Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Medical tax rebates stable after budget speech

Private medical aid members can breathe a sigh of relief after the budget speech. Treasury has been hinting for a while that they were considering reducing of the medical tax credit to fund the National Health Insurance (NHI), fortunately, it remains unchanged for the year ahead. Although it was a relief to members it was also a surprise tax sacrifice, considering the need to fund NHI. This equates to over R30 billion this year and around R35/36 billion for the coming year – a large sum indeed. It is believed the removal of tax credits would have upset too many people who are dependent on it to access private health care and are essentially being rewarded for not burdening the government health care. Before 2012, SARS deducted your medical aid contributions against your taxable income. ‘Originally,’ says Gerhard Van Emmenis, Principal Officer of Bonitas Medical Fund, ‘your medical aid contributions would be a deduction against your taxable income. However, from 2012, SARS introduced a medical credit, a ‘tax credit’ which is deducted from your overall tax liability.’ The medical tax credit consists of the following two amounts: The medical scheme fees tax credit This applies to the premiums paid by you to a registered medical scheme on behalf of yourself and your dependents. The main member, as well as the first dependant on the medical scheme, receive a monthly tax credit of R310 (for the 2018-2019 year). All additional dependants receive a monthly tax credit of R209 (for the 2018-2019 tax year). There are three categories: 1. Under 65 (without disability) 25% of the total contributions paid to the medical scheme Less (4X medical scheme fees credit) Plus qualifying medical expenses paid less 7.5% of taxable income 2. Under 65 (with a disability) 33.3% of total contributions paid to the medical scheme Less (3X medical scheme fees credit) Plus qualifying medical expenses paid 3. 65 or over (with or without disability) 33.3% of total contributions paid to the medical scheme Less (3X medical scheme fees credit) Plus qualifying medical expenses It is important to note that if your premium is a deduction from your salary or wages, your employer is obliged to use the credit system to adjust your monthly PAYE tax accordingly. If you contribute to a medical scheme independently from your employer, you will receive the tax credit on assessment when you complete your tax return. 2. The additional medical expenses tax credit This means that the overall amount of tax you need to pay at the end of the tax year is reduced. The amount of your tax rebate is made up of a percentage of all out-of-pocket expenses you have spent on qualifying medical expenses that weren’t covered by your medical scheme. This amount accumulates throughout the tax year. You will need to keep the slips for these expenses. To calculate the additional medical expenses tax credit, special formulas are used. The specific formula to use depends on your age and whether you or one or more of your dependants has a disability. The following out-of-pocket expenses qualify: Consultations, services or medications from a registered medical practitioner, arthropod, physiotherapist, dentist, chiropractor, herbalist, homoeopath, optometrist, osteopath or naturopath Admission to a registered hospital, including nursing homes Care at patient’s home by a registered nurse, nursing assistant, nursing agency or midwife Medicines prescribed by a duly registered physician (as listed above) and acquired from a duly registered pharmacist Medical expenses on services rendered or medicines supplied outside of South Africa and which are substantially similar to the services and medicines listed above Money paid towards the treatment of a physical impairment or disability (as long as it is a qualifying expense prescribed by the Commissioner). What about over-the-counter expenses It is important to note that unless these are prescribed by a registered medical practitioner and acquired by a pharmacist they don’t enjoy a tax rebate. Examples include medicines, such as cough syrups, headache tablets or vitamins. ‘Whether NHI is going to materialise or not’, says Van Emmenis, ‘The Government’s coffers need filling and the approximately 17% of the South African population on private medical should expect their medical aid tax relief to get less and less in the future.’

March 15, 2019

Bonitas gives back

Members of Bonitas Medical Fund will now have access to free lifestyle vouchers as well as discounted offers on gap cover and financial services products through the Fund’s new multi-insurer platform. This is not another Loyalty programme. ‘Our members’ health has always been a priority and we strive to make healthcare as affordable as possible,’ says Gerhard van Emmenis, Principal Officer of Bonitas. ‘And while our various plans offer a host of benefits, we know that in difficult financial times money matters can add to stress levels. For this reason, we have adopted a multi-insurer platform which offers members discounted lifestyle vouchers as well as exclusive offers on gap cover and various insurance products.’ The past 12 months have been extremely difficult for consumers, impacted by the increase in VAT, the fuel levy and the resulting escalating prices. This has increased the burden placed on consumers struggling to make ends meet. ‘In 2017 a Financial Wellness Indicator revealed that 73.5% of South African households were financially unwell,’ says Van Emmenis. ‘2019 is no different. Consumers are cash strapped so being able to align with strategic partners to offer a comprehensive and tangible way to relieve the money pressure while helping them find them some ‘extra’ money, will go a long way to keeping them physically and financially healthy.’ A report published last year, which reviewed rewards programmes in South Africa, indicated that there are around 100+ existing loyalty programmes with the average consumer subscribed to about nine. ‘The economic landscape is tough to navigate and we didn’t want to add to the pressure already placed on our members by offering a loyalty programme for which they would have to pay an additional monthly fee for. Our multi-insurer platform is premised on negotiating exclusive deals to the benefit of our members. ‘They are designed to add real value aligned to member needs.’ Van Emmenis explains. In brief: These do not cost anything There are no points No levels of membership You don’t have to work for rewards The model is split in two. One: Free monthly discount lifestyle shopping vouchers to offset daily living expenses These are available from over 30 retailers and 6 000 outlets countrywide, such as Shoprite, Takealot and Edgars, as well as for airtime and data purchases and electricity. ‘The deals are aimed at the average South African, with discount vouchers for groceries, data, airtime and electricity. There are also discounts on activewear and gym membership to encourage a healthier lifestyle,’ Van Emmenis says. Two: Discounted financial service products through Medgap and Indie MedGap offers comprehensive gap cover at a discount of up to 26% exclusively for Bonitas members. Indie offers various financial products such as a funeral, critical illness or disability cover, as well as income protection at a discounted premium, together with a free investment at no extra cost. Indie will match and invest up to 110% of Bonitas’ member’s life insurance premiums, with cash drops every five years. The multi-insurer platform is supported by a new, revamped member zone to allow members to manage their medical aid 24/7, on any device. This includes submitting claims, applying for chronic medicine and viewing benefits clearly signalling a new era of medical aid has dawned.

March 2, 2019

Medical aid unpacked

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

October 30, 2018

Medical Aid choices

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

October 17, 2018

Medical aid payments

It’s a lament often heard. There are, however, two sides to every story and the problem doesn’t always lie with the medical scheme. There are a variety of reasons for non-payment ranging from members not following the correct claiming procedures or rules, benefits not being depleted or even providers not billing correctly. Gerhard Van Emmenis, Principal Officer of Bonitas Medical Fund gives some tips on what may have gone wrong and how to fix it. The important thing to remember is that medical aid scheme options differ, which means some options cover procedures that others might not, but there are certain rules everyone needs to adhere to. Your medical scheme will usually tell you the reason for non-payment. If you are unhappy you can take it up with them, however, the best advice is to first check that the fault doesn’t lie with you or the medical practitioner. Your membership number This may sound simple but it is surprising how often an incorrect membership number or dependant code is submitted with a claim. In some instances, this information is omitted or incomplete. A medical scheme cannot pay without proof that you had the treatment. Remember to update your details if you have changed your medical aid option or medical scheme. ICD-10 codes ICD-10 codes are used by medical schemes and healthcare providers, including doctors and specialists to identify specific conditions. These must be correct as they are a diagnosis for specific conditions. If there is no ICD-10 code or, for some reasons that condition is not covered by your medical aid, the account won’t be paid. Schemes also have sub-limits, for example they agree to pay for rehabilitation and the amount they will cover is finite, so check prior to the treatment. Certain dental procedures have definite sub-limits so it is important to read the fine print and check your policy for what is covered and what isn’t. Your contributions are not up to date It sounds simple but check that your debit order has gone through or that your employer has paid your contribution, non-payment of premiums could result in your bill not being paid – especially if your membership is suspended. The claim has expired Be aware that there is a cut-off date for submitting a claim. It is usually four months from the date of treatment. Ensure that the correct date is on the top of the account. Your benefits are depleted If you do not manage your medical aid benefits carefully you can run out of benefits before the end of the year. This means that you may have to pay the bill yourself. Different options have different limits for various procedures so, once again, make sure you understand what your option covers. Medical schemes are required to pay for Prescribed Minimum Benefits in full but you may have to use a specific provider. Waiting periods may apply When you join a new scheme there is a waiting period of three months and sometimes, based on your medical history, a twelve month exclusion could be enforced for certain conditions. If you claim before the waiting period is up, the bill will not be paid. Your hospital/doctor is not on the network Most schemes have hospital and doctors networks who agree on certain rates for their members. If you choose to go to another hospital or a private doctor you could end up paying a large portion of the bill. You didn’t use a Designated Service Providers A Designated Service Provider is a specific provider that has been appointed by a medical scheme for a specific service. If you choose not to use a Designated Service Provider, you may have to pay a co-payment or not be covered – depending on the Scheme Rules or your specific plan limits. Pre-authorisation was not obtained If you are going to undergo a procedure you need to get authorisation from your medical aid ahead of going to hospital and, once again, make sure you have the right information and ICD-10 Codes for this. You’re using medicine that’s not on the formulary Every scheme has a formulary, which lists chronic medication approved by your medical aid. These are often generics which are copies of the original medication but more affordable. Ask your pharmacist for a generic as a matter of course as it will ensure your benefits last longer. The procedure or treatment may be an exclusion All medical schemes have a list of exclusions which are not covered. This often includes cosmetic surgeries and non-medical expenses. Van Emmenis says, ‘If you read the small print and know exactly what the rules are for your medical aid and the plan you are on, you will be able to ensure that your benefits last as long as possible and that the bills are paid.’

April 24, 2018

Medical Aid and VAT

Since the announcement of the 1% Value Added Tax (VAT) increase by the Minister of Finance last month, there has been much debate around its impact on consumers and just how this will affect the money left in their pockets at the end of the month. With the revised general fuel levy, it’s clear that consumers will have to tighten their belts and adhere to stricter budgets. The rising costs of healthcare One area of concern is the cost of private medical aid and VAT. For years increasing healthcare inflation and economic pressures have been a challenge for the healthcare industry. ‘The reality is that when consumers are struggling, medical aid, which is essentially a grudge purchase, is often viewed as unaffordable,’ says Gerhard Van Emmenis, Principal Officer of Bonitas Medical Fund. ‘In addition healthcare costs are not regulated which is why it is crucial for medical aid schemes to continue to explore ways to contain costs without compromising the level of health care offered to members.’ Members’ contributions However he says there is some good news regarding VAT and medical aid because the 1% increase will not impact monthly contributions or annual benefits. ‘Many members are confused as to whether VAT is payable on medical aid contributions but let me reassure you it is not,’ says Van Emmenis. ‘The VAT increase will have no effect on members directly and what they pay every month. Medical aid contributions for 2018 are already set and Bonitas will not increase contributions mid-year to accommodate the change in VAT. So, while the increase in VAT may influence the price of services, it will not impact benefits.’ Van Emmenis says: ‘If your plan covers you at 100% of a Scheme’s Rate, you are still covered at 100% of that rate, no matter what the cost to the Scheme because the Scheme will absorb the VAT when paying for member’s benefits. The only impact is when it comes to savings and day-to-day benefits with members having a 1% lower buying power.’ The Council for Medical Schemes In fact changing contributions in the middle of the year can only be done with the permission of the Council for Medical Schemes following a request from the Trustees of the medical scheme. This is a rare occurrence and most schemes generally put through contribution increases in January each year. The law He adds that VAT is never the property of any private entity but belongs to the Government. ‘We are therefore only vendors that collect the monies on their behalf. From April 1, Bonitas will increase the VAT to all providers of the Scheme by 1%. However, although this will have a direct impact on the budget of the Scheme for 2018 it will be absorbed by operational surpluses and not passed on to members.’ Tax credits One positive announcement out of the budget speech regarding medical aid was around tax credits. ‘Medical tax credits are effectively used as an ‘expense’ when calculating tax and reduces the amount of tax payable by a household belonging to a medical aid,’ says Van Emmenis. ‘There are eight million people who rely on these credits to make medical aid more affordable. Speculation was rife that the tax credit would be removed but it is a relief that private medical aid members have some reprieve.’ Conclusion The bottom line: The 1% VAT increase and the additional 52 cents general fuel levy will have a knock-on effect for South African consumers, things will cost more. However, it will not affect monthly medical aid premiums or member benefits although it will have an indirect impact in terms of healthcare services being more expensive, which will reduce buying power.

April 12, 2018

Advice from the experts

Authenticity – the expression of self

The expression of self is something that we struggle with from birth. The inability to express what your true needs or feelings are creates a frustration within you, which if not managed, can in fact cause serious physical and psychological harm. So how do we manage this? More importantly, how do we help our kids deal with this conundrum. Conceptually, authenticity awakes feelings of peace and joy within you until you realise that maybe you aren’t quite sure what it is you need to do. As adults we have a legacy of hiding who we are, which means that teaching our kids differently can be tricky. To be authentic is in essence quite simple. It’s about acting in line with your values structure; it’s about voicing your opinion not someone else’s. It’s about making life decisions that are in your best interest and not something that you think someone else wants you to do. The best we can do hear, is model this for our kids to see. After all, they learn more from what they observe than what we tell them. Authenticity is about making the choice to be the best you that you can be. This means that we as adults need to re-assess our behaviour and make a conscious decision to model what we want our kids to learn. Of course, in the real world this isn’t always easy as we are so easily swayed by the opinions and perceptions of others. Our society dictates an in-the-box focus on life and in many instances discourages individuality. What the world needs is more people who are prepared to stand up for what is right. We need to teach our children to be individuals who are able to think for themselves. We need to do this by first freeing ourselves from thought patterns that add no value to our own lives. Feel that it is time to drop the shackles of mediocrity? Start by understanding your own value structure. If you are consciously aware of your values, you will make decisions based on your values, allowing no room for external negative input. Actively teach your children that it is okay to make decisions based on their value structure. Of course, we also need to temper that with teaching them to make safe decisions too. Learning to express your true self is the greatest gift your will ever give yourself. It’s a journey of discovery taking you to places you may never have seen or forgotten existed. You will get in touch with your dreams, set goals for a brighter future. For me nothing says I’ve “got it right” than when my daughter stands up for herself and what she believes is right for her. This does sometimes mean I get to bite my tongue every so now and again. It’s worth it.

August 2, 2016

Picky Eating Revisited

Picky eaters come in all shapes and sizes and so do their parents. I define a picky eater as someone who limits what he or she is willing to eat, won’t try new foods and won’t give a rebuffed food a second chance. Food allergies or sensitivities, sensory issues or an honest dislike of a particular food (but not hundreds of particular foods or entire food groups) are not the same as picky eating. If a child’s eating habits are causing trouble at your dinner table, here are 12 ideas to help you return the family meal focus to conversation and togetherness rather than battles over whether young Johnny will eat “just one bite.” 1.If you don’t want your child to eat it, don’t bring it home. When it comes to food one of the pillars of parenting is to protect the home environment. Attention to this non-coercive measure can prevent eating issues in the first place, or help defuse problems that have already developed. You decide what foods are welcome. 2. Institute a “one-meal rule.” If you don’t want to be a short order cook, making a separate meal for different children, stop. Keep the messaging positive: Tell your kids that the house rule is now one delicious dinner for everyone. Parents need to parent,Food related responsibilities in families should go like this: Parents are in charge of what foods are offered at home, and children can choose to eat it or not. If a child rejects the food, it is not the parents’ responsibility to offer something else. It’s fine to make sure the meal includes at least one thing that’s generally acceptable (even if that’s just plain pasta), and you should decide in advance what’s acceptable to you after dinner for a child who didn’t eat (a choice that’s distinctly different for toddlers than for teenagers). 3. A little hunger can go a long way. Snacks are fine but don’t overdo them. If children arrive at the dinner table hungry, they are more likely to eat what is in front of them. I routinely put salad on the table before the entree and found that salad eating spiked as a result. 4. Shop and cook together. Involve your children in every step as much as possible. Take them to the grocery store and ask them to pick any vegetable/fruit they want. Have them help you cook. Depending on their age, this can mean counting out cherry tomatoes to add to a salad, stirring, and later making a meal on their own. Even setting the table instills ownership. 5. Meet them where they are. If your children love roast chicken, don’t start the “one-meal rule” by making exotic pork dishes with a lot of sauces. Make basic food you know they like. This way it will not feel like deprivation. Additionally, make sure they can personalize parts of their meal: If you’re making burritos/omelets/burgers, have all the fillings/toppings in little bowls so they can choose what to add. 6. Don’t force them to eat anything. There are many schools of thought about this. Some people feel you should make them “just take one bite.” I don’t agree and think that this has a very negative implication and tends to backfire. Instead say, “Wow, these roasted brussels sprouts/shredded carrots/spinach pancakes are amazing.” Children who won’t taste don’t get nudged or judged. The 10th time you serve them, your child may, unprompted, take a bite. 7. Talk about what it takes to grow and cook food. Breed respect. When children understand that someone had to plant a seed and harvest a vegetable even before it gets to your kitchen, they will more fully appreciate what goes into making a meal. Even better, plant a little garden. 8. Be consistent but not rigid. Be sure everyone knows what the rules are, but if your rule is a home-cooked dinner every night and you’re exhausted, cut yourself some slack: get take-out. Eat breakfast for dinner. Pull everything out of the fridge and see who can make what. 9. Be a good role model. Children take their cues from their parents: if you don’t like something, don’t pretend to like it but express your pleasure that someone – even you — went to the trouble to prepare it. 10. Play. Experiment. Try different food “games” outside of dinnertime. We’ve had a lot of success with games where everyone can make a lot of choices and mix and match: Vegetable Tasting Extravaganza: trying many vegetables, each prepared in multiple ways. Raw Vegetable and Dip Experiment: trying different dips with different raw vegetables 11. Don’t refer to anyone as a “picky eater” or make a big deal out of their “picky eating.” If your child doesn’t eat carrots, don’t stop serving them, or when your child is a guest at someone else’s, don’t say: My child doesn’t like carrots. If you define them, it makes it much harder for them to change. 12. Use positive peer pressure. When my children were in pre primary school, their friends ate whatever my kids ate when they came to our house. I literally never had a child say: “I don’t eat hummus. I don’t like carrots.” Seeing a peer eat an unfamiliar food automatically makes it safer. You’ll be amazed at how many children will eat something because they see another child eating it.

July 29, 2016

Tips You Can Try TONIGHT To Help With Your Child’s Sleep Problems

Would you like to know one of the most important steps parents can take in order to get their child sleeping through the night? It’s very simple, very easy… and actually pretty fun, too! It’s setting up a bedtime routine. Now, I know you might be thinking “Oh, I already know about bedtime routines,” but stick with me here because there I’m also going to talk about the single biggest mistake that parents make with bedtime routines. Here are 3 easy tips to help you master your child’s bedtime: TIP #1: MAKE SURE IT’S FUN! Okay, this might seem obvious, but I’m going to make sure I say it loud and clear anyways… Don’t make your child angry at bedtime! Seems like common sense, but you’d be surprised how many clients I’ve worked with who insist on including baths in a bedtime routine — even though their child totally HATES baths! When I ask them why they’re forcing their child to do something he or she hates right before bedtime, they usually say, “Because that’s what I was told to do.” Their mom or sister or friend told them that ALL children need a bath before bedtime, so they just started doing it. But trying to get your child to do something she hates right before bedtime is a flat-out bad idea. Tempers flare… tears are shed… and your child gets so emotionally wound up that it takes MUCH longer for her to calm down and get back into her happy place. So make sure your bedtime routine includes only activities your child enjoys! TIP #2: KEEP IT SHORT (BUT NOT TOO SHORT) Specifically, somewhere between 20 and 30 minutes, from start to finish. Why? Well, you want it to be long enough to get your child calmed down, relaxed, and ready for sleep. Plus, bedtime is a wonderful way to spend time bonding with your child. For many parents, it’s the best “quality time” you’ll spend with your child all day! However, if you let your bedtime routine drag on for too long, you risk letting your child get overtired, which makes falling asleep MUCH more difficult! TIP #3: NO SUGAR OR TELEVISION RIGHT BEFORE BED Yes, I know this one sounds “preachy,” but if you’re giving your child sweets (or juice) right before bed, it’s going to be harder for him to fall asleep. Same thing goes for letting a child watch TV right before bed. The juice or sweets will give him a “sugar rush” of jittery energy, which is the LAST thing we want before bedtime. And watching TV or playing on the computer can (for lots of children) overstimulate them, so I recommend NOT letting your child watch TV as part of your bedtime routine. THE BIGGEST BEDTIME MISTAKE… As promised, I also want to share the single biggest bedtime mistake that parents make. It’s simply this… Letting your child doze off BEFORE you put them into bed. Now, I know it’s tempting for many parents to let their child fall asleep while rocking, bouncing, or feeding. After all, for many babies, this is the way they’ve ALWAYS gotten to sleep. Unfortunately, it’s also the reason why they tend to wake frequently in the night. If you’re interested in learning some easy strategies for getting your child to fall asleep on their own at night (rather than being rocked nursed, or otherwise soothed to sleep by you), I’d love to chat further!

July 29, 2016

Is Your Child Suffering From ADHD or ADD?

Do you have a busy child who is always running around, struggles to fall asleep before 10 at night, shouts out answers in the class, has difficulty concentrating and sitting still? Your child may be suffering from ADHD or ADD. But what is ADHD/ADD? Does my child need medication? Is the medication dangerous? Medical professionals use the DSM criteria to diagnose Attention deficit-hyperactivity disorder (ADHD) and Attention deficit disorder (ADD). The following signs and symptoms were taken from Kaplan and Saddock (IV edition): Either (1) or (2): (1) Inattention: Six (or more) of the following symptoms of inattention have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level: (a) Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities (b) Often has difficulty sustaining attention in tasks or play activities (c) Often does not seem to listen when spoken to directly (d) Often does not follow through on instructions and fails to finish schoolwork, chores or duties in the workplace (not due to oppositional behaviour or failure to understand instructions) (e) Often has difficulties organizing tasks and activities (f) Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) (g) Often loses things necessary for tasks or activities (e.g. school assignments, pencils, books or tools) (h) Is often easily distracted by extraneous stimuli (i) Is often forgetful in daily activities (2) Hyperactivity-impulsivity: Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level: Hyperactivity (a) Often fidgets with hands or feet or squirms in seat (b) Often leaves seat in classroom or in other situations in which remaining seated is expected (c) Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feeling of restlessness) (d) Often has difficulty playing or engaging in leisure activities quietly (e) Is often ‘on the go’ or often acts as if ‘driven by a motor’ (f) Often talks excessively Impulsivity (g) Often blurts out answers to questions before the questions have been completed (h) Often has difficulty awaiting turn (i) Often interrupts or intrudes on others (e.g. butts into conversations or games) Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years. Some impairment from the symptoms is present in two or more settings (e.g. at school, work and at home) There must be clear evidence of clinically significant impairment in social, academic or occupational functioning. The symptoms do not occur exclusively during the course of a pervasive developmental disorder, schizophrenia or other psychotic disorder, and are not better accounted for by another mental disorder. Your child may only have Attention Deficit Disorder; this is all the above symptoms except the hyperactivity-impulsivity symptoms. So what should I do if I think my child may be suffering form ADD/ADHD? Take your child to an occupational therapist to determine the possibility of ADD/ADHD and the effect it has had on development and skills. If the therapist suspects that your child is suffering from ADD/ADHD you will be referred to a paediatric neurologist for an evaluation. It is important not to take your child to a GP for medication as a specialist needs to be consulted as medication for ADD/ADHD is schedule 5/6 and works on the neurological system. Your child’s neurological system is still developing and damage can occur if the dosage of the medication is too high. Is medication always necessary? Sometimes medication is necessary – this will help your child to focus her attention; this will improve her concentration and thus learning can take place. Usually children with ADD or ADHD cannot concentrate for sufficient periods in class and thus they lose learning-time – that is why some children with ADD or ADHD fail their grade or fall behind in class. It will not help to hit/punish your child if they suffer from ADD or ADHD because although they try their best to sit still/work/pay attention, they are incapable of doing so – that is why medication is sometimes a blessing for both the child and the parents. It is sometimes difficult for parents to admit that their child needs medication but this is an issue that the parents need to deal with – don’t take valuable learning-time away from your child by not taking him/her to see a trusted paediatric neurologist. Usually the neurologist will start on a minimum prescription of Ritalin (for attention) and Risperdal for hyperactivity/restlessness. These medications will vary according to the age of the child and the severity of symptoms. Remember that it will take some time for your child’s body to adapt to the medication – don’t give up too soon. If unacceptable side-effects persist for more than 2 – 6 weeks, please talk to your doctor. Remember that not all medications work for all children and that the doctor may have to try a variety of medication until he/she finds the combination of medication that works for your child. Helpful hints Children with ADD or ADHD need a structured/disciplined environment to function optimally. Using the same handling approach at school, therapy and at home gives the child clear guidelines of what is expected of him/her. The golden rule to follow with a child with ADHD is a low GI diet. Find out if your child is allergic to any food e.g. dairy products, yellow food (corn, squash), junk food, fruit juice, sugar, chocolate, NutraSweet/Canderal/etc., processed meat, MSG’s, fried food, food colouring or fish as this may cause temper outbursts! Avoid processed foods. These contain additives and preservatives e.g. certain cheeses, certain cold meats Avoid junk food/take-aways Avoid sodas/fizzy drinks Avoid candy Avoid cookies No energy drinks e.g. Play/Red Bull Avoid fried foods E.g. chips, crisps, KFC Avoid additives and preservatives. Fruit juice should be diluted and not given

July 25, 2016

Leave Me Alone!

The realities of teen loneliness, depression and suicide attempts in South Africa By Janine Shamos “There’s no point to this hell called life is there? It never gets better! No-one understands how I feel. They think I’m making it up – just being dramatic and looking for attention. I’ve had enough…”For many teens suffering from depression, loneliness and isolation are part of their daily struggle. “I felt so alone, like no one could ever understand what I was going through. I started asking myself if I was being pathetic and dramatic.” Teens like Lungi (16) are not alone. Research shows that 1 in 5 teens have considered suicide and almost 17% have formulated a plan to take their lives. The teen years can be emotionally turbulent and stressful. Teens face pressures to succeed, fit in, family and financial stress, loss and trauma, and many struggle with self-esteem issues, self-doubt, and feelings of alienation. “Very concerning is that 60% of youth who have a mental health problem like depression, anxiety or trauma, don’t get the help they need”, says SADAG’s Cassey Chambers. Gina (19) is no stranger to sadness. “I’ve had bad things happen my whole life, like since I was just a kid. I just kinda dealt with it, you know?” But last year, Gina’s precious St. Bernard, “Lord”, was poisoned. Already fragile (she was repeating matric and not doing well at school, as well as dealing with very shaky family relationships), Gina’s boyfriend left her. “He said I was like jinxed or something. I felt so alone. I really just gave up.” One Friday, during the school assembly, Gina tried to take her life in the matric girls’ bathroom. Suicide is a desperate attempt to escape unbearable pain and suffering. “Blinded by feelings of self-loathing, hopelessness, and isolation, a severely depressed person can’t see any way of finding relief except through death”, explains psychologist Liane Lurie. “They wish there was an alternative to committing suicide, but they just can’t see one.” This is why SADAG’s teen suicide prevention programme, and National Teen Suicide Prevention Week, is so vital – it gives teens hope for an alternative. Through SADAG’s national school-based programme, “Suicide shouldn’t be a secret”, approximately 700 000 teens have been made aware of the signs, symptoms of depression and suicide, and critically, how to intervene. “We know that many teen suicides could have been prevented if people knew what to look for”, says Chambers who says that SADAG often hears stories of teens who told friends about wanting to die, but were not taken seriously. Lungi spoke to friends about how she was feeling, and even tried to talk to an aunt about the fact that she wanted to kill herself. “No-one really listened to me – they thought I was just looking for attention.” But SADAG has shown that 80% of teen who are suicidal have given some kind of warning, just like Lungi did. Friends are in a key position to pick up on warning signs that a friend or classmate is depressed or suicidal. “It is very important never to take warning signs lightly or promise to keep them secret”, says Lurie. There are so many youth who suffer in silence, scared of being judged, unsure how to talk about how they are feeling. Often, families are the last to know. TV personality, SadeGilliberti, knows this from first-hand experience. “My depression started early, and when I was depressed my parents didn’t know. When my father found out he was shocked, but he supported me.” Family support is a key factor in teen health. “Family support, good communication, friendships and cultural or religious beliefs are all things that can help a teen deal with depression or stress”, says Lurie. One of the hardest things to do is speak to a depressed teen – they are moody and emotional – and many people feel uncomfortable with the topic of suicide. There are many myths and misconceptions about how to deal with a depressed or potentially suicidal friend, and too often victims of suicide are blamed and their families and friends are stigmatised. People don’t communicate openly about suicide with the result that suicide is left shrouded in secrecy. “Many youth wonder if it’s a good idea to say anything to a friend if you notice something wrong”, says Chambers. “They worry about their friend becoming angry but it is always better to risk the friendship that to risk the friend. Get help before someone you care about does something that can’t be reversed.” Help doesn’t always come in the expected way. For one Grade 10 student, life-saving support came from a friend’s sister on WhatsApp. “My brother was worried about a friend of his who was going through a really hard time and was starting to talk very negatively and aggressively”, says Tracy. “He was concerned so I offered to try help.” Shaun didn’t want to talk face-to-face but agreed to chat via the popular social media app. Shaun was feeling very isolated and his family didn’t seem to be taking any notice of his disturbing behaviour – he was cutting his arms, drinking heavily, locking himself in his room, and refusing to go to school. Tracy says she thinks talking to Shaun ‘anonymously’ in a non-threatening way is what he needed to build trust and open up – and ultimately allow him to get the help he needed. Death from youth suicide is only part of the problem. For every completed suicide, there are an estimated 20 attempted suicides. And far too often, these go unnoticed. Fortunately for Gina, a teacher noticed she hadn’t returned from the bathroom and went to check on her. Ms Smit, a Maths teacher, found Gina unconscious on the floor. After being taken to hospital for treatment, Gina had daily sessions with her Life Orientation teacher at school. “He really helped me to heal.” Gina says that her teacher helped her see life in a different way and encouraged her

July 14, 2016

Parents most at risk for colds and flu

As South Africa braces itself for another onslaught of cold and flu infections this winter season, the biggest risk factor for catching the common cold is having children under the age 12. So says leading colds and flu generic medicine provider, Pharma Dynamics. According to Mariska van Aswegen, spokesperson for Pharma Dynamics, parents fall ill almost twice as much as anyone else. “Young children are a reservoir of germs and if they’re at crèche, school or anyplace else where they are around other children, they’re in a super-virus environment, which makes them the perfect vectors for illness and for passing viruses around. Kids hug, touch and cough all over each other. They chew on toys and as a result share their saliva, and then parents hug, kiss and cuddle them. It’s no wonder that the average parent catches a cold more compared to those without children,” she says. A recent study conducted by the University of Utah’s School of Medicine confirms this notion. They found that families with two, three or four children have some type of virus present in their household just under 60% of the time, whereas childless households were only infected with viruses three to four weeks of the year. Each additional child in a household increased a family member’s risk of falling ill. Households with one child tested positive about 18 weeks of the year, while families with more than four children tested positive about 45 weeks of the year – that’s a whopping 87% of the time. Van Aswegen adds that parents who live with small children are 1.5 times more likely to be sick since children under the age of five tend to have at least one virus present in their mucus 50% of the time. “As we enter another cold and flu season it is imperative that those at risk, especially parents of younger children, give their immune systems a boost, whilst adequately protecting themselves from sources of cross-infection. But for a parent with little ones, it’s difficult to take care of yourself when you’re ill, since you have to take care of everyone else. This makes the recovery process so much harder (and unpleasant). “I often get asked whether there is any sense in trying to stop the spread of infection by wearing a mask for example, but the best and most practical way of protecting yourself (and your family), is to practise proper handwashing techniques and to do so often. This could reduce the chances of catching your child’s cold by 30 to 50%. Another way is to stay out of waiting rooms in doctor’s offices, emergency rooms and the shops, and to avoid public transport as much as possible. Also use your judgement about your own situation. If you are pregnant and have had several bouts of flu or have a newborn, you may actually want to wear a mask. “Besides eating your greens, getting enough sleep is another critical factor in fighting off colds and flu. Research tells us that people who sleep six hours or less a night are four times more likely to catch a cold when exposed to a virus, compared to those who get in more than seven hours a night. Most parents probably don’t get enough Zs, but it’s vital to our wellbeing, so try to carefully plan your day to ensure enough time is spent in slumber land,” she advises. Van Aswegen says keeping a clean and dust-free house is equally important. “It might also be worth getting an air filter to clean and purify the air in your home, especially if you’ve experienced wave after wave of illness in your household. “In truth, there is no cure for the common cold or flu, but time-deprived parents may benefit from supplements that can boost their immune system. Look for one’s that contain Vitamin C, zinc and Echinacea, which when used in combination are excellent at combating colds and flu, such as Efferflu C Immune Booster. She says that if you do catch your child’s cold, there is an upside to all of this shared illness business. “Once a child starts to develop a functioning immune system, at about six months, then the exposure to general viruses and germs isn’t necessarily a bad thing since it helps build and stimulate the immune system. It’s important to remember that a child’s immune system will only be fully developed between 12 to 14 years of age, when they finally reach adult levels of antibody formation, so you may be in for a tough few years, but as the children grow up it will help them fight other infections and stay healthier in the long-run,” concludes van Aswegen.

July 13, 2016

Auditory Processing – Another Buzz Word?

Auditory processing has become quite a buzz word amongst school teachers and therapists recently. And rightly so, as it is often under-identified or misdiagnosed as attention deficit disorder or bad behaviour, due to poor listening skills. What is Auditory Processing? Auditory processing is “what the brain does with what the ear hears” (Katz, 1994). In short, it is the ability of the brain to identify, localise, attend, remember and respond to auditory stimuli, generally the spoken word. Central auditory processing disorders (CAPD) or auditory processing disorders (APD) are a pattern of disorders whereby certain of the skills that make up auditory processing skills are relatively weak, thereby affecting listening behaviours. How Do You Know If It Is Auditory Processing, Or Just ‘Not Listening’? Central auditory processing disorder (CAPD) and attention deficit disorder (ADD or ADHD) often present with similar symptoms. The primary symptoms for ADD tend to be inattentiveness, distractibility, hyperactivity, restlessness and impulsivity. The primary symptoms for auditory processing disorder (APD) tend to be difficulty hearing in background noise, difficulty following oral instructions, poor listening skills, academic difficulties, distractibility and inattentiveness.[i] How Is Auditory Processing Assessed? Auditory processing is generally assessed by an audiologist (hearing healthcare professional). The audiologist would begin by assessing the outer, middle and inner ear structure and function to make sure that the hearing levels themselves are within normal limits, and there is no ear wax or middle ear infection preventing your child from listening! Thereafter, the audiologist runs a series of tests. Your child wears a set of headphones and responds to auditory tests. Other tests involve more direct interaction with the audiologist. The results are scored and compared against normative data for children of the same age group. Relative strengths and relative weaknesses are identified. The following subtests typically make up an auditory processing assessment: Auditory memory or sequencing for stories, sentences, words and digits Auditory discrimination between similar sounding words (chat/fat) Auditory closure for words that are missing a portion or are distorted Auditory analysis which involves breaking a word down into parts Auditory synthesis which involves building a word up by parts Speech in noise testing to test the child’s ability to ignore competing background noise Dichotic listening which involves listening to words or sentences presented to each ear at the same time Certain children present with patterns of strengths or weaknesses for certain skills. Depending on the pattern of presentation, this may result in certain difficulties in the classroom environment. Can Auditory Processing Weaknesses Be Treated? Treatment of auditory processing weaknesses is typically tailor-made for your child, depending on the pattern of weaknesses or strengths identified. Speech therapists are typically involved to provide auditory processing therapy, alternatively a home program of exercises may be suggested. Certain classroom modifications may be recommended to the teacher. If the weakness is significant, then assistive listening devices like an FM system may be helpful for some children. What can parents do to help? If you suspect that your child may be presenting with an auditory processing weakness, you can arrange for auditory processing testing to be conducted by a local audiologist . Testing is typically conducted on primary school-aged children age 6-11, but testing can be conducted on teenagers, depending on the tests available at your audiologist. The audiologist will be able to provide further information, specific to your child’s presentation.

July 11, 2016

Exercise During Pregnancy

So you’re pregnant? Congratulations! Suddenly everything in your life centres around the new little person you’re expecting. There’s so much to do and plan as your countdown begins, but how many of us make time to look after ourselves? Sadly, not many do. Work, home life, busy schedules, and antenatal check-ups – they all take time and often the exhausted expectant mom has no time or energy left to consider her own health and wellbeing. That’s why we’re here to help. Here are some top tips for exercise for pregnant moms – these are simple and can be incorporated into your already busy schedule without a lot of fuss or expense. Remember, a healthier, happier you results in a healthier, happier baby. The Benefits Of Physical Activity Physical exercise has many health benefits, including improving your posture and relieving backache. It can also decrease your chances of developing high blood sugar and/or blood pressure. What’s more, if you’re worried about that gorgeous figure you had before falling pregnant, you’ll be pleased to know that certain types of exercise may decrease the chance of getting varicose veins and of putting on extra weight during your pregnancy. Examples of exercises that are safe to do during pregnancy: First Trimester During the first three months, activities such as walking, low impact dancing, household activities such as scrubbing the floor, low intensity swimming, cycling, floor exercises and strength training can be done safely. You can also continue stomach crunches for the first three months. If your breasts are sore or sensitive, you are suffering morning sickness, or feeling very tired, then exercise only when you feel well enough. Second Trimester During month’s four to six, you can safely continue with low impact activities such as walking, low intensity swimming, stationary cycling, low impact dancing, household activities and strength training. During this time you might feel that your balance is affected. If so, stay away from any activity that throws you off balance. Now is the time to rather cycle indoors on a stationary bike, or do something safer such as low impact dancing, gardening, household chores, swimming or walking. You should now stop any curl-up stomach exercises, avoid any moves lying on the back or stomach or bending backwards. You should also avoid lying on your back for long periods. Third Trimester In the last three months of pregnancy, you should only do light exercises such as walking, low impact recreational dancing, swimming and indoor cycling. More specifically, exercises you should avoid at any stage of your pregnancy include: Any exercise with bouncing movements (e.g. running, jumping, etc.) – although if you are already a runner, you can continue as long as your doctor tells you that it is safe to do so Any exercises that could cause you to fall Any contact sport (e.g. karate, or any team sport that involves contact between players) that could hurt your stomach muscles or the baby Any ball or team sports (e.g. soccer, netball, tennis, softball, volleyball, basketball, etc.) Our Top Tips: Aim for light to moderate physical exercise for 30 minutes 3 to 5 days per week. The 30 minutes can also be broken up into bouts of 10 minutes throughout the day. Strength training activities can be done 2 to 3 times per week. For muscles to recover and become stronger, at least one day of rest between sessions is required. During pregnancy, don’t train too hard. You should be able to talk while exercising. You can / should include floor exercises into most exercise sessions. Healthy stomach and hip muscles will support the growing uterus to stretch easily and recover quickly after childbirth. A Note Of Caution: You should stop exercising and see the doctor immediately if any of the following happens: Bleeding or fluid leakage from the vagina Feeling dizzy, out of breath or feeling like fainting Headache or nausea Chest pain Muscle weakness or an inability to walk Pain or swelling in the lower leg muscles Start of labour The baby suddenly stops moving Cramping

July 8, 2016

Increased screen time can lead to higher need for OT therapy in South African children

Occupational specialists warn that too much TV and electronic time can affect physical and social development in children, leading to a higher need for OT. OT specialist, from Sensory Zone, Ray Anne Cook recently addressed a workshop of parents at Toy Kingdom, Canal Walk, Cape Town, to talk more on the importance of play, especially in the foundation years for children. According to Cook, “when children sit in front of a screen, they are not developing holistically; they are not using their bodies to move. The screen is simultaneous visual and auditory stimulation which is not calming or soothing for a child as much as movement and resistance activities are.” Cook elaborates further in the press release below. Some of the key insights include: Sensory Development– at the age of 2 years old, a child does not yet know where their body is and they need to explore and see how their bodies can move in a 3 dimensional world. This is where motor planning skills becomes important so that children can learn to problem solve. Cook highlights the need for traditional play time with educational toys that can encourage problem solving skills. Empathy and Social Skills– children need to learn from a very young age how to react to the world around them, and playing with toys such as dolls and action figures can help with understanding feelings of empathy Spatial awareness– giving your children the freedom to move during play will increase their sense of understanding of their bodies. If a child is frequently knocking into things, it is more than likely that his or her sense of touch and body space awareness is underdeveloped. Signs to look out for? – Cook advises that generally, if a child does not enjoy an age appropriate game or activity, has difficulty engaging with his peers in play, is unable to participate actively in everyday classroom tasks and is struggling to develop independence in age appropriate tasks at home, i.e. play, dressing, feeding, toileting etc., there may be a deficit or delay in skills development What sorts of toys are useful? – Cook includes of list of the sorts of toys to help development, e.g. things that feel weird, toys that require use of both hands etc. To help parents navigate their stores to find skills building toys, Toy Kingdom have introduced a category system in stores nationwide that helps parents identify which toys help to build certain skills. Occupational therapy is a term becoming increasingly known to South African parents as one of the fields recruited to assist with early childhood development, particularly in the areas of play, motor and perceptions skills. A child’s occupation is play and they develop and learn through play. OT specialist Ray Anne Cook recently addressed a group of parents at an OT workshop hosted by toy brand, Toy Kingdom, and emphasised concerns around too much screen time. “When children sit in front of a screen, they are not developing holistically; they are not using their bodies to move. The screen is simultaneous visual and auditory stimulation which is not calming or soothing for a child as much as movement and resistance activities are. ” Cook explained that the first two years in a child’s life focuses on sensory development, followed by sensory motor development from ages 2-4 years which explores touch. “At the age of 2 years old, a child does not yet know where their body is and they need to explore and see how their bodies can move in a 3 dimensional world. This is where motor planning skills becomes important so that children can learn to problem solve.” Cook highlights the need for traditional play time with educational toys that can encourage problem solving skills. She believes that a child who does not learn to problem solve in the classroom, playground or at home and in the community will have trouble tackling issues later on in life. Cook further stresses the importance of nurturing a child’s interest when it comes to toys, and to not force children onto toys that a parent thinks they should be playing with. If the toys or games speak to the child’s interest, the child will be more inclined to play. Children need to learn from a very young age how to react to the world around them, and playing with toys such as dolls and action figures can help with understanding feelings of empathy, as well help to build social skills. “Play is relationship building, this is the space where social skills are developed and parents must be mindful that it’s not about getting the game right, it’s about the experience the child is having. Never force a child to play, let them discover their surroundings” said Cook. Giving your children the freedom to move during play will increase their sense of understanding of their bodies. If a child is frequently knocking into things, it is more than likely that his or her sense of touch and body space awareness is underdeveloped. Cook explains that even doing something as simple as pulling a child on a blanket across the floor will not only be fun for the child, but will teach him or her about the sense of balance. For many parents, knowing what to look out for in their children when assessing their needs for further skill development or occupational therapy can be daunting. Cook advises that generally, if a child does not enjoy an age appropriate game or activity, has difficulty engaging with his peers in play, is unable to participate actively in everyday classroom tasks and is struggling to develop independence in age appropriate tasks at home, i.e. play, dressing, feeding, toileting etc., there may be a deficit or delay in skills development. She also explains that often children’s resistant, controlling or avoidant behaviour can be the first sign that they are finding something challenging. Quality development in the right areas can assist young children to inhibit the basic skills needed to perform efficiently

July 8, 2016

Breastfeeding could save the lives of thousands of infants affected by drought

South Africa is currently suffering one of the worst droughts in recorded history. This poses a major health risk to thousands of infants in drought ridden areas, which can be largely mitigated by simply supporting and encouraging breastfeeding mothers. “Disaster areas are particularly dangerous for infants because their fragile immune systems struggle to cope with stressors like overcrowding, lack of access to clean water and lack of quality medical treatment” says Stasha Jordan, breastfeeding activist and executive director of the South African Breastmilk Reserve (SABR). Diarrhoea is rarely fatal in adults, but it kills over 2 million children under the age of 5 each year around the world. Up to 90% of deaths in emergency situations are due to diarrhoea.1 To compound this tragedy, many of these deaths are avoidable through breastfeeding. A stark illustration of this fact is the investigation by the Centre for Disease Classification (CDC) into the deaths of more than 500 children in Botswana in 2005-06 after a major flood. The study found that nearly all the babies who died were formula fed, and that breastfeeding infants were almost entirely spared.2 Some of these deaths result directly from contaminated water, but even access to clean drinking water does not guarantee an infant’s safety. The United Nations Refugee Agency has found that “insufficient water means that containers and utensils used for mixing milk are often dirty, thus making secondary contamination highly probable. [Dried skim milk], [dried whole milk] or infant formula that are reconstituted with contaminated water are ideal media for breeding harmful bacteria.”3 Proper cleaning and sterilising of cleaning implements, surfaces and hands consumes enormous amounts of water. Feeding an infant eight times a day on formula requires 24 litres of clean water per day, and about 170 litres per week.4 Yet each time there is a humanitarian disaster, aid agencies are flooded with donations of breastmilk substitutes. This stems from a widespread misconception that, during disasters, women’s breastmilk is somehow compromised.5 “Many mothers are worried that, during times of stress or hunger, their breastmilk will not be sufficient to provide for their baby’s needs, and so they are swayed into formula feeding by well-meaning aid workers,” says Jordan, “The irony is that continuing to breastfeed is the single most healthy thing that they could do for their child,” she adds Karleen Gribble and Nina Berry, two leading academics on breastfeeding, state unambiguously that “mothers who are exclusively breastfeeding are able to continue to provide food to their infants regardless of the stress they might be experiencing and their own access to food” and that “exclusive breastfeeding could be considered an emergency preparedness activity.”4 Five of our provinces have already been declared disaster areas as a result of the drought, and millions of the country’s poorest people are struggling to access enough clean water. In that context, supporting breastfeeding mothers is more vital than ever. “It is our collective responsibility as a society to ensure that babies who are already being breastfed continue to be and that babies who are not breastfed re-start breastfeeding,” says Jordan. ”Together we can help prevent a humanitarian disaster and save the lives of thousands of infants,” she concludes. To get involved and alleviate the challenges faced by the SABR, including low breastfeeding rates in South Africa, sourcing donor mothers and funding for the operation of the milk-banks, please visit www.sabr.org.za or call 011 482 1920 or e-mail: info@sabr.org.za. References: Why infant formula causes deaths due to diarrhoea. Karleen Gribble (2007). Protecting infants in emergencies: Information for the Media, IFE Core Group UNHCR policy related to the acceptance, distribution and use of milk products in refugee settings Emergency preparedness for those who care for infants in developed country contexts, Gribble and Berry, International Breastfeeding Journal (2011) Supporting breastfeeding in emergencies: protecting women’s reproductive rights and maternal and infant health, Karleen D. Gribble, Marie McGrath, Ali MacLaine and Lida Lhotska

July 7, 2016

Dyslexia: Fact or Fiction?

Megan struggles to read. She is eight years old and everyone in her class seems to read better than her. Megan tries really hard but it never gets easier. She feels silly. Mom thinks Megan has dyslexia. According to popular belief, dyslexia is a disorder which causes kids to struggle with reading, spelling, writing and studying. Many believe that dyslexia is a neurological disorder in the brain that causes information to be processed and interpreted differently. Some people even believe that dyslexia is genetic. Road to Reading Susan du Plessis, director of Edublox Reading and Learning Clinic, says that if the term ‘dyslexia’ is only used to indicate a reading problem, it’s used correctly, but she doesn’t subscribe to the theory that it’s a neurological disorder. Susan shares this view with many others in both the fields of medicine and education. Many kids are labeled dyslexic from a very early age, long before they’ve even mastered the basic foundations required for reading. Can any child be labeled a ‘poor reader’ if he hasn’t been taught correctly or mastered specific steps on the road to reading? Let’s look at the sport of ice hockey. Before you kit your child out with the protective gear required by the sport and expect him to make the team, he first needs to learn how to ice skate, both forward and backward. He must also learn to turn and stop. Once he has mastered this step, he can move on to learning to control the puck with the stick, to pass and receive a pass, and to shoot. Only when these skills are well practiced and achieved, and he also knows the rules of the game, can he possibly make the team. “It’s exactly the same with reading,” explains Susan. “Without a good foundation and mastering the individual steps, children simply don’t learn to read well.” Steps to Reading Learning to read is a process. In order for a child to master this complex task, he or she needs to master the following skills: Language This vital first step begins at birth. Before any child can learn to read, he or she must have a good grasp of language. It’s the step that fits in at the same level as the ‘learning to skate’ section in our analogy on playing ice hockey. Before any child can learn to read, he must have a good command of language. Cognitive skills The next step on the road to reading starts when your child is two or three years old. Cognitive skills are mental skills that are used to acquire knowledge. Learning difficulties, like dyslexia, are often linked to weak cognitive skills. Concentration, perception, memory and logical thinking are four important cognitive skills needed for reading. Concentration: Children need to be taught to focus their attention and keep it focused for a period of time. Concentration is both an ‘act of will’ and a skill. Skills need to be taught and like other skills, concentration can be improved with regular practice. Perception: Perception is the ability to identify, recognise and interpret something, usually through the senses of sight or hearing. Two important perceptual skills for reading are directionality and form discrimination. Directionality relates to the direction of objects ‘in relation to self’ while form discrimination is the ability to perceive differences in the shape of objects. In reading, both these skills are essential — from learning the letters of the alphabet to syllables and then recognising whole words. Memory: There are many different kinds of memory and each is an important foundational skill for reading and spelling. Visual memory is particularly important, because a child must remember the visual appearance of words and letter sequence in order to read them. Logical thinking: Logical thinking is the ability ‘think head’ in sequence or steps in a way that makes sense or logically follows the previous step. This is an important skill for reading comprehension, because by using logical thinking skills, a child can anticipate what happens next. Susan says that weak cognitive skills can be strengthened and normal cognitive skills can be enhanced to increase ease and performance in learning. “Specific brain-training exercises can strengthen these weaknesses leading to increased performance in reading, spelling and learning,” she states. Just like the ice hockey player who is proud of his achievement when he finally makes the team, so your child, with some extra help in the right areas, can be a great reader — and proud of it too.

July 4, 2016

Winter skincare tips for your baby

One minute you’re wondering if the blistering heat will ever come to an end and the next you’re leaving home in the dark bundled in layers of warmth. It’s May and autumn has taken hold in South Africa. When it comes to your young ones, the changing seasons bring unwelcome bouts of colds and flu – which are often connected to skin ailments. Su-Marie Annandale from baby skincare brand Krayons has the following tips for common autumn and winter skin ailments: Chapped cheeks and nose can often occur from continued running, and wiping of your child’s nose. Annandale suggests taking a facecloth soaked in warm water and gently dabbing the affected area. Once the skin is warm, apply Krayons Aqueous Cream gently in upward stokes until it has been absorbed. Follow this same routine two to three times a day to help your little one avoid chapped cheeks. Heat rash sometimes happens when your babe is wrapped up too warmly. You’ll see itchy red bumps arising from the clogging of sweat glands. The best way to combat this is to dress your baby in breathable layers so that one or two layers can be removed if the weather warms-up. Watch out for overheating, especially in little babies. Take time to pamper at bath time. Use this special time with your children to really indulge their skin. In winter, use Krayons Aqueous cream before the bath and rub generously onto your child’s skin. Make sure that the water isn’t too hot and avoid harsh soap products on their skin in the winter months (when skin is especially dry). Once bath time is over, pat the skin dry and apply another layer of cream before dressing. Finish off with a quick swipe of Krayons petroleum jelly on their lips. Don’t forget to use sunscreen throughout the year. The sun can cause unnecessary damage to young skin in summer and winter. Annandale says that your child’s skincare routine in the winter months should be more proactive than reactive. “Keeping your baby or child’s skin adequately moisturised in the cold will make sure that many skin ailments are avoided.” The full range of Krayons products are available at all major retail outlets for between R7,99 for the Krayons soap bar to R32,99 for the 500ml Petroleum Jelly. Ends. Follow Krayons on Facebook : www.facebook.com/krayonsbabies

June 23, 2016

Time for bed!

An eye-opening estimated 70% of children are not getting enough sleep or enough quality sleep these days! Keep reading to find out what this is doing and how to help them and yourself, as a parent, rest easier! The amount of sleep a child needs varies depending on age and health, but here is a quick guideline to help you gauge how much sleep your child ideally needs! Age Sleep hours needed per day 1-4 Weeks 15 – 16 1-4 Months 14 – 15 4-12 Months 14 – 15 1-3 Years 12 – 14 3-6 Years 10 – 12 7-12 Years 10 – 11 12-18 Years 8 – 9 So, why do we our children need regular, quality sleep? Sleep serves a critical role in our health and well-being and gives your body a rest, allowing it to prepare for the next day. Every movement we make uses vital resources and creates minuscule wear and tear for our bodies. At night, while we sleep, our body finally gets the chance to rebuild itself. While we are awake, our minds are barraged from input from 5 senses, as well as constantly using thought, logic, creativity, and creating memories. Sleep gives the brain the time it needs to sort out and store information, replace chemicals, and solve problems. If you are having a hard time trying to get your kids to sleep as much as they should, here are a few age-appropriate tips to give you a hand: Newborns Observe baby’s sleep patterns and identify signs of sleepiness. Put your baby in the crib when drowsy, before they fall asleep. Place your baby to sleep on their back with face clear of blankets and other soft items. Infants Develop regular daytime and bedtime schedules. Create a consistent and enjoyable bedtime routine, such as reading to them or singing. Make their space “sleep friendly” environment, with soft lighting. Toddlers Maintain a sleep schedule and consistent bedtime routine. Make the bedroom environment the same every night, without much change. Encourage use of a “sleep pal” such as a blanket or stuffed animal. Preschoolers Have a relaxing bedtime routine that ends in the room where the child sleeps. Child should sleep in the same sleeping environment every night, in a room that is cool, quiet and dark, without a TV. School-aged Children Teach them about healthy sleep habits and why sleep is important. Make child’s bedroom conducive to sleep – dark, cool and quiet. Avoid caffeine and sugary food and drink.

June 15, 2016

Rest is critical for everyone

Diana Du Plessis on behalf of Philips Mother and Child Division The early months with your newborn can be very tiring but it’s important that you also try to get enough shut-eye. It is estimated that new parents can lose between 400 and 750 hours sleep in their baby’s first year! The good news however, is that there are a few things you can do to help make life a bit more restful, for everyone. Most new parents like to keep their baby close by in the early weeks. A Moses basket or small crib is ideal as it can be moved around the house so that your baby can be where you are. It is also recommended that babies sleep in their parents’ room for the first six months, in a separate crib. However, after the first few weeks you might begin to feel a bit more relaxed about letting your little one sleep in another room. Staying connected with your baby when you’re not together is very important though and that’s where a good baby monitor can help. Stay Connected Baby monitors allow you to keep an eye on your baby even when you’re not in the room – giving you extra peace of mind. Not only do they let you know when your baby is crying, but you can talk back and reassure them with your voice depending on the model of monitor of course. If your baby is older (and a noisy sleeper), look for a monitor with adjustable sensitivity. You won’t hear every sound, but you’ll know if your baby needs you. Some monitors can also remotely notify you of the temperature and humidity of your baby’s room. Your baby’s sleep and relaxation can be easily affected by even the slightest variations in climate, as babies aren’t capable of efficiently regulating their own body temperatures. The latest monitors mean you can keep an eye on temperature and humidity levels from anywhere in your home and check your baby’s room is comfortable and healthy. Introduce a Routine Some babies find it easier than others to settle. If your baby is a good sleeper, you’re lucky. But, there may still be times when your little one needs a bit of extra help at bedtime with baby sleep training. Introducing a sleep-time routine such as a darkened room, a certain song or lullaby, and a baby sleeping bag instead of sheets and blankets can really help. A soother may also help to settle them. Babies have a strong instinct to suck and that simple sucking action is naturally relaxing. Try and get your baby in the mood for sleep, but encourage them to do the ‘going to sleep’ bit alone, by saying good night and leaving the room quietly. Return to soothe if needed it but leave before your baby is completely asleep. Gradually, they’ll find it easier to settle themselves on their own. A baby who knows how to go to sleep alone nearly always sleeps through the night earlier, as it’s easier to get back to sleep. Most babies are able to sleep the whole 10 to 12 hour night at around 6 to 7 months. Here are some top tips for helping your baby sleep Newborn babies who are more unsettled may benefit from skin to skin contact and lots of cuddles. Newborns also find movement very soothing. For unsettled babies, try gentle rocking in your arms, in the pram, or in a sling or baby carrier. Suckling is also very soothing, so try a breastfeed or soother. Lullabies can help soothe your baby back to sleep, and you can sing or play them through a parent unit, if your monitor has one. The talkback function enables you to reassure your baby without going into the room. This is really useful for baby sleep training and also lets your baby know you are on your way. A night light is comforting for many babies, and is useful when checking on your baby when it’s dark. You could use the night light on your monitor, for example, as it won’t disturb your baby. A special baby sleeping bag is a great alternative to sheets and blankets, as your baby can’t wriggle out of it. They are tog rated for the different seasons and keep your baby at an even temperature when sleeping. Babies and parents really benefit from a bedtime routine from about two to three months onwards. In the early evening, try a bath, a quick massage, a milk feed and maybe a special soothing bedtime song. From about six months, introduce a story and maybe a sleep time teddy or bunny. Encourage your baby to sleep more at night by feeding well and regularly during the day. At night, keep lights low, avoid too much stimulation and only change your baby’s nappy if necessary. It can take a bit of time to learn good sleeping habits, but persevere and you will soon see the results.

June 13, 2016

Healthy is Happy is Healthy

Your child’s health and happiness are essentially two sides of the same coin. We sometimes feel that giving children what they want – sugary treats, screen time, toys – will make them happy. And who does not want to bring joy to their most precious little human, right? However, we tend to harm our children’s health in this process of pleasing, which ironically rather impedes their happiness. If you invest in health, happiness will flow from it. And the happier a child is, the healthier they are in turn – a beautiful upward spiral! When it comes to a kid’s contentment, we need to start thinking long-term rather than giving in to those instant, but very fleeting, feel-good fixes. Happiness often lies in temporary displeasure, so tough out the tantrums, manage the manipulation and enjoy the more steadfast state of serenity! Areas to focus on when you prioritise your child’s health might by now seem like that worn-out notice behind the bathroom door that you still find yourself reading each day. Yet, before we have reached perfection in parenthood (which have the same odds as owning a unicorn), we cannot be reminded enough. Eat, drink and be merry! Your little human simply cannot fully flourish on a faulty diet. Nutrition works like farming: what you put into the soil (e.g. pumpkin seeds) will deliver a correlating crop (in this case – pumpkins). Likewise, if you put good stuff into your child, you will grow good stuff, but if you fill them with nonsense, you will have to put up with a produce of nonsense too. Daily provisions of processed foods, refined grains, sugar and harmful additives are going to affect your child’s body and brain negatively. This will eventually show in his functioning, behaviour and mood. Vegetables (especially the green kind), unprocessed proteins, good fats and fruit (in proportionally less servings than the veggies) are really what your children (and you!) need to operate optimally. Be wary of anything that is not consumed very close to its natural state. Messing with nature’s way – like most modern diets do – also messes up a person’s nature! Concentration difficulties, hyperactivity, depressed moods, anxiety and other childhood problems are often (at least partially) associated with diet. It is just too easy to fill our little ones’ stomachs with convenience foods and to get them smiling with sweets. But what you are really doing (and this might sound harsh) is merely making your own life easier – and even then, only in the short term. You are not investing in durable happiness. If you plan, shop and budget well, you can achieve proper nutrition on a shoestring, too – so do not make budget your excuse. You just need the correct information and, of course, the willpower. Munchkins need to move it move it! Our bodies were made to move and a child will not develop properly without a healthy amount of physical activity. There are many links between movement and mood. Exercise releases a feel-good sensation. It serves as an energy-spender which consequently keeps little busy bees out of trouble and makes them feel less cooped up. At the same time, staying active actually maintains their energy levels to keep them performing vibrantly all day. Furthermore, movement improves sleep (yes – theirs and therefore yours too!). Ultimately, exercise is imperative to overall physical and cognitive health – and an ill or poorly developed child is a miserable one. Positive activities activate positivity A bored kid is a parent’s worst fear for good reasons. Boredom breeds blow-ups. Children need times of appropriate stimulation. Activities like arts, crafts and structured games aid cognitive development and creativity. Remember, what might seem like mere useless fun to you is actually a child doing important business. Positive play in childhood is equal to productive labour in adulthood. Thus, just like we get depressed during times when we have nothing useful to devote ourselves to, children also need to feel well applied to stay content. Just remember that structured activities should be age-appropriate and interjected between physical activity and free play. What happens on the outside reflects on the inside A discussion on health and happiness cannot be complete without looking at a child’s physical and social environment. Healthy relationships (which should include ample affection, positive discipline, the enforcement of a flexible routine and the modelling of health habits) as well as safe surroundings are absolutely invaluable to mental and physical health. Toxins in the environment (e.g. cigarette smoke, pollution, abuse or parental discord) will poison little bodies and minds and will play out in a child’s level of contentment. Protect them from these health hazards as best as you can – even if you are one of them! Bottom line: if you compromise on health, you compromise on happiness. Our inner child is programmed to equate chocolate milkshakes and endless episodes of our favourite cartoon with joy. But let the informed adult in you rather make the choices that will affect your child’s continuous contentment. About the Author Petro Wagner is a pregnant, work-from-home mommy of a two-year-old princess and a limited-edition dog. She has a Master’s degree and further training in Play Therapy, backed by an impressive knowledge of all the Heidiepisodes; knowing the lyrics to endless nursery songs; and having personally met Sleeping Beauty in her real castle in Germany.

June 9, 2016

But it isn’t hurting!

If you think about it, the comment, “I will wait until it breaks”, is completely illogical. It doesn’t make any sense. See, not long ago I noticed low tire pressure in one of my tires, so I prayed all the way to the tyre fitment centre, hoping to arrive without incident. I made it! After evaluating the pressure issue, the technician walked from the garage over to where I was expectantly waiting. I thought to myself, “Oh boy- here we go!” He reported that I had a nail in my tyre, and that they would repair it at no charge. He also told me that for safety reasons, my car would benefit from new tyres in the near future. If I were like a dental patient I might have said, “I think I’ll just wait for a blowout”. See what I mean? It just doesn’t make sense. I didn’t plan on buying four new tyres that day but I did and I didn’t hold it against the technician either. So let’s get real… You the patient and not the prosthodontist has ownership of the problem. Why do you not take time out of your day to visit our practice? Why let your medical aid dictate appropriate treatment? They are your teeth, not theirs! How would you like your teeth to be in 5, 10, 15 years down the line – surely sound and healthy as they could be now. What if we as prosthodontists see something that isn’t necessarily symptomatic at the present time, but could potentially pose a problem in the foreseeable future – how soon would you want to do something about it? If we were able to help you ward off any emergency or pain or inconvenience timeously while saving you some money, would that not be helpful? You are welcome to give us a call to prevent the blowout.

June 6, 2016

Autism and the Senses – A Parent’s Guide

All around the world famous landmarks have been lit up with blue lights – a great way for the world to notice that autism is real, it impacts more people than we can imagine and there is still so much to learn about the condition. Ask any parent, adult, sibling or adolescent living with autism, about what aspect they find most difficult and they will mostly confirm that dealing with the sensory elements of autism is or was their biggest hurdle. At every moment in our 24-hour day, our senses are inundated with new and old sensory input, which gets filtered appropriately in order for one to function effectively. Many autistic children have great difficulty with processing sensory input from the environment, and added to that they have great difficulty communicating what they don’t like about the sensory input. Autistic children are typically sensory sensitive with either low or fluctuating thresholds, meaning that they are hugely affected, (often negatively), by sensory input from their environments. It is just too loud, too bright, too tight or too fast for them. They experience sensory overload on a constant basis and they really battle to cope with this. This video by the Interacting with Autism Project is a fantastic illustration of what somebody with autism must be experiencing when confronted with sensory overload. Their withdrawal patterns and poor social skills are not necessarily caused by sensory overload, but augmented by their sensory issues. Children on the Autism spectrum need consistency, routine and structure. Unpredictable and sensory overloaded environments (like shops and shopping malls) are very difficult for them to cope with, which typically will cause them to throw tantrums, get aggressive and/or withdraw from such environments. Sensory meltdowns occur when there is some form of discordance that happens in one or more of the sensory systems (touch, taste, sound, sight, smell, movement). Low blood sugar levels are also of relevance, as lowered blood sugar levels heighten all the senses. Remove the child from the distressing environment and take him to a safer and calmer place. Parents should be aware of meltdowns, it happens so quickly and without warning – but try not to over protect them or to shield them from stressful environments. Learn to anticipate which sensory system overloads the quickest and be prepared. Exposure to new and uncomfortable environments needs to be done in a gentle and calculated way (when the child is calm and regulated) as it helps them learn to anticipate, to adapt to and to manage these environments. A portable sensory toolkit can be taken with you whenever you are away from home and can include the following items: Sunglasses (to decrease the effect of bright light). A baseball cap or wide brimmed hat (for decreased visual stimulation). An ice cold water bottle with a sport cap for sucking water or an ice cold juice with a straw. A chewy snack, like biltong, dried fruit, chewing gum. Soundproof headphones for very loud environments. A change of clothing (long-sleeved t-shirt to avoid unwanted touch). Deep bear hugs – for a calming effect. Deep breathing – the universal calmer. One’s senses are thus a vital key to coping with autism – it is the window to their souls and interactions. Understand it, use it wisely and learn to look at people and environments form a sensory point of view.

May 30, 2016

Active vs. Passive Listening

There’s a saying that goes “We have two ears and one mouth – so that we can listen more than we speak”. And there definitely is a difference between listening and hearing. Has there been a time when you have been speaking to someone and they’ve answered you completely out of context to what you said or just gave you a one worded answer? This is passive listening. In other words the other person is not fully present in the moment giving you their undivided attention. They may be distracted, thinking of something else, are not interested in the topic on hand, or may just plainly not have much time for you. Considering that 7% of our communication is verbal, 55% is visual (i.e. body language) and 38% is voice (tone, inflection, etc) there are a lot of cues to be looking out for when interacting with someone. Active listening is being fully present in the moment. It means being aware of where you are at in your own head (your emotional state), how you are contributing to the conversation (body language etc), and your impact on the other person (is it positive or negative) and how the other is impacting on you (your reaction). When we are fully present in a conversation, not only are we giving that person our undivided attention, we are also showing them respect and that we value them as a person and what they are sharing with us. They say that 90% of problems in relationships (personal or peer) is due to the lack of communication – either what is not being said (fear of not feeling safe to share, retaliation etc) or what is not being heard (lack of understanding, not being able to see things from the other person’s perspective). Most of the time we listen to respond instead of really hear what the other person has to say. We are so busy preparing our response that we miss vital pieces of information that are coming our way. This primarily has to do with how the brain is wired, to look for the negative. Our brain reacts more strongly to stimuli it deems negative – this stems back to our early days where it was all about survival (and still is today). One way to ensure you are fully present and tuned in to what the other person is saying is to use mirroring. Mirroring is a psychological phenomenon in which people mimic speech patterns, gestures and nonverbal behaviours of others. Research has shown that people who use mirroring effectively tend to build a good rapport with the other person and can be seen in a positive light. The more the relational space (i.e. the space between two people) is safe and open, the better the relating that will take place – in other words, the better the quality of the conversation, communication and the relationship as a whole.

May 19, 2016

Sleep Safety Guidelines for New Moms

I am yet to encounter a new mom whose baby sleeps flat on their back. Every time I visit a fellow new mommy friend, they’ve carefully wedged their new baba on their sides, nestled in between those little foam side wedges and sleep positioner’s. Why? Because they’re worried that if their little one is on their back, and spits up in their sleep, they’ll choke to death on their own vomit. Oh moms. Side sleeping hasn’t been recommended for the last 26 years. Back sleeping is the ONLY safe to sleep position for newborns and infants. That said, allow me to state that I am not inherently paranoid. I let Jake sleep on his tummy for many a day nap (OMG?!? Yes, I just admitted that out loud). And yes, you will find many loose toys in Jake’s cot. And a cot bumper. Nor have I ever used the Angelcare Breathing Mat. (This post should be attached with one of those “Do not try this at home” disclaimers). And now that he is older (and out of the high risk stage), he gets himself into the most obscure sleep positions; twisted and curled like a mini contortionist, face down. Accompanied by his many furry friends (Doo Doo, Doo Doo the 2nd, Kitty, Barney & Bunny). At the end of the day though, I was always fully informed and aware of the risks of SIDS. I’m providing this information for the advancement of your own knowledge. Know the facts. Use common sense and trust your own mommy instincts (because yes, that is a real thing, and yes, you possess it). Also remember that SIDS (Sudden Infant Death Syndrome) is rare. No need for panic. But it’s about being aware, informed and up to date. The information listed below is taken directly from official guidelines as provided by various State and Government departments around the world. I’m just sharing the information so you can make informed mommy decisions of your own. EVER HEARD OF THE BACK / SAFE TO SLEEP CAMPAIGN? It’s a public education campaign used by governments of first world countries to try and decrease the risk of Sudden Infant Death Syndrome (SIDS) – the current leading cause of death among infants. The Campaign was first introduced in the early 1990’s. Countries which have implemented public health campaigns to promote the use of the back sleep position for infants have reduced their rates of sudden infant death by as much as 80%. In the USA, SIDS rates have decreased by 50% – while Australia has seen an 83% decline. BASIC SAFE SLEEP GUIDELINES: Babies sleep safest on their backs. Babies who sleep on their backs are much less likely to die of SIDS than are babies who sleep on their stomachs or sides. Every sleep time counts. Babies should sleep on their backs for all sleep times—for naps and at night. Never on tummy or side. Babies who are used to sleeping on their backs but who are then placed on their stomachs to sleep, like for a nap, are at very high risk of SIDS. Sleep surface matters. Babies who sleep on a soft surface, such as an adult bed, or under a soft covering, such as a soft blanket or quilt, are more likely to die of SIDS or suffocation. Babies must therefore never be left alone on an adult bed or put to sleep on a sofa, bean bag, waterbed or sagging mattress Keep soft objects, toys, stuffed animals, crib bumpers, and loose bedding out of your baby’s sleep areato reduce the risk of SIDS and other sleep-related causes of infant death. Do not use pillows, wedges, positioners, nests, blankets, quilts, sheepskins, or crib bumpersanywhere in your baby’s sleep area. Evidence does not support using crib bumpers to prevent injury. In fact, crib bumpers can cause serious injuries and even death. Use a firm mattress that fits snuggly in the cot with a fitted crib sheet. Avoid using loose blankets. Do not let your baby get too hot during sleep (Remember that a cold baby will wake from discomfort, a hot baby won’t). Around 18 degrees Celsius is the correct room temperature. Don’t let your baby’s head become covered. To prevent your baby wriggling down under the covers, place them in the “feet to foot” position. This means their feet are at the end (foot) of the crib, cot or Moses basket. Smoking remains the most important modifiable risk factor in reducing the risk of SIDS. Make sure that everyone who cares for your baby uses the safe sleeping recommendations to put your baby to sleep. FREQUENTLY ASKED QUESTIONS: Why should I place my baby on his or her back to sleep? Research shows that the back sleep position is the safest for babies. The back sleep position carries the lowest risk of SIDS. Will my baby choke if placed on his or her back to sleep? No. Healthy babies naturally swallow or cough up fluids—it’s a reflex all people have to make sure their airway is kept clear. Babies might actually clear such fluids better when on their backs because of the location of the windpipe (trachea) when in the back sleep position. Healthy infants protect their airway when placed on their backs, provided that swallowing and arousal mechanisms are normal. Cases of fatal choking are very rare except when related to a medical condition. The number of fatal choking deaths has not increased since back sleeping recommendations began. In most of the few reported cases of fatal choking, an infant was sleeping on his or her stomach. Is it okay if my baby sleeps on his or her side? Side sleeping is not recommended as a safe alternative to sleeping on the back and increases the risk of SIDS. Much (but not all) of the risk associated with the side position is related to the risk of the infant rolling onto their tummy. For this reason, babies should sleep wholly on their backs—the position associated with the lowest SIDS risk. What

May 18, 2016

Teen stress a strong risk factor for headaches

Stress has a dire impact on the quality of modern life, and this is sometimes amplified in a teenager’s life. Often pressures from school, home, friends, and physical changes during this highly self-aware period can lead to anxiety and the latest research also suggests it can even have an impact on the frequency of headaches teenagers get. A recent study, published in Paediatric Neurology, aimed to describe the relationship between risk factors, such as stress, depression and anxiety, and potentially protective factors against paediatric headache-related disability. It found that stress is “the strongest risk factor for headache-related disability”. The study was a cross-sectional survey among adolescents seen in an academic neurology clinic, who were reporting four or more headaches monthly. Among the 29 participants, the average age was 14.8 years with a ratio of 31% male and 69% female. The average headache frequency was 11.6 per month and the most commonly reported trigger was stress (86% of the participants reported stress). Headache disability was assessed using the six-item Headache Impact Test (HIT-6) (which is a validated assessment of the functional impact of headaches for both migraine and TTH in adults and has been used in adolescent as well as adult headache populations). Reducing headaches, reducing depression “Depression is a well-known predictor of moderate to severe headache-related disability among adolescents,” says Dr. Elliot Shevel, South Africa’s migraine surgery pioneer and the medical director of The Headache Clinic, “but contrary to the belief of many doctors, depression does not cause headaches, it is in fact the other way around. A headache attack alters the sufferer’s mood due to the pain, and constant pain is one of the most important causes of depression. Therefore chronic headache and migraine pain is often a major contributor to chronic depression.” “Another study has shown that adolescents who missed more school due to headache had higher depression scores and lower academic performance than students who missed less school.” According to Shevel the most effective way to reduce the depression linked to headaches is to find the cause of the pain and treat that. “If you get rid of the pain, the depression in most cases will become less or go away.” He adds that it is important to differentiate between stress and depression. In this case stress can result in headaches, which then in turn can result in depression. “Stress is one of the biggest triggers for headaches as stress causes muscle tension, and muscle tension is one of the primary causes of headache pain. Although its advised, its usually hard to avoid stress (which is the trigger), so at least the muscle tension (which is the underlying cause) can be safely and effectively treated.”

May 9, 2016

Swimming – An all year activity with excellent health benefits

I have been teaching swimming for 10 years with about half of them being in the UK and the last 5 years here in Cape Town. I am always surprised by South- Africans’ attitudes to swimming in terms of its role as an all year sport and activity. We are extremely blessed by the amazing weather in our country. A common misconception is that we should only swim when the sun is shining; this is only true for outdoor pools. The effective heating and covering of swimming pools allow this excellent sport to be enjoyed all year round in comfort. For those of you who remain sceptical, I have put together some of the great advantages of swimming all year. Do remember though, as long as your baby, your children and you are dressed warmly on the way to and from lessons in a heated indoor facility of course, there should be no reason to stop your swimming lessons. Swimming is a fun way to encourage your child to do physical exercise With the colder winter months approaching we all have the tendency to become less active. The rainy weather does stop most of us from spending prolonged periods outside, riding our bikes or going for a walk. Going swimming in an indoor, heated environment provides the perfect shelter from the outside elements. Taking your child to a 30 minute swimming lesson, once or twice per week is no doubt a fun and energetic activity that they love. Swimming is a great form of exercise, because it offers the swimmers a full body workout with very low impact on their joints – “To be swim fit is the best fit!” Swimming develops the whole child Not only is swimming a great way to get physically fit, swimming has also been proven to encourage intellectual and emotional development. According to a scientific study at the German Sports College, Cologne (1979) children that swim all year round fared better academically, particularly in problem solving skills. The good news however doesn’t end there. A four year Early Years swimming Research project (with 45 swim schools in Australia, New Zealand and the USA) found that children younger than 5 who had swimming lessons were more advanced in their cognitive and physical development. The researchers in Melbourne went on to find that the children in this study also had higher IQ’s. Still not convinced? According to Art Kramer (2009) at the University of Illinois and Pittsburgh, exercise helps a persons’ memory, which in turn leads to greater learning potential. In their study they found that people who were fit had a larger hippocampus than those less fit. Swimming enhances brain development in babies and people with special needs. The benefits of swimming for babies and children with special needs are vast. I will cover these in another article, but I thought it would be important to touch on just one of these benefits here. According to a study conducted at the Norwegian University of Science and Technology by Dr Hermundur Sigmundson (2010) it was concluded that even the youngest swimmers were better at balancing and grasping. Working with children with cerebral palsy, downs syndrome and autism, I have also witnessed a vast improvement in these skills after just a relatively short time in the pool. One of the reasons for this is because being in water exposes babies and children with special needs to tactile stimulation of the nerve pathways. Water has over 600 times the resistance of air, so just moving through water is already stimulating. Dr Ruth Rice (1979) found in her research that children learn significantly through touch and the texture of different objects – also known as tactile sensory development. It was proven that this stimulation leads to “significant gains in neurological and mental development.” Swimmers have better social skills It is hardly surprising, having read the previous studies, that swimming will enhance your social skills. Looking at the same study by the German sport college, Cologne, swimmers displayed more self-discipline and have better self-esteem which made them more comfortable in social situations. It was also found by Dr Liselott Diem (1980) that children who had taken swimming lessons from 2 months to 4 years old could adapt to new social situations more easily, because they had more confidence in social settings. Swimming help teach children to take turns, listen, share and cooperate. All necessary skills in social environments. Swimming improves your immune system Contrary to the erroneous belief that your child will be more ill in the winter months if they keep on swimming, swimming will in actual fact improve your child’s immune system. Every time your little one goes under the water it triggers a reflex called the diving response. This is when the body – “starved of oxygen” pumps oxygen rich blood to the vital organs, namely the heart, lungs and brain. This means the vital organs get stronger which helps us cope better with common illnesses. It was actually proven in a study that swimmers have vital organs 20 years younger than their actual age. Swimming reduces your child’s risk of drowning This is the most important reasons for taking your child to swimming lessons, but I sometimes think we get so hung-up on this fact, we miss some of the other great benefits as listed earlier. Swimming is a life-skill and all children should be able to swim. No questions asked. No baby is born not liking water, so when your little one cries for the first few lessons, there is usually another reason for this. A good swimming teacher will look for a way to make your little one feel comfortable and look forward to coming to lessons. Gone are the days of the “Just throw them in!” attitude, as this can do more harm than good. Conclusion: Swimming is a fun and potentially lifesaving activity, with a wide range of health and social benefits. Don’t dismiss this sport and activity because of our

May 2, 2016

When You Need to Pick Yourself Up

Sometimes life doesn’t go according to plan. You have this idea about something that you want to do or achieve, and you put all your focus, effort and energy into it, and then, boom! – it backfires, leaving you with waves of thoughts of ‘what if’s’ and an aftermath of emotions to deal with. This has happened to me a few times. My plan didn’t go according to plan, which left me with a “now what?” situation. I did not think things wouldn’t go according to plan. In fact, I thought it was a done deal I was that confident about the situation. So what does one do when faced with this scenario? Well, you stop looking back. You stop over analyzing. You stop asking yourself ‘what if’? You pick yourself up, you forgive yourself and you focus on moving forward. The greatest growth comes from the insights you get from these experiences. How you apply this new found knowledge is what moves your forward instead of keeping you stuck in the past. Quick exercise When you find yourself in a situation like this, ask yourself these questions: How badly did I want this goal in the first place? Did I do the best I could in this situation? Was there anything I could have done differently? Would the outcome have been different if I took this action? What will achieving this goal do for me? How will it make me feel? Is it worth the sacrifices I need to make to get it? What do I need to do to achieve this goal going forward? Reflection time Failure is not final – it’s feedback. It’s a second chance to start over and to do things differently. It gives us wisdom and experience. It gives us insight and knowledge. It gives us the ability to dig deep within ourselves and to tap into our inner knowing and being. It guides us to look at a situation from a different perspective. Knowing the answers to these questions assists us to make better decisions and to discern whether these goals are in line with our divine truth.

April 26, 2016

Helping mommy, Helping baby

The first week after a baby is born is often referred to as ‘Hell Week’. You don’t know how often your baby will be crying, feeding, sleeping or requiring that all important clean diaper. Mommy is still possibly in loads of pain, especially if she had a caesarean, so it is important that daddy lends a hand. The problem with this is of course that daddy’s are ignored for the most part during the pregnancy. Almost every blog or group dedicated to babies are centred on what mommy is feeling, how mommy can cope with the new baby and which resources mommy can use to assist with a new baby. A great example of this is a new mommy group that my fiancée belongs to. No men are invited to this group as they, “don’t know what it is like to raise a child”. This leads to daddy being unprepared for those ever important first week and possibly for a long time after that. Support from family and friends will also mostly focus on how to assist mommy and although I agree that mommy and baby are the two most important people from birth onwards, I feel that daddy’s should have more support as well. Daddies are under appreciated. Here are 3 easy to remember tips focused on what daddy can do the first few weeks to help both mommy and baby. Change as many diapers as possible: This may seem like a trivial point, but it is greatly important ion various levels. It gives mommy a break from changing which will improve her mood and frustration levels. This will in turn lead to a better and less stressful relationship between mommy and daddy. This is peak bonding time for daddy and baby. Make sure to make as much eye contact with baby as possible and explain each step of the process as you change their diaper. Baby will only recognise your face from about 4 weeks onwards but they can already recognise your voice. Feed baby when you can: Feeding baby is also a wonderful means of bonding with baby. This is made a lot more difficult when mommy is breastfeeding, but daddy can still be involved by burping baby. Skin contact is very important during this bonding time, so try and burp baby being shirtless but remember to have a cloth in between where her face might make contact with your skin. If you are at home after work and it is time for a feeding always volunteer to do the feeding and give mommy a rest. If baby is not sleeping through yet, this takes a while, daddy should give the feeding closest to bed time. If you usually go to bed at 23:00 and her feeding time is 23:30 let mommy go to bed if possible and do the feeding on your own. Mommy can then do the next feeding during the night and allow daddy to be well rested for work. Break the stigma: The reason the stigma exists that men should not wash dishes, clothes, clean the kitchen, etc. is that men do not want to perform these tasks historically reserved for the women of the house. Newsflash!! Women also do not want to perform these tasks. Break the stigma. Washing dishes and giving the kitchen a scrub is a great way of giving mommy a rest. Mommy being rested leads to her being more relaxed, which means the baby is more relaxed. This leads to a less fussy baby that is easier for you as a daddy to bond with. Help yourself by helping mommy which in turn helps baby. Help with washing some of baby’s clothes. Nothing is more frustrating than changing baby and not finding anything that fits and is clean. Washing baby’s clothes can help daddy feel that he contributes to more than just a salary. Bonding with my baby and feeling that you contribute more than just a salary are two main things will keep you going through that first “Hell week”. You feel a sense that you are also part of your baby’s life and making meaningful contributions to their wellbeing.

April 20, 2016

Stress Reduction for Parents

In an article I read recently they were citing a study in which they asked kids what they wanted most from their parents. The parents all thought the kids would say they wanted more time together, but what actually came out of the research was that the number one thing that children wanted was for their parents to be less tired and stressed. Now most parents would agree that this is a pretty tall order. Children almost spell stress and exhaustion. The minute they come along your expenses double, your time and sleep halves, you have more to think about, plan, figure out and far more problems to solve. This is not a recipe for peace, calm and abounding energy levels. So what can we do? Well, there are a few ways that you can reduce stress and even a few tips for gaining more time and energy. Here are some of my favourites: The Victory Position: Put your arms up in a V, lift your head and eyes up as if you’ve just won the 100m sprint. Studies have shown that holding this position for just 2 minutes can drop your cortisol levels by 25% (see Amy Cuddy’s talk on how your body language shapes who you are: https://www.youtube.com/watch?v=RWZluriQUzE ). Cortisol is a stress hormone that affects both how you see yourself and how others see you. Do this daily or find a quiet spot (bathrooms work well) when you are feeling highly pressurized. Look up: Your eyes are connected to your brain and different eye positions are linked to different areas in your brain. Looking down is associated with the emotional centres of the brain and can make you feel worse. Looking up stops the brain connecting with its emotional centres and prevents you from descending into an emotional spiral. This is such a simple tool that can be used anywhere at any time. Use Parasympathetic Breathing: The way that you breathe will activate either the Sympathetic (Fight or Flight) or the Parasympathetic (Rest and Digest) nervous system. Shallow breathing in the upper chest is associated with stress. When you feel yourself getting stressed or overwhelmed and on the brink of losing it you need to double the length of your outbreath. An out breath that is double the length of an in breath forces you to take a very short deep inbreath and then have a slow release. This will kick in the parasympathetic nervous system (acetylcholine) and will calm the sympathetic (adrenaline) and help you to feel calm. Go into the Learning State: This is a mild form of hypnosis (no, you cannot be controlled by anyone else in this state – hypnosis is really a deep form of relaxation) and like the parasympathetic breathing, it tricks the body into believing that you are really relaxed and everything is ok. To do it, raise your eyes up and focus on a spot on the wall above eye level. Once the eyes get tired, expand your vision to the periphery (everything you can see to the left and right while still looking at your spot). Then bring the eyes back down to level, but keep awareness of the periphery. When we are very stressed (being chased by a lion) we have foveal vision – focusing intently on one spot (the lion). But when we are on the patio of our beach house, we expand our vision to take in the entire scenery. So when we activate our peripheral vision it tells our minds that we are on the beach not being chased by a lion and our physiology responds accordingly! This is particularly powerful when used in conjunction with the parasympathetic breathing. Cutting off the sensory overload: Sometimes we really do need time out; to be removed from the excessive stimulus of daily living. Retreat to into a darkened room, go outside for a few minutes, use earplugs / headphones with relaxing music. There are some amazing musical tracks that are specifically designed to relax the brain and it may be worth investing in these if they appeal to you. If you know you are going to have a stressful day, make sure that you have quiet time beforehand, quiet time afterwards, and some tools to use during the day to keep you sane (see above!) Get on top of your finances: There is nothing quite like financial issues to stress you out and affect your sleep. Know where you’re at. Look through all your bank statements and find out where your money is going. Know what debt you have. Then make a plan to pay it off. Cut back on non-essentials, stick to a budget, live below your means. Get the whole family on board. Get more sleep: We need an average of 6-9 hours sleep per night. Make this a priority. If you’re struggling with insomnia, try some or all of the following… Stick to a routine – go to bed at the same time every day and wake up at the same time. Even on weekends. Cut back on alcohol and coffee. Stop watching TV or working on your computer at least 1-2 hours before bed. Drink chamomile tea. Consider taking a melatonin and/or magnesium supplement at bedtime. Use the parasympathetic breathing at bedtime and any time you wake in the night. If you’re lying in bed unable to sleep, use this time to run through in your mind everything you are grateful for in your life. Prioritise and delegate: This is a sure way to deal with overwhelm… Make a list of everything you think you need to do. Divide this list into 3 categories – things you can cross off the list (some things simply don’t need to be done at all), things you can delegate (and who you’re delegating to), things you have to do yourself. For the ones you need to do, prioritise them with an A,B or C. A items need to be done immediately or there are

April 7, 2016

Weight, Fertility and Pregnancy

Getting your body ready for baby-making isn’t only about tossing your birth control and charting your ovulation. It’s also about laying the nutritional foundation for healthy baby building. Begin your eating-well campaign even before you conceive (technically these are your first weeks of pregnancy) and you’ll be doing yourself (and your soon-to-be embryo) a favour. Begin making healthy changes 3 months to a year before you conceive. Evidence shows that healthy nutrition and fertility is linked in both men and women. The ultimate goal is a healthy pregnancy, and this depends upon good quality eggs and sperm. There is increasing evidence to show that diet and lifestyle can directly impact on your fertility health not only for conception but also for your baby’s development. When it comes to getting pregnant, the old adage “you are what you eat” rings true. What you eat affects everything from your blood to your cells to your hormones. WEIGHT AND FERTILITY If you’re trying to get pregnant, or intend to start trying, know that weight can affect your chances of conceiving and having a healthy baby. Twelve percent of all infertility cases are a result of a woman either weighing too little or too much. Women who are overweight or obese have less chance of getting pregnant overall. They are also more likely than women of healthy weight to take more than a year to get pregnant. Research has shown that being underweight or being overweight and obese can lead to fertility problems by creating hormonal disturbances. The main ingredient in the body weight and fertility mix is oestrogen (a sex hormone produced in fat cells). A woman with too little body fat can’t produce enough oestrogen and her reproductive cycle begins to shut down. Often causes irregular menstrual cycles and may cause ovulation to stop altogether. If a woman has too much body fat, the body produces too much oestrogen and may also lead to irregular menstrual cycles and ovulation. However, even obese women with normal ovulation cycles have lower pregnancy rates than normal weight women, so ovulation isn’t the only issue. Research indicated that weight also impacts on the success of donor egg cycles. There is good scientific evidence that obesity lowers the success rates of in vitro fertilisation (IVF). Studies have further shown lower pregnancy rates and higher miscarriage rates in obese women. How do I know if I am a good weight for pregnancy? One of the easiest ways to determine if you are underweight or overweight is to calculate your body mass index (BMI). A BMI between 19 and 24 is considered normal; less than 18.5 is considered underweight. A BMI between 25 and 29 is considered overweight and greater than 30 places you in the category of obese. Reporting in the journal Human Reproduction, researchers documented a 4% decrease in conception odds for every point in BMI above 30. For women whose BMI was higher than 35, there was up to a 43% overall decrease in the ability to conceive. Your BMI alone is not the only thing to watch, however. Your body fat percentage and waist circumference is also important. Bottom line: you need a certain amount of fat to conceive since body fat produce oestrogen. Waist circumference is an indication of visceral fat (excess of body fat in the abdomen). A waist circumference >88cm in a women and >102cm in a man is associated with reduced fertility, an increased risk for insulin resistance (associated with PCOS in women) and other chronic diseases such as diabetes, heart disease and high blood pressure. Are there fertility problems in men with obesity? Obesity in men may be associated with changes in testosterone levels and other hormones important for reproduction. Low sperm counts and low sperm motility (movement) have been found more often in overweight and obese men than in normal-weight men. How much weight should one lose? Even a small 3-5% weight loss can reduce insulin resistance by 40-60% and improve fertility. How quickly will I lose or gain weight? Healthy weight gain or loss is regarded as 500g to 1kg per week. It is therefore gradual and one can expect that six months will be required to restore normal reproductive function and pregnancy. IMPORTANT: Avoid going on fad diets, which can deplete your body of the nutrients it needs for pregnancy and find a weight-loss plan that works for you by talking to a registered dietitian. EXCESS WEIGHT AND PREGNANCY If a woman is obese when falling pregnant, it increases the risk of pregnancy complications and health problems for the baby. Obese women are at an increased risk for developing pregnancy-induced (gestational) diabetes and high blood pressure (pre-eclampsia). The risk of pre-eclampsia doubles in overweight women and triples in obese women. Overweight women have twice the risk of gestational (pregnancy-related) diabetes and obese women eight times the risk, compared with women of healthy weight. A woman who is obese is more than twice as likely to have a miscarriage as a woman of healthy weight. Sadly, there is twice the risk that her baby will not survive. Infants born to obese women are more likely to be large for their age and therefore have a higher chance of delivering by caesarean section. Afterwards the baby may need neonatal intensive care or have a congenital abnormality. Recovery following birth is also more problematic and there is the increased risk of poor wound healing and possible infections. WHAT TO DO? Eating a healthy and balanced diet is crucial when preparing to conceive or you are already pregnant. A balanced diet is one that is rich in good quality protein, low in Glycaemic Index (GI), low in sugar, salt, caffeine and industrially created trans-fats (trans-fatty acids or partially hydrogenated oil). Make clever Protein choices – choose lean protein. Rethink refined carbs and sugar – choose low glycaemic index (GI) carbohydrates and also limit your total daily carbohydrate intake based on your specific metabolic rate. This is especially important if you

April 4, 2016

ADD / ADHD and Alternative Treatments

Over the past years there have been many debates and controversy discussions around what Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) is? Furthermore how it is diagnosed and what are all the options to treating the disorder? The definition of attention-deficit/hyperactivity disorder (ADHD) has been updated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This revision is based on nearly two decades of research showing that ADHD, although a disorder that begins in childhood, can continue through adulthood for some people. Changes to the Disorder ADHD is characterized by a pattern of behaviour, present in multiple settings (e.g., school and home), that can result in performance issues in social, educational, or work settings. As in DSM-IV, symptoms will be divided into two categories of inattention and hyperactivity and impulsivity that include behaviours like failure to pay close attention to details, difficulty organizing tasks and activities, excessive talking, fidgeting, or an inability to remain seated in appropriate situations. Children must have at least six symptoms from either (or both) the inattention group of criteria and the hyperactivity and impulsivity criteria, while older adolescents and adults (over age 17 years) must present with five. Treatment options There are a number of treatment plans that are available to parents when making the appropriate decision when treating their child for ADD/ADHD. Nutritious meals, play, exercise, and learning better social skills are all part of a balanced treatment plan that can improve performance at school, improve your child’s relationships with others, and decrease stress and frustration. Pharmacological Treatment Stimulants such as Ritalin, Concerta and Adderall are often prescribed for attention deficit disorder. Such medications may help your child concentrate better or sit still, however there is a general debate as to whether or not medication is a ‘quick fix’ and what about the long term affects as well as immediate side effects of appetite suppression, insomnia and an overall change in the child’s personality? For some parents they have found medication to be the best result for their child, while others look for alternative treatments and see pharmacological treatment as the last resort. Homeopathy There are many other effective treatments that can help children as well as adults with ADD/ADHD to improve their ability to pay attention, control impulsive behaviour, and curb hyperactivity. According to Dr Raakhee Mistry who is a Homeopath, commented that Homoeopathy has often been used to assist with ADD and ADHD and has been effective. But unlike conventional medicine, there is no one particular homoeopathic medicine for these conditions. The ADD and ADHD symptoms for that particular child and factors that aggravate or ameliorate the symptoms, are taken into account when selecting the remedy for the child. Homoeopathic medicines do not numb or block symptoms, instead they work with the body to re-establish a state of equilibrium. When the patient is in this equilibrium state, the symptoms ease and the patient is able to function better. The aim of homoeopathic treatment is not to keep a patient dependent on medicine, but rather to bring the patient to the space where he/she can maintain this equilibrium state. Many homoeopaths also incorporate other modalities to their treatment such as supplements, herbs and probiotics. A child’s restlessness and ability to concentrate has also been linked to the state of the child’s gut Nutrition Good nutrition can help reduce ADD / ADHD symptoms. Studies show that what, and when, you eat makes a difference when it comes to managing ADD/ADHD. The following tips can be seen below  By scheduling regular meals or snacks no more than three hours apart is a useful tip, which will help keep your child’s blood sugar level, minimizing irritability and supporting concentration and focus.  Try to include a little protein and complex carbohydrates at each meal or snack. These foods will help your child feel more alert while decreasing hyperactivity.  Check your child’s zinc, iron, and magnesium levels. Many children with ADD/ADHD are low in these important minerals. Boosting their levels may help control ADD/ADHD symptoms. Increasing iron may be particularly helpful. One study found that an iron supplement improved symptoms almost as much as taking stimulant medication.  Add more omega-3 fatty acids to your child’s diet. Studies show that omega-3s improve hyperactivity, impulsivity, and concentration in kids (and adults) with ADD/ADHD. Omega-3s are found in salmon, tuna, sardines, and some fortified eggs and milk products. However, the easiest way to boost your child’s intake is through fish oil supplementsTips for supporting your child’s treatmentIn order to encourage positive change in all settings, children with ADD / ADHD need consistency. It is important that parents of children with ADD / ADHD learn how to apply behavioural therapy techniques at home. Children with ADD/ADHD are more likely to succeed in completing tasks when the tasks occur in predictable patterns and in predictable places, so that they know what to expect and what they are supposed to do.  Follow a routine. It is important to set a time and a place for everything to help a child with ADD/ADHD understand and meet expectations. Establish simple and predictable rituals for meals, homework, play and bed.  Use clocks and timers. Consider placing clocks throughout the house, with a big one in your child’s bedroom. Allow plenty of time for what your child needs to do, such as homework or getting ready in the morning.  Simplify your child’s schedule. Avoiding idle time is a good idea, but a child with ADD/ADHD may become even more distracted and “wound up” if there are too many after-school activities.  Create a quiet place. Make sure your child has a quiet, private space of his or her own. A porch or bedroom can work well too as long as it’s not the same place as the child goes for a time-out.Set an example for good organization. Set up your home in an organized way. Make sure your child knows that everything

March 29, 2016

Caring For Your Premmie At Home  

The idea of bringing a newborn home is daunting for most parents, but the idea of bringing your premmie home after a month of NICU is overwhelming. Expect a few glitches. It’s normal to have some less-than-perfect moments with your premature baby, especially in the early days as you get the hang of caring for her without the security of neonatal physicians and nurses nearby. Do consult your paediatrician with concerns, but also remember that the neonatal intensive-care unit (NICU) experts wouldn’t have sent your baby home unless they felt you both were ready. With each day, you’ll get a little more confident, your baby will become better at communicating her needs, and you’ll find your rhythm, just like any other mom-baby team. The day arrives…she is finally coming home! Her Dr made the decision to discharge her at 1.94kg instead of the normal 2.2kg. We are thrilled! Unfortunately for us, my husband is booked for an operation on the same day. All I can say is that the Lord for my parents, especially my mom as she was by my side from the beginning. There are a couple of things that you may need to make a note of… Special equipment Baby may need special equipment that may assist in breathing etc. but your doctor will speak to you about your specific needs. Stock up on tiny clothing, generally it will be a while until baby fits into newborn clothing. Chubby Bunny (link to www.chubbybunny.co.za) supplies clothing from 1kg onwards. We also suggest purchasing a baby monitor, one that can monitor baby’s breathing. This will give you peace of mind when baby is sleeping. Besides relying on support from those around you. Chubby Bunny is there to make the journey a little less stressful. Through education & support, Chubby Bunny’s main objective is to support families whose lives have been touched by prematurity. Special skills Let me set the scene, when a baby is so small they tend to lack ‘choking’ skills. I believe I aged at least 10years the day Olivia came home from NICU. After drinking too much milk she went limp and blue. This happened 3 times that day. After we frantically tapped her, she was back to ‘normal’, we rushed her to the NICU, where I was told this is normal and welcome to motherhood. Besides feeling a little angry, it would have been nice if someone had told me before I brought my premmie home. Although it comes easily to term babies, learning to eat is a challenge for preemies. Whether bottle feeding or breastfeeding, babies need to develop three major skills in order to be able to eat effectively: A mature suck: Premature babies aren’t born with mature sucking skills. In order to drink milk from the breast or a bottle, babies need to have a suck that is both coordinated and strong. A mature swallow: Swallowing large volumes of milk takes a lot of strength, and babies need to develop the muscles in their tongue and jaw to swallow well. Coordination of sucking, swallowing, and breathing: The most challenging of the feeding skills, it can take babies a while to learn how to coordinate breathing with drinking milk. Try and take a CPR course. This life saving skill will give your more confidence when dealing with situations such as these. Support If you were able to attend an antenatal class, then keep close to your midwife. Keep her number on speed dial. If you don’t have someone, then speak to your NICU nurse. They should know of support groups in your area. Follow us on Facebook {Chubby Bunny Premmie Support}, share your experiences with other parents. The premmie journey should be full of hope, and your words could help parents who are going through a similar situation to yours. Chubby Bunny is the first company in South Africa to supply critical starter packs for premmies. We supply high quality goods ensuring the little miracle is well cared for, from organic skin care sensitive for their soft skin, petite clothing small enough to wrap around their tiny bodies, Premmie nappies, a Premmie Support Booklet equipped to help parents understand the NICU and how to care for their Premmies. These hampers can be shipped overnight to main centres South Africa. Visit our online store www.chubbybunny.co.za for more information on the hampers we provide or simply contact Sian at sian@chubbybunny.co.za.

March 22, 2016

Help My Child is a Bully!

I think that any parent who has been summoned to the principle’s office relives that same dread as when this happened as a child. There is usually nothing nice to be said when the upper echelons of the school are getting involved, and to be told that your darling, who seems so normal at home, is creating havoc at school is not easy to hear. Most parents, when informed that their child is being labeled a “bully” understandably go into denial. Now let me first say that labelling your child as anything is a bad place to start. No child is a bully. Just as no child is all victim. Children, like adults, are a complex multitude of traits and behaviours, none of which define them for who they are. The quicker you stop labelling your child as this or that, the quicker you will solve even the greatest of problems. And if the teachers or other staff at your child’s school are labelling kids, well, you need to step in and set this straight. By labelling kids we define them in a certain way, create certain expectations of them, and ultimately this becomes a self-fulfilling prophecy as they live up (or down) to our expectations. Bullying, like all mis-behaviour, is born out of a desire to fulfil a need. We all have certain human needs that must be fulfilled in order for us to survive. These include the need for certainty, variety, love/connection and significance. Briefly, we can elaborate on them like this: Certainty – the need to know that things will be the same, the need for routine, to know what our boundaries are and that they will stay the same, to know that we will have enough food, water, shelter etc, to know that the world that we wake up in tomorrow will look like the one we woke up in today. Variety – the need for things to be different – to have treats and breaks from routine and a bit of excitement and change, to shake things up a bit, to spice things up a bit to alleviate boredom. Love/Connection – to feel unconditionally loved, loved no matter what we do, to be noticed and cared for and part of a group (or family), to feel understood. Significance – to feel important, unique, and worthy of being alive, to be noticed and valued for who we are. Everyone needs these needs in different amounts, but all of them WILL be fulfilled to some degree, whether this is in positive or destructive ways. If you really examine any misbehaviour you will find that your child is trying to fulfil one of these needs in a destructive way. Kids act up, bully, throw tantrums, lie, steal and fight in order to fulfil one or more of these needs that are not being met in positive ways. So when you leave the headmaster’s office, take some time on your own or with your partner to figure out which of your child’s needs are not being met and how you can help them to fulfil these needs in more positive ways. This may take some time, trial and error to get right, but it will definitely be worth it. Bullying is a cry for some need to be met and every child’s cries deserve to be heard.

March 18, 2016

How Loud Is Too Loud?

Noise induced hearing loss is damage that occurs to the sensitive hearing hair cells inside your inner ear specifically in the cochlea. Loud sound travels down your ear canal to your eardrum. The eardrum vibrates and transfers the loud sound to the bones of the middle ear. These bones move and transfers the sound to the cochlea. Inside the cochlea are the hair cells which pick up different frequencies and pass this signal along the nerve to the brain. The force of loud sound causes damage to the hair cells of the cochlea. This cochlea is a delicate organ of hearing and once damage has occurred the damage is permanent. The extent of the damage that occurs depends on the level of loudness and the amount of time spent in that noise. Noise of 85dB or louder is considered dangerous levels of noise. The louder the noise becomes the shorter the time is that a person is allowed to be exposed before permanent damage has occurred. The rule is if the loudness increases by 3dB the time allowed in that environment is halved. How loud does a sound have to be before it causes damage to your hearing? 85dB loudness, for example a hairdryer, is safe for 8 hours 91dB loudness, for example a passing motorbike, is safe for 2 hours 97dB loudness, for example a hand drill, is safe for 30 minutes 109dB loudness, for example a chainsaw, is safe for 2 minutes 118dB loudness, for example an aeroplane taking off, is safe for 14 seconds What could cause noise induced hearing loss: In children: Loud music through iPod or music player Loud sounds through gaming devices Loud music in gyms Loud music at parties or dance venues In adults, in conjunction with the above list: Gunfire Loud machinery noise Is your music too loud?: You have to raise your voice to be heard over the noise You can’t hear someone a meter away Others can hear the words of the song you are listening to through your headphones Speech is dull after you have been exposed to the noise You have ringing in your ears after being exposed to the noise What are the signs of noise induced hearing loss?: Short term: There is no obvious effects at first. Immediately after a prolonged exposure to noise a temporary thresholds shift in hearing will occur where temporary dulling of sound and ringing in the ears will be experienced for a few days. This may feel like your ears are blocked. Long term: Prolonged exposure to loud noise can lead to significant hearing loss and ringing in the ears. A child’s greatest difficulty may be hearing in a noisy classroom. What to do to prevent noise induced hearing loss: Prevention is the better than cure Buy limited headphones, limiting loudness output to 85dB Lower the maximum volume setting in your music device. This is often in the settings of the device. Set the loudness level in the quite, and then don’t adjust it. Set your duration of exposure to short durations, taking small breaks of 15-20minutes between. This will allow the ear to rest and recover. Change your earphones to the smaller earbud earphones. This allows for some sound to escape while the larger over the ear earphones have bigger transducers and allow for a more powerful output. What to do if you expect damage may have occurred: Consult an audiologist to conduct a hearing assessment. Assessments should include a baseline audiogram as well as otoacoustic emission testing.

March 18, 2016

Installing Discipline In Your Child Through Play

Children are wonderful human beings, flexible in the way they are taught what is right from wrong and so dependent on the guidance of a figure which they trust and respect. The ultimate foundation you can lay for a child is leading by example and not forcing a child to do anything he or she does not want to do, may it be a sport, a chore around the house or even going to the mall with you. Only leading by example is what you can do, because if you force a child to do something he/she does not want to do willingly, they may hate it for the rest of their lives or even blame you for it. The key to willing submissiveness can be installed through play, children enjoy playing and they thrive best where they are comfortable and in their happy zone. Some children may have stronger resistance to listening or doing what you want them to do, but each child’s temperament and character is different and should be honed into to get the results the child feels happy with and they feel they can be themselves without any unnecessary pressure or competition. The environment the child grows up in or surrounds him/herself with, is an important component in their growth and development. If your child attends a pre-school, and spends most of their time there, they should feel save, comforted and stimulated. The teachers should lead by example, because that is the authoritative figure the child interacts with on a daily basis and if possible, the same manners should be installed at home and at school, not to confuse the child and for the discipline to be congruent. At home, there may be a single parent or more, the dynamics of a family plays a vital role in how the child reacts to or re-enacts to a certain situation. He/she may be acting rebellious towards a certain parent and to the other totally submissive. The reason for that kind of reaction could be because they feel save with a certain way of authority/discipline and the situation is predictable and boundaries are visible throughout the discipline process. When you perceive that you child is acting up or being difficult, perhaps re-position yourself to their level and become one with their child-like way of interaction and playfulness. They will soon realise that a paradigm shift has taken place and they may automatically feel much calmer and open to what you have to say or demonstrate. Providing age appropriate play and stimulation to your child is imperative to how they understand and perceive what is right from wrong and which boundaries could occasionally be crossed without a harsh scolding or smothering their every move. If you and your child are in a battle to find a midpoint where both feel frustrated and guilty most of the time, feel free to make an appointment for a healthy mediation session.

March 9, 2016

Cookie	Duration	Description
cookielawinfo-checkbox-advertisement	1 year	The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Advertisement".
cookielawinfo-checkbox-analytics	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checkbox-functional	11 months	The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checkbox-necessary	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-others	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-performance	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
viewed_cookie_policy	11 months	The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.

Cookie	Duration	Description
_ga	2 years	This cookie is installed by Google Analytics. The cookie is used to calculate visitor, session, campaign data and keep track of site usage for the site's analytics report. The cookies store information anonymously and assign a randomly generated number to identify unique visitors.
_gid	1 day	This cookie is installed by Google Analytics. The cookie is used to store information of how visitors use a website and helps in creating an analytics report of how the website is doing. The data collected including the number visitors, the source where they have come from, and the pages visted in an anonymous form.

Cookie	Duration	Description
_gat_gtag_UA_18530557_4	1 minute	No description
pron_ip	session	No description
pvc_visits[0]	1 day	This cookie is created by post-views-counter. This cookie is used to count the number of visits to a post. It also helps in preventing repeat views of a post by a visitor.
tk_ai	session	Gathers information for WordPress by themselves, first party analytics tool about how WP services are used. A collection of internal metrics for user activity, used to improve user experience.