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CRYOSAVE

CryoSave South Africa: A Trusted Choice for Safeguarding Your Baby’s Future with Stem Cell Banking

In the rapidly evolving field of medical science, the importance of stem cells in treating various diseases and conditions cannot be overstated. For expecting parents, the decision to bank their baby’s stem cells is a significant step towards securing the health and well-being of their child. CryoSave South Africa emerges as a distinguished choice for this crucial responsibility, and here are three compelling reasons why. 1. Pioneering Legacy in Stem Cell Banking CryoSave proudly stands as the oldest established stem cell bank in South Africa, with a commendable 20-year history of providing private stem cell processing and storage services in Southern Africa. In a region where public stem cell banks are scarce, CryoSave has been a trailblazer, offering families unparalleled access to cutting-edge technology and expertise. A strategic partnership with PBKM Famicord, the fifth-largest cord blood bank globally, further solidifies CryoSave’s reputation as a trusted family stem cell bank in South Africa. PBKM Famicord, with its extensive international presence and expertise, brings invaluable experience to the table, particularly in the transfer of materials for transplantation. 2. State-of-the-Art Facilities for Unparalleled Security CryoSave’s laboratory in Pretoria stands as a testament to its dedication to excellence. The state-of-the-art processing and storage facility adhere to rigorous international standards, guaranteeing the highest quality in cord blood and tissue preservation. The cord blood samples undergo processing and cryopreservation using internationally validated protocols. Rigorous tests, including viability assessments, cell counts, and sterility evaluations, provide an added layer of assurance for parents entrusting CryoSave with their baby’s precious stem cells. Stored within liquid nitrogen storage tanks at temperatures ranging from -196 to -150 °C, these stem cells remain secure within CryoSave’s fortified facility for long-term preservation. 3. International Accreditation for Unmatched Quality CryoSave South Africa’s commitment to excellence is exemplified by its voluntary pursuit of accreditation from the AABB Association. Dr. Robert Crookes, medical consultant to CryoSave South Africa, emphasizes the significance of AABB accreditation in fostering a level of professional and technical expertise that contributes to quality performance and patient safety. As a member of the Cord Blood Association, CryoSave actively participates in an international network that collaborates to advance cord blood banking and therapies. Led by Professor Joanne Kurtzberg, a distinguished transplant specialist in regenerative medicine, this association reinforces CryoSave’s dedication to staying at the forefront of scientific advancements in stem cell therapy. For more information on CryoSave’s commitment and partnerships, interested readers can visit CryoSave’s website. In conclusion, CryoSave South Africa emerges as a premier choice for parents seeking a reliable partner in safeguarding their baby’s future through stem cell banking. With a rich legacy, state-of-the-art facilities, and international accreditation, CryoSave sets a benchmark for excellence in the critical field of stem cell preservation.

Bonitas – innovation, life stages and quality care

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

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

Parenting Hub

5 Types of Birth Defects: Causes, Symptoms and Treatment

Affinity Health, a leading provider of high-quality health coverage, explores different birth defects, their causes, symptoms, and available treatments. “Having a baby is a momentous occasion filled with hope and joy. However, for some families, this journey may come with unexpected challenges in the form of birth defects,” says Murray Hewlett, CEO of Affinity Health. “Birth defects affect about 3-6% of newborns globally. This translates to millions of babies born each year with congenital anomalies. As we observe World Birth Defects Day on 3 March, raising awareness about birth defects is important. It’s important to remember that every baby is unique, and even if a birth defect is present, with proper care and support, many children can lead happy and fulfilling lives.” What Are Birth Defects? Birth defects are structural or functional abnormalities present at birth that can affect a baby’s overall health, development, or physical appearance. These conditions may range from mild to severe and involve various body parts, including the heart, brain, spine, limbs, or internal organs. While some birth defects may be detected during pregnancy through prenatal screening tests, others may only become apparent after birth. Understanding the Causes While the exact cause of many birth defects remains unknown, some common factors may increase the risk: Genetic Factors: Certain genetic mutations or hereditary disorders passed down from parents may raise the risk of birth abnormalities. These may include chromosomal anomalies like Down syndrome or single-gene illnesses like cystic fibrosis. Environmental Exposures: Exposure to harmful substances during pregnancy, such as drugs, alcohol, tobacco smoke, pesticides, or certain medications, can increase the risk of birth defects. Expectant mothers should avoid these substances and maintain a healthy lifestyle during pregnancy. Maternal Health Conditions: Maternal health conditions like diabetes, obesity, or infections during pregnancy can also contribute to the development of birth defects. Proper management of these conditions and prenatal care can help reduce the risk. Nutritional Factors: Inadequate intake of essential nutrients like folic acid during pregnancy has been linked to an increased risk of neural tube defects, such as spina bifida. Taking prenatal vitamins and following a balanced diet can help prevent deficiencies. Advanced Maternal Age: Women who conceive at an older age may have a higher risk of having a baby with certain birth defects, such as Down syndrome. Prenatal screening tests can help assess the risk and provide information for informed decision-making. 5 Types of Birth Defects #1 Heart Defects Some babies are born with congenital heart defects that affect the structure of the heart and its ability to pump blood effectively. Symptoms can range from moderate to life-threatening. Medication, surgery, and other procedures to enhance heart function are all possible treatment options. #2 Neural Tube Defects Sometimes, when a baby’s brain and spinal cord are forming in the early days of pregnancy, they don’t close up like they should. This can cause conditions like spina bifida or anencephaly. Babies with these problems might have trouble moving, learning, or growing like other children. Finding these issues earlier is essential so doctors can help manage them. #3 Cleft Lip and Palate Cleft lip and palate are common birth defects when a baby’s lip or the roof of their mouth doesn’t close up. This can leave a space called a cleft, which might make it hard for the baby to eat or talk. Doctors can rectify the lip and palate with surgery. Sometimes, children might need extra help with speech therapy or dental care. #4 Down Syndrome Down syndrome is a condition that some babies are born with because they have an extra chromosome. This can cause them to look a bit different and learn things a little differently. Children with Down syndrome might need extra support with things like school and healthcare, but with early help, they can do lots of amazing things and reach their full potential. #5 Clubfoot Clubfoot is a congenital condition in which one or both feet are twisted out of shape or position. It can affect mobility and may require treatment with braces, casting, or surgery to correct the alignment of the foot. With early intervention, most children with clubfoot can achieve normal function and mobility. Seeking Support and Treatment If you suspect that your baby may have a birth defect, it’s crucial to seek medical evaluation and support as soon as possible. Your healthcare provider can conduct diagnostic tests, such as ultrasounds, genetic screenings, or imaging studies, to assess the nature and severity of the defect. Early intervention services, including medical treatments, therapies, and support programmes, can help manage symptoms and improve outcomes.

CRYOSAVE

Revolutionizing Blood Cancer Treatment: Cord Blood Transplants Provide Hope for Non-Matched Patients

In the past, people with blood cancer’s only hope of a cure was getting a stem cell or bone marrow transplant from a donor, which is called an allogeneic transplant.  These patients needed a matched donor, thus the recipient and donor had to have the same immunologic proteins, called HLA. If not a match, the donor cells would attack the recipient’s immune system. Over the past few decades, substantial progress has been made in learning how to perform transplants using donated cells that aren’t a perfect match. Only 25% of people that require an allogeneic transplant, will have a sibling that is a match and 75% will need to find a match elsewhere. However, for southern European, Asian, African, Hispanic, Middle Eastern, or mixed ancestries people, it is often difficult to find a match. Where there is no sibling match for these people, patients can benefit from finding a cord blood match. This is where cord blood from a healthy newborn baby is used in the transplant. The following examples illustrate the incredible progress made with cord blood transplants: In May 2023, Duke University of Medicine published an article about the increased use of cord blood transplants in adults. Dr. Edwin Alyea, Chief Medical Officer stated that”. “More patients can benefit from transplants now because there are more donor options.” In  September 2022, the Memorial Sloan Kettering Cancer Centre published an article about how cord blood transplants have saved lives in patients with Leukemia, Lymphoma, and Myeloma. Kirsten Riemer, age 41 of African American and Creole descent, was diagnosed with acute myeloid leukaemia in 2016; and received a cord blood transplant in 2016. She is still disease-free after 7 years. Ali Abouzari, age 67 of Persian descent, was diagnosed with acute myeloid leukemia in 2009; and received a cord blood transplant in 2010. Stuart Apfel, age 63 of Ashkenazi (Eastern European) Jewish descent, was diagnosed with acute lymphoblastic leukemia in 2017; and received a cord blood transplant in 2018. Donamarie Gerardi, age 52 of Southern Italian descent, was diagnosed with diffuse large B cell lymphoma and chronic lymphocytic leukemia in 2001; and received a cord blood transplant in 2006. Wincheng Lin, age 41 of Chinese descent, was diagnosed with acute leukemia in 2006; and received a cord blood transplant in 2009. Keelly Nieves, age 41 of Colombian descent, was diagnosed with myelodysplastic syndrome in 2020; and received a cord blood transplant in 2020. Ankit Sundaram, age 33 of Indian descent was diagnosed with acute myeloid leukemia in 2019; and received a cord blood transplant in 2019. All these above patients have survived their cancer and are still disease-free today and living normal lives. To this day, nearly 400 adults and children have received cord blood transplants at Memorial Sloan Kettering, of these more than 50% were from non-European ancestry. The major benefits of a cord blood transplant are: The cord blood stem cells do not have to be a perfect match and can be transplanted without harm since a baby’s immune system is less developed and therefore less likely to recognize the patient’s body as foreign. The cord blood stem cells can help stop the cancer from returning after the transplant and are also excellent at combating cancer. The patients are also less likely to have the potentially life-threatening complication called graft versus host disease (GVHD).  The stem cells are also immediately available for an urgent transplant, as they are already cryopreserved once a match is found. Given that there are relatively few stem cells in each unit, and the time for the stem cells to settle and start producing blood cells is longer; a way to overcome this is with a new technology called “expansion”. This technology replicates these blood cells in the laboratory before being used in a transplant. Through clinical trials, Duke University has shown that using expansion shortens the time for the stem cells to settle and start producing blood cells from 28 to 12 days. This is much faster than any other transplant technique available. This product, called Omdidubicel, was approved by the Food and Drug Administration (FDA) in April 2023. This means that many more patients will now have access to the therapy. Another option to make cord blood transplants available for more people is to do a haplo-identical cord transplant. This involves a combination of donated cord blood stem cells and half-matched (haploidentical) cells from a related half-matched adult donor, typically a parent, child, or sibling. Medication given after the transplant, dampens the immune response among the newly transplanted cells to discourage graft versus host disease. Another way to make cord blood transplants available to patients that cannot endure high-dose chemotherapy before a transplant is to allow low-dose chemotherapy before the transplant, for it was found in these instances that the transplanted cord blood can recognize and kill cancer cells that were not eliminated by the chemotherapy. Today, more than 50,000 of these transplants have been performed worldwide. Cord blood even contains rare stem and progenitor cells for tissues that are different from the blood. Scientists are studying the likelihood that cord blood cells could be used to repair damaged tissues including those in the heart, brain and pancreas. To quote from an article in Diabetologica in 2011: “By implication, it appears that the stem cells in cord blood may hold more promise for the formation of pancreatic beta cells than those in bone marrow”. With all of these developments in regenerative medicine, it would be a great investment in a family’s future for parents to make the choice to bank their baby’s umbilical cord- and tissue stem cells at birth.   References Gupta AO, Wagner JE. Umbilical Cord Blood Transplants: Current Status and Evolving Therapies. Front Pediatr. 2020 Oct 2;8:570282. doi: 10.3389/fped.2020.570282. PMID: 33123504; PMCID: PMC7567024. https://medschool.duke.edu/stories/more-options-people-blood-cancers https://www.mskcc.org/news/how-msks-cord-blood-transplant-program-has-saved-lives Huang, C.J., Butler, A.E., Moran, A. et al. A low frequency of pancreatic islet insulin-expressing cells derived from cord blood stem cell allografts in humans. Diabetologia 54, 1066–1074 (2011). https://doi.org/10.1007/s00125-011-2071-2

Bonitas – innovation, life stages and quality care

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

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

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Early intervention is key to overcoming infertility

June is World Infertility Awareness Month, a time dedicated to raising awareness around infertility challenges faced by a large number of people across the world. According to the World Health Organisation (WHO), around 17.5% of adults – roughly 1 in 6 worldwide – experience infertility. It’s a major health challenge globally, affecting high-, middle-, and low-income countries alike. World Infertility Awareness Month highlights the Importance of access to infertility therapies through effective parenthood solutions at recognised infertility centres. Causes of infertility Infertility can affect both men and women and can be attributed to many causes. Male infertility can be caused by abnormal sperm production or function, challenges with sperm delivery, exposure to certain environmental factors (such as cigarette smoking, anabolic steroid use, marijuana, alcohol, and certain medications), and damage from cancer or its treatment. Female infertility may result from ovulation disorders, uterine or cervical abnormalities, fallopian tube damage or blockage, endometriosis, early menopause, pelvic adhesions and cancer or its treatment. Age is a key factor in the decline of fertility for both men and women. While men over the age of 40 may be less fertile than younger men, a woman’s fertility declines after the age of 35. This decline in women progresses quickly after the age of 37, due to the lower number and quality of eggs. According to Dr Jack Biko, President of the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG), infertility can stem from issues present at birth or those that develop later in life, affecting one or both partners. “Infertility is determined after 12 months or more of regular, unprotected sexual intercourse without a pregnancy. Women over the age of 35 should seek an evaluation if they have not been able to conceive after six months.” An infertility diagnosis can lead to feelings of distress and anxiety and may negatively impact the wellbeing of a person or a relationship. But help is available. “Early diagnosis by a fertility specialist can identify fertility challenges promptly, allowing for more effective and timely interventions,” says Dr Biko. “Fertility clinics provide medical support as well as counselling and emotional guidance to help couples navigate this difficult time with hope and resilience. Seeking treatment also ensures that you receive a personalised care plan tailored to your specific situation, which optimises your chances of a successful pregnancy.” Consider fertility preservation Age is one of the most common causes of infertility, with the growing trend of people starting their families at an older age. Egg or sperm freezing can help to address this issue. “One option that is becoming increasingly popular with women is elective egg freezing,” says Dr Biko. “It’s a prudent choice for women who wish to preserve their fertility for future family planning. By freezing your eggs at a younger age, typically in your late 20s to early 30s, you may safeguard your chances of conception later in life, when natural fertility starts to decline.” Dr Biko says this proactive approach allows families, especially women, to focus on personal, professional, or educational goals without the immediate pressure of starting a family. “Advances in cryopreservation technology have improved the success rates of using frozen eggs, making it a viable option for those planning ahead. The success of egg freezing, however, is highly dependent on the age of the woman at the time of freezing, with women under 35 having much better outcomes.” This option can be especially empowering for women who have not yet decided to have a child, or who are delaying pregnancy to focus on career advancement. Increasing your chances of achieving a successful pregnancy later in life reduces the stress and pressure associated with the natural decline in fertility. Egg, sperm, or embryo freezing is also used for fertility preservation for medical reasons, such as people with a condition, or facing treatment for a condition, which may lead to infertility. For example, cancer treatments such as radiation, surgery and chemotherapy may either temporarily or permanently impact your ability to produce healthy eggs or sperm, and freezing them prior to starting therapy may improve your chances of starting a family later. Taking control of your reproductive future For many people, knowing they have preserved their healthy sperm or eggs provides a sense of security and control over their reproductive futures. However, there is a lack of awareness about fertility preservation options. Proper counselling tailored to the personal backgrounds of patients is essential, as is the need for accurate information to help people make informed decisions. Empowering yourself through knowledge is a key step in addressing fertility concerns. If you are struggling to conceive or if you would like to preserve your future fertility, don’t delay, have an open conversation about fertility treatment options with your doctor.     References 1. World health Organisation (WHO). 1 in 6 people globally affected by infertility: WHO. Accessed 20 May 2024. Available at:https://www.who.int/news/item/04-04-2023-1-in-6-people-globally-affected-by-infertility#:~:text=Around%2017.5%25%20of%20the%20adult,care%20for%20those%20in%20need. Boivin J et al. Tailored support may reduce mental and relational impact of infertility on infertile patients and partners. RBMO 2022. Mayo Clinic. Infertility. Accessed 20 May 2024. Available at: https:www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317. Alteri A et al. Elective egg freezing without medical indications. Acta Obstetricia et Gynecologica Scandinavica. Panagiota Nakou (20 Mar 2024): Women’s reproductive choice and (elective) egg freezing: is an extension of the storage limit missing a bigger issue? The New Bioethics. DOI: 10.1080/20502877.2023.2300233

CRYOSAVE

Unlocking the Future of Healthcare: What is Cord Blood- and Tissue Stem Cell Banking?

As parents with a newborn on the way, nothing is more valuable than your child’s health. The umbilical cord functions as the baby’s support throughout pregnancy, by connecting them to the placenta. It serves as a source of oxygen, providing them with nutrition and antibodies. The umbilical cord, cord tissue, and placenta have historically been discarded; however, more parents are storing (or “banking”) their baby’s cord blood and cord tissue for possible future use. Cord blood is the blood left inside your baby’s umbilical cord after delivery. The umbilical cord blood is a rich source of stem cells, these “precursor” cells are exceptional because they can mature or grow into different types of blood cells, such as platelets, red blood cells, and white blood cells. It also contains special types of stem cells as found in bone marrow, that can help improve the immune system. Therefore, cord blood stem cells are perfect for treating many of the diseases that can affect the immune and blood system (1). Cord blood stem cells help treat several diseases like leukemia, genetic disorders, diseases of the immune system and much more. Cord blood stem cells have the ability to treat more than 80 approved conditions and are being studied in more than 7,600 clinical trials for numerous regenerative therapies. Today, cord blood banking is already changing lives and there have already been more than 40,000 cord blood transplants around the world since the 1980s (2). Currently, new therapies are continually being developed to use these stem cells. Additionally, stem cells found in the umbilical cord tissue and placenta can also be banked. The umbilical cord itself is also a rich source of mesenchymal stem cells and these stem cells are found in the “Wharton’s Jelly”. As with cord blood-forming stem cells, these tissue-forming stem cells are also a rich and powerful source of stem cells. Both these types of stem cells have strong regeneration and differentiation capacity, possess a high level of stem cells, exhibit less immune rejection, and have fewer DNA mutations, are easily accessible and valuable stem cell sources. Cord tissue contains various exceptional cell types, which might in the future provide therapies for heart disease, spinal cord injury, autism, cerebral palsy, multiple sclerosis, and many more. In the correct environments and given the right signals, the umbilical cord stem cells can differentiate into many different cell types. As a result, they are very valuable in treating an increasing selection of medical conditions where specialised cells are injured and need replacing (3). The term ‘cord blood banking‘ means saving the newborn stem cells found in the blood of the umbilical cord, tissue and/or the placenta. Once the baby is born, it is possible to collect these cells and bank them in cryogenic storage for many years (currently CryoSave saves these stem cells for an initial period of 20 years, after which the period can be extended). The stem cells in cord blood can be collected without any risk to the baby or mother. This is the only chance you will get to store these types of stem cells – in the moments after birth. You can store the most powerful source of stem cells within minutes after birth if you choose to bank your baby’s cord blood and tissue. The cord blood and cord tissue stem cells are younger, have less exposure to harmful environmental factors or disease and are more “unspoiled” than adult stem cells. Storing your baby’s own cord blood safeguards that they will always have immediate access to their own stem cells which is a perfect stem cell match. Thus, any stem cell treatment or future possible organ replacement is available without the chance of rejection. Your baby’s stem cells may also be a match for a sibling (25%) and is always a partial match for the parents (50%). Cord blood banking is non-invasive and should have no impact on your birth plan or delivery process. Your gynaecologist or midwife can perform the collection after your baby is safely delivered. Once they collect the cord blood and a piece of the cord tissue in a sterile manner, and after your maternal bloods have been collected, our dedicated medical couriers will come to the maternity ward to collect the sample and bring it directly back to our laboratory. The cord blood and tissue will be processed, cryopreserved and cryogenically stored for 20 years or more, according to our AABB standard approved procedures. Various other tests will be performed to ascertain the number of stem cells, viability, sterility, recovery percentage and maternal infectious marker status. CryoSave understands that the day of the birth of your baby is one of the most significant days of your life. We make the process as seamless as possible from beginning to end. Once you have decided to bank your baby’s stem cells with us, we will organise everything for you. On the day of the birth, you only have to ensure that you take the Collection Kit with you. Your gynaecologist or midwife will perform the stem cell collection using the items found in your collection kit. We will assist to arrange for a nurse to draw the maternal bloods if required. All you have to do is call CryoSave and we will arrange collection using our dedicated courier to pick up the sample. CryoSave will take care of everything else for you. Your newborn may form part of the next generation to survive beyond 100 years of age. The likelihood is they will need stem cells to keep healthy. These umbilical cord blood and tissue stem cells, in the future, could be used for the treatment of diseases for your baby and even your family and will repair and heal damaged tissue or even regenerate organs. This is why over 4 million families worldwide have chosen to protect their baby’s health by banking their cord blood and tissue.   References: Waller-Wise R. Umbilical cord blood: information for childbirth educators. J Perinat Educ. 2011

Parenting Hub

Babies on the Brain after SA’s Baby Boom Month

During the birthing season, South African storks are on overtime duty due to the high number of babies being born. With South Africa having a collective ‘baby brain’, Lee Hancox, Head of Channel and Segment Marketing at Sanlam, shares some of the biggest financial planning considerations to factor in pre-, during- and post pregnancy. She says, “It’s pivotal to have a holistic plan upfront that you draw up in consultation with your partner, employer, medical aid provider and financial adviser. Preparing for some of the biggest costs is a major factor in ensuring peace of mind, now and later. We outline some of the expenses to consider, but naturally, the exact amounts will vary depending on whether you’re opting for public or private services, your medical aid option, as well as the specific providers you use.” Before Conception: Medical Aid Preparation: Secure adequate medical aid coverage well in advance to account for pregnancy-related expenses. Be sure to consider potential waiting periods (medical aid and gap cover often only ‘kick in’ for pregnancy after 12 months) and coverage limitations. Allocate funds for medical consultations and prenatal supplements like folate. Everyone has a different pregnancy journey, and you may need to budget for various fertility treatment options, from ovarian stimulation medications and intrauterine insemination (up to R10 000) to in vitro fertilisation (IVF). IVF can cost anything up to R100 000 per cycle including R90 000 for the procedure and medication, with an additional R10 000 based on how many embryos you have to freeze (approximately R1 500 per straw. To be safe, budget up to R100 000 for IVF. During Pregnancy: First trimester: In the first trimester, women often underestimate the significant impact pregnancy can have on both their physical and emotional well-being. During your initial doctor’s visit, expect a series of tests to monitor your health and the baby’s growth. These tests may not be covered by medical aid and can incur substantial costs (up to R2 500 or more), encompass evaluations for blood pressure, blood glucose, German measles, and your first sonar scan. Checklist: Find a gynaecologist whom you feel comfortable with and ensure their services are competitively priced. Make sure they’re aligned with your preferred birth plan – some obstetricians are more specialised in C-sections than natural birth, for example. Antenatal consultations, depending on the provider, may range up to R2 500 for essential appointments, with intermittent ones potentially costing up to R850 – or more. Familiarise yourself with your medical aid’s maternity benefits. Begin saving for significant expenses such as prams and baby cots, which can range from R500 to R10 000 each. Consider exploring second-hand options for potential savings. The second-hand ‘mom’ marketplace is massive and worth tapping into. Your doctor may recommend starting additional supplements like omega-3, calcium, and multivitamins during this trimester. Specific pregnancy-designed products can cost up to R350 for a month’s supply. In addition, it’s crucial to conduct thorough research on maternity benefits and hospital/gynaecologist options. Some maternity wards offer hospital tours, allowing parents to assess facilities and inquire about specific policies. Questions regarding the presence of birth partners during delivery or overnight stays for assistance should be addressed. Understanding hospital rules and legal requirements, such as the necessity of a baby car seat before leaving with your newborn, is essential. Furthermore, signing up for baby programs offered by medical aids, hospitals, and stores can provide valuable resources and discounts. Additionally, it’s advisable not to stock up excessively on baby essentials before the baby arrives, considering potential sensitivities and the need for adjustments. Second Trimester: As you start hopefully getting over the morning sickness stage, use your extra energy to get your affairs in order. Review your long-term financial plans including updating your will, revisiting your estate planning and appointing a guardian, adjusting your life cover, and establishing education funds. In this trimester, you can also opt for additional test for foetal anomalies like Down’s Syndrome. These often fall outside medical aid limits and can cost up to R2 400. Checklist Chat with your HR manager to ensure you fully understand your maternity benefits. Prepare to claim for UIF. Depending on your company’s policy, you can expect to receive only a portion of your gross salary for a maximum of four months (there are agencies that can help with the admin for your UIF). Start staggering your baby purchases. Ask close ‘parent’ friends which items they found essential and try to stick to these. Third Trimester: Now’s the time to start to budget for maternity leave, living expenses, and final baby preparations, including attending antenatal classes and finalising birth plans. Checklist: Understand medical aid coverage for hospital stays and any potential out-of-pocket expenses for upgraded amenities, such as a private room. Consider attending antenatal classes to learn important information and make new ‘parent-to-be’ friends. Find a certified doula you feel comfortable with and trust, if you want a non-clinical birth companion to be by your side, during the birth and in the weeks leading up to and after it. This can cost R3 000 or more. Book your birth with your desired hospital and start filling in all the requisite paperwork. Just before birth: It’s wonderful to have a birth plan, but remember to account for curveballs, like your baby’s health and the potential need to switch to a C-section. Make sure your birth team know your desired birth plan but have budget set aside for ‘curveballs’. For example, a vaginal birth in a private hospital will cost about R20 000, while a caesarean costs R25 000 and an emergency caesarean, potentially more. This is very important when specialists charge above medical aid rates. Speak to your obstetrician and make sure you know the rates upfront, and whether he or she offers any discounts if you do not have gap cover, for example. Prepare financially for additional costs, like an extended hospital stay and extra care for your baby if he or she has jaundice, for example. Pack your baby bag and keep it simple!

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 21 of your pregnancy

At week 21 of your pregnancy you’re now just over half to meeting your baby for the first time. You’re still in your third trimester, so take advantage of feeling better with a smaller baby bump while you can. Your body at week 21  Typical pregnancy symptoms during this are an achy back, swollen feet, heartburn, hot flashes, forgetfulness (nicknamed ‘baby brain’) and leg cramps. You may have also noticed stretch marks on tummy, breasts, thighs and butt, and this is thanks to your quickly growing tummy and baby. Headaches during pregnancy are fairly normal, especially if you’re slightly tired or dehydrated. However, if you experience bad headaches for hours on end, or ones that won’t go away, consult your doctor as you may have high blood pressure. This is also known as pre-eclampsia, which is a pregnancy complication characterised by high-blood pressure and protein in your urine. Your baby at week 21 Your baby is now the length of a banana or a carrot. Around this time your baby will also start sleeping and waking at different times (not necessarily the same as yours though). Your baby is also drinking amniotic fluid, although the placenta is how they receive the majority of their nourishment. Things to keep in mind at week 21 Braxton Hicks contractions are also known ‘false labour’ and they are your body’s way of preparing you for labour. These contractions are your womb contracting and relaxing and while they can be uncomfortable, they aren’t painful. Braxton Hicks contractions vary in length, and aren’t rhythmic, which is what differentiates them from normal contractions. There isn’t a treatment for these contractions, but changing your position (if you’re lying down) or taking a relaxing bath or nap can help ease them. If you’re unsure of whether or not you’re having Braxton Hicks contractions or labour contractions, contact your doctor immediately, as you may be going into preterm labour.

Parenting Hub

Can giving up Alcohol Improve Fertility?

Affinity Health, a leading provider of high-quality health coverage, explores whether giving up alcohol can improve fertility. “The question of whether giving up alcohol can improve fertility is a topic of growing interest among individuals and couples hoping to conceive,” says Murray Hewlett, CEO of Affinity Health. “While numerous factors influence fertility, lifestyle choices can and do play a role.” The Impact of Alcohol on Fertility Alcohol consumption can affect fertility in both men and women, but the extent and mechanisms can vary. In Women For women, moderate to heavy drinking can lead to a range of reproductive issues. Alcohol can disrupt menstrual cycles, leading to irregular periods or ovulation problems, making it harder to predict fertile windows. Hormonal imbalances caused by alcohol can affect the reproductive system, reducing the chances of a successful conception. Excessive alcohol use is also linked to an increased risk of miscarriage and may harm the health of the ovum (egg). In Men Men are not exempt from the reproductive consequences of alcohol consumption. Alcohol can lead to decreased sperm count, reduced sperm motility (movement), and abnormal sperm morphology (shape), all of which can diminish male fertility. Alcohol can also affect testosterone levels and other hormones in men, further influencing fertility. Evidence Linking Alcohol to Fertility Issues Numerous studies have explored the relationship between alcohol and fertility, with many finding a negative correlation between high alcohol intake and reproductive health. For instance, research has shown that couples undergoing IVF treatments might experience lower success rates if they consume alcohol. Another study highlighted that even light drinking could potentially extend the time it takes to conceive. The Benefits of Giving Up Alcohol for Fertility  Given the evidence linking alcohol consumption with reduced fertility, abstaining from alcohol could have several benefits for individuals trying to conceive: Hormonal Balance: Eliminating alcohol from your diet can help maintain a healthier hormonal balance, essential for regular ovulation in women and optimal sperm production in men. Improved Menstrual Cycle Regularity: Cutting out alcohol can lead to more regular menstrual cycles for women, making it easier to predict ovulation and optimise the timing for conception. Enhanced Sperm Quality: Men might see improvements in sperm count, motility, and morphology, which are crucial for fertilising an egg. Health Benefits: Beyond fertility, giving up alcohol can lead to better health, including weight management, improved liver function, and reduced risk of chronic diseases. A healthier body creates a more favourable environment for conception and a healthy pregnancy. Increased Energy Levels: Alcohol can disrupt sleep patterns and lead to feelings of fatigue. Eliminating alcohol may result in better-quality sleep and higher energy levels, which are beneficial for managing the demands of trying to conceive and preparing for the energy required for parenting. Improved Immune Function: Regular alcohol consumption can weaken the immune system, making the body more susceptible to infections that could impact fertility. Abstaining from alcohol can help strengthen your immune system, contributing to overall health and well-being. Better Nutrient Absorption: Alcohol can interfere with the body’s ability to absorb essential vitamins and minerals, some of which are vital for reproductive health. Reducing alcohol can improve nutrient absorption, ensuring your body benefits from a nutritious diet. Emotional Well-being: Reducing or eliminating alcohol can have positive effects on mental health, reducing instances of mood swings, depression, and anxiety. Emotional well-being is crucial when trying to conceive, as stress can negatively impact fertility. Financial Savings: The cost of purchasing alcohol can add up. By cutting out or reducing alcohol consumption, you can save money, which can be redirected towards fertility treatments, preparing for a baby, or other wellness activities that support your fertility journey. Practical Tips for Reducing Alcohol Consumption Deciding to give up alcohol while trying to conceive is a personal choice and can depend on individual circumstances, including the frequency and amount of alcohol consumed. For many, reducing alcohol intake or abstaining altogether can be a proactive step toward improving their chances of conception. If you decide to reduce or eliminate alcohol to enhance fertility, Affinity Health offers these tips: Set clear goals: Decide whether you want to cut back or quit entirely, and set realistic, achievable goals. Seek support: Share your goals with your partner, family, or friends who can offer support and encouragement. Find alternatives: Discover non-alcoholic beverages that you enjoy to replace alcoholic drinks during social occasions or meals. Focus on overall wellness: Adopt a holistic approach to improving fertility by focusing on a balanced diet, regular exercise, and stress management. Track your progress: Keep a diary or use an app to record your alcohol consumption. This can help you stay aware of how much you’re drinking and motivate you to keep reducing it. Identify triggers: Take note of situations or emotions that make you reach for a drink and find healthier ways to cope or avoid these triggers altogether. Create new routines: If your social life or relaxation habits revolve around alcohol, try new activities that don’t involve drinking, like joining a class, exploring a hobby, or planning alcohol-free outings with friends. Reward yourself: Set milestones in reducing alcohol and celebrate each achievement with non-alcoholic treats or rewards that support your overall well-being. Educate yourself: Learn about the impact of alcohol on fertility and overall health to strengthen your resolve and commitment to reducing consumption. Be patient with yourself: Change takes time, and setbacks may occur. Be kind to yourself and recognise that every step forward is progress. Consult a professional: If you find it challenging to cut back on alcohol, consider seeking help from a healthcare professional or a support group specialised in managing alcohol consumption.  

Bonitas – innovation, life stages and quality care

Tackling women’s health holistically

‘A woman’s health is her Capital’ As far back as 2014 at the World Health Organization’s (WHO) ‘Partnership for Maternal, Newborn and Child Health Forum’, South Africa stated their alliance with WHO’s statement and said, ‘the health of mothers and their children is key to achieving development equity.’ Which is why Bonitas Medical Fund, the Medical Aid for South Africa, has teamed up with CareWorks, to bolster its mother and childcare benefits and introduce a new Female Health Care Programme. With this renewed commitment to the health and wellbeing of women and toddlers, the Scheme will shine a light on the importance of preventative care and empower women to prioritise their health. ‘In South Africa, women face a range of health challenges influenced by socioeconomic, cultural and environmental dynamics at play,’ says Dr Themba Hadebe, Clinical Executive at Bonitas. ‘Many of these healthcare factors are unique to women. Early disease detection and appropriate care programmes are proven key factors in improving treatment outcomes and prognosis. Dr Hadebe says, ‘It is common knowledge that women often put their own health needs aside to care for their families. This programme will pro-actively assist women and provide them with support, to ensure that they access prevention services when they need to, as well as treatment plans.’ Top health issues in South African women are: Non-Communicable Diseases (NCDs) Diabetes in South Africa’s is the second deadliest disease and is also the leading cause of death among women in the country. 68% of women are obese, which is a strong risk factor for Type 2 diabetes. In addition, it is estimated that 10% of pregnant women in South Africa have gestational diabetes, which may go undiagnosed. This evidences the urgent need for screening and diagnosis.  Breast and Cervical Cancer The statistics are stark: 1 in 6 women worldwide is estimated to develop cancer during their lifetime. By 2040, there will be a projected rise to 30 million new cancer cases amongst women globally. Screening services are encouraged for early HPV (Human Papilloma Virus) detection and breast cancer diagnosis.  Mental Health Approximately 25.7% of South Africans are affected by probable depression, with similarly elevated levels of anxiety, particularly among women. These rates are influenced by socio-economic status, adverse childhood experiences and educational levels. HIV/Aids South Africa has one of the highest HIV prevalence rates in the world – with women, especially young women, being disproportionately affected. Of the 7.3 million adults living with HIV, 64% are women. According to Dr Mizpah Moru, the Clinical Service Manager of CareWorks, ‘The programme is focussed on educating and empowering women to take control of their health and to address any barriers that may stop them accessing health services. ‘We have a highly skilled female team of clinicians who understand the specific healthcare needs of women.’ Online Assessment and Preventative Screening There are various modules in the Self Health Evaluation (SHE) – each are educational and designed to alert potential red flags related to the likes of cardiovascular disease, hypertension and diabetes. Other modules deal with prevalent cancers, mental health, pregnancy and communicable diseases like HIV, as well as screening questions for TB and STIs. SHE and risk identification will enable targeted messaging to members. Screening results will trigger a support process to assist members in accessing appropriate, targeted care programmes. ‘We’ve taken proactive steps to address their unique healthcare needs. Our aim is to provide inclusive, tailored healthcare solutions at every stage of life,’ says Dr Hadebe.  Female members will be encouraged to access their Bonitas benefits to: Promote preventative care strategies for both females and toddlers  Detect non-communicable diseases such as hypertension, diabetes, mental disorders, cancers, etc.  Help females plan appropriately during their reproductive ages Help expecting mothers to detect and manage any risks and complications as early as possible in their pregnancy Improve access for females and toddlers to essential care Improve parent education and awareness about toddler care Expansion of the Maternity Programme  The comprehensive Maternity Programme includes support for new parents with milestone reminders for children under three, immunisation reminders and online screenings for infant and toddler health.  Enhanced support for expecting mothers, includes: Early identification of high-risk pregnancies Weekly engagement for high-risk pregnancies Post-childbirth follow-up calls Online assessments for pregnancy and mental health Midwives and nursing sisters will provide nurturing and caring support to women who have suffered a miscarriage and assist them in working through both the physical and mental issues associated with the loss of their baby.  Support will be offered to parents of neonatal babies  The programme also includes a library of female specific health topics – with a monthly focus – screening reminders and support, all communicated through SMS, WhatsApp, emails, calls and other existing digital platforms.  ‘The aim of the new Female Health Care Programme is to raise awareness and promote education around health and wellness,’ says Dr Hadebe. ‘It’s about influencing behaviour positively and encouraging early screening and preventative services. Importantly, it is also about providing inclusive, tailored healthcare solutions at all stages of life, to help members live their healthiest life.’

CRYOSAVE

Men’s Health: The top health risks and how stem cells could assist in future

Men’s health is a complex topic, and some common trends and factors contribute to men sometimes neglecting their health. Reasons for this might be social expectations and stereotypes, fear of weakness and vulnerability, Work and lifestyle pressures, risk-taking behaviour, as well as the reluctance to discuss mental health issues. Most men are affected by the same diseases that can affect anyone—heart disease, stroke, diabetes, cancer, depression. Men’s health involves a variety of gender-specific issues, like testosterone production, sexual health, and unique issues such as prostate cancer and benign prostate enlargement. Thus, men can take control of their health by eating a healthy diet, making simple lifestyle adjustments, and visiting the doctor regularly. Heart disease and stroke Heart disease comes in many forms. All its forms can lead to serious, fatal complications if undetected. It is estimated that heart disease is the leading cause of death for U.S. men, responsible for one in every four male deaths. Between 70 percent and 89 percent of sudden cardiac events occur in men. Stroke targets more than three million men. High blood pressure is common in males under the age of forty-five. Stem cell therapy has been investigated as a potential treatment for congestive and heart failure patients. Mesenchymal Stem Cells (MSCs) can differentiate into various types of cells, including heart cells. Studies have shown that stem cells can improve heart function in patients with congestive heart failure. Stem cells have been shown to stimulate the growth of new blood vessels and heart muscle cells, and improve the function of existing cardiac cells, thereby improving cardiac function and blood flow and reducing inflammation in the heart. A few studies have shown good outcomes whereby injecting patients with allogeneic umbilical cord MSCs significantly reduces the rate of heart attacks or strokes in patients with chronic heart failure. Stroke is the fifth leading cause of death for U.S. men; it kills about the same number each year as prostate cancer and Alzheimer’s disease combined. Men have strokes at younger ages than women. After a stroke, the brain stem can suffer damage, and stem cells have the potential to help heal this damage. Research has shown that stem cell therapy can promote functional recovery in stroke patients by replacing damaged neurons and promoting the growth of new brain tissue. Cord blood is emerging as a serious competitor in cell therapy for stroke. The main reason is that MNC from cord blood triggers less graft-versus–host reaction than adult sources of MNC. If clinical trials of allogeneic cord blood therapy for stroke continue to meet their endpoints, this could be an exciting new application for donated cord blood.  In the United States, about 795,000 people suffer a stroke each year, and 140,000 are fatal1-3. If only 1% of these patients received cell therapy, that would be comparable to the total number of allogeneic stem cell transplants per year in the United States10. Ultimately, a successful cord blood therapy will find itself in competition against cell therapy products for stroke that are already near approval.  The possibility to utilize cord blood cells as an “off-the-shelf” product (actually out of the cryogenic freezer) with no HLA matching would make cord blood more competitive against other cell therapies that are based on MSC and operate as universal donor products (1-3). Skin Cancer This cancer joins heart disease as the top two leading causes of death for men of all races—and it is largely preventable with proper skin care and regular check-ups. Melanoma, the most serious skin cancer, affects the sexes differently. Men are more likely to die of melanoma than women. This is true at any age. White adolescent males and young adult men are about twice as likely to die of melanoma as white females of the same age. Recent experimental studies in melanoma cell lines confirmed that umbilical cord mesenchymal stem cells (UCMSCs) exert antitumor effects on melanoma by inhibiting proliferation, inducing apoptosis, and suppressing the metastatic potential of these melanoma cell lines (4). High blood pressure Several studies have shown that men younger than sixty-five consistently have higher levels of hypertension compared to women of the same age group. While common, it is not inevitable and can be prevented, delayed, and treated. If ignored, it can lead to heart and kidney failure, vision problems, and even blindness. Stress, lack of physical activity, and being overweight or obese increase the odds, as do genetics. Pulmonary arterial hypertension (PAH) is a progressive illness characterized by chronically elevated blood pressure in pulmonary circulation that can lead to right-sided heart enlargement and failure. In advanced stages, PAH is considered non-curable (5). Clinical researchers in Germany recently reported the first successful treatment of (PAH) using a human umbilical cord mesenchymal stem cell (HUCMSC)-derived therapy. Depression and suicide In 2019, 69% of total reported suicides were men.  The most common cause of suicide is untreated depression, as 90% of individuals who commit suicide are depressed. Men are less likely to seek treatment for depression. Stem cell therapies have emerged as a standard for the treatment of both subacute and chronic inflammatory processes and neurological disorders. Investigations have suggested the potential use of adult stem cell therapy to treat several neurological conditions, such as multiple sclerosis, autoimmune encephalomyelitis, Alzheimer’s disease, other dementia conditions, Parkinson’s disease, and epilepsy. Most studies emphasize the immunomodulatory nature of adult stem cells, with their therapeutic efficiency related to neurological diseases, particularly triggering anti-inflammatory states. Recently, various studies have focused on treating depression with MSCs from various sources and the results from different experimental studies strongly support the potential therapeutic use of stem cells in treating depression (6). Diabetes Untreated diabetes in men can lead to erectile dysfunction and other urological problems, nerve damage (neuropathy), dehydration, and damage to the eyes, kidneys, and hearing. Men, after putting on weight, are more at risk for diabetes than women. Additionally, men typically store fat differently than women, which increases their risk. In a recent meta-analysis, clear evidence was provided for the superior efficacy

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 20 of your pregnancy

Congratulations to you and your baby, you’re officially halfway through your 40 week pregnancy. It’s crazy to think that 20 weeks ago you had your last period, and now a new life is blossoming inside of you – you may even know their gender and are thinking about possible names. Your baby at week 20 You little one is now roughly the size of a grapefruit or banana, and if you haven’t been able to feel your baby move around, at week 20 things may change. Although your baby still has a fair amount of room inside of you, and you should feel her moving around inside your tummy.Their heart is pumping between 120-160 beats per minute and their senses and reflexes are becoming more developed. How you’ll feel at week 20 You may have noticed the appearance of a dark vertical line on your belly, this is normal in pregnancy and is known as a linea nigra. This line isn’t a problem and is caused by hormones during pregnancy. If you’re wanting to travel or are planning to organise a baby nursery in your house, use the time during your second trimester to your advantage, as your pregnancy symptoms won’t be as intense as they were in your first trimester, and your belly won’t be inconveniently big just yet. But that being said keep your needs in mind and don’t push yourself to do something if you aren’t feeling comfortable. Things to remember at this time During your pregnancy you may experience lower back pain thanks to your growing baby putting increasing strain on your body. If your pain is unbearable it’s best to seek the advice of your doctor or physio, but if you are managing there are a few things you can do to make your life more comfortable. Practicing prenatal yoga, deep breathing, being aware of your posture and a pregnancy belt are all things which can help ease your tired back.

Parenting Hub

How do you know if adoption is for you?

People consider adoption for a myriad of reasons, but, like with any parenting endeavour, it can feel daunting to even consider taking on the responsibility that comes with it. How do you know if adoption is the right choice for you? While many discussions around adoption focus on why someone could or should choose this route to become a parent in contrast to biological options, Beverley Beukes, who is a social worker, adoptive parent and the MD of Oasis Haven, a registered Child and Youth Care Centre in Johannesburg, says that there are other helpful self-assessments that potential adoptive parents should be doing to understand if it is the right fit for them. Emotional skills While many different types of people with diverse backgrounds and personalities have adopted successfully, there are some character traits that have strengthened their adoption experience. Beukes says that, as unexpected as it may be, having a sense of humour is one of the most valuable tools in an adoptive parent’s hands. “The ability to laugh at oneself, at the world, and at a child’s antics is a great boost in facing challenges. This doesn’t mean that all adoptive parents are great humourists, but parents who don’t take every little thing too seriously and who are able to laugh along the way find that laughter is often the best medicine and a sense of humour is a survival tool,” she explains. Linked to this is the ability to accept and express emotions. This helps parents with children who have been adopted navigate their own parenting journey in a healthy way – with all its ups and downs – and model good emotional health for their children. Part of this includes being secure in themselves. Successful adoptive parents hold a continuously firm belief that they are the right parent for their child, and they can continue investing in and committing to their child, even when there isn’t always reciprocation from them. Resilience Other resilience skills are also immensely helpful for parents who adopt, such as being able to maintain a sense of perspective so that momentary challenges don’t skew their entire perspective; being able to tolerate unknowns and changes; and flexibility. “Flexibility is an important quality. Adoptive parents must be able to make mistakes, adjustments, and allowances – this is as much an adjustment for them as it is for their child. They need to acknowledge when something isn’t working and to try a different approach,” says Simone Oketch, social worker at Oasis Haven. Being a good communicator and problem solver will go a long way to cultivate this flexibility. Parents will also need to prioritise a sense of family. “Successful adoptive parents see the family as a team that works together. When problems arise, they concentrate on the family as a unit, rather than on one specific member. They view the child in their total environment, knowing the child is influenced by many factors, including school, neighbourhood, friends, and past experiences,” explains Beukes. It may feel overwhelming to look at all of these characteristics and feel like there are areas where you don’t measure up, but remember that parenting is a journey (one that often starts even before you have a child living in your home) and everyone has the capacity to grow in all of these capabilities. Beukes and Oketch co-authored a guide called Strengthening Families in a South African Context, sponsored by Ambassadors for Good, which provides an overview of foster care, adoption and family preservation, as well as guidance for statutory and adoption social workers on supporting families. For more information, visit www.oasishaven.org.

Myboombra

How to build a sustainable maternity wardrobe

Pregnancy is a beautiful journey, a time of profound change and anticipation. It’s a period where your body undergoes remarkable transformations, nurturing new life within. As you prepare for this incredible voyage, one aspect often overlooked is the wardrobe transition – a key contributing factor to helping you feel comfortable as your body changes. The key lies in building a maternity and breastfeeding wardrobe that transcends pregnancy, helping you get more bang for your buck. Myboombra, a local South African maternity brand, aims to do just that and has put together some helpful tips on how to build a sustainable maternity wardrobe – better for your wallet, better for the planet. Choosing Essentials that will Last In the past, maternity wear was synonymous with oversized, shapeless garments destined to gather dust post-pregnancy. However, times have changed, and so has maternity fashion. Today, expectant mothers seek versatility, quality, and sustainability in their clothing choices. The secret to achieving this lies in selecting pieces that seamlessly adapt to your changing body and lifestyle. This is not the time to start wearing the latest runway trends or switching up your style. Invest in core pieces you know you will wear over and over again. Look for pants with a stretchy elasticated band and high quality natural fabrics that have a good stretch like cotton and bamboo which will stand the test of time. This way you won’t have to buy new sizes each trimester. Here’s a list of some basics to start off with: Stretchy comfortable cotton or bamboo panties with a bit more coverage (like these high waisted briefs) Wireless, stretchy cotton or bamboo bra with easy breastfeeding access (we like the cross designs) Elasticated/banded or drawstring pants  Stretchy cotton or bamboo leggings Cotton or bamboo long and short sleeve t-shirts with a relaxed fit and ideally with buttons Wrap shirts and dresses will be your go-to as they are size adjustable and breastfeeding friendly Linen or cotton Boyfriend button-up shirts Shop for Every Stage: Maternity, Breastfeeding and Beyond Pregnancy is a journey filled with milestones, each phase requiring unique considerations. Try to search for clothing that adapts effortlessly to your evolving needs, providing comfort and support when you have a bump, through to when you need easy breastfeeding access. You can find so many maternity and breastfeeding friendly clothes in your average store. Buttons and wrap designs are perfect for nursing post-pregnancy. Avoid buying maternity shirts with closed or high necklines as you probably won’t touch them once the baby arrives.   Be the change: Make Better Choices for your Children In an era of heightened environmental consciousness, sustainability isn’t just a buzzword – it’s a serious life choice that will have an impact on your children. At Myboombra, we are trying our best to move towards a greener future, utilising renewable bamboo fibers that minimize environmental impact. By choosing eco-friendly options like bamboo, sustainable cotton and linen, you’re not just investing in your wardrobe; you’re making a statement for the planet. Ready to embark on your sustainable maternity wardrobe journey? Find sustainable maternity basics with Myboombra that will last throughout your journey of motherhood. www.myboombra.com

CRYOSAVE

Safeguarding the Future: Child Protection Week and Your Child’s Future Health

Every year, Child Protection Week serves as a powerful reminder of our collective responsibility to ensure the safety and well-being of South Africa’s children. Held from the last Sunday in May to the first week of June, this national campaign raises awareness about the threats children face and empowers communities to act. This year’s theme, while yet to be announced, will undoubtedly focus on creating a nurturing environment where children can thrive. As parents, this week takes on a deeply personal meaning.  We are the primary guardians of our children’s safety and well-being, not just in the present, but also for their future health.  While Child Protection Week focuses on immediate threats, it is also an opportunity to consider the long-term health of our children.  One way to do this is by banking their stem cells at birth with a reputable cord blood bank like CryoSave South Africa. Stem cells are the body’s master cells, holding the remarkable potential to develop into a variety of specialized cell types.  These cells have the power to revolutionize medicine, offering potential treatments for a wide range of diseases  including leukemia, lymphoma, genetic disorders, and even some autoimmune diseases. While medical advancements are ongoing, the umbilical cord blood and tissue collected at birth are a rich source of stem cells.  By storing these stem cells with a cord blood bank, parents are making a proactive investment in their child’s future health.  CryoSave South Africa, a leading cord blood bank in South Africa, provides a safe and secure option for this vital biobanking. Here’s how CryoSave South Africa aligns with the spirit of Child Protection Week: Investing in the Future: Just as Child Protection Week advocates for safeguarding children’s futures, storing stem cells offers a potential health shield for your child. These stem cells may be a valuable resource for future medical treatments, offering hope for a healthier tomorrow. Building a Legacy of Care: The decision to bank cord blood is a testament to a parent’s commitment to their child’s well-being. It is adynamic step that demonstrates a willingness to explore all avenues to ensure a healthier future for their offspring. Promoting Family Health: Stem cells from a sibling can also be a potential match for a child needing a transplant. Storing cord blood with CryoSave South Africa can benefit not only the child whose stem cells are banked, but also their siblings. During childbirth, the umbilical cord and placenta are rich sources of stem cells.  These stem cells have the potential to develop into various cell types, offering possibilities for future regenerative medicine.  CryoSave South Africa utilizes a state-of-the-art processing and cryopreservation technique to safely store these stem cells for potential future use. While Child Protection Week focuses on immediate dangers, it also serves as a springboard for conversations about long-term well-being.  CryoSave South Africa offers expecting parents comprehensive information sessions and consultations to guide them through the decision-making process.  Understanding the potential benefits and limitations of cord blood banking allows parents to make an informed choice for their child’s future health. Child Protection Week is a crucial reminder of our collective responsibility to safeguard South Africa’s children.  As parents, this extends beyond immediate threats to encompass their long-term health.  By exploring options like cord blood banking with CryoSave South Africa, we can invest in a future filled with hope and the potential for a healthier life for our children. Remember, while Child Protection Week focuses on present dangers, CryoSave offers a chance to protect your child’s health far into the future. Visit CryoSave for more information on stem cell banking: https://cryosave.co.za/

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 19 of your pregnancy

At week 19 you’re just one week off being halfway through your pregnancy! Your baby is now the size of a mango, and the exciting news is that you’ll soon find out (if you want to) whether your baby is a boy or a girl. Your body at week 19 You may have started to notice some pelvic pain and abdominal pain due to your baby’s growth. Your muscles and ligaments are working hard to support your expanding bump and this can cause discomfort. Regular gentle exercise (and if you were fit before your pregnancy, that’s a bonus) can help strengthen the muscles around your back and pelvis which can alleviate discomfort. Leg cramps are another pregnancy symptom that many expecting moms experience. These frustrating pains can often be experienced near the end of the day. Calf stretches and drinking plenty of water are two ways in which you can help reduce cramps. Your baby at week 19 Your baby is now the size of a mango, and at this time their skin becomes covered in a greasy, waxy substance called vernix caseosa. This protects the skin from the amniotic fluid in the uterus. Your baby’s first set of teeth are developing (although these won’t be visible for a while after they are born) and hair is starting to appear on their head. Things to remember at week 19 Around week 19-20 you’ll have a morphology scan which is an ultrasound which examines your baby’s body, the placenta and umbilical cord. The scan is used to check for any structural abnormalities in your baby, but it will also be the first chance you get to see your baby. This scan is also when you’re able to find out your baby’s gender.

CRYOSAVE

Pippie Kruger: A Courageous Stem Cell Success Story

Isabella “Pippie” Kruger was made famous when, as a 2 and a half-year-old burn victim from Limpopo, she received a revolutionary skin transplant operation. Pippie was severely burned when a bottle of gel firelighter exploded while her father was lighting a braai on New Year’s Eve. She suffered 80% full thickness third-degree burns. She was given a 3% chance of survival by her doctors.  The skin graft was grown from her own cells in a laboratory in the United States, because the technology was not available in South Africa. It was the first time the procedure was performed in Africa.  However, 5 heart attacks, 5 strokes, kidney failure, lung collapses, sepsis and almost 60 operations later, she survived. The medical director, Dr Barrett at Genzyme-Sanofi, a pharmaceutical company owns the rights to the technology known as Epicel. Epicel produces skin for people with extensive burn wounds by extracting stem cells from small patches of patients’ healthy skin. They are placed on a layer of inactive mice cells and fed with special proteins that allow them to grow into thin layers of skin that can cover burns. Epicel is indicated for adult and pediatric patients who have deep dermal or full-thickness burns comprising a total body surface area greater than or equal to 30%. The skin was cultured in America and sent to Johannesburg on a 21-hour flight and working with plastic surgeon Ridwan Mia to ensure that it was transplanted to Pippie within three hours of arriving in South Africa. The Epicel procedure is a costly procedure and luckily the Kruger family managed to raise more than R700 000 for the Epicel procedure through a trust fund that was started by a friend. With the help of  Facebook and almost 10 000 followers, this was accomplished. Pippie’s story has been told in 71 newspapers across the world and by many global radio and television stations. Pippie, now 15, is no stranger to the operating table. Since the disastrous burns accident she suffered as toddler, the young girl has been through a gamut of surgeries, and recently she had her 62nd operation. Link to article: https://cryosave.co.za/2022/05/06/pippie-kruger-a-courageous-stem-cell-success-story/

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 18 of your pregnancy

Your pregnancy is starting to become more obvious, and if you’re trying to conceal your bump, you may start finding this more difficult. Inside your body, you may feel your little one moving inside of you – you may even notice that the movements are in response to noises as your baby can start to register sounds. Your body at week 18 You may have started to notice dizziness when you stand up. To lessen this, get up gently when you stand from sitting or lying down. Your back may be feeling increasingly achey, so avoid doing activities that aggravates it. You may also notice swelling in your hands and feet, as well as increasingly difficulty to get to sleep. Your baby at week 18 Your baby is now the size of an artichoke or a red bell pepper, and it’s around this time you’ll start to notice your baby moving around inside you. You may have noticed this previously, especially if you’ve had a baby before – but this is the time that little one’s movements become more distinct. However, they’ll feel more like a flutter than a strong kick, so don’t be concerned if you’re unsure of what you’re feeling at first.  Things to remember at week 18 Although pregnancy is a happy and exciting time for many moms-to-be, it can also be very stressful. Antenatal anxiety is both fairly common during pregnancy, especially if your pregnancy is unplanned, you have external stresses such as financial strain, or you experienced depression and anxiety prior to pregnancy. A bit of worry during this time is normal, as you are going through many new experiences. However, if you feel like your worry is crippling and you can’t enjoy day-to-day life, then you may be experiencing antenatal anxiety. This is nothing to be ashamed of, and seeking medical guidance can help make your pregnancy easier and happier.

CRYOSAVE

Keeping Your Little One Safe: Essential Burn Prevention Tips for New Parents

Every parent worry about their child’s safety, and the kitchen can be a minefield of potential hazards – especially for curious little ones. Burns are a common concern, with thousands of scalding incidents happening every year. But fear not, new parents! By following a few simple precautions, you can create a safe and enjoyable cooking environment for you and your budding chef. Pippie’s Story: A Powerful Reminder Pippie Kruger’s story is a stark reminder of the importance of burn prevention. This brave South African child suffered severe burns at a young age. Thankfully, advancements in medical care, like stem cell therapy, helped Pippie through the recovery process, allowing for successful skin grafting. While medical technology offers incredible support, prevention is always the best medicine. Tips for a Safe Home: Kitchen Safety Zone: As mentioned earlier, the kitchen can be a hotspot for burns. Implement the “No Child Zone” concept, keeping your child in a safe play area while you cook. Utilize back burners, turn pot handles inward, and keep hot food and drinks out of reach. Beyond the Kitchen: Burns can happen anywhere. Secure fireplaces and space heaters with sturdy barriers. Keep electrical cords out of sight and away from curious hands. Teach your child about the dangers of outlets and never allow them to play with electrical appliances. Sun Safety: Sunburns are a form of burn, and even on cloudy days, UV rays can damage your child’s delicate skin. Apply sunscreen with SPF 30 or higher liberally and reapply often, especially after swimming or sweating. Hot Water Woes: Scalding is a serious threat. Adjust your water heater to a safe temperature, ideally 48°C (120°F) or as recommended by the manufacturer. Install scald-resistant faucets in the bathtub and sinks your child uses. Chemical Concerns: Household cleaners and chemicals can cause burns. Keep them securely stored in high cabinets or locked away, out of reach of inquisitive youngsters. Remember: In case of a burn, immediately cool the affected area under cool running water for 10-15 minutes. For serious burns, call emergency services (10111 in South Africa) for immediate medical attention. By following these simple tips and fostering a safety-conscious environment, you can ensure your kitchen becomes a place of happy memories, not unfortunate accidents. Let us all work together to keep our precious little ones safe from burns!

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 17 of your pregnancy

Week 17 your baby is getting bigger, and this week they’ll start developing more fatty tissue. You may have started to notice an achy back and pelvis, and getting a good night’s sleep may have become increasingly more difficult. Your body at week 17 At week 17 you may see an increase in your appetite, a far cry from the nausea you experienced in your first trimester. Your breasts are also increasing in size as they prepare for milk production – for some women this growth is more than others. Your growing baby’s weight can also put added strain onto your spine and pelvis, meaning you could start to experience backache. Prenatal yoga and supportive chairs and shoes, are all ways in which you can help your body feel more comfy. Your baby at week 17 Your baby is now the size of an onion or orange, and at this time her fatty tissue is starting to form – this will help keep her warm after she’s born. Although the head is still the biggest part of the body, the body proportions are starting to become more even as your pregnancy progresses. Your baby is now learning to suck, so that when they’re born they can easily feed, although this reflex won’t mature until later in your pregnancy. Around this time, your baby’s finger prints will also form. Things to remember at week 17 Your pregnancy changes your whole life, including the way you sleep. Even though the position you sleep in is something fairly simple, which you probably hadn’t put much thought into before. As your pregnancy progresses, a good night’s sleep is something that may become increasingly difficult. It’s recommended that you avoid sleeping on your back in your second and third trimester, as your uterus and baby can put pressure on your spine and vena cava. Sleeping on your left side is ideal as this supports optimal circulation. Once your belly gets bigger, you can even look into getting a pregnancy pillow, which offers support for your entire body.

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Transforming Treatment: Stem Cell Molecules Target Inflammation and Immune Dysfunction

In the rapidly evolving field of medical science, stem cells have emerged as a beacon of hope for treating various diseases. This article delves into the multifaceted role of stem cells in combating viral diseases and managing autoimmune disorders like Multiple Sclerosis (MS). It explores how certain types of stem cells can not only mitigate viral replication but also modulate the immune response, shifting it from a state of inflammation to repair. The article further discusses the potential of umbilical cord stem cells in regulating the immune system, providing new insights into the treatment of MS. Read on to discover the transformative potential of stem cells in medical therapeutics. The Role of Stem Cells in Immune Response Some stem cell types release molecules that reduce viral replication and decrease the cytokine storm and inflammation induced by the immune system. These stem cells are part of both the innate and adaptive immune systems. Stem Cells in Post-Viral Recovery An important aspect of stem cells’ ability to alleviate viral diseases, especially post-clearance complications, is their capacity to shift the innate and adaptive immune systems from an inflammatory state to a repair state. This makes the molecules released from certain efficacious and safe stem cell types a potential new avenue for therapeutic development in Covid-19, particularly for late-stage inflammation and tissue damage once the virus has cleared, especially in the aged population. Stem Cells and Multiple Sclerosis (MS) The Problem: Immune System Abnormalities in MS MS is characterized by immune system attacks against myelin, despite the disease’s cause still being unknown. T-cells, which are immune system cells, enter the brains of MS patients and react with the myelin sheath that surrounds and shields neurons. The unregulated activity of T-cells, which leads to their unusual hostility, is often mediated by T regulatory cells (Tregs). The Solution: Mesenchymal Stem Cells (MSCs) MSCs, which are immature cells that can become any type of cell in the body, are one potential means of restoring T-cell control. Bone marrow contains a type of stem cell called MSCs. It has been demonstrated that MSCs activate Tregs, which in turn regulates T-cell activity. The Experiment: Umbilical Cord Stem Cells (UC-MSCs) Human umbilical cord contains MSC-equivalent stem cells, or UC-MSCs. Compared to MSCs, these cells are more stable, cause fewer immunological reactions, and have a greater capacity for expansion. Researchers cultured UC-MSCs in combination with immune system cells found in the blood of both healthy individuals and MS patients to investigate if these cells may regulate the immune system in MS. Unused human umbilical cords, which provide a plentiful and noninvasive source of these cells, and blood cells from ten healthy donors (mean age 28.38) and twelve RRMS patients (mean age 53.75) were used to create UC-MSCs. The Results: UC-MSCs and Tregs Researchers found that when UC-MSCs were present, resting T-cells from MS patients had a notably higher proportion of Tregs. Additionally, UC-MSCs were able to reinstate the regulatory function of Tregs, by inducing the synthesis of certain proteins known as cytokines that regulate T-cell activity. Overall, these findings showed that using umbilical cord stem cells to treat multiple sclerosis can successfully lower aberrant immune system activity. The potential of stem cells in treating viral diseases and autoimmune disorders like Multiple Sclerosis (MS) is immense. Their ability to modulate the immune system, reduce inflammation, and promote repair presents a promising avenue for future therapeutic development. Particularly, the use of umbilical cord stem cells offers a stable, non-invasive, and effective approach to control aberrant immune system activity. As we continue to unravel the mysteries of stem cells, we move closer to a future where diseases may be managed more effectively and efficiently, heralding a new era in medical therapeutics. References: Cuascut, F. and Hutton, G. (2019) ‘Stem cell-based therapies for multiple sclerosis: Current perspectives’, Biomedicines, 7(2), p. 26. doi:10.3390/biomedicines7020026. Forraz, N. and McGuckin, C.P. (2011) ‘The umbilical cord: A rich and ethical stem cell source to advance regenerative medicine’, Cell Proliferation, 44(s1), pp. 60–69. doi:10.1111/j.1365-2184.2010.00729.x. Khandelwal, V. et al. (2022) ‘Stem cell therapy: A novel approach against emerging and re-emerging viral infections with special reference to SARS-COV-2’, Molecular Biology Reports, 50(3), pp. 2663–2683. doi:10.1007/s11033-022-07957-2. Mebarki, M., Abadie, C., Larghero, J. et al. Human umbilical cord-derived mesenchymal stem/stromal cells: a promising candidate for the development of advanced therapy medicinal products. Stem Cell Res Ther 12, 152 (2021). https://doi.org/10.1186/s13287-021-02222-y Rowden, A. (2021) Stem cell therapy for multiple sclerosis: Explanation and safety, Medical News Today. Edited by N. Hammond. Available at: https://www.medicalnewstoday.com/articles/stem-cell-multiple-sclerosis Sleem, A. and Saleh, F. (2020) ‘Mesenchymal stem cells in the fight against viruses: Face to face with the invisible enemy’, Current Research in Translational Medicine, 68(3), pp. 105–110. doi:10.1016/j.retram.2020.04.003.

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Pregnancy, your body and your baby – week 16 of your pregnancy

You are now 4 months pregnant, and have 24 weeks left to go before you birth day, although this may seem far away your baby has done so much growing in these past 16 weeks and still has lots left to do before they are born.   Your body at 16 weeks Your pregnancy hormones can make your veins stretch, giving you varicose veins. While these distinctive purple lumps are the prettiest sight, generally they are painless and harmless. Pregnancy brain is another sign of a baby that you may have noticed, many moms-to-be notice they may become more forgetful or inattentive. The exact reason for this isn’t clear, however, stress and having many items on your to-do list could be contributing factors towards this. You may also notice some pregnancy weight gain (which is normal and nothing to worry about!) and your boobs will have probably gone up a few cup sizes as your body preps for breastfeeding. Be sure to invest in comfortable bras, such as maternity or sports bras, as this can help ease any discomfort. Your baby at 16 weeks Your baby is now the size of an avocado. This week may be the one that you first start to notice small kicks from your little on moving around. Another exciting marker of this time is the fact that your baby can start hearing your voice, so make sure you chat to them throughout your day. This’ll also be roughly the time that their eyes become more sensitive to light, their bones and muscles are hardening and strengthening and their eyebrows, hair and lashes are forming.  Things to take note of around this time. During pregnancy you may struggle with constipation. This is a fairly common pregnancy complaint thanks to pregnancy hormones and the extra iron you’re taking in your prenatal vitamins. Eating more fibre, drinking lots of water, and exercise can help keep you regular.  If you’re still struggling, chat to your doctor and they may prescribe stool softeners to help.

CRYOSAVE

Preterm Birth Awareness: Supporting Healthier Beginnings

A full-term pregnancy is best for your baby’s health. Full-term pregnancies usually last approximately 40 weeks. Preterm birth is defined as one where a baby is born too early before 37 weeks of pregnancy have been completed. Babies who are born early may suffer from long-term health issues that could include e.g. cerebral palsy, mental retardation, visual and hearing impairments, and general poor health and growth problems. In 2021, preterm births were recorded in approximately 1 of every 10 infants born in the United States. The preterm birth rate rose 4% in 2021, from 10.1% in 2020 to 10.5% in 2021. Causes of premature birth There are factors that may increase the risk of premature birth, such as an infection or placental problems, but the exact causes remain unknown. Some risk factors for preterm birth include being pregnant with multiple babies, clinical uterus or cervix problems (whether current or historical), tobacco or substance abuse, and closely spaced pregnancies (less than 18 months). However, most premature births occur with a natural frequency and doctors have little idea as to the reason why. Is it possible for preterm labor to stop by its own accord? For about 3 in 10 women, preterm labour stops on its own. If it doesn’t stop, then medication or treatment may be given to try delaying the birth. Current data suggest that in the United States, the preterm birth rate has increased to more than 10.5%.  This rate is higher than in any other developed country where this rate compares to 7.4% in England and Wales, 6% in France, and 5.8% in Sweden. There is a general global increase in the rate of preterm births. What are the signs of preterm birth? Mild cramps (period cramps), pressure in the belly or pelvis, low and dull backache, contractions where the muscles in the belly tighten every 10 minutes or less, vaginal spotting or bleeding, changes in vaginal discharge, water breaks. We cannot always prevent preterm birth’s. However, you can lower the risk by following this advice. See your doctor early and regularly in your pregnancy for prenatal care. Take care of any health problems, including diabetes, high blood pressure, or depression. Don’t smoke, drink, or use illegal drugs. Eat a diet that includes a variety of healthy foods especially foods rich in iron and folic acid. Gain a healthy amount of weight (not too much or too little). Protect yourself from infections (wash your hands well; don’t eat raw meat, fish, or unpasteurized cheese; use condoms when having sex; limit domestic pet chores such as changing cat litter). Reduce stress in your life, try yoga, meditation, being active, joining support groups. Be active every day. Try to get 30 minutes of exercise daily South Africa has experienced an increase in early delivery of baby’s post COVID-19. This is confirmed by a preterm birth rate of 11%. CryoSave South Africa urges mothers-to-be to take good care of yourself and your baby during pregnancy. If you are determined to bank your baby’s cord blood to ensure future stem cell health insurance possibilities, talk to your healthcare provider early in your pregnancy. This will enable you to prepare and review your stem cell storage options. Preterm babies need extra oxygen and help from machines to help them breathe which can damage their lungs. A life-saving treatment using stem cell from the umbilical cord should soon be available. References https://www.youtube.com/watch?v=itZI3uHs_28 https://health-e.org.za/2020/11/18/premature-births-antenatal-access/ https://www.marchofdimes.org/about/news/march-dimes-2022-report-card-shows-us-preterm-birth-rate-hits-15-year-high-rates

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

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

CRYOSAVE

How cord blood stem cells save lives

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

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

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

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Fetal MRI: Insights from a specialist

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

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

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

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

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

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