Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Debunking myths about Mpox

Myths are widely held beliefs about various issues, including illness and disease. They come about through frequent storytelling and retelling. Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund, helps debunks myths about monkeypox (mpox). Myth 1: Mpox (formerly monkeypox) is a new disease created in a lab Fact: The mpox virus was discovered in Denmark (1958) in a colony of monkeys at a laboratory kept for research. The first reported human case was in 1970 in the DRC. Mpox is a zoonotic disease, meaning it can be spread between animals and people. It is found regularly in parts of Central and West Africa and can spread from person to person or occasionally from animals to people. Myth 2: Mpox comes from monkeys Fact: Despite its name, monkeypox does not come from monkeys. The disease earned the name when the ‘pox like’ outbreaks happened in the research monkeys. While monkeys can get mpox, they are not the reservoir (where a disease typically grows and multiplies). The reservoir appears to be rodents. Myth 3: Only a handful of people have contracted mpox Fact: Globally, more than 97 000 cases and 186 deaths were reported across 117 countries in the first four months of 2024. South Africa is among the countries currently experiencing an outbreak. On the 5 July, it was reported that the number of mpox cases in the country has risen to 20. This after four more cases have been confirmed in Gauteng and KwaZulu-Natal in the last few days. 15 patients have, however been given a clean bill of health. Myth 4: It is easy to diagnose mpox Fact: It is easy to mistake mpox for something else. While the rash can be mistaken for chickenpox, shingles or herpes, there are differences between these rashes. Symptoms of mpox include fever, sore throat, headache, muscle aches, back pain, low energy and swollen lymph nodes. Fever, muscle aches and a sore throat appear first. The rash begins on the face and spreads over the body, extending to the palms of the hands and soles of the feet and develops over 2-4 weeks in stages. The ‘pox’ dip in the centre before crusting over. Laboratory confirmation is required. A sample of one of the sores is diagnosed by a PCR test for the virus (MPXV). Myth 5: Mpox is easily treated Fact: ‘Currently,’ says the National Institute for Communicable Diseases (NICD), ‘there is no registered treatment for mpox in South Africa. However, the World Health Organization (WHO) recommends the use of TPOXX for treatment of severe cases, in immunocompromised people’. However, the Department of Health (DoH) has only obtained this treatment, with approval on a compassionate use basis, for the five known patients with severe disease. There is no mpox vaccine currently available in South Africa. Myth 6: You can get mpox from being in a crowd or from a public toilet seat Fact: Mpox is not like Covid-19 which is highly contagious. It spreads through direct contact via blood, bodily fluid, skin or mucous lesions or respiratory droplets. It can also spread though bites and scratches. Studies have shown that the virus can stay on surfaces but it is not spreading in that way or in a public setting. The risk of airborne transmission appears low. Myth 7: Mpox is deadly Fact: While mpox lesions can look similar to smallpox lesions, mpox infections are much milder and are rarely fatal. That said, symptoms can be severe in some patients, needing hospitalisation and, in rare cases, result in death. It is, however, painful and very unpleasant. So, it is important to avoid infection. Myth 8: Mpox is sexually transmitted Fact: You can become infected though close, direct contact with the lesions, rash, scabs or certain bodily fluids of someone who has mpox. Even though this could imply transmission though sexual activity, it is not limited to that. You can also be exposed if you are in close physical proximity to infected people, such as spouses or young children who sleep in the same bed. Myth 9: I can’t protect myself from getting Mpox Fact: You can take precautions: Avoid handling clothes, sheets, blankets or other materials that have been in contact with an infected animal or person. Wash your hands well with soap and water after any contact with an infected person or animal and clean and disinfect surfaces. Practice safe sex and use personal protective equipment (PPE) when caring for someone infected with the virus. Myth 10: You can’t stop other people being infected by you Fact: You may not protect them by 100% but you can isolate. Also, alert people who have had recent contact with you. Wash your hands regularly with soap and water or use hand sanitiser, especially before or after touching sore and disinfected shared spaces. Cover lesions when around other people, keep skin dry and uncovered (unless in a room with someone else). Mpox is a notifiable medical condition but is treatable, if you are concerned, call the DoH toll free number of 0800 029 999 but remember, your GP is your first port of call for all your healthcare needs.

July 12, 2024

Pregnancy, your body and your baby – week 25 of your pregnancy

As you enter week 25 of pregnancy, you will be nearing the end of the second trimester and the start of the third. You may find that your rise in energy levels you felt at the beginning of your second trimester is now beginning to drop. Your baby at week 25 Your baby is now roughly the size of a cauliflower and they are slowly starting to become the chubby baby you’ll expect at birth, as fat is added to their body every day. Your little one is also starting to develop a sense of balance, becoming more aware of what is up and down. Not only this but your baby’s lungs are slowly developing closer to maturity, as blood vessels (caprillirs) grow and they start to practice breathing in amniotic fluid. Your body at week 25 As your baby grows, it is normal that your back and pelvis may be starting to take some strain. This is also thanks to pregnancy hormones which cause your ligaments to soften. To avoid any injuries, make sure you aren’t tempted to over stretch if you’re doing something such as yoga and don’t lift any heavy objects around the house or office. If your back is feeling sore, gentle exercise in water, such as aqua aerobics, can help alleviate the aching. However, if your back is seriously painful , chat to your doctor about finding a physiotherapist who can help you during this time. Other common pregnancy symptoms around this time are heartburn, sore feet and ankles, camping in your legs, swollen and bleeding gums, dizziness, trouble sleeping and stretch marks. Although many aspects of pregnancy (and certainly afterwards) are rewarding, there are also many parts of it which can be uncomfortable. Things that you should keep in mind Cravings are a natural part of pregnancy (and these generally peak in your second trimester), and they are the sudden desire to eat a particular kind of food. These can be odd foods and combos that you’ve never had the urge to eat before, and generally these are personal to you. Strange combinations, such as pickles and ice cream, might suddenly be on your most wanted list. Just be aware of what you are consuming, as trying to keep things healthy will be best for your growing baby. Unfortunately big meals can also mean heartburn, so little and often can often be the answer here. The book: http://picklesandicecreamcookbook.com/

July 9, 2024

Pregnancy, your body and your baby – week 24 of your pregnancy

You’re a good few weeks past half way of your pregnancy, which means you are closer than ever to finally meeting your little one. In terms of months, you’re about 6 months in, which means you only have 3 left to go! Your Body at Week 24 As you near your third trimester, you may notice that your body is feeling more uncomfortable thanks to your growing baby. Back ache, tired swollen feet, leg cramps and constipation are all pretty common during pregnancy. You’ll also be gaining weight (which is completely normal) and your breasts are also bigger. Heartburn may be something that you’re struggling with and this is normal during pregnancy thanks to hormones and your growing baby taking up space. Your pregnancy hormones are the reason the valve between your stomach and throat doesn’t close as it should, as the hormones relax the tight muscle between your stomach and your esophagus. Your growing uterus can also put pressure on the stomach, making it more likely that acid can spill out. Your Baby at Week 24 As your baby grows, they are putting on more and more weight, and their muscles are developing and gaining strength – which means their kicks are getting stronger and harder. Your little one also has hair at this point, however, none of it is pigmented yet. Your baby is pretty active now, and you should feel them move around regularly, however, unless you don’t feel your baby moving around for long periods of time, stillness is nothing to be concerned about. Things to take note of While it may seem obvious, eating healthily and frequent exercise are both ways to stay mentally, physically and emotionally happy and healthy during pregnancy. While a few stresses here and there are common, a constant state of worry or sadness is probably a sign of antenatal depression or anxiety. If you feel like you don’t have the energy for small tasks or every small detail of your pregnancy is triggering anxiety, it may be best to both seek the support of those you love, and medical professionals.

July 2, 2024

Pregnancy, your body and your baby – week 23 of your pregnancy

Your growing baby is making her presence known, and you may regularly feel little kicks inside you when she is awake. Your body is also starting to take some strain, and you may have uncomfortable feet and back to name a few. While you are excited to meet your little one, you may notice this excitement in strangers who might attempt to touch your baby bump, and this added attention is not necessarily something you’re happy with. Your body at week 23 At week 23 you may be experiencing a variety of bodily aches and pains as your body takes on the strain of growing and carrying a small human. Leg cramps, swollen feet, bleeding gums and a tired, sore back are unfortunately all normal during pregnancy. During this time you may also feel stressed out and overwhelmed. Although pregnancy is a beautiful and exciting time, it can also be very stressful for moms to be. You may be under financial strain, and you may feel pressure at work to finish up pieces of work before going on maternity leave. All of this is normal, and if you feel like you’re not coping well it’s important to speak to a health professional who can help you through this tough time. Your baby at week 23 Your baby is now the size of a squash and in their 23 week, your baby is now able to survive outside your body if they are born prematurely (although they aren’t’ ready to be born yet and have lots of growing to do!). Their lungs are developing and their face is fully formed, it just needs to do some filling out first. Your baby is also gaining weight each week (they should double in weight in the next 4 weeks), so by the time your baby is born, she’ll be the plump, chubby little one you’re expecting. Their middle ear bone is also hardening, and they are able to hear you talking to them. Things you should remember at week 23 During your second trimester as your baby bump grows you may experience both wanted and unwanted attention to your baby bump, as well as advice from everyone – from strangers to your mother. Dealing with this added attention can be overwhelming at first, but be sure to state your boundaries clearly if strangers attempt to touch your bump. While some moms-to-be may not mind extra attention, others may not like the invasion of their space when strangers want to touch their growing baby belly.

June 25, 2024

Partnership with GOTG brings water to teaching hospital

When a hospital has interrupted water supplies, the consequences are dire. Water that is essential not only for handwashing, hygiene and drinking but for cleaning and sterilising instruments, laundry, cooling medical gas and suction compressors for patients on ventilators. The list is endless. It is clear that both the patients’ health and the medical staff’s ability to provide quality healthcare will be severely compromised. This is what happened at Kalafong Hospital – an 1 118-bed teaching hospital in Atteridgeville, Pretoria. The hospital was built in the 1973 and services a large population of residents in Pretoria and beyond. The University of Pretoria uses Kalafong Hospital as a training institute for the Faculty of Health Sciences. They reached out to Gift of the Givers (GOTG) with respect to water challenges at the hospital and GOTG agreed to step up to another issue that required humanitarian aid. ‘We rely on stable water supply to service patients adequately and provide a safe training environment for our students,” said Professor Priya Soma-Pillay, the Chairperson of the School of Medicine at UP. ‘As the Chairperson of the School of Medicine at UP responsible for training at our health facilities, I’m grateful to Gift of the Givers Foundation and Bonitas for hearing our plight. With consistent and reliable water supply we can ensure the health and safety of patients, staff, students and the proper functioning of medical equipment.’ GOTG began exploring the possibility of a borehole to supply uninterrupted water and partnered with Bonitas Medical Fund for funding. Drilling began on 20 January this year and by the 26 January they found water at 148 metres. The borehole currently yields 8 000 litres per hour and is literally a fountain of life for this healthcare facility. In addition, 8 x 10 000 litre water storage tanks have been installed. The partnership between Gift of the Givers and Bonitas began in 2018, the key objective: To provide relief to the most vulnerable and marginalised communities, specifically in the field of healthcare interventions. Bonitas donated R1.2 million to the Kalafong Hospital borehole project. Lee Callakoppen, Principal Officer of Bonitas says, ‘This and the other projects carried out together with GOTG, align with the Scheme’s commitment to being the medical aid for South Africa. It is the perfect partnership, as we have the same passion and drive to assist where it is needed most. ‘ The borehole will provide water to the hospital’s reservoir and supplement the municipal water supply by 150 000 litres a day. This is over half of the hospital’s daily consumption of between 200 000 and 250 000 litres. It will also help lower running costs by reducing the water bill, these savings can be channelled into other operational costs. Importantly though, when there are intermittent water cuts in the area, the hospital can rely solely on the borehole to continue to function efficiently. The water was tested using The South African National Standard (SANS) 241 test – a drinking water specification that outlines the minimum requirements for potable water to be considered safe for human consumption, after an ultraviolet system was installed Other projects involving the partnership between GOTG and Bonitas include: Sponsoring final year medical students who were struggling financially, water interventions at Tower Psychiatric Hospital, Senekal Orphanage, Cwebeni Village in the Eastern Cape, disaster relief after the KZN floods and the sponsoring an audiology programme testing the hearing of 16 000 learners in KZN. Dr Imtiaz Sooliman says, ‘We know what a difference this consistent water supply has made to Kalafong Hospital. After all, clean water is life and clean water is health. We look forward to our continued partnership with Bonitas, always with the health and wellness of South African being the priority.’

June 24, 2024

Pregnancy, your body and your baby – week 22 of your pregnancy

Your second trimester has you feeling more yourself, and feeling your growing baby moving inside your tummy is bound to bring a smile to your face. Your body may be feeling some strain as your baby grows in weight and size, and you’ll need to remember to eat healthy in order to ensure that you little one receives all the needed nutrients from you. Changes to your body at week 22 Your body may be feeling slightly uncomfortable all round thanks to the changes that pregnancy has had on your body. You may notice your back, pelvis and hips aching, leg and foot cramps, as well as swollen feet. This can be alongside heartburn, constipation (and possible haemorrhoids) as well as stretch marks. Your baby’s growth at week 22 Your baby is now approximately the size of a coconut and is sleeping in cycles – the time that you don’t feel them moving around will be when they are asleep. At this time your little ones taste buds are developing, and what they find tasty later in life may be influenced by what you’re eating. So try to keep it healthy and to stick to fruit and wholesome veggies. Their eyes are almost fully developed but lack colour in the iris. Your little one is also becoming more sensitive to outside stimuli, so you may notice that they react to loud noises. Things to remember at week 22 During your pregnancy, eating healthily is something that is important to keep in mind. Afterall, what you eat is nourishment for your baby. During your second trimester try and eat foods that are rich in protein, calcium and iron. These will help your baby’s growth – protein helps in tissue development, calcium helps in the formation of bones and teeth, and iron helps carry oxygen to your developing baby.

June 18, 2024

Advice from the experts

TB – Serious but Curable

Tuberculosis (TB) is a serious public health issue in South Africa. 280 000 people fell ill with TB during 2022 and, of these, an estimated 54 200 died from the disease. South Africa is one of the 30 high burden TB countries, contributing 87% of the estimated cases worldwide. According to the Department of Health, the main driver of TB infection is HIV, with around 48% of TB patients living with HIV. As a member of the United Nations, South Africa has committed to reducing new TB cases by 80% by 2030, compared with 2015 levels. Clinical data presented by the World Health Organization (WHO) indicates that our country is meeting some of its targets but there are still too many people falling ill and dying. ‘It is important to remember that TB is curable’, says Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund. ‘However, we all need to be more aware of how contagious it is, the symptoms, the impact of the disease, the importance of getting medical attention and adhering to the treatment regimen.’ ‘TB also has a big impact on the economy, not only in terms of healthcare expenses but lost productivity – due to absenteeism and the direct and indirect costs to business. ‘We know that not everyone has access to private medical care but public healthcare facilities offer free testing and treatment. If you test positive for TB, the Department of Health will provide the necessary medication. Crucial to overcoming this disease is to follow and complete the treatment regimen as advised by your healthcare giver.’ Some TB facts: What is TB? It’s a disease that mainly affects the lungs but can also be found in any other body organ. It is caused by an organism (germ) called Mycobacterium Tuberculosis which is found in the sputum (a mixture of salvia and mucus) coughed up by someone with TB of the lungs. The organism (germ) usually destroys the soft tissue of the lungs resulting in difficulty breathing and blood can be coughed up in severe cases. If untreated, TB can cause death. How is TB contracted? The disease is passed on from one person to another. The germs spread into the air via microscopic droplets if an infected person sneezes, coughs or releases saliva. The incubation period is 6 weeks. TB Symptoms If you are concerned about your health or having been exposed, you must get tested urgently. Symptoms of the TB include: Excessive coughing – a cough that has been present for more than two weeks and is productive, (a cough that has phlegm) Chest pains Loss of appetite and weight Low grade fever Night sweats Chills Coughing up blood In children the symptoms may present as a cough for 2 weeks or more, loss of energy and appetite and quite often a mild fever. Who is most at risk of contracting TB? People living with HIV/AIDS Living in the same house as someone who has had or has TB Anyone who has had active TB in the last two years Those with diabetes Residents of informal settlements Children under five The undernourished Alcoholics and smokers Mineworkers Prisoners Pregnant women Can you have TB and not be sick? TB can be ‘latent’, in other words it’s in your body but not active and therefore you not capable of spreading it. However, if your immune system becomes weak, the TB can become active and you become ill. Having HIV/AIDS is a key factor in the TB epidemic which is why it is so important that the people living with HIV are screened and treated. How is TB diagnosed? Diagnosis of TB is quite complex since many symptoms can be quite similar to those of other common lung diseases. South Africa has moved towards more intensive and active methods of identifying cases, for example by screening all those attending primary health clinics. TB testing and treatment is free. The Mantoux Tuberculin Skin Test (TST) and blood tests do not differentiate between latent and active TB which means a sputum sample needs to be taken or a chest X-ray. Treating TB TB is definitely treatable. However, medication must be started as soon as possible, and it must be taken regularly – as per the instructions. Also important is to finish the course of medication. It takes six months for TB to be cured completely but, within 2 weeks of starting treatment, the person will no longer spread the disease. Treatment must be completed. If treatment is missed, the risk of a drug resistant strain of TB is possible, which is difficult to treat and requires a longer treatment period. How can TB be prevented? People on TB medication must complete their treatment, this prevents the spread of TB Cover your mouth and nose when coughing or sneezing Wash hands with soap and water Immunise of all babies at a clinic within 1 year of birth Keep your body healthy by eating balanced meals and exercising Stop smoking Keep your windows open in your home if living with someone with TB – fresh air blows the TB germs away and sunshine kills the TB germs. TB in the workplace If any employees display TB symptoms, they should stay home and limit contact with others as much as possible until the results from a TB test are known. Once a person has been on TB treatment for 2 weeks, they are no longer infectious and can continue to work.

March 20, 2024

Epigenetics and Motherhood

What does Epigenetics mean? Gene expression is the process of how often or when proteins are produced from the blueprint within your genes. While genetic changes can alter which protein is made, epigenetic changes affect gene expression to turn genes “on” and “off.” Since your environment and behaviour, such as diet and exercise, can result in epigenetic changes, it is easy to see the relationship between your genes and your behaviour and environment. The study of epigenetics looks at how actions and the environment can influence your genes. Unlike genetic changes, epigenetic changes are reversible and do not change DNA sequences, but they may affect how your body reads DNA sequences. How does epigenetics relate to Nature Vs Nurture? Epigenetics explains how early experiences can have permanent effects. The genes children inherit from their biological parents provide information that guides their development. For example, how tall they could eventually become or the kind of temperament they could have. How does epigenetics affect us before birth? Environmental factors may alter the epigenetic profile of a fetus during early life, specifically in the prenatal period, which may increase vulnerability to diseases later in life, such as obesity, cardiovascular, diabetes, etc. Donor Eggs Epigenetics and Birth Mother. Birth mothers using donor eggs have a significant impact on the development and future health of their babies. Since the baby’s DNA only comes from the egg donor and the sperm donor, many women using egg donation worry that they will not share any genetic information with their child. However, the switches that turn our genes on and off may play an even greater role in health and development. These switches are known as epigenetic controls. Abundant research has shown us that the prenatal uterine environment plays a crucial role in fetal brain development, childhood metabolism, immune health, and numerous other factors. Given our limited understanding of the processes that affect fetal development, what can a pregnant woman do to improve her prenatal environment? Following the common practice most women use during pregnancy might be the best approach in order to foster a healthy uterine environment for your baby, it is essential that you maintain a good weight, follow healthy diet habits, refrain from drinking alcohol, limit caffeine intake, and take prenatal vitamins. Stress management and maintaining stress-reducing activities during pregnancy are equally important for creating a healthy uterus for your baby. An emerging concept, fetal adaptation, explains how epigenetic regulation impacts development later on in development, in contrast to embryogenesis and implantation early on in development. Epigenetic modifications allow the fetal genotype to respond to a variety of developmental environmental factors. Even though early gestation is the most susceptible period for the fetus, environmental stimulation in late embryonic development, infancy, and early childhood can also have long-term health effects in later life. It has been shown that a high-fat diet supplemented in adulthood induced large-scale methylation changes in skeletal muscles, as did folic acid supplementation during the peri-pubertal period. All these studies suggest that plasticity of the human epigenome may also persist into adulthood and epigenetic mechanisms are involved in life-long adaptation. In conclusion: In contrast to conception, which begins when an egg cell meets a sperm cell, motherhood begins in the womb. The factors influencing childhood begin in the mother’s body long before she becomes pregnant. Your uterine environment will influence your baby’s development in various ways. When you begin taking care of yourself before you become pregnant, and continue doing so as your baby develops inside you, you’ll be able to pass on health benefits to your child, ensuring they have the best possible future.

March 19, 2024

A bad marriage doesn’t have to be a bad divorce

Divorce is more often than not a dreaded life event. High emotions are involved creating conflicts which in turn interfere with the process of moving on. People find themselves stuck in a situation from which they initially wanted to move away from but the unpleasantness of dealing with a person they no longer get along with is remaining a painful present occurrence. I like to stress that if you are in a bad marriage, you don’t have to be in a bad divorce. On the contrary. A divorce, for most parties, is a solution to a life they no longer want to live together. So how do you divorce well when you no longer get along? Here are 5 principles to a good Divorce: Respect each other and agree to disagree. You are no longer getting along to a point that you want to divorce. Agree that whatever has caused your relationship to come to this point needs to be acknowledged. Mutual non aggression. Whether verbal or physical, rudeness or aggression is only a weak imitation of strength. Acknowledge that your situation is what it is. Fighting it or the other person is not going to change the circumstance, only the outcome. Ask yourself then if fighting is going to result in a better or worst outcome. Mutual non interference in each other’s lives. It is important to be at peace with the fact that you both now have separate lives. New places to live, possibly new friends and perhaps a new love interest. What your ex does is no longer of your business. Be interested in your life and all the exciting things that are waiting to happen. Win-Win. To end a bad marriage is to result in a happy separation. Making a divorce difficult to try and get back at each other for whatever hurt was caused will not result in anyone winning and most likely make the person creating most of the chaos more unhappy after than before. Amicable coexistence. Why live in constant hostility when you can live in peace? This is especially of value for divorcing parents whose hostility will affect their children. No matter what you do, you both exist at the same time and, especially as co-parents, are more likely to remain in each other’s lives. It’s your choice to make it a good or bad experience. Nadia Thonnard Founder SADSA | The South African Divorce Support Association

March 19, 2024

How to Teach Kids to Care

I hear parents complain that their kids don’t appreciate what they have. So much is available to our kids today that it’s hard for them to imagine being without. Then when they push their parents for more, it triggers a feeling of resentment for the parents as they think about all they’ve done and provided for their kids so far. My own kids occasionally threw in the, “All my friends have an (insert anyone of these here: iPhone, TV, Xbox, Six Flags pass, etc.), why can’t I have one?” It’s common for them to think that every other child has what they want, even though it may not be true. Remain calm when they make these claims and stand firm in your position to not cave at their demands. Instead of reminding your children of all that you’ve bought or done for them, let their cries for more stuff be your reminder to get them involved in something that gives to others. From food banks, to pet adoption groups, to the Salvation Army and churches, all communities have opportunities for individuals, families and even children to volunteer in service to others. There is no better way to teach your children the act of giving then to do it right alongside them. Avoid dropping your kids off with an organization for them to volunteer, unless it’s an organization that is specific to youth participation. You are the primary and most important teacher for your children so roll your sleeves up and get in there with them to participate. I read a news story recently, featuring a 16-year-old boy in Rhode Island who started a project of providing brand new donated shoes to homeless children. In the four years it’s been running, he’s provided 16,000 pairs across 32 states. The article in People magazine included testimony from recipients of this giving organization’s gifts to families. And where did this admirable young man get the notion to start such a wonderful organization? His parents took him to a homeless shelter when he was five years old. When he realized that his light-up sneakers did not compare to the shoes worn by the homeless children, which were falling apart, that experience remained with him and influenced his actions as he approached the teen years. As the story supports, telling your children about those who are less fortunate than they are, may not be enough to matter. When I was a child, I remember my elders warning me about all the children that were starving in foreign countries, in hopes of getting me to eat my dinner. Providing an experience for your children in seeing and hearing from those less fortunate can make all the difference. One final thought on this matter of teaching children and teens to care. Suppose there are some things that you do want to provide for them. Instead of running out and making an instant purchase, consider a dollar-for-dollar matching initiative if they have the means to earn money. Or at the very least, put limitations on when and how long they can use the item. Delayed gratification is something more children need to experience to appreciate what they do and do not have.

March 15, 2024

Pregnancy, your body and your baby – week 10 of your pregnancy

At week ten, you are officially a quarter of the way through your 40-week pregnancy with only a few more weeks left of trimester one. In your first trimester, you won’t look it but your body will have gone through many changes to accommodate your growing baby. This trimester its particularly important to keep taking prenatal vitamins containing folic acid as your babies spinal tube and organs develop. Your baby at week 10 Your little baby is now the size of a strawberry and is now referred to as a fetus and not an embryo. She is growing rapidly inside you and is slowly started forming bones and ligaments, their little arms and legs are slowly becoming more functional and your baby’s jawbone is also started developing. Nerves are starting to form in their spine and her kidneys are starting to function. Your body at week 10 At week ten your baby bump may be starting to show, but it may be a few weeks before your family and friends notice or you decide to tell anyone. Because of your slowly growing baby belly, it may be a good idea to invest in your first few items of maternity wear, as pants that are too tight around your waist is an added discomfort that you shouldn’t have to deal with. You’ll still be managing a variety of pregnancy symptoms, from morning sickness to frequent urination. You may still be struggling with fatigue, but thankfully this pregnancy symptom should lessen in your second trimester. Things to keep in mind Week ten (between week 10 and 12) is roughly the time that you would choose to have your baby genetically tested. Genetic testing isn’t required but it is a good option to consider so that parents-to-be are alerted to potential genetic disorders before birth. A genetic test is particularly important if you have hereditary genetic problems in your family, or if you and your partners are carriers for a particular disorder.

March 15, 2024

Back and Pelvic Pathology in Pregnancy – the Need for Support

Back pain is a common ailment during pregnancy. As many as 50 to 90% of women suffer some form of back or pelvic girdle pathology or ailment because of pregnancy. Pelvic girdle pain (PGP) is defined as pain or discomfort experienced in the lumbar spine, abdomen, pelvis and thigh areas. PGP is highly common in pregnancy and includes sciatica, pubic symphysis pain and round and broad ligament pain. If back and pelvic injury or pain is not managed correctly and addressed during pregnancy it can persist long after birth and has the potential to carry on throughout life. Often the symptoms progress and lead to structural and biomechanics changes in the spine and pelvic regions. The causes of perinatal back pain include weight gain, balance and postural changes, hormonal joint and ligament effects, weakened abdominal muscles and pre-existing spinal pathology. The increasing weight of the pelvic and abdominal areas places a large force on the spinal, sacral, pelvic and lower limb joints. This weight distribution shift-causes a change in the body’s centre of gravity and these joints need to compensate to achieve postural steadiness. The load placed on the spinal joints, muscles and ligaments can be damaging and pain and pathology may develop where it never did before. This force also exacerbates any existing pathology or previous injury sustained by the spine. Weight gain during pregnancy also negatively affects the optimum functioning of these joints placing them under further strain. During pregnancy balance is affected. The body’s centre of gravity is shifted due to the forward pull of the increasingly heavy abdomen. Adjustment of posture and limb orientation is needed to accommodate the changing weight distribution to achieve effective balance. The postural changes required to maintain balance can lead to a varied number of spinal ailments as the upper back tends to become rounded, the chin pokes forward and the lower back extends, pushing the abdomen out even further. Poor posture then weakens the muscles of the upper back and possibly causing thoracic, neck and shoulder pain, as well as headaches. The lower back may suffer the same result with pain in the lumbar, sacral and pelvic region, sciatica and neural and muscular strain. Weight gain, posture and balance changes can also lead to falling and mechanical injury to the spine. The pregnant body secretes hormones which prepare the body for the growing foetus as well as the impending delivery. Relaxin is a hormone secreted that softens the ligaments, tendons, cartilage, muscles and joints in the body which allow for the stretching of the pelvic joints and hips during delivery. Relaxin also relaxes the smooth muscle in the uterus to allow for growth and expansion. In turn it influences the entire body causing cartilage and ligaments to soften, muscles to relax and joints therefore become more prone to injury and pain. Joints in the spine and pelvis become increasingly vulnerable to injury and pain as their stability is further compromised due to this effect of relaxin. The hormonal effects of relaxin as well the weight of the abdominal and pelvic contents can lead to varied degrees of incontinence, constipation and haemorrhoids. Due to the expanding uterus and the growth of the abdominal and pelvic areas weakening of the abdominal muscles tends to occur as they need to stretch to accommodate this growth. The core abdominal muscles, which are responsible for support, strength and correct biomechanics are weakened too. This muscular structure becomes compromised during pregnancy which in turn can allow for injury and pain as their protective function has been diminished. Diastases recti, where the abdominal muscles separate from each other, may occur in severe conditions. Sciatica, pubic symphysis pain and diastase’s, facet joint pathology, sacroiliac joint dysfunction, muscular spasm, spinal disc and neural irritation are a few manifestations due to the above-mentioned factors. These need to be effectively managed to reduce discomfort during and after pregnancy as well as any long-term negative spinal and pelvic effects after birth. Treatment options include correcting poor biomechanics, exercise, muscle strengthening and release, joint mobilisations and infiltrations, postural adjustment, pain management modalities and support bracing. The goal is to provide support and structure to this vulnerable area, to reduce discomfort, pain and pathology and promote a healthy back in later life. The BellyUp maternity support brace is designed to alleviate the majority of the above-mentioned symptoms by providing support of the heavy abdomen, back and pelvis. The female body undergoes a vast amount of physical change during pregnancy and the back and pelvic areas are often left in a destabilised state due to the preparation for birth. Bracing allows for increased stability, support and function during a time when the female body requires it the most. Bracing with a product like the BellyUp will minimise injury and pathology caused by pregnancy, which in turn will reduce back and pelvic symptoms experienced by women later in life. Julie Klinkert (BSc Physio (WITS))

March 14, 2024

Tackling Engorgement While Breastfeeding

It is completely normal for your breasts to become full, heavy and even painful when your milk comes in, when you have missed a feed, or when you have a sudden increase in your supply. Generally, this will last no longer then 24 hours (with the exception of milk coming in), the areola should remain soft and your baby should be able to latch on without any hassle. True engorgement occurs when the duct system is not cleared adequately, causing an accumulation of fluid. Increased pressure in the milk ducts and glands produce breasts that feel firm, hard, tender and warm or even hot to touch. The skin may become translucent and the nipples may flatten and even get lost in the breast. Milk flow slows down and relief is not found easily. A mother can experience engorgement at any time during her breastfeeding journey whenever milk is not removed adequately. However, it is most common in the weeks immediately following birth. This is because feeding patterns are so irregular and your body has not yet adjusted to suite your baby’s needs. Consequences of Engorgement Engorgement can compromise your milk supply – remember that milk removal promotes milk production. Breast tissue allows milk storage for as long as 48 hours before the rate of milk production and secretion begins to decrease rapidly. Engorgement affects the letdown reflex – the flattened nipple of an engorged breast makes it difficult for your baby to get a good latch. This insufficient latch makes it almost impossible to stimulate the nipple adequately in order to promote letdown. Without the letdown reflex, your baby will not be able to remove milk from your breasts and the pressure in the milk ducts will increase even more. Cracked nipples – when a baby is trying but struggling to latch correctly, you are increasing your chances of getting sore, cracked nipples. Increased risk of infection – when things remain stagnant in the breast, bacteria has a chance to grow resulting in breast infections such as mastitis Permanent tissue damage – increased pressure in the breast for lengthy periods of time can cause cells in the breast to shrink and to eventually die off Relieving Engorgement Engorgement is very painful and it can be a little scary, but it certainly is no reason for one to stop breastfeeding. It is important to remember that it is a temporary situation and with proper treatment, it is usually resolved within 48 hours. Feed – every two hours or even sooner if baby desires. Place no time limits on feeding times. Continue to feed at least 8 times in 24 hours even after engorgement has resolved. Massage – gentle breast compression during feedings will help drain the breast more adequately Express – using a good quality electric breast pump express a little milk before each feed. This will help to soften the breast making it easier for baby to latch. Expressing between feeds may also be necessary depending on the stage of engorgement. Massaging and compressing the breast during pumping may increase the flow significantly. DO NOT express between feeds for longer than a period of 48 hours as this can lead to an increase in milk supply making it impossible to relieve engorgement. Ice – cold compress applied between feedings will help ease discomfort Rest – lying flat on your back with your feet elevated will gel to reduce swelling in the breasts Cabbage – Researchers suggest that phytoestrogens present in cabbage contribute to reducing swelling in tissues. Scour the inside of a chilled cabbage leaf with a fork and place inside your bra. Change your leaves with every feed. As soon as your baby or pumping provide relief, discontinue the use of cabbage as it can suppress milk production or even dry up your milk completely. Preventing Engorgement Ultimately, prevention is the best cure. here are a few key tips: Initiate breastfeeding within the first hour of life Ensure a correct latch and positioning to optimise milk extraction Become familiar with your baby’s feeding cues and feed on demand Do not limit time spent at the breast – allow your baby to drain one breast fully before moving over to the other side Listen for swallowing when your baby is nursing – this is a good indicator of milk removal Avoid the use of artificial nipples for at least 6 weeks post birth as this may cause nipple confusion Minimise interference with breast feeding If baby is not feeding well, be sure to express milk to maintain your supply until feeding is corrected Try not to miss feeds. Wean slowly. If the time has come for you to wean your baby off the breast, do it slowly and carefully

March 13, 2024

Sensory Defensiveness

Mary’s little boy was not doing anything by the book. He did not give her the usual two week honeymoon period after he was born. He just screamed from day1. He would not latch and within three weeks was being bottle fed, even though breastfeeding was so important to Mary. He cried all day every day – not colic hour – it was colic twelve hours! Then everyone said the crying would stop at 3 months, but it just got worse. By the time William was 6 months old, he had had every test under the sun. Mary was exhausted and was sick of the screaming – no one had said it would be so bad and she just felt like a useless mom. William suffers from what we call sensory defensiveness. He has an aversion to touch, even when it is nurturing. He recoils from smells and screams whenever a door bangs or a dog barks. By understanding what is at the root of his fussiness, his mom will have a much easier time managing his behaviour. We all have a specific threshold for sensory information, just as we have a pain threshold. If your baby’s threshold is high, he will be able to deal with a lot of sensory input and be happy and interactive without becoming over stimulated. However if your baby’s threshold is low, he will have a very low tolerance for sensory input. Soft and gentle touch may then seem threatening and painful. If all touch is threatening, being hugged, stroked and massage will not be pleasurable. Breastfeeding will be an intolerable event because it is fraught with tactile experiences, being skin to skin. Likewise if your baby has a low tolerance for sounds, he will stir very easily and wake at the slightest sound. Furthermore, a door banging or an unexpected dog bark will over stimulate your baby, causing him to cry. Being sensitive to smells is particularly overwhelming because the world is so full of odours and we battle to predict or control them. For a baby who is oversensitive to smells, an uncle who smokes or the smell of cooking in the kitchen may be totally unnerving. If you think your baby is an oversensitive baby, go to the checklist on this site to determine whether he suffers from sensory defensiveness. If your baby is sensory defensive, you should: Approach him with firm deep touch as opposed to light fluttery touch Schedule baby massage for the morning rather later in the day when he is already over stimulated Swaddle him for breast feeds to help him be calmer for feed times Not wear any perfume for the first year as he will probably be sensitive to it Wear your baby in a sling or pouch to calm him Play white noise or quiet lulling music to block out the effect of sudden loud sounds Speak to him before touching him so he is able to predict that your touch is coming If you suspect sensory defensiveness is at the route of your baby’s fussing, it is worth getting hold of an occupational therapist to determine whether he is sensory defensive and the extent to which the sensitivity will impact on his daily function. Being the parent of a sensory defensive baby is not easy and you may find he has a harder time settling than other babies. The support of a therapist will help you with ideas for daily life and keeping your baby happy.

March 13, 2024

Advantages of Umbilical Cord Blood over Bone-Marrow and Peripheral Blood Progenitors Transplants

Umbilical cord blood (UCB) is a very effective alternative source of blood-forming stem cells, especially for patients with blood cancers or disorders where there are matched donors that are not immediately available. Notwithstanding the fact that 50 million donors are registered in the USA bone marrow programs, many minority groups, will not be able to find a suitable, unrelated donor within a quick period to be able to save the life of the patient. In this respect, UCB has expanded transplant availability for many patients of racial and ethnic minorities across the world. Since the first UCB transplant in 1988, over 50 000 stem cell transplants are being performed annually worldwide, and that number is growing. Over half of the patients have been cured with this technique. In the USA only 30% of patients who need a stem cell transplant can find an appropriate donor within their family, while the rest must turn to public registries of bone marrow donors and donated cord blood units. For the past 4 decades, paediatric UCB transplants have been performed with high success rates both for blood-related diseases as well as metabolic storage diseases. The transplant of UCB has several advantages over bone marrow and blood stem cells. These include less stringent immune-matching (HLA-matching) criteria, the naïve state of cord blood stem cells which leads to a lower incidence of rejection, better stem cell growth potential, immediate availability of the cryopreserved stem cells, and a lower risk of relapse. Currently, even the transplant rate and success of donor UCB transplants in adults have improved. Although there are disadvantages to using donor UCBs, such as slower engraftment of certain cells and overall immune recovery, these two factors have been overcome by various techniques. Some of the techniques for donor UCBs include the improvement of recovery of certain types of blood cells that helps with immune recovery and engraftment, multiplying -, “homing” – and delivery of the stem cells, and the use of double cord blood units per transplant (1,2). Another way to improve the scope of application of UCB transplants in elderly and really sick patients is to have less intense treatments before transplants which allow for better engraftment after the transplant. In addition to the oncology applications, UCBs have also been used in the treatment of several nerve and heart disorders with varying degrees of success. These diseases, once approved, will hold great promise for the application of UCB transplants in the future. References: https://parentsguidecordblood.org/en/news/competing-strategies-expand-cord-blood-use-transplants https://parentsguidecordblood.org/en/faqs/how-are-cord-blood-stem-cells-different-other-sources-stem-cells https://www.lls.org/sites/default/files/file_assets/cordbloodstemcelltransplantation.pdf Malgieri A, Kantzari E, Patrizi MP, Gambardella S. Bone marrow and umbilical cord blood human mesenchymal stem cells: state of the art. Int J Clin Exp Med. 2010 Sep 7;3(4):248

March 12, 2024

Do Your Kids Know How to Express Love and Compassion

Here’s an exercise I learned from a 9-year-old girl little girl, my youngest daughter who today is 28 and expecting her first child. She revealed the exercise during one family meeting 19 years ago when it was her turn to facilitate. In our family meetings, everyone rotated through the facilitator role which created intense excitement for each of our three kids when it was their week to lead the group. On the night of Shauna’s turn to facilitate, she reminded me to turn the answering machine on so that no calls would interrupt our meeting. If we had today’s technology back then, I can guarantee that she would have collected everyone’s cell phones and placed them in another room so that no distractions took anyone away from this sacred, weekly event. After an opening poem was read or prayer was said, Shauna immediately passed out a few supplies to each person; a business-sized envelope, a small stack of slips of paper, and a bunch of crayons and markers. Along with those supplies, placed in front of her was a ball of yarn and a metal single hole puncher. She waited until she had everyone’s attention and then began by providing instructions. We were instructed to decorate our envelope in any way that we wanted, as long as we included our name. She came around to each of us and punched two holes in the flap of the envelope and then cut a foot-long piece of yarn from the ball she had. Back at her seat at the head of the table, she instructed us to tie each end of the piece of yarn to one of the two holes in the envelope flap, creating somewhat of a handle. Once everyone had a personally decorated envelope with a loop of colored yarn attached, she instructed us to use the slips of paper to write love notes to each person in the family and to place them into appropriate family member’s envelope. Near the end of the family meeting, she led us down the hall to hang our envelopes on our bedroom doorknobs, ready to accept more handwritten notes. Later that night, I was amazed when all three kids willingly went to their rooms when bedtime arrived. Later when I checked in on them, each of them was hidden under their blankets, busily writing by flashlight. And when my wife and I turned in for the night, we found our yarn-hung envelopes overflowing with notes written by the three children. We too ended up staying awake later than usual that night, reading the cutest love notes written in their child-like handwriting, relating all of the things they loved about us or things they were happy about. It brings tears to my eyes now as I remember all the things my kids related to me in those precious little notes. Somewhere in a box in my basement is a large manila envelope, holding some of those handwritten love notes that will be keepsakes for as long as I live. They contain the loving words of my precious children who today are trying to find their way in this world as adults. I pull those treasured notes out now and then to recall the words they wrote when they learned to express their love for their mother and I, and each other.

March 11, 2024

WHERE SHOULD YOUR BABY SLEEP?

Deciding where your baby should be sleeping is a very personal decision by you as a family. You know your family best! Even when assisting clients, this is a discussion as a team (us and the parents). Discuss the pros and cons of why you want to do it or why it might not be best for your family. I am here to tell you that your baby/toddler/child can sleep well no matter WHERE they sleep. Another thing to keep in mind is that when you decide where your baby sleeps, this is NOT a permanent choice. You can change your mind if your initial choice did not work out and change where your child sleeps as they grow up or your circumstances change. There are some important things to consider, though. We are here to give you some options and considerations: 1. CO-SLEEPING Co-sleeping is when you share a sleep space with your child and can be divided into what is known as bedsharing and room sharing: Bedsharing: This is when parents and babies sleep together in a bed, couch or chair. If you choose to bedshare, you need to do it safely. The reality, however, as new research shows, is that bedsharing with younger babies is associated with higher risk of SIDS. For newborns, the safest option is to use a co-sleeper. But once your baby can sit up at around five months, this is no longer a safe option, as the open sides of the co‑sleeper are quite low and your baby is top heavy. If your baby looks over the side of the co-sleeper, they can fall out. It’s also the reason why you should move your cot to a lower level at around the same time. Room sharing: This is when parents sleep in the same room as their babies but not in the same bed. The American Academy of Paediatrics (AAP) continues to recommend that parents room share with their baby for at least the first six months, preferably a year, because it is associated with lower rates of SIDS. You can influence each other’s sleep, however – white noise throughout the night can possibly assist with this. Babies need 11 to 12 hours of sleep per night, you don’t; so you will go to bed later than your baby. When you come in later, it could wake them. The same could happen if you go to the bathroom at night or if you wake up early. Babies are noisy sleepers and their general night noises could keep you out of sleep. Similarly, some baby cots are noisy and just your baby moving around, which they do, could wake you up. 2. OWN ROOM AND OWN COT Creating a safe and beautiful baby room is often one of the top things moms do while pregnant. If you have created a beautiful, safe baby room, it might just be time to use it! As mentioned before, you can influence each other’s sleep in a negative way when sharing a room. The reality, though, is that the move can often be worse for us as parents. HOW to do the move out of the room: Moving them one shot. Not wasting time and just having them settle can especially help when your baby is close to 12 months or already a toddler. Gradually moving the cot further away from you in the room and then out. This gives baby and parents time to adjust. First having baby sleep in their own room and cot for naps, and once you all get used to the idea, then also moving them to their own room at night. 3. SHARING A ROOM WITH A SIBLING We want your baby to be in your room or a separate space until they sleep through the night. This reduces the potential for your children to disturb each other at bedtime or wake each other at night. Many parents are worried about the kids waking each other throughout the night. We have found this to be a very unfounded fear, as children are pretty good at blocking out sounds. Some things that can help to create a comfortable shared sleeping environment: Block out curtains to help with bedtime and morning light. White noise placed between the cot and bed to minimise their sleeping sounds. Placing the cot and bed as far apart from each other as possible. There is no right or wrong choice when it comes to where your little one sleeps. Inevitably, you might use all the options at one point in your parenting journey. To BETTER sleep!

March 11, 2024

Pregnancy, your body and your baby – week 9 of your pregnancy

At week 9 of your pregnancy, you’re probably more aware than ever of your growing baby inside of you, as the first two months of pregnancy are now behind you. You may be dealing with a variety of different pregnancy symptoms as your baby slowly grows bigger. Your baby at week 9 At 9 weeks in, your baby is looking more human, with mini arms and legs developing, and the tail which was initially present is slowly disappearing. Your baby is now the size of a grape or a cherry and her facial features are also becoming more prominent. At week nine your baby is also becoming more active and beginning to move around. However, you won’t be able to see or feel this just yet – but it’ll be visible on ultrasound. If you’re struggling with painful breasts, a maternity or sports bra can offer you more support and help alleviate some of your uncomfortableness. When your body becomes more used to your pregnancy hormones, it’s likely that some of your pain may ease, but throughout your pregnancy, it’s a good idea to find clothes that you feel comfortable in. How you’re feeling at 9 weeks At nine weeks you may be feeling a variety of emotions, alongside the many other pregnancy symptoms, such as morning sickness, which peaks at around week 9. Your symptoms may be particularly difficult to deal with if you’re still keeping your pregnancy quiet from your colleges and friends, but if you are struggling emotionally open up to your partner or health care provider. Things to keep in mind At this point, it may be a good idea to chat to your doctor about possibly restructuring your exercise routine. It could be a good time to start incorporating prenatal yoga or pilates as these activities help you get ready for labour and childbirth. Staying active is also a great way to keep healthy during your pregnancy, but depending on what activities you did before getting pregnant, you may need to think about adjusting your training program.

March 8, 2024

Toddler Teeth

Teething is a painful experience not only for the young child but certainly for the parents who have to endure watching the agony and helping to provide relief. One feel so helpless trying to relieve their pain and having to endure those awful sleepless nights. They are many housewives remedies to see one through the “agony”. Some mothers suggest rubbing brandy or whiskey over the sore gums (just enough to not make the young child into an alcoholic!). Another alternative teething ring or a hard rusk to bite on. The good thing is that the stage passes by in due course. Like everything in child-rearing, everything depends on the parent from feeding, bathing, changing diapers, breaking wind and so on. And so it is with teeth as well. They are precious and need looking after. Baby teeth are not to be taken casually. They fulfil a vital function in growth and development of the child. Besides being used for eating and chewing and learning how to speak, they also are fundamentally important in maintaining space for the permanent teeth to erupt. Baby teeth are also prone to decay. It is very important to avoid having the child go to sleep with a milk bottle. This causes rampant decay known as “baby bottle syndrome”. Prevention is better than cure. It is the parents’ responsibility to look after these baby teeth from the moment they appear in the mouth. In the early stages of tooth eruption, they can be effectively cleaned by wiping them with a gauze swab. As more teeth come into the mouth with the growth of the child, they can then be introduced to a toothbrush. Monkey see monkey do. If the child watches the parents enjoy brushing their teeth, they will want to do the same. Toothbrushing can really be fun. Make it a game and sing some songs. Cultivate an appreciation for the preciousness of beautiful teeth from an early age. The are many children’s toothbrushes on the market and children’s toothpaste which are pleasantly flavoured. There is no particular preference in their choice. Rather it is the conscientiousness and motivation of the parent to ensure that the teeth are properly looked after from the very beginning. Dummy and thumb sucking may well affect the milk teeth by creating a widened space between the front teeth. I recall one of my teachers saying that it is inadvisable to stop a child from dummy or thumb sucking prematurely or forcibly. They are doing so because of an emotional need and will stop in due course. It is much easier to straighten teeth than to straighten the psyche. All too often one hears from adult patients how they were traumatised in the younger years by the dental treatment that they receive then. They remember a painful injection; a very difficult extraction; being forced into the dental chair against their will; unsympathetic dentist and parent. All of these scenarios are part of crisis management which could have been avoided had the child been taken to dentist timelessly before any problem had occurred. Dental caries is easily detectable and should be treated promptly. More importantly though, it can be prevented and avoided with a good home care by a responsible parent. It is believed that dental decay is an infection passed from parent to child. Therefore it is inadvisable to have the parent suck on the dummy before passing it on to the child. The first visit to the dentist should be at roundabout age 2 to 3 at which time all that is needed is the experience of the fun to ride up and down on the dental chair. It is disastrous for the parents to show fear of the dentist because that fear is contagious. The whole experience should be one of fun and excitement. Regular dental visits should become routine and hopefully the child will be able to bounce out of the chair and exclaim “look, no cavities”.

March 6, 2024

Exploring Delayed Clamping and Stem Cell Banking Synergies

The subject of delayed cord clamping (DCC) has been researched and discussed in numerous studies. The most important consideration at the time of the delivery is the health of the mother and baby. Delayed cord clamping has been shown to be beneficial to the baby and thus in the setting of cord blood banking, delayed clamping is an acceptable practice and is encouraged. Recent studies have shown that DCC show an increased amount of red blood cell stores in newborns and thus lessening the risk of iron deficiency anaemia later in the baby’s life. This is specifically important in preterm babies and those at risk of anaemia. In very preterm babies (22 weeks–28 weeks), DCC for 30 seconds, or more, has led to increased survival and a lowered risk for severe neurological injury. In further studies, DCC also showed an improvement in fine-motor and social skills in kids at four years of age in comparison to kids of the same age that had no cord clamping at birth. There is, however, a small risk of increased hyperbilirubinemia/jaundice (because of the additional red blood cells infused during DCC) in some infants after DCC. An estimated 50% of term and 80% of preterm infants develop jaundice. Delaying cord clamping for one minute or more resulted in only a 6%–21% decrease in the total volume of cord blood collected and a 9%–31% decrease in the pre-processed total nucleated cell. It is estimated that about 60% of DCC collections still meets the upper level for the number of total nucleated cells. However, a prolonged delay will allow the blood in the cord to clot, and the opportunity to collect the blood for stem cells will be lost; therefore, if clamping is delayed, it is recommended not to delay for more than two minutes. What major myths exist relating to the optimal clamping time? Myth: If you don’t do DCC, you are robbing the baby of 30% of its blood. Fact: When the umbilical cord is clamped soon after birth, the infant’s blood volume is the same as its volume in utero (in the womb). Myth: The longer you wait to clamp the cord, the more blood the baby gets. Fact: The continued transfusion of cord blood when delaying the clamping in normal birth is reliant on contractions of the uterus, the umbilical arteries close around 45 seconds after birth and the umbilical vein in 1–2 minutes. For c-sections, the blood volume in infants increases till 40 seconds and actually decreases thereafter. Myth: Delaying the clamping of the cord confirms the advantages observed by researchers. Fact: Factors affecting the transfusion of additional blood cells include the timing of cord clamping, gravity, the onset of respiration, uterine contractions and drugs affecting it, maternal blood pressure and birth asphyxia. Facts relating to COVID-19 and delayed cord clamping The use of delayed cord clamping during COVID-19: Most Gynaecological institutions have stated that these procedures should remain according to usual center practice, while following infection control precautions. They have stated that delayed umbilical cord clamping is extremely improbable to increase the risk of transmitting pathogens from an infected mother to the fetus; however, some institutions have selected to forbid this exercise in term infants, in whom the benefits are modest. This practice they believe will minimise newborn exposure to any virus in the immediate environment and reduce the chances that the newborn will require phototherapy for jaundice. Some institutes also prohibit skin-to-skin contact in these cases, although the Paediatric institutions have not advised against this. References Arthur, R. (2021). ‘We are on track for a watershed year for approvals of new regenerative medicine and advanced therapies’. Retrieved 10 November 2021, from https://www.biopharma-reporter.com/Article/2021/09/01/We-are-on-track-for-a-watershed-year-for-approvals-of-new-regenerative-medicine-and-advanced-therapies Ntege EH, et al. Advances in regenerative therapy: A review of the literature and future directions. Regen Ther. 2020 Jun; 14: 136–153.

March 5, 2024

World Hearing Day

World Hearing Day is an annual event organised by the World Health Organization (WHO). Held on 3 March, it’s a global campaign to raise awareness around the prevention of hearing loss and the importance of hearing health and ear care. To help create more awareness, Bonitas Medical Fund is offering free online hearing screening for all South Africans, over the age of 18. Hearing loss is an under-diagnosed medical condition that significantly impacts the physical and mental health of those who have any degree of hearing difficulty. Disabling hearing loss is often called the ‘invisible epidemic.’ It affects more than three million South Africans and over 1.5 billion people globally. With the theme ‘Changing mindsets: Let’s make ear and hearing care a reality for all!’ World Hearing Day emphasises the significance of early identification and interventions in preventing hearing loss. Hearing is vital in that it connects individuals to their surroundings, enabling communication, learning and social interaction. Yet millions of people, worldwide, face hearing challenges which can impact their quality of life. Free online hearing test ‘Last year we partnered with hearConnect and introduced a free online hearing screener for members on our website,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘Through this partnership we have extended this functionality and made it available to all South Africans.’ How it works The online, validated, speech-in-noise hearing test, uses the latest in audiological technology combined with the highest standards of clinical expertise. Go to https://www.bonitas.co.za/hearing-screening and, in just two minutes, you can test your hearing status. All you need is access to a computer or your mobile, headphones or earphones, a quiet area and then you’re all set to take the test. Post the test If the screening test indicates you are experiencing hearing loss, hearConnect is available to guide you through the next steps. Alternatively, make an appointment with an audiologist, consult your GP and/or visit the nearest clinic. What causes hearing loss? Hearing loss can come about as you age or as a result of loud noises, illnesses and disease, genetics and trauma (contact sport). Other factors, such as too much earwax, also reduce your ability to hear. Hearing loss repercussions One of the biggest concerns associated with hearing loss, when it is not treated properly, is the long-term impact it has on the quality of life. Prevention and early detection are important, after all, hearing is the foundation for speech and language development, as well as learning and communication. There are many challenges associated with hearing loss. These include language development that impacts our ability to read, write, spell and concentrate. It affects social skills resulting in isolation, depression, loneliness, cognitive impairment, unemployment and an increased risk of dementia. World Hearing Day underscores the need for accessible and affordable hearing care services and encourages everyone to prioritise their hearing health. ‘As a medical scheme we know that patients with untreated hearing loss experience more inpatient stays compared to those without hearing loss,’ says Callakoppen. ‘There is a 17% increased risk of emergency department visits, readmissions and rate of hospitalisation as well as longer hospital stays. ‘Our partnership with hearConnect includes a full audiology benefit management programme on selected plans for our members to ensure they maintain ear health. This includes a follow up with ongoing treatment steps if hearing loss is detected.’

March 1, 2024

Pregnancy, your body and your baby – week 8 of your pregnancy

It’s week 8 of your pregnancy and your baby is beginning to look more like a little human. You’ll probably be feeling many of the first-trimester pregnancy symptoms but you shouldn’t be showing just yet, so enjoy your flat figure while it lasts! Your body at week 8 Even if you don’t outwardly look pregnant, you’re definitely feeling it. Your first trimester brings morning sickness (not just in the morning!), tender breasts, fatigue, pregnancy cramps and a heightened sense of smell. Dealing with morning sickness and fatigue its important that you remember to stick to a healthy lifestyle. Eating well, exercising often and trying to make sure you get enough sleep. It’s important that you take prenatal vitamins during this time as well. Where your baby is at Your baby is now roughly the size of a bean or a raspberry. They are becoming more distinctly human, developing arms and legs. Their digestive system also develops around this time. If you get an ultrasound you may notice that your baby has a disproportionate body, with a large head – this is because the upper body develops faster than the lower. However, in 32 weeks time, your baby will be a normal-sized little-human. Things to remember Your first prenatal check-up around this time, where you may have blood tests and an early ultrasound to check your baby’s growth and heart rate. If you have lots of questions for your doctor it is a good idea to write them down, so you don’t forget when you arrive – especially if this is your first pregnancy. During the first trimester, you are at higher risk for a miscarriage. It is estimated that 1 in 8 women experience miscarriages, often before they realise they are pregnant. Signs of a miscarriage are cramping and pain in the lower back and abdomen, as well as light spotting to heavy bleeding. If you suspect miscarriage, it is important that you contact your doctor so that they can help you during this time.

March 1, 2024

Mushrooms are a Super Cool Superfood in 2024!

According to global trend analysts and pundits from the food industry, 2024 is going to be another great year for mushrooms! Whole Foods in the US each year puts out its predictions on what we will be eating, and those in the know say they’re pretty accurate year in and year out! According to Forbes, top of the 2024 Whole Foods list is “putting the ‘plant’ back in ‘plant-based’”. “With the rise of flexitarian and vegan diets, many meat-free alternatives have flooded the market,” explains the news magazine. “However, it seems consumers are not necessarily interested in animal alternatives made from a long list of products they do not understand, and would rather eat veggie burgers and other products made of vegetables and ingredients they can understand.” “Consumers are looking for healthier and more sustainable products,” agrees Adam Leman, lead fermentation scientist at the Good Food Institute in Washington, speaking on cultivated meat alternatives in the Hob Hill Gazette of August last year. “Mycoprotein (protein from fungus) requires far less caloric input to produce one calorie for human consumption as compared to animal protein. Additionally, it’s high in fibre, very low in fat and has no cholesterol.” The mycoprotein he speaks of is derived from mycelium, the root system of mushrooms, which contains all nine amino acids needed to form a complete protein. It can be grown quickly and is set to take the alt-meat category by storm. Culinary professionals from the US Specialty Food Association’s Trendspotter Panel are in full agreement with the fungi forecast, declaring that “Mushrooms are mushrooming! “Mushrooms for taste, mushrooms for texture, mushrooms for health benefits,” they add, saying that in the coming months “people will discover mushrooms in every food and beverage category” – think social media already going wild for mushroom coffee! Netherlands’ Innova Market Insights actually noted the significant rise in fungi consumption since 2018 to name mushrooms one of their most up-and-coming ingredients of ’24. Clearly it’s past time to start seeking out simpler plant-based products with fewer ingredients and additives, or take the leap straight to nature’s easiest meat substitute – the Big Brown mushroom, also known as a portabella. Light on the pocket, packed with nutrients, and always available in supermarkets, mushrooms can be treated just as you would a burger patty or a piece of steak. No stress or fuss, and always delicious. And even if you don’t want to make your mushrooms the centrepiece of every meal, they’re always happy to take on a side roll. In fact, the fungi side game is really strong, from Greek Mushroom & Potato Salad https://rebrand.ly/j2yjr05 to Mushroom Gravy https://rebrand.ly/cat3xw2 and Coconut Creamed Greens & Mushroom https://rebrand.ly/xo98dbx! Other trends set to impact the dinner table this year: Food as medicine. This is especially appealing among young people, whether for disease prevention or cure. See https://rebrand.ly/gv4ygyo for many of the reasons mushrooms are so good for you. Plant-based seafood. It’s been around for a while, but is expected to gain traction as new products come to market. Don’t worry, if fish flavours aren’t your thing, there’s always the fungi. Water conservation and stewardship of the plant are being taken ever more seriously by diners worldwide. Go to https://rebrand.ly/fgc25iq for mushrooms’ sustainability credentials. Global flavours. Buy local and use the spice aisle to travel with your tastebuds. According to Whole Foods, TikTok’s “Little Treat Culture” is about to move mainstream. It’s about creating little moments that bring a fizz of joy to your life, so that perfect (mushroom) mouthful is about to become everything! Feed your appetite for fresh mushroom dishes at https://bit.ly/31Tza3V.

February 28, 2024

Key facts about Cholera

South Africa had recorded at least 46 suspected cholera cases in the first month of 2024. According to the Minister of Health, three of these cases were due to cross-border travel. With these outbreaks making headline news, Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund has put together eight key facts about cholera. Researchers have estimated that each year there are around 1.3 to 4.0 million reported cases of cholera, resulting in between 21 000 to 143 000 deaths. However, general consensus is that this is under-estimated because of low reporting and limited laboratory services. What is Cholera? Cholera is an acute diarrhoea disease caused by the bacterium Vibrio cholerae. It can either be mild or without symptoms or severe and life-threatening if left untreated. Who is at risk? The highest at-risk populations are more often in underdeveloped countries where poor sanitation and inadequate hygiene practices contribute to its spread, especially in areas with limited access to clean water and proper sanitation facilities. Cholera can be endemic or epidemic. A cholera-endemic area is where confirmed cholera cases were detected but not brought in from somewhere else. A cholera outbreak/epidemic can occur in both endemic countries and in countries where cholera does not regularly occur. How is it spread? It is primarily spread through contaminated water and food. Ingesting water or food contaminated with faeces containing the bacterium can lead to infection. It is not likely that cholera is spread directly from one person to another. What are the symptoms? The symptoms of cholera typically include profuse watery diarrhoea, vomiting, and dehydration. In severe cases, rapid fluid loss can lead to electrolyte imbalances, muscle cramps and shock. Without prompt treatment, severe dehydration can be fatal within hours. How long before you show symptoms? It takes between 12 hours and 5 days for a person to show symptoms – which could include acute watery diarrhoea with severe dehydration. How serious is it? According to the World Health Organization (WHO) only around 25% of infected persons become symptomatic. Of these, 10 – 20% experience severe disease. How do you treat Cholera? Cholera can be effectively treated with rehydration therapy, which involves replacing lost fluids and electrolytes. This can be orally – in non-severe cases – or via intravenous fluids for more severe cases. Antibiotics may also be prescribed to shorten the duration of illness and reduce the severity of symptoms. Immediate treatment in an outbreak is essential which is not always the case in poverty -stricken areas. Can you prevent Cholera? Yes, you can, it involves improving sanitation and hygiene practices, ensuring access to clean water, and promoting proper food handling and preparation. Measures such as boiling, filtering or treating water with chlorine tablets can help reduce the risk of contamination. Additionally, practising good hand hygiene, especially before eating or preparing food, can help prevent the spread of the disease. A global strategy on cholera control was launched in 2017: ‘Ending cholera: a global roadmap to 2030’, had a target to reduce cholera deaths by 90% as well as timely access to healthcare services during outbreaks. Remember, your GP should be your first port of call for all your healthcare needs. Bonitas believes there needs to be coordination of care and encourages you to see your GP who can refer you to a specialist or auxiliary provider as and if the need arises.

February 28, 2024

Talking about HPV and cervical cancer

The theme for 2024 Cervical Cancer Awareness is, ‘Learn. Prevent. Screen.’ South Africa has a high rate of cervical cancer which has been attributed to the fact that not enough women are screened regularly. Screening can detect early changes in the cervix, which can be treated and may save your life. Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund, gives the low down on cervical cancer – caused by persistent infection with the Human Papillomavirus (HPV), why it is essential to screen for the virus and the development of a vaccine to help prevent it. Why a vaccine against HPV? HPV infects the cells of the cervix and, in some cases, the virus can persist – leading to abnormal changes in the cells that may eventually become cancerous. Over 99% of all cervical cancers are caused by persistent infection of high-risk types of HPV, including HPV-16 and HPV-18. ‘For this reason, we have expanded our preventative care benefits to include the HPV vaccine across all plans, to help prevent cervical cancers,’ says Dr Hadebe. ‘As recommended by The World Health Organization (WHO), this is 2 doses for females aged 9 to 14 years and 3 doses for females aged 15 to 26 years per lifetime’. Screening for HPV and cervical cancer Screening is also essential to mitigate the risk of developing cervical cancer. Screening aims to identify cervical cell changes and detect early cervical cancers before they cause symptoms. Two screening tests help with detection: Pap test (Pap Smear) Cervical cancer is usually a slow-growing cancer that may not have immediate symptoms but can be found with regular pap smear tests (a procedure in which cells are scraped from the cervix and looked at under a microscope). The test looks for cell changes (pre-cancers) in the cervix that may progress to cancer if not treated. HPV test Looks for the virus, particularly HPV-16 and HPV-18 that cause 90% of cervical cancers. It is recommended that between the ages of 21 and 65, women should have a pap smear every two years and, from the age of 30 onwards, a pap smear and HPV test can be done every 5 years. Signs and symptoms The symptoms of the HPV virus can include: Lesions on the genital area as well as darker lesions on other parts of the body, to painful bumps on your upper limbs and skin growths on the balls of the feet and heels. Staging of cervical cancer Just like other cancers, cervical cancer is graded according to the severity. From in situ, which means it hasn’t spread to nearby tissue, through stage one: It’s still in the original organ and is small. If it progresses it spreads to the surrounding lymph nodes and, in the most severe form, the cancer has metastasized to surrounding tissues and other lymph nodes. As cervical cancer develops, the following may occur: Abnormal bleeding, for example bleeding after sex Pelvic pain unrelated to the menstrual cycle Heavy or unusual discharge Increased urinary frequency Pain during urination ‘Cervical cancer is the most prevalent cancer among women after breast cancer,’ says Dr Hadebe. ‘Yet it has a good chance of being cured, if diagnosed at an early stage and treated promptly. Which is why, it’s important to have regular pap smears to detect any changes in the cervix and to vaccinate young girls to protect them against possible HPV infection.’

February 26, 2024

Securing the Future: A Step-by-Step Guide to Joining CryoSave’s Family with Stem Cell Banking

In the ever-evolving landscape of medical advancements, securing the future health of your family has become more accessible than ever. CryoSave, a leading name in stem cell preservation, offers a comprehensive and streamlined process for parents looking to safeguard their child’s health through the preservation of umbilical cord blood and tissue. Let’s take a closer look at what happens when you decide to join CryoSave. Beginning the Journey: Registration Online: To initiate the process, prospective parents can register online through CryoSave’s user-friendly digital application form available on their website, www.cryosave.co.za. This straightforward step sets the foundation for the journey ahead. Delivery of Collection Kit: Once registered, arrangements are swiftly made to deliver the CryoSave collection kit to your doorstep. This kit contains everything necessary for the collection process, ensuring that you, your midwife, or doctor are well-equipped for the upcoming birth. Bringing the Kit to the Hospital: An essential reminder for expectant parents is to take the collection kit with them to the hospital when the time comes for the birth. This proactive step ensures a seamless transition to the collection process. The Collection Process: Risk-Free and Painless: One of the key benefits of CryoSave’s process is that the collection is entirely risk-free and painless for both the mother and the baby. This is a crucial aspect that prioritizes the well-being of all involved. Immediate Collection Post-Birth: After the birth, the collection is performed promptly by your doctor or midwife. A small section of the umbilical cord (approximately 20cm) and 150ml of blood are collected, securing valuable stem cells for future use. Ensuring Completion: Before concluding the collection process, it is vital to ensure that maternal blood samples are collected, all necessary documents are filled out, and everything is packed correctly. This meticulous attention to detail guarantees the integrity of the collected samples. After the Birth: Initiating Contact with CryoSave: With the collection completed, the next step is to contact CryoSave. A seamless communication process is established, marking the beginning of the post-collection phase. Specialized Courier Service: CryoSave takes care of logistics by sending a specialized courier to collect the kit. This courier is entrusted with the safe and timely transport of the samples to CryoSave’s state-of-the-art laboratory for processing and storage. Processing and Storage: Confirmation and Certificate: Once safely delivered to the CryoSave laboratory, parents receive a confirmatory email and certificate. This communication serves as tangible evidence that their baby’s stem cells are securely stored in a liquid nitrogen tank within CryoSave’s highly secured facility. Long-Term Cryo-Preservation: CryoSave South Africa commits to cryo-preserving your baby’s cord and tissue stem cells for a minimum of 20 years, offering peace of mind and a long-term investment in your family’s health and well-being. In the journey with CryoSave, each step is thoughtfully designed to prioritize the safety, comfort, and future health of your family. By seamlessly integrating cutting-edge technology with compassionate care, CryoSave stands as a reliable partner in securing the potential health benefits locked within your baby’s stem cells. For more information on our processes and facilities, visit the CryoSave website and feel free to contact us for an obligation free personalised quote.

February 20, 2024

Pregnancy, your body and your baby – week seven of your pregnancy

By now you probably know that you’re pregnant, but some moms only find out during this week or later. Even if you haven’t started looking outwardly pregnant, there is a good chance you’re definitely feeling it, with the likes of fatigue and morning sickness. Your baby is going rapidly day-to-day, with continued brain and body development for the next 33 weeks. Where your body is at This week you’ll likely be feeling some or all of the symptoms generally experienced during the first trimester of pregnancy. It’s important throughout your pregnancy that you maintain a healthy lifestyle, even if doing so feels tough at times. Eating the correct foods and taking prenatal vitamins will ensure that your baby gets the correct nutrients from you. It is important to remember that during pregnancy your needs will change, so you should keep this in mind when tailoring your diet. Miscarriage and ectopic pregnancies are both serious complications that can happen during early pregnancy. Miscarriage is the spontaneous loss of the foetus before week 20, unfortunately, this is not reversible and is usually due to abnormal development. Ectopic pregnancy often shows around 7 weeks and is when the fertilised egg implants outside of the uterus. Unfortunately, neither complication can be reversed, and losing a baby early in pregnancy is likely to be very traumatic for the mom-to-be and family. It’s important that you seek medical and psychological support if you are struggling post ectopic pregnancy or miscarriage. What your baby is doing Your baby is now the size of a blueberry but is shaped more like a tadpole than a human, however, their tail is getting smaller and will soon disappear. At this point, your baby has continued to develop limbs, facial features, spinal cord and lungs, heart and kidney.

February 19, 2024

How to manage early pregnancy sickness

Affinity Health, a leading provider of high-quality health coverage, discusses ways to manage early morning sickness. Pregnancy is a beautiful and transformative journey for many women, but it often comes with its fair share of challenges. One of the most common early pregnancy symptoms is morning sickness, which can make those first few months challenging. “Early pregnancy sickness is a natural response to the hormonal changes occurring during pregnancy,” says Murray Hewlett, CEO of Affinity Health. “While it can be uncomfortable, it is usually a positive sign that the pregnancy is progressing as expected.” What is Morning Sickness? Morning sickness affects approximately 70-80% of pregnant women. While the name suggests that it occurs only in the morning, this condition can occur at any time or night. It typically begins around the sixth week of pregnancy and peaks between the ninth and 16th weeks. What Causes Morning Sickness? While the exact cause is not fully understood, hormonal changes, notably the surge in human chorionic gonadotropin (hCG), significantly trigger symptoms. Although every woman’s experience with morning sickness is unique, symptoms often include nausea, vomiting, loss of appetite, increased salivation, sensitivity to smells, fatigue and dehydration due to fluid loss from vomiting. 15 Ways to Manage Morning Sickness Affinity Health provides these 15 coping strategies and tips to help expecting mothers cope with the challenges of morning sickness: Dietary Adjustments Eating smaller, more frequent meals to avoid an empty stomach can help reduce nausea. Opt for bland, easy-to-digest foods like crackers, toast, or plain rice. Hydration Staying well-hydrated is crucial during pregnancy. Drinking fluids, such as water, herbal tea, or electrolyte-rich beverages, can help prevent dehydration. Rest and Stress Management Getting adequate rest is essential to manage fatigue and stress, which can exacerbate nausea. Relaxation techniques, such as deep breathing exercises or prenatal yoga, can be beneficial. Medication Sometimes, healthcare providers may recommend anti-nausea medications if dietary and lifestyle changes do not provide relief. Acupressure and Alternative Therapies Some women find relief through acupressure wristbands or alternative therapies like acupuncture. Prenatal Vitamins Taking prenatal vitamins as prescribed by a healthcare provider is essential to ensure the mother and baby receive crucial nutrients. Ginger and Lemon Ginger and lemon are known for their soothing properties. Sipping on ginger tea or adding a slice of lemon to your water can provide relief from nausea. Aromatherapy Certain scents, such as peppermint or lavender, can help alleviate nausea. Consider using essential oils or scented candles for relaxation. Stay Cool Avoid getting too hot, as heat can trigger nausea. Stay in well-ventilated areas and use fans or air conditioning when needed. Distraction You should consider activities that take your mind off nausea, such as reading a book, watching a movie, or listening to calming music. Support System Lean on your support system, whether it’s your partner, family, or friends. Their understanding and assistance can make a significant difference during this time. Avoid Trigger Foods Identify foods that tend to worsen your symptoms and avoid them. Sometimes, spicy, greasy, or highly seasoned foods can be triggers. Herbal Remedies Some herbal remedies, like peppermint, rooibos, or chamomile tea, may relieve nausea. Keep a Journal Keeping a journal to track when and what triggers your nausea can help you identify patterns and make necessary adjustments to your routine. Maintain Good Oral Hygiene Nausea can sometimes lead to bad breath or a metallic taste in your mouth. Regularly brushing your teeth and using mouthwash can help combat this. When to Seek Medical Help While morning sickness is generally considered a normal part of pregnancy, severe symptoms can lead to complications such as dehydration and weight loss. If you experience severe nausea and vomiting, consult your healthcare provider. They can provide guidance, recommend treatments, and ensure the health and well-being of both you and your developing baby.

February 16, 2024

Pregnancy, your body and your baby – week six of your pregnancy

Week 6 of your pregnancy At week 6 of your pregnancy you’ll most likely know that you’re pregnant now, although some mom’s realise as quickly as 3 weeks or as late as 12. Every week your body is changing to accommodate for your growing little one. Your body at 6 weeks 6 weeks in and you may be experiencing a range of pregnancy hormones. One of the most common and challenging first trimester pregnancy symptoms is morning sickness, although these waves of nausea can strike at any time. It is important to eat bland foods little and often. Even though this nausea may be uncomfortable to deal with, it’s nothing to worry about unless you can’t keep any food down throughout the day. Fatigue is another unpleasant aspect of pregnancy that you may have started experiencing in your first trimester. Napping often, letting others take over some of your chores and work, as well as keeping hydrated are ways in which you can help yourself. Your pregnancy fatigue may be worse during your first and third trimesters. Exercise and a healthy diet are also important (at this point and throughout your pregnancy) and you’ll probably be able to do most of the exercise you’re used to – just stay away from anything heated (such as heated yoga) or high risk. Your baby at 6 weeks Your baby is now the size of a pea, still tiny enough that you won’t be able to spot a tell-tale pregnancy bump. Your uterus has begun expanding to accommodate your new baby, and may have started pressing down on your bladder (que the frequent urge to use the bathroom). Inside you, your baby is starting to look more like a little human, and her eyes, nose, ears as well as limbs have started slowly forming. Liver, kidneys and lungs are also starting to take shape.

February 12, 2024

10 ways to manage your medical expenses

‘As you begin 2024 with a clean slate in terms of medical aid benefits, it’s a good time to look at ways to manage medical expenses,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. Here are 10 tips to empower yourself in managing medical expenses. Designated Service Providers (DSPs) and networks Healthcare costs in South Africa are generally unregulated which means providers are free to charge any tariff. ‘Using DSPs and hospital networks means that favourable tariffs for members have been negotiated,’ explains Callakoppen. ‘Using networks also means you can reduce or eliminate co-payments.’ Tariffs and rates of payments The Scheme Rate is the amount a scheme will pay for specific treatments and procedures. However, 100% of the scheme rate doesn’t necessarily mean 100% of the account will be paid. Ask for a quote from your practitioner and/or hospital ahead of any procedure. If there is a major discrepancy, try and negotiate an adjusted fee. The value-add benefits Make use of the free wellness screening and testing offered by your medical aid. There has been an intensified drive to detect, prevent or manage various chronic conditions as well as vaccinate against potential diseases and conditions. ‘After completing an online wellness questionnaire or a wellness screening, you are able to access the ‘Benefit Booster’ providing access of up to R5 000 in additional funds to use for out-of-hospital expenses.’ The Bonitas ‘Be Better Benefit’ includes an annual wellness screening, per beneficiary, to check blood pressure, blood glucose, BMI and cholesterol. It’s about being on the right path to good health and wellness. Other benefits include Flu vaccines, HIV tests, lipograms, mammograms, prostate screening, pap smears, pneumococcal vaccines, whooping cough boosters, HPV vaccines, stool tests for colon cancer, dental fissure sealants, online hearing screenings and contraceptives. Ask your pharmacists Ask your pharmacists for over-the-counter medications for less serious illnesses. Pharmacists are able to provide sound medical advice about problems like rashes, colds or illnesses that are not severe. Also use generic medications where possible. A generic’s active ingredient or drug content is identical but is between 30% and 80% cheaper. Managed Care The prevalence of Non-Communicable Diseases (NCDs) has been increasing year-on-year, so have mental health issues, which is a risk factor for NCDs and vice versa. For this reason, it is important to make full use the Care programmes your medical aid offers. ‘At Bonitas we offer support for NCDs through a range of Care programmes including Audiology, HIV/AIDS, cancer, diabetes, mental health, back and neck, hip and knee replacements as well as hospital-at-home.’ Remember to pre-authorise Pre-authorisation is required for all hospital admissions, out-of-hospital screenings and procedures. Always ask if there are any co-payments or sub-limits that will apply and how to avoid these. For planned procedures, make sure you use a DSP or check whether the procedure can be in the doctor’s rooms or a day clinic. Be aware of consulting after hours Be careful about using after-hours consultations or emergency rooms unless it’s absolutely necessary. In a bona fide medical emergency, one has no choice and this usually results in admission to hospital. Manage your chronic medicine correctly The golden rule for chronic illness benefits is to try to use the medication on the scheme’s formulary and to obtain this from a specified pharmacy, either on the network or a DSP. PMBs Make sure you understand what is covered under Prescribed Minimum Benefits (PMBs) and to use a DSP to ensure that claims are paid from risk, not from your medical savings account. Gap Cover Gap Cover is designed to cover the difference or part of the difference between what the medical scheme pays and the service provider charges for in-hospital procedures/treatment and specified outpatient procedures. Ensuring you ‘work smarter’ with the benefits and medical expenses during the year, is a win-win situation for your health and pocket.

February 7, 2024

Unlocking the Potential: Cord Blood Stem Cell Therapy and the Spectrum of Treatable Diseases

Over the past three decades, the field of cord blood stem cell therapy has witnessed remarkable progress, with more than 40,000 successful transplants worldwide. These transplants have emerged as transformative treatments for various medical conditions, particularly blood disorders, inherited metabolic disorders, and immunodeficiency syndromes. As the therapeutic landscape continues to expand, cord blood stem cells have found applications in over 80 approved therapies, offering hope for patients facing a diverse range of diseases. Treatable Diseases and Therapies: Cord blood stem cell transplants have proven effective in treating a multitude of diseases, ranging from blood cancers to inherited metabolic disorders and bone marrow disorders. The following is a glimpse into the scope of treatable diseases and approved therapies: Blood Cancers: Acute Lymphoblastic Leukaemia (ALL) Acute Myeloid Leukaemia (AML) Chronic Myeloid Leukaemia (CML) Myelodysplastic Syndrome (MDS) Multiple Myeloma Hodgkin’s Lymphoma Non-Hodgkin’s Lymphoma Inherited Metabolic Disorders: Hurler Disease (MPS type IH) Osteopetrosis Adrenoleukodystrophy Krabbe Disease Bone Marrow Disorders: Aplastic Anaemia Unspecified Fanconi Anaemia Other Diseases: Blood Disorders Bone Marrow Failure Syndrome Immunodeficiencies Neuroblastoma Solid Tumours For a comprehensive list of current treatable diseases and therapies, interested readers can refer to the Parents’ Guide to Cord Blood and CryoSave’s dedicated page to these diseases. Ongoing Clinical Trials: The frontier of cord blood stem cell therapy extends beyond approved therapies, with ongoing clinical trials exploring the potential applications of these cells in various conditions. Some of the areas currently under investigation include: Acquired hearing loss Alzheimer’s disease Acute Ischemic Stroke Autism Spectrum Disorders Amyotropic Lateral Sclerosis Bronchopulmonary dysplasia Cartilage repair Critical limb ischemia Cerebral Palsy Congenital Diaphragmatic Hernia Congenital Heart Diseases Childhood Hearing Loss Corneal Epithelial Wounds Ulcerative Colitis / Inflammatory Bowel Disease Duchenne Muscular Dystrophy Diabetic Foot Ulcers Diabetes Mellitus (Type I & Type II) Encephalopathy (neonatal) Epidermolysis Bullosa Fertility Global development delay Graft versus host diseases Glaucoma Hypoplastic left heart syndrome HIV Hydrocephalus Ischemic Stroke (pre/peri-natal) Intraventricular haemorrhage Infant Lung Disease Idiopathic Dilated Cardiomyopathy In-Utero Brain Injury / Stroke Liver Cirrhosis Neurodegenerative Disorders Preterm Neonatal Complications Parkinson’s Disease Rheumatoid Arthritis Severe Hypoxic-ischemic Encephalopathy Systemic Lupus Erythematosus Spinal Cord Injury Skin-Wound / Burns Sweat Gland Diseases / Regeneration References Cairo MS, Rocha V, Gluckman E, et al. Alternative allogeneic donor sources for transplantation for childhood diseases: unrelated cord blood and haploidentical family donora. Biol Blood Marrow Transplant. 2008; 14:44-53. Cairo MS, Tarek N, Lee DA, et al. Cellular engineering and therapy in combination with cord blood allografting in pediatric recipients. Bone Marrow Transplant. 2016;51:27-33 Gluckman E, Ruggeri A, Rocha V, et al. for Eurocord, Netcord, World Marrow Donor Association and National Marrow Donor Program. Family-directed umbilical cord blood banking. Haematolgica. 2001; 96: 1700-1707. Mazonson P, Kane M, Colberg K, et al. Prevalence of medical conditions potentially amenable to cellular therapy among families privately storing umbilical cord blood. Matern Child Health J. 2016 (online). https://clinicaltrials.gov

February 6, 2024

Pregnancy, your body and your baby – week five of your pregnancy

Week five of your pregnancy is the week that many women find out that they are pregnant. You’ll notice the skipped period and your pregnancy test will come out positive, you’ll also start to notice some pregnancy symptoms if you hadn’t already. Your body at 5 weeks pregnant This week you’ll notice pregnancy symptoms, and this is just the beginning of a huge number of changes you’ll feel taking place in your body. At this point your pregnancy hormones will probably be affecting you, making you feel nauseous, your breasts tender. You could also be experiencing spotting and cramping, as well as frequent urination and cravings. The pregnancy hormone, human chorionic gonadotropin (hCG), is responsible for many of these changes, and this hormone is why your test shows up positive. Not only will your body physically change, but you’ll probably be dealing with mental changes as well. No only can your changing hormones cause your moods to fluctuate, but finding out you’re pregnant can also be an emotional experience. Remember any emotions are valid, even if you’re feeling overwhelmed and confused, as opposed to excited. If you’re struggling it’s important to reach out to those around you or seek professional help. Your baby at 5 weeks pregnant Your baby is now roughly the size of orange or apple seed and her tiny face is already starting to form, even though she looks more like a tadpole than a human. During this time your baby’s neural tube is developing – this will become their spine and brain – which is why folic acid is so important at this point. Folic acid taken daily reduces the risk of spinal tube defects. By 5 weeks your little one’s heart will have also started beating. If your pregnancy is healthy, you won’t be having an ultrasound before 8 or 9 weeks of pregnancy, so it’ll be a few more weeks before you get to see your baby.

February 5, 2024

Smile-Ready for School: Oral Health for Back-to-School Success

The start of a school year is always a nerve-wracking and exciting time for both kids and parents – whether your child is off to daycare or big kid school. Parents always want to make sure they set up their children for success and to show up as the best versions of themselves, and while this includes making sure your little one is fully kitted with the required uniform, stationery and lunchbox – sending your child back to school with a healthy and confident smile is also a vital part of that checklist. As you get ready to entrench your family into the school routine – making sure oral health is prioritised will be essential to ensuring they have a successful school year. As our little one’s teeth are developing, taking care of them is critical not only for preventing things like decay and gum disease, amongst other things, but healthy teeth and gums also contribute to overall well-being. Plaque buildup eventually leads to cavities, gingivitis or severe gum disease that puts teeth and gums at risk – and even other parts of the body. Developing good dental habits from a young age can help prevent dental problems in the future. In fact, good oral health habits can, in the long run, lead to saving on doctor/dentist visits and missed school days. Oral health must be prioritised as early as the age of 2 and should change as the teeth do. So, we challenge parents to take their children’s oral health seriously as they start new habits and routines. What’s also crucial is knowing which phase your child is in when it comes to brushing their teeth. We like to break this up into 4 phases, which entail the below: Phase 1: Dependent cleaning – prioritise as early as when your child has their first tooth. This is where mom or dad takes control of their child’s oral hygiene. Phase 2: Supported brushing – from two-and-a-half years old. Your child is beginning to show some independence and do things on their own, which includes wanting to brush their own teeth. It’s important to Use a pea-sized amount of kids toothpaste. Adult toothpaste might burn too much. Choose a soft, dense bristle kids toothbrush – adult toothbrushes are too large for a child’s small mouth. Start brushing all the tooth surfaces, doing large circles over the tooth and gums (about eight counts per tooth) Brush the chewing surfaces using a scrubbing method A plaque-disclosing tablet can show your child where to brush and where plaque is present. They can easily see the plaque and brush on these surfaces Parents should also brush after the child has brushed their teeth to ensure hard-to-reach areas are not missed. Phase 3: Supervised brushing – from nine years old. Regularly checking on them and motivating and supporting them with their oral health is encouraged. This not only lets them know that they are doing the right thing, which will keep them motivated to keep brushing every day, but it will give you the chance to spot any technique that needs to be fixed early on. Phase 4: Independent brushing – young adults. They’re responsible for brushing their teeth and looking after their oral health. This is when you know that your guidance has paid off, and they can keep up with the routine on their own. As parents, we are responsible for ensuring we give our children the best life and opportunities possible. Gifting them a healthy smile, which contributes to their confidence and overall well-being, is certainly one that cannot be overlooked. Written by: Richard Meyer, GM at Curaprox

February 2, 2024

The Importance of Storing Cord Blood Stem Cells for Future Health

The decision to bank your baby’s cord blood stem cells is a significant one, offering potential health benefits for both the child and their siblings. Understanding the intricacies of stem cell matching and the role these cells play in medical treatments is crucial for making an informed choice about storing this precious resource. Who Can Benefit? Your baby’s cord blood stem cells are a 100% match for themselves, ensuring a personalized and compatible source for potential future medical treatments. Siblings, on the other hand, may also benefit, but a crucial step is determining their compatibility through a process called tissue typing or HLA (Human Leukocyte Antigen) testing. This method reveals whether siblings can utilize each other’s stem cells for approved therapies. Biological siblings share a 25% chance of being a match, a statistic that highlights the importance of storing cord blood for each child in the family. Biological parents are considered a partial match, termed ‘haploidentical,’ emphasizing the need for alternative sources in certain situations. Importance of Matching in Transplants In cases where an individual cannot use their own stem cells due to an inherited condition, having cord blood from a matched sibling becomes invaluable. If the sibling did not inherit the same condition, their cord blood becomes a preferred source for stem cells in potential transplant scenarios. This emphasizes the critical role cord blood banking plays in securing a suitable match for transplantation, significantly increasing the chances of successful treatment. Comparing Match Chances Understanding the probabilities associated with different sources of stem cells is vital in appreciating the value of cord blood banking. The chances of being a suitable match for a transplant vary based on the source of stem cells: Autologous (Your own stem cells): 100% chance of a match. Syngeneic (Stem cells from identical twins): Each twin has a 100% chance of a match. Haploidentical (Stem cells from biological parents): A 50% chance of matching. Allogeneic (Stem cells from biological siblings): Each sibling has a 25% chance of matching. Banking your baby’s cord blood stem cells is an investment in their future health. The potential benefits extend beyond the individual, providing a lifeline for siblings who may require compatible stem cells for medical treatments. As the statistics show, the chances of finding a transplant match from unrelated donors are extremely low, making cord blood banking a proactive and strategic choice for families concerned about their long-term well-being. References Waller-Wise R. Umbilical cord blood: information for childbirth educators. J Perinat Educ. 2011 Winter;20(1):54-60. doi: 10.1891/1058-1243.20.1.54. PMID: 22211060; PMCID: PMC3209739.

February 2, 2024

Pregnancy, your body and your baby – week four of your pregnancy

This may be the week that you realise that you’re pregnant. Many women don’t notice so early-on, but if you’ve been trying for a while you may take a pregnancy test before when your next period was due. Your body at 4 weeks Although your body is changing, chances are you may not have noticed just yet – at the end of this week you’ll probably notice (or maybe earlier or later – depending on your menstrual cycle) that you’ve missed your period. This is one of the more obvious pregnancy signs, but your body is changing in other ways as well. When your fertilised egg implanted into your uterus you may have noticed some cramping and spotting. You may write -off other early pregnancy signs as pre-menstrual changes, however, there are some symptoms that are unique to having a baby. Such as nausea, spotting and cramping, and a raised body temperature. If you haven’t already, now is the time to quit any unhealthy habits, such as drinking alcohol and caffeine, and smoking. It’s also a good idea to take prenatal supplements if you haven’t started yet. If you’re feeling healthy and your pregnancy symptoms are all normal, you’ll only need to schedule an ultrasound at week 8. Your baby at 4 weeks Your baby is a tiny mass of cell inside you, roughly the size of a poppy seed, but just because it’s so small doesn’t mean lots isn’t happening. In the next few weeks, this tiny ball of cells will form the neural tube, which is the beginning of the brain and spine. At this point, the cells that are your baby are dividing up, becoming more defined. Three layers are developing – the ectoderm, the mesoderm, and the endoderm – and these will later develop to become your baby’s organs and tissues.

February 1, 2024

10 Reasons to choose cord stem cell banking for your baby

Stem cell storage is more than just a medical choice; it’s a step towards securing your family’s well-being. With the promise of potential treatments and the assurance of peace of mind, let’s explore ten vital reasons why storing your child’s stem cells is a decision worth considering. Reason #1: Collection at Birth – a once-in-a-lifetime opportunity: The collection of umbilical cord blood and tissue stem cells takes place shortly after birth. If not done at this time these precious cells are discarded as medical waste. It is the reason why collecting cord blood stem cells is particularly important because there is only one opportunity to collect them immediately after birth, unlike other types of stem cells. These stem cells have the ability to differentiate into various cell types and tissues; therefore, they can be used for treating various critical diseases. Reason #2: Potential Future Medical Treatments Umbilical cord blood-derived (UCB) stem cells can be used in the treatment of blood-related diseases. As for UCB stem cells, using the patient’s own stem cells called “autologous transplants”, are readily available when needed. Currently, several blood diseases are believed to be critical diseases and are immediately needed (unlike matching with a donor which can take months), every minute counts. Therefore, cord-blood banking is very important to be done and prepared for any future emergencies. One of the primary reasons to store your baby’s stem cells is the potential for them to be used in medical treatments. Stem cells might be used in the future to treat a range of diseases and conditions, should the need arise, such as cancer, diabetes, cerebral palsy, and more. By storing your baby’s stem cells now, you may be able to provide them access to life-saving treatments in the future. Reason #3: Low Risk There really isn’t much risk involved at all! The collection process is completely safe for both mother and child and involves only a few minutes shortly after birth for collection. Even delayed cord clamping can be done. Additionally, cryogenic storage is entirely secure and totally reliable; even in the event of a disaster, your baby’s stem cells will remain safe with us until needed. Reason #4: Inexpensive Options Although it may sound like an expensive option initially for many parents, having the ability to treat many life-threatening diseases in the future is truly priceless. As the number one cord blood bank in South Africa, our mission is to make stem cell storage more affordable for families and offer different plans and flexible payment options to suit your needs. Reason #5: Ensuring Your Child’s Future Cryopreserving and storing your baby’s stem cells is an asset for use in their future health and well-being. Nobody knows what might happen in the future, and should your child develop a life-threatening illness, then having access to their stem cells could save their life. In the past decades, the technology has advanced substantially and will continue to do so in the years ahead. By banking your baby’s stem cells now, you can ensure they have access to any new treatments or therapies that arise from further scientific research. Reason #6: Peace of Mind Knowing that your child’s stem cells are stored safely away can give parents peace of mind about their long-term health expectations. The stress associated with trying to find a suitable donor if needed down the line, as well as removing any concerns about matching or rejection issues for transplants from unrelated donors. Reason #7: Beneficial for the entire family Umbilical cord blood stem cells not only are used for the children themselves but also potentially used by the immediate family members. Parents have a 50% chance of a match and siblings have a 25% chance. Besides treating blood-related diseases, these stem cells from cord blood and cord tissue can also be used to treat the family member’s other degenerative diseases. Therefore, collecting and banking UCB-derived stem cells can provide peace of mind for you and your family in the future. Reason #8: The demand is growing Stem cells isolated from umbilical cord blood have been used to treat different kinds of diseases apart from blood-related diseases, including diabetes, strokes, nerve damage, muscular diseases, etc. It is believed that the stem cell umbilical cord blood market is growing by 16,% due to the increased awareness of cord blood stem cells’ potential in treating various medical conditions and also by the rising incidence of chronic diseases in the population. Reason #9: High processing standards in a state-of-the-art facility Safety is considered an important aspect of the umbilical cord blood and tissue stem cell banking process. At present, UCB- and UCT-derived stem cell collection and banking is of the highest standard with international accreditations and certifications. Therefore, you and your family can rest assured that once frozen, your stem cells can be stored for decades. Reason #10: Revolutionary innovations of umbilical cord blood transplantation The innovation of umbilical cord blood stem cells for therapeutic use has made significant progress since the 1980’s and more than 40,000 UCB transplants have been performed. Umbilical cord blood and tissue stem cells are now being studied as an alternative treatment for many diseases such as type 1 diabetes or type 2 diabetes, multiple sclerosis, and heart failure, to name but a few. Storing your baby’s stem cells poses many advantages for parents that wish to protect their child’s health long-term without breaking the bank. It offers potential medical treatments which could save lives down the line, but also offers peace of mind knowing that you have taken steps towards safeguarding your children’s health — no matter what happens in life. Our promise is that we will do our best to take good care of your future and provide you with the highest quality and most reliable service.

January 30, 2024

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