Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Pregnancy, your body and your baby – week 27 of your pregnancy

Congratulations, you are now in the last week of your second trimester and approaching the third, which will start at the beginning of week 28 – so you are nearing the final stretch of your pregnancy. You’ll find that you’re probably becoming more used to your little one moving around inside of you and while you may have enjoyed less fatigue during trimester two, this unfortunately may begin to change. Your baby at week 27 Your baby is starting to pack on the final pounds before birth (which should be in 13 weeks, but not all babies arrive at their due date). Inside of your uterus, your little one will be kicking and grasping, slowly developing their muscle tone before birth. Your baby will also be practicing breathing and swallowing with the amniotic fluid. Your body at week 27 Haemorrhoids are a common pregnancy, thanks to your uterus becoming larger and putting pressure on your veins. Haemorrhoids are swollen veins in the anus and rectum, and these are both uncomfortable and painful. While these are unwanted, they generally aren’t harmful to you or your growing baby and normally go away after birth. Other pregnancy symptoms common during this time are leg cramps, aching pelvis and back, heartburn bleeding gums, constipation, trouble sleeping, frequent urination and stretch marks. Things to remember at week 27 At week 27, something you can start considering is putting together a birth plan. A birth plan is a written document that communicates your wishes during your pregnancy (think of the ideal way you’d like your birth to go) as when the time comes, you probably won’t be thinking clearly. There is no right or wrong way to go about doing this – some may be detailed and others just cover the basics, the choice is yours!

July 23, 2024

Pregnancy, your body and your baby – week 26 of your pregnancy

Although you are yet to meet your baby, they are slowly taking over your life and you may notice weekly and even daily changes in your body. Some days you’ll feel better than others, and it’s important that you take each day as it comes. Both by taking advantage of your good days, and being gentle on yourself on the bad ones. How your body may feel during this time Tiredness, an achy body, a sore mouth and stretch marks are all part of your pregnancy journey. Your belly and breasts are also growing, so make sure that you accommodate your body and dress in clothes that are both supportive and comfy. Your baby’s growth at week 26 Your little one’s lungs are now working hard, getting ready for the day that she’ll need to start using them. At this time the lungs start to produce surfactant, which’ll make it possible for your baby to breathe at birth. Your baby’s suck reflex is growing stronger (they may even suck their thumb!), and their eyes may open for the first time around now and they’ll start to practice blinking. Not only this, but your little one also has eyelashes that are starting to grow. Now that your baby can hear you, you can also spend some time talking to them. Research has shown that babies prefer the sound of their mothers voices and you may even notice that they start responding to the sound of your voice, and by late pregnancy they should be able to distinguish between voices. What you should keep in mind at this time Something to keep aware of during your pregnancy is the possibility for gestational diabetes. Gestational diabetes is high blood sugar levels during pregnancy, and it’ll go away after birth. However, moms who develop gestational diabetes are at higher risk of developing type 2 diabetes after birth. Warning signs are unusual thirst, frequent urination and dizziness, if you feel like you are checking these boxes then it’s important to speak to your doctor about treatment. If treated effectively, there is no reason you shouldn’t have a healthy pregnancy.

July 16, 2024

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

Advice from the experts

Motherhood & the Pressure to Conform to Unrealistic Body Images

Motherhood is a transformative journey, a unique experience that shapes each woman in remarkable ways. In today’s world, where social pressures abound, it’s essential to recognise the impact of unrealistic body standards on new mothers during pregnancy and postpartum. Many mums-to-be embrace their growing bellies, celebrating the life within, proudly displaying their baby bumps and appreciating the miracle of pregnancy. Other mums, however, may feel alienated from these changes and out of control of the adjustments taking place both inside and outside their bodies. Experiencing dissatisfaction with one’s body during pregnancy can have significant implications for both maternal and foetal well-being, leading some women to adopt extreme dietary restrictions or even trigger a relapse of an existing eating disorder. One’s self-esteem can be further impacted when comparing oneself to unrealistic portrayals of pregnant women in the media, where stretch marks and uneven skin tone have been edited out. After birth, an obsession to ‘return to normal’ can be as damaging, leaving new mums feeling pessimistic and depressed about themselves instead of accepting that motherhood has upgraded them to a new life stage and status. The reality is that the ‘perfect’ pregnancy body doesn’t exist. The true beauty of birth into motherhood lies in your authenticity. Understand that it’s normal to have mixed feelings about your changing body during pregnancy. Many women go through similar emotions. If you feel inadequate or negative about yourself, it can help to: #1 Shift your mindset from aesthetics to functionality. Marvel at how your body is preparing to grow and deliver a new life into the world. #2 Share your feelings with a trusted friend, partner, or family member. Talking openly can help lighten your mental load. #3 Take the time to honour yourself by appreciating the strength, endurance, and resilience your body exhibits during pregnancy and childbirth. #4 See it as an invitation to educate yourself and learn about the changes your body will undergo during pregnancy and postpartum so you can balance and support your mind and body better. #5 Create a pregnancy mantra or positive phrase. Repeat it regularly, especially when feeling low, and practise better self-talk. Dispelling Fears & Myths: Pregnancy brings significant changes in all areas of one’s life, and the fear of the unknown may cause anxiety. As your body goes through the gestation phase, you will experience hormonal shifts, weight gain, bloating, mood swings, swollen feet, back pain, morning sickness and skin changes that can make some women feel helpless and overwhelmed. While you may witness your favourite celebrity or influencer appearing to breeze through their pregnancy with perfect glamour, you are not seeing the full story of real life; everyone has low days where our biorhythms are on the fritz. Understand it is the media’s job to photoshop and gloss up for the best aesthetic look rather than reveal the everyday practical challenges. Challenge the myths circulating in women’s conversations and challenge yourself to decide what is true for you. For example: Myth: Pregnancy Makes You Hungrier: True. Pregnancy hormones often lead to an increased appetite; this is a natural body indicator for more fuel as you use more energy to grow a new person. Having more significant portions is normal. Myth: You Need to Eat for Two: False. There’s no need to eat for two. Only in your third trimester do you need about 200 extra calories per day. Focus on a balanced diet and quality nutrition, which will satisfy you more. Myth: You Should Gain a Kilogram a Month Throughout Pregnancy. Not exactly. Weight gain in pregnancy doesn’t happen evenly; most pregnancy weight happens after 20 weeks, and the recommended weight gain during pregnancy varies based on your pre-pregnancy weight and body mass index (BMI). On average, expect to gain 1 to 1.5 kilograms in the first three months (more if expecting twins) and 1.5 to 2 kilograms each month until delivery. Myth: Excessive Weight Gain Is Fine. False. Too much weight gain puts you at risk for gestational diabetes and preeclampsia. Aim for 11 to 16 kilograms (more for twins) if you are of average weight and height. How to Embrace Your Changing Body Focus on nourishing your body with wholesome foods and staying active—your well-being matters. Weight gain, stretch marks, and loose skin are natural parts of pregnancy like age is a natural part of life. Your growing belly is a testament to the life blossoming within. Each stretch mark tells a story of strength. See this period as a call to walk your path rather than following another. Appreciate motherhood as an opportunity to create a closer relationship with yourself as you take on the responsibility of nurturing another tiny human being. Prioritise your well-being rather than focussing on attaining a specific appearance. Understand that your body is doing incredible work, and imperfections are okay. Consult a healthcare provider who can guide you through the physical changes and address weight concerns. Knowledge is empowering; learn about the changes you’ll experience with the support of the Vital Baby social media accounts, and connect to Sr Londe online, Vital Baby’s trusted advisor who provides advice through monthly Instagram Live videos for new mums and mums-to-be, answering your specific questions during the sessions. Connect to other Moms and join support groups and online communities where you can share experiences and hear stories from other women, which can normalise the challenges and help you feel less alone. As the journey of motherhood unfolds, Vital Baby stands alongside expectant mothers, offering support, encouragement, and a celebration of the incredible transformations that occur during pregnancy and childbirth. We encourage new moms to focus on their body’s remarkable achievements and know that every curve, and every scar tells a story of resilience and love. Together, let’s redefine beauty beyond the superficial and honour the miraculous transformations that occur during the sacred journey of motherhood.

April 4, 2024

Affordable ways to maximise your nutrition during pregnancy

As South African consumers we have become accustomed to the term ‘tightening your belt’ which means to live more frugally and to spend money wisely in this cash strapped economy. South African’s spend on average around R1403 per month on groceries, that can be compounded by the stress of other monthly expenses specifically when one is trying to make better food choices and save for a growing family. Considering this, here are a few actionable tips to help expectant mothers in maintain a healthy diet by making strategic choices and using available resources to ensure that your developing baby gets all the nutrients needed without breaking the bank. Plan your meals Planning your meals in advance will help you make sure you have all the necessary ingredients, avoid impulse buys, and stay within your budget. You can create a budget-friendly shopping list by including affordable yet nutritious items that provide all the nutrients for your growing baby and provide satiety for mum. Look at simple, cost-effective meals by adopting small habits like avoiding pre-packed portions or doing a weekly scan of supermarket savings to stretch your rand further. Having a written list makes it easier to analyse your food intake and will help you avoid food and financial waste. Instead of wasting food, find ways to repurpose and use leftovers. For example, leftover vegetables can be turned into a stir-fry or soup, and leftover meat can be added to salads or sandwiches. Keep it homegrown Local markets and street vendors often offer fresh produce at lower prices compared to supermarkets. By shopping at these places, you can save money while still getting fresh and nutritious ingredients for your meals. Consider planting a small kitchen garden where you can grow your own fruits, vegetables, and herbs which can be a cost-effective way to supplement your diet with fresh and nutritious foods. Fruits and vegetables are packed with essential vitamins and minerals such as vitamins A, B, C and E; folic acid and calcium that are important for a healthy pregnancy. Your baby is what you eat Protein is an essential nutrient during pregnancy, but it can also be expensive. To ensure you are getting enough protein without breaking the bank, opt for affordable protein sources such as beans, lentils, eggs, and canned fish like sardines or pilchards. Avoid processed foods as they tend to be more expensive and often lack nutritional value. Rather incorporate affordable staple foods such as maize meal, rice, and potatoes into your diet, these foods are often budget-friendly and provide necessary carbohydrates for energy. Water is an essential component of a healthy diet, especially during pregnancy. Make water your main beverage and avoid sugary drinks, which can be expensive and provide empty calories. You can also download the Philips Pregnancy+ app which is an additional valuable resource for expectant parents. The app supports parents and baby in a healthy and safe pregnancy and provides a comprehensive guide through all stages of pregnancy. “We’ve been helping families around the world for over 100 years, and we know that nourishing your body is important for the health and safety of you and your baby. Prioritising certain food groups, managing portions, and staying within a budget ensures that you and your baby receive the necessary nutrients for optimal health and development,” says Nelisiwe Xundu Consumer Marketing Lead: Personal Health Africa.

April 3, 2024

Children and nutrition

Adequate baby and child nutrition is imperative in order to achieve appropriate growth & development, build defence against infections and to decrease the overall incidence of life-threatening disease in childhood. Approximate energy, protein, iron, and folate requirements during childhood Age Energy kJ/day Protein g/day Iron mg/day Folate mcg/day 0-6 months 2700 13 6 65 7-12 months 3500 14 10 80 1-3 years 5500 23 10 150 4-8 years 7000 30 10 200 9-13 years 10000 45 18 300 (Adapted from the National Academy of Sciences- USA) Baby nutrition (0-6 months) During the first 6 months of life most nutrient requirements are met by exclusive breastfeeding. Babies should thereafter be weaned onto solid foods such as vegetable feeds and cereals. It is important to view weaning as both a nutritional and developmental experience as babies explore various tastes and textures. Breastmilk is advantageous because it contains several active enzymes, hormones, and growth factors. Breastmilk also has antibacterial and antiviral properties. Research has also shown that breastfeeding can delay the onset of allergy. The Baby Friendly Hospital Initiative (BFHI) was launched in 1991 by the World Health Organization to support breastfeeding mothers. Infant and toddler nutrition (1-3 years) This age group requires a good balance between breastfeeding and complementary feeds. It is recommended to start with a few teaspoons of nutrient dense food prepared hygienically. It is important to track the weight of the child during this crucial period of weaning. Food fortification is another implementation that helps prevent iron deficiency and nutritional anaemia. Child and teenager nutrition (5-12 years) Eating habits developed during this stage of development sets the scene for the approach to food well into adulthood. Encouraging three healthy meals a day is recommended but appetite may decrease during this phase which may worry parents. However, the incidence of childhood obesity is on the rise in South Africa which can put children and teenagers at significant risk for chronic conditions such as type 2 diabetes and hypertension. Malnutrition Malnutrition may present as an abnormally high or low body mass, poor growth, failure to thrive, swelling of soft tissue (oedema) and recurrent infections due to a compromised immune system. Inappropriate intake of energy and protein may lead to malnutrition. Furthermore, certain micronutrient deficiencies may lead to unique signs & symptoms, such as Vitamin A deficiency or iron deficiency. Protein energy malnutrition (PEM) This type of malnutrition depends on how long protein and energy has been insufficient for the child. Other factors that impact the severity of PEM include age of the child and other associated vitamin, mineral and trace element deficiencies. It is vital to keep track of a child’s weight for height which can be a useful indicator of protein and energy intake. Vitamin A deficiency Vitamin A is found in milk, egg yolk, fish oils, some vegetables and fruits. The diets of children with Vitamin A deficiency are often deficient in other nutrients. A deficiency in Vitamin A can cause dry eyes, night blindness and an increase in the severity of serious infections. Research has shown that Vitamin A supplementation during complicated measles decreases the duration of complications. If Vitamin A deficiency is suspected, a dose of Vitamin A should be given immediately. Vitamin A should be made easily available for children at local clinics and hospitals. Diets rich in Vitamin A containing foods should be encouraged such as green leafy vegetables, pumpkin, squash and carrots. Vitamin B complex deficiency Vitamin B complex can protect against disease and is essential for metabolic processes. Some signs of Vitamin B complex deficiency include dermatitis, diarrhoea, dementia, mood instability and anaemia. Good food sources of B vitamins include, meat (especially liver), seafood, poultry, eggs, dairy products, legumes, leafy greens and seeds. Vitamin C deficiency Vitamin C facilitates the absorption of iron. Interestingly, cow’s milk is low in Vitamin C and breastmilk is rich in Vitamin C. Other sources of Vitamin C are citrus fruits, broccoli, berries, melons, potatoes, papaya, guava and tomatoes. Vitamin C deficiency results in poor collagen, poor wound healing, bleeding and haemorrhage. Iron deficiency This can occur commonly in especially the first year of life because milk is low in iron. Iron deficiency can lead to a poor immune system causing an increase in infections, gastrointestinal symptoms, impaired effective absorption of food and vitamins, impaired thermoregulation, fatigue, and impaired cognitive function. Zinc deficiency Zinc is a trace element which aids in metabolic processes and immunity. It also helps maintain epithelial integrity and growth. Zinc deficiency is associated with growth faltering, low birth weight babies and skin lesions. Zinc supplementation is widely available for those children who may require it. Prevention of nutritional disorders Good health education as early as during and after pregnancy, at clinics and schools is critical. The use of Road to health booklets, growth and weight charts should be easily accessible in order to prevent malnutrition. “My plate” is one tool accessible on www.myplate.gov. This resource will allow children to explore food ideas and serves as a visual reminder to make healthy food choices. Conclusion My hope is for all children to grow up healthily while cultivating a positive attitude towards food. Food is vital fuel providing energy that can allow our children to thrive if chosen appropriately and in the correct portion sizes. The caregiver is the most important individual in a child’s life. You can make it easier for your kids to choose healthy options by keeping fruits and vegetables on hand and nutrient-dense foods easily available in the home. Sit down as a family and indulge in nutritious, wholesome meals together. A balanced diet is a balanced body. Dr Candice Shah Specialist Paediatrician Netcare- N1 City Hospital, Cape Town

April 3, 2024

A Journey of Hope: Xander Vermeulen’s Remarkable Path with CryoSave

In the intricate tapestry of medical advancements and human resilience, few stories resonated as deeply as that of Xander Vermeulen. Born a decade ago, Xander’s life took an unexpected turn when a severe open fracture left his left arm impaired. Yet, amidst the challenges, a glimmer of hope emerged through CryoSave—a decision made by his parents at his birth that would prove to be transformative. A Decade of Preparation – Xander’s journey with CryoSave began at birth, a decision by his parents to bank his stem cells—an investment in his future health. Little did they know, those tiny cells would one day hold the key to his rehabilitation. November 2020: A Turning Point – Tragedy struck in November 2020 when Xander suffered a severe open fracture on his left arm. The subsequent surgeries and skin grafts failed to restore full functionality, leaving Xander grappling with a disability that profoundly impacted his daily life. CryoSave Steps In – Amidst the uncertainty, CryoSave emerged as a beacon of hope. Through partnerships with surgeons and stem cell experts, CryoSave embarked on a mission to assist Xander in his journey towards rehabilitation. This collaboration marked the beginning of a remarkable chapter in Xander’s life. October 4, 2024: A Collective Effort – A significant update to Xander’s story unfolded as a team of medical professionals stepped forward to offer their expertise and resources pro bono. Dr. Deon Weyers, a specialised Plastic and Reconstructive Surgeon, led the charge in reconstructing Xander’s arm. Supported by Dr. Giancarlo Cavedon, a specialized Anesthetist, Kelly Glazebrook, an Occupational Therapist specialized in hand therapy, Paula MacClarin, along with her team of Physiotherapists, Adrian Singh, an Orthotist, and Cure Day Clinic, this collective effort underscored the power of collaboration in transforming lives. November 30, 2023: A Milestone Achieved – On this day, a significant milestone was reached as the first procedure—the placement of a tissue expander—took place. This pivotal moment symbolized a step forward in Xander’s journey towards arm rehabilitation, with stem cells poised to play a crucial role in his healing process. March 12, 2024: Progress and Optimism – As the expansion neared completion, optimism filled the air. With each passing day, Xander’s unwavering resilience served as a testament to the human spirit. The impending second procedure held the promise of further enhancing Xander’s quality of life, thanks to the dedication of CryoSave and its partners. March 20, 2024: A Moment of Triumph – The second procedure unfolded with precision and skill, as Dr. Deon Weyers conducted flap reconstruction on Xander’s arm. Enriched with Xander’s own stem cells, this innovative approach marked a triumph of science and compassion—a testament to the remarkable strides made in medical technology. As expectant parents prepare to welcome a new life into the world, the option of stem cell banking presents a unique opportunity to safeguard their child’s future health. This procedure, conducted directly after birth, is risk-free and painless for both mother and baby. By banking their child’s stem cells, parents are investing in a potential lifeline—a resource that may hold the key to unforeseen medical challenges down the road. As Xander’s story illustrates, the decision to bank stem cells is not merely a precautionary measure but a tangible expression of hope—a gift that has the power to shape the course of a child’s life for years to come.

April 2, 2024

Probiotics and Travel: Your Gut’s Best Friend On the Go

Travelling is an exciting adventure, but it can sometimes throw your digestive system off balance. Multi-strain probiotics contain a variety of live micoorganisms1a that provide health benefits,1b including enhancing gut health1c while on the move. Benefits of Multi-Strain Probiotics The human digestive system is filled with hundreds of different types of tiny organisms living together in balance with one another.2a Most of these tiny organisms are bacteria.2b The types of bacteria in your gut can be influenced by various factors including what you eat. 2c Probiotic bacteria are like the good guys in this digestive ecosystem. They move in, take up residence, and help things run smoothly. They can help your digestive system work the way it’s supposed to.2d Probiotics can also lend a hand to your immune system,2e helping immune cells do their job better. Managing Irritable Bowel Syndrome Unfamiliar foods, and stress can exacerbate IBS symptoms, which may include abdominal pain and bloating.3a Lactobacillus rhamnosus GG may reduce the frequency and severity of abdominal pain in children,4 while probiotic strains like Bifidobacterium lactis and Lactobacillus casei Shirota may help regulate bowel movements and improve stool consistency.5 How Multi-Strain Probiotics Can Help Alleviate Discomfort During Travel Consider adding a multi-strain probiotic supplement to your travel itinerary, such as ProbiFlora™. ProbiFlora™ which contains multi-strains of well-studied probiotics proven to rebalance the GUT microflora.6 The ProbiFlora™ range includes ProbiFlora™ Adult Intensive Rescue – 9 Strain7, ProbiFlora™ Adult Classic Bowel Support – 4 Strain8, ProbiFlora™ Adult Everyday Flora Balance – 2 Strain9, ProbiFlora™ Rx Intestinal Flora Care10, ProbiFlora™ Junior Everyday Flora Balance11, ProbiFlora™ Probiotic Infant Drops 3 strain-Regular drops12, and ProbiFlora™ Junior Fit For School Chewable Tablets13. ProbiFlora™ – the PROs in probiotic health – to PROtect you and your family with PROven multi-strain benefits. ProbiFloraTM’s range of products are available from leading pharmacies and retailers nationwide. For more information, visit https://probiflora.co.za/ and join the conversations on Instagram and Facebook. 2023102610320533 References: Kwoji ID, Aiyegoro OA, Okpeku M, Adeleke MA. Multi-strain probiotics: Synergy among isolates enhances biological activities. Biology (Basel). 2021 Apr 13;10(4):322. doi: 10.3390/biology10040322. PMID: 33924344; PMCID: PMC8070017. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070017/. Last accessed September 2023. City of Hope. The skinny on probiotics and a healthy digestive system. Available from: https://www.cancercenter.com/community/blog/2020/07/the-skinny-on-probiotics. Last accessed September 2023. Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol. 2014 Jun 14;20(22):6759-73. doi: 10.3748/wjg.v20.i22.6759. PMID: 24944467; PMCID: PMC4051916. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4051916/. Last accessed September 2023. Francavilla, R., et al. (2010). A randomized controlled trial of Lactobacillus GG in children with functional abdominal pain. Pediatrics, 126(6), e. Available from: https://pubmed.ncbi.nlm.nih.gov/21078735/. Last accessed September 2023. Araújo MM, Botelho PB. Probiotics, prebiotics, and synbiotics in chronic constipation: Outstanding aspects to be considered for the current evidence. Front Nutr. 2022 Dec 8;9:935830. doi: 10.3389/fnut.2022.935830. PMID: 36570175; PMCID: PMC9773270. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9773270/. Last accessed September 2023. Adcock Ingram data on file. (strain documents) ProbiFlora™ Adult Intensive Rescue Professional Information, 26 August 2021. ProbiFlora™ Adult Classic Bowel Support Professional Information, 21 June 2022. ProbiFlora™ Adult Everyday Flora Balance Professional Information, 20 October 2020. ProbiFlora™ Rx Intestinal Flora Care Professional Information, 2 December 2021. ProbiFlora™ Junior Everyday Flora Balance Professional Information, 25 August 2021. ProbiFlora™ Probiotic Infant Drops 3 Strain Professional Information, 27 June 2020. ProbiFlora™ Junior Fit for School Professional Information, 29 August 2022.

April 2, 2024

Pregnancy, your body and your baby – week 12 of your pregnancy

This is now the last week of your first trimester, which is week 1 to 12. Your clothes are probably starting to feel a little tighter than they used to, but the good news is that some of the first-trimester pregnancy symptoms, such as morning sickness and fatigue should be easing up soon. During the first trimester, your baby will have grown from an egg to a fully formed baby (with lots of growing to do) and you’ll have had your first check-up and ultrasound. Your body at week 12 At week 12 you’ll probably notice that your morning sickness may start to subside. This is because the hCG hormone is starting to level off. However, not all moms are this lucky, as some experience nausea in their second trimester as well, or even throughout their whole pregnancy. Stomach pain, cramping and constipation are also pregnancy symptoms you may be experiencing. Not all women experience constipation, however, it is fairly common thanks to pregnancy hormones. If you experience sharp or severe pain, it’s important to seek medical help as quickly as possible. Things to keep in mind Throughout your pregnancy both your mental and physical wellbeing is important. Many articles on pregnancy neglect to explain the mental challenges that expecting moms can struggle with during this time. Pregnancy hormones, the added stresses of a new life growing inside you and previous or current depression and/or anxiety can mean that you may also struggle with antenatal depression and anxiety. Tell-tale signs of antenatal depression are feeling sad or anxious all the time, and lack of interest in things that used to. If you do feel that you’re struggling it’s important that you reach out to a health care provider and rely on family and friends for support. Joining a support group of moms, or moms-to-be in a similar position can also help you feel more at ease. Where is your baby at in week 12 Your growing baby is now roughly the size of a lime or a plum. At this point all your baby’s important features, body parts and organs are in place, they just have lots of growing and maturing to do. Your baby’s tiny developing bone marrow is starting to make white blood cells and their muscles and nervous system are maturing.

April 1, 2024

How to care for children during divorce

Parents going through a divorce/separation are mostly always concerned about what it is going to do to the children and how to minimise the impact it will have on them. If you want to minimise the negative impact of your relationship breakup on your children, you must first take care of yourself. When going onto a plane, we are always given some safety instructions at first and one of them, in case of cabin de-pressurisation, is to first put on the oxygen mask yourself and then help the person next to you, because in all logic, if you are wanting to help someone else but you are not getting the oxygen yourself, you will struggle and possibly not even be able to help the person next to you. You will end up being the one needing help. Same goes with a relationship breakup. Such an event brings a lot of emotions. Emotions which you may not have been prepared to deal with. Without taking care of yourself first, you will not be a prepared parent to assist your children. Many parents send their children to therapists at this time of high stress, and it is an avenue that is wise to take when you recognise some symptoms which you don’t know how to handle, but truth is, your children need their parents first and foremost at this critical point in their life. Not a stranger. So in order to properly be there for your children and take care of them during and after the divorce/separation, first you must take care of yourself. Here are some recommended steps, specifics for parents going through a divorce. Divorce & Co-Parenting Coaching Divorce & Co-Parenting Coaching is highly recommended for parents concerned about their children’s well-being at this challenging time in their lives. It will allow you to make sense and process your emotions and receive help to help your children. Divorce Mediation Once you have your “oxygen mask” on, i.e, you are working through your own emotions, engaging into Mediation is the best way forward in finalising the details of your ending relationship while keeping an amicable environment for your children. If you think going to court and fighting a legal dispute is scary, imagine how your children must feel! Parenting Plan Equip yourselves with a good parenting plan. There is only so much that one can think of and manage by themselves. A Parenting Plan will assist you to have an overview of what your children need and how it can fit with your needs, now that you have two households to consider.

March 29, 2024

Protecting Your Young Children’s Teeth

It is possible for children to reach adulthood without ever experiencing tooth decay. But to ensure this, good oral health should begin in infancy. Parents must provide this care in their child’s early years. Later, parents will need to instruct, monitor and motivate the children to maintain good oral health habits. Children learn healthy practices from their parents, so parents must be good role models. Attitudes and habits established at an early age are very important for good oral health throughout one’s life. A child’s dental care actually begins before birth. A pregnant woman’s diet provides the nutrients required for good development of the unborn child’s teeth. After the baby is born, good oral health of the newborn can be achieved by gently wiping their mouths and gums after every feeding, putting only water in their bedtime bottles, and massaging the gums to comfort the child when teething. When a child is frequently given a bottle contains liquids with sugar as a pacifier or sleep times, a baby bottle tooth decay can result. This serious condition can destroy the infant’s teeth. If you must give your baby a bottle bedtime, be sure it contains only water. Brushing should begin as soon as the first tooth erupts. Parents should brush and floss a child’s teeth daily until the child can be taught to do this alone. Then a child’s brushing and flossing should be supervised and encourage by parents. Fluoride is one of the most effective ways of preventing tooth decay in children. Fluoride protection can be obtained from the fluoridated drinking water supply, fluoride tablets or drops, fluoride toothpaste and topical fluoride treatments given at our office. Your child’s particular fluoride needs can be discussed with us. Your child’s first dental visit should occur by the first birthday. Then visit should occur regularly was recommended by the dentist. Sealants can provide excellent protection against tooth decay. These are clearer shaded liquid plastics that are painted onto chewing surfaces of the children’s permanent back teeth. When combined with brushing with fluoride toothpaste and flossing, sealants offer major protection against tooth decay. As a child grows, you should continually encourage preventive dental care routines, such as brushing and flossing, eating a balanced diet and having regular dental checkups. Your child may be fortunate enough to say, “Cavities? Never had them,never will!”

March 27, 2024

Stem cell banking gives hope

In the heartening narrative penned by Taryn Vollmer, we are granted a profound insight into the transformative power of stem cell preservation and the invaluable role played by CryoSave. Taryn’s journey, marred by personal loss and health challenges, underscores the significance of stem cell harvesting as a beacon of hope in the face of adversity. Through her poignant account, we are reminded of the critical importance of informed choices and proactive measures in safeguarding the health and well-being of our loved ones. Taryn’s story resonates as a testament to the unwavering commitment of CryoSave to deliver exemplary service and support, transcending boundaries to provide reassurance and solace to families worldwide. Tarryn writes to the CryoSave Family: “I am writing to thank you yet again for your fabulous service. This has been the second time we have stored our stem cells with you and you have made the experience a memorable one. I have always felt passionate about my children saving their stem cells. I had a boyfriend when I was younger and he was diagnosed with Leukaemia at the age of 26. His only chance of survival was a bone marrow transplant. He was half Italian and half Scottish so finding a bone marrow match was always going to be a challenge. We managed to find a match in Germany however it wasn’t a 100% match. This created all sorts of complications and unfortunately, he died shortly after the transplant. This was the first time I learned about stem cells and the benefit of harvesting them. I always wonder if he would be alive today if he had harvested his own at birth. A thought that could have so easily have been answered if only our parents were more informed regarding stem cells and harvesting. So naturally, when I fell pregnant with my first child, CryoSave was a no-brainer and the process to harvest and store the stem cells was a breeze. To cut a long story short, we were recently blessed to have another child via a surrogate. I was diagnosed with breast cancer 5 years ago and to save my life and avoid metastatic breast cancer, the only option that I had was to get rid of the hormone that spreads my cancer namely estrogen. This resulted in a full hysterectomy at the age of 36. I had been blessed to have done a fertility cycle before the operation and had two embryos available for surrogacy. Only two chances of which the first was successful in March this year. I was unsure if we could do stem cell harvesting using a surrogate. Everything surrogate-related is very complicated in South Africa so I expected the same with CryoSave. To say I was pleasantly surprised is an understatement. The cryo-save people knew exactly what I was talking about and directed myself and my surrogate through the process. It was simple and easy and harvesting was a dream. Once again thank you for your excellent service. I now see stem cell harvesting differently. It is kind of like an insurance policy except it is one that money can’t buy when you need it. When people die, the loved ones always ask “If only they left a life insurance policy, things would be so different”. Well, in some of these cases, if stem cells were harvested, maybe these people wouldn’t have even died. Medical technology and research are continually changing and I do not doubt that the use of stem cells will exponentially increase over time. It is an exciting time for a company like CryoSave.” Taryn Vollmer’s heartfelt narrative resonates with a broad audience, illuminating the transformative potential of stem cell preservation and the unwavering support offered by CryoSave. As we reflect on Taryn’s journey—one marked by resilience, hope, and unwavering determination—we are called to action. Let us seize the opportunity to embrace the promise of tomorrow by exploring the possibilities afforded by stem cell preservation. Together, let us embark on a journey of empowerment and enlightenment, fuelled by the belief that through proactive measures and informed choices, we can safeguard the health and well-being of generations to come. Join us in championing the cause of stem cell preservation, for in doing so, we pave the way for a future defined by healing, hope, and boundless possibilities.

March 26, 2024

Pregnancy, your body and your baby – week 11 of your pregnancy

You are now almost at the end of trimester one, which is good news as the second trimester is often seen as easier than the first. Both you and your baby will have undergone many changes during these first 11 weeks, and you’ll have gone from a hoping-to-be-mom to an expecting one. Pregnancy has its ups and downs, so it’s important that you look after yourself (and by default your growing baby) at this time. How you’ll be feeling at week 11 At week 11 your baby bump may be beginning to show, but don’t worry if your baby bump isn’t showing yet, as this varies from pregnancy to pregnancy. It’s likely that if this is your first pregnancy and you don’t have multi babies inside you, you won’t start showing as quickly. If your morning sickness if beginning to ease you may notice that you’re feeling hungrier than normal. If this is the case, make sure that you fuel up on healthy snacks that are nutritious to both you and your growing baby. You may find that your cravings are completely different from what you’d normally eat, and your old favourite food is one you that makes you feel queasy. Hormones, senses that are heightened and a need for comfort food are all reasons behind these strange (but normal) pregnancy cravings and aversions. Your baby at week 11 Your baby is now the size of a lime or a fig, and their body is slowly starting to straighten out. At this point, your baby’s hands and feet, as well as their ears, nose and mouth are becoming more developed. Hair follicles are beginning to form, as well as nail beds and their reproductive organs are developing, however, you won’t be able to tell gender via ultrasound just yet.

March 22, 2024

Dealing with Colds and Flu in the Warmer Months

We typically associate colds and flu with chilly weather, envisioning long winter nights snuggled up with a warm blanket and a hot cup of tea, nursing a runny nose or a scratchy throat. However, contrary to popular belief, these illnesses can strike at any time of the year, including the warmer months.1 Cepacol®, the brand known for its sore throat lozenges and hot medication, offers guidance on how to deal with colds and flu in the summer and spring months, ensuring you can continue to enjoy the sunshine even if you are under the weather. Why Colds and Flu Can Still Occur in Warmer Weather While it’s true that the viruses that cause colds and flu thrive in dry, cold conditions,2 scratchy throats, stuffy noses, and fevers can strike at any time of the year,1 even on a beautiful, sunny day. The Importance of Prevention The first step in dealing with colds and flu in warmer months is prevention. Regular hand washing is one of the most effective measures to prevent the spread of germs.3 In the summer months, when people are often on the move, carrying hand sanitiser can be a good substitute when soap and water are not readily available. Maintaining a healthy lifestyle is another key to preventing illness.4a This includes eating a balanced diet high in fruit and vegetables4b, exercising regularly4c, getting adequate sleep4d, taking steps to prevent infections (such as regular hand washing4e and vaccines4f), and minimising stress 4g. How to Treat Colds and Flu If you do catch a cold or the flu during the warmer months, treatment will be similar to what you would do during the winter. Rest5a and hydration5b are crucial, with the latter even more critical in warmer weather when your body may be losing more fluids through sweating. Over-the-counter medications can help alleviate symptoms such as congestion, sore throat, and fever.5c While your instinct may be to stay indoors, if your symptoms are mild and you’re feeling up to it, try to spend some time outside. Fresh air and sunshine can boost your mood and speed up your recovery. Vitamin D, obtained from sunlight, plays an essential role in immune function.6 How the Cepacol® Cough & Cold Range Can Provide Relief With various formulations available, such as lozenges, throat spray, medicated drinks, and syrup, Cepacol® makes it convenient for consumers to find the perfect solution for their needs. The Cepacol® Cough & Cold range includes a variety of products packed with multiple benefits: Cepacol® Cough & Cold Syrup7: Offers targeted relief for a persistent cough, congestion, and sore throat. Formulated with ivy leaf and pelargonium, it provides cough relief while combating cold and flu symptoms with their antibacterial and antiviral properties. The non-drowsy formulation is alcohol-free, making it safe to be taken from the age of six. Cepacol® Plus Cough & Cold Syrup8: Specifically designed for night-time relief, this syrup addresses two troublesome symptoms: coughing and nasal congestion. It combines ivy leaf, pelargonium, and valerian extract, offering night-time cough relief. Cepacol® Throat Spray9: This throat spray combines ivy leaf, pelargonium, and menthol. It quickly numbs the throat, providing temporary pain and discomfort relief. Cepacol® understands the daily needs of individuals experiencing cold or flu symptoms, which is why they have developed these comprehensive solutions. With their range of products, there’s a Cepacol® option for everyone. So, if you’re dealing with colds and flu in the warmer months, rest assured that Cepacol® has you covered! Cepacol®‘s range of products is available at leading pharmacies and retailers nationwide. For more information, visit www.cepacol.co.za and join the conversation on Facebook. 2023082410307736 References: Murphy R [Verywell Health]. Are Summer Colds Caused by Different Germs Than Winter Colds? Available from : https://www.verywellhealth.com/summer-cold-winter-cold-7556002. Last accessed August 2023. Horizon Health News. Why do viruses spread more in winter? Cold temps are key. Available from : https://www.horizonhealthnews.com/why-do-viruses-spread-more-in-winter-cold-temps-are-key/. Last accessed August 2023. Centers for Disease Control and Prevention. Show Me the Science – Why Wash Your Hands? Available from : https://www.cdc.gov/handwashing/why-handwashing.html. Last accessed August 2023. Harvard Health Publishing. How to boost your immune system. Available from : https://www.health.harvard.edu/staying-healthy/how-to-boost-your-immune-system. Last accessed August 2023. Hopkins Medicine. The Do’s and Don’ts of Easing Cold Symptoms. Available from : https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-dos-and-donts-of-easing-cold-symptoms. Last accessed August 2023. Aranow C. [National Institutes of Health]. Vitamin D and the immune system. Available from : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166406/. Last accessed August 2023. CEPACOL® Cough and colds syrups approved professional information, February 2022 CEPACOL® Plus cough and cold syrup approved professional information, February 2022 CEPACOL® Throat Spray approved professional information, February 2022

March 20, 2024

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

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

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

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

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