Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Introducing BabyLine

Parenting is a joy but it can also be overwhelming and just a little daunting. There is no degree or diploma, you are simply launched into it and there’s a steep learning curve. You instantly have a new life depending on you and, combined with sleep deprivation, the challenges of adjusting to being a parent and wanting to do the best for your child, you need all the help you can get. Bonitas Medical Fund is doing just that with the launch of the first dedicated toddler’s health advice line, called Babyline, to its members. Here help is at hand, from professionals, as you take the necessary baby steps along the path of looking after the health of your toddler, up to the age of three. Essentially Babyline is 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. ‘Parents are often confronted with a host of children’s health issues, particularly in the first three years. In an effort to help educate and support Bonitas moms and dads and to ensure their medical aid benefits last longer, we have partnered with Paed IQ’s babyline service,’ explains Bonitas Medical Fund. ‘The service was developed in conjunction with the Department of Paediatrics at the University of Pretoria and is based on a concept used by the top providers of child health advice in the USA.’ ‘The system of telephone advice, guarantees members instant and real time access to pre-eminent, professional advice and standardised paediatric protocols,’ explains Dr Iqbal Karbanee of Babyline. ‘Our aim is to give parents the best possible resources to help them maintain and improve the health of their child. It’s about giving anxious parents peace of mind when it comes to an urgent health concern and, hopefully, will also alleviate unnecessary trips to doctors or hospitals.’ 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. ‘We do have to stress that although the Babyline is designed to assist parents with health concerns, nurses do not provide diagnosis or prescriptions. They are on call to offer advice on how best to deal with the current health problem or refer you to the nearest healthcare facility,’ concluded Bonitas Medical Fund.

February 15, 2017

Get bang for your buck

Most medical aids have launched their benefits and premium contributions for 2017 and, as in the past, the increases passed on to members are double figures, which outstrip inflation. Bear in mind that your actual increase may be somewhat different because often these are weighted, vary from option to option or even from dependant to dependant. The medical aid landscape can be tricky to navigate. So now, more than ever, is the time to learn how to ‘box smart’ to ensure that you maximise the value you derive from your medical scheme benefits. Dr Bobby Ramasia, Principal Officer of Bonitas Medical Fund, provides some insight into maximising the benefits on your chosen medical aid. Understand your benefits Take the time to read the information sent to you by the scheme and/or your broker. If you have access to information sessions at your place of work, or have a consultant who visits your workplace, attend the sessions to get a better understanding. Getting the best out of your hospital cover: If your scheme has appointed a Designated Service Provider (DSP) network for hospitals, you will usually pay a lower monthly contribution in exchange for using a hospital from this network for planned procedures. In the same manner, if your scheme has an arrangement in place for doctors and specialists, there will usually be an incentive (full cover by the scheme) for using ‘these’ providers. The penalty for using providers not contracted with the scheme is usually the payment of shortfalls or co-payments. For planned procedures, it’s also worth checking with your scheme if you will obtain better cover by using contracted providers or having the procedure performed in the doctor’s rooms or day clinic, where possible If you are going to be admitted to hospital for a planned procedure, always check with your scheme, at authorisation stage, if there are any co-payments or sub-limits that will apply. An example here is for joint replacements, where most schemes have specified sub-limits if you do not use their DSP. Chronic Illness Benefits: In terms of the Medical Schemes Act, there are 26 common chronic illnesses which all options on all schemes are required to cover for medication and treatment. However, here too, schemes have the ability to apply measures designed to contain costs. Almost all options on all medical schemes apply a medicine formulary. This is a list of drugs which the scheme will cover in full. If you use medication that is not on the scheme’s formulary, you will be liable for the difference in cost. So it is best to discuss the formulary medication with your doctor to see if this is appropriate for you The schemes can also specify that you obtain your medication from DSP pharmacies. Check to see if you are able to use the scheme’s DSP – if there are none close to you, most schemes also designate a courier pharmacy which will deliver the medication to you at a preferred address. So, the golden rule for chronic illness benefits is to try to utilise the medication on your scheme’s formulary and to obtain this from a specified pharmacy. Many medical schemes also cover additional chronic illnesses – although this is usually from the more expensive options. If your particular condition is not covered on your current option it is worth further investigation. It’s important to understand that this cover is at the scheme’s discretion and the additional conditions covered vary from scheme to scheme. Know your rights! In terms of a High Court ruling, Medical Schemes are obliged to meet the cost of in-hospital Prescribed Minimum Benefit procedures at cost, in full. Make sure you know what ‘in full’ means – so you don’t get any surprises. So if you have been admitted to hospital check with your doctor if it’s for one of these procedures. If so, as a general rule, you shouldn’t be saddled with any shortfalls – so ask for your broker/consultant’s assistance if you are! Why you might have co-payments A medical aid co-payment is a fee that the member is liable for when making use of certain medical services. The medical aid would not cover 100% of the costs and the member would have to pay for a certain percentage of the medical service before the medical aid pays their portion. These co-payments usually apply to specialist or elective medical procedures. This will differ from one medical aid scheme to another. It is one of the reasons why you should always do thorough research before deciding which medical aid scheme is the best option for you. The ideal option would, of course, be the one that does not require many or any co-payments from the member. If your benefits and/or savings were exhausted before the end of the year and you had to pay out-of-pocket for some medical expenses; it might save you money to upgrade to a richer plan with more benefits, albeit at a higher contribution amount. Conversely, if you are young, healthy and generally did not utilise your benefits and/or savings, it may be prudent to downgrade to a cheaper medical aid option Talk to your providers! Talk to your doctor/specialist before being admitted to hospital for a planned procedure. Check what they are going to be charging and what your scheme will cover. If there is a large difference don’t be afraid to approach your doctor to see if they are prepared to adjust their fee, especially if you could afford to pay upfront.

January 16, 2017

Choosing Medical Aid

Most medical schemes have launched their benefits and contributions for 2017 and it is the time when you should be re-looking at your existing medical aid cover or, if you are wanting to join a scheme, investigating which one suits you best. The medical aid landscape can be tricky to navigate so it is important to compare options and schemes to ensure you find a medical aid that works for you and your family’s health and is within your budget. Dr Bobby Ramasia, Principal Executive Officer of Bonitas Medical Fund, helps guide you through choosing the best plan, whether it’s through the open market or through an employer. If you are already on a medical aid scheme Before you choose the best medical aid option, you need an idea of what your typical health care costs are. You should also consider the following for you and your dependants over the past twelve months: How much you spent on day-to-day healthcare expenses Where you or any of your dependants admitted to hospital Did you need to visit a specialist regularly How much often do you or your dependants visit a GP Do you and your dependants have any chronic conditions How much do you spend on dentistry, optometry and over-the-counter medicine Did you exhaust your day-to-day benefits and/or savings this year How much did you pay in co-payments and/or deductibles Then consider which of the expenses listed above were once-off and won’t come up again soon (like childbirth) and which are likely to come up again and again (such as flu). You should be able to find a list of your medical claims on your current medical aid’s website. The day-to-day detail: Often the cost containment measures medical schemes apply for the day-to-day benefits are broad. So investigate, or bear in mind, the following: Does your medical aid contract with doctors and specialists and, if so, are you willing to use them? Using contracted or network doctors usually means obtaining full or improved cover levels, while using doctors outside of the network usually results in restricted benefits or co-payments. It also helps ensure you are getting more value for money as doctors on your medical scheme’s network will not charge you more than the rate agreed with your medical scheme. Must you be referred to a specialist by your GP? Does your medical aid offer additional GP consultations, which they will pay for, after you have exhausted your day-to-day benefits? Does your medical scheme offer any additional benefits such as maternity, preventative care or wellness benefits that are paid from risk and not savings or day-to-day benefits? You can also follow these tips to get more value for money: Use generic medication wherever possible – get into the habit of asking your doctor and pharmacist about this Try to keep your claims within any specified sub-limits, e.g. optometry Find out if your option has any day-to-day benefits that are paid by the scheme from risk (not from your day-to-day sub-limits or savings). Two examples where this sometimes applies are dentistry and optometry. Additional benefits: Ask what supplementary benefits might be available to you that can potentially save significant day-to-day expenses. These could include the following; Preventative care benefits, ranging from basic screenings (blood pressure, cholesterol, blood sugar and body mass index measurements) through to mammograms, pap smears, prostrate testing. In some cases this extends to maternity programs, dental check-ups, flu vaccinations and more. These usually require authorisation from the scheme, failing which they are simply met from your day-to-day benefit limits. A mammogram costs in the region of R900, so don’t look a gift horse in the mouth! Age impacts your decision If you have young children, ensure that the medical aid option you select provides sufficient child illness benefits. For young couples looking to start a family, check that your option provides sufficient cover for maternity benefits. However, if you are slightly older then ensure that the option you select covers chronic conditions and provides sufficient in-hospital cover in the event of hospitalisation. Ensure the affordability of the medical aid plan selected. When comparing the different medical aid options available, consider all the costs involved before you make your final decision, such as: The monthly contributions, as a rule of thumb, you medical aid contributions should not exceed 10%of your monthly income at an individual or household level Other costs associated with your medical aid option e.g. if your option only allows consultations with doctors on a network, then you must ensure that the cost of travel to a network doctor (including hospitals and other healthcare service providers) The cost of co-payments for various benefits claimed. A medical aid co-payment is a fee that the member is liable for when making use of certain medical services. The medical aid would not cover 100% of the costs and the member would have to pay for a certain percentage of the medical service before the medical aid pays their portion. These co-payments usually apply to specialist or elective medical procedures. This will differ from one medical aid scheme to another. It is one of the reasons why you should always do thorough research before deciding which medical aid scheme is the best option for you. The ideal option would of course be the one that does not require many or any co-payments from the member.

November 15, 2016

Hospital Plans

You know that sinking feeling when you go into hospital for a procedure believing you are covered? When it takes longer to recover from the shock of the bill than the actual surgery? Thousands of people who have health insurance are waking up to the fact that the term can be a classic contradiction. Far too many consumers are confused between the terms hospital plan and health insurance. This is not made any easier by the fact that health insurance is available in two forms – GAP Cover and hospital insurance. According to Dr Bobby Ramasia, Principal Officer of Bonitas Medical Fund, the National Treasury has been approached to make amendments to the Demarcation Act in terms of medical aid schemes and medical insurance. Currently, medical aid schemes and the hospital plans they offer are not considered as insurance because medical schemes are non-profit, strictly controlled and regulated by the Council for Medical Schemes and the Medical Schemes Act 131 of 1998. However, medical insurance policies are ‘for profit’ companies. The recommended changes to policy will also address when insurance is paid out – the industry is pushing for this to come into effect from day one as opposed to a waiting period of a few days. Medical Aid Hospital Plans A hospital plan provides you with basic, yet important medical cover. They differ from scheme to scheme but in essence this plan – regulated by the Council for Medical Schemes – includes cover for all your required in-hospital procedures and check-ups. So when you are admitted into hospital for a procedure or due to an accident or illness, your expenses are covered – within the limits set by your particular plan. You are required to cover almost all of the other day-to-day out of hospital costs (such as visits to the doctor, specialists and medicine). The law also requires that medication for 27 chronic conditions – known as Prescribed Minimum Benefits or PMBs – must be covered by all medical plans, including hospital plans. These include: Addison’s disease Asthma Bronchiectasis Cardiac failure Cardiomyopathy Chronic obstructive pulmonary disorder Chronic renal disease Coronary artery disease Crohn’s disease Diabetes insipidus Diabetes type 1 Diabetes type 2 Dysrhythmias Epilepsy Glaucoma Haemophilia Hyperlipidaemia Hypertension Hypothyroidism Multiple sclerosis Parkinson’s disease Rheumatoid arthritis Schizophrenia Systemic lupus erythematosus Ulcerative colitis Bipolar Mood Disorder However, at times there may be a shortfall between what the Plan pays and the actual tariffs charged by the hospital and specialists. You will be expected to make up the financial difference and this is where GAP Cover or a Hospital Insurance policy can help cover the shortfall. Health insurance The good cop GAP Cover as the name suggests, assists with additional insurance cover to help pay for the difference between specialist charges and the amount paid by the hospital plan. Again the amount of cover differs from policy to policy. Many consumers purchase GAP Cover in conjunction with a hospital plan to provide for additional cover, however it can only be used for specialist service costs and not general healthcare related costs. Bonitas says that the proposed amendments propose that GAP Cover includes any and all shortfall costs for health related services and products, ie, between the costs that medical schemes are obliged to cover and what is charged by the medical practitioner. GAP cover complements medical schemes – it has never been a problem as it covers the costs between medical scheme tariffs and benefit limits. It is legitimate and a good cover for shortfalls. The bad cop Hospital insurance is not a medical aid but rather provides you with cash benefits that are paid to you while you are in hospital due to illness, accidents or intensive care of convalescence. You are able to use the money however you please, to cover your medical expenses or daily household costs. In short, hospital insurance is: Governed by the Financial Services Act (Short-term Insurance Act) Does not cover Prescribed Minimum Benefits (PMBs) Can include Personal Accident risk cover such as disability and loss of limbs, inability to work, salary protection, death and/or funeral covers. Paid directly to the Insured Used in conjunction with Medical Aid Not tax deductible So why the bad cop? Firstly it is a set amount which might not cover your hospital or medical bills, leaving you financially short and, in many cases, it does not kick in until a waiting period of three to five days. You will be responsible for settling all your medical bills and although the thought of being paid R5 000 a day while you’re are in hospital sounds appealing, this usually falls way short of the actual costs charged by surgeons, anaesthetists and hospitals. Turning the bad cop good The new amendments propose introducing payment from day one rather than having a waiting period and, as with gap cover and hospital plans, hospital insurance will be far more regulated going forward to ensure the practical protection of a consumer’s medical needs. The best news though is that the guidelines are opening the door for collaboration between medical schemes and insurance providers to offer a broader product range. ‘We have seen a growth in health insurance products over the past few years,’ says Dr Ramasia. ‘This is mainly due to medical aid being prohibitive for low income earners. For those strapped for cash there are healthcare options though. We suggest you shop around for the best plan that covers your – and your family’s – healthcare needs and your pocket.’

September 22, 2016

Advice from the experts

Autism and the Senses – A Parent’s Guide

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

May 30, 2016

Active vs. Passive Listening

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

May 19, 2016

Sleep Safety Guidelines for New Moms

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

May 18, 2016

Teen stress a strong risk factor for headaches

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

May 9, 2016

Swimming – An all year activity with excellent health benefits

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

May 2, 2016

When You Need to Pick Yourself Up

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

April 26, 2016

Helping mommy, Helping baby

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

April 20, 2016

Stress Reduction for Parents

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

April 7, 2016

Weight, Fertility and Pregnancy

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

April 4, 2016

ADD / ADHD and Alternative Treatments

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

March 29, 2016

Caring For Your Premmie At Home  

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

March 22, 2016

Help My Child is a Bully!

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

March 18, 2016

How Loud Is Too Loud?

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

March 18, 2016

Installing Discipline In Your Child Through Play

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

March 9, 2016

Cultivating Healthy Relationships

Many of my clients ask me “How do other couples manage to have happy relationships?” thinking that they are the only ones in this world that are at loggerheads with their partner. My answer is simple: There is no such thing as the perfect person or perfect relationship. Rather, it’s how perfect can you be for each other and for the benefit of your relationship? Those couples that you think have it all together or have the fairytale relationship have learnt how to deal with the ups and downs, or what I call ‘speed bumps’, in a healthy constructive way. No two individuals are the same. We have different upbringings which influence and shape us into the person we become as an adult and determine the type of relationships we forge with others. This includes elements such as culture, spirituality, beliefs, emotional awareness, values and outlooks on life and more. Couples need to have real honest discussions up front at the beginning of their relationship in order to avoid surprises later. These discussions need to include topics such as: values, beliefs, spirituality, parenting, financial matters, household chores, career aspirations and life goals. This helps to manage the expectations we have from our partners in that they need to take care of our every need and desire and make us happy. They do not. Happiness comes from within. Yes we can help others grow and learn but ultimately we are responsible for our own happiness. If couples do not keep the connection going through communication, spending quality time together, establishing relationship boundaries, working towards common goals and having respect for each other and their relationship, over time there will be no relationship. Every couple experiences speed bumps, it’s normal as your relationship progresses through the different phases of the relationship cycle. As you settle into your relationship you both grow and evolve as individuals and so too does your relationship. Emotional intelligence is integral to having healthy relationships. Having the capacity to understand, manage and verbally express your feelings with your partner is invaluable and key to your relationship success. The good news is these skills can be learned, but if the person you’re with has no interest in developing their emotional intelligence, it will be a bumpy road. Society has stereotyped many of us in to not expressing (let alone acknowledge) our emotions. Particularly men and boys, they are taught to suppress and avoid feelings through labels such as ‘cowboys don’t cry’ and ‘men are supposed to be tough’. Often men withdraw because they are overwhelmed by emotions and don’t know how to talk about them or how to soothe themselves. They withdraw in order to get away from what they are experiencing and what they are feeling. It always amazes me how we are prepared to invest so much time, effort, energy and resources into areas of our lives such as the car we drive, the house we live in, our career and material assets. Yet we don’t think much further than our wedding day as to what it takes to sustain a relationship and only grudgingly invest when the divorce courts are looming…. So what are some of the ways that couples succeed at their relationships? They understand that communication is the key to a successful relationship They accept that relationships involve work and are prepared to do what it takes for the benefit of each other and their relationship They are willing to accept another person for who they are; their views and opinions even if they don’t agree with it They accept that some problems will never be resolved and would rather focus on the good stuff They’re willing to put someone else’s interests before their own and see a different perspective They’re willing to work through the challenges and find a win-win outcome They’re not looking for someone else to complete them, they are already comfortable with who they are as an individual They’ve realised that no one is perfect, not even them They are ready to be real and vulnerable with someone else They’re not prepared to quite or give up each time they hit a speed bump It’s the small steps you take each day that lead to your success in the long term. Everyone can have a happy relationship if they are prepared to do what it takes.

March 3, 2016

Who Can Discipline My Child?

The older our children get, the more they interact with the world at large. And the more they interact with other people out there, the more likely they are to run into other people’s rules and values. So is it ok for someone else to discipline your child? And what should you do if you don’t like how they do that? Well, whether your like it or not, other people are going to react when your children challenge their values or push buttons on their own unresolved stuff. This is neither good not bad – Children will learn that everyone has their limits and they will learn about the natural consequences of interaction with other human beings. Every household will have it’s own rules based on the values of the people living there. This is part of learning how to socialise – seeing that other people have different values and ways of being can help a child to broaden their horizons and see different perspectives. And the same goes for having other people’s kids over to your home – if someone else’s child seriously challenges your values or pushes your own unresolved buttons, you are likely to react whether you want to or not. And obviously if a child is harming you or your child you need to intervene. I think it is totally appropriate to discuss the ground rules of your home with a visiting child or his/her parents. This way everyone is clear from the outset of what is ok or not in your home. It may help to remember that with children under 10 it is most likely that their highest value is around play. Keep the kids busy with good games and suggest new ones when tensions rise or boredom sets in and they shouldn’t get up to too much nonsense! If you disagree with the rules laid out in someone else’s home or even at school, I would simply discuss this with your child as a way of pointing out that other people have different rules based on what is important to them and based on different situations. This is normal, and it does not mean that the same things will be allowed (or not allowed) at home. Obviously if someone handles discipline in a traumatic or degrading way, you will need to address this and/or keep your child away from these people in future. Handling this appropriately comes down to your confidence as a parent and as a human being. You need to learn to speak up for yourself and speak up for your kids. You have every right as a parent to be specific as to how you want your child to be treated. It may help to find out what triggered the discipline in the first place. If you can figure out what boundary was crossed or what value was challenged, you may be able to explain both to your child and the offending adult what just happened and how it can be avoided in future without the need for discipline. It is all about open and respectful communication. An adult who feels that they have been heard and understood is more likely to listen to your alternatives. The other place that you may need to address other people disciplining your kids is at home with your domestic helper, nanny or au pair. It is important to discuss with your nanny what you have decided as a family are the boundaries and allow her to follow through with this. The one thing I would add would be that the nanny should also have the right to her own boundaries and to be treated with respect. I have seen many children speaking abusively to a nanny with the parents watching on and not intervening. Children in these situations will learn to treat some people as less important than others and not to treat all people with respect simply by virtue of them being human. Your children do need to branch out from home and learn to cope in a world where you will not always be there to step in for them, and where the rules are not always going to be the ones that you have agreed upon as a family. This is an important part of their growth and socialisation, and unless it is abusive, it’s time for you to take a nice deep breath and let them go forth and learn!

March 3, 2016

My baby was born before her/his time…now what?

Its 6am, the electric breast pump is going in one hand and I’m sipping my tea using the other. I have had a baby, and the only thing I have to show for this is leaking ducts and a searing stomach cut. No baby cries coming from the room next door, no nosy family members dropping by to see the new baby. Nope my baby that I have come to know as little blob is lying in an incubator 20min drive from our home. Depending on your baby’s prematurity and birth weight, your baby will need to spend time in the NNICU (Neo-Natal Intensive Care Unit). This is incredibly hard to endure, as a mother you have gone from carrying this little angel for months and now you have no choice but to leave them in an incubator. Going home is hard, seeing them is hard…but thankfully each day gets better. Different people cope in their own way. I just looked forward to receiving positive news at the beginning of each visit and just being able to wrap her hand around my finger was heaven. My husband on the other hand was all about the numbers and graphs. He had to measure each and every weight increase no matter how small. As annoying as this may seem, this was his coping mechanism. NNICU Equipment Here are a few descriptions on some of the monitors and equipment the NNICU staff may be using on your baby. (It is important to remember that not all premmies use all of this equipment, it all depends on their individual needs). Cardiac monitors: These use stickers on the chest connected to wires (called leads) that hook up to a monitor to make sure that baby’s heart is beating at the correct speed and with the correct rhythm. Respiratory monitors: Often part of the cardiac monitors, these use leads to monitor baby’s breathing rate and pattern. Peripheral IVs: These are the “regular” IVs that go into a vein for medications or fluids. Peripheral IVs may be in the feet, hands, arms, or scalps of premature babies. Although scalp IVs look scary to parents, they are very common in the NICU since premature babies don’t always have good veins for IVs in their hands and feet. PICC lines: Percutaneously inserted central catheters, or PICC lines for short, look like regular IVs. They have longer catheters, or tubes, than regular IVs, and travel through the vein into the large veins that empty into the heart. Insertion of these lines is one of the procedures NICU babies commonly undergo. Umbilical catheters: These are inserted into the umbilical cord stump and travel to the large veins and arteries near the heart. Umbilical lines may be inserted into an artery in the umbilical cord, a vein in the umbilical cord, or both, to allow fluid and medication administration, blood pressure monitoring, painless blood sampling, and other procedures. Nasal cannulas: A nasal cannula is a set of small nasal prongs may provide a higher concentration of oxygen than room air. They may also deliver room air at a higher flow, which helps to keep airways open and encourage babies to breathe on their own. CPAP: Continuous positive airway pressure, or CPAP, is a mask or a special set of nasal prongs placed firmly on baby’s nose to constantly blow air. The constant pressure encourages open airways and reminds babies to breathe, and higher concentrations of oxygen may be used. Ventilators: If a baby is put on a ventilator, then procedure called intubation will be used to place a special tube called an endotracheal tube in the airway through the mouth or nose. The ventilator, or respirator, is the machine that delivers breaths to babies who cannot breathe on their own or who don’t breathe well. ECMO: Extracorporeal membrane oxygenation is a highly specialized procedure to oxygenate baby’s blood. ECMO is used only in very sick babies at highly advanced NICUs. With ECMO, the baby’s blood is pumped out of the body so that oxygen can be added and carbon dioxide removed. The blood is then returned to the body. Feeding tubes: A feeding tube travels from the mouth (orogastric- called OG) or from the nose (nasogastric- called NG) to the stomach. Infants who are too sick or weak to eat from the breast or from a bottle receive food through these tubes. Inserting the tubes and giving feedings through them are common procedures among premature babies. Incubators: Premature infants have trouble keeping themselves warm, so incubators are used to provide a warm place for baby to rest. Skin probes constantly measure the baby’s temperature, so he or she doesn’t get too warm or too cold. Phototherapy: Preemies are more likely to have problems from jaundice. Phototherapy lights, also called bili lights, are special lights that help the baby’s body break downbilirubin, the chemical that causes jaundice. It may be easy to feel useless when surrounded by all these machines. But don’t worry your baby needs you more than you think. Insist on doing Kangaroo Care as much as possible. Read to your little one. Hearing your heart beat and voice will relax your baby. (Remember your voice and heart beat was the one constant your baby will remember from being in the womb). Ask questions, stay informed. It is your right as a parent to know what’s going on. Good luck with your journey. Please take good care of yourself, and give yourself permission to make the very best of this brand new parenting experience. Support & Preparation Besides relying on support from those around you. Chubby Bunny is there to make the journey a little less stressful. Through education & support, Chubby Bunny’s main objective is to support families whose lives have been touched by prematurity. Chubby Bunny is the first company in South Africa to supply critical starter packs for premmies. We supply high quality goods ensuring the little miracle is well cared for, from organic skin care sensitive for their soft skin, petite clothing small enough to wrap around their tiny bodies, Premmie nappies, a Premmie Support Booklet equipped to help parents understand the NICU and how

February 25, 2016

Sugar Drinks at School, a Leading Cause of Obesity and Impaired Learning

With hundreds of thousands of learners back at school, parents are reminded to restock their fridges and pantries with foods and beverages that provide brain-boosting nutrients to help their children perform at their best. SA’s recently released National Health and Nutrition Examination Survey (SANHANES) refers to the poor state of children’s school lunches in the country. Of particular concern is the high intake of sugary cool drinks – about 2 in 3 learners buy sugary drinks at least twice a week, with each soft drink containing up to 55g of sugar. According to the World Health Organisation (WHO) that is 40g more sugar than the recommended maximum daily limit for children. Drinking too many sugary drinks is considered to be the leading cause of obesity in adolescents, especially among schoolboys. The study points out that the prevalence of obesity has doubled in teenage boys the past six years, making them more prone to chronic lifestyle diseases such as diabetes. According to nutritional experts, these beverages are loaded with empty calories and provide little or no essential nutrients. They are linked not only to weight gain but also to poor health and tooth decay in children. Nutritionists recommend water or herbal teas as a healthier alternative to fizzy drinks or sugar filled fruit juices, with Rooibos tea topping the list. Ernest du Toit, spokesperson of the SA Rooibos Council says Rooibos is as effective as water for hydrating the body and has additional health properties that water doesn’t have. “Rooibos is affordable, tasty and amazingly beneficial for children. It is rich in antioxidants which helps to protect healthy cells from damage caused by free radicals and can reduce the risk of a variety of diseases, including cardiovascular disease and some cancers. Rooibos also prevents DNA damage, inflammation and is helpful in combating diabetes. “Added to this, Rooibos contains no caffeine, fats or carbohydrates, is a natural immune-booster and relieves allergy symptoms, which are common in children,” remarks du Toit. Sugary drinks have also been found to have an adverse effect on children’s brains. A study conducted by the University of California revealed that consuming excessive quantities of sugar-sweetened drinks can have a major impact on children’s brain function and impair their ability to concentrate and learn at school. In contrast, Rooibos tea will keep your child’s mind sharp since it shields the brain from stress and it protects against a process known as lipid peridoxation (whfree radicals damage brain cells and nerve tissues.) Du Toit adds that Rooibos is also incredibly nutrient-rich. “It is rich in Vitamin C, calcium, manganese and fluoride, helps to build strong bones and teeth, and is safe to consume without limit.” To help parents pack refreshments that will make the grade, the SA Rooibos Council has compiled the following Rooibos iced tea- and popsicle recipes that will have the kids asking for more. 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 your children love. You can even get them involved in mixing their own flavours. Note: Juiced or squeezed fresh fruit usually delivers the best results, but you can also use 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. The good news is that cold rooibos can be kept in the fridge for up to two weeks without spoiling. Rooibos ice-lollies: By pouring some Rooibos iced tea into popsicle containers or ice-cube trays and freezing it, you can also make fun, refreshing, healthy after school or sports treats.

February 12, 2016

Headaches – A Leading Cause Of Absenteeism

In a developing economy such as South Africa a healthy work force is vital for future growth. It is therefore not only necessary, but vital to identify causes of absenteeism amongst working-age adults. A recent study found that not only are migraine and tension-type headaches among the most common causes of lost work time, but the prevalence is around the age of 40 – a time when individuals are at the peak of their work abilities. The study was published in Occupational Neurology and examined the substantial impact of headaches on individual work productivity. Furthermore, it found that it also places a burden on the employers and society in terms of medical costs. The research also indicates a difference in demographics which is also reflected in absenteeism: Approximately 18% of females and 6% of males in the general population suffer from migraines. Dr. Elliot Shevel, a South African migraine surgery pioneer and the medical director of The Headache Clinic, says chronic daily headaches (which mean 15 or more headache days per month) are a leading cause for absenteeism and it represents a widely accepted stage of pain progression that occurs in 2-4% of the population. “Treatment of headaches can be acute or preventive. The goals of acute treatment are timely alleviation of pain and associated symptoms without reoccurrence and restoring the ability to function. This also minimizes the use of back-up and rescue medications, and is thus providing the best cost-effective management which will in turn lead to better individual productivity,” he says. “Migraine preventative medications are used to decrease future attack frequency, severity and duration, improving the response to acute treatment, and improving the overall function of the patient.” The current study suggest using preventative medications in instances where patients are reporting migraines either 3-6 or more days per month, especially when these are working days. The burden from letting headaches go untreated also results in societal costs from underemployment and unemployment among those of working age who suffer. Shevel recommends sufferers should seek professional help when headaches or migraines start to interfere with their functioning at work. “We have a multidisciplinary team who can apply both acute and preventative treatment.” Contact us on 0861 678 911 or visit our website at www.theheadacheclinic.net to find out more.

February 5, 2016

Meal planning for the child with ADHD

Ask ten nutrition experts what you should eat and you will get ten, often-conflicting diet plans. Add Attention Deficit Hyperactivity Disorder (ADHD) to the mix and you will be even more confused. Firstly ADHD is not caused by diet. There have been numerous studies over the years to support this statement. Does diet affect ADHD children? Of course, Diet, as in “what we eat”, affects each one of us whether we have ADHD or not. If you feel unsteady on a stairway, you grab the banister to steady yourself. Likewise, if your child’s (or your) brain chemistry is off kilter with ADHD, favouring healthy foods engenders equilibrium. By providing a healthy diet and environment is the most pleasurable – and the least invasive – way to care for your loved ones and yourself. The information given in this article need not be exclusively for the use of the ADHD child but all members of the family will benefit from making this subtle yet effective change to their daily eating schedule. The diet for the ADHD child is the bedrock on which you need to build all other therapies. It is no use adding a handful of supplements to your child’s diet if their actual daily intake is not even meeting the basic recommended dietary intakes (RDI’s) for their age. Supplements added to a balanced healthy diet will be much more effective if taken with good food than as an isolated tablet. The ADHD child’s response to therapies like Occupational therapy, physiotherapy etc. will be much better if the child has the necessary energy resources to draw from during a therapy session. If your child requires medication to treat her ADHD symptoms then starting off with a sound, healthy dietary platform will only enhance the effectiveness of the medication. Likewise attentiveness, concentration and participation in class is a lot more probable if your child has eaten a healthy, well balanced breakfast and this is true for all children, not just children with ADHD. Allergies have also been studied extensively with their link to ADHD so let’s just briefly unpack this before we go into the details of some healthy diet tips. Children and adults, who have allergies, be they to foods, additives or the environment are not generally happy people while their allergies are aggravating them. A child who has rhinitis (runny nose) and is constantly sniffing and coughing due to the aggravation of a post nasal drip will struggle to sit still and focus on what the teacher is saying or the work he should be doing. The distinction needs to be made between ‘food allergies causing ADHD versus the symptoms of the allergy exacerbating the symptoms of ADHD. If you suspect your child has allergic tendencies to certain foods then you must get that seen to by taking your child to a specialist or undertaking an elimination diet under the advice of a trained professional. Having said all of this, changing diet is a process and not like taking a pill. It takes time, commitment and patience and more importantly ‘buy-in’ from the family members. When changing eating habits, it is important to involve the family members and give explanations. Children respond well when they understand. Children are also extremely trusting and if the change can make sense they will generally give it a good try. When making changes to the diet it is important to observe the context of the whole change process. For example if you cut out all chicken from your child’s diet, it may not be the lack of chicken that is causing irritability and discontent. It might be that you took away all her favourite meals in one shot and she’s a little upset about it. Looking at the whole picture is a good idea and moderation is always good. Wanting your child to eat well is one thing. Getting him to do so is another. As already mentioned the best way to get your child to eat well is to eat well yourself. That is having good food at hand and minimizing the less healthful choices. Letting your child help prepare food magically whets her appetite. Creating something yummy is empowering no matter what your age. Daily foods to include: Good Starches If you take in a lot of sugary treats such as sweets, fizzy and sugary cool drinks, cakes and biscuits it will cause your blood sugar levels to rise and fall due to the insulin (hormone to break down sugar) levels that will rise and fall. This constant up and down will result in mood changes and irritability. When children get a blood sugar drop, unlike us, they will try and feel better by getting busier and will do what ever it takes to stay alert which often results in over compensation. Offer low glycaemic carbohydrate foods as often as possible, like seed bread, rice, pasta, provitas etc. Foods are well labelled with Low Glycaemic Index labels and these should be foods of choice for your ADHD child. Limit fruit juices to 1 glass diluted fruit juice per day. Eat whole fruits instead. Aim to include 2 – 3 fruits per day. Offer water for thirst. Iced rooibos tea mixed with a little pure fruit juice is also a refreshing option. Remember however that it is the glycaemic (sugar) load of the whole meal that is important so including a protein with the carbohydrate will be an advantage to stabilizing blood sugar levels. This also helps when you offer starches that are a little higher on the glycaemic index, like a white hot dog roll or a tortilla. Good proteins Have a serving of protein rich food at every meal and snack, including breakfast. Sources of protein include eggs, fish, meat, cheese and soybeans, nuts, peanut butter. Eat snacks like cheese sticks and biltong slices. Good veggies For the good of your health, use a wide variety of vegetables and prepare them in diverse ways. Aim daily to include 3

February 4, 2016

Stimulating the Right Brain Can Create a Genius Baby

You can create a genius baby if you understand how the human brain is structured. In most adults, the left hemisphere of the brain is dominant. Left-brained people think in a logical, linear manner, while right-brained people think in a non-linear, intuitive fashion. The left-brained learn best through hearing, while the right-brained learn best through seeing and feeling. Our school system, geared to logical, linear thinking, favors the left-brained. Right-brained children often do only averagely well in school because they are not able to show how they arrived at their answers, having reached them by unusual methods or through sheer intuition. You should therefore not lose heart if your child gets low grades in school. It may be a sign of a genius in the making! A great example of a right-brained person is the scientist Albert Einstein. An acknowledged genius, he suffered from speech difficulties in early childhood. So, is there a genius baby in your house? There may well be. As Glenn Doman and Makoto Shichida, two right-brain educators, put it: accessing the right brain enables a child to learn better and could unlock genius-like abilities. These include speed-reading skills, a photographic memory, the ability to accurately sketch something seen only once, a facility for performing instant math equations, and rare musical talent. The right brain is also responsible for visual and spatial processing, and the ability to see problems in multiple dimensions, as great physicists do. Einstein possessed this ability. If the right brain is so much more intuitive and creative, why is our left brain more dominant? For a very good reason. It does the important job of filtering out a lot of the information bombarding our senses. This helps us to avoid “sensory overload”. If the right brain was dominant, we would constantly be reacting to a host of information being thrown at us. Think of the autism sufferer who, being hypersensitive to sensory stimuli, finds ordinary social interactions overwhelming, and you get the idea. Our left brain helps us hold a conversation while ignoring background noises. It ensures that a great deal of the sensory input we receive remains beneath the radar of conscious awareness. Right-brain teaching helps us to reclaim some of the benefits of right-brain dominance by changing the way we absorb and recall information. Most people memorize data by storing it in their short-term memory in the left brain. Only repetitive use leads to its transfer it to the long-term memory of the right brain. Right-brain teaching helps us bypass the left brain and directly access our long-term memory, helping us learn faster. It allows us to recall information received on a subconscious level – for instance, through speed reading. Unlike left-brain learning, right-brain learning does not require conscious effort. In small children, the right brain is already activated, making learning especially rapid. This is because the right brain develops before the left and is dominant until the age of three and a half. So, if you want your child to be a genius baby, stimulate her right brain. [hr] Author: Madeleine Fitzpatrick. Madeleine Fitzpatrick is the editor for BrillBaby. Go to www.brillbaby.com to learn more on how to make a genius baby.

January 21, 2016

Picking Up The Pieces

Previously we touched on understanding high risk pregnancy and what causes prematurity , this month we will be taking a look at the conflicting emotions we go through when we have given birth prematurely. It can be a trying time for both parents, both emotionally and physically draining. Whirlwind… No one is fully prepared for childbirth let alone a premature one. Depending on the circumstances, it can be a situation of fear, disorientation and overwhelming bewilderment. I believe we all have that moment of realisation…what just happened was no dream. My daughter was born at 3:50am, I was unconscious through most of it. When I finally awoke at 7am, the lack of movement from her was replaced by pain. Alone in my hospital room and unable to move…I will never forget that feeling of devastation and hopelessness. These feelings were short lived as I sprang into action, I had a duty to perform. I won’t lie, I was emotionally numb. My mind accepted that was my little girl in the incubator, my heart on the other hand wasn’t so sure. Slowly my heart warmed, and I finally accepted that I was now a mother to an amazing little fighter. Sixteen months down the line, I am still working through the PTSD, but everyday gets better. Life changing journey… Parents may worry after a year, two years, ten years or twenty, that they have not “gotten over” the traumas and losses of having a premature baby. They may concede that they are more vigilant now. They sometimes find themselves very afraid that something awful will happen to their child. Memories pop up in the most unexpected places. Tears well up without warning. They secretly wonder if they have PTSD or are not moving through the “stages” of grief in the “right” way. They imagine that the premature birth irreparably damaged something in them. In short, they fear that something is terribly wrong with them. Parents who have uncomplicated pregnancies and full-term deliveries have a community of people that they join when they have their babies. More and more, they find the changes that they feel acknowledged and validated. Parents of full-term babies say with a chuckle, “I’ll never be the same again” and most other parents know just what they mean. None of us will ever be the same again — but a lot of the time, we’re not so sure that anybody knows what we mean. Our journey was distinct. Our transformation took a startling path — perhaps a longer road or one with more twists and turns. We are different now. And the unease we feel, I believe, comes in part from our struggle to figure out who we are now, how we fit in to the world we used to inhabit, and how we want to move forward. One thing is for certain. You will never be quite the same, again. But I would like to suggest that this journey leaves us altogether wiser, stronger, tenderer and more human. And it is the lessons that we learn that we pass to our children. What can I do? It’s ok to seek help, rather sooner than later especially if you are thinking of having another baby in the future. Take some time and think about the way things used to be — the way you used to be. Think some more about what this experience has given you. The journey is ongoing. The road you are on will never be the same one that you thought you were entering when you imagined parenting this baby. The parent you imagined that you would be is probably somewhat different than how you developed. But this difference does not mean that you are damaged. It does not mean that you have not “recovered” from the premature birth. What it means is that you are transformed. And that’s exactly as it should be. Support & Preparation Besides relying on support from those around you. Chubby Bunny is there to make the journey a little less stressful. Through education & support, Chubby Bunny’s main objective is to support families whose lives have been touched by prematurity. Chubby Bunny is the first company in South Africa to supply critical starter packs for premmies. We supply high quality goods ensuring the little miracle is well cared for, from organic skin care sensitive for their soft skin, petite clothing small enough to wrap around their tiny bodies, Premmie nappies, a Premmie Support Booklet equipped to help parents understand the NICU and how to care for their Premmies. These hampers can be shipped overnight to main centres South Africa. Visit our online store www.chubbybunny.co.za for more information on the hampers we provide or simply contact Sian at [email protected]. Next month…What to expect…my baby was born before her/his time…now what.

December 18, 2015

Happy Families From Colief®

Our growing number of products are there to help your growing family.The Colief infant care range puts a smile on everyone’s face. Colief® Infant Drops – for when nature needs a helping hand… It can be incredibly distressing to hear your baby crying endlessly with colic, yet feel unable to stop it. Fortunately there is a natural solution at hand. Colief Infant Drops contain natural enzymes which help break down lactose in milk, making it easier to digest. Simply add a few drops to your baby’s normal milk (expressed breast milk or formula milk). Colief is the natural way to ease digestive discomfort caused by lactose; proven to reduce the hours of crying. Colief® Baby Scalp Oil is formulated, with naturally derived ingredients, to gently moisturise and soothe your baby’s skin and scalp. Simply massage into the baby’s skin or scalp and the hydrating blend is quickly absorbed, helping soften and clear the scalp of ﬂakes or scaly skin. Colief® Baby Scalp Oil is made with nourishing ingredients gentle enough to use from three months upwards, including Rosehip Oil, Chamomile and Vitamin E. Colief® Vitamin D3 Drops is a food supplement rich in vitamin D3 and can be easily mixed with food or liquids and in the case of young babies, can be given directly by mouth. Colief® Vitamin D3 Drops have been formulated to contain no ﬂavourings, preservatives, sugar or colourings and are safe to use from one month upwards. Why take a vitamin D3 spplement, to assist the development of healthy teeth and heathy bones (and Moms will benefit from vitamin D3 drops too).

December 17, 2015

To Give and To Receive

I think it is time to balance out the season of giving. There is a strange misconception out there that it is better to give than to receive. Some may even go so far as to say that “blessed are those who give”. To complete the sentence then, “cursed are those who receive”! In fact, it takes both sides to complete the equation. In order to give there must be someone to receive. Both are essential sides of the same coin. I find that most people are quite comfortable with giving. It is a nice feeling after all to hand someone a shiny package and see the joy on their face as they open it to discover that you know exactly what they like. Children, too, from a very early age, enjoy giving – they give us stones they picked up on the playground, they give us a lick of their melting ice cream, they give us a favourite teddy to sleep with for the night when we’re feeling sad, they give us beautiful artworks on the walls of our houses! What we tend to do as well meaning parents is to emphasise this joy of giving and imply that this is better than to be on the receiving end. Now children naturally receive well – anyone who has seen their child with a pile of presents on Christmas morning knows that they are only too happy to keep on taking. By adulthood, however, we cower away from such indulgence in receiving. We see it as something for children, or greedy people, or those with no constraint. Our children are watching us as we argue to split the bill instead of graciously accepting our meal as a gift from a friend, as we tell people not to bother buying us birthday gifts but to rather donate something to charity, as we celebrate festivities by enjoying giving our children gifts but not including ourselves on the receiving end. Now I’m not insinuating that we need to rush out and spend a fortune on amassing useless doodads that have been flown in from China. What I’m suggesting is that we learn to enjoy both sides by making both giving and receiving meaningful for everyone. There are many ways to enjoy this without becoming mass consumers. What I would like to see are parents raising their children to continue to enjoy receiving. To learn to be grateful both for what they give and what they receive by watching their parents do the same. Our children can’t possibly become successful in life is they become uncomfortable with receiving. All business transactions require both, all relationships require both, having a healthy spiritual, mental and emotional life requires both. Allow yourself to be part of the festivities this year and know that as you enjoy receiving, your children are learning to honour themselves and their desires and to be open to what life has to offer them. Blessed are those who give and those who receive.

December 10, 2015

Easy Hydration For Breastfeeding Moms

Many of us moms give a lot of thought to eating well while we are breastfeeding, knowing that we are passing on the very nutrients we consume to our precious bundles of joy. However, apart from avoiding alcohol and minimising our caffeine intake, less thought may be given to what we might be drinking on a day to day basis. The nutritional impact of what we drink is one important consideration; the other is that it is also vital for breastfeeding moms to stay properly hydrated. Common advice includes ensuring you get the recommended eight to ten glasses of fluids a day; to drink a glass of water at each breastfeeding session and to give preference to caffeine-free rooibos tea. Fresh fruit and vegetable juices, that are free of preservatives and other chemical additives, also frequently get the nod of approval from nutritionists. However, when it comes to hydration strategies for breastfeeding moms, there’s a new kid on block that is grabbing global attention; and that’s coconut water. Due to its phenomenal electrolyte content, pure coconut water is an isotonic drink which is more hydrating than water. Now more easily available in South Africa, coconut water provides breastfeeding moms with a refreshingly different and completely health-filled option when it comes to avoiding dehydration. Unlike coconut milk and coconut cream which are derived from the meat of ripe coconuts; coconut water is the almost clear fluid contained in young, green coconuts. It’s a traditional, staple drink of islanders in the tropics that has been highly valued for centuries for its restorative and health-giving properties. Coconut water is packed with the essential electrolytes, potassium, magnesium, calcium, sodium and phosphorus, which our body needs for all major functions, from muscles and nerves to heart and brain. It is common for breastfeeding moms to feel fatigued, and coconut water is the ideal energy-boosting pick-me-up that is free of chemical additives. Coconut water is also rich in vitamins, particularly the B vitamins, as well as trace minerals such as zinc, selenium and manganese. It is full of amino acids, enzymes and health-boosting plant hormones known as cytokinins. It is known for its soothing effect on the digestive system and its active support of a well-functioning immune system. If this wasn’t enough, coconut water happens to be a wonderfully low-calorie option. It is virtually fat free and very low in natural sugar, which is just perfect for moms trying to shed those last few pregnancy kilos. In order to optimise on all the fantastic goodness that natural coconut water offers, it is important to read the products’ labels and be aware of the sources of this ‘elixir of Nature’. Avoid options that are derived from concentrates or that include additives such as sugar or preservatives. Recently launched in South Africa, CocoZone is a brand that offers 100% pure coconut water that is extracted and tetra-packed for freshness at the source, which is a single origin plantation farmed without the use of chemical fertilisers, herbicides and pesticides. If you are feeling bored with yet another glass of water during breastfeeding, or you have resolved to cut high calorie drinks out of your diet while you are breastfeeding, consider reaching for refreshing taste from tropics that is nothing but good for you, and good for baby too! For more information or to find your nearest stockist please visit www.cocozone.com

November 26, 2015

Holiday Guilt

Mothers, particularly, are notorious for the amount of guilt they carry around. It starts right from the birth… the natural birthers feel bad that their babies have squashed heads; the caesarians feel bad that they couldn’t not cut-it! Then the working moms feel guilty for not being with their kids and the stay-at-homers feel guilty because their kids are driving them nuts and they wish they were elsewhere, and that they’re not adding to the household income; and the half day moms feel bad because they’re neither properly contributing at work or at home. And on and on it goes. And then come the holidays… Just to compound the guilt a little, the working moms wish they could take more time off, the ones at home wish they could have a break, everyone feels bad because they don’t have the cash to do all the million holiday activities that are out there and screaming for enrolment. At some point we’ve got to all just STOP and accept that we are good enough, we are doing enough and our kids are going to be ok, whether they do the vacation cooking/drama/tennis/pottery class or not. And the real crux of the matter is that, as with most things, it is the quality and not the quantity of time with our children that really counts. If you have 5 minutes or 5 hours with them, make sure that in that time you really connect, on their level, focusing on what they want to do, meeting them where they’re at. Switch off your phone, clear your mind of the myriad other things you need to do, and simply connect. And holiday activities with the kids do not need to break the bank – I bet that your children would be just as happy with a picnic in the park, a visit to a friend, or riding their bikes up and down the road if it meant that they got your full attention for the duration of whatever it was you decided to do together. Let’s all take a break from the guilt this holidays and just do the best we can and let ourselves off the hook when we can’t. As I always say to my clients, it’s about baby steps – if all you can manage is 5 minutes of playing Barbies on the floor, then it’s 5 minutes more than yesterday, and these little moments of presence with our children add up and make for the most special holiday memories they’ll have.

November 26, 2015

How To Eat Less Salt

Eating too much sodium, most of which we get from salt, can lead to high blood pressure. This in turn can cause heart disease, kidney disease and strokes. So it is worth trying to cut down the amount of salt eaten. Almost two-thirds of the salt we consume are added by food manufacturers when food is processed. Of the remainder, about half is added at home during cooking or at the table and half is naturally present in food. Low salt diets may assist in the prevention and treatment of high blood pressure and The Heart and Stroke Foundation of South Africa (HSFSA) recommends that not more than one teaspoon (6g) of salt per day should be consumed. The average diet contains an average of 9g of sodium. A low salt diet contains 2 – 2.5g of sodium ( +- 1tsp salt) High salt foods to be used in moderation: Processed, smoked and cured meats Polony, ham, bacon, sausages, corned beef, pickled tongue, bacon, salami, pepperoni and smoked pork Pre-packaged and convenience meals Ready meals and take away foods (pies, pizzas, pastas, etc). Stocks and packet, tinned soups Used to flavour or thicken soups, stews or casseroles. Some soups can provide more than half a teaspoon of salt per portion. Cheese Processed cheese, cheese spreads, blue cheese and feta cheese Salty nibbles and snacks Crisps, salted/flavoured pretzels or popcorn, crackers and salted nuts. Sauces Worcestershire, soya, tomato and barbeque sauce Pickles Gherkins, pickled onions, capers, artichokes, atjaar and other pickled vegetables Hard margarine or salted butter Use the minimum amount of salt in cooking: Try not to add further salt at the table. Always taste food before you add salt It may help to gradually reduce your salt intake, so that you can get used to the taste changes Try using more herbs and spices to flavour your foods Don’t use salt substitutes as they are high in other minerals Try to cut down on foods that are high in salt such as tinned, packaged and processed foods, tinned and packet soups, stock cubes, chips, salted nuts and salty meats like ham and bacon Avoid sauces that contain lots of salt e.g. soya sauce Check processed foods to see if salt, sodium bicarbonate, sodium benzoate or monosodium glutamates are mentioned among the ingredients Check labels for sodium content – a low sodium food is one containing less than 120 mg sodium per 100g weight of food Limit sodium intake to less than 2g/day (1t = 2,3g) Healthy alternatives for flavouring foods If you use salt in food preparation, do not add extra salt at the table. Learn to use herbs and spices instead of salt, and to enjoy the natural flavour of food. Here are some ideas: Pork Apple, cider, coriander, ginger, lime, orange, sage, thyme Chicken Coriander, basil, chives, dill, fennel, garlic, ginger, lemon juice, marjoram, mint, oregano, paprika, parsley, rosemary, tarragon, thyme, white pepper, white wine Beef Curry, balsamic vinegar, black pepper, horseradish, mustard, red wine, tomato Fish Bay leaf, dill, fennel, lemon juice, onion, parsley, tarragon, tomato, white pepper, white wine Ostrich or venison Coriander, onion, pineapple, tomato chilli Lamb Curry, aniseed, basil, cardamom, cayenne pepper, cinnamon, cloves, cumin, juniper berry, mint, mustard, oregano, redcurrant jelly, rosemary Rice Coriander, onion, red or green peppers, saffron Pasta Basil, black pepper, garlic, oregano Potatoes Black pepper, nutmeg, parsley, paprika, (low fat or fat free) yoghurt Salads Coriander, basil, black pepper, garlic, lemon juice, oregano, (low fat or fat free) yoghurt, toasted flaked almonds

November 25, 2015

Stopping Night Feeds In A Young Toddler

It is important to note that everyone wakes up spontaneously many times during the night. So, even if your toddler is ‘sleeping through’ the fact is that he is probably waking up at least 4 – 5 times a night. Most of the time he will simply stir, turn over or call out, but will be able to go back to sleep. Should he wake fully, he will be able to go back to sleep independently by using comforting and familiar methods that he knows such as finger sucking, holding onto or snuggling down with a security object. Poor sleepers, however, wake in the same way, but are unable to self soothe to go back to sleep without some sort of external intervention from a care giver such as being stroked or tickled, given a drink or having a parent sleep alongside them. These children therefore have difficulty staying asleep and wake up frequently in the night. As long as your child is not ill, it is important to know that toddlers do not need any nutritional support during the night in the form of milk feeds. A bedtime milk feed is always a good idea as it is a lovely end to the day where you can spend some quality “cuddle” time with your little toddler. Try to ensure that the feed is completed before your child falls asleep. Getting rid of night time feeds Remove the expectation of this middle of the night “event”, and he will no longer wake up for it. So, if he is used to breastfeeding or getting a bottle of milk or juice in the middle of the night, stop offering it, and he will soon stop waking for it. As long as weaning off the breast is done with a lot of emotional support from all the child’s parents, nanny etc, it should not interfere too much with his sleep patterns. However, if he has a sleep association with the breast, he will need plenty of reassurance when he wakes in the night expecting a feed !! Stay with him, hold him and rock him until he is asleep (no matter how much he protests!) Do this each time he wakes. Offer him sips of water in case he is thirsty. When he is happy to comforted without a feed, but still needs you to be there, begin sleep training. Be firm and loving, and most of all consistent. Yes, it is as simple as that! It is important to implement sleep training with each waking session no matter how much he protests. If you are trying to break a feeding-to-sleep habit, pick him up if he does not settle, and gently rock him until he falls asleep, no matter how much he protests. Only place him back into his cot when he is asleep. Repeat this each time he wakes. It may take a few sessions (maybe a day or two) for him to learn that he doesn’t need to feed in order to fall asleep. With a bit of luck he will simply stop waking, but he may need some persuasion to go back to sleep totally unassisted, so you will need to move to the next step when you are ready. Getting rid of rocking to sleep habit Sometimes it will be easier for you to settle your little one, then leave the room for short periods of time to enable you to catch your breath and regroup your emotions, so when he wakes you up in the middle of the night expecting to be rocked back to sleep, Pick him up and hold him close until he stops crying. As soon as he is calm and drowsy, but not asleep, place him gently back into his cot. Say some soothing words and walk away from the cot, even if he begins to protest. Stay away from him for one minute, then return to his side if he is still protesting. Pick him up and settle him (no matter how long it takes). Reinforce the sleep object. When he is calm and drowsy, but not asleep, place him gently back into his cot. This time, wait for two minutes before going back to him if he is still crying, then repeat your calming strategies. If necessary, repeat the procedure, each time adding two minutes of crying time before going back in to soothe or settle him. Keep going each time he wakes in the night, starting from one minute of separation at the start of each session. The hardest part, of course, is to follow through with the behaviour management each time he wakes in the night expecting to be fed or rocked back to sleep. Persevere, it will be worth it! BY ANN RICHARDSON

November 18, 2015

Childhood Obesity

Globally, obesity is rapidly on the rise. For the first time in the history of mankind, the number of people who are overweight or obese measure up to the number of people who are underweight due to hunger. It has been estimated that if something is not done about the surge of obesity, half of all people will be overweight/obese by 2030. The most worrying is that this trend is not only seen amongst our adult population but also amongst children. Over a decade, overweight has increased from 10.6% to 18.2% in South African children aged 2 – 5 years. Consistently, girls and female adults are more affected. South Africa further carries a double burden of malnutrition with not only rising rates of childhood obesity but also still high prevalence of child undernutrition. Undernutrition places a child at especially high risk for developing obesity, which then promotes the vicious cycle which we are grappling with in the current socio-economic environment. Being overweight or obese increases one’s risk of heart disease and stroke, high blood pressure, diabetes and certain cancers. Overweight or obese children have an increased risk of developing these diseases earlier in life and are more likely to remain obese throughout their adult life. Not only does obesity have far reaching health effects for a child, but it also has vast social and economic implications. These can include bullying, teasing and low self-esteem, as well as increased healthcare costs and loss of income later in life. So what then is the cause for the increase in obesity amongst our children? Poverty, unhealthy diets and physical inactivity are largely to blame. According to Dr Vash Mungal-Singh, CEO of the HSFSA, “Our children are being brought up in an obesogenic environment where unhealthy foods are aggressively marketed to them, time in front of computers and televisions are increasing and appropriate environments for children to be active, safely, are few and far between.” With urbanisation we have also seen an increase in the consumption of sugar-sweetened beverages, energy-dense, nutrient poor foods and lower consumption of fruit and vegetables. Poor feeding practises early in a child’s life further exacerbates the problem. Studies have shown that there is a link between low birth weight and overweight later in life due to overfeeding as an infant. The introduction of ‘weaning foods’ too early (<6 months of age) is another key driver of obesity later in life. In fact a child’s risk starts even before birth with the health and diet of the mother, a concept referred to as the importance of the first 1000 days of a child’s life (from conception to 2 years of age). Poverty has an overarching impact within this context. Lower income groups tend to have higher obesity rates as they opt for foods that are cheap and the most filling, which often means high in energy, fat, sugar and salt with very little other nutritional value. The pregnant mother and young child are most affected. It is clear that obesity is in fact a very complex problem that requires a multi-pronged approach. We are therefore very fortunate to have the support of the National Department of Health in tackling this epidemic with a clear strategy and bold target to decrease the prevalence of obesity by 10% by 2020. This strategy builds on the guidelines of the WHO initiative on ending childhood obesity and includes a wide spectrum of activities including policy and legislative change, education, access to healthy foods and safe places to be active. The HSFSA wants to encourage all parents and caregivers to take action and play their part to prevent overweight and obesity in their own children, starting with the pregnant mother. It is imperative for all pregnant mothers to get appropriate care before, during and after pregnancy to ensure the healthy weight and growth of their babies. Exclusive breastfeeding for the first six months of an infant’s life, followed by appropriate complementary foods is a very effective way in reducing the risk of obesity. Providing healthy foods for young children and adolescents, limiting the intake of sugar-sweetened beverages and encouraging play time rather than TV time are all great strategies to combat overweight and obesity. Sources: For the first time in the history of mankind, the number of people who are overweight or obese measure up to the number of people who are underweight due to hunger. (Global Issues. Obesity. (2010). URL: http://www.globalissues.org/article/558/obesity) It has been estimated that if something is not done about the surge of obesity, half of all people will be overweight/obese by 2030 (Dobbs, R. et al. (2014). Overcoming obesity: an initial economic analysis. McKinsey Global Institute.) Over a decade, overweight has increased from 10.6% to 18.2% in South African children aged 2 – 5 years. (Shisana, O, et al, & SANHANES-1 Team (2013) South African National Health and Nutrition Examination Survey (SANHANES-1). Cape Town: HSRC Press.) Studies have shown that there is a link between low birth weight and overweight later in life due to overfeeding as an infant. (Vasylyeva, T.L., Barche, A., & Chennasamudram, S.P. (2013). Obesity in prematurely born children and adolescents: follow up in pediatric clinic: Nutrition Journal 2013, 12:150, http://www.nutritionj.com/content/12/1/150) Consistently, girls and female adults are more affected. South Africa further carries a double burden of malnutrition with not only rising rates of childhood obesity but also still high prevalence of child undernutrition. (Arington, C. & Case, A. (2013). Health: Analysis of the NIDS Wave 1 Dataset. National Income Dynamic Study. URL: http://www.nids.uct.ac.za/publications/discussion-papers/wave-1-papers) The Heart and Stroke Foundation South Africa (HSFSA) shines a spotlight on ending childhood obesity.

November 16, 2015

How To Teach Children About Appropriate Sexual Behaviour

I recently endured a rather nasty experience with a man who quite clearly did not understand sexual boundaries and the concept of consent. Having left me feeling in turn helpless, bewildered and angry; it got me thinking: If this is how I feel as an adult woman with good communication skills and world experience, how can we empower our children so that they are less likely to be victimised? I don’t think I’m alone when I admit that I have experienced several incidents of inappropriate sexual behaviour right from when I was a child through to adulthood, at work and privately. The trouble is that there’s a stigma attached to talking about it. This is partly because we figure we should just be strong and ‘bite the bullet’ and maybe because we feel partially responsible? Could we have unintentionally encouraged the behaviour by being too open, too friendly, too flirtatious, too provocatively dressed, etc.? There have been a few school incidents I have heard about recently which indicate to me that our children desperately need to learn about sexual boundaries and appropriate sexual behaviour. We don’t want them turning into adults who continue the culture of entitlement, sexual harassment and sexual violence so prevalent in South Africa. Children need to learn: What is regarded as natural, healthy sexual behaviour? When and what is inappropriate sexual behaviour? How are our laws supposed to protect children? What can kids can do if they need help? What is natural, healthy sexual behaviour pre-puberty? The truth is that most children experiment with some kind of sexual behaviour before the age of thirteen. Most of it is normal and healthy. Even very young children experience pleasurable sensations from touching their own genitals and feel sexually aroused, without knowing or understanding what sexual arousal actually is. Many children indulge their curiosity about each other’s bodies by looking (you show me yours and I’ll show you mine) and/or touching in games like playing ‘doctor’ or ‘house’ where they can try out gender roles and behaviours. The key is that healthy play of this kind is usually light-hearted and spontaneous, with children of similar age and size, and participation is voluntary. Also, this curiosity would normally be balanced by curiosity about other aspects of their lives. Even though this kind of sexual exploration may result in embarrassment (especially if caught or found out) it would not normally leave the child with deep feelings of anger, shame or anxiety. Usually if children are discovered and told to stop, the behaviour lessens, at least in front of adults. How adults handle children involved in this sort of healthy sexual play can have a huge effect on the child later in life. Getting angry, showing your shock or disgust or making the child feel guilty is not the way to handle it, even if the behaviour is inappropriate. Distracting smaller children and clearly explaining our societal rules for sexual behaviour is the best way to teach your children. Here’s what you need to cover: Certain behaviours are socially acceptable in public and others aren’t. It depends on one’s age and where you are. e.g. In many cultures it’s okay for small children or babies to be naked in public, but it isn’t okay for bigger children to do this, and against the law for teens and adults. It’s okay to show affection like a hug or hold hands, but it isn’t socially acceptable for teens or adults to French kiss and touch each other’s private parts in public, and in some countries it is even illegal to kiss or hold hands! It is certainly against the law to display any sexual behaviour or have sex in public. Other behaviour is only okay for your private space. For example, you can throw a tantrum in your room but it isn’t acceptable to shout and scream at other people or show aggression in public. Although it is normal for children to touch their own genitals, it is something to be done in private not public. Children do not have to be ashamed or guilty about masturbating, but it should not become an obsession either – that’s not healthy. If your culture and religion has firm rules about masturbation explain these and why these rules are important to you and your family. We are all entitled to have our own personal space. This is to do with privacy and etiquette/good manners. For example, it isn’t okay to go right up to someone you don’t know and touch them. When we’re getting to know people, we gradually build up intimacy so that eventually with friends or people we care about, it becomes okay to break into each other’s personal space, as long as they’re okay with that. We all need privacy, so discuss which areas of your home are private areas; e.g. the toilet, the bathroom, bedrooms. Make rules you all agree to, e.g. no locking doors, knock before entering, not allowed in without permission. When and what is inappropriate sexual behaviour in children? Many factors influence children’s sexual development – the environment in which they grow, develop and interact has a big influence on their knowledge, attitudes and behaviours. In establishing whether the sexual behaviour of young people is normal, concerning or harmful, it’s important to consider the current social, cultural and familial context. We need to understand what their behaviour is telling us. Children show their wants and needs through their behaviour, and don’t always have the language, experience or ability to get help, so adults must look carefully at the behaviour to interpret it. It’s essential to think about why the child or teen is exhibiting the behaviour and also the nature of the behaviour, the location and the frequency must be taken into account. A broad guideline with examples from the Traffic Lights Guide to Sexual Behaviour in Children and Young People is below. The full brochure with red, orange and green light behaviour by age is obtainable

November 13, 2015

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