. “One in three children with behavioural problems have allergic reactions to foods. Other than overt physical reactions, individual food allergies can affect thought processing and cause irritability, agitation, aggressive behaviour, nervousness, anxiety, ADHD, autism, hyperactivity and learning disabilities,” says Holford. A trial study conducted by Dr Joseph Egger, head of the Pediatric University Hospital in Munich, Germany, and his team in 1985, which studied hyperactive children to find out whether diet could contribute to behavioural disorders, found that 79% of the children participating reacted adversely to artificial food colourings and preservatives, but also found that different foods produced the same symptoms in different individuals. “In the 1980s, researchers found plenty of evidence that allergies affect any system in the body and are behind a diverse range of symptoms, yet this research has largely been ignored since,” says Holford. Patrick Holford is a pioneer in new approaches to health and nutrition, specialising in the field of mental health. Having suffered throughout his childhood and adolescence with migraines, sinus infections and ear infections, Holford sought a solution and discovered that his troubles were due to milk and yeast allergies. “The truth is that the majority of people are likely to suffer for years not knowing that they have an allergy – but also not knowing how to treat it,” says Holford. Not to be confused with an intolerance or sensitivity, an allergy is an exaggerated physical reaction to a substance where the immune system is involved. As our personal defence system, the immune system releases chemicals when it comes across a substance it doesn’t like. The chemicals released by the immune system in response to an allergy result in symptoms such as mood-, attention-, memory- and intellectual impairments, as well as behavioural problems, overt physical ailments and delayed reactions that make pinpointing the allergy difficult. Other symptoms of a food allergy include nausea, cramps, flatulence, fatigue, throat trouble, sweating, skin rashes, acne and boils, migraines, apathy and confusion, depression, and paranoia. “The good news is that you can grow out of most food allergies and reduce your child’s allergic potential,” says Holford. According to Holford, the best way to prevent and reduce allergic potential in your child is to stick to the following dietary guidelines: Completely remove wheat and dairy products from their diet for a month or so and see if their symptoms improve. Have an IgG ELISA food allergy test done and see a nutritional therapist. Improve your child’s digestion by including plenty of fresh fruit, vegetables and seeds in their diet. Ensure you keep antibiotics and painkillers to a minimum, as they damage the digestive tract. Include fish in their diet to ensure that they are getting sufficient Omega 3 oil, Zinc and Vitamin A. Avoid foods containing chemical food additives. The most common ones to look out for are aspartame, tartrazine and MSG. Eat whole, natural foods as much as possible. Choose organic food (free from pesticide residues).   For further information on food allergies, nutrition and childhood behavioural problems, visit www.holforddirect.co.za.

Bonitas – innovation, life stages and quality care

Medical Aid choices

It’s business as usual for medical aids… While the NHI remains a work in progress in terms of policy and planning, currently nothing changes in terms of medical aid schemes. As the NHI White Paper stipulates: Until the new system is fully implemented and operational, it is ‘business as usual.’  And, even when NHI is implemented, medical aids will still exist.  According to Gerhard van Emmenis, Principal Officer of Bonitas Medical Fund, South Africa’s second largest open medical scheme, one of the changes that will be seen once the NHI is a fait accompli, will be a decline in the number of medical schemes. ‘From what I understand, and we are talking of the future, there will be three or four medical aids which will serve as complementary health product providers and fill the gaps left by the NHI.’ Medical Aid ‘launches’ will go ahead in September – when schemes announce amended plans and premium increases for 2019.  Costs of medical aid It is also the time when new members sign up and existing members scrutinise and review their existing cover, whether it’s a full medical aid or hospital plan.  Medical aid may seem like a grudge purchase until you find yourself faced with unexpected and expensive medical cost. Unfortunately, healthcare inflation continues to outpace general inflation by about 5%. So while consumers are struggling in the economy generally, medical aids have to explore ways to contain costs without compromising the level of health care offered to members. Time to scrutinise the small print The medical aid landscape can be tricky to navigate so it’s important to compare all the available options and schemes to make sure you find a medical aid that works for you and your family’s health and is within your budget. Bonitas offers some advice on what to look out for and consider ahead of making a final decision.  If you are already on an existing medical aid  Before you decide on the best medical aid option, you need an idea of what your typical health care costs are. Reflect on the following over the past twelve months: How much you spent on day-to-day healthcare expenses  Were you or any of your dependants admitted to hospital  Did you need to visit a specialist regularly  How often did you visit a GP Do any of you have any chronic conditions How much do you spend on dentistry, optometry and over-the-counter medicine  Did you exhaust your day-to-day benefits and/or savings in the year How much did you pay in co-payments and/or deductibles Then consider which of the expenses listed above were once-off and won’t come up again soon (such as childbirth) and which are likely to come up again and again (such as flu).  Empowering yourself with information Also take the time to read the information sent to you by the scheme and/or your broker to ensure you understand what it being offered so that you can make informed choices.   The day-to-day detail for new or existing members Often the cost containment measures medical schemes apply for the day-to-day benefits are broad. So investigate, or bear in mind, the following: Does your medical aid contract with hospitals, doctors and specialists and, if so, are you willing to use them and are they close by? Using contracted or network providers usually means obtaining full or improved cover levels. It also helps ensure you are getting more value for money as doctors on your medical scheme’s network will not charge more than the rate agreed with your medical scheme. Must you be referred to a specialist by your GP? Does your medical aid offer additional GP consultations, which they will pay for, after you have exhausted your day-to-day benefits?  Additional benefits Ask what supplementary benefits might be available that can potentially save significant day-to-day expenses. These could include the following: Preventative care benefits, ranging from basic screenings (blood pressure, cholesterol, blood sugar and body mass index measurements) through to mammograms, pap smears, prostate testing. In some cases this extends to maternity programmes, dental check-ups, flu vaccinations and more. These usually require authorisation from the scheme, failing which they are simply met from your day-to-day benefit limits.  Ways to get more value for your money Use generic medication wherever possible – ask your doctor and pharmacist about this Try to keep your claims within any specified sub-limits, e.g. optometry Find out if your option has any day-to-day benefits that are paid by the scheme from risk (not from your day-to-day sub-limits or savings) 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 has the largest GP network in the country.  Age impacts your decision If you have young children, ensure that the medical aid option you select provides sufficient child illness benefits Check the maximum age of child dependents.  Some allow students to remain on the scheme until they are 25, while others cut off at 21 or 23 However, if you are slightly older, then check that the option you select covers chronic conditions and provides sufficient in-hospital cover in the event of hospitalisation. Also keep an eye out for programmes that help you to manage chronic conditions such as diabetes and cancer.  Ensure the affordability of the medical aid plan selected When comparing the different medical aid options available, consider all the costs involved before you make your final decision, such as: Affordability of the monthly contributions given your monthly income and expenses.  As a rule of thumb, your medical aid contributions should be around 10% of your monthly income at an individual or household level As a general rule, the lower the cost of the option the fewer the choices available to the member regarding medical treatment, healthcare providers and medications. However, this can greatly benefit people who have very limited resources available to them for healthcare, or for people who don’t have chronic and existing

Speech and Audio Inc

Exploring Middle Ear Infections

What is a Middle Ear Infection?  A Middle Ear Infection (also referred to as Otitis Media by healthcare professionals) refers to an infection, inflammation or fluid build up behind the eardrum.      Middle ear infections can either be acute or recurrent in nature. Recurrent Otitis Media is defined as 3 or more separate episodes of Acute Otitis Media within a 6 month period.  Otitis media with effusion, also known as ‘glue ear’, describes fluid that remains in the middle ear after the infection has resolved. It is usually not painful, but does affect the child’s hearing ability. Middle Ear Infection is the most common childhood illness and is very common in children aged between 6 months and 4 years. This is due to the Eustachian tube being shorter and more horizontal than it is in older children and adults. The Eustachian tube is meant to help equalize the pressure in the middle ear and drain the fluid in the middle ear – when fluid cannot be drained and stays in the middle ear it is likely that it becomes infected. Who is at risk for Middle Ear Infections? Children aged between 6 months and 4 years  75% of children will have at least one middle ear infection by the time they are three years old. Nearly half of these children will have three episodes by the time they are three years old Children who are bottle fed while lying flat When children are being bottle fed, they should be propped up at a 20 degree angle, at least. This ensures that the milk does not flow back into the middle ear Children who have not been breast fed Children with prolonged dummy use Children exposed to smoke Family history of Middle Ear Infections Children with allergies Children who are more susceptible to colds and flu specifically those prone to sinus infections Symptoms of a Middle Ear Infection Hearing difficulties Ear pain Tugging of one or both ears Difficulties sleeping Fever Loss of balance Irritability Discharge from the ear  What should I do? When should I get help? Most cases of acute Middle Ear Infections should resolve by themselves. It is recommended that the child is treated for pain for the first 48 hours, however, if they symptoms worsen or do not improve then it is recommended that the child be seen by a doctor. The doctor will generally prescribe antibiotics. It is extremely important to complete the course of antibiotics.  A child who has any discharge coming from their ear should see a doctor immediately.  If your child has had multiple cases of Middle Ear Infections it is recommended that you take your child to an Ear Nose and Throat Specialist (ENT), who will decide if grommets are necessary.  Your child having grommets inserted is a relatively simple procedure that places small ventilation tubes within the ear drum. The grommets allow for drainage of fluid in the middle ear, let air into the middle ear as well as equalise the pressure between the middle ear and the ear canal.  All children who have suffered with Middle Ear Infections should be taken for a full diagnostic Audiological evaluation with an Audiologist once the middle ear infection has been resolved.  What to expect from an Audiologists visit The audiologist will conduct a full comprehensive Audiological evaluation which will include an in-depth evaluation of your child’s outer ear, middle ear and inner ear. The Audiologist will complete the following examinations: Otoscopy An Otoscopic examination is used to visualize the ear drum. During this assessment, the audiologist will be able to see if there is still presence of a Middle Ear Infection or if the ear drum has burst during the ear infection.  Tympanometry Tympanometry is an examination used to test the middle ear volume and pressure. During this assessment the Audiologist will be able to see if there is a middle ear infection present, if the ear drum is intact and if the pressure in the middle ear is normal.  Audiometry The Audiologist will then conduct a pure tone audiometric examination. During this test, the audiologist will be able to determine your child’s current hearing ability and if any damage has occurred to your child’s hearing by the ear infection.   Middle Ear Infection complications  The following complications may arise from Middle Ear Infections: Burst ear drum In severe cases of Middle Ear Infections the fluid build-up puts too much pressure on the eardrum and subsequently causes the ear drum to burst (hole in the ear drum). This can either heal by itself over time or the ENT may deem surgery necessary to repair the hole.  Delayed speech and language During an ear infection the child’s hearing is reduced by 24-45 dB. Their hearing is similar to how you hear while under water or with foam earplugs in your ears. This is a crucial time for speech and language development. If a child is not getting adequate speech and language input due to their decreased hearing, their speech and language development may become delayed. In these cases, it is important to seek professional help from a speech-language pathologist as soon as possible.  Permanent hearing loss In some cases when there have been too many occurrences of Middle Ear Infections or the damage from the infections is too extensive, it may cause permanent hearing loss. In these cases a hearing aid may be beneficial. It is important to seek professional help from an Audiologist as soon as possible Prevention of Middle Ear Infections Never bottle feed your baby, while they are lying flat Avoid exposing your child to second hand smoke Keep up to date with your child’s recommended immunisations Although some preventative measures can be taken, it is important to note that if a child is susceptible to Middle Ear Infections, there is very little that can be done to completely avoid them. If you are worried about your child’s hearing or speech development, it is important to consult a medical

RediscoverDairy

Why breakfast really is the best way to start your day

The importance of breakfast has long been a part of the prevailing wisdom, and the habit of eating breakfast has always been a marker of a healthy lifestyle.  Yet, if there’s a meal that is going to be skipped, it’s probably breakfast; and this is a pity because research clearly shows that there are many vital health benefits associated with eating breakfast regularly.  Studies show that 1 in 5 South African children skip breakfast. For the first time, a broad coalition of health partners including leading non-profit organisations, health professional associations as well the National and Provincial Departments of Health, have aligned National Nutrition Week (9 – 15 October 2018) with National Obesity Week (15 – 19 October 2018) to promote a shared and very important message that eating breakfast is the best way to start your day. After our longest fast, a healthy breakfast kick-starts the metabolism, lights up mental functioning and boosts physical energy on a day-to-day basis.  However, the health benefits of breakfast are not just experienced over the short-term.  Studies show that eating a healthy breakfast regularly over the long term helps to reduce risks of heart disease and stroke, high blood pressure and Type 2 diabetes.  This correlates with studies that show that children, adolescents and adults who eat healthy breakfasts regularly have better, sustainable weight outcomes and are at a lower risk of becoming overweight and obesity. “It is ironic that one of the common reasons for skipping breakfast is the desire to lose weight when it has the opposite effects,” says Rebone Ntsie, Director: Nutrition at the National Department of Health.  “The lack of breakfast leads to a far greater risk of compensating with unhealthy snacks to get through to lunchtime and with bigger lunch portions.”  Ntsie points outs that, according to the 2016 South Africa Demographic and Health Survey, 68% of women and 31% of men in South Africa are overweight or obese. Life-threatening, severe obesity affects around 20% of women and 3% of men.  Approximately 13.3% of children under 5 years of age are overweight or obese; and according to the 2012 South African Health and Nutrition Examination Survey (SANHANES), 14.2% children aged 6 to 14 years are overweight or obese. CEO of the Heart and Stroke Foundation South Africa, Professor Pamela Naidoo says: “At least 80% of early deaths caused by heart disease and stroke can be avoided by following a healthy diet, which includes eating a healthy breakfast, in combination with regular physical activity and avoiding the use of tobacco.  It is important to understand how the food choices we make contribute to overweight and obesity.” Many South Africans consume large amounts of sugary drinks and eat a lot of  convenience foods that are typically high in sugar and fats.  There’s also a common preference for highly refined starchy foods over those that are minimally processed and healthier.  Taking in too much food energy from nutrient-poor foods leads to weight gain. However, making poor food choices is not the only issue.  Professor Naidoo points out that our modern lifestyles easily lead to ‘portion distortion’.  “Large portion size is also a major contributor to weight gain whether people eat out or at home,” she says. “With a gradual increase in the amount of food being purchased and served ready cooked, many people can no longer recognise the size of a healthy portion.”   Lack of knowledge and poor food choices lead to unhealthy diets, which are a risk factor for non-communicable diseases.  Dr Christine Taljaard-Krugell, ADSA (Association for Dietetics in South Africa) President, points out the importance of engaging with a registered dietitian to help make healthy breakfasts a habit for the whole family.  “Other reasons so many South Africans skip breakfast include food not being available, it not being a family routine, time pressure in the mornings, not feeling hungry or not liking typical breakfast foods.  From food budgeting to menu planning and meal preparation, there are solutions to all these issues.  Information and help are available.” What should a healthy breakfast consist of? Breakfast should consist of at least one food group (excluding beverages). However, to stay fuller for longer and improve the variety of nutrients you take in at breakfast, it helps to include foods from three or more food groups. A rule of thumb is to choose a minimally processed starchy food combined with a food from at least one of the following groups: vegetables or fruit dry beans, lentils, split peas, soya fish, chicken, lean meat or eggs milk, maas or yoghurt plant oils, soft margarine, peanut butter In addition, it is important to drink clean safe water instead of a sugary drink. The ‘breakfast is the best way to start the day’ campaign offers some key messages to inspire making a healthy breakfast a long-lasting habit and family routine: Be ‘breakfast ready’ and beat the morning rush – Breakfast doesn’t have to be a big production – with some planning and preparation, it can be quick and easy.  Before you go to bed at night, set up your kitchen for breakfast.  Soak the oats and slice the fruit so you don’t have to do it in the morning. Cook extra maize meal porridge for the next day’s breakfast when making supper, or boil some eggs the night before.  Make it healthy and enjoyable – “It’s easier to make breakfast a daily habit if you enjoy it,” says Carol Browne of the Nutrition Society of South Africa (NSSA).  “While our cultures may define what breakfast foods are, there are really no hard and fast rules.  It doesn’t matter whether you eat the same things as others for breakfast – it just matters that you have a healthy start to the day.  This means having a minimally processed starchy food, as part of the meal, and combining it with food from at least one other food group.” For example, maize meal porridge with maas and an apple; brown bread with pilchards and sliced tomato; Last

Ali Samuels

How to Treat Poison Ivy Rashes

Poison ivy has grown more toxic than ever before, making your family time outdoors a potentially big hazard for your children. Fortunately, kids are no more susceptible to poison ivy than adults, and the symptoms they experience are exactly the same. Here’s some tips on how to keep you and your family safe from the effects of poison ivy. How It Makes Your Child Sick The urushiol found in poison ivy is what causes trouble. This substance is found in every part of the plant and has no tell-tale warning signs of its presence: it’s odourless and lacking colour. The only physical sign is its sticky, sap-like consistency, something that can really only be recognised once contact is made. Even brief contact with urushiol can cause a rash that lasts up to three weeks. But touching poison ivy itself isn’t the only danger. Urushiol can be transferred from animals or even clothing that has come into contact with the oil. The best way to protect your children from poison ivy is to teach them about its appearance. The old line “Leaves of three, leave it be!” is enough for little ones, but if you wish to be vigilant yourself you’d do well to learn more specifics about the plant. How To Tell Your Child Is Afflicted Contact may not be immediately recognised. That’s because it can take one-to-three days for the earliest symptoms to appear. Once they do, you’ll notice a pattern on your child’s skin based on how the urushiol touched them. It’s when blisters, swelling, itchiness, and inflammation occur that your child will need special attention. Even a small amount of the plant’s oil can cause rashes, and your child may not be able to resist the urge to itch. If they do itch, they risk spreading the rash to other areas of their body. These symptoms will pass naturally in a few weeks. However, if the symptoms worsen, impact your child’s ability to breathe, if they have a fever, or if the rash covers over half of their body, seek professional medical treatment as soon as possible, as these symptoms may be caused by heightened sensitivity. If poison ivy is burned and the smoke inhaled, or if the plant is ingested, these symptoms affect the lungs, digestive tract, and other internal organs. Such cases require emergency medical treatment and could prove fatal if left alone or addressed improperly. The More You Know, The Safer You’ll Be As the old saying goes, “Prevention is the best medicine.” If your child loves the outdoors, make sure they wear long-sleeved cotton shirts and pants to limit the amount of exposed skin. If you suspect your child has come into contact with poison ivy, thoroughly wash the affected part of their body with warm, soapy water as soon as possible. You can wash away the urushiol up to fifteen minutes after exposure and eliminate the risk of rash. If a rash does ensue you can start treatment at home by alleviating the itch with cool baths, ice packs, over the counter pain relievers, and calamine lotion. It is absolutely necessary that your child understands not to itch the rash! In severe cases where the pain is too much, a doctor can prescribe steroid creams. Though most cases aren’t serious, exposure to poison ivy can still be painful and traumatic for a child. Through education both you and your children can be more alert to the dangers posed by poison ivy and will be better prepared to handle any incidents resulting from exposure.

Parenting Hub

Is Stress Holding Your Teenager Back?

Teenagers grow up and eventually become the parents of teenagers!  The circle of life is such that we forget, often with some relief, what it was like to deal with the stressful challenges of our changing bodies, academic expectations and social interactions when WE were teenagers.  Cindy Glass, Director and Co-founder of Step Up Education Centres explains “The reality is that long-term, unchecked stress can lead to the greater challenges of anxiety, depression and negative behavioural choices in our teenagers.”  Cindy looks at this important subject in greater detail… 1. What causes stress in teenagers?  Teenagers are complex, over-thinkers by nature.  It is not surprising then, that what may seem to us to be a minor challenge, could indeed be a cause of debilitating stress in our teenager! Negative body, and self-image. School pressures, these can be social or academic. Making mistakes (including poor behaviour choices) and the fear of failure. Financial or personal concerns arising from their families. 2. What are the signs of excessive stress in teenagers? They start sleeping too much or too little. They experience panic attacks. They can start acting aggressively or withdrawing from activities that they once enjoyed. Fatigue that affects normal activities. Stressed teenagers tend to eat way too much or way too little. This would be out-of-character. Regular mood swings, crying and angry episodes can indicate excessive stress. 3. How can you help? Non-judgemental communication is key!  Aim to listen to understand!  Listen to support and help them find positive solutions. Challenges are a part of teenage life and cannot be avoided, just make sure your teen knows that you are the go-to person they need! Encourage your teen to exercise regularly and to make healthy nutrition choices.  A healthy, fit body can weather many-a-stressful-situation. Teach emotional intelligence skills: self-awareness, self-regulation, self-motivation, empathy and social skills are essential in developing positive body- and self- image.  These skills will also help your teenager navigate the complexities of interpersonal relationships!  Know that mistakes are inevitable. Speak of mistakes being learning opportunities and help your teen to find positive solutions. Discuss perspectives.  It is essential to understand that everyone is coming from his/her perspective and that, so often, upsetting encounters with others is as a result of their experiences and perspectives of life in that moment.  Remember, if you have not caused the negative encounter, it is not your stuff!  4. When would you need to seek expert help? Seek immediate professional help if your child is having suicidal thoughts. Seek help if the symptoms of stress are not subsiding or if they are getting worse.  Cindy explains “Stress can be a two-edged sword.  It can motivate us to positive action, and it can result in potentially serious emotional and physical challenges if it becomes long-term and excessive.  Watch for the latter and aim at seeking ways to ease the effects of negative stress in your teenagers!” 

Toptots Head Office

Sensory Diet

As a parent you are very aware of giving your toddler a balanced diet.  Five fresh fruit and vegetables a day are what we are aiming at. How many of us even consider that we need to give them a varied sensory diet as well? Creating a sensory rich environment for your toddler will help them strengthen their bodies and their brains. Mature thinking and learning are based on neural pathways that develop as a child masters physical coordination, balance and skilled movement.  Yet many parents view “child play” as an outdated activity.  We live in a digital age- let them master computers, electronic games so they may conquer the universe!  How wrong they are! We need to get our children back to the games we played, back to exploring a three dimensional world where they get full of mud and run and jump in puddles. Let’s look at Emily, a four year old. She is a bossy little girl who tells her parents what to do. She is a fussy eater that would eat yoghurt all day if she could, refuses to dress herself and does not play well with other children. If they brush against her, she pushes and shoves. If she shows affection she hugs too tightly. Dad thinks she needs stronger boundaries from Mom.  Mom feels she is just expressing a strong will. At school Emily never likes to play with blocks or draw. When she does use the crayon it is with hard strokes which often break the crayon frustrating her even more.  When Emily runs, it is with a clumsy gait and she often falls.  At the end of the day she is tired and irritable. Is Emily just being naughty or is there more to this behaviour? Research done with children showing similar patterns indicate that this may be a sensory processing disorder. This is a common but very misunderstood problem that affects behaviour, influences the way children learn, move and relate to others and feel about themselves.   Emily needs to learn how to modulate her senses in order to cope with day to day life. She exhibits this bad behaviour when she can’t cope with what’s happening around her, when she feels overwhelmed.  So how do we help Emily and all the little ones like her? What we need to do as parents is to focus on developing and maintaining a balanced sensory diet for our children. As they develop and grow we need to relax and think about incorporating sensory experiences in to their day to day life. Let’s begin by looking at tactile stimulation.   A child can be hyper or hypo sensitive to touch. In both cases it will affect learning and the way we interact with people. Emily might be hypo sensitive, hence she pushes or hugs too hard. Not everyone realises that we have internal senses as well, called the near senses. These play a vital role in our development especially in the early years. Movement is the only way to stimulate this internal sense.  Emily needs more movement to help with her balance. Smell and taste are interlinked. Expose them to different smells and let them explore different tastes, even ones they don’t like.  Emily is sensitive to the textures of her food and that could be the reason that she is a fussy eater. The eyes and ears are the senses that can give us the most problems later. If we don’t process what we see and hear we have auditory or visual processing problems which lead to learning difficulties at school. Emily finds the noise of the classroom too much and prefers to be on her own. For this week don’t just think five fresh fruit and vegetables think five sensory activities to enrich their learning experience.

Parenting Hub

MySchool sponsors children’s diabetes camp

Life is never the same again for children and teens diagnosed with Type 1 diabetes. Diabetes is  one of the most prevalent diseases in South Africa. Type 1 diabetes which occurs mainly in children and young people,  is an autoimmune disease, where the insulin producing cells in the pancreas are destroyed by the bodies own immune system. It s chronic, life-threatening and exceptionally demanding in its daily treatment regime.  With a major organ, the insulin-producing pancreas, in fail-mode, the patient has to manually replace its functions 24/7.  To function normally; to avoid complications and death, a child with Type 1 diabetes is subjected every single day to a minimum of 3 to 5 insulin injections, 6 finger-pricking blood glucose tests and a rigidly-controlled diet.  It is a disease management programme that severely taxes the self-discipline and emotional resilience of most adults.  There is little wonder that it is often overwhelming for a child who is still developing on all fronts, and often very taxing on  the entire family.  Worldwide, one of the most effective strategies for helping children and teens diagnosed with Type 1 diabetes is camps that bring them together for education, care and solidarity. This is why the MySchool fundraising programme decided to sponsor the latest Children’s Diabetes Camp organised by non-profit organisation, Diabetes SA in association with the Diabetic Clinics of the Tygerberg, Groote Schuur and Red Cross Children’s hospitals. Thanks to MySchool supporters, 50 children and 20 nurses and leaders enjoyed an action-packed three days that combined vital education with fun and comradeship.  “Children with diabetes have very challenging lives,” says Margot Mc Cumisky, the National Manager of Diabetes SA.  “They most often develop a negative attitude towards living with this chronic disease which they experience as isolating them from their peers and being burdensome on their families.  That’s why it is really important for camps to bring them together.  They realise that they are not alone in their suffering and feel supported; they learn how to self-manage the treatment and gain confidence; they start to feel that they are empowered to manage their self-care, deal with the socio-emotional challenges and lead a healthy life despite the enormity of their diagnosis.” While Children’s Diabetes Camps are open to those from all walks of life, many of the young sufferers in the Western Cape come from under-privileged communities and could not afford to attend even though camp fees are kept as low as possible.  In the absence of government funding, Diabetes SA is reliant on donors to hold Children’s Diabetes Camps on an ongoing basis.  Research has shown that the camps do help limit the burden of disease on the country.  Hospital admissions are reduced after camps; and parents and children’s doctor’s report that they find that their children are more motivated to play their part in managing the disease. “For a child diagnosed with Type 1 diabetes, the world they have always known can suddenly become hostile,” says Helene Brand , MySchool’s Social Responsibility Manager.  “They cannot eat what every other child is eating.  They have to know so much more than any other child does about the role of the pancreas, the hormone insulin and nutrition.  At school, they have to remove themselves from situations to test and to inject.  They could find themselves judged and alone.  At home, they are commonly the focus of parental anxiety and stress; and family drama that is centred on their condition.  These camps give them a much-needed break, as well as the skills and insights they need to manage their disease optimally.  I am really proud of MySchool shoppers because they made this important sponsorship possible.” You can sign up for your free MySchool MyVillage MyPlanet card online or simply by downloading the free mobile app and make Diabetes South Africa one of your beneficiaries.  Every time you swipe at the till point of a participating retailer, they make a contribution on your behalf, at no cost to you at all.  Go to www.myschool.co.za or your app store to sign up for your free MySchool MyVillage MyPlanet card.

Toptots Head Office

Brushing those teeth

Do you have problems with brushing your little ones teeth? Most of them do at some stage or another. It’s his mouth and he is letting you know that he has control over it. It’s just another struggle on his part for self-determination. He is not going to give in and it would not be wise for you to give in because even baby teeth need to be cleaned. So what now! Enlist the help of a third voice. You know the dentist has much more clout than you have. We had the most fantastic dentist when my kids were little. He started checking their teeth from a very young age and would ask to count them, having a quick look at the same time. He then told them that they had such lovely teeth and must be looking after them very well. At home all I had to do was say “Remember Dr Robinson said you had to brush your teeth to keep them healthy.” This worked very well. The other option is to give them a choice. Have a few toothbrushes on hand. Different colours, some with pictures on. Let him choose which one to use, it helps them feel in control. The third trick is to let him brush his teeth himself, this will help to develop his motor skills and independence and then you finish up with a good clean afterwards.   It really is only at around seven years of age that they can be relied upon to brush properly so don’t let them do it on their own until then.  Limit the bottle with juice. Sugars in the juice remains in their mouths and eats away at the tooth enamel causing cavities.  Rather give your child lots of fresh water to drink. When all else fails let them scream… at least you can see the teeth!

Parenting Hub

Get your kids excited about brushing

By Philips Oral Health Every parent wants what’s best for their child’s health, but not all parents are experts in the dentistry field and let’s be honest, we can’t remember brushing our teeth at such a young age and the process is quite different now as an adult. What’s more, brushing your teeth as an adult is a routine activity – a dull process – so if we’re not that excited, how do we get our kids excited about it? Our challenge as parents is to promote good oral health and hygiene to our kids at a young age – rather than getting frustrated trying to convince them to brush properly.  Good oral health goes beyond having a nice smile – its fundamentally intertwined with overall well-being. Dental practitioners have long been aware of the relationship between the mouth and the body and poor oral health and gum disease has been associated with several non-communicable diseases – so it’s important that while the kids are young, parents are focusing on instilling life-long good oral habits.  Most parents are doing the brushing of their children’s teeth while they are young and until they have developed their motor skills. But demonstrating proper brushing techniques and making the process as fun and creative a possible is critical. Not only is it’s a good learning processes, but a bonding experience as well. So how do you kick start an exciting path to lifelong health oral habits? We have a few tips and tricks to take care of your little one’s oral health:  Teach them the importance of brushing and flossing their teeth from a young age. Dental care for children should start as soon as they start developing teeth. Get the right size toothbrush – a long handle may be needed if they are a little reluctant to open their mouths wide – but funky toothbrushes can go a long way. Sing a song, tell a story or watch a movie/video to make tooth brushing fun – this also ensures that they brush for the recommended two minutes. Make sure that you know the right technique of tooth brushing because your child will follow your example When they are younger you can brush their teeth by standing behind them or having them sit on your lap. As they get older they will naturally want to brush themselves – just make sure that they are brushing properly Let them stand on a step or stool to face the mirror and do not forget to teach them to brush their tongue as well as it is a popular hiding place for bacteria Stick to a routine – make sure they don’t miss their daily teeth brushing routine twice a day – in the morning and before bed so there are no excuses. If your children are 6 years and older, alcohol-free mouthwash can be used after they have brushed their teeth as it flushes out any additional bacteria – but remember to get the flavour they like! Make brushing fun again by using an electronic toothbrush as these are more effective than they’ll ever be at removing plaque and bacteria, and will protect your children’s gums from aggressive brushing.  An annual dental check-up is essential – so make sure to find a dentist that they like. It should never be a dreaded visit. Remember you are their role model of good oral hygiene – so the more fun you have, the more you use brushing time to bond – the more likely they get excited about brushing! 

Impaq

Getting insight into bullying

Rita Niemann Bullying is an example of school violence, which mostly stems from aggression and poor self-image. Bullying can be defined as a conscious, wilful, and deliberate hostile activity and as it tends to happen at any point in time, it makes it very difficult to predetermine. Louw and Louw (2007:230) emphasise the need for humans to belong and states that social development is characterised by an increasing involvement with peers as that contributes towards satisfying emotional needs. Teachers and parents, therefore, must account for the various phases of relationship building during adolescence and must guide children towards sound social and interpersonal relationships. Because bullying cannot be contextualized by group, age or gender, any child can fall prey to a bully. However, children tend to follow the example of their parents and if parents condone acts of aggression or violence, children tend to emulate such acts, resulting in others feeling threatened and unsafe. Legislatively, every learner has the right to be educated in an environment that is “clean and safe” and is “conducive to education” (RSA, 2006). Unfortunately, bullying has become both a national and international concern. Most acts of bullying are related to an imbalance of power to ensure dominance, boosting the bully’s self-image and getting attention (even if it is negative attention). Barbara Coloroso (2005: 49-51) identified different kinds of bullies. Those who: have powerful personalities, are admired by others and are not easily recognised as being a bully. use gossip and verbal abuse to manipulate others. show little emotion, but is determined to continue the bullying. are hyperactive, struggle with schoolwork and have poor social skills. Any child can become a bully’s target depending on the bully’s inner insecurities. Bullies tend to prefer submissive children, but it could also simply be because the person is younger, smaller, thinner, fatter, or even because of his or her gender. Bullies also tend to choose targets who have characteristics they crave themselves, such as being clever and dedicated. Parents and teachers often wonder why victims do not report the bullying. Often, victims of bullying feel ashamed because of what is happening to them, or they feel that there must be something wrong with them. They also fear that the bullying may get worse if it is reported. Bullying must be dealt with swiftly and deliberately – see the follow-up article in this regard. References Coloroso, B. 2005: The bully, the bullied and the bystander. From pre-school to secondary school – how parents and teachers can help break the cycle of violence. London:Piccadilly. Louw, D., & Louw, A. 2007. Child and Adolescent Development. Bloemfontein: ABCPrinters. Niemann, R., Marais, N., Swanepoel, Z. & Moosa, M. 2016. Problem areas in schools In: Jacobs, M. Teaching-learning Dynamics, Johannesburg: Pearsons Republic of South Africa (RSA). 2006. Regulations for Safety Measures at Public School). Government Gazette No. 26663.  Pretoria: Government Printers.

Parenting Hub

Sports in Education: Core Skills Addressed

By: Zelda Varela (Crawford Preparatory Fourways Sports Coordinator) Can you remember that elated feeling of being part of a team, or maybe not making the A- team and then being so determined that you put in the extra hard work to improve to be selected? Can you remember being forced to run around the field five times, doing push-ups for days at end, because you thought the PE teacher disliked children and was trying to make you suffer?  Whether you have good or bad memories related to sport or any physical activity, one thing is for sure, that physical activity promotes not only your health but instils good personal attributes required throughout life. Team sports boost self-confidence and self-esteem. Being part of a team helps children to find a sense of belonging. It teaches acceptable ways to interact with others and how to be considerate and respectful of teammates. Physical activity promotes agility and coordination. It supports healthy growth of muscles and bones, which is critical in schooling years while children are still growing and can help to reduce stress and anxiety levels, especially with the highly pressurized society that we find ourselves living in. Through participation in sport your child will gain five different skills including research skills; social skills; thinking skills; communication skills and self-management skills.  Social & Communication skills: it teaches acceptable ways to interact with others and how to be considerate and respectful of teammates.  Thinking Skills: In a team sport situation, children learn to think and perform under pressure, critical basic thinking skills are promoted, which in turn can help in coping with everyday life. (http://thinkingforsuccess.com/cognition-sports.html) Self-management & Research skills: Be on time for practises/matches. Remember sport clothes and equipment needed for a sport. Children build self-confidence by participating and feeling good about themselves and their achievements. Physical activity helps children set goals for themselves which leads to learning how to deal with failure and success, and to have a positive attitude no matter what the outcome of an event. Encourage your children to get active and uncover any potential opportunities and skills that young people may find useful not only in the sport sector but other sectors of their lives.

Speech and Audio Inc

Cooing over Communication

One minute they are crying, the next they are conversing!  Communication development begins at birth. From the time your precious newborn gives their first cry, they start learning all about language, communication, and connecting with the world around them. Babies have “conversations” through their cries, facial expressions and body language long before the arrival of their first words. The development of language takes place through the encouraging and loving interactions young children have with the people in their lives. It is through responsive and repetitive processes that young children learn how to communicate.  Why do baby’s communication abilities matter? Communication skills that are learnt in the first year of life are what set the bar for success in many learning areas. Communication development is directly linked to the development of reading, writing (spelling) as well as building social skills and forming relationships later on in life. Language skills are divided into three main areas – RECEPTIVE LANGUAGE, EXPRESSIVE LANGUAGE, and PRAGMATIC LANGUAGE. Development of all areas is vital for effective communication, and begins developing after birth.  Receptive communication involves the ability to receive and understand information. Listening and reading fall into this category.   Expressive communication is the ability to convey a message to another person. Speaking and writing fall into this category. Expressive skills are more difficult to develop than receptive skills.  Pragmatic communication refers to social language abilities or the “rules” of language. These are vital for communicating our personal thoughts, feelings and ideas. It includes what we say, how we say it, our body language and whether the communication interaction is appropriate to the given situation.  Language Acquisition Guidelines By Maureen Wilson (Speech Language Pathologist) Age Receptive Expressive Pragmatic 0-3 months Moves in response to sound or voice Shows interest in caregiver Briefly looks at people Quiets in response to sound Excites when caregiver approaches Smiles and coos Quiets when picked up 3-6 months Fixes gaze on face Responds to name Vocalizes to expressions and sounds 6 months Enjoys being played with Initiates vocalizing with another person 7 months Responds to name Responds to ‘no’ most of the time Listens when caregiver is speaking to them Uses hands to request Different vocalizations for different moods Anticipates actions 9 months Babbles Vocalizes to toys or pets Dances to music Intentional two way communication Recognizes familiar people Makes physical contact to gain attention Shouts to attract attention 10 months Plays peek-a-boo Points to request Shakes head ‘no’ Waves ‘bye’ when cued 11 months Recognizes familiar people and objects when named Looks at named pictures or objects Pushes and pulls others to direct them Reaches to request object 12 months Identifies two body parts when asked Gives objects upon request Imitates words to best of ability Uses 5-10 words (typically names and preferred objects) Alters behaviour based on others reactions Vocalizes to respond 14-18 months Follows 1-step instructions without cue Uses gesture + word combinations Uses exclamations – ‘uh oh’ Uses ‘Hi’ and ‘Bye’ Can roll toy back and forth Points to desired objects Comments Protests Acknowledges speakers with eye contact / response 18 months Nod/shakes head for yes/no Identifies 3 body parts on self or doll when asked Understands IN and ON Vocabulary at least 50-100 words (50% nouns) Words are understood outside of routine activities Names familiar objects on request How can I help? Communication skills can be stimulated and elicited from birth. It is so important to provide opportunities for your babies to “talk” to you from birth. Conversations with your baby might feel very one sided initially but your baby will still try to join in! You can encourage communication development by smiling, talking, playing, and reading with your baby. It will help them develop the communication skills needed to build meaningful relationships and succeed in school.  Use a high-pitched, sing-song voice. This helps get and keep your baby’s attention while you talk. Play with sounds. Get silly while playing and make sounds that connect with what your child is doing. Use facial expressions and gestures to communicate the meaning of words. Describe your actions throughout the day while performing daily routines such as changing nappies, dressing, feeding, and bathing your child. Pairing the same words with routine activities is a great way to develop language. E.g. “I am changing your nappy, this wet wipe might be cold!” Describe the objects your child walks by when walking around the house / shop / outside.  Encourage two-way communication. When your child communicates with you using sounds, words, or gestures, be sure to respond and take turns in the “conversation”. Read with your child. “Reading” can simply mean describing pictures without following the written words. Choose books with large, colorful pictures, and encourage your child to point to and name familiar objects. Expand your child’s vocabulary by building on the words they already know. For example if your child says “dog” you could say “Yes, that’s a big brown dog!” Reword your child’s phrases. If your child makes a speech or language error, respond with the phrase in the correct form. This helps them learn proper pronunciation and grammar. For example, if your child says “Doggy big” you can respond with “Yes, the doggy is big”. Remember to respect your child’s need to disengage when they become tired. Observe and end the conversation when they let you know it’s time to move on to something else.  When should I worry? It is important to remember that language development occurs at different rates and all children develop at their own pace. Guidelines are there to show you the averages, when these skills should be present and observable, but do not have to be necessarily mastered. Having a general guideline for milestone development can help to determine whether there is a language delay present.  Often, parents want to “wait and see” how things turn out. However, if there is a language delay present, early intervention is the most ideal form of intervention. Early intervention can change a child’s developmental trajectory

Parenting Hub

Why nutritional supplements taste so good

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

Clamber Club

Empower your child

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

Impaq

Bullying: What parents and schools can do

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

Parenting Hub

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

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

Paarl Dietitians

Coffee: Good or Bad for you?

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

Parenting Hub

The need-to-know about ADHD medication abuse

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

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