Bonitas – innovation, life stages and quality care

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.

Julie Kay Belly Way

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))

Jenna Richards

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

Meg Faure

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.

CRYOSAVE

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

Aupair Exclusive

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

Good Night Baby

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!

Bonitas – innovation, life stages and quality care

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

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

Sammy Hammond

Breastfeeding: the most common challenges and how to deal with them

Breastfeeding can be a beautiful and special time between you and your baby. It can however, come with some challenges. In fact, statistics show that up to 60% of mothers do not breastfeed for as long as they intended to due to challenges faced.  Below are some of the most common breastfeeding challenges or difficulties and how you can deal with them to ensure that you and your little one have a pleasant breastfeeding experience.  Pain or discomfort Pain experienced when breastfeeding can be caused by nipple tenderness, bleeding, blistering and/or cracked nipples.  How to deal with pain: Breastfeeding should not be painful. Please consult a lactation consultant to assist you.  It is important to ensure that your baby is latching correctly and find a breastfeeding position that supports an optimal latch. Make use of nipple cream (chat to your Dr or pharmacist about a recommended brand) or use a small amount of your own breastmilk to soothe your nipples.  Use breast pads to protect your nipples from chaffing on your bra or clothing. Engorgement Engorgement can be very uncomfortable and occurs when breast milk has not been adequately removed, resulting in hard and sore breasts.  How to deal with engorgement: Pump and/or nurse your baby frequently (between 8-12 times a day).  Ensure that your baby is latched on correctly so that he/she can empty your breasts. A poor latch can also result in engorged breasts.  Take warm showers or apply a warmed cloth to your breasts to encourage milk flow.  Breast massage  My baby’s not latching  There are a number of reasons your baby may not be able to achieve a sufficient latch. These include poor coordination, prematurity, discomfort and/or mom having flat or inverted nipples.  How to deal with a poor latch: See a lactation consultant! Lactation consultants are trained to identify and solve breastfeeding challenges.  Try out different breastfeeding positions. There is no one size fits all – try various holds to establish which suits you and your baby best. Support your baby’s neck, shoulders, and hips with your hands. Consider the use of a nipple shield if you have flat nipples – these can be a short term solution to assist your baby to latch. It is advised to consult a Lactation consultant before purchasing a nipple shield.  Not having enough breastmilk  Breastmilk supply is initially low while your body adjusts your hormones to trigger breastmilk production. This usually takes 2-4 days, after which your milk supply should increase to provide the optimal amount of breastmilk for your baby. There are various things that can negatively affect milk supply, and these vary between women.  How to deal with not having enough milk Feed your baby on demand. This should range from every 2 to 3 hours (can be more), day and night. Stick to this range if you are expressing too. It is important that your breasts receive this stimulation, either from your baby feeding, hand expressing or a pump. Try and get as much rest as possible (easier said than done with a newborn). Eat well and frequently as well as drink plenty of water throughout the day and night. If you have friends and/or family around, ask for assistance with chores so that you are able to focus on breastfeeding.  If you are hand expressing and still have a low supply, consider purchasing or renting a breast pump. These pumps are effective in mimicking what your baby does at the breast as well as stimulating milk production. Skin-to-skin; research indicates that skin-to-skin assists with increasing breastmilk production.  If your milk supply remains low or diminishes, consult your Doctor and/or a Lactation Consultant.  Leaking breasts This is a common occurrence in the initial stages of breastfeeding, however, usually subsides after 5-6 weeks.  How to cope with leaking breasts Wear nursing pads inside your bra in the day and night  Feed your baby or express frequently (every 2-3 hours). Producing too much milk  Once your milk supply is fully established, you may find that you have more milk than your baby needs, resulting in coughing, spluttering or vomiting after a feed.  How to cope: Express a small amount of milk before a feed. This ensures the initial let down is not too strong for your baby.  A reclined (lean-back) feeding position allows your baby to control the flow rate of milk from your breast as gravity is minimised.  Take your time and allow your baby to rest after a feed. If he/she has taken in too much milk, moving a lot or too quickly can cause her to vomit.  Above, are only some challenges that new mothers may face when breastfeeding. It is important to not “suffer in silence” but rather to seek the assistance of a lactation consultant. Luckily there are plenty of lactation consultants around that will be happy to assist you and your baby. 

Good Night Baby

Don’t get “nap trapped”

More and more in recent times have I been hearing the word ‘nap trapped’. Nap trapped is when parents feel ‘trapped’ at home because their little one can sleep well only in the cot or in a specific area for naps. This can even mean that because of the timing of naps, moms don’t want to join friends, go to classes or join groups. There is an added level to being nap trapped, as it could also mean that your baby can sleep only on you or next to you. I KNOW I was nap trapped with my babies. For such a long time, my children were sleeping horribly, and once I found something that worked, I was so petrified that if I changed something they would go back to the horrible sleeping. We could never go out for dinner, because my little ones had to sleep at home. Outings during the day or during holiday caused me so much anxiety in the end that I did not want to do anything outside the house as it just made me stress. One holiday in Cape Town (by this time, my kids were already four and two years old), we had some friends over for an early afternoon braai. I had finally stopped breast feeding, so I could drink some wine again (of course, after not drinking for years, one glass was enough). We had a fantastic time; their kids were a similar age than ours and all were enjoying themselves. Because the sun goes down later in summer in the Cape, with a shock, at 20:00, I realised that my kids were not even close to getting into bed (they had a very strict 19:00 bedtime). And there they were, running around, swimming, playing and having a great time… I had never even given them the opportunity before… And I was fine, they were fine. I was actually the only one who realised what time it was. Because they normally slept really well, they could cope really well with one night of going to bed later. And that is the reality most of the time. Even the most social couple I have helped had something on three times a week over bedtime (that is really social, I can’t remember ever being that social, even before kids!). AND even for that social couple, it was still the exception. For four out of seven nights, they were at home, could follow the bedtime routine and make sure that their baby got proper sleep. Don’t try to create your life according to the exception and also don’t be afraid of the exception. Most of the time, you will be at home, and when you are at home, make sure that your baby gets the best sleep that they can. So that when those exceptions happen (they have a short nap or skip the nap or go to bed later), they will be ready and deal with it and will be fine. There are, of course, some additional things that you can try for naps or bedtime when you do go out for dinner to at least hope you have a good time: Try to relax. In the end, if you are going to be anxious, your baby will feel it and this can make the whole situation much worse. This might mean that you need to plan a bit. This might mean that you need to allow other people to help when they offer. Or, this might just mean that you need to know that whatever you do for those couple of hours will not alter everything that you have done before. If your little one can sleep in the car, well, use it. If you are traveling during time that falls over the nap time, extend the drive a little if you have to (I know petrol is expensive!) to just ensure your baby gets a bit of sleep before you get to your activity. If your little one can sleep in a stroller, use it! Even if it is a short nap, it is better than nothing. Try using a portable white noise machine or white noise app in the stroller as well as closing it and moving it around to see if this helps to get your little one to sleep in the stroller. Some babies sleep great in a stroller when they are small, but might not sleep so well anymore as they get bigger. BUT, then, they might get into it again. If you go to a braai/dinner at someone else’s house, ask them if they have an extra cot or take your camp cot with. Do a short bedtime routine as you would at home. Instead of bathing, you can just wipe your baby’s face and feet with a warm cloth. They will survive one night of not bathing. Try to put them down even if it means helping a bit to get them there. BUT, if they don’t sleep after 10 to 20 minutes, call it. Take them with you to friends and try to enjoy yourself. You can take turns holding the baby with your partner and friends. It is one night. Too many times, I have heard moms say that they want a baby that can sleep anywhere. These moms would say things like: “I can remember falling asleep under the table at weddings!” My response:  First, how many weddings do you attend? Second, sleeping anywhere has a lot to do with your baby’s personality and age, but most importantly, lastly, why create rules for the exception? By Jolandi Becker – MD of Good Night

CRYOSAVE

Exploring Delayed Clamping and Stem Cell Banking Synergies

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

Bonitas – innovation, life stages and quality care

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

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

Parenting Hub

Babies R Us Support Preemie Mom’s in Need During Pregnancy Month

400 Care Bags Donated to Rahima Moosa Mother and Child Hospital in Johannesburg Babies R Us has delivered four hundred mom care bags to the Rahima Moosa Mother and Child Hospital in Johannesburg to mark Pregnancy Awareness Month. This initiative forms part of the annual Babies R Us Preemie Heart Campaign, which allows customers to buy a purple preemie heart at all Toys R Us and Babies R Us stores in support of World Prematurity Day, observed annually in November. In addition to the mom care bags, last year, the Babies R Us team handed over a NICU incubator to the Rahima Moosa Hospital’s NICU unit. The Rahima Moosa Mother and Child Hospital is the only mother and child hospital in South Africa, providing care for a very large number of women and children and delivers around 14,000 babies every year – the second highest number of babies in the country after Chris Hani Baragwanath Hospital (Africa’s biggest hospital). Each mom care bag contains several essential items, including a blanket and baby toiletries and mothers who have currently have babies in the NICU unit, received a pack of preemie sized diapers. “We hope that these bags will bring joy to many moms in need, and we are sure that they will find the necessities in the bag very useful,” said Ronel Grant, Head of Wellness at Babies R Us. “The Babies R Us Mama Club slogan is ‘We’ve got you’ and the team would like moms to know, that this extends to moms across all walks of life in South Africa.” Dr Joy Fredericks at Rahima Moosa Hospital comments: “Once again, we extend our sincerest gratitude to Babies R Us for your unwavering support towards mothers and babies in our community. Your generous donation of 400 care bags provided mothers with essential items bringing relief and restoring hope to those navigating uncertain times.” Most notably, Grant adds that beyond managing the journey of parents and babies, the Babies R Us, Mom and Baby Wellness Clinics can be found at several stores including: Gateway, Pavilion, Mall of Africa, Boksburg, Canal Walk and Wonderpark shopping centres. “We also provide free virtual antenatal courses, presented by midwife, Sister Claire de Villiers, who is the Babies R Us midwife at the Gateway Clinic.” Free virtual Babies R Us Antenatal courses are also offered, consisting of two modules; guiding mom from the first stages of pregnancy, to giving birth and taking baby home for the first time. The course is presented via Teams, Sister Claire de Villiers has 34 years’ experience as a registered nurse and midwife,  and shares expert guidance and information to all moms embarking on their pregnancy journey. Grant adds that as a further extension of the Babies R Us expert advice pillar, Carey Haupt, a lactation expert also presents a virtual lactation course, sharing information and guidance with all moms about the reality of breastfeeding. Babies R Us stores can be found inside every Toys R Us store and offer moms everything they would need from bump to baby during their pregnancy journey. Bookings for all clinics and courses can be made via the website:  www.babiesrus.co.za, under the tab Clinic and Course bookings.  

CRYOSAVE

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

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

Bonitas – innovation, life stages and quality care

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

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

Parenting Hub

How to manage early pregnancy sickness

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

Bonitas – innovation, life stages and quality care

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

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

CRYOSAVE

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

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

Bonitas – innovation, life stages and quality care

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

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

CRYOSAVE

The Importance of Storing Cord Blood Stem Cells for Future Health

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

Parenting Hub

The New Great Tasting Grape Flavour, Panado®’s Latest Paediatric Range Addition

Panado® has expanded their paediatric range with a new Grape flavour syrup,1 designed to help relieve pain and fever in children.1 As a trusted2 name in South Africa, Panado® knows that parents want convenient and great tasting products for their children. That’s why our new Grape flavour is colourant-free, tartrazine-free, alcohol-free, and sugar-free1, ensuring that your child gets the pain and fever relief they need.  Providing comfort to little ones who are feeling unwell can be a daunting task for parents, particularly when children are not able to effectively communicate their discomfort.  Panado® is trusted2 by South African families for providing relief of pain and fever1 in babies, toddlers, and children, but it is also convenient and great tasting. This makes it a go-to choice for parents who want a reliable solution that is easy to administer and appealing for their little ones to take. Fever is one of the most frequently cited reasons parents or caregivers seek medical help for their children. It is often a source of concern for parents and health care practitioners, who believe it may be linked to a greater risk of seizures (fits).3a A fever is defined as a body temperature of more than 38 °C in children.3b     Our syrup contains paracetamol, an option for treating pain and fever in children,4 and caters to diverse tastes and preferences while being gentle on little tummies5. But we didn’t stop there. We know that getting children to take medicine can be a challenge, which is why we’ve made sure that our grape flavour is also taste-bud friendly and easy to take.  With its clear syrup, there’s no need to worry about messy clothes or unsightly stains. Plus, the grape flavour is sure to make medicine time more appealing to kids. 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.  Add in your child’s age and weight, and our calculator will automatically calculate how much Panado®  you should give your child, and which product is best suited for your child. So, next time you find yourself in the middle of a parenting rollercoaster with pain and fever, remember to reach for Panado® Paediatric Syrup – Grape Flavour – the clear choice for parents and kids alike!  Parents trust2 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.            2023032710267635 References: Panado ® Paediatric Alcohol Free – Grape Flavour. Approved package insert. October 2022. Circana, MT,  October 2023 MAT. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Fever in children: Overview. 2013 Dec 18 [Updated 2019 Jun 6]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279455/. Last accessed February 2023. de Martino M, Chiarugi A. Recent Advances in Pediatric Use of Oral Paracetamol in Fever and Pain Management. Pain Ther. 2015 Dec;4(2):149-68. doi: 10.1007/s40122-015-0040-z. Epub 2015 Oct 30. PMID: 26518691; PMCID: PMC4676765. Available from: https://pubmed.ncbi.nlm.nih.gov/26518691/. Last accessed February 2023. Bannwarth B. Gastrointestinal safety of paracetamol: is there any cause for concern? Expert Opin Drug Saf. 2004 Jul;3(4):269-72. doi: 10.1517/14740338.3.4.269. PMID: 15268644. Available from: https://pubmed.ncbi.nlm.nih.gov/15268644/#. Last accessed February 2023. Wilcock A, Twycross R. Therapeutic reviews: Acetaminophen (Paracetamol). Journal of Pain and Symptom Management, 2013;46(5):747-755.

Bonitas – innovation, life stages and quality care

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

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

CRYOSAVE

10 Reasons to choose cord stem cell banking for your baby

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

Parenting Hub

What are the costs of cord blood banking?

At CryoSave we understand that becoming a parent comes with financial strain. That is why we offer flexible pricing options, structured to your needs.” as this will give an indication that even though there is so much benefit, CryoSave makes it easier in terms of cost.  Below is a breakdown and explanation of the costs of stem cell banking. The collection kit The collection kit includes everything your doctor/midwife will need for the collection. The collection kit is paid upfront when you sign up for stem cell banking. The reason this is paid upfront is to ensure that the kit can be couriered to you immediately to be available once the baby is born for the collection to take place and after completion the kit will be collected by a specialised courier. Processing the collected samples Once the samples (collection kit) are received by the CryoSave laboratory, the samples need to be processed. This means that the cord blood cells are separated. The cord blood and tissue are processed according to international standards. CryoSave is an internationally AABB (Association for the Advancement of Blood and Biotherapies) accredited facility. All cord blood samples are processed using internationally validated processing and cryopreservation protocols. The cord blood and tissue stem cells will be kept in a liquid nitrogen storage tank (between -196 and -150°C) at our secured facility for long-term storage. In addition to the above, blood is also drawn from the mother at birth. The vials for these tests are also included in the kit. These samples will then be analysed by pathologists for infectious markers. Stem cell banks must do quality checks on all samples and before freezing a representative sample is taken for quality testing. The number of blood-forming stem cells and the % viability of the cells present in each sample is measured. Other checks are done to determine the recovery of stem cells after processing. Stem cell banks must also test for microbiological infection in each sample. After successful storage, the parents are notified of the success of the cord blood and cord tissue processing and negative microbiology. Parents will also receive a certificate for both the cord blood and cord tissue for their records. If difficulties are encountered during delivery that might have affected the collection of the cord blood or tissue, the Laboratory Director or Medical Director will call the gynaecologist to ascertain the reason for the problematic delivery. They will also contact the parents to inform them and discuss the collection with them. If the sample is needed for an approved transplant, CryoSave offers parents free shipment of the samples to anywhere in the world where the transplant will take place. A sample will only be released if approval is provided by an approved transplant centre and after discussions and approval documentation has been signed by the transplant physician, the parents, and the cord blood bank. Storage After processing is complete the cord blood and tissue stem cells are cryopreserved and cryogenically stored in the vapour phase of cryogenic nitrogen freezing tanks at -196° C and maintained there until needed. When you consider all these costs; running any cord blood bank is rather expensive. This includes the cost of running the liquid nitrogen facility, maintenance of equipment, regulatory-, compliance- and operational costs (including staff salary expenses). The storage fees paid over 20-30 years, is a critical element of cost as this is to ensure that the stem cell bank you banked your baby’s stem cells with, can safely and securely store your samples for the required time to come. Storage fees should therefore be a non-negotiable cost when it comes to this process. Conclusion In addition, the search for donor stem cells can take months for a life-threatening disease and can cost anything between R600k – R1m. If you bank with a private cord blood bank, the stem cells are immediately available. Considering the above, the cost of R25 000 for the collection kit and processing fees, and storage fees less than R50 p/m should not seem expensive. Only the collection fee is paid upfront. Repayment terms are available. At CryoSave we understand that becoming a parent comes with financial strain. That is why we offer flexible pricing options, structured to your needs. Contact us today to get a personalized quote.

Bonitas – innovation, life stages and quality care

New Mommy Tips

Caring for Baby The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Circumcision care Newborn circumcision is a surgery that removes the loose skin (foreskin) that covers the end of a baby boy’s penis. It may be done for various reasons and usually heals with 7-10 days. Follow the care instructions you were given by your baby’s doctor. Often times they will recommend that you use a small amount of petroleum jelly on the site at diaper changes to prevent irritation. Contact your baby’s doctor if you see blood or pus around the circumcision or if you smell an odour coming from the site. Myths about newborns The following are common myths about newborns: Myth: Don’t touch their “soft spots” – Truth: Known as the fontanels, these areas are a thick protective membrane, not your baby’s brain, so if you happen to touch them gently nothing bad will happen; as with all of your baby, handle that area with gentle loving care. Myth: Baby girls don’t have periods – Truth: Baby girls may have a “mini period” within the first few weeks of life which is the result of the stimulation of their uterus by Mom’s high estrogen levels. If you ever have questions about what’s happening with your baby, contact your doctor. Myth: Babies don’t get acne – Truth: Some newborns will develop acne due to circulating hormones from their mother between 2 weeks and 2 months of age; you don’t need acne creams, just cleanse the area gently. Myth: Babies have flat chests – Truth: Some babies may temporarily have swollen breasts due to their mothers circulating hormones; this can happen to boys and girls. Myth: Sneezing must mean my baby has a cold – Truth: Newborns have tiny noses and often have some congestion, so they may sneeze a lot at first; if they have thick, coloured mucus and are sneezing a lot then they may be developing a cold. Never hesitate to contact your doctor if you are worried about what’s going on with your baby. No question is ever “dumb” if you are worried. Bathing your newborn Your baby doesn’t need a full bath every day, only 3-4 times a week. When giving them a full bath make sure the water is warm, but not hot, by testing the temperature with your elbow – if it’s too hot for your elbow, it’s too hot for your baby. Use mild bath soap made specifically for babies – harsh soaps may dry and irritate their skin. Always keep one hand on the baby while they are in the bathwater. There are some parts of your baby that will need to be washed with mild soap every day, especially their face, chin, neck and bottom. Do not use soap on their belly button (navel) or on a circumcision until it’s healed. Make sure the room you are in to bathe your baby is warm and free of drafts. Every baby is different so don’t hesitate to talk with your baby’s doctor if you have any questions about caring for your newborn. Healthy skin for newborns You don’t need to use lotion or powder on your baby unless it’s been recommended by their doctor. Don’t use fabric softener or bleach on their clothes as these can irritate their skin. Use mild detergent to wash their clothes, making sure to wash new clothing before you put it on the baby. Be careful not to overdress your baby – if you are comfortable in a t-shirt and shorts, your baby will be fine in a t-shirt or short sleeved onesie and a diaper. Diaper care for your newborn Periodically check your baby’s diaper to see if it’s wet or soiled. Change their diaper whenever one becomes wet or soiled. When changing your baby’s diaper, wash their bottom with mild soap and warm water or use disposable baby wipes. Be sure to wash your hands each time you finish changing a diaper. Additional tips for care of newborn For mouth care, wipe you baby’s gums daily with a clean damp washcloth or an infant toothbrush. To prevent scratches, keep your baby’s finger and toenails cut short. Remember that newborns sleep a lot – usually between 16-18 hours a day. Make sure to schedule your baby’s first check-up as recommended by their doctor – it’s usually recommended between 2-4 weeks of age. Umbilical cord care Do not place the baby in bath water until after the umbilical cord stump has fallen off. Keep the umbilical cord stump clean and dry – if it becomes soiled you can clean it with a cotton ball, mild soap and water. Umbilical cord stumps usually fall off about 2-4 weeks after birth – contact your baby’s doctor if this doesn’t happen. If the umbilical cord stump turns red around the base, bleeds, develops coloured drainage or a bad odour contact your baby’s doctor right away since it could be a sign of an infection. Contact your baby’s doctor if you have any questions or concerns about your baby’s umbilical cord stump. Teething pain relief The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. To help soothe the pain from teething give your baby a teething ring, a wet washcloth cooled down in the refrigerator, or feed him/her cold foods such as applesauce or yogurt. You can also talk to your doctor about giving your baby acetaminophen (Tylenol) to ease the pain.

CRYOSAVE

Choosing the Right Stem Cell Bank: Private, Government, or Community – What Parents Should Consider

Some of the earliest decisions that parents face, can be amongst the most challenging. The choices that parents must make before and after the birth of their baby can have long-term implications for their future health. These days, one of these major decisions includes whether to collect and store the cord blood and tissue of your new-borns umbilical cord and placenta during delivery. Then there is also the question about the choice of the various types of stem cell banks. There are three types and options for stem cell banks. These are: Public Stem Cell Banks In South Africa, there is no public cord blood bank available, as the government does not provide a facility for collecting and storing cord blood samples. At public stem cell banks, families can choose to donate the cord blood, but in doing so, they relinquish ownership of the sample, making it unavailable for their own or their family’s use. This absence of a public cord blood bank poses challenges for families in South Africa who may require cord blood stem cells for potentially life-saving treatments in the future. To address this limitation, families may need to explore private cord blood banking options, which come with associated costs and ongoing maintenance fees. Private banks allow individuals to store their baby’s cord blood exclusively for their own use, providing a potential source of compatible stem cells if needed. However, the availability of private cord blood banking ensures that families have an alternative for preserving cord blood in South Africa, despite the lack of a public option. Community Stem Cell Banks If individuals decide to bank their baby’s stem cells with a community bank, they will incur lower costs for registration, processing, and storage. However, the trade-off is that they do not have exclusive rights to the sample for their own family’s use. Typically, the initial banking period in such cases is limited to 10 years. Community banking of cord blood is open to everyone, meaning there is no guarantee that the donating family will be able to access these cells if they ever require them. Public and community banking operates on the principle of donation, allowing anyone in need to potentially utilize the donated stem cells if they are a compatible match. Unfortunately, if a family needs the stem cells in the future but they are no longer available to them, obtaining donor stem cells becomes a significant financial challenge. The cost of acquiring donor cells can range from R600 000 to R1 million. Additionally, the search for a suitable donor can be a time-consuming process, taking months. In cases of life-threatening diseases, this delay can be a critical obstacle for individuals and their families, leaving them with limited options. Private Stem Cell Banks Private cord blood banking offers individuals a means to ensure the future health of their family. The process involves an initial cost for the collection kit, processing of the sample, and subsequent storage fees. However, flexible payment plans are often available to accommodate varying financial circumstances. Typically, the storage period spans 20 years, and the associated fees can be paid on a monthly, annual, or upfront basis. Moreover, it is possible to extend the storage term beyond the initial 20 years. The cost of private cord blood banking should be viewed as a form of lifetime insurance for one’s family, rendering it highly affordable. By opting for this option, the stored samples remain exclusively accessible to the donor and their immediate family, ensuring immediate availability in the event of a medical treatment requirement. Additionally, there is a 25% chance that the stored samples will be an exact match for siblings with the same parents, and a 50% chance of being a match for the parents themselves. This significantly enhances the potential benefits of private cord blood banking for family members who may require stem cell treatments in the future. CryoSave is your dedicated premier private family stem cell bank. Our stem cell products are stored exclusively for your family’s use. Our ultimate focus is to ensure the highest quality service delivery and maintenance of your child’s precious stem cells.

Parenting Hub

UNDERSTANDING TEMPER TANTRUMS AND HOW TO DEAL WITH THEM

Affinity Health, a leading provider of high-quality health coverage, explores the underlying causes of temper tantrums in children and offers strategies for managing and defusing these challenging situations. “Temper tantrums are a common and challenging aspect of childhood development that can leave parents, caregivers, and even bystanders feeling anxious and overwhelmed,” says Murray Hewlett, CEO of Affinity Health. “The neuroscience behind tantrums reveals that meltdowns happen due to the ongoing development of children’s brains. They still need to acquire the coping mechanisms to manage intense emotions effectively. The good news is that most kids will grow out of temper tantrums as they learn to express themselves better.” Understanding Temper Tantrums Toddlers possess various skills, yet temper control isn’t typically one of them. Temper tantrums are intense, emotional outbursts that often occur in young children, often between the ages of one and four. These outbursts can take various forms, from crying and screaming to kicking, hitting, and even breath-holding. While temper tantrums can be distressing for children and adults, they are a normal part of child development and communication. Common Causes of Temper Tantrums While every child’s tantrum trigger is different, a few common causes for meltdowns may include the following: Frustration: Children often lack the language skills to express their needs and frustrations adequately. When they encounter obstacles or cannot communicate their needs, frustration can lead to tantrums. Seeking Attention: Some children may use tantrums to gain attention from parents or caregivers. Negative attention, such as scolding or reprimanding, can be just as rewarding for them as positive attention. Fatigue and Hunger: Tiredness and hunger can exacerbate emotions and lead to increased irritability in children, making them more prone to tantrums. Transitions and Changes: Changing routines, from playtime to mealtime or leaving a favourite place, can be challenging for young children and may trigger tantrums. Overstimulation: Excessive sensory input, such as noise, bright lights, or crowded spaces, can overwhelm children, making them more likely to have tantrums. Independence and Autonomy: As children strive for independence, they may become frustrated when their desires conflict with parental limits or expectations. Emotional Regulation: Young children are still learning to regulate their emotions, and tantrums can be a way for them to release pent-up frustration, anger, or sadness. How to Deal with Temper Tantrums Dealing with temper tantrums requires patience, empathy, and practical strategies. Here are some steps and tips for managing and diffusing temper tantrums: Stay Calm: Parents and caregivers must remain calm during tantrums. Losing your temper can escalate the situation. Ensure Safety: Ensure the child’s safety and the safety of others during the tantrum. Remove any potential hazards or objects that could cause harm. Provide comfort and reassurance without giving in to the child’s demands. Let them know you understand their feelings. Use Distraction: Sometimes, redirecting a child’s attention to a different activity or object can help defuse the tantrum. Set Limits: Establishing clear and consistent limits and boundaries for behaviour is essential. Be firm but loving in enforcing these limits. Offer Choices: Giving children choices within reasonable limits can help them feel a sense of control. For example, you might say, “You can choose between these two snacks,” or “Which of these two t-shirts do you want to wear today?”. Time-Outs: Sometimes, a brief time-out in a safe and quiet space can help a child calm down. You should explain the reason for the time-out and use it as a moment for reflection rather than punishment. Teach Emotion Regulation: As children grow, help them understand and manage their emotions by teaching them techniques like deep breathing or using words to express feelings.  Positive Reinforcement: Praise and reward positive behaviour to reinforce good choices and encourage cooperation. Seek Professional Help: If temper tantrums are frequent, severe, or interfere with daily life, consider consulting a healthcare provider or child psychologist for guidance.

Vital Baby

Raising a Vegan Baby: Tips and Ideas for Nutritional Success

Vegan-based diets are becoming more popular, especially in South Africa, where more than 100 000 vegan mothers gave birth in 2020. But can you raise a healthy vegan baby? The answer is yes if you take care of their nutritional needs for growth and development. A vegan diet for babies must be well-planned and balanced, and you should seek support from a registered dietitian with experience in pediatrics. Gestation: If you are a vegan mum, you should ensure that you eat a well-balanced diet and increase your intake of certain nutrients during pregnancy. Your daily nutrient requirements increase considerably when you are expecting. You need more iron, folic acid, B12 and other B vitamins, vitamins A, C and D, plus extra protein, and calcium. Some nutrients, like selenium and iodine, can be passed on through your breast milk, but it may be worth seeking professional advice from a registered dietitian to ensure that your diet contains enough for you and your baby. Typical adult vegan diets tend to be low in fat and high in fibre, which is not suitable for growing children, who need a lot more energy and nutrients from food to meet their nutritional requirements for normal growth and development. Vegan diets are naturally high in fibre and too much fibre can fill little tummies quickly, curbing appetite and stopping them from eating enough to get adequate nutrients.   Breastfeeding is best for vegan babies, and you should try to breast feed as long as you can and continue to supplement solid feeds with breast milk.  Vital Baby helps to ensure both parents can get involved with the baby’s nourishment with the daily use of a manual or electric Nurture Flexcone breast pump which helps you to save and store breastmilk for feeds when you can’t be there and for topping up breastmilk at mealtimes.   Occasionally, newborn infants may need a little help during feeding. The Vital Baby Feed Assist bottle enables you to gently squeeze the base of the silicon squeeze bottle to encourage milk flow through the teat and to assist with the latch. Anti-colic valves help to reduce air intake. If for some reason you are unable to breastfeed, you can use plant-based baby formula instead in either powder, concentrate or liquid form. Make sure you choose a formula that is fortified with vitamin B12, vitamin D, iron, calcium, and other essential nutrients for your baby.  The Vital Baby Nurture Milk Formula Dispenser has been specially designed so that the revolving lid can click accurately into position above each compartment, and the wide, easy-pour spout makes it simple to dispense the milk formula into the bottle, avoiding spillages. Starting solids Parents can begin feeding their babies a vegan diet when they start eating solids, usually around six months of age. Your baby can enjoy fruit and vegetable purées, enriched with a variety of vegan protein, calcium, and good fat sources. These include lentils, mashed beans, quinoa, tofu, tahini, yeast extract, finely milled nuts and seeds and fortified soya products like milk or plain soya yoghurt. Most plant-based yogurts contain live active cultures, so your baby can get the same gut health benefits of probiotics from non-dairy alternatives. Beans, chickpeas, lentils, nut butters, whole meal bread and rice and fortified breakfast cereals are all good iron sources for your baby. And adding vitamin C-rich food (e.g., oranges, strawberries, cabbage, pepper, and pineapple) will help with iron absorption. It is not advised to feed your child low-protein vegan milk alternatives like almond, coconut, or rice milk as they will fill up their tiny tummies without providing much nutrition. Critical nutrients for your vegan baby’s diet: Protein: pulses (beans, lentils, peas), nuts (almonds, walnuts), seeds (sunflower seeds) and tofu. Iron: beans (kidney beans), pulses (lentils), peas (green peas), green leafy vegetables (spinach), nut butters (peanut butter), tofu (firm tofu). They should have an iron-rich serving at every meal. Vitamin B12: fermented yeast products (nutritional yeast), fortified foods (soya milk) or supplements. Iodine: Moms may need to supplement when baby is over 2 years old or use iodized salt sparingly. Calcium: beans (navy beans), pulses (chickpeas), sesame seeds (tahini), dark green leafy vegetables (kale), white bread (whole wheat bread), plant-based milk (almond milk). Vitamin D: exposure to sunlight, fortified foods (margarine) or supplements. Selenium: Brazil nuts (just one or two per day is enough), sunflower seeds (roasted sunflower seeds), mushrooms (shiitake mushrooms) or supplements. Omega 3: chia seeds (ground chia seeds), hemp seeds (hemp hearts), tofu (silken tofu), linseed (flaxseed oil), rape seed oil (canola oil), hazelnuts (roasted hazelnuts), pecans (raw pecans) and walnuts (chopped walnuts).  Vitamin B2: wheat germ (toasted wheat germ), almond butter (smooth almond butter), avocado (ripe avocado) and mushrooms (portobello mushrooms).  The NOURISH Prep and Wean from Vital Baby provide inspired ideas for food combinations and nutrition packed meals home cooked in your own kitchen. Steam, cook, and blend healthy homemade meals quickly for your little one with three modes – sterilise, steam cook and blend – perfect for batch cooking and feeding later. With five blending modes you can tailor consistency of food to your child’s stage of weaning – from smooth purees to chunkier textures while its 2-tier steaming system allows you to cook multiple foods with different cooking times all at once. It is suitable for use with fruit, vegetables, meat, and fish. Ideas for your 9+ month Vegan Baby Blend fresh or frozen fruit (e.g., banana, mango, berries) with plain soya yoghurt and a dash of maple syrup.  Mash a ripe avocado and a ripe banana together with a fork until smooth. Spread on whole wheat toast or crackers. Sprinkle with some cinnamon or nutmeg for extra flavour. Mash a ripe banana with a fork and stir in chia seeds and plant-based milk. Refrigerate overnight or for at least an hour until thickened. Serve with fresh fruit or nuts on top. Cook some quinoa in water or apple juice until fluffy. Stir in some grated apple, raisins, and cinnamon.

Lifesaving South Africa

Preventing the unthinkable

Sunshine, watermelon and flip flops… summer holidays are around the corner! If you’re a parent you’re probably planning activities to keep your little ones occupied, or maybe pulling together your holiday travel plans. Whilst you are ticking off your packing list and racing to get your shopping done, be sure to take a moment and consider how you will keep your children safe around water this summer holiday. Drowning happens quickly and silently and can devastate a family in a matter of minutes. More than 700 children under the age of 15 years old die from drowning every year in South Africa, but even non-fatal incidents in which a child is rescued can leave a family dealing with long term social and health consequences. Recent evidence from Australia suggests that an infant’s risk of drowning triples as they reach one year of age. In South Africa, we know that children under 5 years old have the highest drowning rates compared to other age groups, but rates remain high in older children as well. Young children tend to drown in water in and around the home, while older children drown in larger, open bodies of water. Whilst these numbers are sobering, it is important to remember that most drowning incidents are preventable.  Here are some tips for keeping your children safe around water this summer. 1- Layers of barriers Many drowning incidents in very young children are unwitnessed, meaning that no-one is around at the time that the child enters the water. Young children often fall into water unintentionally while playing nearby or fetching toys that they may have been playing with earlier. One of the most effective ways to prevent drowning in young children is to ensure that there are barriers preventing them gaining access to water around the home. This means ensuring that pools are fenced off or have a safety cover that meets local safety standards, even better if you have both. Having a cover or fence alone is not enough – it must be used correctly! This means replacing the cover completely when a pool is not in use or ensuring that a gate is closed and not easily opened by children. It’s important to remember that hot tubs, paddling pools, blow-up pools, and portable above ground pools all present a drowning risk and should be protected appropriately or emptied when not in use. Pools aren’t the only area of risk around your home either – small ponds, reservoirs or storage tanks should also be protected by a barrier preventing access.  2 – Designated supervision So many drowning stories start with “I thought he/she was watching”. Counter intuitively, drowning incidents can happen easily in a crowd because they are silent and not signaled by splashing as many people think. Consider the large family braai where everyone is chatting around the pool and kids are splashing and laughing. Everyone is there but no-one is watching. Designating an adult to supervise children enjoying any water is essential. A supervisor should be an adult, not an older sibling, who is sober, not distracted by their phone or a book and within arm’s reach should something go wrong. As a parent it’s so easy to fall into the trap of thinking that nothing bad ever happens, so I’ll just step away to take that phone call or take the pot of the stove. Supervision is about someone being able to respond appropriately in the tiny percentage of times that things go wrong, not the majority of times where it’s just another day of summer fun. Forget about the “dad bod” or “mummy tummy” – get your cozi on and enjoy the water with your kids. 3- Learn CPR and know your emergency number Knowing what to do in an emergency can make the difference between a tragedy and a close call. CPR is simple to learn and, if performed early, can save a life and reduce the chances of long-term neurological damage in a drowning incident. Calling 112 from any cell phone in South Africa will reach a call centre who will route you to the closest emergency service. 4 – Swim between the flags When heading to the beach, make sure to swim only where and when lifeguards are on duty. Lifeguards do not replace adult supervision of children, but swimming between the red and yellow beach flags ensures that you are in the safest location on any given beach.  5- Be mindful of unfamiliar homes and holiday locations Even the most diligent, water smart parents can get caught out while travelling. It’s important to consider water safety when visiting family who might have older children or no children, or while staying in hotels and guesthouses that are unfamiliar and exciting to explore. When you’ve arrived at your holiday location, take a slow walk around the property, and consider it from the perspective of your children – where is the water? Where are the access points? How can you prevent access? If you’re visiting an unfamiliar beach, dam or river, speak to locals or lifeguards to find out where the safe swimming spots are. 6- Watch out for lilos and pool floats That flamingo pool float is super fun but be very cautious using it on any large open bodies of water or rivers. Floaties get caught by the wind and currents very easily and can quickly take a child (or adult!) out of their depth. 7- Teach your children survival swimming skills Summer holiday preparation happens year-round and enrolling your children in a survival swimming or learn-to-swim programme can help them learn the essential skills of safe entry and exit and what to do when they fall in. Speak to them about water safety from a young age to ensure that safety becomes engrained in their behaviour. 8 -Teach your children to become Watersmart Lifesaving SA has launched a free online e-learning WaterSmart hub, making water safety content accessible to all South Africans.  The hub includes animated videos

Wriggle and Rhyme

It’s the most wonderful time of the year!

The festive season is upon us.  Shops are full of Christmas cheer and wherever you go, Christmas music fills the air. Do you have a favourite Christmas song? There are some obvious recurring hits out there that come around every single year, like a merry-go-round. Yes, I’m talking about Michael Bublé, Boney M, Mariah Carey.  You know the drill! That’s because, music has a huge role to play in our celebrations.  It gets us moving, it creates a mood, and it builds memories. Music gets us moving Play some music, turn up the volume, and what happens? We get a feeling that we want to move! Whether it’s tapping our fingers on the steering wheel of the car, swaying slightly, or tapping our foot, the instinct is there. That’s even more true for children. They haven’t built up a sense of awareness of others, so they move like no-one’s watching. Dancing, jiggling their bottoms, clapping their hands, bopping their heads up and down, you name it! Music helps us to celebrate special seasons and events because it gets us moving. Music creates a mood Music also stimulates our emotions. It has the ability to make us feel happy, sad, soulful, joyful, excited, scared etc. If you want to test this, watch a scary movie and turn off the soundtrack.  Suddenly the movie isn’t quite as scary! Getting up and moving, stimulates the oxygen supply to our brains and also triggers the release of endorphins. This contributes to us feeling positive about the music we’re experiencing. Music builds memories What is it about music and memory that’s so powerful? The details of our lives pass us by every day, with very little embedding into our long term memories. It’s unlikely that we’ll remember what we ate for dinner 2 weeks ago or a passing interaction with a person years ago. But, when we hear a familiar song, the memories come flooding back. Music doesn’t just help us to remember details, it connects with our emotions.  We remember how a particular memory made us feel, and that’s really powerful. Music helps us to celebrate special times because it embeds details into our brains, and like a search engine, helps us to retrieve those memories at a much later stage, with the music acting as a trigger. Switch off the screen, turn on the music! With all of this in mind, let’s be intentional in the way that we use music over this festive season. Let’s harness all that music offers knowing that it’ll get us moving, help to create a happy mood and embed some wonderful memories into our brains. Let’s switch off screens and use music and auditory resources to encourage our children to listen and look out at the world around them. Musical resources With that in mind, we have some wonderful, uniquely SOUTH AFRICAN musical stories for your little people to enjoy. These are accessible on your favourite streaming platform (Apple music, Spotify etc.) and are a great alternative to screens.  Just go onto the platform for search for “Wriggle and Rhyme”.  There are 4 different albums available. Wishing you a safe and happy festive season, and a wonderful 2024! For more info about the W&R musical stories and online resources, have a look at www.wriggleandrhyme.co.za/our-music  Find us on Facebook and Instagram @wrigglerhyme #wrigglerhyme

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