Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Are day hospitals the new trend?

Globally, day surgery hospitals have changed the experience of patients by offering an alternative to acute/conventional hospital surgery. Hospital costs the highest expense In South Africa, the concept of day hospitals is also gaining popularity – particularly as a result of high hospital costs. Lee Callakoppen, Principal Officer of Bonitas Medical Fund, says, ‘Using our hospital dashboard for the full 2019 year, direct hospital costs were 43% of the total scheme expenditure. These excluded doctor and allied services while a patient was in-hospital. The increase in the use of day hospitals Internationally there is a trend in increased day surgery for multiple reasons including: Improved anaesthesia (with quicker recovery period) Improved pain control (anaesthetic blocks and improved medication) Instrumentation and procedures (keyhole surgery). Cost saving initiatives Private medical aids are struggling to keep up with rising healthcare costs, which usually outpace inflation by 3+%. They are continually looking for ways of reducing costs and keeping premium increases as low as possible without prejudicing the quality of healthcare or financial stability of the fund. ‘We negotiate special rates through our hospital networks and Designated Service Providers (DSPs) and encouraging members to use our Managed Care initiatives. Encouraging members to use day hospitals is another way in which we can save on costs. That said, the strategy amongst acute hospitals is to reduce the tariffs for day surgery to the level of day clinics to prevent a market shift away from their facilities. For the Scheme and members this is a win-win as it still translates to cost savings. Examples of price differences ‘There remains a difference in costs between day and acute hospitals,’ says Callakoppen. The table below represents savings across some of the most prevalent surgeries. Procedure Difference in Case-Mix Adjusted Hospital Cost per Event (Acute Hospital Base) Corneal, Scleral And Conjunctival rocedures -6.3% Eyelid Procedures -28.1% Circumcision -13.9% Tonsillectomy And/Or Adenoidectomy (Child) -13.0% Tonsillectomy And/Or Adenoidectomy (Adult) -11.7% Myringotomy (grommets) -15.5% Colonoscopy -15.4% Other advantages of day hospitals Patient satisfaction No overnight stay – patients are admitted, operated on and discharged on the same day Child-friendly wards and facilities – day hospitals are the ideal alternative for children requiring same day surgery as the trauma of overnight stays are eliminated Lower risk of infection – due to the fact that patients return home on the same day, the risks of cross infection are reduced, which results in a shorter recovery Mortality and major morbidity is extremely low (<1%)* Improved surgery scheduling – decrease in waiting lists Why is take up not higher? Day hospitals clearly have marked advantages but the reason take-up is not that high, is there are some perceived disadvantages of using them. One which is the geographical access – specifically in areas like the Eastern Cape. There is concern around procedure complications and the need for a patient to have advanced care. But legislation is strict around day hospitals and they have to be located within five kilometres of an acute hospital for exactly this reason.’ The issue of doctor access is another factor inhibiting the rapid increase in use. Many doctors have their consulting rooms close to an acute hospital and are unwilling to travel further. Equipment may be limited in day hospitals but the increasing list of procedures which can be performed in day hospitals speaks to this challenge being overcome. This is probably why the percentage of day cases, split between acute hospitals and day hospitals, is still biased toward acute hospitals. Currently the split of day cases being done in acute hospitals is 74% and 26% in day hospitals. This implies that 74% of all procedures which could be performed in a day hospital are currently performed in acute facilities. Safety is foremost Not all patients can go to day hospitals. Callakoppen says, “It should be noted that this percentage will be lower as some patients would have anaesthetic and comorbidity risks and from a safety perspective may rather have the procedure performed in an acute hospital where overnight facilities are available. Additionally, not all day clinics are adequately equipped to do some procedures and, as such, the true percentage will be lower.’ Day hospital options for 2021 Bonitas currently has 68 day hospitals on the BonCap network and 30 day clinics on the Select options. According to Callakoppen, ‘This will be enhanced in 2021 when we implement a day surgery network across all options. A comprehensive list of procedures that should be done as day procedures has been collated for our members. If any of these procedures need to be done then members must use a facility on the day surgery network, or alternatively pay a co-payment. While the day surgery network will be comprised mainly of day clinics, it should be noted that certain acute (conventional) hospitals will need to be included on the network where there are areas of access constraint to them.” Will day hospital use be enforced? The Day Hospital Association of South Africa has proposed that medical aid enforce day hospital use in the future but also caution that there are some cases which cannot be carried out in day hospitals. He says, “The Scheme is in agreement with the concept. Although we do promote the use of day hospitals, we must bear in mind that there are some procedures for which this is not suitable. High risk patients who require more intensive post-surgery care would require acute/conventional hospitals. But the benefits of day hospitals should definitely be considered by all patients when undergoing a procedure.”

November 17, 2020

Sunburn in babies, how to prevent and treat it

Living in sunny South Africa, worrying about your baby being exposed to the sun’s rays is a valid concern. Too much unprotected time in the sun can be harmful to your baby, leading to painful sunburn and, even skin cancer later in life. Here’s how to prevent and treat sunburn if your little one has spent too long outside. How to treat sunburn Babies and toddlers are more sensitive to the sun as they have less developed skin than adults. Prevention is better than cure when it comes to sunburn, however, if your baby has spent too much time in the sun, the reddy, painful burn will only show up a view hours later. Those who have darker complexions tend to be less sun sensitive, however, everyone has some risk of sunburn. Redness, swelling of the skin (warmth) and pain are all symptoms of sunburn. If the sunburn has caused fever, chills, blisters and headaches its best to consult your local health practitioner. You can treat mild sunburn with a cooling bath, moisturiser or aloe gel – all of which will help cool irritated and inflamed skin. Giving your baby extra fluid in the days following the burn should prevent dehydration. It is recommended that you keep your baby out of the sun until the burn has healed.x Tips for preventing sunburn Sun is strongest between 10am and 4pm so limit your little one’s sun exposure during this time. When your baby is spending time outdoors in the sun, be sure that they are wearing a hat and sunblock with an SPF of higher than 30, if your baby is older than 6 months (if they are younger you will need to find alternative protection for them). Try to find sunblock that is formulated for kids (as this will work best for sensitive skin) and do a patch test on their skin before using it. If your child doesn’t like the feel of sunscreen (or is younger than 6 months), sun protective clothing is the better option.

October 21, 2020

Ten tips for choosing the right medical aid

The medical aid landscape can be tricky to navigate so it’s best to compare all the available options and schemes to find a medical aid that works for your budget and your family’s health. Bonitas Medical Fund helps guide you through choosing the best plan. Analyse your healthcare needs No two people or families are alike, medical needs differ so do a quick personal healthcare needs’ analysis to determine what cover you need. If you have dependants, factor in their healthcare needs too. Factors to consider include: How often you visit your family visit a doctor or specialist Over-the-counter medication or chronic medication required Chronic conditions like high blood pressure or diabetes Specific conditions like cancer, HIV or renal failure Dentristy Optometry This will help you decide on whether you need a comprehensive medical aid or a hospital plan. Read the small print Benefits vary from plan to plan, so establish what is and isn’t covered and look at whether the option offers additional risk benefits which can save on day-to-date expenses. Such as free wellness screenings (blood pressure, cholesterol, blood sugar and BMI measurements) through to mammograms, pap smears and prostate screening. In some cases this extends to maternity programmes, dental check-ups, flu vaccinations and more. Managed Care options Managed Care programmes help members manage severe chronic conditions such as cancer, diabetes and HIV/AIDS. What about savings? Medical savings are a fixed amount a medical scheme gives you at the beginning of the year. There are ways to maximise your savings but first you need to know what you annual allocation is. The day-to-day detail Look at what the scheme suggests as a way to make your benefits last, bearing in mind the following: Some plans require you to use a specific GP, hospital network and have a list of Designated Service Providers (DSPs). These keep costs down because the scheme will have negotiated special rates with these services providers. Check the network in your area before making a final decision. 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? Virtual Care and technology Technology and virtual care is being embraced by medical schemes and members. Check what is offered on the plan you’re considering and whether it you want access to your benefits 24/7. Age impacts your decision As parents of young children, ensure the option you select provides sufficient child illness benefits If slightly older, select a plan that covers chronic conditions and provides sufficient in-hospital cover in the event of hospitalisation Ensure the affordability Consider all the costs involved before you make your final decision, such as: Monthly contributions: The rule of thumb is that contributions should not exceed 10% of your monthly income. A medical aid co-payment is a fee that the member is liable for when making use of certain medical services. These co-payments usually apply to specialist or elective medical procedures and will differ from one medical aid scheme to another. Waiting period and exclusions The Medical Schemes Act and the specific scheme’s rules determine this. Bonitas recommends that you enquire with the relevant scheme about their exclusion list and waiting periods. Brokers Using a broker doesn’t cost you anything. An independent broker will help you work your way through the different options and help choose the medical aid plan best suited to your and your family’s needs. For more information on the product offerings from Bonitas go to www.bonitas.co.za

October 21, 2020

Bonitas takes the edge off contribution increases

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

September 23, 2020

Elective surgeries – the disruption, the trends and back to business unusual

On 9 September, South Africa recorded 1990 new cases of the pandemic in 24 hours. The country has now slipped to the eighth worst affected nation in the world in terms of the number of Covid-19 infections. In spite of this elective surgery has been given the green light and its back to business – albeit with strict protocols in place to safeguard staff as well as patients. Almost five months ago elective surgeries came to a standstill. This was reflected in claiming patterns in the private healthcare sector during lockdown – a disruption of the norm globally. In South Africa, elective surgery in both the private and public healthcare space and specialists’ visits are just two of the areas which have been affected by Covid-19. The link between the two is clear: Fewer specialists’ visits mean fewer referrals for surgery. So what exactly is elective surgery? The term can be ambiguous. It does not mean, as the name implies, that the surgery is optional but rather that it doesn’t need to be performed immediately. It can be scheduled at the patient’s and surgeon’s convenience. Some of these surgeries are necessary to prolong life, for example an angioplasty or, as in most cases, improve the quality of life. In brief, elective surgery is ‘A planned, non-emergency surgical procedure.’ Elective surgeries dropped by over half According to Lee Callakoppen, Principal Officer of Bonitas Medical Fund, ‘there has been a 60% reduction in hospital authorisation requests compared to 2019. A study release in March predicted that an estimated 28.4 million elective surgeries worldwide, would be cancelled during the 12 weeks of peak disruption due to the global pandemic. This has been a similar experience to other industry role players and is predominantly due to a combination of member fears related to Covid-19, lockdown and provider caution.’ Surgeries delayed not cancelled The postponement of surgeries was done to prevent patients taking up hospital beds and to avoid unnecessarily exposure to the virus – a strategy that worked well to flatten the curve. Surgeries were delayed based on provider discretion and subsequent patient engagement. Callakoppen says, ‘Providers are best placed to make these clinical decisions in the interests of their patients. If the procedures were emergencies or urgently required to enable member quality of life, those would have proceeded.’ The public sector too experienced backlogs in terms of elective surgeries. Examples are procedures including but not limited to, cataracts, orthopaedic surgeries, scopes, caesarean sections, tonsillectomies and adenoidectomies. BHF cautioned funders In July, The Board of Healthcare Funders (BHF) and its members in the healthcare funding space requested members of medical schemes to proceed with caution in scheduling elective surgical procedures. Dr Rajesh Patel, Head of Benefit and Risk at the BHF, said, ‘While the relaxation of the lockdown restrictions is good news for people, the country and the economy at large, we are still in the eye of the storm.’ The way forward? ‘As we move toward Level one, elective surgeries are almost back to normal,’ says Callakoppen. ‘It’s time to address the backlog of surgeries not considered emergency during lockdown. These include slow-growing cancers, orthopaedic and spine surgeries, airway surgeries, surgeries for non-cancerous tumours as well heart surgeries. We caution against a rush of elective surgeries though. Any surgery has an impact on the immune system which means the patient has a greater risk of contracting Covid-19 and developing complications from it. ‘It must further be noted that in some instances surgery is often recommended by specialists as one of the key courses of action. But we have noted that managed care protocols, in many instances, improve clinical outcomes with lower risk to the patient. One such example of this is spinal surgery, which is often unsuccessful. From a Bonitas perspective, we have noted that in the back and neck programme which enforces functional rehabilitation has been far more effective for our members. In addition, the risk to the member is significantly lower.’ Bonitas recommends the following is taken into account: That elective surgeries should only be resumed in instances where not having the procedure will severely impact the members’ health and quality of life That the current state of a patient’s healthcare is assessed – individuals with chronic conditions such as diabetes, asthma HIV/AIDS and hypertension, are at high-risk of developing Covid-19 complications The patient’s age is taken into consideration (older individuals are identified as one of the most vulnerable groups) The impact of waiting on the patient’s healthcare outcomes (for example, is it essential that the surgery takes place now or can it safely be deferred for a few months) Alternative care protocols – in some cases surgery, which should be a last resort, is prescribed without considering other treatment protocols such as rehabilitation. The most common examples of this include back and spine procedures, elective c-sections as well hip and knee replacements The use of day hospitals and clinics, where possible, to limit the possible chance of infection We may have flattened the curve but we are by no means out of the woods. Current Covid-19 cases in South Africa prove that. What is happening in hospitals? ‘Surgeries are being resumed responsibly with due collaboration and consideration exercised between the surgeon, the patient and hospital staff,’ says Callakoppen. Where there are capacity constraints, surgeries will be classified in terms of priority at the various hospitals. Pre-operative screening will continue. Facilities will continue to utilise separate zones for Covid-19 positive patients, Persons Under Investigation (PUI) and those for whom the status is unknown at the point of admission. Surgeries will be carefully planned and scheduled. Specialist visits on the up ‘Consultations are starting to increase once again but providers in general are likely to remain prudent. However we urge people who have not had their necessary annual check-ups, particularly our high risk members, to consult with their doctors. There may be members who have put these consultations on hold and are now more comfortable to visit a specialist. But care coordination

September 11, 2020

Physical touch & newborns – why is this so important

The birth of your baby is a beautiful and special moment in both of your lives. You may be wondering about your newborn’s senses, while they are born with all necessary senses, some are less precise than others and develop as your baby grows. Physical touch is an important aspect of your child’s growth, coming from your womb, where they are tightly cocooned in your womb. Skin to skin contact offers benefits to both you and your baby, and touch is one of the senses that can help comfort your baby, making them feel more secure and helping strengthen the bond between the two of you. Why is touch important? Touch enables your baby to learn more about the world, bond with their mother and learn communication skills, as touch and body language will be the first way that you can ‘speak’ to one another. Breastfeeding is an important part of this, as your baby then spends time in her mother’s arms. The benefits of touch goes beyond the physical. Contact between mom and baby has been shown to lower cortisol levels, which in turn benefits the functioning of the immune system. Children that are deprived of touch can be more aggressive with other conduct disorder problems. What is swaddling? Coming from a tightly packed womb, you’ll find that your baby is comforted by touch and close cuddles. Swaddling your baby in a blanket is also another technique that you can use on young babies to help them feel more secure, as it stops them from upsetting themselves from their own startle reflex. It’s important that your newborn finds their new world a comfortable and soothing place. Swaddling is an old technique, and beyond helping your little one feel safe and secure, your baby is likely to sleep better and will be kept nice and cosy in their blanket. If you decide to swaddle your baby it’s best to do so from birth, as opposed to introducing it when they are older as this can increase the risk of Sudden Infant Death Syndrome. Using the proper techniques when swaddling is also important, as incorrect wrapping can lead to issues.

September 8, 2020

Advice from the experts

Chiropractic care for mothers during and after pregnancy

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

February 16, 2018

Should We Be Giving Our Teens Condoms?

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

February 16, 2018

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

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

February 14, 2018

Pregnancy and Migraines

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

February 14, 2018

Headaches associated with impaired learning ability and negative mood

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

February 13, 2018

SA Children more at risk from sunburn at school

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

February 12, 2018

The benefits of eating well during pregnancy

When you discover you are pregnant for the first time – your whole world shifts. Up to this point decisions you made with regards to your eating only had a direct effect on your body. Suddenly what you eat affects your unborn baby in more ways than we even realized. Benefit 1: A good balanced nutritious diet will have all the necessary nutrients to allow for optimal growth of your little one! Keep it simple but healthy. You need to eat foods from all the food groups. Avoid fad dieting while pregnant as you will miss out on some essential nutrients. You need a range of fresh fruit and vegetables as this gives you the vitamins and minerals you and your baby need. Lutein is an anti oxidant found in green leafy vegetables and is very good for your babies immune system and brain development. Carotene is found in orange veggies and is very healthy for your babies eye and skin health. A healthy skin may be protective for your baby against allergies later on in life. Aim to eat at least five servings a day. Protein foods like meats, eggs, milk, nuts etc are very important for muscle development and for keeping your placenta well nourished with a healthy blood flow. Some pre term deliveries may result from a placenta that has ‘dried’ up too soon. So aim to eat at least 4 portions (palm size) daily. If you are struggling with nausea in these early days then it may be helpful to get a good supplement that you can take to ensure you meet you protein needs. Starch foods like rice, pasta, wholegrain breads and cereals are very important for energy for you and your baby and also for fibre. Like fruit the fibre in these whole grain products ensure that you stay regular when drunken with adequate water. Have 3 -4 servings of healthy low GI starch daily and at least 1.5L water through out the day. Fats like avocado, linseeds, flaxseeds, olives etc are important to provide the essential fatty acids necessary for you the mom to retain brain cells J and for your little one to create new healthy brain cells. Aim to have 4 fat servings per day (1 tsp/serving or ¼ avocado) Benefit 2: A lot of ongoing research is looking at the moms diet and including high risk allergen foods and initially the thinking was that we should avoid allergens during pregnancy however this has not shown to be beneficial and may even be more harmful. The recommendations now are to include all allergen foods as long as you are not allergic to one of them. So avoid all foods except those you are allergic to. Benefit 3: Some very interesting and current research is going on at the moment around fussy eating and when foods were introduced to babies and its affect on fussy eating behaviour. We know that babies swallow amniotic fluid and we know that babies can taste tastes in the amniotic fluid. So there is some research looking at the variety of vegetables eaten by a mom and then acceptance of theses vegetables later. So in summary if you want your little one to eat his veggies it may all start in the womb!!!!

February 12, 2018

The Effects of Pregnancy on our Intimate Bits

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

February 9, 2018

Eating During Pregnancy

When you discover you are pregnant for the first time – your whole world shifts. Up to this point decisions you made with regards to your eating only had a direct effect on your body. Suddenly what you eat affects your unborn baby in more ways than we even realized. Benefit 1: A good balanced nutritious diet will have all the necessary nutrients to allow for optimal growth of your little one! Keep it simple but healthy. You need to eat foods from all the food groups. Avoid fad dieting while pregnant as you will miss out on some essential nutrients. You need a range of fresh fruit and vegetables as this gives you the vitamins and minerals you and your baby need. Lutein is an anti oxidant found in green leafy vegetables and is very good for your babies immune system and brain development. Carotene is found in orange veggies and is very healthy for your babies eye and skin health. A healthy skin may be protective for your baby against allergies later on in life. Aim to eat at least five servings a day. Protein foods like meats, eggs, milk, nuts etc are very important for muscle development and for keeping your placenta well nourished with a healthy blood flow. Some pre term deliveries may result from a placenta that has ‘dried’ up too soon. So aim to eat at least 4 portions (palm size) daily. If you are struggling with nausea in these early days then it may be helpful to get a good supplement that you can take to ensure you meet you protein needs. Starch foods like rice, pasta, wholegrain breads and cereals are very important for energy for you and your baby and also for fibre. Like fruit the fibre in these whole grain products ensure that you stay regular when drunken with adequate water. Have 3 -4 servings of healthy low GI starch daily and at least 1.5L water through out the day. Fats like avocado, linseeds, flaxseeds, olives etc are important to provide the essential fatty acids necessary for you the mom to retain brain cells and for your little one to create new healthy brain cells. Aim to have 4 fat servings per day (1 tsp/serving or ¼ avocado). Benefit 2: A lot of ongoing research is looking at the moms diet and including high risk allergen foods and initially the thinking was that we should avoid allergens during pregnancy however this has not shown to be beneficial and may even be more harmful. The recommendations now are to include all allergen foods as long as you are not allergic to one of them. So avoid all foods except those you are allergic to. Benefit 3: Some very interesting and current research is going on at the moment around fussy eating and when foods were introduced to babies and its affect on fussy eating behaviour. We know that babies swallow amniotic fluid and we know that babies can taste tastes in the amniotic fluid. So there is some research looking at the variety of vegetables eaten by a mom and then acceptance of theses vegetables later. So in summary if you want your little one to eat his veggies it may all start in the womb!!!!

February 8, 2018

8 Awesome Benefits of Pregnancy Massage

Massage is not just about it feeling good, it actually comes with many health benefits that you may not be aware of. Having a massage while you are pregnant can actually help to lessen some of the unpleasant pregnancy symptoms you may be suffering with as well as be a lovely way to unwind and relax. I had a pregnancy massage when I was 6 months pregnant and on my honeymoon. I really struggled with my first pregnancy and it was amazing to have that massage. The strangest thing though is that I felt the most amazing sensation of stress relief when the area in the crook of my elbow was massaged on the one side. When you are pregnant your body goes through some incredible changes and a massage can really help your body and your mind to cope better. If you are pregnant it is really important to highlight that you need to see a massage therapist that is qualified in prenatal massage. 1 Increased Blood Circulation This will bring more oxygen to mother and the baby, stimulating the lymphatic system. This will result in a stronger immune system and help to reduce toxins in the body. Increased blood circulation will also result in your baby getting better nourishment. An added bonus is that increase blood circulation will help prevent varicose veins from forming which is common during pregnancy 2 Massage Helps To Relieve Lower Back Pain Lower back pain is a common pregnancy symptom that can be caused by the hormone relaxin that causes ligaments that support the spine to relax. This can cause instability and pain. Pregnancy massage improves lower back pain through improving the lumbosacral tilt that occurs during pregnancy. 3 Relieves Depression and Anxiety In case you didn’t know, it is actually very common for postnatal depression to start during the third trimester of pregnancy instead of when you expect it to start (after your baby is born). Massage helps to stabilize hormone levels which can relieve anxiety and depression. Massage also releases endorphins that soothe and relax the mother. 4 Improved Sleep Any woman that has been pregnant knows how hard it can be to really relax and sleep well while pregnant. Due to massage relaxing the nervous system and extra feel good hormones moms to be will sleep better. In addition to the mom being more relaxed the other benefits of massage such as back pain relief will also make the mother more comfortable which will help her sleep better. 5 Decreased Swelling Edema, which is the swelling of joints during pregnancy, is caused by decreased circulation while pregnant as well as the increased pressure on major blood vessels. Having a pregnancy massage can greatly reduce edema by improving circulation and reducing the fluid collected in swollen joints. 6 Reduced Muscle Pain and Headaches During pregnancy your body changes and your center of gravity moves. In addition to this there is quite a bit of extra weight placed on muscles and joints. All these changes result in your muscles taking strain and can also result in headaches. Pregnancy massage can help to relieve this pain and to reduce any headaches if you are suffering from them. Pregnancy massage will also help you to keep better posture which will also in turn help to reduce muscle strains and pains. 7 Reduces Common Discomforts During Pregnancy Along with all the above benefits having a pregnancy massage can also help with lessening numerous other common pregnancy symptoms such as sciatica, heart burn, constipation, carpal tunnel syndrome, leg cramps and much more. 8 Prepares Your Body For Labor and Birth Studies has shown that women that have pregnancy massages have less complications during birth as well as fewer postpartum complications. These women reportedly had shorter hospital stays, shorter labors and less incidence of post natal depression.

February 7, 2018

Childbirth education for an empowered birth

‘Empowering Birth’ is the theme of Pregnancy Education Month in February 2018, when childbirth educators, Bio-Oil and hospitals nationwide will be highlighting how education empowers expectant parents and helps create a better birth experience. For more details visit www.pregnancyeducation.co.za. Birth is the most natural process on earth and yet studies have shown that one in every four women describes her birth as traumatic, one in every five to 10 meets the criteria for post-traumatic stress disorder and one in three or four has postpartum mood disorder. Studies have also found that women who fear childbirth experience longer labour and were more likely to need an emergency caesarean than those who did not. ‘There is a link between a lack of knowledge, fear and the experience of childbirth,’ says Lynne Bluff, national co-ordinator for the Childbirth Educators Professional Forum (CBEPF), which is partnering with Bio-Oil and hospitals nationally for Pregnancy Education Month 2018. With the theme ‘Empowering Birth’, the campaign highlights how pregnancy education empowers expectant parents and helps create a better birth experience. ‘It is so important that parents are comprehensively informed about birthing options safest for the mother and infant in the event of a low-risk, normal pregnancy,’ says Professor Suzanne Delport, neonatologist. Good childbirth classes, says Bluff, will equip parents with knowledge about all available childbirth options and the pros and cons of each, practical tips and techniques for the birth and after it, and the confidence that comes from knowing what to expect and how to cope. Ideally childbirth educators are nurses and midwives, as well as being parents themselves, who can prepare expectant parents for every aspect of childbirth and instil faith in their own ability and strength to give birth. ‘We believe that when parents are informed, any type of birth, from homebirth to caesarean, can be an empowering one. It shifts from a potentially overwhelming experience to one that is fulfilling, positive and, ultimately, beneficial to mother and child,’ says Anna Guerin of Bio-Oil. ‘There is simply no substitute for evidence-based information provided by qualified and experienced professionals. With quality childbirth education, parents are empowered and properly prepared in a warm and supportive way,’ says Bluff, who is also a registered nurse and midwife. “Although childbirth is one of life’s most significant milestones many parents are simply ignorant of the facts vital to decision making,” says Bluff. For example, many parents are not aware that when a baby passes through the birth canal, he or she picks up a multitude of micro-organisms that will benefit their health and guard against chronic illness for the rest of their life; or that there are a number of caesarean options available, some more friendly to mother and baby than others. And most of us know little of the interplay of birthing hormones that click in, one step at a time, to pave the way for birth, help manage pain and stress and give us the feeling of joy when seeing baby for the first time. To find out more about childbirth education, Pregnancy Education Month activities or to find a childbirth educator in your area, visit www.pregnancyeducation.co.za. #PregnancyEducationMonth #EmpoweringBirth

February 2, 2018

Surviving a Heterotypic Miscarriage

I had a heterotypic miscarriage and it was painful. Heterotypic pregnancy is when one is carrying twins, the one foetus grows in the uterus and another in the tube. It is rare in natural conception to have a heterotypic pregnancy, research estimates that 1 in 30,000 pregnancies are heterotypic pregnancies. I lost my first child on Christmas day. I had just finished preparing Christmas lunch and was taking a bath when I started vomiting, felt what the doctor later called ‘acute abdominal pain’. My 10year old son had to help me out of the bath, assist me while I was getting dressed (my mother, my husband and my nieces had gone to get some last-minute necessities for the lunch). My son called his dad who came rushing and took me to the hospital. At the ER, the doctor attending did a pregnancy test and the results were positive, she then told me that I was showing signs of an ectopic pregnancy. She wrote her diagnosis on my medical file and I was wheeled to the ward. When the gynaecologist arrived, he did a sonar and reconfirmed that I was indeed pregnant but that the pregnancy was in the womb and not an ectopic pregnancy. He then ordered the nurse to run some tests and in the morning told me that my oestrogen levels were higher than normal which meant that I was pregnant, however my oestrogen levels were lower than the previous day which meant that I was having a miscarriage. He further explained that I would undergo a ‘minor procedure’ i.e. evacuation of the womb. December 26, 2016, I went for evacuation of the womb. I did not feel better, I was still bloated, I still could not do much, I was in pain. 10 January 2017: I was back in the hospital and the diagnosis, ruptured ectopic. At 3 am that morning I felt so much pain, it felt like period pains, at the same time I was freezing cold and sweating at the same time. I woke my husband up and asked him to call someone to take us to the hospital (he panics so I’d not have made to the hospital). I told him that I was feeling faint and the next thing I remember is being carried out of the house to the car; by this time, I was vomiting and without energy. I woke up in the ER briefly and the next thing I remember is waking up in ICU, surrounded by doctors and nurses who looked very concerned. Now when nurses get concerned and curious, then I know something is not good. “My dear can you hear me?” one of the nurses asked, I nodded. As she put lip balm on my lips she said “You look much better than you did last night…” she then told me that my doctor was on his way and he will discuss a few things with me. My doctor arrived he looked at my medical file and when the nurse asked what the diagnosis was, he simply showed her the file. When my husband asked him what the diagnosis was, he said; “Don’t worry about that now, let’s take care of your wife’s health.” I went to the theatre for a laparoscopy. In the surgery, three fairly small incisions were made, two in my tummy and one in the navel; and because my tubes were ruptured, the fallopian tube containing the pregnancy was surgically removed. Upon my return to the ward, my doctor seemed to be concerned about something, he asked the nurse how much was ordered and the nurse replied “two”. “No no! We need five at least and we need it within the next hour” my doctor said. Moments later blood was delivered, the nurse explained to me that I had lost blood. “It happens with ruptured ectopic pregnancies, so now your heart is pumping faster, trying to compensate for the blood loss and is beating at twice the normal rate. You need at least five blood ”. The nurse had been coming to my bedside at least three times a day just to see how I am and explain to me what the next steps would be. Some struggles after the surgery: I went through physio therapy, to learn to walk and move I was constipated for about two weeks I was on schedule 5 pain medication for weeks I had no appetite I could not play my children or sleep because the pain was unbearable A week after I was discharged from the hospital, I went for a check-up and the doctor told me that I had had a Heterotypic pregnancy. He apologised for not seeing the issue when I’d come in on Christmas day. It only hit me as I set at home counting that in September 2017 I could have been a mother to twins, that I had to be at death’s door to get a proper diagnosis. My doctor apologised and told me that he did not know which of my tubes were removed, to this day I do not know. Perhaps mommies will learn to ask their doctors to not only check the womb but the tubes as well, to avoid or diagnose what may be missed. To my unborn children, I’d have loved you, as I do now

February 1, 2018

Play is crucial for early child development

Only 29 percent of South African children have access to safe, child-appropriate play areas in their communities, this according UNICEF, but a local organisation – Play Africa is championing for this change countrywide. Gretchen Wilson-Prangley, CEO of Play Africa – a social enterprise organisation driving inclusive public learning for the country’s most vulnerable says play is “exceedingly important” for children of all ages and an integral part of early learning and healthy social development. “Neuroscience has confirmed that the first few years of a child’s life is crucial for early learning. And play forms part of early learning and is far more valuable than we realise,” she says. Wilson-Prangley says play sparks imagination, enhances creativity and problem solving capacities, promotes teamwork and helps to instil empathy and compassion for others. “I believe in the importance of helping to advance children’s basic rights and this includes the right to play,” she says. And since many South African children lack toys and other learning materials that can help stimulate a range of child-initiated, open-ended activities which bolster cognitive, physical, social and emotional development, Wilson-Prangley explains that her organisation seeks to promote one single message – there is no cost to play. Their workshops encourage parents and children to make use of everyday materials when playing. “We demonstrate just how to transform everyday items into play materials using the imagination. Few people know that you’re able to make a robot or a rocket ship using clean milk containers, or a car out of empty loo paper rolls. What’s important is the process and the imagination and creativity it stimulates,” she says. Further, she says play is a “good way to engage” and helps children make use of their imagination; she also describes it as “pleasurable and enjoyable”. “Playing overall gives children an opportunity to stretch their thinking and imagination, it also invites repeated active engagement which is highly beneficial for children of all ages,” Wilson-Prangley says.

January 19, 2018

Bonitas Talks Babies

When do advise your medical aid that you are pregnant? If you are a prospective member, you need to do so upon application or within 30 days after the completion of your application. If you are already a member with no waiting periods, you can access the out-of-hospital maternity benefits without advising the medical aid that you are pregnant. However, you need to obtain pre-authorisation for the delivery of the baby, which can be done from 20 weeks onwards. Are there waiting periods? Waiting periods may apply to members who join a medical aid while already pregnant. If you join while you are pregnant the pregnancy will not be covered. When do you advise the medical aid that the baby is born and needs to be added onto your medical aid The baby needs to be registered within 30 days from the date of birth to ensure there is no break in cover and your child will be covered from the first day of life. Are there any things you need to know or be cautious about when pregnant regarding medical aid so that you do not find yourself out of pocket We advise members to use doctors and hospitals on the network to avoid out of pocket payments. Bonitas offers a wide range of maternity benefits which includes cover for consultations, amniocentesis and scans as well. These benefits are in addition to savings to give members more value for money. Bonitas advises that any false information or non-disclosure of any material information provided upon application will result in the membership being declared null and void. In addition Bonitas Medical Fund offers Babyline – a dedicated children’s health advice line In 2016, Bonitas introduced Babyline – a 24-hour children’s health advice line manned by paediatric trained registered nurses. They are on the other side of the phone to assist with any parental concerns, or health related issues, 24/7, 365 days of the year. How does it work? Bonitas parents, or their caregivers, simply call the Babyline number on 0860 999 121 to reach a paediatric trained nurse. Through a series of questions asked regarding the health issue, parents will be provided with professional advice on what to do next. Depending on the symptoms, the advice might be to head straight to the ER or to see a doctor or specialist. The nurse will advise which healthcare provider is the most appropriate, given the health issue. The services offered by the Babyline include: Home care advice Clinic/primary care/GP referral for the same day Clinic/primary care/GP referral for the following day After-hours care within the next six hours Immediate referral to the ER The Babyline service is available to members across all the Bonitas plans, for children under 3 years. Sharing our content with parents you know will go a long way to making us smile for the day

January 17, 2018

Children get stressed too!

It’s a new school year! It’s exam time! Both of these occurrences during your child’s school life come with their own level of stress – for your child. When your child starts a new school year, or begins exams parents often focus on the stress that they themselves are feeling, rather than taking into account that their child is feeling the pressure as well. “Children don’t deal with stress, or show stress the same way that adults do, and often parents can over-look these clues,” says Carla Yssel, brand manager for Linctagon®. “When children are stressed they are not sure how to deal with it, and this can often manifest itself in a complete change of behaviour – being moody, crying, withdrawing from activities, and even complaining of stomach aches and headaches. Parents need to be on the lookout for these types of behavioural changes when big events in their child’s life occur, such as starting school, or tackling exams.” Although, some stress can be a positive as it can motivate your child to overcome what is worrying them, being over-stressed can cause illnesses. The stress hormone corticosteroid suppresses the immune system, and results in your child getting a cold or even the flu. “We are often consumed with whether our children have the correct stationery, or have prepared enough for their exam, that we forget to actually take care of them,” says Yssel. Yssel provides 5 tips on how to look after your child during stressful times: Be prepared in advance: Make sure that your child has everything they need long before school starts, and gets through all their studying with enough time to revise before an exam. This will give your child the peace-of-mind they require to overcome any stress they may be feeling. Get enough sleep: A good sleep is sure to improve your child’s concentration, and also allow them to feel ready to take on the new day with confidence and a clear mind. Talk to your child: Your child needs to know that you support them, and that you understand what they are going through. Talk to them about what they can expect on their first day of a new school term or year, or that no matter how they do in their exam you will support them through it all. Give them the edge: When your child starts to feel a cold or the flu coming on, give them Linctagon® Effervescent (which can be used from age 12) or Linctagon® Effervescent Junior (can be used from the age of 1) to help get over colds. Linctagon® effervescent and Linctagon® effervescent Junior contain the active ingredient Pelargonium sidoides and with its active support can shorten the duration of the common cold as well as reduce the severity of symptoms with the added Vitamins A and C, anti-inflammatory MSM and immunity enhancer Zinc (Alt Med Review, 2007). This will allow your child the opportunity to get back to what really matters; quicker than usual (Lizogub et al, 2007), and it is suitable for children and adults who are diabetic. Take time out to laugh: Just because your child is writing exams, or getting ready to go back to school it doesn’t mean that all fun needs to end! Laugh with your child; let them forget what they are stressed about, and just have a moment to breathe. Sharing our content with parents you know will go a long way to making us smile for the day

January 10, 2018

Will you bank them, or bin them? Wise up on stem cells before it’s too late.

Becoming a parent is fraught with responsibilities. Prospective parents should know the facts about the life-saving abilities of umbilical cord stem cells so that they can make informed decisions for their families. Stem cells should be called master cells as they can replicate, regenerate and differentiate themselves into any one of 200 different specialised cells in the body, and are used to treat over 80 potentially life-threatening blood related diseases including leukaemia, lymphoma and bone marrow failures. Blood stem cell transplantation, using stem blood cells from sources such as bone marrow, has been performed for more than 50 years, with more than one million blood stem cell transplants across the world playing an important role in the treatment of bone marrow failures, blood cancers, blood disorders, metabolic diseases, immune deficiencies and autoimmune diseases. Cryo-Save South Africa has listed the top 10 most noteworthy facts about stem cells that you need to know: Stem cells are your body’s internal repair system Stem cells continuously replace dead or diseases cells with healthy ones to maintain a normal functioning body. They fall into two major groups; pluripotent and multipotent stem cells. Pluripotent stem cells are powerful, meaning they can develop into any type of cell in your body. However, these cells are still fraught with ethical controversy. Multipotent stem cells, also called adult stem cells, can develop certain tissue cells to maintain your body’s organs as you age, such as blood-forming stem cells. Blood-forming stem cells produce new and healthy red blood cells to carry oxygen to all parts of our body; white blood cells to fight bacteria; and platelets which form clots to pervert excessive bleeding. Best time to collect stem cells is at birth Stem cells age as we age, so the best time to collect blood stem cells is at birth. These cells have not been exposed to pollution and poor lifestyle choices and can therefore offer greater therapeutic possibilities and better transplant outcomes. Stem cells from umbilical cord blood don’t need to be a 100% match for transplants Although your baby’s umbilical cord blood stem cells are a 100% perfect match for own use, there is a 25% probability for a 100% match for siblings. However, unlike bone marrow transplants, you often don’t need a 100% match using cord blood stem cells, which means the probability of finding a suitable donor is so much greater. Stem cell storage is not that costly Stem cell storage is available to anyone who wishes to store their baby’s umbilical cord stem cells. Cryo-Save offers multiple cost options and interest-free payment plans from as little as R273.00 per month to store cord blood and R350.00 per month for storing both cord blood and tissue. Mixed ethnicity parents should store stem cells The chances of finding a perfect matching blood stem cell donor for an allogeneic (matching donor) transplant are only 1:1,00,000, but the odds are much lower for anyone from a mixed-race family Despite its diverse ethnic make-up, Africa has no public cord blood stem cell bank, which makes the likelihood of finding a matching donor even more challenging. Therefore, Cryo-Save encourages mixed race families to store their babies’ stem cells. Banking stem cells is not just for families with a history of cancer Many people don’t realise that stem cells now play a part in the treatment of over 80 blood diseases and conditions. Every day we are seeing more diseases developing, and more clinical trials are taking place to identify treatments of many of these diseases. Some of the most promising research is being done to use children’s’ own umbilical cord blood stem cells in the treatment of cerebral palsy and autism. Additionally, statistics show that more than 90% of cancers develop due to lifestyle factors, not genetics, and that the incidence of cancer is increasing. Stem cell collection is a safe medical procedure Collecting stem cells from an umbilical cord is quick, painless and non-invasive, posing no medical risk to mother or baby. It is only after the clamping that the blood and tissue are collected from the umbilical cord for stem cell processing. Stem cell banking is possible with any type of birth Cord blood and cord tissue collections can be performed at both vaginal and caesarean deliveries. Immediately following the birth but before the placenta is delivered, the healthcare provider collects the cord blood from the baby’s umbilical cord. You can store your second child’s stem cells if you didn’t store for your first child Today, umbilical cord stem cells are used in more than a third of blood stem cell transplants around the world. Siblings have a 25% chance of being a perfect match. But because cord blood stem cells do not require a perfect match for transplant, the likelihood that siblings will be a match is much higher. Therefore, storing your second child’s stem cells has the possibility, depending on the degree of matching, to treat your first child should a stem cell transplant be required and may also be used for other immediate family members. Stem cell storage is available in South Africa Cryo-Save has been storing umbilical cord stem cells for families all over the world since 2000. It is the leading family stem cell bank in Europe and ranked fifth most influential cord blood bank in the world by Bio Informant. Cryo-Save South Africa offers both local and international storage options in either Pretoria or Europe for both cord blood and cord tissue. This local laboratory complies with the highest international standards and importantly complies to the coveted American Association of Blood Banks accreditation standards. Just as some people need organ transplants to treat or cure diseases, blood stem cells can be transplanted too. If the blood forming stem cells in our bodies cannot produce healthy cells or stop producing cells completely, we cannot function normally and our stem cells will have to be REPLACED with healthy ones that can be found in the bone marrow or umbilical cord blood. Sometimes these stem

December 18, 2017

Holiday Blue’s

December: Time for festive lights and great food and fun with the family and holidays and presents and singing and cheer and… suicide. What?! Yes, despite the festivities, this is the time where depression and suicide are most prevalent. All the pressure to have a good time and the fantasy of how perfect it is going to be can be downright miserable, and if you’re already prone towards depression can really take you down the spiral. Depression is a whole body-mind phenomenon, and so there are many things that you can focus on and shift in your life to both prevent and treat depression. Of course, if you’ve already gone so far down into hell that you can’t even imagine implementing these things then you need to get some help, but my xmas wish for you is that you take note of these things before you disappear down the rabbit hole. This is a summary of my full depression checklist that I use myself to give myself a leg-up when I need it. Check in with yourself regularly and make sure that you have these basics in place: EXERCISE/MOVEMENT: This is the single most effective and most underutilized treatment for depression. Get up off the couch! DIET: The key things here (other than good all round nutrition) are Omega 3’s, probiotics, magnesium, Vitamin D and the B Vitamins and water. Make sure you’re getting these in your diet, or supplement. ILLNESS: Make sure your depression isn’t a remnant of a previous illness. Allow yourself time for recovery. ENERGY LEVELS: Take a break. Get enough sleep! STRESS LEVELS: Breathe, breathe, breathe. HORMONES: Don’t confuse your life falling apart with a bout of PMS. APPEARANCE: Look after yourself – treat yourself to a manicure, a new outfit, a homemade facemask. PURPOSE: Do something every day that moves your soul. BOREDOM: Sign up for an online course, go to an interesting talk, read a good book. DAILY GRIND: Add some fun into your week and prioritise. GOALS: Take some baby steps towards something meaningful to you. TRAUMA: Find the growth points in what you have been through or get some help to work through your past. SEASONAL: Brainstorm some fun ways to make the season more bearable for you. SOCIO-POLITICAL: Stop watching / listening to the news. Change the subject. Don’t get drawn into other people’s fears and negativity. CLUTTER: Do some Spring (Summer) cleaning. Start with a small area or just one drawer. MUSIC: Switch from Leonard Cohen to The Beatles! TOXINS: Clear out harmful chemicals from your home and life. CONNECTION: Reach out to a friend who really cares and is open to listening. FUN: Find enjoyable things to do with your family other than just day-to-day necessities. TIME: Get rid of irrelevant time wasters and see what in your life can be delegated to somebody else. WORRIES: Take action on niggling worries. ASSUMPTIONS: Question the things you are thinking (eg the mess in the house means nobody cares about me)… always ask: “Is this really true?” PERFECTIONISM: Let it go. You are enough (write this on your mirror now!) FANTASY: Let go of how you think life “should” look and appreciate it as it is. Find 3 things right now to be grateful for. Do this daily. DEPRESSION IS BAD: Depression is there to help you to grow, to reprioritize your life, and to get on track living your purpose. Question the idea that it is bad and see if you can gently welcome it in and allow it to change you! Life is not always going to be happy-go-lucky, and just because the festive season swings around at this time of your does not mean that your mood will too. Let go of the pressure to be joyous and filled with fun and allow yourself to be as you are. Take tiny steps towards addressing the things in the list above – just start with whatever you can manage and see how little changes over time amount to massive shifts. This festive season, be real, be safe and look after your whole self.

December 14, 2017

How to be sure your child has a positive inner voice

In 2004, I started reading Dr. Phil McGraw’s book Self-Matters it is the first place I heard of and learned about the concept of elf-talk or the inner voice. I love the way he explained it. What I took away from it was the concept of a quietly running tape which urns underneath all the other voices in your life and this voice is the one where people live from. It is based on all the things you heard as a child not only about yourself but about the way life works in general these are the voices primarily of your parents. Therefore, it is what we hear our parents say about us and life that creates the foundations of our inner voice. As a parent coach, this caused me to step back and examine my whole concept of what it means to be an effective parent. I have concluded that effective parents have several things in common when it comes to creating a positive inner voice for themselves first and as a result for their children. I have found this can help even if their children go differing messages early if parents are willing to communicate these inner changes with their kids. Authenticity Examination of own Inner Voice Recognition of Values and Self Positive Parenting Authenticity is defined as living a life true to yourself. I believe authenticity is about aligning your life so the following parts of you are congruent. Beliefs Thoughts Feelings Words Actions As I was reading Dr. Phil’s book it began to occur to me I had no real idea what my self-talk was and how it was shaping my life. I began to wonder if other people felt the same way. At the time, I was working with a group of moms and I began to talk with them about what I was reading and how it was affecting my life and I wondered what they thought. It was amazing every woman in the group of 12 shared the same feeling. Exploring your own self-talk-taking the time to stop and get your mind and surroundings as quiet as possible while thinking about a decision. Finding out what our own inner voice was saying and deciding about whether this is what we wanted for our lives. We began to think about and create a space where we could be open and vulnerable with one another about how do develop our own self-talk. As we did so something interesting started to happen, the kids started to respond differently to how we interacted with them. Upon reflection, we recognized in developing our own connection with our inner voice it causes significant changes in our outer voice as well. This is where I began to realize that authenticity is the true foundation of parenting. I call authenticity living a life based on what I truly believe, and let that be the basis from which I think, say, feel, and act. Bringing my life into congruence. This causes me to be clearer on what I want and what I expect. Living an authentic life is not easy. If you want to learn more about it. I wrote a post for Inspire Me Today which gives a short post on how to start. Exploring your values and goals-Being authentic is primarily about exploring who you are and what you want in your life. I have created a list of ten questions I ask every client today. You can use them to help you think not only about the values you consider important. But, also why they are important to you. 1. What is the most important thing in your life? 2. What is your biggest dream? 3. Who are the most important people in your life and why? 4. If you could do anything in the world for your work life, what would it be? 5. If you could do anything in your personal life what would it be? 6. What do you spend the most time doing? 7. In one to three sentences write down what you would want people to say about you after you die. Are you living in a way in which people would say that? 8. What are your most important roles in life? Why? (I.e. mother, father, sister, friend) 9. What would you say living a spiritual life is to you? 10. If you could sit down to dinner with three important people in your life dead or alive and have; what three people would you ask> What would you ask them? These questions get down to the core of your belief system and therefore get to the heart of what your inner voice is saying to you. It was not until I came up with this list and answered the questions myself that I began to really define what my life was about and why. It was this understanding which gave me the courage to strike out on my own and start a nonprofit organization based on effective parenting. I firmly agree with Dr. Phil when he says, “you can’t lead where you haven’t been”. We adults need to know, understand, and adjust our own inner voice to be a positive one before we can ever get our children’s inner voice to be positive. This is because it is our voice which forms the foundation for the future inner voice of our kids. If we are not positive, they will not be either. How we answer the above 10 questions will help to know what you value and why. Once we know this we can then step back and examine how we feel about things and weigh what we think, say, and do based on these insights. Here is how we change our voice. Know our values and why we think they are important. Based on these values create positive statements to replace the negative ones which may come up. When making decisions listen to our inner voice for any negative feedback.

November 21, 2017

Spectacles can mean the difference between success and failure for an underprivileged learner

Sight is something most people take for granted, yet at least 239 million children around the world suffer from impaired vision that could be corrected by spectacles. Since 80% of all learning occurs through vision, children who cannot afford spectacles are at a major disadvantage in education environments, which can lead to lower earning potential later in their lives.* As we observe World Sight Day on 12 October, the Adopt-a-School Foundation (AAS) encourages partners in the private sector, civil society, and government to support its efforts to address the issue of impaired vision that affects millions of underprivileged learners in South Africa. AAS first encountered this issue six years ago in Bodibe, a small village nestled in the rural part of the North West province, when they were conducting educator development programmes in 11 schools in the community. Educators shared their frustrations with AAS, saying that many children were being disruptive and unable to concentrate. When AAS investigated the matter, they decided to test the learners’ eyesight, and found that more than half of the children had vision problems. “At AAS we use a unique Whole School Development (WSD) approach to school development,” says Banyana Mohajane, Head of Skills and Social Development at AAS.“Rather than tackle an individual issue, WSD works to improve the school holistically by focussing on the academic, infrastructural, social, and security environment in which a school operates. This includes issues such as learner health and well-being, and includes eyesight testing,” she continues. “Most children in our adopted schools have never had their eyes tested,” explains Mohajane. “Through the introduction of mobile eyesight testing clinics, we have found that up to 15% of these learners have vision problems, which could lead to poor academic performance,” she continues. The benefits of treating impaired vision are immediate and clear. Research by the World Economic Forum has found that simply correcting the vision of primary school students is equivalent to another six months of additional schooling in terms of test scores. There is also strong evidence that the provision of spectacles leads to higher earnings, and can lead to increases in GDP.* “Over the last six years we have partnered with optometrists to conduct nearly 60 000 eyesight tests. We have donated 2 697 pairs of spectacles to learners in need and have referred the more serious cases to specialists and the Department of Health,” continues Mohajane. “Together with our partners, we hope to test the eyesight of many more school children across South Africa,” she concludes. For more information on Adopt-a-School or to contribute to this programme, visit the Foundation’s website at www.adoptaschool.org.za, email [email protected] or call 011 592 6430.

November 21, 2017

No more headaches about exams

Examinations are stressful enough for learners and students, without them having to worry about headaches and migraines. Unfortunately it has become an ordinary occurrence for students and many of them feel helpless when dealing with this problem. They can feel so overwhelmed that they completely forget about the effects this is having on their health. Dr Elliot Shevel, South Africa’s pioneer in the field of migraine surgery and the medical director of The Headache Clinic, says headaches and migraines can have adverse effects on the performance of students and suggests the following measures: Be aware of your posture when studying as this can result in a tension headache. Use a good chair that supports your back and that gives the ideal posture. Visit www.headacheclinic.co.za to get a free copy of the Ideal Computer Posture. Learn the right stretching exercises to stretch the muscles of your head, face, neck and jaw. Finding out what triggers your headaches by keeping a diary. Each time you suffer from a headache, make a note about the warning signs, triggers and severity. If you can discover some of your personal triggers, you may be able to avoid future headaches. This diary is important as it will give your medical professional an accurate history of your headaches. Dietary migraine is a common affliction. These are usually triggered by foods that assist with energy such as chocolate. Chocolate raises the blood sugar levels quickly and then allows it to drop quickly again. Low GI (Glycaemic Index) foods give a more even blood sugar level. Use the nutritional facts label to help choose healthy foods when shopping. A dietary trigger diary is available on www.headacheclinic.co.za under “Free Assistance”. Beware of Medication-Overuse Headache (MOH). Medication is only appropriate for someone who suffers a few times a month. According to the International Headache Society, if you are taking medication more than twice a week you are at risk of developing MOH. This means that the drugs you are taking will cause the migraine to become more severe and more frequent over time. Dehydration is a common trigger, adequate intake of fluid throughout the day to prevent headaches. The human brain is more than 75% water, and it is very sensitive to the amount of water available to it. When the brain detects that the water supply is too low, it begins to produce histamines. “If the problem persists, it is imperative that you get an accurate diagnosis” says Shevel. “There are a number of treatment options that can be investigated. The longer the headache persists, the more damage will be done. One must get to the bottom of the problem and resolve the pain permanently.”

November 17, 2017

How to fix a broken diet?

Are you not getting the results you wanted or your diet plan stopped working? Every diet and exercise system is going to stop working at some point. No matter how great it seems initially, that diet will break. And when it does, your next step is crucial. In this newsletter we’ll be discussing the main strategies to fix a “broken diet” and start eating better. DON’T REALISE YOUR DIET IS BAD In my many years as a dietitian, I came well aware that we humans generally suck at realising what we’re eating. For one, we typically tend to remember the “good things” we do – how we turned down the rusks as they were going round the office last Friday, or how we managed to go a whole week without alcohol. And when we do something “bad” we’re really good at justifying it. “It was so-and-so’s birthday, “or “Yes, I did have that slice of cake, but my friend had 2 slices, so I’m not as bad as her,“ are common reasons I hear for making poor dietary choices. In fact, we’re so bad, that a study from the New England Journal of Medicine found that obese subjects underreported their food intake by an average of 47%, and overestimated the amount of calories burned from exercise by 51%. What does this mean? It means that we think we are eating a lot less than we are, and that we think the exercise we are doing is burning far more calories than it really is. End result – we make little progress and become disheartened with the results. STEP 1: GET TRACKING – KEEP A FOOD DIARY I am a huge fan of food logs. For a start, it gets a person thinking about exactly what they’re eating. Mindless eating is a big problem for many. Writing down everything one eat and drink, over a 2-week period, gets you off to a great start in identifying possible problem areas and underlying nutritional deficiencies. STEP 2: IDENTIFY AND CORRECT NUTRITIONAL DEFICIENCIES Most people think they need a complete diet and exercise make-over. “I have to cut out sugar… and dairy… and carbs… and saturated fat. Plus I have to eat more protein… more healthy fats… and more vegetables. I have to start drinking lots of water too. And exercise… maybe a 6 am boot camp… yeah.” I don’t know about you, but I get exhausted just thinking about changing all this, all at once and often people set themselves up for failure. Let’s call it the “Mission Impossible” approach. Often, people struggle with how they look and feel because their physiology doesn’t work the way it should. This can be hormonal imbalances, but it’s more often dietary deficiency: not getting the right nutrients, in the right amounts, to feel your best and get the best results. Dietary deficiencies are more common than you think A study published in the Journal of the International Society of Sports Nutrition showed that it’s really hard to get all the essential vitamins and minerals from food alone. Of the individual diets that were studied – every single diet was deficient in at least three nutrients. Some diets were missing up to fifteen nutrients! The most common deficiencies included vitamin D, zinc, calcium and some of the B-vitamins. The most common deficiencies I see at Paarl Dietitians are water (low-level dehydration), vitamins and minerals, protein (particularly in women and in men with low appetites), essential fats e.g. omega-3 fatty acids (95% of the population is deficient here), vitamin D, iron and B-vitamins. Bottom line: Dietary deficiencies are very common. Chances are you’ve got one, no matter how good you think your diet is. That’s a problem because when you’re deficient in key nutrients, your physiology doesn’t work properly. And when your body doesn’t work as it should, you feel rotten. Energy levels, appetite, strength, endurance, and mood all rely on getting enough of these essential nutrients. When you don’t get them, things break down. Correcting deficiencies Analysing a food log and blood testing can uncover specific nutrient deficiencies that can be corrected by means of dietary adaptations and nutritional supplementation. As soon as we get the nutrients we need, we thrive. Once we’re getting all the essential nutrients necessary for proper functioning we can move on to bigger issues. These include adjusting food amount (what some call calorie intake) and food type (which includes diet composition or the distribution of protein, carbohydrates and fats). STEP 3: DO NOT EXCEED YOUR METABOLIC RATE For our body to function normally, it needs a constant supply of energy and a variety of nutrients. The amount of energy or number of caloriesyour body uses to carry out these basic functions is known as your basal metabolic rate (BMR) — what you might call metabolism. Thus the metabolic rate is the rate at which the body burns calories. So how much should one eat? The problem comes in when energy is taken in excessive amounts. Too much energy and the body will store the excess as fat and you will gain weight. In other words, if your body uses 1500 kcal to maintain weight, you need to take in at least 500 – 1000 kcal less to lose ½ kg – 1kg per week, therefore a 1000 kcal diet plan. Our practice assess metabolic rate and an individual’s eating plan are devised according to the person’s metabolic rate. By knowing your metabolic rate, we are able to provide correct food amounts and portion sizes to ensure long term weight loss. The secret lies in calorie and portion control. Remember the success of weight loss is an individual approach. Don’t count calories, Be Calorie-Conscious Calorie counting can be very exhausting, time-consuming, confusing and incorrect! Plus this approach just doesn’t suit everyone’s’ lifestyle. Being ‘calorie-conscious’ is a much better approach. The term ‘calorie-conscious’ is a great one, and can often be a real eye-opener. I like to go over an individual’s food diary and pick

November 17, 2017

Some games are good for cognitive development – experts say

Certain toys and games play an integral part in a child’s cognitive development and one of the best ways to nurture a young brain is through play – it challenges thinking and the ability to process information. The body as an “architect of the brain” Parenting expert Nikki Bush explains that the body is an “architect of the brain” during childhood and in order to best understand the world around them, children need to be exposed to a range of scenarios to ensure the brain remains stimulated. She says that school, home and the outdoor environments are important; and so are toys and games with educational value, like Lego, and arts and crafts. Engaging in conversation with both adults and children is also a “big advantage” and encourages interaction and open communication. Different stages; different needs “Children go through different stages of development that all play a role in their ultimate cognitive development. Different environments, different people and different toys with value help to stimulate the young mind and assists children to interpret new information accurately,” Bush says. And a young brain learns easily, she explains that during childhood the brain is “extremely plastic and elastic” and with the result, learning is much easier for young children than older people. “Ever hear the saying that a child’s brain is like a sponge? That’s because it’s 100 percent correct, much learning happens when they’re young as they’re able to absorb information and understand things quite easily,” she says. Phases of learning: Concrete Semi-concrete Abstract The concrete learning phase is most important, Bush says no images on screens or in a book can substitute the real thing, “real trumps everything in early learning”. The Child Development Team at Toy Kingdom South Africa says stocking toys that are good for cognitive development is high on its priority list. The range of Hape products, along with Lego are just few developmental toys on the store’s shelves. “Children thrive on three-dimensional learning. And the concrete phase allows a child to interact with a real object with their bodies. They are able to feel that an apple is round, see its colour, taste and smell it,” she says. Bush says children should be able to internalise and experience with their bodies for an ultimate memorable learning experience.

November 14, 2017

Your child is sick, and you feel guilty. Why?

There is nothing worse than when your child is sick. As a parent, you feel the need to do everything in your power to take care of your child. “But, the truth is, although you can do everything in your power to try and prevent your child from getting sick, or getting hurt, these things happen,” says Carla Yssel, brand manager for Linctagon®, “and mommy guilt is a real thing.” We don’t account for the guilt that a parent feels when their child is sick. “Mommy guilt, and daddy guilt are real emotions that almost all parents feel – it’s the feeling that you haven’t done enough to protect your child from anything and everything,” says Yssel. Yssel says parents need to give themselves a break and she gives them following advice: At night instead of looking at all the things that went wrong during the day, congratulate yourself on the things that you did right. This will enable you to see that you did succeed during the day and not everything is as bad as it may seem. Give yourself a break. Remove yourself from the guilt for a little bit – go for a cup of coffee, meet a friend for dinner – remember who you are as a person and not only as a parent. This will give you a break, and when you return you will be able to focus more on your children. Be prepared (as much as you can be). When it comes to children things can tend to go a different direction than expected, and you need to have the basics covered in case they do. Keeping a stocked first aid kit including band aids, and antiseptic ointment are a must. Children get sick – deal with it. Your child is not sick because you have to work, or because you gave them fish fingers one night for dinner instead of vegetables. Your child is sick because that is what happens. Linctagon® boasts a full range of medicines to help deal with any aspect of the common cold or flu, and Linctagon® Effervescent Junior can help children get over colds quicker than usual. It contains the active ingredient Pelargonium sidoidesand through its active support can shorten the duration of the common cold as well as reduce the severity of symptoms. It also contains added vitamins A and C, anti-inflammatory MSM and immunity enhancer Zinc.

November 9, 2017

Breastfeeding can help prevent both breast cancer and childhood cancer

One in every 20 women in Southern Africa will develop breast cancer at some point in their lives.* As we observe Breast Cancer Awareness Month in October, the South African Breastmilk Reserve (SABR) urges women to take action to reduce their risk of developing breast cancer. “Many women understand the basics of breast cancer prevention, for example getting enough exercise, maintaining a healthy weight, and eating properly,” says Professor Suzanne Delport, breastfeeding activist and Medical Director of the South African Breastmilk Reserve (SABR). “Few realise that breastfeeding your child for at least a year significantly lowers the chance of contracting breast cancer later in life,” she continues. While breastfeeding, the mother and infant are benefited simultaneously. Breastfeeding also improves long term outcomes for both mother and infant long after cessation, particularly outcomes related to cancer. A long period, six to twelve months, of breastfeeding: Decreases the risk of invasive breast cancer by 7%. This percentage translates into the annual prevention of 20 000 breast cancer deaths globally. Decreases the risk of ovarian cancer by 18%. Has long term beneficial effects on the health, nutrition, and the intellectual development of a child. Greatly reduces the risks of obesity and both type 1 and 2 diabetes in a child.**** Clinical studies have proven that producing breast milk tends to inhibit cells from “misbehaving” and becoming cancerous. Many women have fewer menstrual cycles while breastfeeding, which in turn lowers their oestrogen levels, which are a major cause of breast cancer. Women also tend to lead healthier lives while breastfeeding, and will often stop smoking and drinking alcohol while they are nursing.** Breastfeeding also reduces the chances of your child developing childhood cancers. A recent study found that babies who were breastfed for at least six months appeared to have a 19% lower risk of childhood leukaemia compared to children who were never breastfed or were breastfed for a shorter period.*** “Of course, breastfeeding is just one factor in combatting breast cancer. Women should take as many precautions as possible to reduce their risk,” says Delport. “It’s vital that every woman in South Africa learns how to conduct breast exams on themselves and commit to having regular mammograms. Smoking is also a huge contributor, and quitting this habit can reduce your risk of all cancers enormously,” she continues. Some women develop breast cancer before they have children, or even while they have a young child of breastfeeding age. “A breast cancer diagnosis doesn’t necessarily mean that you won’t be able to breastfeed,” says Delport. “Many breast cancer survivors go on to successfully nurse their infants. It’s important to explore all the options with your doctor, and not to give up hope,” she continues. “Human milk banks exist, in part, to help those mothers who are unable to breastfeed at all,” explains Delport. “So even if you’ve had a double mastectomy, you’ll still be able to feed your child with nature’s perfect baby food,” she concludes. To get involved and alleviate the challenges faced by the South African Breastmilk Reserve (SABR), including the 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: [email protected].

November 9, 2017

Drink Rooibos Tea to Improve Concentration During Exams

Coffee and energy drinks are usually the go-to beverages for high school learners and students to help them cram for finals during the stressful months of October and November, but science suggests they drink rooibos tea as an alternative to help them stay on top of their “A” game. Several studies point to rooibos tea’s ability to protect healthy cells from damage caused by free radicals and that its high level of antioxidants could reduce the effects of oxidative stress, which learners and students typically experience in the lead up to and during end-of-year exams. Adele du Toit, spokesperson for the SA Rooibos Council explains that the brain appears to be especially susceptible to excessive oxidative stress, because of its high demand for oxygen. “Dietary antioxidants, like the polyphenolic compounds found in rooibos, have been shown to protect neurons against a variety of neurodegenerative conditions. Reactive oxygen species (ROS) or more commonly referred to as ‘free radicals caused’ by poor nutrition, cigarette smoke, excessive alcohol intake, pollution, among other factors, are harmful elements that trigger oxidation (disruption of a living cell) in the body and brain. The stress hormone, cortisol, which is elevated during exam time, increases inflammation, and further intensifies free radical production. “When these free radicals cause oxidation in the body, they damage the healthy cells which could hinder one’s ability to learn and retain information. Rooibos counters this impact by reducing the effect of oxidative by-products in neural pathways thereby stimulating concentration and focus. “Unlike coffee, which could give you the jitters followed by a crash, rooibos tea is a cleaner-burning and longer-lasting fuel for the body since it doesn’t contain any caffeine or tannin. An added bonus is that it also relieves tension and headaches,” she remarks. While consuming small amounts of caffeine daily is not harmful, drinking too much, such as during exam time, could prove dangerous and lead to a physical dependence since it is highly addictive. The temporary boost of energy it gives you, may also keep you awake for longer than is needed, which could lead to unwanted fatigue on exam day. Du Toit recommends six cups of rooibos tea a day for optimal replenishing of critical antioxidants. “Rooibos tea has no side-effects and contains some of the strongest and most unique antioxidants in the plant kingdom, including aspalathin and nothofagin. Students should make the most of this natural energy drink, which is tasty, affordable and can be enjoyed hot or cold.” Here’s a few fun twists on rooibos tea to get you through your finals: Basic rooibos iced tea: One litre of Rooibos tea using four to six teabags Sweeten the tea with honey to taste and leave it in the fridge to cool overnight Experiment with this basic iced tea, by adding mint, lemon, orange, granadilla, mango or apple, or a combination of flavours until you find one that you love. Juiced or squeezed fresh fruit usually delivers the best results, but you can also use honey and preservative-free fruit juice. Mixing it with cold rooibos will make it go further and keeping a jug of it in the fridge should mean you don’t have to keep buying juice. Rooibos can be kept in the fridge for up to two weeks without spoiling. Rooibos and berry iced tea: 8 rooibos tea bags or flavoured rooibos of your choice 1 cinnamon stick 4 whole cloves 6 thin slices ginger 4 cups (1 litre) boiling water 4 cups (1 litre) 100% berry juice, chilled Lemon juice to taste Place tea bags, spices and ginger in a large glass jug and pour over boiling water. Stir well and allow to cool for about two hours. Remove tea bags, ginger and spices. Add berry juice to the tea and season with lemon juice to taste. Enjoy cold with ice and mint leaves, fruit and lemon. Rooibos ice-lollies: By pouring some Rooibos iced tea into popsicle containers or ice-cube trays and freezing it, you can also enjoy it as a refreshing treat when you get the munchies while you’re studying. For more info about the health benefits of rooibos, visit www.sarooibos.co.za

November 9, 2017

Exams: Study Time vs Screen Time – Striking the Balance

Helping children to build a healthy relationship with technology, and knowing how much of what is enough, is challenging for parents under the best of circumstances. Exam time however throws a whole new spanner in the works, an education expert warns. “While some parents might want to introduce new house rules or impose a total ban on screen time during important periods such as exams, that approach could be counter-productive,” says Nola Payne, Head of Faculty: Information and Communications Technology at The Independent Institute of Education, SA’s largest private higher education provider. “However it is necessary to review and agree on how devices and especially social media will be used during this period,” she says, “and parents and guardians should play an active role in assisting young people to strike the right balance.” Payne warns that parents will face a lot of resistance if they implement a total ban on social media interaction, which will not be conducive to a positive studying environment. “Matric and other exams are already very stressful, and social media can help learners and students unwind and let off steam by sharing their concerns, clearing up study material confusion and encouraging each other. “A better approach would be to rather restrict social media during focussed 1-2 hour study sessions so concentration is not interrupted, and allow it during breaks – preferably away from the desk – in conjunction with a healthy snack and some fresh air.” Payne says that in general, parents should assist their children to build a healthy relationship with technology from an early age, noting that technology has become an integral part of children’s lives. “While there are of course dangers and concerns, technology has also brought many advantages and opportunities. Our children need to build a set of skills – hard skills and common sense ones – around technology as it will always be a huge part of their lives, whether when researching school work, investigating higher education options or searching for career opportunities, or whether for entertainment or engaging with social media contacts.” She says that approaching technology positively and pragmatically right from the start can help families engage better. “It can improve their resourcefulness, open up new avenues for learning and help them better understand how to manage social interactions. Parents need to be honest about their own concerns and should support and mentor their children by creating the right environment in the online world, as they would in the offline world. “Encourage the learning, whether it is online or offline, but set boundaries and time limits on digital engagement, study methods (which should also include pen and paper and not just digital learning) and also digital social interactions during exam time. There are thousands of mobile apps and software applications that support learning in a fun and constructive way, and that can ensure that study time is in fact study time, and not Facebook time in disguise.” Payne says there are 4 simple things parents can do to ensure healthy technology habits for life: Create and schedule fun offline activities and spaces where the family can interact without technology. Spend time with your younger children sharing your “tech time”. You can sit with them and create study notes or play an educational game together. This form of interaction can open up interesting discussions, in a natural way, and not feel like it is a forced conversation. The interest you show in your young child’s technology interactions will build a feeling of trust between yourselves and technology will be seen as a constructive tool for learning. Respect your children’s privacy. This could be as simple as asking for their permission before you share and tag pictures of them online. If they don’t want you to do it, then respect their wishes. Set boundaries (which the adults need to adhere to as well), for instance not interacting with technology during dinner or if someone is talking to you. “Parents need to embrace our changed world and work with their children to encourage a balance between technology and the physical world,” says Payne.

November 6, 2017

Is our knowledge about dyslexia dated? What is the contemporary view?

“According to popular belief, dyslexia is a brain disorder which causes otherwise smart and intelligent children to struggle with reading, spelling and writing,” explains Susan du Plessis, Director of Educational Programmes at Edublox. “The problem is that a lack of education about dyslexia has caused many myths that discourage parents the moment they hear of the dreaded word.” The term ‘dyslexia’ originated in 1884 and was coined by the German ophthalmologist, Rudolf Berlin. It comes from the Greek words ‘dys’ meaning ill or difficult and ‘lexis’ meaning word. Since then, researchers across a variety of disciplines have tried to understand the causes and possible solutions for the problem. “Instead of viewing the collective research in its entirety, we tend to catch bits and pieces. Some of our beliefs about it date back to times before modern-day technology and research revealed the good news about dyslexia,” Susan continues. In a nutshell, some of these misguided beliefs include: The brain of dyslexics differs from poor readers with low IQs; These brain differences are the cause of dyslexia; A host of famous individuals such as Albert Einstein, Walt Disney and Hans Christian Andersen were dyslexic; There is no remedy for dyslexia. One source states it quite bluntly: “Dyslexia is like alcoholism, it can never be cured.” * Susan explains that contemporary research sheds doubt on some of these old beliefs. With the rise of modern fMRI-scanning technology which allowed neuroscientists to explore the human brain in more depth than ever before, old myths about dyslexia have been debunked. Neuroplasticity is a field of study that is significantly influencing the grasp that we have on dyslexia. According to research conducted in this field, the human brain has the ability reorganise itself by forming new connections throughout a person’s life. The findings from a variety of recent studies contradict earlier beliefs in the following ways: Using brain imaging scans, neuroscientist John D. E. Gabrieli at the Massachusetts Institute of Technology found that there was no difference between the way poor readers with or without dyslexia think while reading. ** In a study, published online in the Journal of Neuroscience, researchers analysed the brains of children with dyslexia and compared them with two other groups of children: an age-matched group without dyslexia and a group of younger children who had the same reading level as the children with dyslexia. Although the children with dyslexia had less grey matter than age-matched children without dyslexia, they had the same amount of grey matter as the younger children at the same reading level. Lead author Anthony Krafnick said this suggests that the brain differences appear to be a consequence of reading experience and not a cause of dyslexia. *** Studies of the biographies of Einstein, Disney and Andersen and many other “famous dyslexics” reveal little resemblance with individuals who are currently labelled dyslexic. For example, Einstein was reading Darwin’s writings at age thirteen. “The myth of these ‘famous dyslexics’ has been perpetuated by advocacy groups over many years to keep dyslexia in the lime light,” says Susan.“The problem is that myths like these distract from the scientific study of the field and subtly hints that it can only be okay to have dyslexia if a string of famous people also struggled with it, while that is not the case.” The belief that dyslexia cannot be overcome is deeply rooted in the theory that the brain cannot change. Today we know that the human brain is a powerhouse. New connections can form and the internal structure of the existing connection can change. Susan has been extensively involved in research on the subject of reading difficulties over the last 25 years, and has made a few observations that may give South African parents hope. “At Edublox, we believe that dyslexia is not a DISability but simply an INability. While there are other causes, the most common cause of dyslexia is that the foundational skills of reading and spelling have not been mastered properly. Massive strides can be made when children’s cognitive deficits are addressed, and have seen we have seen amazing results with this approach.” Javier Guardiola, author of the research paper, ‘The evolution of research on dyslexia’ applauds contemporary research and how it has contributed to our understanding of the subject. “Dyslexia is currently an interdisciplinary field of study, involving disciplines as varied as education and neurobiology. Researchers hope that the answers to this complex learning disability lie in the intersection of all these disciplines,” he writes. **** “To create awareness about dyslexia, we need to keep abreast of the latest research and what this means for our children. As parents, we need to keep looking for solutions and support systems that will help us tackle the symptoms associated with dyslexia. And the good news is there has never been a better time in the history of the field,” concludes Susan.

November 3, 2017

When to supplement your child’s diet

Children come in all shapes and sizes. But if you’re noticing that your child is shorter than her friends at school, it’s natural to wonder, “is my child growing normally?” Most children take well to eating solids for the very first time. Being naturally inquisitive, children will try a variety of gloopy and colourful tastes and textures. Unfortunately, as babies become toddlers, their tastes in foods begin to change dramatically. As parents, this period may be particularly stressful leaving you worried about whether or not your child’s diet adequately meets their growing needs. This is a greater concern if your child is growing more slowly than their peers. Therefore, it is important to know what the ‘norm’ is when it comes to your child’s growth and development. Registered dietitian Abigail Courtenay has answered a few questions commonly asked by moms. What are the consequences of undernutrition/ underweight¹ ²: Being underweight interferes with optimal growth and development as it is often related to nutrient deficiencies. Specific nutrients are required to support your child’s cognitive health, immunity and physical development. What are the causes for slow growth? There are many factors that could lead to slow growth namely: Poor appetite (this may also occur in healthy children) Acute or chronic illness Restrictive eating due to illness (like allergies) or misinformation Poor absorption (e.g. coeliac disease) Chewing or swallowing difficulties (e.g. children with cerebral palsy) What is considered normal eating behaviour? You can safely assume that children gaining weight appropriately according to their growth chart are getting enough to eat (even if you believe they should be eating more). Children from the ages of 3-5 years have demonstrated the ability to self-regulate their energy intake. Your child’s appetite will depend on a variety of factors such as level of tiredness, activity levels and growth spurts. Some children experience what is known as a food ‘jag’. This is when a child gets fixated on a certain type of food or food group and refuses all other foods. It is not clear how long these food jags last but often a child’s overall nutritional status is not affected by them. ¹ What can I do to help my child enjoy food more¹? Offer a variety of nutritious foods Repeat exposure to foods (sometimes it can take up to 15 repeated exposures before a food is liked/ tolerated) Scheduled meal and snack times (this makes eating a routine and assists in managing your child’s nutritional needs) Provide more frequent but smaller meals Be your child’s role model for healthy eating (i.e. eat healthy foods yourself!) Remove distractions at mealtimes (i.e. TV, tablets and phones) What should I avoid doing¹? Don’t force or pressurise your child to eat Don’t prepare separate or special meals for your child Don’t give rewards for trying new foods Why shouldn’t I force or pressurise my child to eat? Pressuring young children to eat may cause overeating, which may lead to excessive weight gain, or may cause them to actually eat even less as a result of the stress. Either way, pressuring children to eat may upset your child’s natural appetite control system, resulting in them ignoring their internal hunger and satiety cues. ¹ When should I consider supplementation (in the form of a nutritional drink)? If you are concerned about your child’s diet, observe slow growth patterns, or if your child is falling behind in height and weight, this could be a good opportunity to introduce a drink-type nutritional supplementation*. Drinks are often well tolerated by most children and can be made into fun and tasty snacks using a variety of flavours like hot chocolate or fruit puree. Drinks are preferential because they are easier to consume in-between meals, more than food, and may be more acceptable and manageable to a child. * PediaSure® is a tasty and convenient nutritional drink that can be used to supplement a child’s diet during these times. By giving two glasses of PediaSure® to your little one (as an early intervention) per day, you can support their nutritional status, promote healthy growth and normal development. ³ References and notes: Practice-based Evidence in Nutrition: Toddler and Preschool Nutrition – Influences on Appetite and Eating Behaviour. Key Practice Points. Last Updated: 2016-04-01. Mahan KL, Escott-Stump S. Krause’s Food and Nutrition Therapy. 12th edition. Philadelphia: Elsevier/Saunders Publishing. Huynh DTT, Estorninos E, Capeding RZ, et al. Longitudinal growth and health outcomes in nutritionally as-risk children who received long-term nutritional intervention. J Hum Nutr Diet. 2015; doi: 10.1111/jhn.12306: 1-13.

November 3, 2017

7 Things every mom should know about trampolines

We know that moms, always being the cautious ones, often feel skeptical about trampolines and the prospect of their kid bouncing on one. Much of it is due to unfounded rumors or exaggerations. It’s only unfortunate that the benefits of trampolines don’t get passed around as often… to the detriment of everyone involved. Let’s clear up some of the misconceptions and find out why moms all over America have taken to trampolines and enjoy bouncing with their kids! 1 Trampolines Are Very Safe Compared to the trampolines of yesteryear, most of the trampolines on the market now come equipped with a plethora of safety features to minimize the risk of any accidents. Almost all trampolines come equipped with an enclosure and generous safety padding to ensure maximum safety. An overwhelming majority of trampolines we’ve tested meet the minimum safety requirements. Safety is also enhanced if you abide by the recommendations, which state that only children above 6 should bounce on the trampoline. Also, never let more than one child bounce. Most of the accidents happen when jumpers collide with one another mid-air, not when someone falls off (which the enclosure prevents anyways). Our extensive database of trampoline reviews can help you make the optimal purchase decisions and we put special emphasis on the trampolines’ safety features. As you’ll see, these trampolines are in no way like those old beaters without a safety net or even stable legs! 2 You Can Keep an Eye on Your Kid If you had a trampoline, where’d you put it? In your back yard, of course. And where would your kid play? In the back yard, as well, bouncing on the trampoline! This way, your child will always be near you and you can easily see what they’re doing. There is no risk of them running around the neighborhood unsupervised. You can simply relax on your patio and be safe knowing where your child is at any time, instead of not knowing where your child is and calling all the moms in the area sick with worry. 3 It’s Healthy for Your Kids… Trampolines are an excellent way for your children to exercise. Think about it – these days most of the kids are glued to their phones or computers and won’t do anything outside. And even if they do, parents feel uneasy as the neighborhoods of today are not what they used to be. Luckily, trampolines solve both issues. It’s in your back yard and the kids can be active. Bouncing on a trampoline burns 60% more calories than jogging, according to a NASA study. It is a low impact exercise, meaning it doesn’t strain the joints and ligaments the way running does. The forces are much more evenly distributed all over the body, thus eliminating knee and foot pain common when jogging. Exercising on a trampoline is a great way of maintaining healthy body weight and fighting the obesity epidemic. They are especially good if your children don’t have a semblance of athletic prowess nor any inclination to do something about it. Instead of nagging and urging them to exercise, they will happily bounce on the trampoline, as they will view it as a fun game instead of a boring exercise. They’ll be none the wiser and won’t ever get the wind of your devilish scheme! 4 … And You And by that, we don’t mean only in a physical way. Any benefits already stated (and much more that we had to left out) also apply to adults. But the benefits aren’t only physical. Yes, trampolines are a great way of reducing stress and unwinding after a particularly tough day at work. And yes, they will help you keep trim and slim, strengthen your bones and your lymphatic system. But they will also let you bond with your kid better – by being near them – and your partner as well. The children will be more tired and will go to bed earlier, thus saving you a lot of frustration and arguing with your spouse – a sight too often seen in homes all around the country. 5 You’ll Be the Coolest Mom Enough with the health talk – now it’s vanity time! Seriously, we all want for our kids to have the best we can provide. It can be disheartening to hear that your kid wants to play elsewhere because their friend has that cool toy that their parents bought them. Why not bring out the big guns? With a trampoline, your kid, and as a consequence, you, will become the coolest folks in the neighborhood – and everyone will flock to your back yard (if you so desire, of course). It can be a boon for your kid’s social life, and who knows – a nice opportunity to catch up with your neighbors as well! 6 They won’t break the bank People often have a misconception that trampolines are something ridiculously expensive and only the richest people can afford it. While trampolines that cost a king’s ransom certainly exist, even a modest budget will go a long way. There are a lot of trampolines that are both affordable and well-made. As little as $300 can get you a fair, decently-sized trampoline of about 14ft with all the usual safety features that make trampolining a worry-free exercise. However, not all trampolines are the same. To help you separate the wheat from the chaff, our handy review database will do all the work for you! 7 They Liven Up the Back Yard Trampolines need not look ugly and drab. There is a plenty of models that look fresh and sharp. A nice trampoline is a great way to improve the look of your back yard, especially if there is a lot of empty, unused space. They come in various sizes and shapes, and if you prefer rectangular over oval or round trampolines, there is plenty of choice. Now that you see that trampolines are loads of fun for everyone involved, it’s time

October 30, 2017

How to Talk to Kids about Death

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

October 26, 2017

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