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

Free virtual medical consultations for all South Africans

Bonitas Medical Fund announced that it has extended its free virtual medical consultations to all South Africans. This facility includes medical advice about COVID-19, other medical problems, the writing of prescription, where necessary and free delivery of chronic medication.

Bonitas – innovation, life stages and quality care

Don’t dread the dentist

Most of us are scared of the dentist which means dental care can easily be overlooked but, taking good care of your teeth will not only leave you with a brilliant smile, it will also keep your mouth healthy. By following a good at-home care regime and regular dental visits, you can decrease the likelihood of health problems in the future.

Bonitas – innovation, life stages and quality care

When you have a pain in the neck or back

Back pain is a common problem – 80% of us will experience an episode at some point in our lives. It is associated with many factors that vary from person to person but can be caused by an injury, a disc or joint problem, an irritated nerve root or poor posture. The pain might be acute or chronic but living with either can be debilitating.

Bonitas – innovation, life stages and quality care

Enhanced maternity benefits in 2020 from Bonitas

Around 9 000 babies are born to Bonitas Medical Fund members annually and while most of these little members are welcomed into the world without any hitches, about 20% of pregnant moms experience complications during childbirth. Many experience challenges of some kind during their pregnancy, or immediately after the birth of their child. For this reason, the Fund is making maternity education and support a focus for 2020. The aim is to offer pregnant members all the support and guidance they need to improve their health and that of their baby. It is about making the pre- and post- birth period as stress-free and healthy as possible.

Bonitas – innovation, life stages and quality care

Medical Aid – making the right choice

Private and public healthcare has been in the news lately and will continue to be a topic of discussion around the Department of Health’s proposed National Health Insurance (NHI) Bill as well as the current socioeconomic landscape.  Traditionally in September, private medical aids present their products, plans and pricing for 2020 to existing members, or potential members, so that they can make informed choices. ‘It is imperative that the decision you make regarding you and your family’s health and wellness is balanced against affordability,’ explains Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘For existing medical aid members, it’s the time to analyse the plan they are on, whether it meets their health needs and compare it to the various options available.  If you’re joining a scheme for the first time, you need to consider your specific healthcare needs and spend time investigating which plan will be best suited to deliver on this.’ However, medical aid plans can be confusing which is why it’s important to compare the various options and schemes to ensure you find a medical aid that works for you and your family’s health and that is within your budget. For people who have a broker, that should be the first point of call to help you can make an informed decision. Here are some steps to help simplify the decision.  Analyse your healthcare needs Completing a quick personal healthcare needs’ analysis will help you determine what level of cover you need. If you have dependants, you need to factor in their healthcare needs too.  Consider how much you and your family spent on medical expenses over the past year as a guide and then ask the following: How often did your family visit a doctor Do you require medicine often Did you or the family need to visit a specialist Are any of you in need extra cover for cancer, HIV, renal failure or any other specific conditions How much did you spend on dentistry, optometry and over-the-counter medicine Then consider which of the expenses were once-off and won’t come up again soon (like childbirth) and which are likely to come up again and again (such as flu) as well as chronic conditions like high blood pressure and diabetes.  Check how much cover you require If you find you hardly claimed (if you are on a medical aid) or have very a few medical expenses, then you will need a lower level of cover. However, if you have a large number of medical expenses, you will require one of the more comprehensive plans.   Once you’ve established this you can decide whether you require a full medical aid or a hospital plan.  Are you happy to use a network Some plans require you to use a specific GP, hospital network and have a list of preferred providers. This helps to keep costs as low as possible because the Scheme will have negotiated special rates with these services providers. Check whether there is a wide enough network in your area to cover your specific needs. Check your budget Once you have an idea of what you might need for the year ahead in terms of healthcare, then it’s time to look at your budget. Decide what you can afford and remember that the rule of thumb is that contributions should not exceed 10% of your monthly income.  Read the small print  Make sure you read all the details including the benefits. These vary from plan to plan so establish what is covered and look at whether it offers additional risk benefits which can potentially save on the day-to-date expenses. These could include anything from free wellness screenings (blood pressure, cholesterol, blood sugar and BMI measurements) through to maternity benefits, flu vaccinations, mammograms, pap smears and HIV tests. All of these are costly if you have to pay for them yourself. What about savings Medical savings are a fixed amount medical scheme gives you at the beginning of the year.  You can use your savings for daily out-of-hospital medical expenses, such as GP and specialist consultations and over the counter medicine. There are ways to maximise your savings but first you need to know what you annual allocation is.  Age can influence the decision If you have young children, ensure that the medical aid option you select provides sufficient child illness benefits. For young couples looking to start a family, ensure the option provides sufficient cover for maternity benefits. However, if you aging then you need an option that covers chronic conditions and provides sufficient in-hospital cover in the event of hospitalisation. Some additional advice Remember to be honest on your application form, disclose all information about you and your dependents’ health. Membership can be suspended or cancelled if you fail to do so Any waiting period or exclusions? Schemes may impose certain waiting periods for new members joining or for a pre-existing medical condition. This is based on the guidelines of the Medical Schemes Act and the specific scheme’s rules. Finally, get expert advice ‘Your health and that of your family is important so it is vital that you are comfortable with the choice you make and are confident your healthcare needs will be taken care of,’ says Callakoppen. ‘My advice is to make sure you are informed. Read the information and fine print and compare what the different plans are offering before you commit. If you are still unsure, phone the scheme and ask questions or check with your broker or financial advisor.’

Advice from the experts
Parenting Hub

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

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

Doug Berry

Grieving with children

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

Parenting Hub

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

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

Munchkins

Nutritious Knock-Ons

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

Munchkins

Ban the baby blues

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

Munchkins

Do Cribs Cause Brain Damage?

We recently received a message from one of our followers to ask our opinion on the type of articles that are claiming that sleeping in cribs can cause brain damage in babies. Munchkins Coach Celeste Rushby, who is also an Occupational Therapist and mother of 3 (all of which were born very prematurely) answers: ‘’Over the past few years I have read, amongst many others, Jill Bergman’s book (Hold your Prem) and have also attended many courses presented by Dr Nils Bergman, who is an expert on Kangaroo Mother Care (KMC) and its positive effects on young babies, especially premature infants. I have also attended numerous other baby sleep courses. I also studied Neurodevelopment Supportive Care of High-Risk Infants and read many articles about the research on baby sleep and the neural implications of various environmental influences that have an impact on it. Unfortunately, I have often found that a selection of social media articles incorrectly reference some of the above-mentioned books/courses – often twisting the wording in the hopes of selling their own views on the subject. Firstly, these articles often refer to studies that have been done with “infants”. The term infant can refer to any child, ranging between the ages of new born to 12 months old.  The generalisation is a concern, since the actual age of the baby is extremely important in formulating relevant conclusions. Results of these type of studies done on a 2-week old baby, for example, would differ significantly when done on, say, a 6-month old baby. Personally, I encourage moms to practice Kangaroo Mother Care and baby wearing often for the first 6 weeks, while baby adjusts to the change from womb to world (or until 4-6 weeks adjusted age for premature infants). That is when babies need it. Then we gradually help baby to feel comfortable in his/her own cot by including mom’s scent on a cuddle blankie, along with slow, rhythmic patting (to mimic mom’s heartbeat in the womb) and a sucking tool to help baby transition to the comfort of the cot – but never leaving the baby to cry at this stage. Often referred to as ‘’Ferberizing’’ (thanks to Dr Ferber who first started with this method), is the old ‘’cry out method’’ where you put baby down in the cot, walk out, close the door and leave baby to scream and scream to eventually give up and pass out. Doing this can actually cause baby to go into fight-flight-fright mode, which releases cortisol and adrenaline hormones. This is what is referred to when articles start referencing neurological damage and a reduction in brain growth. It can also make baby feel rejected and unloved with possible long-term negative psychological effects. Some sleep trainers still encourage the use of this method, which is not a method that I support at all. The proposed “research” offered in the specific articlethat this response is based on, that compares co-sleeping babies to cot-sleeping babies, was conducted on a mere 16 babies. Accurate medical research would only be recognised when conducted with AT LEAST 1 000 babies. Nevertheless, the reason that babies who sleep on mom have far more “quiet sleep” versus their cot-sleeping counterparts is quite simply, due to the Moro reflex (also known as the startle reflex). If the cot-sleepers were sleeping on their tummies (like those sleeping on their moms’ chests) or if they had been swaddled when in side- or back-sleeping positions, they wouldn’t be having any autonomic responses which are caused by the Moro reflex – especially if given a sucking tool. The Moro reflex is responsible for the frequent waking (with arms flailing) in un-swaddled back- or side-sleeping babies, and continues until 12 to 15 weeks old. Articles that are written on these topics can often be disturbing due to misconstrued information that is offered up as “research”, with highlighted extracts such as “stress and lack of sleep damages brain development”.And it can, of course, but not in the way that these articles are claiming. A baby that is dependent on mom to fall asleep (after 10 to 12 weeks) is also dependent on mom to put them BACK to sleep after every sleep cycle. This broken sleep is not only bad for baby’s development and health, but terrible for mom too! How on earth are you supposed to be an affectionate, caring, nurturing mother (which is what your baby needs most) when you are stressed and severely sleep deprived? When mom and baby sleep well, both are SOOO much happier, and have better brain function and immune systems, as well as better overall psychological health and a stronger bond with each other. Babies over 6 weeks do not NEED their moms to assist them to achieve sleep happily and comfortably without any stress. Unfortunately, parents often make the mistake of teaching their babies that they aren’t able to self-soothe, and need their mother’s help. This continues to become a learnt behaviour which leads to dependence on external sources to help them fall asleep (and stay asleep). I have often found when helping parents who’s 6month+ old babies are still dependent on mom to fall asleep (and to stay asleep), that the babies are anxious at sleep time and “fight” sleep. But in the case where baby has been gradually and age-appropriately taught to self-soothe, the babies would be more likely to enjoy a little cuddle with mommy, then just about dive into their cots with the same “oh yay, it’s sleep time” feeling we experience when we get to go to bed! They are then most likely to happily roll over with their cuddle blankie and peacefully drift off to sleep. Then everyone gets good quality sleep, which results in good quality awake time too!’’

Good Night Baby

Do you hate bedtime?

A correct bedtime routine can really help your child transition to sleep As a parent, I am sure you have often read about the importance of a bedtime routine. This newsletter attempts to provide a few “bedtime routine secrets”. The most important thing to remember with your child’s bedtime routine is that it really is the start of sleep. Recently, there has been hype in the media about how sleep is a time for our brains to get rid of toxins. So what happens at bedtime? The wonderful thing about bedtime is that it helps our children transition into the “wonderful slumber of sleep”. Have you watched the inspiring TED video about how important sleep is? Watch it now; you will never think the same about sleep again. Why is bedtime routine important? Bedtime routines cue our children’s brains to prepare them for sleep. Children thrive on predictability, consistency and routine. Keep it simple, predictable and the same every night. My top tips for a bedtime routine: Keep it short – no longer than 30 minutes. If you have a child older than 6 months, feed him prior bath time. A bath is the best start to your bedtime routine. For a toddler, set an egg timer for 30 minutes before bedtime to get him used to the idea that sleep is soon to follow. No IPads/TV/computers for at least two hours before bedtime. Rather invest in some quality family time. Keep bedtime early. Typically, after 8pm it should only be mom and dad left in the living room. (I recently commented on a very good article featured in the Baba and Kleuter Magazine’s September edition about early bedtimes). What about older children? Remember that children (until they reach puberty) need to sleep for a solid 11 or 12 hours at night. Therefore, an early bedtime for the whole family is a good idea. In addition, you and your partner will still have a few hours left in the evening to enjoy quality time with each other.

Good Night Baby

What To Do With Sick Children

I very often get this question from parents: What do I do if my child is ill? Just think back to the last time you had a cold: Even though you felt more fatigued, and your body needed the rest, you definitely did not sleep as well. Typically, a cold sufferer is congested, and wakes during the night to blow their nose, clear their throat or drink some water. Your children are no different.  I’ve, very rarely, met a child who sleeps perfectly through an illness. The ugly truth is that no-one sleeps well when they’re ill, and very few children sleep soundly when they are sick. Prepare yourself. There are definitely going to be some wake ups that you should respond to. You have a sick child that will need some comfort and attention, and it is important that you support your child through this uncomfortable stage. However, it is important to maintain the normal sleep routine as far as possible. It is easy to fall into an emotional trap. Many parents, at the onset of child illness, commence with night-time feeding. However, if you’ve got a healthy, 6 month, 8 month old, or 10 month old, who has had several weeks or months peaceful sleep, there’s no sensible reason to start night-time feeding if they are ill. You could offer your child a sip of water as the throat might seem a little dry. You might need to wipe the nose. It’s even fine to give a few cuddles. However, you want to make sure you put your child back in their usual sleeping environment. Expect and allow them to continue to use the skills that they have accumulated in the last few months of using the Good Night programme. Most children will not let you change their strategy. Even if you try to rock your ill child to sleep, the child will most likely resist it. Parents have experienced their little ones pushing them away or arching their back toward the crib. Older children might even point to their cribs, or say “no” to the cuddling. If your doctor has recommended that you offer some night feeds to aid the healing process of a serious illness, or if the child has had a very high fever for a few days and night-time feeds will curb the dehydration, then it is essential to follow doctor’s orders. Always remain mindful of how you are implementing your actions, however, as you definitely don’t want to let your child fall asleep while feeding or by using it as a prop when the child is ill. The goal should be to maintain the healthy sleep habits that were learned by you and your child, while providing the nurturing and support to the ill child. Offer to feed, keep her awake through the feed, and then place her right back in the crib again. When people are very concerned about their sick babies, they often put the baby in bed with them. However, it is more sensible to move a mattress to your baby’s room. Set up camp, and keep an eye on the sick child without changing her immediate sleep environment. Once you’re convinced she’ll manage on her own, get yourself back to your own bed as quickly as you can. While this might initially be more effort, the long term benefits are priceless. It is far less disruptive to move into your child’s room to watch over her, than taking her into bed with you. Keep the long term reward of sweet sleep in mind, and continue to nurture and support the sick child to wellness, so that the sleep cycle is maintained. Article Credit: Dana Obleman

Skidz

The Importance of Early Brain Development

As parents we want what is best for our children and want to teach and help them grow into successful, well-rounded adults. To achieve this we need to invest in the development of our children’s brains. The emotional, social and physical development of young children has a direct effect on their overall development and on the adult they will become. That is why understanding the need to invest in very young children is so important, so as to maximise their future well-being. Neurological research has shown that the early years play a vital role in the brain development of children. Babies start to learn about the world around them from a very early age and these first learning experiences deeply affect their future physical, emotional, social and cognitive development. These early learning experiences start just before and after birth already, so starting young is extremely important as optimizing and investing in your child’s early years sets them up for success later in life. According to James J. Heckman, a Nobel laureate and Director of the Centre for the Economics of Human Development at the University of Chicago, “Learning starts in infancy, long before formal education begins, and continues throughout life. Early learning begets later learning and early success breeds later success, just as early failure breeds later failure. As a society, we cannot afford to postpone investing in children until they become adults, nor can we wait until they reach school age – a time when it may be too late to intervene. The best evidence supports the policy prescription: invest in the very young and improve basic learning and socialising skills.” As parents we often don’t know how to optimally develop our children’s brains and the very dedicated spend hours researching on the internet. Skidz Clever Activity Boxes has done everything for you. The age ranges start from birth until five years and the program has been developed by four experts in early childhood development.  It includes an easy to follow manual and the equipment used to do the many activities. Using the Skidz program gives you time to play and have fun with your child while they learn and develop, as well as the peace of mind knowing that you are doing age appropriate activities with them. You can follow Skidz on Facebook at www.facebook.com/skidzsa The website for more info and orders is http://skidz.co.za or email us at [email protected]

Skidz

How early learning builds a child’s other abilities

We often read articles and speak to Early Childhood Development experts such as Paediatricians and Occupational Therapists, who assess a child’s progress based on developmental milestones. Being a part of many mommy groups, I often find some moms who say that this focus on milestones is misguided. The problem is that many don’t really understand why looking at milestones as a guideline is important. Some even say things like “My child didn’t crawl and she is fine”, but what measures as fine? I’m not talking about major problems or delays in development, but things that we only see later in life. It is also important to note that these developmental skills that are learnt and developed through exploration and play, is the foundation of other skills used later in life. Investing in the development of your child especially in the first few years cannot be emphasised enough. The easiest way to explore this would be through examples, so here goes. When a baby is born, he can’t see or hear very well and his sensations are far from perfect. When looking at visual stimulation babies need to be exposed to high contrast colours and patterns.   In the earliest months a baby lays down the main ‘visual pathways’ of his brain. The cortex of his brain has 6 layers of cell which transmit different signals from the retina in the eyes to the back of the brain. On layer for example transmits vertical lines, another horizontal. Others will deal with circles, triangle and squares. If, for example, a baby would only see horizontal lines, then when he crawled or walked he would continually be banging into the legs of tables and chairs because the visual pathways which where laid earlier could not process vertical lines. Here are some more examples of how what a child physically does in the first few years of life plays a major part in how well he will develop other abilities. The Brainstem:  Controls the flow of messages between the brain and the rest of the body. Activity learnt: Grasping Touching Crawling Walking Reaching Turning Pushing Pulling. These activities lead to: Hand-eye coordination Gross motor skills Prewriting ability The Cerebellum:  Coordinates voluntary movements such as posture, balance, coordination, and speech, resulting in smooth and balanced muscular activity. Activity learnt: Spinning Tumbling Balancing Dancing Listening Swinging Rolling These activities lead to: Balance Sporting ability Bicycle riding Writing skills Fine motor coordination Reading skills. The Emotional brain (amygdala and temporal lobe):  Emotions, like fear and love as well as brain functions, like memory and attention. Activity learnt: Cuddling Stroking Playing together These activities lead to: Love Security Bonding Social skills Cooperation Confidence The cortex:  Associated with higher brain function such as thought and action Activity learnt: Stacking toys Building puzzles Recognising and making patterns Playing word games Repetitive play and music These activities lead to: Math Logic Problem solving Fluent reading Spelling Writing A good vocabulary Painting Memory Musical ability Another point to consider is that for a child learns from concrete and active experiences. To understand an abstract concept he would first have to understand the physical concept. For instance, to understand the abstract concept of roundness, he must first have experienced real round things like a ball. There are endless examples that could be explored but the conclusion is the same. Experiences and active play to reach milestones are extremely important for future successes. SKidz gives you as a parent the tools to stimulate and play with your child, which encourages not only his physical ability, but also sets a firm foundation for healthy relationships, where he feels loved and secure. The program has been developed by 4 experts in early childhood development and is divided into 5 boxes so that you only need to buy the appropriate one at a time. Each box comes with all the equipment needed to do the activities as well as a step by step manual, with easy to follow instructions as well as developmental information, so that you know what areas you are developing through that activity.  The range is divided into the following ages 0-6 months, 6-12 months, 12-18 months, 18-24 months and 2-5 years. More info on this wonderful product can be found on the website http://skidz.co.za. All orders are also placed from the online shop on the website. For some up to date news, articles and specials follow SKidz on facebook at www.facebook.com/skidzsa.

Mia Von Scha

Earning Screentime

I’ve never been a fan of kids spending hours and hours in front of screens. When I grew up we didn’t have computers, and we were limited to one TV program a week. I resented this at the time, but looking back on my childhood I have memories of riding my bike round the neighbourhood, playing makeshift games of softball in the back yard, climbing trees, making mud pies, dressing up, designing doll’s clothes, and doing a multitude of other creative activities. Our days were full and spent almost entirely outdoors, and most of all fun. Of the TV programs that I did watch I have a few scant memories that don’t amount to much. We don’t have a TV at home now, although we do download movies and select TV shows for ourselves and the kids. When they were very little our children had some time with us on our computers playing learning games, and we didn’t own an iPad until they were quite a bit older. However, over the years it has become easier and easier to slip into bad habits and lose track of how much time they are actually spending in front of a screen. One hour became two, and on the weekend sometimes became four. It is convenient for us as adults to know that the kids are busy and entertained while we catch up on some work, tend to the garden, make the dinner and do the hundred other things on our to do lists. It is easier to hand them an iPad than to encourage them to come up with something else to do. What I noticed, though, was that after a couple of hours on an iPad or playing Mine Craft on their computers, my little darlings turned into little monsters. When they emerged from behind whatever electronic device they had disappeared behind, it was like that were coming down from drugs. They would fight each other, fight us, become rude and uncooperative, and sometimes even throw proper tantrums. It was not ok. Something had to be done. I genuinely considered removing all technology from our home and just dealing with the onslaught of anger and resentment that would surely follow. The thing is, I’m actually not against technology in general and I’m even quite impressed by games like Mine Craft and the kind of skills that kids are learning while they play. And then, of course, there’s the thing of this being our children’s future. Whether we like it or not, they are part of the digital age and they are going to need to navigate these worlds in order to progress. So what I decided was to simultaneously encourage them to engage in other activities and limit their screen time in a way where they could still be in control of how they were spending their time outside of technology. I created a points system. 100 points = 1 hour of screen time. I specifically made it easy enough that with a little effort, they can earn 100 points in a day. I was also careful to include many things on the list that they actually enjoy doing and that will help them to advance their own values and interests (they can get points for drawing, playing the piano, reading a book, doing a creative project or science experiment). I did, of course, add a few things that I would like too (making their beds, helping with cooking and gardening, tidying their rooms)! They don’t have to do everything on the list. In fact, there’s nothing that they have to do. Every item is optional. If they choose to earn all their 100 points by drawing pictures, that is fine. If they’d rather do a variety of things, that’s also ok. My intention is to keep it fun and light so that they can see that they can enjoy life outside of a computer: Real life also has something to offer. The result was remarkable. I explained to them why I was implementing the new system and they could see themselves that they were irritable and grumpy after a day online, so they were open to the idea from the start. Within a day they were up to all sorts of things around the house, they had rekindled their relationship with each other (which had become somewhat rocky), they were cheerful and engaged in life and such a pleasure to be around. We also started connecting more as a family – playing board games, going for walks, planning family outings, chatting around the dinner table. Both children became avid readers overnight. It has been about 3 weeks now and our entire household is transformed. And, they’re still getting to play on their computers at least every second day, or even every day if they feel motivated to do so. But it isn’t the be all and end all of everything. The Lego has come out of its dusty spot in the corner, our home is filled with artworks again, there is quite literally music and singing filling the air. Screen time is earned and enjoyed, but it’s no longer the focus of their every moment. Memories are being made. Connections are being nurtured. We are all happier and more fulfilled. Life is good – both online and off!

The Headache Clinic

Is food triggering your Migraine?

Migraine is a very common problem that affects about 18% of all women and 6% of all men.  Studies have shown that environment, lifestyle, and diet can play a large role in how often you get migraines. Dr Elliot Shevel, Medical Director and founder of The Headache Clinic says that the most commonly reported migraine triggers include alcohol (especially red wine and beer), chocolate, aged cheese, cured meats, food preservatives that contain nitrates and nitrites, and monosodium glutamate (MSG). Although these are the most common, almost any food can be a trigger. Even so, only about 20% of migraine suffers have an identifiable food trigger. There is no certainty why certain foods trigger headaches, but suggested mechanisms are as follows: Chocolate 22 percent of headache sufferers identify chocolate as one of their headache triggers. But many people with migraines have increased appetite and food cravings just before their headaches start. Reaching for a chocolate bar may be the result of a migraine, rather than the cause. Alcohol Sulfites used as preservatives in red wine have been linked to migraine headaches. Alcohol in any drink causes the blood vessels in the scalp to dilate, and can also result in dehydration, both of which might be headache triggers. Alcohol is also a potent trigger for cluster headaches – otherwise known as “suicide headaches”. They are known as suicide headaches because the pain is so severe that sufferers do sometimes actually commit suicide. Caffeine Caffeine can actually help get rid of a migraine headache, and caffeine may be included in some migraine medications, but too much caffeine can be a headache trigger when you come down from your caffeine “high.” Aged cheese It is generally agreed that aged cheese is more likely to cause a headache, because it contains a substance called tyramine that forms as the proteins in cheese break down over time. The longer a cheese ages, the more tyramine it has. MSG Monosodium glutamate (MSG), which is found in soy sauce and as a food additive has been implicated in causing migraine. The interesting thing though, is that in cultures where MSG is used extensively, the percentage of migraine sufferers is the same as in other countries. Ice cream The stabbing pain you get when you eat ice cream too fast is a reaction to the cold, not the ice cream itself. An ice cream headache is more likely if you are overheated. The pain peaks in about 30 to 60 seconds. “Cold foods like ice cream may be migraine triggers for people who suffer from migraines, but for most people, the pain goes away quickly. Bananas Bananas usually don’t appear on lists of foods that are headache triggers, but they could trigger a migraine for people who are sensitive to tyramine, the same substance found in aged cheese. Preserved meats The nitrates and nitrites used as preservatives in hot dogs, bacon, and lunch meats may dilate blood vessels and trigger headaches in some people. According to Dr Shevel, studies can’t tell you what food may trigger your headaches, but many people do have food triggers. There are a few important things to remember about migraine food triggers says Shevel: Migraine attacks are often due to multiple factors.  There are many non-dietary trigger factors for migraine. When you’re already stressed, not sleeping well, and not exercising, eating a food trigger may make it more likely to have a migraine attack. In this case, it is the combination of all of these different things that contribute to the migraine, and not just the one food. Your personal food triggers can be difficult to figure out.  Here are some suggestions: Keep a food diary along with your headache diary, to help identify what you ate before migraine attacks. You can download a diary by clicking here Some foods can trigger a headache right away, while with other foods the headache can be delayed up to 24 hours. If you think a specific food is triggering migraine attacks, you may try to avoid that food for a month. Only limit one food at a time so that there can be no confusion as to which one affected you and monitor your symptoms to see if they improve. Be careful about trying extremely strict diets.  There is a risk of avoiding foods that are not necessarily migraine triggers and you may be missing out on many important nutrients. Dr. Shevel is South Africa’s pioneer in the field of migraine surgery and the Medical Director and Founder of The Headache Clinic, says that although migraine has many triggers, most people cannot identify their individual triggers. The best way to treat migraine is not to focus upon the triggers, but upon the underlying pain source. With the latest state-of-the-art diagnostic and treatment techniques developed at The Headache clinic, it is possible to prevent migraine pain in most patients, once the cause of the pain is eliminated.

David Lorge

Rewire your brain with THINK

The 5-step happiness hack. Here’s something you’ll be familiar with: you’re at home, just minding your own business when all of a sudden a negative thought pops into your head. Maybe you’ll be at your sink, washing up after a nice meal. The hot water is running, and the smell of soap is in the air. You’re rinsing a plate after a particularly vigorous scrub, when all of a sudden, you notice that it has a small chip on its side. Then your thoughts run out of control: “This is a disaster! I have to get all new plates now!” “But I can’t afford it!” “If only I got that promotion that they gave to stupid Andrew.” “What’s wrong with me?!” “I’m such an idiot.” “My life is going nowhere!” Etc. Etc. Etc. Yip. A tiny chip in an old plate can spark off an avalanche of negative thoughts — growing ever more destructive until they take on a life of their own and crush your happiness in their wake. It’s a terrible way to live, yet it is the norm for many of us. We don’t realise that this way of living is a conscious choice that we make. And even fewer of us know that we have the power to control our negative thoughts. Lucky, the brain’s emotional circuits are connected to it’s thinking circuits, which we access whenever we use our conscious mind. That means that you can’t become happier by sheer force of will, so the trick is to change your emotions and behaviours by first changing your thoughts. The Cognitive Behavioral Specialists at Captain Calm have developed a technique that will train you to do just that — it’s called THINK. The technique is simple; we teach the same things to kids. Even the name, THINK, is an acronym to help you remember the steps. As simple as it is to learn, putting it into practice takes hard work and dedication. However, like anything challenging, it is worthwhile. We’ve seen firsthand how the implementation of this technique has changed people’s lives and helped them to become a far more positive, rational, happier version of themselves. So, if the Avalanche is the villain of your mind, then the most effective way to fight him off is by developing a super power. That’s exactly what THINK is — a mental superpower. One that will give you extraordinary control over your mind so that you can break free from the oppression of negative thoughts and unleash your full potential.   Here’s the first step. Take a step back Negative thoughts tumble down from the mysterious mountain that is your subconscious. There’s no stopping them, and you definitely can’t control the thoughts that your subconscious mind presents to you. However, you can learn to become more aware when negative thoughts enter your conscious mind and notice when you’re on the brink of a negative thought avalanche. Here’s the important part when you’ve realised that — that you take a step back and make the choice that you will not be swept up in your thoughts. Instead of being outside, battered by the crushing ice and snow, rather be inside your house, where you are safe, warm and merely observing the avalanche through your window — aware of your thoughts but removed from them. This is a practice called meta-cognition, which is just a snazzy term for ‘thinking about your thoughts.’ It’s important for you to build up your meta-consciousness muscles so that you can learn to be aware of your negative thoughts and not allow them to go unchecked, take over and make you miserable. How do you do that? It’s quite simple really: take a step back — respond, don’t react. Assess your thoughts rationally and know that you have the power to control them. Huge breath Now that you’ve removed yourself from the heat of the moment (or the cold, to continue the metaphor), you need to centre yourself and calm down with the next step — a huge breath. Breathing plays a vital role in balancing your body and mind. It helps you to calm down and think clearly. When you’re having negative thoughts that cause fear or anger, your heart races and adrenaline starts to surge through your body. Adrenaline is very useful when there’s an actual threat, but when there’s only a perceived threat, like the one a negative thought causes, it becomes a problem. The symptoms of panic start to set in — symptoms that impair cognitive function and add to your feelings of stress. You need to get your adrenaline levels under control, and the best way to do that is by balancing your oxygen and carbon dioxide levels. Oxygen fuels adrenaline. That’s why humans hyperventilate in stressful situations and why people who are having panic attacks breathe into a paper bag — so that they inhale more carbon dioxide to counterbalance the surge of oxygen-fueled adrenaline. So take a deep breath. Go on, give it a try now. If you can breathe in, hold your breath and exhale for seven seconds each, then you’re doing great. Identify your thoughts To change your negative thoughts, you first need to identify exactly what it is that you are thinking — bringing to light what it is that is holding you down. When you identify your thoughts, you regain control over them and take their destructive power away. You might find that you’re jumping to irrational conclusions. You may even find that what is making you feel down is not necessarily the thought on the surface, but something deeper. This step allows you to address your thoughts and pay attention to them because negative thoughts exist for a reason — they are trying to tell you something. You need to make sure that you respond to them positively and appropriately. Don’t just ignore them or push them aside or you will be neglecting important information that will help you adapt and better your life. A word of caution — It’s important not to dwell on this step for too long. If you do, you will be allowing yourself to slip back into the path of the

Prima Toys

How Play Fosters Your Child’s Development

Anyone would be forgiven for viewing toys as simply special occasion gifts that offer a temporary distraction for our children, or as objects that entertain our little ones while we busy ourselves with other grown up duties. Yet beyond this, toys open up a whole world of learning opportunities for our kids. Playing with toys equips children with skills that foster their development beyond imaginary battles between the Teenage Mutant Ninja Turtles and their enemies or playing house with the yummy smelling Num Noms. Toys help kids develop fine motor skills and think creatively along with many other valuable dexterities. The more children play with toys the more equipped they become for progression to other stages of their lives. Children learn a number of skills they will need and use as adults as they play. When children use toys such as Poppit – where they create things using clay and moulds – they are able to build and make and refine their fine motor skills while doing so.  They also learn about different colours and using them successfully.  Once the building project is complete, this stirs up feelings of achievement. “I win! I’m good at that!” In the same way that adults feel a sense of accomplishment when they’ve seen a project through from planning to completion, children too feel a sense of pride after building their Poppit kingdom from scratch. These feelings build and reinforce self-esteem and self-confidence in a child. Playing with dolls like Baba Tasha, Baby Born or Sofia the First encourages role play where kids are able to be mom and dad for a while and look after baby, put it to sleep and take care of it.  Role play has the ability to lengthen attention span through the making up of games and stories with multiple storylines, characters and endings. This enables children to develop better judgement, reasoning and problem solving and negotiation skills. When playing with friends or siblings these skills can go even further to include taking turns, working together in a team, listening to each other, playing fair and helping each other. On your next trip to the toy store, before you pick up a toy to brighten up your little one’s day, remember that toys play a big part in advancing your child’s development beyond what they are learning at school. Think about what stage of growth they are in and match your toy selection to the skills you would like them to practice and learn. For more information go to www.primatoys.co.za

Barbara Harvey

Gestational Diabetes: What to Eat?

Gestational Diabetes is a hormone imbalance where the Pancreas starts making not enough insulin for both Mom and baby. It usually dissipates once the infant is born. Maintaining health in the meantime really does depend on Mom’s diet. Being a diabetic myself I want to share with you the strategies I use. This blog is to help you as soon as you get home. It will help you until you can get further medical help. Carbohydrates are the number one issue for diabetics.  This is because the pancreas is responsible for keeping the sugar in the bloodstream even. Every carbohydrate becomes sugar in the blood. The key here is to avoid simple carbohydrates. The darker the carb the better. Because simple carbs digest very quickly in the body. For instance, sweet potatoes are better than any other kind of potato, pumpernickel bread is better than white or even wheat. Sprouted bread is great, make sure you get a name brand like Ezekiel or something from a Whole Foods or Trader Joe’s to be sure it is not full of pesticides. Grains Some grains are better than others for slower digestion of the sugars in the food. The key to remember is the closer a grain is when it comes out of the ground when you eat it the better. Therefore, eating steel cut oats is better than packaged oats. Here is an article from the Huff Post of 17 yummy looking recipes. Brown rice is better than white rice. I use the following recipe for brown rice. 1 cup of brown rice 3 cups of water 1 carrot washed not peeled 1/2 onion 1 stalk of celery 1 tsp Salt 1 tsp Pepper Pre-heat oven to 350 degrees. Put all ingredients in a cassorle dish and cover. Bake on a cookie sheet for 45-55 minutes or until all the water has evaporated. Remove veggies before eating. Or you can cut the vegies into bite sized pieces before cooking makes a great side dish. Sugar is the one thing most folks have issues with replacing. Sugar substitutes can be horrible. Both on the pallet and in the body. Natural ones are better. The two I interchange are stevia and monk fruit. I have developed a taste for both. Some people do prefer monk fruit as it seems to taste less bitter. For stevia I love Sweet Leaf  brand. They have so many products available it boggles the mind. They have everything from loose powder, packet, tablets, and liquid water enhancers, to flavored sweeteners for your variety of needs. I love to add the vanilla drops when I make smoothies, or a squirt of chocolate and caramel in my coffee for a treat. Monk fruit mostly comes in powder form I have tried Monk Fruit in the Raw. But, another brand some friends use seems just as good it is called Lakanto  Milk I have learned most Diabetics have a hard time with cow’s milk. The lactose carries a lot of sugar. However, if you are going to drink cow’s milk stick with whole milk. In the skim milks they add sugar to replace the fat so it tastes better. You can try drinking other kinds of milk. Almond, coconut, goat, and cashew are the most popular. I drink Califia Farms an almond milk. I have tried most brands this has the feel of cow’s milk in the mouth, which is why I like it. Califia also carries creamers, cold brew coffees and other items. Many of which you will have to order online. I have tried coconut milk,  and have used it from time to time. However, like the oil you have to like the strong taste of coconut. Goat’s milk is another which I like but get it in a carton not canned because it picks up the tinny flavor. Consider goat milk is drunk by most of the world. Also, rice milk is an alternative. I have not tried it so I have no hints on it. Protein is a great friend of the diabetic. Because proteins cause carbohydrates to be more steadily absorbed by the body. I suggest if you eat a carb eat protein too. Fish, meat, nut butters, cheese, and eggs are all considered proteins. Then there are beans and legumes which are considered both a carb and a protein. Quinoa is the only grain which is also a whole protein. It is a good alternative to eating rice and oats. I use the same recipe  for Quinoa as brown rice (above). Another great thing about protein is that the number of proteins in a product lessens the carb count. If the proteins on a product is at 5 grams (g) or above you can subtract one carb per each gran of protein over 5. So if a product has 15 g of protein and 25 total carbs you can say the food has 10 g of carbs.A serving of protein is about the size of your palm. Fruits and Vegetables generally it is best to stay away from high glycemic fruits such as bananas, and dried fruits. Juice of all kinds are also not recommended. Because if the number of fruits it takes to make one glass of juice. One orange may have 15 carbs, the five oranges in a glass of juice has 45. When eating fruits reach for preferably fresh or frozen berries, oranges, apples, cherries, grapes. kiwi, plums, peaches, nectarines the list is extensive You also want to watch for waxy and starchy vegetables. These include things like beets, peas, corn,  and white potatoes. Instead, you want to reach for fresh or frozen peppers, broccoli leafy green vegges, okra, parsnips, radishes, cucumbers, onions, rutabaga, the list goes on and on. Important Rule for eating carbs-There is one basic rule for women eating carbs 15 g of carbs per snack, 30 per meal between 90 and 120 per day. Keep in mind this includes grains and fruits. One piece of fruit is generally

Parenting Hub

Steps to Successful Baby Massage

There are a few small steps to follow to make infant massage successful. Get yourself ready.  Make massage part of your daily routine.  Keep interaction the main aim, rather than getting the  massage routine right. Keep in mind, touch is natural, and massage is simply stylised touch. Massaging your baby allows for bonding, ensuring extra feel good hormones are released by baby, mum and dad. And if you are lactating, prolactin and oxytocin are released ensuring a plentiful milk supply. Get the room ready.  Usually babies are “in the buff” when getting massaged, so ensure the room is warm, put on a heater and close the windows. If you find a heater too hot and uncomfortable for yourself, then preheat the area with a heating pad under the bed linen, then switch off or onto low once you start. Ensure items like a spare nappy, massage oil and milk are ready.  Babies can get thirsty after and during massage.  Often it’s giving your baby the comfort of a familiar feed that allows you to continue massage.  Just be warned, if your baby does feed in between, no tummy massage. Use cold pressed vegetable oil.  Why not just use any oil or lotion?  Cold pressed oils retain their natural antioxidant goodness.  This means minerals, vitamins and omegas can be absorb by your baby’s skin.  Also if baby puts her foot/hand into her mouth or eyes, there will most likely be no reaction. Steer clear of nut oils though, until you have established your baby’s unique allergy tolerance.  I find Grape-seen oil a lovely light oil to start with. Where to begin massage.  The legs and arms are probably the best place to start massage, whether you have done it many times before or this is your first try.  This is because it feels safe for your baby, and it is easier for mums and dads to control a leg or arm.  Keep the strokes going in an upward direction towards the chest, this improves blood flow around the whole body. Some babies do not like massage, and so here you have to choose whats best for your baby. Keeping massage sessions to just the legs for a while, and keeping sessions short is one way to ensure success.  Under 7 mins.  Or switch it up and do a few massage movements while baby is in the bath.  Keep the massage short and do some more later in the day.  Increase this time slowly, and suddenly you will have your kids lining up for their daily dose. Babies sometimes love massage and then suddenly not.  Use this unusual and sudden change to your advantage. It may be the first clue that your baby may be at the beginning stages of getting sick.  And it may also indicate that baby has had a stressful day, and so extra cuddles are required. And yet still some babies do not like massage, no matter what you try.  Deep touch, light feather touch, only 7 minutes, in the morning, in the night. That’s also okay, I am sure you know a few of your friends who would rather never hug. Sensory integration takes time, patience is the answer here.  Touch should never be forced, no matter the age.  Keep listening to your infants unique verbal, and non verbal clues. Some parents who have children with special needs, have found massage to be an especially special bonding experience, a time of quiet non verbal communication and attachment to one another. Babies of any age can benefit from massage.  Massage can help increase sleep, improve restless sleep, reduces muscle pain for toddlers who are just crawling and walking while improving motor skills, massage can reduce stuffy noses, and can improve digestion.  At times babies appreciate songs or rhymes and talking during the massage, simultaneously stimulating language skills. And yet at other times a quiet peaceful room, to increase sleeplessness is most useful. Keep it fun and lighthearted, a time to bonding, a time to reconnect after being apart and  for getting to know one another.The key to successful massage, make your massage routine fit your families unique needs and schedules.

Kim-Young

HypnoBirthing – Taking the birthing world by calm

The world for the pregnant woman is one filled with excitement, anticipation, anxiety and, in many instances, a very real fear or trepidation, particularly for first timers. HypnoBirthing® is designed to alleviate the factors which cause fear, allowing you to birth your baby using your body’s natural, perfectly designed, and ultra-efficient muscles and pain relief to manage the process calmly and with minimal discomfort. Understanding how pain occurs At the onset of labour, all the senses mentioned above become heightened, and all too often, the fear responses take hold, and begin to govern the progress of the labour. In physiological terms, the body’s response to fear is to release adrenaline, causing muscles to tighten (the flight, fight or freeze response), and blood to divert to the major survival organs (of which the uterus is not one). Thus, the very muscles designed perfectly to birth your baby begin to work against each other and cause pain. The pain causes the body to release more adrenaline, and a cycle of pain-adrenaline-pain is triggered. Added to this, the lack of oxygen in the uterine muscles creates lactic acid, increasing the level of pain even further. The way your body is supposed to work In contrast, when a woman is excited and relaxed about meeting her baby, and she understands and trusts that her body is perfectly designed for the task, she releases endorphins, the body’s natural relaxant, at the onset of labour, which supplement the hormones specifically released to allow her to birth her baby easily. This powerful natural combination of endorphins (which help the muscles relax and are also 200 times more potent than morphine!) and hormones makes the birth an exhilarating and exciting process, rather than one filled with escalating pain and discomfort. How HypnoBirthing® works for you By using a range of simple self-hypnosis, breathing and relaxation techniques, from around 28 weeks of pregnancy, HypnoBirthing® mums are, with regular practice, able to reach a deep state of relaxation, allowing them to switch off the part of the mind which is responsible for triggering the adrenaline release. You’re in full control – the techniques produce an effect no different to the mild state of hypnosis experienced when you become engrossed in a good book, watch TV, daydream, or drive (ever got somewhere and not remembered parts of the journey?). The relaxation makes pregnancy easier and more enjoyable, and HypnoBirthed babies are on average significantly calmer and more relaxed infants. HypnoBirthing® statistics speak for themselves 95% of women are capable of having a ‘comfortable’ birth without medical intervention; 70% of women that have used HypnoBirthing® used no pain relief at all; a further 15% used only something mild such as Entonox (gas and air). HypnoBirthing® was founded by Marie Mongan in the late 1980s in the US and is now taught in 34 countries worldwide. Only practitioners affiliated with the HypnoBirthing® Institute (still run by Marie Mongan) are qualified to teach the course, of which there are now many generic versions.    

Parenting Hub

The key to dealing with your child’s fever

Most parents will attest that watching a child go through the discomfort of a fever can be very stressful on both emotional and practical levels. Knowing just what to do, and when to do it, is a challenge moms have faced for many generations. Clinically speaking, fever is a normal physiological response that allows the body to fight an infection.  This sounds simple enough, but there are many realities at play that make the management of a fever especially complex for parents. Firstly, a raised temperature can be a warning sign of serious illness as well as an indicator of a child’s normal response to an infection. This is one of the primary reasons parents are often so worried about a child’s raised temperature. Another issue is the fact that fever is uncomfortable and distressing for the child, and no parent wants to see their child stressed unnecessarily. If steps can be taken to reduce the load that comes with a fever, they should be. As a result of this complicated context, establishing clear guidelines through which to assess a fever is a very important exercise for parents and health practitioners alike. Experts make it clear that the parent’s primary goal in treating a child with a fever should be to improve their overall comfort, rather than to focus on the normalisation of body temperature. When, however, the fever contributes to pain or notable discomfort, such as a headache, the use of analgesic medication for relief is appropriate. In addition to paying careful attention to assessing and controlling the child’s general discomfort, parents should also familiarise themselves with the broader guidelines set out by health professionals in the management of fever in children. Essential Fever Management Tips Avoid over and under-dressing: Obviously parents should avoid under-dressing the child, but it’s also important to remember that over-dressing prevents the body from cooling. Dress the child in cool, light clothing, preferably a single layer. Cover them with a sheet or light blanket. Relieve pain as it arises: Use approved paediatric products able to offer effective yet gentle relief if the child is in discomfort and / or pain. Products like Calpol are safe to use from 3 months to 6 years for the symptomatic relief of mild to moderate pain caused by teething pains, fever, toothache, sore throats and headaches. Use fluids: Children lose water during a fever and can become dehydrated, so give them plenty of cool liquid to drink. Love: There is nothing more comforting to a distressed child than receiving love and affection. Calpol is available in a 100ml bottle at a Recommended Retail Selling Price of R39.99 Calpol is also available in a 50ml bottle at a Recommended Retail Selling Price of R19.99 Calpol directions for use: Shake the bottle before use NOT RECOMMENDED IN INFANTS UNDER 3 MONTHS 3 months to 1 year:  ½ a medicine measure (2.5 ml) 1 – 2 years: 1 medicine measure (5 ml) 3 – 6 years: 2 medicine measures (10 ml) May be given 3 to 4 times daily, but with an interval of 4 hours between each dose. Doctor should be consulted if no relief is obtained within the recommended dose. (2) DO NOT USE CONTINUOUSLY FOR LONGER THAN 10 DAYS WITHOUT CONSULTING A DOCTOR Footnotes: 1. Janice E. Sullivan, MD, Henry C. Farrar, MD, and the SECTION ON CLINICAL PHARMACOLOGY AND THERAPEUTICS, and COMMITTEE ON DRUGS, Fever and Antipyretic use in Children, Published in Pediatrics 127:580–587, April 7 2011, Page 1 2. Janice E. Sullivan, MD, Henry C. Farrar, MD, and the SECTION ON CLINICAL PHARMACOLOGY AND THERAPEUTICS, and COMMITTEE ON DRUGS, Fever and Antipyretic use in Children, Published in Pediatrics 127:580–587, April 7 2011, Page 1 3. National Collaborating Centre for Women’s and Children’s Health, Feverish Illness in Children NHS National Institute for Clinical Excellence Quick Reference Guide 47, May 2007, Page 14 4. Noel Cranswick and David Coghlan, Paracetamol Efficacy and Safety in Children: The First 40 Years,  Published in the American Journal of Therapeutics 7 p. 135-41,  2000, Page 1. About GSK GlaxoSmithKline (GSK) is one of the world’s fast moving consumer health care companies.  GSK has a factory in South Africa, situated in Cape Town. The company has a proud track record of helping South African families to do more, feel better and live longer through the use of appropriate, scientifically proven products. For more info visit: www.gsk.com

Paarl Dietitians

Feeding Problems in the Early Years of Life

When you’re a new mom or dad, it can be a huge challenge to parent a baby who’s always cranky. Friends may say your baby is “colicky” or suffer from “reflux” What’s going on and how can you make it through this? COLIC Colic is common, poorly understood & frustrating feeding problem and cause considerable stress for parents & health professionals. Colic is the word derived from the Greek word meaning ‘colon’ and it implies that the baby cries because of stomach pain. Colic affects 10-40% of all babies. It is present equally in boys and girls and equally in both breastfed as well as formula fed babies. Crying seem inconsolably for hours at a time for no apparent reason and tends to occur in the late afternoon and early evening. Symptoms appear typically around 2 weeks of age, lasts until 4 months of age Symptoms usually peaks at 6 weeks of age Spontaneous resolution by 3-6 months of age (3 months: 60% of babies, 4 months in 90% of babies) Starts in premature babies 2 weeks after the due date Higher incidence in C-section babies Characteristics Inconsolable crying – for hours at a time, fussing & irritability in otherwise healthy baby Cry longer and louder for at least 3 days of the week and last about a minimum of 3 hours a day Present with excessive & persistent crying Difficult to comfort Screaming Drawing up of the legs/knees after feeds Tension of the body Fist clenching Arching of the back Flushing of the face Cause: Nobody really knows and the cause of colic remains a very controversial subject. What we do know is that it is related to an immature digestive system. Researchers have been trying to find out why babies cry for no apparent reason and some of the explanations include: Pain caused by build up of wind in the baby’s stomach. This may happen if they Overfeeding – swallow air when they cry, feed or suck. An intolerance to lactose A cows’ milk protein allergy/intolerance Imbalance in intestinal microflora (good and bad bacteria) Maternal smoking Whatever the reason, the most important thing to remember is that the crying is not anybody’s fault. You could be the most attentive, sensitive parent in the world and still have a colicky baby. You can be assured that colic usually resolve by itself within 4 months. Is there anything I can do to help my baby? There are many different things you can try to soothe your baby’s crying and discomfort. Every baby is different and respond differently to treatment, so if it doesn’t work today it may work tomorrow. 1. Keep a diary of your baby’s behaviour. Record your baby’s activities, sleeping, eating, crying, fussing for at least 4-7 days in a row. This will give you a good impression of your baby’s behaviour and possible triggers. 2. Positioning Hold your baby to your chest in the upright position or gently rock him in your arms. The closeness and body warmth will be comforting and soothing. 3. Getting rid of the wind When babies cry they gulp air which can make them windy. Try burping him by supporting his tummy against your shoulder and help dislodge any trapped wind. Massaging the tummy in a circular motion or a warm bath also help to relieve discomfort. 4. Making-up feeds Be careful when making feeds up, don’t shake the bottle to vigorously as this trap air bubbles. Ensure that the bottle is not in a horizontal position during feeding because it could cause your baby to swallow air. 5. Teat size An anti-colic teat or slow flow teat/bottle is a useful option to try. 6. Type of milk Breastfeeding:  If a baby is breastfed, correct latching to the breast is important to prevent swallowing air bubbles. Make sure that a breast is emptied before moving onto the next breast, since the hind milk contains much less lactose than the fore-milk and by swopping breasts to quickly your baby will end up filling themselves with fore-milk which could worsen the colic. Eating rich or spicy foods, dairy products or gas forming foods have all been associated with possible reactions in babies. If you think your baby’s crying is linked to something you’re eating a dietitian would be able to assist you with an elimination diet in order to identify the possible culprit foods as well as on a suitable vitamin/ mineral supplement to avoid any nutritional deficiencies. Formula feeding:  If your baby is unable to digest lactose (milk sugar) in a formula or is intolerant to cows’ milk protein then it may be beneficial to change their milk formula either to an lactose-free formula or an extensively hydrolysed infant formula. Your dietitian would be able to advise you on the most suitable formula. 7. Frequency of feeds It could benefit your baby by reducing the volume of feeds and increasing the frequency of feeding to help ease digestion.E.g. instead of having 6 feeds of 150ml at a time change it to 8 feeds of 115ml at a time. 8. Probiotics There is a possibility that the colic symptoms could be due to an imbalance between the friendly bacteria and the unfriendly bacteria in your babies’ digestive system.  Thus by supplementing the so-called friendly bacteria it may help to restore the imbalance and resolve their symptoms. 9. Digestive enzymes Enzymes can be given before feeds to help with digestion. If your baby is unable to digest lactose their body most probably lack the  enzyme lactase that usually digest lactose. A failure to break down lactose by enzymes causes the milk sugar (lactose) to end up in the large intestine where it starts to ferment and produces gas, eventually leads to discomfort and some cases diarrhoea. REFLUX AND REGURGITATION It is estimated that 15-30% of normal babies experience problems with mild to moderate regurgitation (spitting-up) and gastro-oesophageal reflux. It is not common immediately after birth, but normally appears within or during the first week

Skidz

Brain food – Eating for optimum brain function

As parents we always want what is best for our children, but we don’t always necessarily know what that might be. With some research we find what milestones our children should be reaching and how we can help them develop their brains. You might even have met a parent who refuses to feed their child sugar and might have thought it mean or wondered why. You might be one of the parents who have done it so that your child doesn’t get all hyper from sugar but why is it so vitally important to fee your child a healthy balanced diet? Many people know of the advantages that it has for the body, but how does it affect the brain? For the brain to work effectively it needs two things. A high-energy diet, this means lots of fruit and vegetables and oxygen. This is why exercise is not only good for the body but also for the brain. Your child’s diet needs many important minerals and nutrients to grow and develop optimally. Linoleic acid which is a polyunsaturated fat which is not made by the body is vital for proper transmission of information. In simple terms our brains transmit information through axons. These axons are insulated by the myelin sheath which needs polyunsaturated fat to repair itself. Basically, the better the insulation the better information is transmitted. So include vegetable oil and nuts in your diet. Iron is also important, as an iron deficiency decreases attention span, delays development, and impairs learning and memory. Potassium and Sodium is also needed in the right combination, which is found in raw fruit and vegetables. These include bananas, apricots, avocados, tomatoes, potatoes and pumpkins. Table salt however is not recommended. There are 5 simple steps to follow to feed your child’s brain. Eat a good breakfast with plenty of fresh fruit. Include half a banana or some kiwi. You can serve it with some plain full cream yoghurt too. Eat a good lunch, which includes fresh vegetables. Make fish, nuts, and vegetable fats important parts of your diet. Exercise regularly to oxygenate the blood. Encourage your kids to actively play outside, climb and run. Something to get the heart going. Drink plenty of water to get rid of the toxins in the body. Fizzy drinks or any other drink loaded with sugar should rather be avoided, so also tea and coffee for mom and dad, as these all dehydrate the body. Combine a healthy diet with age appropriate exercises and activities to give your child a head start by developing both his or her body and brain. SKidz Clever Activity Boxes provides the perfect exercises for brain and physical development. Each set includes a variety of activities with all the equipment needed to do them. Learning through purposeful play and exploring is what it encourages.

Parenting Hub

Flu – Don’t hesitate. Vaccinate…

 According to the World Health Organisation (WHO), every year there are around 5 million cases of severe flu with between 250 000 and 500 000 resulting in death. In South Africa the flu ‘high’ season is usually from April/ May through to August/September. Called ‘seasonal influenza,’ flu spreads very quickly, especially in crowded areas such as schools and public transport. When an infected person coughs or sneezes, droplets infected with viruses spread and people close by breathe them in. The virus can also be spread by contaminated hands. To prevent transmission, people should cover their mouth and nose with a tissue when coughing and wash their hands regularly. A cold is not flu Colds are viruses too. According to the Mayo Clinic there are more than 100 viruses that cause colds. Like flu, colds hit the respiratory system causing a runny or stuffed up nose, watery eyes, perhaps a sore throat and sometimes a cough. You might also get a low fever. But, unlike flu, colds come on slowly. Most people can feel themselves getting sick at least a day in advance. What exactly is flu? Flu is a viral infection that targets your head and chest – usually coming on suddenly. You may experience some of these symptoms: A high fever (higher than 39°C) with chills Dry cough or sore throat Blocked nose or nasal discharge Sweating and shivering Muscle aches and pains, especially in the legs Fatigue and wanting to sleep all day Get a flu shot Bonitas Medical Fund recommends having a flu vaccine and says it is the first line of defence when it comes to protecting yourself, with studies showing it reduces the risk by about 50 to 60%. The vaccine trains your body to recognize flu and fight it. There are three types of flu viruses: A, B, and C. Type C has the mildest of all the symptoms but type A and B are the cause of the flu epidemics each year. The vaccine is made up of a small, inactive part of that season’s flu virus. Being inactive, it cannot infect your body with the virus, yet it allows your body to make antibodies to fight it. In that way you’re building up immunity. Should a pandemic occur, at least your body has had time to acquire immunity against the current circulating flu viruses. Most medical aids offer one free flu vaccine a year and it’s a good idea to take up the offer, otherwise head to your doctor, pharmacy or clinic and pay for a vaccine. ‘The annual flu vaccine protects you against the current season’s three or four most common flu virus strains,’ explains Gerhard Van Emmenis, Acting Principal Officer of Bonitas.‘Besides protecting yourself it also protects the people around you, especially those more susceptible to getting ill and, if you do still get flu, it will be very much milder. ‘About 14.08% of absenteeism in corporate South Africa is related to influenza,’ says Van Emmenis, ‘although the vaccine isn’t perfect and there’s no 100% guarantee, it is by far the best way to lessen your chances of getting it. By doing this you can play a part in maintaining your and your family’s wellness and keeping yourself healthy.’ Bonitas advises everyone to have a flu vaccine but particularly those in high risk groups and it’s best to have this before the end of April. These include: People aged 65 or older, especially if living in a retirement home Anyone with a heart and lung problems, including asthma or with chronic illnesses like anaemia, diabetes or kidney failure Immune-suppressed people, including those who are HIV-positive Caregivers and close contacts of any of the above. Smokers, as they are more prone to respiratory illnesses Cancer sufferers The WHO reports that some preliminary studies suggest that obesity, and especially extreme obesity, may also be a risk for more severe disease. Children under the age of 12 years Children are also at risk Dr Iqbal Karbanee from Bonitas Babyline – the first dedicated children’s health advice line in South Africa says, ‘Children in particular have an immune system that is not yet fully developed. As a result they are very susceptible to getting the ‘flu. In addition, children are often exposed in crowded environments such as creches and pre-schools. There is a constellation of symptoms and signs to look out for including increased secretions from the nose, cough, fever, a sore body, diarrhoea and vomiting.’ Vaccines for toddlers and children For children over the age of six months having the vaccine for the first time, two doses are indicated, given one month apart. If a child has had a ‘flu vaccine before, then only one dose is required. Up to the age of 8 years, the dose of the vaccine given to children is half the adult dose. If a child is ill, the illness should first be treated fully before a vaccination is done. Prevention is best The most effective preventive measures are to reduce spread and contact through isolation when a child is ill. Keeping your child out of pre-school is essential to prevent further spread, or letting them staying at home until they feel better. ‘We realise these measures are subjective and not always possible,’ says Dr Karbanee, ‘so the best, safest and most cost-effective method of prevention remains vaccination.’ Taking antibiotics Remember taking antibiotics when you have a virus will not help and in some cases do more harm than good. It is only when it turns into a bacterial infection, following an infection with viral influenza, that an antibiotic can be taken. Signs of a bacterial infection include: Sinus pain, earache, a sore throat and a cough that lasts longer than 7-10 days. To get better take the prescribed medication, stay in bed, drink lots of fluids and give your body time to fight the infection. Both flu and colds are contagious which means you do need to take time off work to recuperate – this will help avoid spreading the disease and with

The Heart & Stroke Foundation

Tobacco smoking threatens childhood development

Smoking in SA – the good and bad by numbers Smoking rates in South Africa have decreased from 33% to 21%, largely thanks to effective legislation and taxation. However, the decline in smoking has plateaued over the last decade, and South Africans still smoke too much – with nearly 8 million adults lighting up 27 billion cigarettes every year. Smoking prevalence remains the highest in the Western Cape, where 42% of men and 1 in 4 women still smoke#. “Smoking increases your risk for heart attacks and stroke, lung cancer, pneumonia and emphysema – and also doubles your risk of tuberculosis. 50% of smokers will die early –  14 years earlier on average – from a smoking related disease”, says Prof Richard van Zyl-Smit of the UCT Lung Institute. Smoking habits often start young and children of smokers are more likely to start smoking themselves. The latest South African Global Youth Tobacco Survey reports that 17% of grade 8 – 11 learners smoke cigarettes regularly. A more recent study found similar figures amongst Western Cape University Students, with the use of waterpipes, commonly known as a hubbly bubbly or hookah, rapidly increasing. “Perhaps the most worrying finding is that 66% of high school learners don’t feel confident enough to ask someone not to smoke around them. These highlights just how vulnerable even a 17-year-old is to second-hand smoking,” says Dorothy Du Plooy, CANSA’s General Manager, Southern Business Unit. Tragically, the damage inflicted by second-hand smoking starts about 18 years earlier. The devastating effects of second-hand smoking on unborn and young children “The consequences of second hand smoking around infants and even unborn children are well known. Tobacco affects foetal development, increasing the risk of stillbirths, miscarriages, premature birth, certain congenital malformations, poor foetal growth, and sudden infant death syndrome.” Says Prof Tony Westwood, Head of paediatrics at Somerset Hospital, Western Cape Department of Health. This negative impact of parental smoking was illustrated again specifically here in the Western Cape, in the Drakenstein study. Researchers confirmed that 250 mothers-to-be were smokers by blood test, and could compare them with non-smoking mothers. Infants of mothers who smoked, or who lived in smoking households, already had nicotine in their blood at birth. Infants of smoking mothers were more likely to be small at birth, to develop pneumonia, and have poor lung function and reduces lung volume in their first year of life**. “This study reminds us of some of the early adverse effects of second-hand smoking. Repetitive exposure over many years will result in more and more damage which can lead to intellectual impairment, poor linear growth, learning disorders, ear infections, poor lung function causing the child to be more likely to get severe pneumonia, asthma, and other developmental problems”, explains Prof Westwood. The CEO of HSFSA, Prof Pamela Naidoo, elaborates, “Parents and caregivers have to play an active role in discouraging the onset of smoking.” She continues, “ultimately a lifetime of smoking or second-hand smoking leads to cancer, lung disease, heart diseases and strokes. Childhood tobacco exposure could mean these diseases set in at a much earlier age than otherwise expected. As South Africa’s burden of lifestyle diseases continue to increase, stopping smoking has never been more important.” Tobacco breaks the budget Tobacco can also indirectly hamper development in children – by robbing a household of several hundred Rand a month. In doing so, tobacco perpetuates the cycle of poverty as the poorest people spend less of their income on essentials such as food, education and health care. “The financial benefits of quitting come from direct and indirect cost savings. A packet a day amounts to R12 000 per year, excluding interest. The cost savings from averting pneumonia, developmental delays, heart disease, emphysema, and early retirement are far greater,” added Dorothy Du Plooy from CANSA. Whilst the tobacco industry remains a hugely profitable sector, the economic benefits for the country don’t add up either. Tobacco hinders economic growth, strains the healthcare system, worsens health inequalities, exacerbates poverty, and impacts on productivity in the workplace. In addition, growing tobacco instead of other crops has negative consequences on our environment and for sustainable agriculture. Tobacco production requires large amounts of toxic pesticides and fertilizers, contribute to deforestation and climate change, and produces over 2 million tonnes of solid waste every year, reports the World Health Organization. Be the change – let’s protect our children together All adults have a responsibility to respect the health of those around them. This never seems more important than when the health of children is at risk. For World No-Tobacco-Day 2017 the Western Cape Tobacco Task Force makes four simple requests to the public, including non-smokers: 1.    Smoke somewhere else Parents who choose to smoke, please do not smoke in the same room or near your children. Doing this does lasting and increasing damage on your son or daughter’s health. Rather smoke in another room, outside or have a no-smoking-in-the-house policy. Smoking in your car with a child younger than 12 years of age is also illegal. 2.    Mothers and mothers-to-be should seek help to quit Women trying to fall pregnant, already pregnant, or breastfeeding should actively seek help to stop smoking during this important period. “The first 1000 days of a child’s life, from conception to the child’s second birthday, is the best opportunity to make a difference and we need to empower mothers and fathers during this time and beyond”, says Maureen McCrea, Deputy Director Health Promotion from the Western Cape Department of Health. 3.    Smoking less is (also) more Many people have tried unsuccessfully to stop smoking or are still trying to do so. It is important to remember that smoking less is also success, and every cigarette less per day means less damage to you, and the children around you. 4.    Know your rights and speak up Be aware of the smoking legislation. ‘It is illegal to sell tobacco to anyone below the age of 18; to smoke in a car with a child younger than 12 years of

Parenting Hub

Refusing to Vaccinate Children could fuel rise in Antibiotic-Resistant Super-Bugs

The recent spike in measles cases in Gauteng and the Western Cape is as a direct result of parents refusing to vaccinate against the illness, which is of growing concern since the reckless habit of not vaccinating in general could fuel a rise in antibiotic-resistant superbugs, warn experts. Annemarie Blackmore, Pharma Dynamics’ Antimicrobials Portfolio Manager says vaccinating your child is paramount in the ongoing fight against antibiotic-resistant superbugs. “Antibiotic resistance is when an antibiotic has lost its ability to effectively control or kill bacterial growth and is exacerbated by the unnecessary and incorrect use of antibiotics. Vaccines have the potential to decrease disease, which can in turn reduce the need for antibiotic use,” remarks Blackmore. Many parents remain particularly sceptical of the Measles, Mumps and Rubella (MMR) vaccine, following a UK study that linked the vaccine to autism. It also sparked a wide debate on social media and raised a question around the safety of vaccines in general. Blackmore says the study has since been proven fraudulent by an investigation published in the British Medical Journal (BMJ), but the damaging effects remain, and as a result, many parents are in two minds about whether to vaccinate their children. “Contrary to these mistaken beliefs, vaccines are and will continue to play a pivotal role, and even more so in the next two to three decades, in combatting illnesses and anti-microbial resistance alike.” South Africa is still some way off in meeting its immunisation targets, which given the alarming rise in not only diseases such as measles, but superbugs in recent years, it has now become a top priority. The total immunisation coverage in the country over the 2013/2014 period stood at 84.4% according to the district health barometer by the Health Systems Trust – an NPO with a focus on improving health systems in the country. The figure points to a drop in almost ten percentage points from the 94% coverage, which was recorded the year prior, indicating a significant decline in the overall administration of vaccines. According to Blackmore there is a 30-year void in the discovery of new types of antibiotics, with no registered classes of antibiotics having been discovered since 1984, which reaffirms the importance of using what precious antibiotics we do have, responsibly. “Already AMR is estimated to kill more than 700 000 people globally per year. If not addressed, 10 million people are expected to die annually because of drug-resistance by 2050. “Everyone can and should play their part by vaccinating themselves and their loved ones against the diseases outlined in the World Health Organisation’s (WHO) expanded immunisation programme. To access this list, visit http://pharmadynamics.co.za/wp-content/uploads/2016/11/VaccinatorsManualFinal.pdf,” urges Blackmore. Measles is one of the most infectious diseases in the world and could cause brain damage, pneumonia and/or blindness. Look out for a high fever and flu-like symptoms. Two to three days in, tiny white spots may appear inside the mouth, followed by a rash, which usually starts out as tiny flat red spots on the face, neck, trunk and extremities. If you suspect your child has the measles, visit a GP or nearest clinic to you immediately.

Paarl Dietitians

Tackling the Fussy Eater

Selective eating or fussiness is a common phenomenon among toddlers, children and even adults. This may be a more serious situation than “I just can’t stand spinach”, and this may include toddlers or children who refuse food or meals altogether or limit, restrict or avoid total foods and food groups due to taste preference or anxieties. We explore causes and potential problems as well as some solutions. WHY SHOULD WE BE CONCERNED ABOUT SELECTIVE EATING AND LIMITED FOOD INTAKE? The main health concern in people with selective eating is risk of nutrient deficiencies, which happens quicker than we realise. It is very common for fussy eaters to suffer from brittle bones, iron deficiency and a poor immune system or mouth ulcers which can all be signs of nutritional deficiency. Poor dietary intake can also impact on the muscle mass, strength and energy levels of the individual. Furthermore, if it is a childhood problem, and is not dealt with, it can easily translate into an adult condition. WHEN SHOULD WE GET CONCERNED ABOUT SELECTIVE EATING AND LIMITED FOOD INTAKE? It is important to distinguish between when it is just a phase that will be overcome and when it is a rather serious situation that may need to be taken seriously and perhaps seek professional help. There are a few red flags to look out for: when less than 20 types of food are accepted when fear and anxiety is involved during eating or pertaining to food when entire food groups are rejected i.e. dairy products or meat or meat alternatives when it is causing stress and pressure in social situations when there are obvious signs of weight loss or nutritional deficiencies HOW TO TACKLE SELECTIVE EATING Put your mind at rest Anxiety over food intake and health will only make the situation worse so try to avoid it. If you have concerns about your child or loved one’s health, growth or weight due to the selective eating, send them for a health check at your GP or speak to a dietitian. If it is a recent development, be assured that it might be a passing phase. Rely on a good multi-vitamin and mineral supplement that provides 100% of the recommended daily intake of most vitamins and minerals and make sure it is cost effective and age appropriate. Keep a food diary To get more information on the quality of the diet, keep a detailed food diary of everything that was consumed for a week. Be specific about quantities, times and brand names of products. Have it analysed by a registered dietitian who often has computer software that can provide a detailed analysis. This will tell you exactly which nutrients are deficient in the diet that may need attention. Avoid the battles To fight, argue and nag is going to heighten the anxiety and make the situation worse. Try and avoid confrontation about the issue. In the case of children, they often thrive on attention, even if it is negative attention. Often if the bad behaviour or food refusal is ignored and not acknowledged, they will try something else to gain attention and the phase shall pass. Also be sure to give positive feedback when food was eaten and praise good behaviour. Avoid overcompensation and never force Do not fall into the habit of offering anything “as long as they will eat something”. Children especially, will start to accept more food if you rely on their hunger signals and not give any food they might desire. The more it becomes a manipulation tool, the harder it will be. Force feeding is strongly discouraged and will aggravate the situation. Rather remove the offending food, without an issue, and offer it at a later stage, avoiding offering a preferred option. Do not use food as a bribe or reward. Encourage frequent exposure Research shows that a food type needs to be offered around 8 to 15 times before it will be accepted. Keep offering a wide variety of food consistently without pressure, but with positive encouragement. Make meal times fun and relaxed Sometimes you have to be creative and pull out all the stops to make meal times fun and pleasant. Have a food fight in the garden, involve your child in cooking and baking, and make interesting shapes and fun food presentation. Have meal times together as a family. Set a good example for your children. About 20 – 30% of children have this issue at some point, so do not feel excluded or isolated if this is what is happening to you. If it becomes unmanageable, seek professional help before it all spirals out of control.

BabyLegends Hugseez

What is Reflux?

Reflux is a very common problem in tiny babies.  It is also known as possetting or spitting up and happens when milk that has been ingested travels back up through the oesophagus or food pipe. Babies also have stomach acids that are necessary for the breaking down of food.  When you feed your baby milk, the mixture of acid and milk can be regurgitated and can make baby very uncomfortable.  If you’ve ever suffered from heart-burn, then you know what it feels like. A Baby Wrap Carrier can prove to be incredibly handy to help alleviate reflux as it allows your baby to be in a comfortable upright position with no added pressure on his or her little tummy. When baby is feeling uncomfortable and a little stressed, carrying him or her in a Baby Wrap Carrier, helps to soothe and calm baby. Whilst reflux is messy and can be very frustrating, it is also very normal and at least 40% of babies suffer from this problem.  Up to 5% of babies can have as many as six or more episodes a day.  However, it is a temporary problem that usually gets better as baby grows and their digestive system matures.  A very small percentage of babies have what is known as severe or persistent reflux (gastro-oesophageal reflux disease or GORD).  Should you at any time believe that you baby falls within this percentage, we would highly recommend setting your mind at rest with a visit to your paediatrician. To understand the cause of reflux, you need to bear in mind that your baby’s stomach is very small at birth and grows bigger quite slowly as baby grows.  Baby’s food pipe (oesophagus) connects the little mouth to the little stomach at the bottom of which there is a valve that is controlled by a ring of muscle.  Sometimes as baby’s tummy becomes full with milk, the little valve doesn’t stay properly closed and allows some of the mixture of milk and stomach acid to move back up the food pipe.  We would caution against adding cereal to make baby’s milk thicker as there is no scientific proof that this helps with reflux.  Once again, if you are unsure, consult your doctor first. Reflux can be prevented in a number of ways : Feed your baby in an upright position  Hold baby upright for about 20 or 30 minutes after each feed  Put baby in a baby wrap carrier after each feed Try giving baby smaller, but more frequent feeds For bottle fed babies, burp every two or three minutes during feeds and also make sure that the hole in the teat isn’t too large.  A teat that’s too big can cause milk to come out too fast which in turn makes baby gulp, swallowing air and exacerbating reflux Try raising the top of baby’s cot by putting a flat pillow under the mattress and whilst your baby should still sleep on his or her back, it may help if their little head is slightly higher than their feet

Doug Berry

BWRT: Reworking our Emotional Wiring

A short time ago, I attended a weekend seminar that introduced myself and several notable psychologists and psychiatrists to an emerging therapeutic technique with thus far, amazing results. BWRT is the acronym for Brain-Working Recursive Therapy and I’d like to tell you a little about this potentially life-changing approach to modern therapy. Brain Working Recursive Therapy® is an innovative new concept of psychotherapy, completely unlike anything that has gone before it. It presents an entirely new view of the subconscious mind – one that is extremely ‘user friendly’ and easy for the client to understand – as well as an elegant way of providing psychotherapy that gets easily beneath the Conscious Critical Faculty. The mind behind this amazing therapy is a man by the name of Terence Watts, who together with his South African counterpart, Rafiq Lockhat, have taken this approach from concept to practice over the years and are now training mental health professionals to utilise it for their client base. BWRT® has been designed to disconnect emotive responses from memories that are deeply troubling and create new, adaptive neural pathways that do not have the old undesirable emotional responses attached to it. This therapy is largely content-free, which means that it is not always necessary for the client to divulge their troubles in great detail, and of short duration, using the client’s own thought processes to effect a release from the symptomatic pattern – and there is a strict protocol which ensures maximum effectiveness and safety. In essence, we are creating new “emotional memories” that attach to the recorded memory of an event or period or anxiety-provoking situation. The client does not necessarily forget the event, but has altered the emotional response to it to be much less traumatising, allowing them to process the event from a healthier, less disruptive vantage point. Conducted by qualified, trained and experienced professionals, there is no significant risk to the client. Their wellbeing and emotional needs are paramount. They must be willing to engage on a level that will have them dealing with an emotional event and related trigger. The risk is that the technique doesn’t work for them, although every effort will be made to the contrary! Clients are informed that this is a short duration therapy process and with effective treatment, they shouldn’t have to present for more than 3 sessions with their therapist! BWRT is proving truly effective with the following concerns:  Commitment Anxiety Phobias,  Panic attacks,  Generalised anxiety disorder,  Exam anxiety,  Social Phobia,   Success Inhibition,  Fear of failure,  All types of Performance Anxiety,  Self-Worth/Self-Confidence Issues, Fear of Authority, Relationship Issues, Grief, PTSD and many more.   The list of professionals using this type of therapy is growing with every training conference, and the results are proving outstanding! If you’re interested, please don’t hesitate to contact myself for further information!

Parenting Hub

Toddler Food Battles

Solving a complex problem at work, finally achieving a personal goal is nothing compared to your child finishing a whole plate of food. Isn’t it amazing that no matter how big your accomplishments in your day, NOTHING, absolutely nothing compares to the satisfaction you get watching your toddler successfully finish a meal. You can sleep peacefully know your baby has eaten ‘well’! Having a fussy eater is more common than you may think. While some babies eat almost anything they can get their little hands on, other babies are a lot pickier. Some fussy eaters are simply trying to express their independence with a say in what, when, where and how they eat. Others just need some coaxing, distraction and gentle encouragement. Perhaps your family dinner table has become a battleground? Then it is time to take the stress out of mealtimes with your toddler and child, end the arguments over food, and feed your fussy eaters. There is nothing like a food battle to cause stress and anxiety in parents – take heart and remember fussy eating isn’t just common, it’s normal! Understanding your child A classic time for problems to arise is when your baby is 12 months old. As a child is more aware of the world his natural instincts make him more suspicious of new foods. Nature’s way of protecting us from eating food that is potentially harmful. If you’re one of the lucky parents that sailed through weaning, another common time for problems to arise is during the challenging 2’s. Having lulled you into a false sense of security, your toddler could wake one morning with dietary requirements that even a top chef would struggle to meet. Children’s appetites are affected by growth cycles and they have different taste preferences to adults. You will encourage her appetite to work properly if you give her more when she’s hungry and let her eat less when she’s not interested. Growth slows down and appetites fluctuate between one and five years of age. Studies have shown that most children get plenty to eat even if it seems like they are barely eating at all. Try looking at mealtimes from a child’s perspective. Toddlers have a different agenda: from their point of view, eating is a waste of their playing time, and if we make mealtimes boring by nagging, it’s even worse. Here are some tips to help your little fussy eater learn to eat better, while giving you some peace of mind. 1. Put your mind at rest: If you are concerned about the health of your child, take her for a check up at the doctor to rule out any potential health problems. Keep a food diary for 2 weeks and record EVERYTHING that she eats and drinks (include quantities). You can then get this assessed by a health professional to assess adequate nutritional intake. Give an appropriate vitamin & mineral supplement during the fussy eating phase. 2. Stay off the battle field: Remember picky eating can also be a child’s way of asserting his independence and may have less to do with the actual food than his need to push the limits of your authority and assert some control over his life. This is why pressurizing a child to eat often back fires and you become a ‘casualty of war’. 3. Wean at the appropriate age Weaning late has shown some link to fussing eating. Parents who delay introducing their babies to chewy food and a variety of tastes could find their babies grow up developing food fads. A recent study showed that babies should be introduced to a more varied diet between the ages of 6 to 9 months to decrease the risk of becoming fussy eaters. Babies learning to eat will spit food out, and this is more than likely due to a ‘tongue-reflex’ action than a sign that your baby doesn’t like the food. Keep trying with that food and soon he will get used to it and swallow. 4. Fun food presentation Sandwiches cut into moon shapes, cracker with a smiley face, carrot sticks as soldiers and apple boats can make food presentation more enticing Presenting meals as a smorgasbord from which they can pick and choose from a variety of colours, shapes and textures. Toddlers and young children prefer foods that are identifiable and not one big mush. Using a compartmentalized plate that prevents different foods from touching is a great help. 5. Make mealtimes fun and relaxed Use it as an extension of playtime and time when you and your baby can bond uninterrupted (no cell phone calls or sms’s !!!). Do puzzles, read a book, tell a story. 6. Educate Talk about the food and its value in simple terms. E.g. this piece of chicken will help your muscles grow strong like daddy (or superman!!) and this carrot will give you beautiful eyes like Cinderella! 7. Involve your child in food preparation By involving your child they will be likely to eat what THEY have made and may eat a bit while preparing their meal. 8. Empower your child in decision making Allow your toddler to choose between two food options. Children are more likely to eat food they have chosen for themselves. 9. Serve simple, easy to prepare meals. There is nothing more demoralizing than spending ages cooking a gourmet meal for your baby, who after the first spoonful turns her head away. Prepare easy meals that you know your child likes and should they refuse the food, offer one alternative that is a sure win e.g. Yogurt. 10. Milk intake By the age of one, babies need drink only 500ml of milk daily. Most babies can go onto cow’s milk from one years of age unless health reasons dictate otherwise. Do not substitute milk for meals 11. Social eating People are social beings as are our children. Nothing makes a toddler want his food more than having another toddler after his food. Invite a friend over

Parenting Hub

Play Therapy

Essentially play therapy is psychotherapy for children. As children communicate by means of play, this is the most effective form to assist them with their feelings and understand what is concerning them. Play therapy however, does not mean that the child goes to the therapist to just play and have “fun” and neither does it necessarily mean that the child has to talk to the therapist in the conventional way. Children don’t have the necessary skills to have an in depth discussion with a therapist about what is bothering them, much like adolescents and adults are able to. Play therapy is thus a means for the child to ‘talk’and/or communicate via playing and for the therapist to understand and to ultimately assist the child heal. Play therapy is a researched supported, well thought – out, and developmentally based approach to helping children cope with and overcome difficulties that may arise in their lives. Play therapy therefore encompasses psychotherapy through various methodologies. What that means is that in order to help the child, various methods are used, which are based on diverse theoretical schools of thought, for example, cognitive behavioural therapy, psychoanalysis, and gestalt therapy, to name a few. Many child psychologists tend to be eclectic in their approach to play therapy, therefore they draw on various schools to assist the child. Within the various schools of thought various “tools” are used to assist the child. A skilled child psychologist will take the direction from the child as to what approach and technique would best suit the individual child. Some techniques or “tools”are described here: Bibliotherapy For a long time psychologists have been using books to help children with a wide variety of problems which is called bibliotherapy. There are many storybooks available to help children understand and cope with such diverse problems as divorce, understanding death, and making friends. The stories generally contain a positive role model which children can relate to and give them realistic examples of how to cope with the various difficulties. Art therapy Many psychologists use art techniques to help children communicate and explore their troubled feelings. Because most children love art they learn to communicate their emotions, cope with anxiety, and heal emotional hurts. With art, children can express feelings and concepts for which they don’t yet have words for. Some children naturally gravitate towards art or doing something creative and this is an ideal method to assist children with their difficulties. Puppets Puppets are a useful and non-threatening tool for children to communicate with. It is usually easier for children to express (difficult to communicate) emotions such as fear, anger, confusion, anger and sadness by acting them out whilst utilising puppets. In addition, puppets often provide an opportunity for the play therapist to interact with the child and also to add and solicit material as required. For example, to increase a child’s ability to cope with difficult situations in a positive manner rehearsing or playing out with puppets can serve as a powerful example as to how they need to ‘see’ the new skill, whilst simultaneously talking about it and practising it by the use of puppets. Psychodrama Psychodrama is a method of helping children tell their ‘stories’ and safely express strong feelings. The child creates their own ‘production’ whereby they communicate their feelings. New behaviours and roles are also tried out with the help of the child psychologist in order for the child to learn new skills and develop coping resources. Sandtray therapy/Sandplay Sandplay is another way for children (and adolescents) to express what they have difficulty with, the inexpressible. The process of sandplay/sandtray therapy is to use sand along with miniatures which provide children with symbolic ways to represent their inner world. It is a fun, non-threatening approach where children feel safe to explore feelings that may be otherwise overwhelming for them. Guided Imagery/Visualisation Guided imagery and visualisation is a process whereby children are assisted by using their imagination in a focused way to help with a variety of problems, such as anxiety and difficulty with concentration. The child psychologist provides scripts which are fun and easy to use and which help the child master new skills to overcome their difficulties. Therapeutic Games There are numerous games, developed by child psychologists, that provide a fun way of assisting children and adolescents explore various concerns and learn new skills. Games assist children with specific issues such as divorce, managing anger, mastering social skills, improving self-esteem and dealing with bullies to name just a few.

Lynne Brown

Childhood Allergies

Spring is set to arrive soon and what a wonderful time of the year it is, unless, of course, you’re the parent of a child plagued with allergy symptoms that are exacerbated at this time of the year. Seasonal allergies, commonly known as hay fever, are caused by pollens from trees and grasses or airborne mould spores. Symptoms include sneezing, itching of the nose and mouth, red, watery and itchy eyes and a consistently thin and clear discharge from the nose that may also become blocked. However year-round allergies to house dust, animal dander, feathers, mites and chemicals may also be troubling your child. And then, of course, there are food allergies. In infants the first symptom of a food allergy may be a rash such as eczema (atopic dermatitis) or a rash that resembles hives. This may be accompanied by colic, nausea, vomiting and diarrhoea. However food allergies in children can also contribute to chronic health problems, such as asthma, ear infections, fatigue, headache, irritability, chronic runny nose, acne, bedwetting and even difficulty maintaining concentration (attention deficit disorder, or hyperactivity). Dark circles under the eyes (called “allergic shiners”), along with a puffy look to the face, are frequently seen. (Cow’s milk is very often the culprit here). Allergic children often look wan or pallid and lack vitality. This is because food allergies can also cause digestive problems that interfere with the absorption of vitamins and minerals, no matter how nutritious the diet In the presence of an allergen, a child’s built-in defence system releases histamines and similar chemicals to fight what it perceives as an invader. A string of reactions such as the swelling and congestion of nasal passages and increased mucous production results. Conventional medicine using prescription antihistamines, nasal sprays or decongestants, treats symptoms only. Many of these medications have nasty side-effects and if used consistently may lose their effect or rapidly produce dependency. A Nutritional Therapy Approach To Treating Food Allergies The most common foods that cause allergic reactions in children are wheat, dairy products, eggs, fish and seafood, chocolate, citrus fruits, soy products, corn, nuts, peanuts and berries. On the chemical list are additives such as artificial colourants, preservatives (e.g. benzoic acid), flavour enhancers (e.g. MSG) and sulphites found in some frozen foods, dried fruits and medications. To identify what foods are making your child miserable use an elimination diet or keep a diary recording your child’s symptoms and the foods eaten. (Some children seem to be particularly drawn to a problematic food and actually crave it, so be wary if your child wants to live on peanut butter or wheat bread or dairy products). Simply eliminate the suspected food from the diet for a few weeks and watch for improvements. Eliminating all dairy products would be a good place to start. Dairy foods can stimulate an increase in mucous production. Rice, oats or goat’s milk are possible alternatives. If your child’s allergies are seasonal, it may also be helpful to avoid whole wheat during the allergy season. Good substitutes include buckwheat, corn/maize, rice, millet and quinoa. If all the identified problem foods are eliminated from a child’s diet for at least 6 months and then introduced slowly one by one she should be able to tolerate small amounts of these foods. What Else Can Help? Encourage your child to drink lots of water to thin secretions and ease expectoration. Allergic children need a good wholesome diet comprising mainly raw fruit and vegetables. Avoid giving your child any processed foods as they will contain some of the additives mentioned previously. Nutritional Supplements That May Help Vitamin C, preferably in mineral ascorbate form with bioflavonoids, is a natural anti-histamine and a powerful promoter of a strong immune system, making it the most important anti-allergy vitamin. MSM (methylsuphonyl methane) is being prescribed more and more for its anti-allergenic properties. Essential fatty acids, such as those found in fish oil help to regulate the inflammatory response. Quercetin, a plant bioflavonoid naturally found in many fruits and vegetables, acts as anti-inflammatory agent and stabilises mast cells in allergy sufferers. Mast cells become unstable during an allergic reaction and release large quantities of histamine. A high quality green whole food multivitamin and mineral supplement will ensure optimum intake of essential nutrients and sufficient digestive enzymes. Ways To Prevent Allergies In the past it was believed that it was essential to avoid sensitization of infants before birth and for the first three years of life and so moms were advised to reduce exposure of the foetus/infant to known food allergens. However despite this, food allergy in children has increased world wide. Now there is a new take based on “The Development of Oral Tolerance” whereby it is believed that by exposing an infant before and after birth to small quantities of foreign proteins, the child’s immune system is stimulated to produce anti-bodies. Mothers are now encouraged to eat a wide range of foods during pregnancy, so that small amounts of all kinds of proteins can cross the placenta to sensitize the foetus. Mothers should also breastfeed for at least 4 months while eating a wide range of different foods. For infants that cannot be breastfed, hydrolysed infant formulas and goat’s milk formulas are a safer option than soy-based formulas. Soya is a well-known allergen which can cause as many allergic reactions as cow’s milk. Holding back on solid foods until baby is 5 months old is still recommended and using only one solid food at a time in small portions (1 teaspoon a day) to keep track of any adverse reactions. The latest research also suggests that pregnant women would do well to take supplemental probiotics every day for a few weeks before their due dates and while breast-feeding as this may help prevent childhood allergies. Bottle-fed and caesarian-section infants ought to be given probiotics orally from birth. Encouragingly most children, except those suffering from peanut allergy, outgrow their allergic response. Statistics show that 25% of infants are free of symptoms

Parenting Hub

Anxiety In Children

Most psychologists and other mental health professionals use The Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition Revised (DSM-1V R) to diagnose various difficulties or problems in children, adolescents and adults. Having a name or a “label”is useful in many ways, for example without a name and specific criteria it becomes difficult for further research with regard to understanding and developing effective and valuable treatment. (Medical Aid schemes in South Africa won’t reimburse clients without a diagnosis). A name for the difficulty also makes it easier for parents to understand and often provides relief with the next point of receiving effective treatment from the clinical or child psychologist. A common clinical diagnosis in children is anxiety. Anxiety is the umbrella term for various types of anxiety which can be described as follows: Social Anxiety Disorder A child or adolescent with a social anxiety disorder shows significant and persistent fear of social situations in which they perceive potential embarrassment or rejection may occur. They experience acute (immediate) physical reactions to feared social reactions. These children often know their fears are greatly exaggerated, however feel powerless, hopeless and overwhelmed to do anything about them. They often avoid the situation which fills them with dread at any cost to the detriment of their academic and social life. Some children may just be fearful of one or a few social situations. In this instance the difficulty is referred to as a specific social phobia. When a youngster is afraid and avoids many social situations, it is referred to social anxiety disorder. Generally, the symptoms fall into three categories: Cognitive symptoms, what a child/adolescent ‘thinks’. However, are not always evident in young children as they may react with intense anxiety and not be able to verbalise what is distressing for them. Physical reactions, how the body reacts to situations; and Behaviour, which is mostly the avoidance of the perceived fearful situation. Separation Anxiety Disorder The crux of this disorder is excessive anxiety about being separated from the person to whom the child is most closely attached. For most children, this is the parent, especially the mother. Fear of separation from the mother or father is a normal part of development in children between the ages of eight and fifteen months. At this stage in their development, children are expected to object to separation vociferously with tears and other signs of distress. However, in older children extreme anxiety from brief separations from their parent/s is not developmentally appropriate. Separation anxiety disorder thus becomes detrimental to the child and stressful for the parent. Children with separation anxiety disorder typically cry, scream and cling on to their parent when faced with separation. If they have to leave their home or other familiar places they become tense and fearful, especially if they have to go alone. They miss out on many fun aspects of being a child such as going to parties and being free and having fun, or going for sleepovers. Even within their own homes children with separation anxiety are afraid to be left alone. They often follow their parents around and are reluctant to go to the bathroom or to any other room by themselves. Children with separation anxiety disorder often have significant difficulties sleeping alone. A common problem associated with Separation Anxiety Disorder is school refusal, whereby on most mornings there is an excessive upheaval and fuss to get these children ready, in the car and off to school. Difficulties in this regard are worse on Mondays, after holidays or after a bout of illness which required absence from school. Obsessive Compulsive Disorder (OCD) Children with Obsessive Compulsive Disorder have persistent and recurring thoughts “obsessions” that seem to have an adverse effect on their daily life and generally involve exaggerated and irrational anxiety or fears. The children feel compelled to perform repetitive behaviours, known as “compulsions”, in an attempt to ward off anxiety caused by their obsessive thoughts. Post Traumatic Stress Disorder (PTSD) Post Traumatic Stress Disorder occurs when children experience a physical, environmental or emotional trauma. Therefore, if a child has experienced a crime related trauma, such as being hijacked, experienced a burglary or mugging, or whether they experienced a natural disaster such as a flood, or being in a motor vehicle accident they may develop PTSD. One has to bear in mind though, that at times, what children experience as traumatic may not necessarily be perceived to be traumatic by adults (such as turbulence on an aeroplane) but might be especially upsetting to a child. Consequently, a child may experience the traumatic incident again and again via nightmares, continuously thinking about what happened, or by re-enacting the event when playing. Children with PTSD can experience symptoms of general anxiety such as difficulty sleeping and eating. They also tend to be irritable, avoid reminders of the trauma and are easily startled. Specific Phobias Children with a specific phobia experience intense fear of a specific object or situation (such as spiders, dogs, elevators) which is irrational or unrealistic. Children with these phobias often avoid situations linked to their fear. The most common specific phobia is the fear of animals, (especially dogs), snakes, insects and mice. Panic Disorder Children who suffer from panic attacks experience debilitating bouts of unexpected and recurring panic and fear. Panic Disorder is rare in young children, however it becomes more common among older children and adolescents. Panic attacks are relatively short periods of extreme anxiety. During a panic attack, the young person quickly by terrifying mental and physical sensations. The symptoms are: Pounding heart and/or increased heart rate Sweating Trembling and shaking Chest pain Abdominal discomfort and nausea Sensation of choking Dizziness or feeling “light headed” Feelings of unreality or detached from oneself Fear of losing control or “going crazy” Fear of dying Tingling or feeling numb Even when a child is not in the grip of a panic attack, just the thought that it could possibly happen again can make a child extremely anxious. Panic disorder causes

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