Pregnancy, your body and your baby – week 15 of your pregnancy

Congratulations, you and your baby are now at week 15, while your baby still has lots of growing to do, you should make sure that you make the most out of feeling more energetic during trimester two. Join prenatal classes, enjoy walks outside and start planning how you’ll rearrange your house for the arrival of your new bundle of joy. Your baby at week 15  Your little one is now roughly the size of an apple or pear, and at this point your baby’s ears and eyes are starting to become more developed, and are moving into the correct place on their head. Soon they may even be able to hear the sound of your voice. During this time their bones and muscles are also getting stronger, not only this but her limbs are getting longer and are able to move. You won’t be able to feel any movement just yet, but it won’t be long! Your body at week 15 At week 15, your increased energy levels may also mean that you may experience increased libido. Although you may have higher energy levels, you’ll probably also notice that your expanding belly is itchy, thanks to stretching skin. If you are feeling increasingly hungry, thanks to a reduction in morning sickness, be aware of what you’re putting into your body. Certain foods, such as ripened cheese, can be damaging to your baby. However, the inclusion of healthy snacks can be beneficial to both of you, and by doing research or chatting to a dietician, you can make sure that you include food groups that’ll be nutritious to you and your baby. Things to keep in mind at week 15 Another pregnancy symptom is sensitive gums and teeth. The reason for this is hormonal changes which increase the blood flow to your gums, making them swell. Not only this but you may be more susceptible to gum disease and pregnancy gingivitis (which about half of all women experience during pregnancy). Because of this it’s important that you look after your teeth and gums, and check in the dentist during your pregnancy.

April 22, 2024

How cord blood stem cells save lives

Throughout the world the most widely used stem cell treatment is hematopoietic (or blood) stem cell transplantation, for example, bone marrow transplantation. However, in recent years, cord blood stem cell transplants have shown superior results in comparison to bone marrow, in terms of risks of rejection, contamination, and infection. They also surpass bone marrow in their capability to restore cells damaged or deceased from chemotherapy or radiation treatments. Cord blood has a lower risk of graft-vs-host disease (GVHD). Approximately 1.24 million blood cancer cases occur yearly worldwide, accounting for roughly 6% of all cancer cases. Worldwide, almost every 4 minutes someone is diagnosed with a blood cancer and every 9 minutes, someone dies from a blood cancer. It is estimated that every year, about 18,000 people, aged between 0 – 74 years of age, might benefit from a potentially life-saving bone marrow or umbilical cord blood transplant. Worldwide there are currently about 50,000 stem cell transplants done yearly, with growth at a rate of 10-15% per year. In the past 4 decades the recognition of stem cell treatments has drastically increased, mostly due to its high efficacy and recorded success rates of up to 80%. It is estimated that 1 in 3 people might one day benefit from regenerative cell therapy. Cord blood stem cells save lives. There are currently over 80 diseases approved for routine treatment with cord blood stem cells. In transplants cord blood stem cells helps rebuild a healthy blood and immune system that has been damaged by disease. There are some of the more than 80 diseases where a child could use his or her own cord blood. However, many of the diseases on the proven treatment list are inherited genetic diseases. Usually, a child with a genetic disease who is in need of a transplant would require a cord blood unit from a sibling or an unrelated donor. In this instance when a family has banked cord blood stem cells the matched sibling’s stem cells will be immediately available. Research indicates that transplants using cord blood from a family member are about twice as effective as transplants using cord blood from a non-relative. Cord blood and cord tissue stem cells are being studied in regenerative medicine clinical trials for conditions that have no remedy. Families that invest in cord blood, cord tissue, and placental tissue banking are not just investing in the medicine of today—they have realised the potential of stem cell and regenerative medicine in the future. The healing potential of hematopoietic stem cells (HSCs) as found in cord blood is a long way from being exhausted. There are promising trials underway (over 1300 stem cell trials currently) with these cells that have the ability to continue the innovation in treatment that started with the first successful stem cell transplants many years ago. These include stem cell treatments for some bone, skin and corneal (eye) injuries. These diseases can be treated by grafting or implanting tissues, and the therapy relies on stem cells within this implanted tissue. Some of these procedures are widely accepted as safe and effective by the medical community and are routinely used for treatment. However, various other diseases and applications of stem cells are yet to be proven in clinical trials and should be considered highly experimental. These unapproved treatments would benefit people that have autism, cerebral palsy, spinal cord injuries, type 1 diabetes, Parkinson’s disease, amyotrophic lateral sclerosis, Alzheimer’s disease, heart disease, stroke, burns, autoimmune diseases, cancer and osteoarthritis. Parents endeavour to keep their children and family safe, especially when dreaded disease or an unforeseen medical condition occurs in a family. They want to be assured that there are accessible, effective treatments immediately available to the family. Banking your baby’s cord blood offers you with life-giving stem cells and gives reassurance knowing that you can access your baby’s preserved stem cells at any time. Cord blood transplants have been proven effective in treating these conditions: Blood Disorders Acute Myelofibrosis Agnogenic Myeloid Metaplasia (Myelofibrosis) Amyloidosis Aplastic Anemia (Severe) Beta Thalassemia Major Blackfan-Diamond Anemia Congenital Amegakaryocytic Thrombocytopenia (CAT) Congenital Cytopenia Congenital Dyserythropoietic Anemia Dyskeratosis Congenita Essential Thrombocythemia Fanconi Anemia Glanzmann’s Thrombasthenia Myelodysplastic Syndrome Paroxysmal Nocturnal Hemoglobinuria (PNH) Polycythemia Vera Pure Red Cell Aplasia Refractory Anemia with Excess Blasts (RAEB) Refractory Anemia with Excess Blasts in Transition (RAEB-T) Refractory Anemia with Ringed Sideroblasts (RARS) Shwachman-Diamond Syndrome Sickle Cell Disease Cancers Acute Biphenotypic Leukemia Acute Lymphocytic Leukemia (ALL) Acute Myelogenous Leukemia (AML) Acute Undifferentiated Leukemia Adult T Cell Leukemia/Lymphoma Chronic Active Epstein Barr Chronic Lymphocytic Leukemia (CLL) Chronic Myelogenous Leukemia (CML) Chronic Myelomonocytic Leukemia (CMML) Ewing Sarcoma Hodgkin’s Lymphoma Juvenile Chronic Myelogenous Leukemia (JCML) Juvenile Myelomonocytic Leukemia (JMML) Myeloid/Natural Killer (NK) Cell PrecursorAcute Leukemia Non-Hodgkin’s Lymphoma Prolymphocytic Leukemia Plasma Cell Leukemia Leukocyte Adhesion Deficiency Multiple Myeloma Neuroblastoma Rhabdomyosarcoma Thymoma (Thymic Carcinoma) Waldenstrom’s Macroglobulinemia Wilms Tumor Immune Disorders Adenosine Deaminase Deficiency (SCID) Bare Lymphocyte Syndrome (SCID) Chediak-Higashi Syndrome (SCID) Chronic Granulomatous Disease Congenital Neutropenia DiGeorge Syndrome Evans Syndrome Fucosidosis Hemophagocytic Lymphohistiocytosis (HLH) Hemophagocytosis Langerhans’ Cell Histiocytosis (Histiocytosis X) IKK Gamma Deficiency (NEMO Deficiency) Immune Dysregulation, Polyendocrinopathy, Enteropathy, X-linked (IPEX) Syndrome Kostmann Syndrome (SCID) Myelokathexis Omenn Syndrome (SCID) Phosphorylase Deficiency (SCID) Purine Nucleoside (SCID) Reticular Dysgenesis (SCID) Severe Combined Immunodeficiency Diseases (SCID) Thymic Dysplasia Wiskott-Aldrich Syndrome X-linked Agammaglobulinemia X-Linked Hyper IgM Syndrome X-Linked Lymphoproliferative Disorder Metabolic Disorders Congenital Erythropoietic Porphyria (Gunther Disease) Gaucher Disease Hunter Syndrome (MPS-II) Hurler Syndrome (MPS-IH) Krabbe Disease Lesch-Nyhan Syndrome Mannosidosis Maroteaux-Lamy Syndrome (MPS-VI) Metachromatic Leukodystrophy Mucolipidosis II (I-cell Disease) Neuronal Ceroid Lipofuscinosis (Batten Disease) Niemann-Pick Disease Sandhoff Disease Sanfilippo Syndrome (MPS-III) Scheie Syndrome (MPS-IS) Sly Syndrome (MPS-VII) Tay Sachs Wolman Disease X-Linked Adrenoleukodystrophy Further reading: https://www.lls.org/facts-and-statistics https://priorityyoumd.com/what-is-the-success-rate-of-stem-cell-therapy/

April 16, 2024

Pregnancy, your body and your baby – week 14 of your pregnancy

Week 14 of your pregnancy and you’re in month four of your pregnancy with five to go – almost half way already. Trimester two of pregnancy means you should be feeling renewed levels of energy and you may even notice that your appetite has increased thanks to morning sickness slowly easing up. Your baby in week 14 Your baby is now the size of a peach, and now often moves her arms and legs – but you won’t be able to feel this yet. If you could see into your belly, you may even notice your little one sucking their thumb! Around this time the grasp reflex is evolving, and hair growth is starting as follicle under the skin, so that when they’re born your baby should have silky strands of hair. Your little one’s genitals are now also fully developed, but it’ll still be difficult to tell their gender on ultrasound. Your body in week 14 Luckily during your second trimester you’ll be feeling more yourself, with rising energy levels, breasts that are less tender and dissipating nausea. You’ll also probably starting to show a bit as well, however, some moms, especially those expecting multiples, may start showing sooner. This is because your uterus is rising out of the pelvic region and into your lower abdomen. During the second trimester you’ll also notice that you’ll start to put on weight, don’t be alarmed by this as it’s completely normal and healthy during a pregnancy. Things to take note of  If you found that during your first trimester your pregnancy symptoms meant that you generally stayed away from exercise, embrace your renewed energy levels and start doing gentle exercises such as water aerobics, prenatal exercise classes and gentle walks. This’ll be beneficial to both you and your growing little one.

April 15, 2024

Fetal MRI: Insights from a specialist

When an unborn baby has an abnormality, decisions about the delivery and neonatal care can often be planned in advance – with the help of an MRI. However, MRI image acquisition can be tricky and quality reporting is an acquired skill. Dr Lauren Raubenheimer is an expert in the field, having honed her skills in London under word-renowned fetal and neonatal imaging specialist, Prof. Mary Rutherford.  She recently joined SCP Radiology as a consulting radiologist and provides insights into fetal MRI and what it can mean to expecting couples and their healthcare providers. ‘When a couple discovers the baby that they carry has an abnormality, the impact is enormous and can be life changing. As a mother, I have a huge emotional investment in my work. I hope that my findings give parents more answers as they navigate a difficult path.’ She says that, in many cases, the timing and route of delivery, as well as the neonatal care that will be required, can be planned in advance with help from an MRI. ‘Nothing is better than confirming a minor abnormality, with a good prognosis and giving parents some reassurance.’ Here she talks about the how, why and when a fetal MRI is indicated and the safety factors taken into consideration when doing so. When would fetal MRI be recommended? Patients are typically referred from Fetal Medicine Specialists after an abnormality has been detected on a screening ultrasound. An MRI can be done to confirm the abnormality, as well as to assess for abnormalities that are not readily visible through standard imaging techniques. This can significantly affect the prognosis. A fetal MRI can be performed either in the second or third trimester. ‘My special interest is in developmental fetal brain abnormalities but I also perform MRIs for body abnormalities, including congenital diaphragmatic hernia, congenital lung lesions, spina bifida, kidney anomalies and fetal tumours.’ Why not ultrasound? MRI can be superior to an ultrasound in certain instances. Such as assessing the folding of the brain and assessing parts of the brain obscured by the skull, when amniotic fluid is low (amniotic fluid is a clear to slightly yellow liquid that cushions a fetus within the amniotic sac) and when mothers have a high body mass index (BMI). How are quality images obtained? Fetal movement has previously been an obstacle in getting good quality MR images in the past. ‘But with today’s magnets and the use of faster imaging sequences, we can obtain excellent image quality, she explains. That said, a very busy baby calls for considerable skill and patience from the radiographer and, at SCP Radiology, fetal MRI scans are done exclusively by the lead MRI radiographer, Andrea Nagel. Safety comes first Safety is of utmost importance.  Present data shows ‘no conclusively documented harmful effects of MRI imaging on the developing fetus, providing it is at the safe and optimal level (1.5 T”)’. For the peace of mind of expectant parents, Dr Raubenheimer adds that MRI does not use ionising radiation and intravenous contrast is not administered in fetal MRI. ‘By working within strict parameters, potential harm to the fetus is prevented’. About referral and funding Fetal MRI is covered by medical aids but, as is the case with all other MRI scans, preauthorisation is required.. It is preferable that patients are referred from a Fetal Medicine Specialist after a detailed ultrasound. ‘Having access to ultrasound reports and knowing the exact gestation is crucial to an accurate MRI report’, Dr Raubenheimer emphasises. In general, she is in close communication with her colleagues in fetal medicine when it comes to individual patients. Parents who want to read more about the safety of and preparation for fetal MRI, can download SCP’s information sheet from the website: www.scp.co.za About Dr Lauren Raubenheimer Dr Raubenheimer obtained her MBChB with first class honours from the University of Cape Town and her radiology qualification with distinction from the same institution. After graduating, she worked in both the public and private sectors in South Africa and developed a special interest in fetal imaging and neuroradiology. She enrolled for the European Diploma in Neuroradiology (EDiNR) and, in 2019, did an observership in fetal and neonatal brain MRI at the St Thomas’ Hospital Centre for the Developing Brain in London, under the guidance of Prof. Rutherford. Since then, she has reported fetal MRIs for Groote Schuur Hospital, as a volunteer medical specialist from 2019 to 2023 as well as private-sector fetal MRIs, first in Stellenbosch and more recently at Mediclinic Cape Gate in partnership with SCP. Aside from her fetal imaging work, she also currently does contract reporting for an international radiology provider.

April 12, 2024

Sleepless Nights: Understanding and Addressing Pain and Fever in Children

There’s no “right” moment for pain and fever to strike. Yet, when they jolt your child awake in the wee hours, the challenge often feels magnified. Understanding the symptoms of pain and fever and knowing how to address them can make the experience less daunting for everyone involved. Why Do Children Experience Fever? Fever in children is defined as a temperature of 37.8°C or higher.1a It’s essential to understand that a fever is not an illness. Instead, it’s like the body’s alarm system, indicating that it’s actively confronting an illness or infection.1b  This natural response serves a crucial purpose; it kickstarts the immune system, mobilising it to fend off invaders. In essence, when the body’s temperature rises, it’s creating an environment that’s less hospitable to germs.1c However, as beneficial as this might be internally, it’s not always a comfortable experience for our young ones. The elevated temperatures can lead to feelings of unease, discomfort, and restlessness, which can be concerning for parents and caregivers.1d Why Do Children Experience Pain? Pain in children can stem from multiple causes. Some of the straightforward causes include the usual bumps and scrapes that come with active play2a or the common headaches that might stem from a long day2b. There are also those tummy troubles which can range from a simple upset stomach to more severe aches2c. Various infectious illnesses can also be culprits, such as ear infections, strep throat, pesky stomach bugs, skin infections, and even pneumonia2d. Don’t forget the short-lived but often sharp pain that accompanies immunisations2e, and for our littlest ones, the discomfort of teething 2f.  How Pain and Fever Can Impact Your Child’s Sleep We all know that a child’s sleep is crucial for their physical growth, mental development, and overall well-being.3 However, when they’re unwell, their sleep can get disrupted. The goal is about reducing your kiddo’s distress and increasing their comfort so they can get a better night’s sleep. How to Help Your Child If pain or fever is bothering your child, it’s crucial to address it promptly and appropriately. Here are a few ways to provide relief: Fluids: Keep the juice and water coming! A fever can lead to dehydration, so make sure they’re drinking often and staying hydrated.4a Bathing: A tepid bath can do wonders to cool a feverish child down. Just remember, cold water or rubbing alcohol are no-nos. They can be harmful!4b Dress Code: Think summer vibes. Toss out the heavy PJs and let them wear something breezy and light.4c Snuggle Essentials: If they’re feeling a bit chilly, drape them with a light sheet. It’s all about keeping them cozy!4d The Power of Panado®: Always choose a pain and fever medication that is suitable for your child’s age and weight and measure the dose accurately: Always check the label or call your paediatrician for the correct dosage for your child.4e  Dosage details for the Panado®  range of products can be found at   https://panado.co.za/dosage-calculator/ and are calculated according to your child’s age and weight. A fever should naturally break on its own in one to three days, but you will want to seek out your paediatrician if your child’s fever persists.4f Turn to the Power of Panado® Paediatric Range of Products Panado®  contains paracetamol, which boasts over 150 years of clinical experience.5  It’s fast-acting6 and gentle on sensitive tummies.7 Panado®  paediatric range of products includes Panado®  Paediatric Syrup, Strawberry,8 Panado®  Paediatric Syrup, Peppermint Alcohol and Sugar-Free,9 Panado® Paediatric Syrup, Peppermint 5 ml Sachets10, Panado®  Infant Drops11 and recently launched Panado® Grape flavour which colourant-free, tartrazine-free, alcohol-free, and sugar-free.13 Parents trust12 Panado®  for the power to fight their little one’s pain and provide fast6 relief when needed most.  Panado® products are available at Baby City, Pick n Pay, Checkers, including Hypers, Shoprite, Clicks, Dis-Chem, and Independent Pharmacies. For more information, visit visit https://panado.co.za/ and join the conversations on Facebook.   2023083110309095   References:   University of Rochester Medical Center. Fever in children. Available from:  https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P02512. Last accessed August 2023. UPMC Health Beat. Types of pain in children and how to treat it. Available from: https://share.upmc.com/2017/02/pain-in-children/. Last accessed August 2023. Johns Hopkins All Children’s Hospital. The importance of sleep for kids. Available from: https://www.hopkinsallchildrens.org/ACH-News/General-News/The-importance-of-sleep-for-kids. Last accessed August 2023. Children’s Health. What to do when your child has a fever. Available from: https://www.childrens.com/health-wellness/what-to-do-when-your-child-has-a-fever. Last accessed August 2023. 150 years of paracetamol. GP Pharma Update Mar/Apr 2019 Moller PL, Sindet-Pedersen S, Petersen CT, et al. Onset of acetaminophen analgesia: Comparison of oral and intravenous routes after third molar surgery. Br J Anaesth 2005;94(5):642-8. doi:10.1093/bja/aei109. Available from: https://pubmed.ncbi.nlm.nih.gov/15790675/. Last accessed August 2023. Goodman & Gilman’s.The pharmacological basis of therapeutics, 13th ed. Acetaminophen. p696 Panado® Paediatric Strawberry Syrup approved package insert, March 2002. Panado® Paediatric Syrup Alcohol and Sugar-Free professional information, May 2022. Panado® Paediatric Syrup professional information, May 2022. Panado® Infant Drops (Drops) approved professional information, August 1990. Circana, MT,  October 2023 MAT. Panado ® Paediatric Alcohol Free – Grape Flavour. Approved package insert. October 2022.

April 11, 2024

Cord Blood- and Tissue-Derived Stem Cells: Can Autism be treated?

Autism Spectrum Disorder (ASD) is a complex neurological condition that usually develops in childhood. ASD is a neurodevelopmental disorder characterized by difficulties with social interactions and communication and the presence of repetitive and restricted behaviours.  As awareness about the condition has grown, so has the recognition that autism isn’t an intellectual disability and can occur in people with average and above-average IQs. Autism diagnosis rates have tripled in less than two decades. Approximately 1 in 44 children are identified as having ASD. Boys are four times more likely than girls to be diagnosed with autism. Autism affects all ethnic and socio-economic groups. Most ASD cases are idiopathic (a disease or condition which arises spontaneously or for which the cause is unknown). Approximately 15% to 20% of ASD cases are caused by specific genetic mutations. Some of the genes involved in ASD include ADNP, ARID1B, ASH1L, CHD2, CHD8, DYRK1A, POGZ, SHANK3, and SYNGAP1. In most individuals with ASD caused by rare gene mutations, the mutations occur in only a single gene. Both, 16p11. 2 deletion and duplication have been associated with the risk for autism spectrum disorder (ASD). Other deletions that are associated with ASD are 3q29 deletion and 1q21.1 deletion. There is no cure for Autism, however, various treatments and therapies assist with the day-to-day lives of people with ASD. Currently, several clinical trials are investigating the use of stem cells derived from cord blood and/or cord tissue. These trials are designed to ease or decrease the symptoms of ASD and are not cures. In future, there remains a strong need to generate supporting scientific data on stem cell therapy for use in ASD. The studies that have been conducted thus far, showing proof of clinical improvement, have not been standardised, there is therefore a need to collect further data. Various stem cell types have been used, and different routes of administration (intravenous/intrathecal), dosage levels, and duration of treatment were used. Additionally, the time to follow-up needs to be more standardised, and only then will it allow for the accurate assessment of long-term outcomes and comparisons of different choices and procedures of transplantations with respect to ASD treatment. Clinical studies have been undertaken using different sources of stem cells, i.e. bone-marrow, umbilical cord blood-derived stem cells, and cord tissue-derived stem cells. These studies focused on alleviating ASD symptoms by modulating inflammatory processes in the brain. In most of these studies, significant improvements were reported in the first few month’s post-infusion. These were also sustained and measurable after 12 months.  Children with higher baseline nonverbal intelligence percentages showed greater improvement. The clinical studies mentioned above reported no severe adverse events after cell transplantation and encountered only minor adverse events, such as nausea, vomiting, and pain at the site of injection. These preliminary clinical trials provide us with an encouraging opportunity for the application of stem cell therapy in the treatment of ASD. However, only with additional neuro-rehabilitation such as behavioural and speech therapy, sensory integration, or psychological intervention, etc., which will support the efficacy of stem cell therapy, will the full potential of this type of treatment of ASD be realised. Breaking news (2022): Rutgers scientists studied neural precursor cells (NPCs) – of patients with ASD. They discovered the NPCs – that create the three main kinds of brain cells: neurons, oligodendrocytes, and astrocytes – either overproduced or underproduced the number of permanent brain cells. These NPCs are formed prenatally during a period that stretches from the end of the first trimester through the second, about weeks eight to 24 of the 40-week gestation period of a human fetus. The scientists say this data might in the future assist in identifying a  “biomarker, which could signal when to introduce therapy or to identify signalling pathways for drug targeting in future.” References Lord C, Risi S, DiLavore PS, Shulman C, Thurm A, Pickles A. Autism from 2 to 9 years of age. Arch Gen Psychiatry. 2006 Jun;63(6):694-701. Hyman, S.L., Levy, S.E., Myers, S.M., & AAP Council on Children with Disabilities, Section on developmental and behavioural paediatrics. (2020). Identification, evaluation, and management of children with autism spectrum disorder. Paediatrics, 145(1), e20193447. https://www.rutgers.edu/news/stem-cells-either-overproduce-or-underproduce-brain-cells-autistic-patients

April 9, 2024

Pregnancy, your body and your baby – week 13 of your pregnancy

At week 13 of your pregnancy you are now in your second trimester. This trimester is often nicknamed the honeymoon period, as your pregnancy symptoms should have started easing up, and your baby is still small enough that you don’t feel uncomfortable. Your body at week 13 At week 13 your energy levels should start increasing, but if your nausea and fatigue don’t disappear just yet – don’t despair, some moms experience these for longer than others. This increase in energy won’t stick around forever, so make the most of this time while you can and tick important to-dos off your list. Your blood flow will also increase during this time, and because of this you may see blue streaks under your skin from your veins and experience an increase in libido. Your baby at week 13  Your baby is now the size of a lemon and her body proportion is slowly starting to change, although the head is still the biggest part of the body. Your baby is growing rapidly,  and during this time, her intestines are moving from the umbilical cord into the stomach. Her eyelids are shut to protect the eyes as they develop and her vocal cords are also developing, so that when your baby is born she’ll be able to cry and laugh and eventually say her first word. Things to remember in this week  Around this time is when some people choose to tell family, friends and employers that they’re expecting. You should pick when you feel most comfortable to tell everyone, however, this time is often chosen, as your risk of miscarriage will have decreased and you’ll have had your first pregnancy ultrasound, which should confirm that your baby is healthy.

April 8, 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

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

WHAT YOU NEED TO KNOW ABOUT BREASTFEEDING AND RETURNING TO WORK

Returning to work need not be cause for anxiety or a reason to abandon breastfeeding. Carefully managed you can make the transition seamlessly. Here are 4 tips to make breastfeeding whilst going back to work easier: Consider when you are going back to work The age of your baby when you return to work will determine the urgency with which you need to pursue getting her to take to bottles.  If you know you are returning to work before your baby is 6 months old, you will need to prioritize establishing bottle-feeding. The reason is that milk is the priority food under 6 months of age and your baby will not be deriving much (if any) nutrition from solids at this stage. Expecting your baby to go all day without a feed is not realistic so you need to work on establishing the bottle – preferably with expressed breast milk If you are returning to work between 6 and 8 months, your baby should still have a mid morning and mid afternoon feed so it is preferable to have them on a bottle for these two feeds. That said, priorities are changing and you can be more flexible – not giving these feeds or using a sippy cup.  If you are returning to work from 8 months on, it is not essential to get your baby onto a bottle as your little one only has the need for either a mid afternoon or mid morning milk feed (other than the waking feed and bedtime – which you will be there for anyway). So rather skip the bottle stage altogether and move towards a cup or sippy cup. Expressing successfully The best advice you will probably get if you are returning to work when your baby is young is to invest in a good quality electric breast pump.  Take it with you to work. At around the time of your baby’s feed, go to a quiet space, put your feet up if you can and express. Once you have expressed, refrigerate the milk or place it in a cooler box until you get home.  Understand your baby’s sensory personality Some babies alternate between bottle and breast-feeding as easily as can be. While others resist bottles and give their moms a tough time when they return to work – even going on a starvation diet for the hours when mom is at work and feeding all night. The reason babies respond differently to the transition to bottles, is related to their sensory personality. Some babies are more sensory sensitive than others and battle with change.  If your baby is more sensory sensitive, she may find the novel texture of the teat and the new flavor of the milk a real problem to tolerate. Slow to warm up and sensitive babies in particular find the transition a challenge. For these babies, you do need to plan ahead and work at exposing them to bottle feeds ahead of time. It is worth determining your baby’s sensory personality as this will help you be more empathetic and plan ahead to ensure a smoother route.  When your baby won’t take the bottle If your baby refuses the bottle and yet needs the feeds while you are away, you will need to keep persisting. In the month leading up to your return to work, try to get her to have 1 bottlefeed a week and closer to D-day, one feed a day from bottle until she accepts it.  To do this – offer expressed breastmilk – this is best for her and is a taste she is used to, so she is more likely to take to it. Then choose a feed when she is rested and not fractious – eg mid morning feed. The ask someone else to give it to her, not you. Try a few different teats until you find one she likes. Good luck with your journey back to work. It can be tough but often the trauma is more for mom than for baby, so take heart. 

March 28, 2024

Play Is Learning

I’m always touting the importance of allowing your kids time to just be – not proving their worth through academics or sports or any other activity designed to agree with our adult agendas. But have you ever noticed what it is that kids get up to when left to their own devices? That’s right, they play! And while adults have come to see play as an idle waste of time, it is in fact the most important state for true learning. You see, when they’re imagining that their bed is a pirate ship and the inside of the toilet roll is a telescope, they’re going beyond the boundaries of their current reality through imagination. And it is this exact process that we use as adults to understand the meaning of abstract concepts like language or mathematics. We need to be able to see these abstractions playing out in our minds, imagining what they symbolise; and if we’re unable to go beyond the formula on the page, we will never conceive of the truths that they represent. Also, in that state of play children are relaxed and trying out new skills, social behaviours and ideas in a safe space. The minute we come in with our rules and regulations and conditioning, we abort that safe feeling and send them into “fight or flight” mode, biologically hampering learning by sending blood away from the prefrontal cortex (or higher thinking centre) and into the hindbrain (where all our survival reflexes reside). 95% of what we remember has to do with our state and only 5% with formal learning – which is why we can remember how much we hated our 2nd grade teacher and how terrible she made us feel, but we can’t remember anything about the lessons in her class. All true learning happens in a relaxed state of play (even as adults, our ability to perform well is best done in what athletes call “the zone” or spiritual masters call “eternal presence” – the state of complete relaxation and total absorption into the activity at hand). All the highly intelligent and great contributors to our knowledge and society – the Einstein’s and Edison’s – were daydreamers as children. As Einstein himself said, “Imagination is more important than knowledge. Knowledge is limited. Imagination encircles the world.” If we, as parents and educators, can embrace play and imagination in everyday life, whether at the dinner table or in the classroom, we will allow our children to develop without limitations into the powerful beings they were meant to become.

March 28, 2024

How your body changes post pregnancy

Affinity Health, a leading provider of high-quality health coverage, discusses how your body changes after pregnancy and how to care for your post-pregnancy self. From conception to delivery, a woman’s body undergoes incredible transformations to nurture and support the growing life within. However, the journey doesn’t end with childbirth. “While there is ample information about the stages of pregnancy, the postpartum phase is sometimes neglected,” says Murray Hewlett, CEO of Affinity Health. “Understanding how the body changes postpartum and giving your body the time it needs to replenish nutrients, balance hormones, and recover muscles will greatly influence your early days as a new mom.” Weight Fluctuations and Body Image One of the most noticeable changes after pregnancy is the weight loss associated with giving birth. The baby, placenta, amniotic fluid, and excess water retention contribute to a significant drop on the scale. However, this initial weight loss is often followed by a period of weight fluctuation and sometimes even weight gain, especially in the first few months. Give yourself grace and patience during this period. Try to maintain a balanced diet and exercise when your healthcare provider gives you the green light. Avoid crash diets or extreme workouts, as they can be detrimental to both your physical and emotional well-being. Changes in Breast Size and Shape Your breast size increases during pregnancy, and you might become tender or sore. After childbirth, when milk production begins, they can become even more engorged. This change is natural and necessary to provide nourishment for your baby. Once breastfeeding ends, you may notice a decrease in breast size, and the skin may not regain its pre-pregnancy elasticity entirely. It’s common for women to experience sagging or a loss of fullness. Wearing supportive bras and practising chest exercises can help maintain breast health and appearance. Skin Changes While some women experience a radiant pregnancy glow, others may develop skin conditions such as melasma (darkening of the skin), acne, or stretch marks. Stretch marks are prevalent on the abdomen, breasts, and thighs due to the skin stretching as the baby grows. Using moisturisers, staying hydrated, and practising good skincare can help alleviate some skin concerns. Over time, many of these changes tend to fade or improve. Pelvic Floor and Abdominal Muscles As your body prepares for delivery, the abdominal muscles separate to make room for the growing baby – a condition known as diastasis recti. The pelvic floor, which supports your uterus, bladder, and rectum, can also weaken during pregnancy and childbirth. Engaging in post-pregnancy exercises like Kegels can help strengthen the pelvic floor muscles. Physical therapy may be necessary for more severe cases. Core-strengthening exercises can also help in the recovery of separated abdominal muscles. Hair Changes Some women experience thicker, shinier hair during pregnancy due to increased blood circulation and hormone levels. However, post-pregnancy hormonal shifts may lead to hair loss or changes in hair texture. Hair loss, often referred to as postpartum shedding, can be distressing for some women. Fortunately, it is usually temporary and resolves on its own. Emotional and Psychological Changes While physical changes are often the most visible, the emotional and psychological changes accompanying motherhood are equally significant. Transitioning to motherhood can bring about many emotions, including joy, love, anxiety, and even inadequacy. It’s essential to prioritise your mental health during the post-pregnancy period. Seeking support from friends, family, or a therapist can be immensely beneficial. Remember that asking for help and taking breaks is okay when needed. Embrace the emotional changes as part of motherhood’s beautiful and challenging journey. Menstrual Changes It’s common for some women who breastfeed to experience delayed or irregular menstrual cycles, as breastfeeding can suppress ovulation. Once you stop breastfeeding or reduce nursing frequency, your menstrual cycle resumes its usual rhythm. Other women may experience heavier or more painful periods post-pregnancy. These changes are often temporary and should be discussed with your healthcare provider if they persist or become problematic. Changes in Libido Many new mothers find that they have a reduced interest in sexual activity during the postpartum period. It’s important to communicate openly with your partner about your needs and feelings regarding intimacy. Remember that these changes are temporary, and your sexual desire may gradually return as you adjust to your new role as a parent. Prioritising self-care and finding moments of intimacy with your partner can help maintain a healthy connection. Sleep Disruption Lack of sleep can profoundly impact physical and emotional well-being, exacerbating feelings of fatigue, irritability, and stress. To mitigate sleep disruption, consider enlisting the help of a partner or family member to share nighttime caregiving responsibilities. Establishing a regular sleep schedule for your baby may also help them sleep better and provide you with more peaceful nights.  

March 27, 2024

HOW TO KEEP A RECORD OF YOUR BREASTFEEDING

Keeping a record of your breastfeeding may seem a little time consuming. Not only do you need to feed your baby, but then document the entire process as well! However, there is huge merit to the art of keeping a successful breastfeeding log book.  Believe it or not, a record of your feeds holds many, helpful secrets for you. The most important one being you will be able to track your little one’s over all health progression. Within this article, we will highlight what metrics you should be keeping track of, and how they will benefit you and your baby in the long run. Read on below now and get acquainted with the art of keeping a record of your breastfeeding and unlock the secrets it holds for you today. Why You Need To Record Your Breastfeeding As a parent, any information you can keep on your child’s development is pure gold. This is where a breastfeeding log book comes in incredibly handy. Within its pages you will be able to document vital statistics of your baby’s feeding habits. These will help you recognize any problems, should they arise, as you will be familiar with your child’s eating habits.   Furthermore, a breastfeeding record wont only help you, but others who may eventually become responsible for your child as well. When you eventually return to work, this log book will be able to provide either your nanny or day care centre with crucial information on your baby’s eating habits. They will know roughly when to feed your little one, how much to feed them and knowing how many times they should change your child throughout the day. Criteria To Document In Your Breastfeed Record Here are the top five criteria you should be keeping track of when you begin to record your breastfeeding patterns: #1: How Often Your Child Feeds Keeping a record of feeding frequency helps you in two areas: you will know how often your baby feeds throughout the day. You will also be able to start creating a feeding schedule off of this data. Knowing how much your baby feeds will give you a good indication as to how much milk you will need to have available. Your body is a wonderful thing. During your breastfeeding journey, it should produce the exact right amounts of milk for your little one to feed comfortably. However, keeping a breastfeeding log book will help you understand how much milk you should express and store for times you may not be around to feed your baby.  **Top Tip: remember, your breast milk can be frozen without compromising its nutritional value. It can then be used at a later stage. Another wonderful thing about keeping track of feeding habits is that you will begin to be able to build a feeding schedule. You will know exactly when your little one begins to get niggly and be able to swiftly go into feeding mode! Having a schedule will also help you plan your own life. You will be able to schedule event and outings around that precious tie with your baby. As mentioned above, you will also be able to provide other care takers with useful information on when your child should be fed throughout the day. #2: How Long Your Baby Feeds For Knowing how long your little one feeds for is another snippet of useful information. It will help you establish how many minutes need to set aside per feed. You will also be able to track how many minutes is spent on either breast. Once again, this will help you establish an accurate feeding schedule. It will also help you familiarise yourself with how long you should be pumping each breast when you begin to express your milk when going back to the office. #3: When Nature Calls In your feeding log book, you should also track how many soiled nappies your baby produces throughout the day. This is incredible information to have because should your child become ill, and either produce too many or too few soiled nappies, you will be able to pick up on it immediately.  Monitor both the wet nappies, as well as the dirty ones. This will allow you to keep track of your child’s digestive health on an ongoing basis. #4: The Weigh In Make a note to also keep track of your baby’s weight within your feeding records. The general rule of thumb stipulates that within the first two week’s of your baby’s life, they should be weighed every five days. Between two weeks to six months, you should weigh your baby once a month. Don’t weigh your baby at home. Rather, take him or her to your doctor and get accurate results! Keeping track of your baby’s weight gain (or loss) will allow you to monitor their growth. Should their weight fluctuate dramatically from one month to the next, you will be able to notice it instantly, and seek the correct help going forward. #5: How Do You Feel Another important metric to take note of is how you feel post feeding. Particularly, monitor how each of your breasts feel after this time. Should one feel particularly full, you will know you need to express that one after each feed. In the same right, should both still feel full, you will know to express both. By doing this, you will also be able to keep track of what feels normal and what doesn’t for you. Should your breasts begin to feel different, keep track of these changes and consult your doctor about them.  How To Keep A Record Of Your Breastfeeding Cycles Documenting your breastfeeds sounds simple enough. And truth be told, it is. As such, there is no reason you should be tracking your breastfeeding cycles. You can keep track of your feeds in the following ways: Write them into a note book Make digital notes on your phone Keep a record in a feeding log book We find it

March 26, 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

How To Handle Nap Time

If you want to easily handle nap time, there are a few easy tips to look out for with your little one. All parents struggle to find their feet with each child’s nap schedule – as no two babies are alike. However, there are a few tips to follow to help you figure out the perfect nap time pattern for your baby. Read on below now for more! Nap Time Tip #1: Look For Signs Whilst yawning is a tell-tale sign that your baby is ready for some shut eye, there are a few other great habits your little one may show to indicate their sleepiness. The top three signs that your baby is ready to nap are: Rubbing their eyes Crying Fussiness  Nap Time Tip #2: Do Not Wake Your Little One When your baby falls asleep, ensure that they continue to do so. Do not wake your baby from their nap. Even if they have fallen asleep in the car, simply carry the whole car seat – with baby inside – into your home, setting them safely on the floor.  Nap Time Tip #3: Look After Yourself Many moms will try squeeze in a few chores whilst their baby is down. However, you need to look after you during this time. Having a baby can be tough on your sleep as a parent. So when your little one has a nap, do the same. Try get some rest and relaxation in and recoup yourself.  Nap Time Tip #4: Set Up A Routine Children love routine and this is no different during nap time. Set your child a schedule and try to practice these tips too: Use your baby’s crib for day nap time and their night’s rest. This way they will begin to associate their crib with sleep.  Try to avoid scheduling a nap time for the late afternoon as this may affect their evening sleeping routine. Have the same nap routine in place for every day, this will help your child familiarize themselves with it.

March 25, 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

Fanciful Faces Inc.: A Magical Wonderland for Your Celebrations!

Step into the enchanting world of Fanciful Faces Inc., where joy takes center stage, and every celebration becomes a canvas of laughter and delight. Known for their extraordinary entertainment services, this company is not just a party planner; it’s an architect of unforgettable moments and a creator of magical memories. A Kaleidoscope of Services  Imagine a world where face painting isn’t just an art form but a transformative experience. Fanciful Faces Inc. turns faces into living masterpieces, thanks to their skilled artists who are more like dream-weavers than painters. And when it comes to clowns, these jesters of joy are the heartbeat of any event, spreading infectious laughter and whimsy wherever they go. But the magic doesn’t stop there. Balloon sculpting turns ordinary balloons into intricate wonders, while jumping castles become portals to a gravity-defying kingdom of pure delight. It’s not just about services; it’s about crafting an experience that lingers long after the confetti settles. A Sprinkle of their Signature Spectaculars: Face Painting: Where smiles become masterpieces. Clowns: Masters of mirth and laughter engineers. Balloon Sculpting: Ordinary balloons transformed into extraordinary wonders. Jumping Castles: Bouncy kingdoms where gravity takes a backseat. Water Slides: Splashy aquatic adventures for sun-soaked celebrations. Magicians: Illusionists turning events into enchanting experiences. If you don’t find exactly what you’re looking for, feel free to reach out to Fanciful Faces Inc., and they’ll happily tailor the perfect entertainment for your event! A Symphony of Joy and Fun Picture the sound of children’s laughter harmonizing with the playful melodies of Fanciful Faces Inc.’s entertainers. Their events are not just about services; they’re an orchestrated symphony of joy. Each celebration becomes a crescendo of laughter, a dance of delight, and a parade of unforgettable moments. A Haven of Happiness for Every Child Beyond creating magical moments, Fanciful Faces Inc. is committed to fostering a haven of joy for every child. In their belief, childhood is a treasure trove of enchantment, and no child should miss out on the magic. With Fanciful Faces Inc., every celebration becomes a treasure hunt for joy. Looking to the Future As Fanciful Faces Inc. spreads joy today, the dream is to paint even larger canvases of happiness in the future. Envisioning more laughter, more celebrations, and more magical adventures on the horizon, Fanciful Faces Inc. goes beyond being a part of your celebration; it’s a dedicated partner in shaping a future where joy knows no bounds. With plans for community outreach and exciting collaborations on the horizon, fuelled by the unwavering desire to spread love and happiness far and wide. Closing Note – Choose the Canvas of Joy  In the grand tapestry of life, Fanciful Faces Inc. is the brushstroke that adds vibrancy, the burst of confetti that creates magic. Choosing them isn’t just about getting a service; it’s embracing an experience where every smile, every giggle, and every moment becomes a stroke on the canvas of joy. Choose Fanciful Faces Inc. – where every event is a masterpiece of merriment!

March 21, 2024

Babies R Us Premium Parenting Event is Back

Calling all new, seasoned, and soon-to-be moms and dads to join the Real Mama Club Events The annual Babies R Us Real Mama Club event series is back this year, bigger and with more events than ever. Calling on all moms and dads – whether you’re new to parenthood, a seasoned pro, or eagerly awaiting your bundle of joy – join Babies R Us at one of the eight nationwide events taking place from April to November. The event series provides an opportunity to discover the secrets to successfully navigating the journey of parenthood. Spanning across the Western Cape, Eastern Cape, KwaZulu Natal, and Gauteng, are set to be the highlight of your parenting journey. The lineup is packed with real insights to help you navigate both the highs and lows of parenthood. Everything from baby milestones to introducing solids, navigating relationships to car safety, postnatal depression, sex after birth and securing your baby’s financial future are combined with an entertaining morning full of spoils, a fabulous goodie bag, delicious lunch, stunning venues, and opportunities to engage with both baby and brand experts. Among many childcare experts some of the speakers will feature renowned professionals such as Kath Megaw, a Pediatric Dietitian and author of ‘Weaning Sense,’ Ayanda Mkhwanzani, a fund and investment specialist from Old Mutual; and Spicey Madlalose, one of South Africa’s leading experts in car seat safety and a product specialist for Joie. “Parenting is an adventure unlike any other, filled with countless challenges and endless moments of joy,” says Catherine Jacoby, Marketing Manager at Babies R Us. “They say it takes a village to raise a child, and these events are exactly that – a space for mothers to connect, learn, and grow together as part of the Real Mama Club community.” She adds: “We’re once again providing a space for all mamas to connect with each other and gain solid advice on what to expect and how to overcome some of the challenges of parenting.” “This event series has grown over the last three years to become a much-anticipated calendar event annually,” she adds. “It’s for this reason we have increased the number of events and included other regions to give mamas the opportunity to meet new mama friends, share insights, get advice and enjoy a perfect day out.” What’s more, it’s not limited to mamas. We have seen many soon-to-be dads joining their partners at these events. “We also have baby care on hand so parents attending can be rest assured their little ones are taken care of by the Super Nannies team,” she adds. Tickets are on sale via the Babies R Us website at a cost of R250 and the ticket includes: a goodie bag packed with mom and baby essentials, an opportunity to engage with our baby and brand experts, a free lunch, and a chance at winning one of many exciting prizes. “We are including some of our most popular brands at the events with a full expo area where parents will have the opportunity to learn from over twenty brands including, Tommee Tippee, Joie, Bounce, Old Mutual, LOVA, Fisher Price and Pampers to name a few,” adds Jacoby. “We know parenting is hard, but it is incredibly rewarding. The aim of these events is to remind parents they are not alone and that we are here to support them through the reality of parenting,” she explains. “Babies R Us is more than just a baby retail store, we offer free antenatal care, wellness checks for mom and baby, a family wellness department and the best products at all stages of parenting, all curated by professional moms, the Real Mama club events are an extension of this.” “We’re looking forward to sharing our attendees’ parenting journey with our mama’s as we parent together,” she concludes. Event Calendar: April: Western Cape/Waterfront (5th April) May: Eastern Cape/PE (3rd May) June: Gauteng/Menlyn (7th June) July: Gauteng/Sandton (5th July) Aug: KZN/Gateway (2nd Aug) Sept: Gauteng/Hyde Park (6th Sept) Oct: Western Cape/Waterfront (4th October) Nov: KZN/Gateway (1st Nov)   For more information and tickets visit: https://www.babiesrus.co.za/mama-club or on social media @BabiesRUs_za #RealMamaClub

March 21, 2024

Breastfeeding While Pregnant

Congratulations, you’re pregnant… again. And whether this age gap was planned or not, you’d like to continue breastfeeding your baby / toddler through your pregnancy. Here’s what you need to know. In most cases, breastfeeding while pregnant is completely safe but it is also a very personal decision with many factors to account for. What suits one family may not suit another. During pregnancy, hormonal changes in the body can make breastfeeding a challenge. For one, you will most likely find that you are extremely tired or sick in the first trimester. This can make eating a healthy, balanced diet close to impossible. Your milk may taste different causing your older child to wean himself or you might find that your breasts and nipples become too sensitive to continue breastfeeding. Something else to consider is that by the time you reach your second trimester, your body will begin to switch things up a bit. Instead of producing the volumes of mature milk that your child is used to, you will go back to producing colostrum for your new baby. Some toddlers are happy to continue drinking even though they are now receiving colostrum while others will flatly refuse and self-wean because of the new taste and composition of this ‘milk’. Taking the drop in volume or lost interest into account, it is important at this stage that you begin to supplement your child’s diet with an alternative milk source. Your choice of milk will depend entirely on the age of your child. Cause for concern. A big concern when it comes to breastfeeding while pregnant is whether the nipple stimulation from your older child suckling will cause you to go into pre-term labour. There is much controversy around this. Nipple stimulation triggers your body’s production of oxytocin, which helps with milk letdown and also plays a role in the contractions you have during labor. But whether the amount of oxytocin released is enough to trigger labour or not, we do not actually know. This question is begging for a medical study and at this stage, there is none. However, preliminary data does suggest that breastfeeding and full term, healthy pregnancies are quite compatible. It is important to realise that during pregnancy, the amount of oxytocin released in response to nipple stimulation is somewhat less than when a woman is not pregnant. Secondly, the uterus during pregnancy is not completely at the beck and call of oxytocin during the 38 weeks of the ‘preterm’ period. Even high doses of Pitocin (labour inducing drugs) is unlikely to trigger labour unless the uterus is ready. As with any pregnancy, it is important that you are open and honest with your pregnancy care giver about your wishes to continue breastfeeding. There are most definitely cases where breastfeeding during pregnancy is not advised. In conclusion, when making the decision to continue breastfeeding, it is wise to take into consideration how breastfeeding will fit in with your needs for rest, adequate pregnancy weight gain and your overall sense of well-being. It is also of utmost importance that you pay attention to your diet, drink plenty of liquids and keep taking your prenatal vitamins.

March 19, 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

“Sleep When Your Baby Sleeps” – Planning for Newborn Sleep Bliss

I am the mother of two beautiful boys and have experienced two polar opposite newborn phases; one pure undisturbed bliss (even with a three-year old running around) and the other where the wheels completely fell off around eight weeks postpartum. After my first, very wobbly experience, I am here to share how I fought for and set myself up for the most wonderful, enjoyable, relaxing and sleep-filled (yes, I really am using those words!) postpartum with my little Leo, our baby lion (named by my firstborn, Max). Both my babies were born into my arms at home, in births I had manifested and dreamed of. I won’t go into too much detail about what I did wrong when Max was brand new. But as a first-time mom, most of it was due to being uninformed, taking bad advice, not listening to my intuition and not giving myself, the most important part of the mother-baby dyad, the care, quiet and nurturing I needed to look after my tiny newborn. I have since learned that our babies and children feed directly from our nervous systems; they physically need us to regulate themselves. I knew that with Leo I had to plan very carefully and put the necessary support, boundaries and expectations from those around me in place very securely before he was born to allow myself the space and time I needed to be able to stay in a calm, happy, ventral vagal state while having a newborn in my arms and a three‑year-old to tend to as well. I knew that this would mean that my newborn would be calm and happy too, as he was feeding off my nervous system. So, for me, there were a few very important things I planned so I could rest and sleep once he was born: I made sure that my three-year-old would be looked after and his needs met by my parents during the day. I still did his bedtime every night, even the day Leo was born, which is a blessing one has when birthing at home. I made sure my fridge was stocked with all the right postpartum foods to help nourish me after birth and give me all the energy I needed to establish breastfeeding. A great book I read was The First Forty Days: The Essential Art of Nourishing the New Mother by Heng Ou with Amely Greeven and Marisa Belger. I followed a forty-day confinement/resting period after giving birth, where I stayed in my home for this special time. I didn’t leave my bedroom for the first seven days and slowly made my way into the rest of the house only when I felt I was ready. This tradition is followed in many cultures; however, in our own fast-paced Western culture, it has been largely overlooked. In my opinion, this is why so many mothers have difficult newborn phases filled with the social pressure to get back to normal life way too quickly. All they should be doing is looking after their baby while others care for them. Some of you reading this may be thinking, how the hell would I even do that? And that is why I said I had to ‘fight’ for my postpartum bliss. It doesn’t just happen, I promise you! I took a Chinese herb called Calm Shen and an incredible amino acid called L‑theanine, which I wish more mothers knew about. These aided me in restful sleep and calming the anxious mind, so I found it easy to drift back to sleep at night after feeding and to lay down for a nap with my baby and actually sleep. I made sure I lay down to rest and sleep whenever Leo was napping. Because I felt so calm, so held by those around me and so safe, I was actually able to nap with my teeny one in my arms and not just lay there wide eyed and wired, wondering if he would wake up the next time he stirred. I also became very comfortable with newborn active sleep patterns, where they are fast asleep but moving around and making noise like crazy (enter me sleeping with ear plugs day and night!). With Max, I used to jump up to rock and feed him the moment he moved, which meant that most of the time, I was actually waking him up and being the reason for his short naps and poor nighttime sleep. I went to bed super early. Now when I say early, I mean like 7:30 pm, latest 8:00 pm. My three-year-old goes to bed at 6:00 pm and sleeps through the night, so Leo and I would follow close after him. This meant I had 12 hours in which to get as much sleep as I could, taking the edge off feeling anxious about how much sleep I got. For most nights, this ended up being a good eight hours for me (obviously interrupted by feeding). BLISS! I used a Love to Dream swaddle, Sleepyhead pod, soft white noise and a Lulla Doll as a lovey from day one and made sure there was some light for our day naps and that nighttime was completely dark. For the first 16 weeks, I co-slept with Leo and had him next to me either in my arms or in a co-sleeper. I mastered the art of breastfeeding while side-laying, which meant I often fell asleep while feeding him. This was another way we had our long blissful naps during the day, always laying together. Something I used to dread with Max became something I truly miss now that Leo is eight months old and sleeping happily through the night in his own room. I seriously loved my postpartum journey, from my empowering one-hour-long unassisted homebirth in our beautiful new home by the sea in Cape St Francis (where the midwives arrived five minutes before he was born – but that’s a story for another day!) to my dreamy newborn cuddles and sleep-filled days and

March 18, 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

What To Expect When Expecting Multiples

Taking care of yourself during a multiple pregnancy starts with eating well – except that little research has been done on what that means for a mother carrying multiples. In the absence of any real science, it’s probably best to aim for healthy, balanced meals. You will need to drink plenty of fluid, ideally eight large glasses of water a day as a minimum. It’s worth bearing in mind that sugary snacks can give you highs and lows which may be unpleasant. Slow-burning foods such as whole grain breads and crackers, vegetables, beans, oats, brown rice and whole grain pasta will tend to keep your blood sugar more stable and may satisfy you for longer. You will need more protein, calcium, iron, folic acid and Vitamin B12 than in a singleton pregnancy, so make sure you have a varied diet. Try to eat little and often. Fresh foods are likely to give your body more of what it needs nutritionally than foods that have been processed. Taking a pregnancy supplement is also a good idea. How big will I get? Expectant mothers vary in size as in any pregnancy, but you can certainly expect to gain more weight than women carrying a singleton. In addition to the extra baby or babies, multiples mums carry extra placentas, amniotic fluid and maternal body fluid. As the babies grow, keeping physically comfortable can be a challenge. It’s probably best not to plan a huge amount of activity for the last few weeks of pregnancy – getting in and out of cars as well as negotiating seatbelts can become difficult, and you will probably be more tired with all the extra work your body is doing. It can help to swap tips with other pregnant mums (as well as share experiences and get a little sisterly support) Boring but important, pelvic floor exercises do minimise the risk of a prolapsed uterus later in life, as well as help your pelvic floor return to normal after the babies are born. To do them, tighten the muscles around your vagina and anus (it feels like stopping the flow of urine) and count to five before relaxing the muscles. Do this ten times, repeating the whole routine five times a day. It can help if you put a discreet note somewhere you’ll see it regularly (such as inside your purse) reminding you to do a set. No one need know… Gentle exercise during pregnancy can ease tension and help your muscle tone. Don’t do anything where balance is key as your centre of gravity will be changing as your belly grows. Low-impact sports like walking and swimming suit many people. Whatever you choose, start slowly and stop if you feel any cramping, pain or shortness of breath. Try to look after your emotional wellbeing as well as physical health. The extra hormones can sometimes make you feel emotional and overwhelmed. This is normal, even though it may surprise or upset you when it happens, especially if it isn’t how you usually react. If you feel stressed or anxious, talk to a health professional or family member. Preparing for the arrival of your twins, triplets or more! The prospect of birth can be such a daunting one that many parents find it hard to think beyond that miraculous and improbable event. Try to bear in mind that once your babies are here, you will be very busy. The time before they arrive is a great opportunity to research some of the practical issues ahead of you, reading up on everything from what happens in a multiple birth to twin/triplet sleep routines. Go out to teas in your area and meet other multiple parents. There is nothing like meeting other parents who already have young twins, triplets or more for finding out what you really need to know – such as which equipment you will need extra sets of. You may even be able to pick up some useful items second-hand. SAMBA has a fantastic second hand Facebook page, Moms of Multiples Resale JHB. Attend Expectant Parents seminar hosted by SAMBA. These seminars will prepare you for the birth of your multiples and give you tips on how to breastfeed, sleep routines, a dads perspective and more. Bonding All mothers respond to their babies in different ways, whether they have one baby or four. Some are immediately besotted with them, others initially indifferent. Both of these responses are normal. Some mothers worry that they will not be able to bond with more than one baby at a time – or that they will have a favourite. And some babies appear more loveable than others. However you feel at the beginning, your babies will grow on you. Try to make time to cuddle and get to know each of them individually. Bonding with higher multiples can be especially difficult as you have proportionately less time with each baby. Try roping in some help. Even if it is only once a week, ask a trusted family member or friend to take one or more babies out for a stroll in the pram while you have some special time with just one. Switch babies each time so they all get a turn. If you are separated from one or more babies – for example, if they are in neonatal care – you may find it hard to believe that the babies are really yours. This can make you feel a little detached, but try not to worry. When you start to look after the babies yourself it will begin to feel real. In the meantime, display photographs of the babies in your home and show photographs to friends. Common Symptoms Your body will go on an incredible journey as you nurture the babies developing in your uterus to the point where they can exist outside. Inevitably, there are aches, pains and discomforts along the way because of the sheer scale of the task you are accomplishing. If any symptoms worry you, talk

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
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