Pregnancy - Parenting Hub

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Giving birth – the facts and the myths

With so many truths and myths flying around when it comes to pregnancy and giving birth, it’s no wonder you get confused. Not only does every existing mother and aunt know the ‘right’ answer to everything, but doctors also have varying opinions. Have you ever walked out of the doctor’s office realising that out of the ten important questions you want to ask, 8 slipped out of your mind during the consultation? Don’t worry, it happens to the best of us. We have listed some popular beliefs and delved into whether they are true or false. Breaking of the waters makes the contractions stronger, thus can speed up labour. True. While there are other medical reasons why breaking the waters may be necessary, once a woman is around 7cm dilated, this process helps speed things up for the painful last three. However, this will only be used if you absolutely need to have things go a bit quicker. So don’t count on it to help you out if you’ve been in labour for 30 minutes without any complications. Braxton Hicks contractions are regular and strong, and will wake the mother up if she is asleep False. Real contractions will start at the top of the uterus and the intense pressure, like a tight belt around her waist, will wake her up. True contractions feel like menstruation cramps. While Braxton Hicks may not be a walk in the park, you will know the difference because they won’t come in regular intervals and increase in intensity. If you lift your arms above your head during pregnancy, the umbilical cord will slip around the baby’s neck. False. The baby is submerged in water and thus gravity will have no influence. Furthermore, the baby may become entangled by the umbilical cord because of the length of it. But the baby can swim through a loop in the cord as well. Dilation of the cervix can occur at any given time of the pregnancy. True. Some women have an “incompetent cervix” which means that the cervix does not tighten properly and a woman who had a child previously, has a slightly dilated cervix. In labour, dilation of the cervix is capable of happening earlier in the pregnancy. This is not necessarily a problem, but your doctor will talk you through it, depending on each case. An epidural might not be possible if the mother previously had an extensive back injury. True. Although this statement is true in certain circumstances, the skills of the anaesthetist will determine the likelihood of the mother having an epidural. If you feel that this may be a problem, make an appointment with the anaesthetist prior to the birth to talk about your options. An emergency epidural can be done if the baby is under stress False. This is not true as an epidural takes up to 20 minutes to have an effect. If the baby is under stress, 20 minutes to wait will be too long. The most successful method of managing pain during labour is the one the mother choose True. To manage the pain of labour, the mother needs to have the right attitude and support. Sometimes a combination of non-pharmacological methods (hypnosis, reflexology, massage and water therapy) is more effective than any given pain medication. While the term ‘mind over matter’ sounds like hocus-pocus when it comes to the pain of birth, it really has proven to help. So if you believe that having a water birth will help you, then you’ve already done some of the work. Bleeding in pregnancy at any given time necessitates a trip to the emergency room. True. Bleeding is always regarded as suspicious and should be investigated. So ignore those who scoff at your apparent paranoia and get yourself checked out ASAP. If the mother wakes up in the morning in the last trimester with a swollen face and extremities, she should contact her primary caregiver immediately True. This may indicate a rise in blood pressure and must be investigated immediately. You should take a urine sample for testing as well. The mother should insist that an advanced lactation specialist help her with breastfeeding. False. All midwives are trained to help and assist the mother with breastfeeding difficulties. However, it is true that a lactation specialist have a particular interest in and passion for breastfeeding. Some hospitals do not have lactation specialists available, then the ward midwife can assist effectively. With the right attitude and the right support, breastfeeding can be a success. The delivery of the placenta occurs within 15 minutes after the birth of the baby with a contraction True. But don’t worry, this contraction is not as strong as during the birth and the tissue is soft and moulds into the area, so the expulsion will be far easier than delivering the baby.

September 29, 2021

What should I do if I have symptoms of COVID-19 and I am pregnant?

Given today’s current global COVID-19 pandemic, worrying about the potentially harmful viruses’ effect on your pregnancy and baby is a valid concern. You’re probably wondering the best ways to avoid the virus when pregnant, and what to do if you think you may have caught it. How can I protect myself and my baby from catching the corona virus? Protecting yourself from COVID-19 while pregnant, is similar to that of anyone else avoiding the virus. Minimise contact with others through social distancing, frequently wash and sanitise your hands, and avoid touching your nose, eyes and mouth. Don’t be tempted to skip important prenatal visits in lieu of avoiding the virus – chat to your doctor about the best way forward with regard to this. Although slightly disappointing, cancelling events such as baby showers is a good idea, as the risk of exposure and infection becomes bigger with larger groups. Being pregnant, it’s a good idea to be extra precautious where possible. However, the RCOG (Royal College of Obstetricians and Gynaecologists) states that pregnancy doesn’t increase your risk of becoming unwell from coronavirus, and the majority only develop mild to moderate symptoms. What should I do if I think I have COVID-19 while pregnant? If you think you may have COVID-19 or have tested positive for corona the first thing you should do is contact your doctor. However, it’s best to avoid travelling to the doctors office as you may come into contact with someone positive for COVID-19 in these spaces. As the virus is new, this means that the studies that have been conducted are limited. Because of this it’s essential to follow social distancing guidelines to try and protect yourself, however, if you do contract the virus there is no immediate need for stress, as pregnancy doesn’t increase your risk.

September 23, 2021

Covid-19 Information for Moms-to-Be

Pregnant women do not appear to be more severely unwell if they develop Coronavirus than the general population. As this is a new virus, how it may affect you is not yet clear. It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.

September 16, 2021

Preparing for baby with Mom2B®

Oh, the happiness of hearing about a longed-for pregnancy! And what fun preparing for the tiny arrival. Where will baby sleep? What baby equipment and cute clothes are needed? Don’t forget mom’s pregnancy wardrobe to cover that expanding tum… Meanwhile during all this activity and joy, little one is calmly doing his or her unseen baby work – growing and developing to meet the world on that important due date. To help baby and herself during this time of preparation, mom-to-be knows that it is important to eat nourishing food. But because she is the one doing the running around while baby is just a passenger, finding the time and energy isn’t easy. What helps is to stock the house with chicken, fish, salads, vegetables, fruits and high fibre foods like brown rice, chick peas or oats. These meet her need for smaller and more frequent meals and help her cope with typical tummy problems like nausea, constipation, and cravings. Mom2B® Pregnancy Shakes can go on the list as part of her pregnancy and breastfeeding preparation too. They are affordable and yummy meal supplements in chocolate, strawberry or vanilla flavours and can be taken once or twice a day, helping her to acquire important nutrients for herself and baby. Just add milk or water for a drink of protein, carbohydrates, vitamins, minerals and an impressive nutritional content. No wonder Mom2B® is South Africa’s number one pregnancy shake. (*Nielsen MAT Aug 2019) Mom2B® Pregnancy Shakes, available from Takealot, selected pharmacies and retailers, cost around R144 for a 400 g tin of 8 servings. For more information: www.mom2be.co.za or Facebook https://web.facebook.com/NativaMom2B WIN! Are you preparing to welcome your little baby, or perhaps organising a baby shower for family member or friend? Enter and stand a chance of winning a Mom2B® hamper comprising of of 6 shakes, Nema the Mom2B® lamb, and a shaker bottle. Valued at over R1000!

August 2, 2021

SHOP VITAL BABY ONLINE AND OUR TOP PICKS FOR EXPECTING MOMS

We heard your suggestion and we have delivered – you can now shop for your favourite Vital Baby items online at www.vitalbabyshop.co.za From breast-pads to bottles, from sterilizers to thermometers, Vital Baby has everything an expecting mother could possibly require. Take a look at a few of our best seller items across the website. vital baby® NURTURE™ Easy Latch Newborn Starter Set Included in the pack: 2x vital baby® NURTURE™ breast like feeding bottle 150ml, cap and collar 2x vital baby® NURTURE™ breast like feeding bottle 240ml, cap and collar 4x vital baby® NURTURE™ breast like teat slow flow 1x vital baby® newborn 100% silicone soother 1x non-scratch bottle & teat brush vital baby® NURTURE™ breast like feeding bottles are: Expertly designed to mimic mum’s breast, the teat flexes like mum’s nipple, providing easy latch on. Advanced triple anti-colic valves to reduce air intake. Silicone is soft and smooth against baby’s delicate face. Wide neck bottle is easy to clean and fill. BPA-free. A range of teats with varying flow rates to keep up with your growing baby is available. For hygiene and safety reasons, it is recommended that the teats should be replaced at regular intervals. vital baby® NURTURE™ Flexcone™ Electric Breast Pump 1x vital baby® NURTURE™ flexcone™ electric breast pump The vital baby® NURTURE™ flexcone™ electric breast pump together with it’s very soft silicone breast cup and flexcone™ provides gentle cushioning around your breast and mimics the suckling action of your baby to provide the most natural and effective breast milk expression ever! With 9 different speed settings to give ultimate control, the vital baby® NURTURE™ flexcone™ electric breast provides a uniquely tailored feeding experience. The simple touch panel control is easy to use and quick to operate. It is discreet, quiet, lightweight and portable for total convenience. Perfect for use when at home or away; cordless operation with the built-in rechargeable battery, or plug in with the USB cable included – the choice is mum’s! vital baby® NURTURE™ Easy Pour Breastmilk Storage Bags The unique design of our easy pour breast milk storage bag makes it simple to fill, store and easy to transport. The leak proof secure seal ensures no milk is lost when storing breast milk in the fridge or freezer and the wide neck and free-standing base of each storage bag makes it easy to fill. Simply remove the pre-perforated tab when you are ready to fill the bag, then pour in your freshly expressed breast milk with ease, and securely lock the freshness into the bag with the easy use zip fastener. It’s as simple as that! When you are ready to use the stored breast milk, there is a special easy-pour spout. You re-open the bag by simply cutting along the dotted line, ensuring that your valuable breast milk does not pour over the sealing zip which may have been handled during filling. Our breast milk storage bag avoids possible contamination and maintains a high standard of hygiene, easily and effortlessly. vital baby® PROTECT™ Contactless Thermometer Quick, accurate and super simple to use, our multi-use 4 in 1 infra-red contactless thermometer detects the temperature in just 2 seconds and gives the result on its large fever alert colour changing, digital display. Choose which mode you need to give you ultimate peace of mind during the day, night or even at bath or feeding times! Learn more about Vital Baby on http://www.vitalbabyshop.co.za or follow them on social media at @vitalbabysa.

July 29, 2021

Infertility challenges during COVID-19? Help is available!

June is World Infertility Awareness Month, a time dedicated to heightening awareness about infertility – a medical condition often not widely spoken about yet something which affects a surprisingly large number of couples around the world.1a “Infertility is when you cannot get or stay pregnant after trying for at least a year and you are under the age of 35, or if you are over the age of 35 and are unable to get or stay pregnant for six months,” says Dr Sulaiman Heylen, President of the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG).” In the past few years, the number of couples seeking treatment for infertility has dramatically increased due to factors such as postponement of childbearing in women, and lifestyle factors such as stress, smoking and body weight.1b However, an additional recent stumbling block has been the fear of contracting COVID-19 which has had an impact on delaying people’s fertility journeys. For those already undergoing fertility treatment, when COVID-19 hit, there was a suspension of treatment worldwide and the subsequent delay of fertility treatments has resulted in much psychological distress for many patients.2a The month of June therefore aims to highlight why it’s so important not to let the pandemic ruin one’s fertility plans. “In addition to psychological issues, there are the physiological ones too,” says Dr Heylen. “Delaying fertility treatment due to fear of COVID-19 can further reduce your chances of successful treatment outcomes, with studies showing a reduction in live birth rates in patients who have postponed treatment.” “Treatment was suspended during the hard lockdown, but clinics are open once again, and particularly ‘high risk’ patients whose chances of falling pregnant would be further reduced by delaying treatment are encouraged to seek assistance,” says Dr Heylen. Dr Heylen says that infertility is a disease as defined by the WHO that can lead to disability (loss of function). “Section 27 of the constitution entrenches the fundamental right to access healthcare services and specifically includes reproductive health. SASREG feels that fertility services are an essential service and should therefore not be withdrawn for patients for whom delay in treatment would affect their prognosis.” “It’s very important to stress that assisted reproductive technology (ART) clinics are safe and have taken precautions to ensure the health and safety of patients and staff, while we await the availability of the vaccines,” says Dr Heylen. “There is minimal risk of exposure to the virus at these clinics and there is therefore no need to wait for a vaccine to reach out to receive fertility treatment.” Dr Heylen also notes that there has been much misinformation circulating online about the potential negative impact the COVID-19 vaccine might have on fertility, which has been causing patients to delay treatment while deliberating whether to have the COVID-19 vaccine or not.2b With COVID-19 vaccines now available globally, the British Medical Journal (BMJ) has stated that there is “absolutely no evidence” that these vaccines can affect the fertility of women or men.3a “Patients undergoing fertility treatment should be encouraged to receive a COVID-19 vaccine when it becomes available to all South Africans,” says Dr Heylen. “There’s no evidence that vaccination before or during fertility treatment will impact the outcome of treatment in any way. As the vaccine does not contain any actual virus, there is also no reason to delay pregnancy attempts after vaccination.” People undergoing fertility treatment (in vitro fertilisation (IVF), frozen embryo transfer, egg freezing, ovulation induction, intrauterine insemination, or using donated gametes) can be vaccinated during treatment but may wish to consider the timing given the potential side effects in the few days after vaccination.3c People may start their fertility treatment immediately after being vaccinated, unless they wish to have a second dose before pregnancy.3d Those who are donating their eggs or sperm for the use of others can also still have a COVID-19 vaccine.3e Don’t delay fertility treatment One in every four couples in developing countries is affected by infertility4a, while one in six couples worldwide experience some form of infertility problem at least once during their reproductive lifetime.1a The current prevalence of infertility lasting for at least 12 months is estimated to affect between 8 to 12% worldwide for women aged 20 to 44.1a “More than 50% of patients who visit a fertility centre are 35 or older,” says Dr Heylen. “It is very important for people not to wait too long when they consider having children. Young women need to be aware that there is a slow decline in fertility from their 20s until the age of 35, after which it starts to decrease rapidly until the age of 45. About half of infertility cases can be linked to the male. It’s therefore extremely important to investigate your fertility options and fertility preservation earlier in life, rather than leaving it too late. A woman who is not ready to have a child can choose to freeze her eggs to try to preserve her ability to have a child later on should she wish to.” Treatment options It is now estimated that more than 9 million babies have been born worldwide since the first IVF baby was born in the last 70s.1c The most common fertilisation treatment is intracytoplasmic sperm injection (ICSI)1e. This accounts for around three quarters of all treatments globally while conventional IVF accounts for around one quarter.1e Success rates from frozen embryo transfer are increasing too.1e “The good news is that over the last decade the advances that have been made in the field of assisted reproduction are massive and there is hope for those who might be suffering from some form of infertility,” says Dr Heylen. “You are not alone and there are many options available to help you realise your dream of having children.” Visit a fertility clinic near you to speak to a doctor about the options available to you and your partner. For more information, visit www.merckfertilityjourney.co.za #WorldInfertilityMonth #DontDelay #Merck

June 11, 2021

The silent victims of PND

One in three women suffer from Perinatal Distress (PND) in our country, according to the South African Depression and Anxiety Group (SADAG). But the terrifying truth is that it’s not just the women who suffer; it’s often their partners who take strain, even to the point of being diagnosed with PND themselves. Hubby’s hormones Women’s hormones undergo major changes during and after pregnancy, but they’re not the only ones. The lack of sleep and increased stress that new fathers experience can also take a toll on their bodies, creating real hormonal shifts that are often overlooked. Craig*, whose wife Claire* was diagnosed with PND soon after the birth of their first child, began to feel off kilter around the same time, but “everyone was so concerned with Claire, nobody even asked me how I was doing.” Because Claire wasn’t coping, Craig felt added pressure to take on extra duties with the baby and around the house – on top of maintaining a full-time job. He “somehow muscled through” those first few difficult weeks, which turned into months before he realised how severely it had affected him. Real men do cry At the end of his rope, Craig realised he had to do something about his situation. He reached out to a friend, who suggested he see a doctor. Through a combination of medical support, psychological therapy, and practical assistance (in the form of family, friends and a night nurse), Craig made a full recovery and is the happy husband and father he always dreamed of being. “It was the darkest and scariest period of my life,” he confesses. “Sometimes I’m not even sure how I made it through, but I am so glad that I did.” Not only is it unhelpful to bottle up emotions instead of working through them in a healthy way, it also sets an unrealistic and unhealthy example for older children and others who look up to you as a male role model. Like all humans, men experience a range of feelings triggered by both hormones and environmental factors, and by reaching out for help, you are doing the best thing for yourself, your family, and for society in general. Risk factors Each father is an individual, but there are broad factors that may place someone at added risk of developing PND. These include a personal or family history of mental illness, a strained relationship with the mother of the child, or difficulties with the child – this could be anything from colic to serious medical conditions that induce additional stress and/or concern. Financial pressure, problems at work and feeling unsupported (not having a circle of family or friends to confide in) can also increase the risk. Single fathers are also at added risk. However, perhaps the biggest risk factor is that so many cases of paternal PND go undiagnosed (or are diagnosed too late, once major damage has already been done) because the condition is not acknowledged or accepted as a legitimate illness. “Let me tell you, it is real!” implores Craig. It’s essential that every new and expectant dad ensure he has the support of at least a few key friends or family members who can be a shoulder to lean on and, occasionally, a pair of hands to hold the baby. Further, we as a society need to update our mindset when it comes to supporting new and growing families. “People always ask how the baby is,” Craig points out. “Sometimes they ask how the mother is doing. But nobody ever asks the dad.” A family affair Treatment of the mother is important but should not be in isolation from treatment of the family as a unit. Some doctors are reluctant to include fathers in the treatment plan for PND or even to talk to them about it, because of concerns about breeching doctor-patient confidentiality. This further disempowers fathers from helping to heal the family unit as a whole. It’s crucial to find a healthcare practitioner that sees and treats new and expectant families together (this, of course, includes a broad range of family structures including unmarried partners, same-sex families, adoptive parents and single-parents with their own unique support structures). Don’t live in denial Craig’s advice for dads struggling with PND? “It doesn’t matter how you got here. It doesn’t matter what you think of mental illness. It does matter that you are here. It does matter that your partner needs kindness and the way to provide that is to accept that you are here. Then act.” You heard the man! Make that call. Take that first step. You – and your family – deserve it. *Names have been changed to protect identities.

June 9, 2021

Matrescence – The Birth of a Mother

“Do you remember a time when you felt hormonal and moody? Your skin was breaking out and your body was growing in strange places and very fast? And at the same time people were expecting you to be grown up in this new way.” This is the beginning a TED talk by New York-based psychiatrist Alexandra Sacks. In answer to her questions, I immediately thought about my teenage years: adolescence. She continues, “These same changes happen to a woman when she’s having a baby. We know that it’s normal for teenagers to feel all over the place, so why don’t we talk about pregnancy in the same way?” After running a support group for mothers for several years, it has become apparent to me that while not all mothers develop Peri-Natal Distress (previously known as Postnatal Depression), all mothers do seem to battle in one way or another with the transition from woman to mother. This transition, and all the idiosyncrasies that go with it, was not something I had ever consciously considered. There are hundreds of books about the transition from child to adult. Adolescence is talked about in our culture; it is recognised as an awkward time in one’s life. Despite the obvious similarities, the same cannot be said for the transition from woman to mother. Even in the medical community, most of the focus is on a baby’s health rather than a mother’s, even less so her mental health. Unrealistic Expectations Many women post birth or adoption will seek psychiatric help, thinking that they might have PND. Dr Sacks has spoken with countless new mothers who tell her that they are battling. This is what she hears repeatedly from her patients: The women thought motherhood would make them feel whole and happy; they thought a maternal instinct would tell them what to do; they expected to want to put the baby first. These mothers did not know that these expectations were unrealistic. Because they were not living up to these expectations, they thought something was wrong with them. They thought that their feelings were unnatural, and that perhaps it was PND. The women were experiencing a sort of cognitive discomfort, but not the clinical signs of mental illness. They did not have PND. Dr Sacks struggled to put a name to what this phenomenon was. Then she found an old academic paper from 1973. Anthropologist Dana Raphael (who created the profession of a mother supporter: the doula) had coined the term ‘Matrescence’. Yes, this word sounds like adolescence. Both are times when the body changes and hormones shift, leading to emotional upheaval. Matrescence is not a disease, but doctors are not educated about the impact of matrescence on a woman’s life, and it consequently becomes confused with PND. In reality, it is not a simple case of either you have PND, or you feel absolutely perfect. Most mothers will struggle through the transition. Identity Shift Matrescence is not only about the physical changes that happen to a woman’s body whilst becoming a mother. This is how ALL mothers, both natural and adoptive, go through matrescence. Psychiatrist Dr Daniel Stern describes becoming a mother as a massive identity shift. Being aware of this is important because a mother who understands it will have more control over her behaviours, which in turn leads to better parenting. In addition, if a mum is in touch with her own emotions, then she can be more empathetic to her children’s emotions. What is it that makes matrescence so uncomfortable? Dr Sacks describes it as an emotional tug-of-war; a push and pull on a woman’s feelings. Human babies are very dependent on their mothers, and the hormone oxytocin helps a mother’s brain to ‘pull in’ to her baby. However, her mind is pushing away. There are other parts to her identity, such as relationships, work, hobbies, intellectual pursuits, etc. Then there are her physical needs: sleeping, eating, exercise, sex, and going to the toilet alone! This feeling of ambivalence, of wanting their child close but also craving space – is uncomfortable. Mothers are experiencing two opposing feelings at the same time. Realistically the experiences of motherhood are a mix of good and bad. Women have the unattainable image of “the ideal mother” in their minds. It sets them up to feel shame and guilt for not meeting this impossible standard. Mothers are too ashamed to speak about their ambivalent feelings for fear of being judged. That can be a trigger for developing PND. Let’s talk Motherhood is a natural progression. Most mothers find it hard. Ambivalence is normal and there is no reason to feel ashamed. If this were more widely talked about, mothers would feel less alone and stigmatised. It may even reduce the prevalence of PND. Women need to talk to each other to change the way our cultures understand this complex transition. Talk to other mothers, friends, other women! There is nothing wrong with a woman keeping a part of herself separate to being a mother. In fact, it is healthy and normal. Dr Sacks wrote in a New York Times article in 2017: “Knowing the causes of distress and feeling comfortable talking about them with others is critical to growing into a well-adjusted mother.” This, she says, will help new mothers and those around them to acknowledge that while PND is an extreme manifestation of the transition to motherhood, even those who do not experience it undergo a significant transformation. “When a baby is born,” she says, “so too is a mother; each unsteady in their own way.”

May 28, 2021

Could you have PCOS and not even know it?

Despite being incredibly common, affecting around 1 in 10 women, polycystic ovary syndrome (PCOS) is still one of the most underdiagnosed conditions around. So much so that, of those who have it, only 1 in 3 will be diagnosed. In short, there’s a fair chance you might have it – and a good chance you don’t realise it! PCOS tends to fly under the radar because signs can be easy to miss or attributed to something else. This is why it’s important to be aware of the condition and its symptoms, especially since getting the right treatment can be life-changing. But first – what is PCOS? PCOS is a hormonal disorder that also affects your metabolism in a way that causes insulin resistance. Ultimately, your body stops listening to insulin’s “instruction” – to convert the sugar in your bloodstream to energy. Instead, after lingering in your blood for too long – essentially raising your blood sugar – the sugar ends up being stored away as fat. This is why those suffering from diabetes as well as PCOS tend to experience weight gain. Another side effect of insulin resistance is that it triggers your ovaries to produce higher-than-normal amounts of androgen, the male hormone. The results manifest invisibly as cysts on your ovaries. The visible signs, however, include acne, excessive hair growth in unwanted places such as your face and irregular or missed periods. If left untreated PCOS can lead to infertility, type 2 diabetes and even cardiovascular disease. In short, if you’ve got it, you really want to diagnose it and treat it. Know the signs The frustrating thing about PCOS is that it’s not always so easy to recognise the symptoms. Life gets busy so we don’t keep track of our periods. Weight gain can be attributed to getting older or skipping out on gym. That recent spate of chin pimples? Perhaps that’s just “maskne” or a stress breakout. To make things even trickier, not every woman will develop all the signs. After all, it’s not unusual to develop PCOS and never spot as much as a single chin hair, let alone develop a mustache. Other less obvious symptoms include insomnia, fatigue and a craving for carbohydrates as well as anxiety or depression. When you consider that list, it’s easy to see how they could all be overlooked as just the side-effect of a stressful life mid-pandemic and not an extremely common syndrome. So here’s the good news If you suspect you have PCOS you’ll be glad to know there’s a lot you can do about it but your first step is to visit your doctor or gynaecologist. They’ll be able to ask the right questions and run a simple series of tests to help you get a diagnosis. As far as treatment is concerned, this could include medication as well as making certain lifestyle changes. For example, eating a low glycaemic index (GI) diet and getting regular exercise will help you manage your blood sugar levels. You can also manage your condition with our brand new ovarian health nutritional supplement – Ovaria by Lamelle Pharmaceuticals. It contains 4000mg of Myo-Inositol, the required dose clinically proven to reduce the symptoms of PCOS of women in their fertile era. A naturally occurring sugar associated with the vitamin B family, Myo-Inositol helps reduce your androgen levels by normalising your blood’s insulin levels. The result is an improvement in many PCOS symptoms including weight gain, acne and hair growth. In fact, Ovaria is proven to reduce unwanted hair growth by 29% in just 6 months. It can also increase your ovulation rate – improving your chance of getting pregnant – in as little as 16 weeks and help normalise your menstrual cycle. You’re not alone Ultimately, if you suspect you might be suffering from PCOS, don’t hesitate to chat with your doctor today. An early diagnosis means the sooner you’ll enjoy a better quality of your life while reducing your risk of PCOS-related conditions like diabetes. As far as treatment options go, you’ll have several to choose from and all of them can be enhanced by Ovaria. You’re not alone. Together, we can help put you back on the path to wellness. Learn more: https://lamelle.co.za/ovaria

May 13, 2021

Gestational Diabetes: Reasons, risks and recovery

Kathy Malherbe speaks to the clinical team at Bonitas Medical Fund to get some insights on Gestational Diabetes (GDM) and tells the story of mother-of-two, Theresa’s (36) experience with Gestational Diabetes. Diabetes is a condition whereby your body is unable, in varying degrees, to produce or respond to the hormone insulin. This causes abnormal metabolism of carbohydrates and elevated levels of glucose in the blood. Diabetes is commonly divided into four types: Type 1, Type 2 (often lifestyle related,) Gestational Diabetes and Diabetes Mellitus. Normally when you eat, your blood sugar rises. The pancreas, a gland deep in your abdomen, releases a hormone called insulin. It helps move sugar from your blood into your cells for energy and storage. In a non-diabetic person, the blood sugar will go back down to normal after eating. What is Gestational Diabetes? Gestation comes from theLatin gestare, which means ‘to bear’ or ‘give birth to’. Medically speaking it is the period between conception and birth. There are two types of Gestational Diabetes. Women with class A1 can manage it through diet and exercise. Those who have class A2 need to take insulin or other medications. Gestational Diabetes usually goes away after you give birth. But it can affect your baby’s health, and it raises your risk of getting Type 2 diabetes later in life Unlike Type 1 diabetes, Gestational Diabetes is not caused by a lack of insulin but by other hormones produced during pregnancy that can make insulin less effective, a condition referred to as insulin resistance. Gestational Diabetic symptoms disappear following delivery. Why does it develop? During pregnancy, your placenta makes hormones that cause glucose to build up in your blood and produces a hormone called the Human Placental Lactogen (HPL). HPL breaks down fats from the mother to fuel the growth of the baby. Usually, your pancreas can send out enough insulin to handle it. But if your body can’t make enough insulin or stops using insulin as it should, your blood sugar levels rise and you get Gestational Diabetes. It can lead to insulin resistance and carbohydrate intolerance in the mother. Who is at risk? About 10% of pregnancies result in Gestational Diabetes. The causes are not known but the risk factors include: Age-older women High blood pressure, high cholesterol, heart disease Obesity Not exercising Immediate family history of diabetes History of Gestational Diabetes in a previous pregnancy Have had a miscarriage or a stillborn baby Polycystic Ovarian Syndrome It is important to note that there is no definitive way to prevent Gestational Diabetes. Even mothers who have had Gestational Diabetes in a previous pregnancy may not get it with a later pregnancy. Warning Signs of Gestational Diabetes Sugar in the urine Unusual thirst Frequent urination Fatigue Nausea Blurred vision Vaginal, bladder and skin infections. When and how is it detected? In most cases, Gestational Diabetes develops in the second or third trimester (from week 14 to the birth) and disappears after the baby is born. A screening or finger prick blood test can be done at a clinic or pharmacy to give you a snapshot of your blood sugar levels. However, a formal diagnosis requires a blood test and sometimes this will need to be repeated. Gestational Diabetes is detected by using an oral glucose tolerance test (OGTT) or a random blood glucose test. The OGTT test is done by a nurse or doctor taking a blood sample from your vein to test the blood sugar levels. Then you will drink a glass of water mixed with glucose. An hour later you will have another blood test. Your blood glucose level should rise after you finish the sugary drink, then go back to normal, as insulin moves glucose into your cells. If it takes too long to go back to normal you could have diabetes. What the test shows The blood glucose is measured in milligrams per deciliter (mg/dL). Two hours after you finish the glucose drink, this is what your results mean: Below 140 mg/d: Normal blood sugar (7.8mmol) Between 140 and 199: impaired glucose tolerance or prediabetes (11mmol) 200 or higher: diabetes (11.1mmol) The random glucose blood test is carried out a couple of times to see if your glucose varies widely. If initially you are not diagnosed with Gestational Diabetes, the test may be repeated at around 24-28 weeks. What are the dangers? In many cases it can be controlled with a healthy diet and exercise but at least one in ten women will need their blood glucose levels controlled with medication. If your diabetes is not picked up during pregnancy it can cause risks at birth. The most prevalent is shoulder dystocia which is when the baby’s head gets stuck during the birth. This can cause: Fractures to the collarbone and arm Damage to the brachial plexus nerves. These nerves go from the spinal cord in the neck down the arm Lack of oxygen to the body (also called asphyxia). In the most severe cases, this can cause brain injury or even death It can also lead to babies being large for their gestational age which can result in birth complications How can you help yourself? By adhering to an eating programme that is healthy for you and for your baby including: Eat protein with every meal Include daily fruits and vegetables in your diet Limit or avoid processed foods Pay attention to portion sizes to avoid overeating Exercise regularly. Aim for at least 30 minutes of exercise 5 days a week. Just remember to speak to your doctor before starting any new exercises Don’t skip meals. To regulate your blood sugar levels, aim to eat a healthy snack or meal every 3 hours or so. Eating nutrient-dense foods regularly can help keep you satiated and stabilise blood sugar levels. Take your prenatal vitamins, including any probiotics, if they’re recommended by your doctor. Being diagnosed with Gestational Diabetes can be extremely stressful and dangerous to both mother and baby. It is imperative to have your blood glucose monitored during pregnancy. However, if you are tested regularly, stick to a healthy eating programme and exercise regularly,

May 6, 2021

Antenatal Advice: The secrets of sleep in pregnancy

Spoiler alert….A lifetime of being obsessed with sleep starts now!Whatever your stage of pregnancy, chances are your sleep has been somewhat interrupted. Be it nausea, restless legs, inexplicable temperature fluctuations, or night time baby disco, the obstacles to a good nights shut-eye can seem endless. To learn about how to put baby your baby safely to bed, you can sign up for our Free Baby Care Workshop, where our expert Midwife will give you all the information you need. You can book your place here. Here I’ll share my top tips, as a Midwife and mum, to getting the best night’s sleep possible. Smart hydration. Getting 2 litres of water every day is extra essential in pregnancy. Being well hydrated fends off dizziness and keeps the bowel happy, but night time wee trips are bound to disturb your sleep. The effects of hormones on the bladder in early pregnancy and the increased blood flow in later pregnancy mean the urinary system is in overdrive. Try to get your intake in earlier in the day, keeping fluids to a minimum from 2 hours before bed to reduce nocturnal loo trips. Whatever the time of year, pregnant women usually feel warmer than usual at night. This can cause night time disagreements with partners as the duvet is discarded and windows flung open. Try sleeping on top of your normal duvet with a light tog single duvet or sheet just for you, while your other half stays cosy. Lone sleepers have the luxury of kitting the bed out to suit them; try light layers that can be peeled off as required. Restless legs and cramps are common in pregnancy. Again, hydration in the day is crucial, and there is significant research to show that magnesium supplementation will aid in leg cramps and is safe in pregnancy. Most pregnancy multivitamins contain 40-50% of the recommended daily intake of magnesium, and additional dietary intake should also help in the form of foods like green leafy vegetables such as spinach, nuts and seeds and dark chocolate (yay) Invest in a maternity pillow. These need little explanation; just treat yourself! Supporting your bump, helping you get comfortable on your side (blood flow to baby is best on your left side due to the anatomy of your vascular system), which will double up as a breastfeeding pillow, even a baby nest when little one is just learning to sit up and needs some crash mats! If nausea is an issue for you, keeping a small snack by the bed will usually help. If you feel sick at night, an empty tummy makes matters worse. A plain biscuit or salty cracker to nibble on should settle the ill feeling. If nausea is new or is accompanied by pain or a temperature, get to your GP without delay. You could have a kidney infection—the joy. Insomnia in later pregnancy is very common, even when no obvious cause can be identified. You’ve done all your troubleshooting, and you’re still lying awake! Some say it’s mother nature preparing new Mums for night feeds. Whatever the cause, it’s exhausting. When many Mums are working until 38 weeks, switching to herbal tea like camomile is a good idea and has some relaxation tracks ready. Try not to get too stressed about not sleeping, and remember to talk to your Midwife or GP at your next antenatal visit if you feel you are sleep deprived; you may need some time off work. To learn more about sleep and a whole host of other topics, please join us at our Free Baby Care Workshop, where our Expert Midwife will talk through topics such as how to care for your baby’s cord, nails and how to put baby to sleep safely. You can book your free place here.

April 28, 2021

What are the benefits of attending an Online Antenatal Class?

Having a baby is a fundamental part of human nature, and some people don’t see any reason to attend an antenatal class. After all, women have been having babies for thousands of years, and there weren’t antenatal classes available way back when… right? However, today’s modern parents seek the most up-to-date evidence-based information to ensure the safe delivery of their baby. Research around the safe and healthy delivery of baby has progressed significantly in the past two decades, with this research proofing that expectant Mums who attend an Antenatal Class have: Increased likelihood of vaginal birth Lower rate of inductions Higher likelihood of breastfeeding Decreased need for pain medication in labour Increased confidence for labour and birth Women and partners who’ve attended antenatal or childbirth classes report that they feel more prepared because they know what to expect due to increased communication between them and their caregiver. Overall, making women more likely to have a positive birth experience. The Baby Academy believe that helping and guiding women and their partners at this exciting time is paramount. Their FREE Baby Care Workshop and 1-day Antenatal Class aim to help prepare, empower, and support women and their birthing partners. Places in their Free Baby Care Workshop are limited and book out quickly, so we recommend early booking. Simply click HERE to book your free place.

April 13, 2021

Free Pregnancy Class for Expectant Parents

If you are pregnant, you will be delighted to hear that The Baby Academy are running FREE Online Workshops for first-time pregnant women, tailored for those in their second or third trimester of pregnancy. Their Expert Midwife will deliver the most up-to-date evidence-based information on how to care for your baby safely. At the free workshop, you will learn: How to care for your baby’s cord How to care for your baby’s skin and nails How to put your baby to sleep safely to prevent SIDS (Sudden Infant Death Syndrome) Plus, a host of practical, evidence-based demonstrations on how to care for your baby Places in their Free Baby Care Workshop are limited and book out quickly, so we recommend early booking. Simply click HERE to book your free place.

April 8, 2021

Plant-based pregnancy

As the wife of ultra-endurance triathlete and Ironman Africa Champion, Kyle Buckingham, Lauren, knows a thing or two about needing to look after her body and keep energy levels high. So when Kyle made the move to a fully plant-based diet over a year ago, Lauren, followed suit and honestly believes that this is what has contributed to her feeling so amazing through the last 6 months of her pregnancy. “From the time I found out I was pregnant at 5 weeks, nothing had changed,” says Lauren. “I didn’t even feel pregnant until I went into my 2nd month, after which I had occasional afternoon nausea until I went to bed. And just as fast as that feeling started it stopped on the first day of my 3rd month!” “I am still working as a sports massage therapist, dealing with athletes on a daily basis which requires a lot of my energy and input, and then just getting on with my normal daily things. I have yet to experience a drop in energy and I am into my 6th month now!” So how has Lauren coped with any cravings she has had during the past 6 months? “I have only had one craving so far and thankfully that only lasted two weeks. All I wanted was a cheese sandwich dipped in tomato soup! I was able to change dairy cheese for a vegan cheese option which was great, it was the weirdest combo, but I loved it!” While Lauren and Kyle made the switch to a plant-based diet quite quickly for Kyle’s training, Lauren realises that this might not be as easy for others. “If you are thinking of moving to a plant-based diet, I would suggest starting with either replacing one meal a week or possibly having one day a week that is only plant-based,” explains Lauren. “That way you can slowly get used to the various options and see what works for you.” “Fry’s started Meatless Monday’s which is a great place to start, they also have a few tasty recipes on their website that are super easy to try out!” What has been the biggest advantage that Lauren noticed since being on the plant-based diet? “Energy levels, when I made the switch my energy levels never dipped and throughout my whole pregnancy so far I have not gained extreme weight!” Here are some of Lauren’s favourite recipes for you to try out! Versatile Veggie Chilli by: Jamie Oliver INGREDIENTS – 500 g sweet potatoes 1 level teaspoon cayenne pepper , plus extra for sprinkling 1 heaped teaspoon ground cumin , plus extra for sprinkling 1 level teaspoon ground cinnamon , plus extra for sprinkling olive oil 1 onion 2 mixed-colour peppers 2 cloves of garlic 1 bunch of fresh coriander (30g) 2 fresh mixed-colour chillies 2 x 400 g tins of beans, such as kidney, chickpea, pinto, cannellini 2 x 400 g tins of quality plum tomatoes lime or lemon juice, or vinegar , to taste METHOD + Preheat the oven to 200˚C/400˚F/gas 6. Peel and chop the sweet potatoes into bite-sized chunks, then place onto a baking tray. Sprinkle with a pinch each of cayenne, cumin, cinnamon, sea salt and black pepper, drizzle with oil then toss to coat. Roast for 45 minutes to 1 hour, or until golden and tender. Peel and roughly chop the onion. Halve, deseed and roughly chop the peppers, then peel and finely slice the garlic. Pick the coriander leaves, finely chopping the stalks. Deseed and finely chop the chillies. Meanwhile, put 2 tablespoons of oil in a large pan over a medium-high heat, then add the onion, peppers and garlic, and cook for 5 minutes, stirring regularly. Add the coriander stalks, chillies and spices, and cook for a further 5 to 10 minutes, or until softened and starting to caramelise, stirring occasionally. Add the beans, juice and all. Tip in the tomatoes, breaking them up with the back of a spoon, then stir well. Bring to the boil, then reduce the heat to medium-low and leave to tick away for 25 to 30 minutes, or until thickened and reduced – keep an eye on it, and add a splash of water to loosen, if needed. Stir the roasted sweet potato through the chilli with most of the coriander leaves, then taste and adjust the seasoning, if needed. Finish with a squeeze of lime or lemon juice or a swig of vinegar, to taste, then scatter over the remaining coriander. Delicious served with guacamole and rice, or tortilla chips. SERVE with rice and pappadums Chunky Veg Yellow Thai Coconut Curry INGREDIENTS Yellow or Green Thai paste 1 can coconut milk (extra if necessary) 1 medium onion, diced ½ red bell pepper, roughly chopped (bite size) ½ yellow bell pepper, roughly chopped (bite size) 3-4 mixed courgette, chopped bite size pieces 1 cup chopped butternut (bite size) 2-3 carrot chopped (bite size) handful chopped baby spinach leaves Flexitarian optional -Add strips of tofu or calamari METHOD Add oil and Thai paste to pan allowing paste to warm and release flavours. Add can coconut milk and mix with paste. Bring to a simmer. Add onion, butternut and carrots first until semi firm (15-20min) with lid to keep moisture in. Add remaining veggies except the spinach, simmer about 30 min or until all veggie are soft enough to eat but not soft enough to mash. Al dente. Add spinach and stir together until wilted. Add extra coconut milk, water or oat milk to top up the sauce. Add tofu or calamari strips to pan and simmer in coconut milk until turns white. SERVE with sushi rice and pappadums.

March 30, 2021

How to make the best out of your Preemie’s NICU Journey during Covid-19

Let’s be honest having a preemie and ending up in the Neonatal Intensive Care Unit (NICU) is no place a mother dreams of being when she finds out she’s pregnant, and honestly, I would never wish this for any mother. But, the NICU does not have to be all bad, after all the NICU is the next best place other than your womb to help your premature baby grow stronger. The NICU tries to mimic a mother’s womb as best as possible for our tiny little miracles. So, let’s get straight to the point, as a NICU preemie mom myself I know how useless and helpless you can feel when the nurses do everything for your baby, especially now during the COVID 19 pandemic restricted visiting hours. The first few days, even weeks can be very daunting, and you might even be unsure and scared to ask or do anything. Let us look at some ways how you can get involved and make the best of the NICU journey for you and your preemie during the COVID 19 pandemic ASK QUESTIONS AND SPEAK UP: Giving birth to a premature baby can be incredibly stressful and it’s easy to feel disconnected. Most parents are unsure and do not even know where to start when it comes to asking questions. SOME GOOD QUESTIONS TO ASK: What is your Kangaroo Mother Care – Skin to Skin policy during the COVID-19 pandemic, and when may I start with KMC? How often may we visit our baby during the Pandemic? May I have a number to phone in to the NICU to hear how my baby is doing when I get discharged? What am I allowed to bring into the NICU for my baby? What other rules do you have in your NICU? GET TO KNOW THE STAFF: Get to know the nurse caring for your baby, it helps to have a friendship with the nurse looking after your preemie, this will make you feel more at ease and will improve your ability to ask questions and advocate for your baby. Remember that you are baby’s mom, and that you play an incredibly important role in also helping them through this experience. One thing to remember as a parent in the NICU is that you are your babies only advocate, you need to speak up if something is bothering you or ask questions when you are unsure. Something that will also help you navigate around the NICU is to learn the ‘’NICU language’’ This also comes from asking questions, this way you will learn to know what certain beeps and ‘’stats’’ on the machines mean and will make you more confident around your preemie, and gives you more freedom to bond with your baby, by understanding the environment they are in. BONDING: COVID-19 has forced NICU’s to implement extreme measurements and rules to keep the NICU safe from COVID, making it a bit more challenging for mothers to be with their babies to bond. Here are a few ways you can Bond with your baby during your visit: Skin to Skin – Kangaroo Mother Care has so many benefits, do as much skin-to-skin with your baby as possible. Studies have shown that skin to skin is not just amazing for bonding, but also improves milk supply and has MANY other advantages for premature babies. It helps them cope with stress More stable heart rate It regulates their body temperature It improves the nervous system functioning More stable sleep patterns Better cognitive control Regulates heart rate and respiration Reduces post-natal depression in mom Improves weight gain for baby THROUGH SMELL: Ask your NICU if you may place a NICU bonding heart with your baby. A person’s sense of smell is closely linked to memory throughout life, and these memories can often trigger certain emotions that provide relief. For a baby in the Neonatal Intensive Care Unit (NICU), certain smells — like a mother’s — can provide comfort in more ways than one. Mom places one clean fabric heart on her skin for a few hours to absorb her unique scent. When mom must leave the NICU she leaves the NICU heart near her baby in the isolate to provide comfort and continue bonding even during times of separation. NICU BONDING HEARTS – https://www.littlelittleprem.co.za/product/nicu-bonding-heart/ ROUTINE: It is natural to feel like the nurses are taking over. A mother’s instinct is to provide and care for her new-born baby. In the NICU this might not always be possible. Ask the NICU staff to give you the schedule of when they will change baby’s nappy and feed baby. Try to be there to feed (hold the feeding tube) and, or change your babies’ nappy, Ask the nurse to show you how to reconnect the pulse oximeter as it can easily fall off and needs to be changed frequently. These are tiny things that you as a mother want to naturally do and can do for your baby and will help the bonding between you and your little miracle. READ AND SING TO YOUR BABY: Your little baby has been listening to you and your partners voice in utero and finds your voices comforting as it is familiar to your baby. Reading and singing to your baby can help soothe your baby and has many benefits for brain development. Singing and reading also improves the bonding between parent and baby. Unfortunately, with the COVID – 19 pandemic some NICU’s only allow short visits for one parent a day. Record your voice while you read a story or sing a song. You could ask the nurses to play the recording to your baby when you are not there or record your partners voice and play it to your baby when you visit. EXPRESSING MILK: Expressing your breastmilk for your baby has become something you do more than sleep at this moment, and it can be very stressful sometimes. Carey Haupt, a qualified lactation consultant and ex-preemie mom, thought of expressing

March 18, 2021

World Down Syndrome Day: What to expect parenting a child with Down Syndrome

Finding out that you will be a parent is an exciting time for many. But finding out you will be a parent to a child with Down Syndrome, is often met with shock. If you will be raising a child with Down Syndrome, it can be challenging, so make sure you have a good medical team who can support you. 18 March 2021: With the world observing World Down Syndrome Day (WDSD) on 21 March, it is a good time to demystify what parents can expect from the first few months of life if they are expecting a child with Down Syndrome. This is especially so given that there are many cultural taboos around talking about, or having a, child with Down Syndrome. “The most important thing to understand is that raising a child with Trisomy 21 is challenging, given that the entire family dynamic will be affected. High levels of support and understanding are essential,” says Dr Iqbal Karbanee, paediatrician and CEO of Paed-IQ BabyLine, a trusted telephonic medical advice service for the first 1000 days of a child’s life, starting from conception to birth and beyond. Down Syndrome is caused by the triplication (trisomy) of the 21st chromosome and affects approximately 1 in 800 newborns. According to Dr Karbanee, it is the commonest chromosomal abnormality. He says that there are many features of Down syndrome that can be picked up during pregnancy and screening is readily available. The screening is offered mostly in high risk cases of which the commonest is an older expectant mom. “If you are pregnant and are diagnosed, it can be a major shock and parents have to face the choice of carrying on with the pregnancy or not. This is an intensely personal decision and should be carefully considered after discussion with all involved, and importantly, also the medical team.” Babies affected by Down Syndrome have a higher risk of abnormalities affecting multiple systems of the body. Parents will need to understand that the newborn will require a cardiac assessment as well blood tests to ensure the body’s systems are functioning normally. Feeding can be a problem as low muscle tone is associated with Trisomy 21. “The best way to approach this is to ensure the medical team is involved often as regular follow-ups and check-ups will be important. You need to make sure you can trust your medical team; this will be essential to getting the help your baby needs,” says Dr Karbanee. He adds that if you already have other children in the family, the needs of the child with Down Syndrome will be different to other children and will require everyone to adjust accordingly. “Developmental milestones will be delayed so expect the baby to sit and crawl much later than normal. Special schooling will be necessary as well as ongoing visits for physiotherapy and possibly Occupational and Speech Therapy,” says Dr Karbanee. “Having said that, while having a child with Down syndrome may be a huge adjustment for the entire family, the good news is that children with Down syndrome tend to have a pleasant personality and parents report that they are a delight to the family. “Speak to your paediatrician about all of your concerns, fears, or expectations, as it is her or her role to co-ordinate the care of the child and ensure that the health of the child is optimised,” concludes Dr Karbanee. About Paed-IQ BabyLine Paed-IQ BabyLine is a trusted, telephonic medical helpline for pregnant moms and new families. With healthcare advice given by qualified, experienced and medically trained nurses, we aim to improve health outcomes during the first 1000 days of a child’s life, starting from conception to birth and beyond. We are there for mommies-to-be at all stages of their maternity journey as well as new parents or caregivers to young children. By offering early and appropriate medical intervention through advice, we have helped to safeguard the health of over 10000 children, and helped moms and families successfully navigate the medical concerns of their young children. Visit https://paediq.com/ for more.

March 18, 2021

Trimester two overview

Your second trimester begins in week 13 and ends at week 28. During this time your morning sickness will ease off, and initially your baby will be small enough that your body won’t be in too much discomfort, earning this trimester the nickname of the honeymoon period of pregnancy. During this trimester you’ll probably tell your family, friends and employees you’re expecting and your tummy will begin to show – time to upgrade your wardrobe! Your body during your second trimester During the second trimester the pregnancy you’ll hopefully notice that your morning sickness is easing up and your energy levels should begin to rise. While you will be feeling better don’t put pressure on yourself to exercise or socialise more than you’re comfortable with. This trimester your baby bump will go from barely noticeable to one that you may struggle to hide. Embrace your changing body and adapt your exercise plan to accommodate your baby, prenatal yoga and pilates classes are a great way to stay in shape, meet other moms-to-be and prepare for labour and delivery. A growing belly and breasts, Braxton Hicks contractions and leg cramps are all common pregnancy symptoms you may experience during this trimester. Not only this but you may experience dental issues, sore and swollen feet, and an achy back and/or pelvis. Your baby’s growth during the second trimester Your little one does lots of growing during your second trimester, and during this time you’ll begin to feel them moving around inside your belly (this is also known as quickening). Not only this, but during trimester two your baby’s ears develop to the point that they can hear your voice and other external sounds. During the second trimester your baby’s eyes and ears become more developed and you’ll soon be able to find out their gender on an ultrasound (if you want to!). Your baby’s muscle tone is also improving, they’ll be swallowing amniotic fluid and their sucking reflex will develop – they may even suck their own thumb. Important things to note during the second trimester At week 19 to 20 you’ll have an anatomy scan. In this scan your doctor will be able to see how your baby is developing, and if there is anything unusual that would be cause for concern. During this scan the doctors will also be able to tell you the gender of your baby – if you decide to be told you can start thinking of baby names! This trimester is also a good time to decide how and where you’d like to have your baby. Decide on if you like a hospital or home birth, and start putting together a birth plan.

March 16, 2021

What is Perinatal Distress… and what does it really look like?

Most of us have heard of perinatal distress, also known as postnatal depression or PND, but why is this common and treatable illness often misunderstood and underdiagnosed? I was propped up in bed trying to feed my one-week-old infant staring at a pamphlet titled: “Postnatal Depression”. I thought to myself, “oh that’s when a new mother lies in bed all day crying. I definitely don’t have that. I’m not even going to open this pamphlet. I’m exhausted, I have my hands full with a fussy baby, I don’t have time to read this and besides, I don’t have PND anyway.” Two months later, I was hospitalised for nearly two weeks, followed by months of therapy and medication. You guessed it: I had PND. This medical condition had gone undiagnosed long enough for it to ravage my body and mind, as well as tear a hole through our entire family. When I look back at that dark and difficult time, I often think to myself that if only I had understood then what PND truly looked like, this illness would never have been able to take such a powerful hold on my life. The jaw-dropping reality is that PND affects well over 10% of women within the first year of giving birth. Many of those women are never diagnosed and treated because they don’t know what PND is or may be too ashamed to seek help. Why do we know so little about PND? Let’s rewind a little. PND used to stand for Postnatal Depression, a mental health condition in which mothers would experience depression and anxiety after their baby’s birth. Fast forward to present day: PND now stands for Perinatal Distress, because experts now understand that this mental health condition can occur both before and after giving birth (yes you can have PND when you are pregnant!) and that mothers can experience a wide range of symptoms. These may include depression, anxiety, obsessive compulsive behaviours, sleep disorders, anger and more. In the most extreme cases (postnatal psychosis – a medical emergency) a mother may experience hallucinations or voices. The full list of symptoms is a long one, but may include some or all of the following: Feeling low, sad, tired, hopeless, alone, scared, angry, bored, irritable, guilty, on edge. Changes in appetite (either eating more or less than usual) Weight loss or gain Loss of interest in enjoyable activities; not looking forward to things. Lack of interest in the baby Panic attacks Overwhelming, scary thoughts. Even thoughts of harming yourself or the baby Changes in energy levels, sleep patterns or tiredness (hard to gauge with a new baby when you’re sleeping less anyway, but if you are unable to sleep when you are exhausted, there may be a problem) Mood swings, crying more often, restlessness and irritability Brain fuzz or racing thoughts Herein lies the Problem These symptoms cover most of the common emotions experienced by mothers in the perinatal period. Some of these symptoms are completely normal and result from extreme hormonal fluctuations associated with pregnancy and birth. However, these symptoms should only last for a couple of weeks after the baby is born (The Baby Blues). So how can a mother tell what is normal, and what is PND? A good rule is that if you feel like you’re not yourself, or you are not coping, have a chat to your healthcare provider. If you don’t feel like you can talk to your GP, obstetrician or clinic nurse, then turn to a trusted friend or family member. You do not have to suffer in silence. There are various treatment options available to you which are perfectly safe, both before and after giving birth. With the correct treatment, PND can be completely resolved. Left untreated, it may be fatal, to both a mother and her child. Why do most women have only a vague idea of what PND can actually look like? Because we don’t talk about it! Even in todays’ open-minded world of acceptance, there is still a heavy burden of societal stigma attached to a mother’s mental health. When a woman is pregnant or has a baby, she is expected to be happy! “You’ve been so blessed!”; “Enjoy every minute, they go by so fast!”; “You’ve got what you always wanted – you must be thrilled!” These are all phrases that most mothers have heard at some point. If she is struggling inwardly, she may feel guilty that she is not happy. Mothers are often wracked with insecurity, which they can keep well hidden. She may worry that she will be seen as ungrateful, or even unfit to be a mother. PND survivor Hayls Lieberthal wanted nothing more than to have a child, but as her pregnancy progressed, so did her self-doubt. “I was told all the time, ‘you are carrying life, you’re very blessed’ and ‘You have nothing to feel sad about!’” She vividly recalls a woman saying to her “look at you, you must be so excited!” and found herself lying behind a false smile: “I am so excited I can’t wait!” Meanwhile, on the inside all she could think was “I can’t do this.” From the moment your pregnancy is confirmed, healthcare professionals typically focus intensely on a mother and baby’s physical health, but less on a mother’s mental health. Even when a healthcare provider is aware of PND and asks the patient all the right questions, a mother may not divulge how she truly feels because she feels ashamed. After I had my first baby, I was overwhelmed by my new life and role. There were times that I thought I had made a terrible mistake, and that maybe I wasn’t cut out to be a mother after all. These feelings were shameful to me, and I didn’t feel like I could tell anyone. Little did I know that those feelings are incredibly common among new mothers, even mothers who do not have PND. The Truth about PND PND is not

March 15, 2021

Your second trimester – making the most of it

Your second trimester is from the beginning of week 13 until week 28, during this time your pregnancy will begin to show. However, you should feel like you have more energy than you did in trimester one. This is why this trimester is also nicknamed the honeymoon period of pregnancy – your baby isn’t big enough to make you uncomfortable and your pregnancy hormones should have eased up. During this time there are one or two things that you can keep in mind to make the most of this time while you’re feeling better, and to ensure that your baby (and you) are kept healthy and happy. Childbirth classes, preparing your mind and body Even if this isn’t your first baby, childbirth classes can help prepare you for what is to come. If you’re feeling anxious about labour and birth, these classes will help ease your worries, by informing you what is to come and how best to manage your mind and body coming up to, during birth and after birth. Prenatal exercise and a healthy lifestyle Stay fit and healthy during your pregnancy is important to both you and your baby. What you eat and regular exercise are both ways in which you can provide needed nutrition to your baby and keep yourself healthy. Low impact exercise, such yoga, swimming, walking and prenatal pilates can help improve your sleep, and increase your strength and muscle tone. Keeping active can even have the added benefit of helping prepare your body for labour and birth. Maternity wear and staying comfortable Not only is learning about your pregnancy and staying healthy essential but staying comfortable is also important. The second trimester is generally when your tummy will start looking and feeling bigger, so invest in some trousers that have more give in the waistline. Luckily certain fashion items, such as flowy dresses and layered knits, may even mean you can still keep using your pre-pregnancy clothes.

March 9, 2021

WORLD BIRTH DEFECTS DAY

World Birth Defects Day (WBDD) is a day observed on 3 March. Besides the very important aim of improving the health and quality of life of those affected by congenital conditions, one of the main goals of this annual awareness day is to share what is already known about how to prevent birth defects1. There are many types of birth defects, which are also known as congenital anomalies, congenital disorders or congenital conditions1, the most common of these severe defects are heart defects, neural tube defects and Down syndrome2. Every year an estimated 7.9 million children, 6 percent of total births worldwide, are born with a serious birth defect3. Neural tube defects (NTDs) occur when the spinal cord fails to close properly4. The most common neural tube defect is spina bifida which can occur anywhere along the spine if the neural tube does not close all the way, which can result in the backbone that protects the spinal cord not forming and closing as it should. This often results in damage to the spinal cord and nerves5. The most serious neural tube defect is anencephaly, which is when a baby is born without part of its skull and brain. Babies born with anencephaly will eventually die4. Fortunately, some congenital disorders can be prevented2, particularly neural tube defects3. Folate (vitamin B-9) is important in red blood cell formation and for healthy cell growth and function6. This nutrient is crucial during early pregnancy to reduce the risk of these birth defects of the brain and spine. The synthetic form of folate is folic acid6. There is overwhelming scientific evidence linking an increased intake of synthetic folic acid to a reduced risk of neural tube defects3. In fact, research indicates that at least half the cases of neural tube defects could be prevented if women consumed sufficient folic acid before conception and during early pregnancy3, with some estimates stating that consuming enough folic acid (at least 400 micrograms per day) can reduce certain birth defects of the brain and spinal cord by more than 70 percent4. Folate is found naturally mainly in dark green leafy vegetables, beans, peas and nuts. Fruits rich in folate include oranges, lemons, bananas, melons and strawberries6. Many cereals and pastas are also fortified with folic acid6. Taking a prenatal vitamin, containing at least 400 micrograms of folic acid daily4, ideally starting three months before conception, can help ensure that women get enough of this essential nutrient6. A prenatal vitamin, such as PregOmega Plus, which is South Africa’s No.1 prenatal choice7, contains not only 500 micrograms (mcg) of folic acid, but also added Omega 3, Calcium, Vitamin D and Magnesium and other vitamins and minerals. While not all birth defects can be prevented, there are certain things that a woman can do before and during her pregnancy to increase her chances of having a healthy baby. Besides getting 400 micrograms (mcg) of folic acid every day before falling pregnant, other steps include regular check-ups and prenatal care, not drinking alcohol, taking recreational drugs or smoking, preventing infections where possible, and checking with a healthcare provider about any medications they may be taking or thinking about taking, whether these are prescription, over-the-counter medications or even herbal8. Please remember to speak to a doctor, pharmacist or gynaecologist about what supplements to take before and during pregnancy. Go tohttps://pregomega.co.za/ for more information.

March 3, 2021

EXPLICIT AND CRINGE-WORTHY WOMB STORIES UNCOVERED IN LIBRESSE’S CAMPAIGN

Feminine hygiene brand, Libresse, has launched its most intimate campaign, yet. The compelling initiative empowers women to explicitly share honest, cringe-worthy experiences of womanhood. From the profound diagnosis and fertility treatments, to severe menstrual cycles. The Womb Stories series, features women of various ages and commits to nullify common myths that exist around their complexities. In mid-February 2021, Libresse introduced the powerful stories on its digital pages, collaborating with the voices of ordinary women around the world. The campaign stems from the social misinterpretations, lack of knowledge and stigma that linger around the female body. Commonly, women are deprived to speak out in confidence and unapologetically about what really happens to their organs- the effects thereof and the process it takes to overcome it. Libresse, as a personal care brand identified this as a concern and set out to drive these important dialogues. It distinguished itself in an audacious manner, outlining and showcasing the gruesome nature to which the uterus and womb experience change. The choice of words used are blunt and the visuals portrayed mirror the pain felt during this intimate journey. Endometriosis, Menopause, Hysterectomy and miscarriages are some of the issues that are covered. “This campaign highlights that a woman’s journey with her body is not simplistic. It reveals the emotional, complicated and sometimes painful realities of women’s intimate experiences. We want to reverse the stigma that is often associated with uteruses, periods and vaginas by encouraging women to have open conversations about their bodies, says Mpho Nojiwa, Marketing Brand Manager of Libresse. The campaign will further launch Womb Table, a video segment that will gather doctors and experts, Dr Sindi Van Zyl, Dr Boitumelo Makaulule and Dr Chriselda Kananda to further discuss some of the issues that resonate with South African women.

February 26, 2021

NEW TO MOTHERHOOD IN COVID-19 TIMES

The six weeks after childbirth, known as the post-partum period, is a vulnerable time for women and their infants. The impacts of the ongoing pandemic have only heightened concerns that new mothers in South Africa are able to access the care and resources they need as they step into motherhood. It’s not unusual for the need for post-partum follow-ups to extend for four to six months, especially in cases where there are physical and emotional issues and health complications. In South Africa, primary health care provides free services to pregnant and lactating mothers, as well as children under six years. Given the severe economic impact of the global pandemic, this access to post-partum care has become particularly important to the country’s new mothers. As with pregnancy, nutrition is a particular focus of post-partum care. New mothers need the support to recover from the rigours of pregnancy and childbirth so that they can cope well with the different challenges presented by infant care. Exclusive breastfeeding, which means providing only breastmilk to the exclusion of water, tea, juice or food, from birth for the first six months of life, is crucial and requires ongoing support within the family and through community and healthcare connections. According to ADSA (The Association for Dietetics in South Africa) spokesperson, Professor Lisanne du Plessis breastfeeding is not only the best source of food for babies; it is also a major cost saver for food-insecure families and a major immune support for vulnerable children. Therefore, we have to make sure during this COVID-19 time that our new moms are healthy and well-nourished. She says, “Mothers should try and eat a healthy balance of fresh, whole foods including carbohydrates from unrefined, whole grain starches; proteins from meat, eggs, fish, chicken, beans and legumes; healthy fats; fruit and vegetables as well as dairy thatsupplies vitamins and minerals. They should try to avoid fast foods and other ultra-processed foods that are high in salt, sugar, preservatives, and unhealthy fats. It is interesting to note that breastfeeding moms need around 500 additional calories daily, which equates to an extra snack such as a wholewheat bread sandwich with cheese or peanut butter; one to two glasses of milk, and an extra vegetable plus a fruit. What is most important is a focus on fresh and whole foods. New moms who are battling currently with household food insecurity need to raise this issue with their primary health care providers and get connected to a community-based or non-profit initiative which supports families through food parcel or other food security programmes. When it comes to nutrition, post-partum care and breastfeeding, some of the same pregnancy restrictions should continue. Prof du Plessis says, “Limit coffee drinking to just one cup a day, avoid other drinks and snacks that contain caffeine, and keep avoiding cigarettes and alcohol.” An issue for many new moms is managing the weight they gained through pregnancy. Another Registered Dietitian and ADSA spokesperson, Cath Day says, “Don’t rush it. Don’t worry about how much you weigh for at least the first six weeks after the birth of your baby. During this time, concentrate on eating fresh and minimally processed food. Focus on your support system and on getting enough rest. Once you have healed from childbirth and established a good breastmilk supply, you can begin to think about getting your body back. Go slow, do what you can, and be kind to yourself. If you are not back to your pre-pregnancy weight by six months, then you can start looking at your diet and exercise regime. Remember, it took you 9 months to gain the extra weight, so give yourself enough time.” As disruptive as the pandemic has been, and how it has shaped many women’s experience of pregnancy, childbirth, and new motherhood, what’s important to remember is that COVID-19 has not changed the essentials of bringing a new life into the world. Moms need the same as they always have. They need support and encouragement from their families and friends. They need access to good, fresh foods. They need easy access to quality healthcare and professional support when needed. Day says, “There is currently no evidence to suggest that pregnant women and new mothers need to adapt their nutrition specifically in response to COVID-19. Pregnant mothers and new mothers should concentrate on eating a healthy and well-balanced diet made up of minimally processed and fresh foods such as wholegrains, legumes, nuts and seeds, plenty of fruit and vegetables, lean proteins, and plant-based oils. Combat stress with a healthy, balanced diet along with enough sleep and exercise. Consider stress management techniques such as walking, deep breathing, meditation, yoga or Pilates. It is really important that if mothers require nutrition and food support, there are various government, non-government and community-based programmes providing food parcels and other social relief.” Prof du Plessis adds: “Although everyone is encouraged to stay at home with COVID-19 regulations in place, it is important that new mothers continue to go for their check-ups and take their babies for routine immunizations and follow-up clinic visits, according to the schedule in the Road to Health booklet. During these visits, mothers should ask questions about their health and their children’s growth, health, and nutrition. They should also request breastfeeding support if they are experiencing challenges to their goal of breastfeeding exclusively for the first six months. The pandemic has not changed the essentials of life, and post-partum maternal and infant health remains a high priority in our country.”

February 12, 2021

Pregnancy and COVID

Looking back at last year, we had no idea how COVID-19 would change the way that we live. It has crept into every facet of our lives. We have had to change the way that we work, learn, bury our loved ones, and socialise. Nothing is “normal” anymore. COVID-19 has had a profound impact on women who are pregnant. The ability for pregnant women to receive health care and general support from friends and loved ones have changed drastically. Pregnancy is a time where a woman and her partner need to be supported and have their regular medical checkups to help them have a healthy baby. Our new normal does not allow for large baby showers, friends popping over for a chat and a cuddle of your baby. Grandparents can’t visit in hospital and in some NICU visitation to the baby is very limited. So how then does a woman and her partner prepare for pregnancy and the time when your baby comes home? Here are 5 topics to consider: Social distancing / Self Isolation during and after pregnancy: The current research suggests that women who contract COVID-19 while pregnant have an increased risk of severe illness and death compared to non-pregnant women. They also have an increased risk of having adverse pregnancy outcomes like prematurity. Over the last year we have learnt that it is almost impossible to have no risk of contracting COVID but if you do need to leave your house, you can consider the risk of the activity. This will allow you to plan and put in place ways to reduce the risks. There may even be some activities you will have to avoid. In general, the more people you have close and prolonged contact with will increase your risk of getting COVID-19. You also need to consider the actions of the people that you live with and how they are interacting with other people. The best way to protect yourselves from contracting COVID-19 is to limit interactions with people. Steps that you can take when you need to interact with others are: Wear a mask over your nose and mouth, try to keep about 2m away from other people, wash your hands with soap and water for at least 20 seconds and if indoors try to be in a well-ventilated room. Events like baby showers, shopping for baby items and visit of friends once baby is home, need to be rethought as to how to make it safer for you and your baby. Some baby shower ideas are online zoom parties or drive by and drop off the gifts and a note. What ever you decide to do, consider the risks and how to reduce them. My Breastpump has an online store where you can have breastfeeding items delivered to your home: https://bit.ly/3obw7vH Look after your health. Keep all your health care appointments. Talk to your health care provider about the safest way to deliver your baby. You might consider having a home birth with a Midwife or giving birth in hospital. Eat a health balanced diet and take all your vitamin and mineral supplements. Keep active so that you are strong for the delivery. Find online antenatal classes to help you prepare for your delivery. The class should include information on different delivery types, how to recover from delivery, information of how to care for your baby once you get back home and are breastfeeding. Finding out what your hospitals policies are around COVID. It is best to know what the hospital policy is regarding COVID testing before delivery, your partners ability to see your baby, what if you do have COVID and visitation during hospital stay for family members. This will help you to be prepared and to pack your maternity bag accordingly. Many hospitals are not allowing non-parents to visit in the maternity ward. This may be lonely and scary, but it does allow you and your partner to have a baby-moon, where you both can focus on getting to know your little one, gives you time to learn how to breast feed and allows you to rest and recover after your delivery. Learn as much as you can about breast feeding. Breast feeding, although it is natural, is a learnt skill that you and your baby will need to learn. It is important to know how to breastfeed, what is normal and learn as much about breastfeeding before you give birth. Include your partner so that he will be able to help you if and when you need it. There are many videos that you can watch on YouTube about breastfeeding with a deep latch. You can visit our website for more information on breastfeeding and expressing milk. It is highly recommended that you find a lactation consultant that can give you an online breastfeeding workshop while you are pregnant. This gives you the necessary information to breastfeed well and someone you know that can help you if you need the help. If you would like to book a consultation with Carey a SACLC please email info@mybreastpump.co.za for more information on a breastfeeding workshop. Have a plan for when you get home. The first few weeks after the birth can be difficult due to sleep deprivation and learning to care for your new child. COVID-9 just makes it so much harder because we are all social distancing. Have a plan or ideas of how you are going to make life simpler for yourself. Firstly, let your family know about visitation and how you would like them to interact with your new baby. Let them know what you would like: No visit policy, Visit but you can only look though the window or you can visit but you must wear a mask and sanitise. Will you have someone in the house to help you? If so, will that person need to self-isolate before they move in? You can ask your friend s and family to support you by taking

February 10, 2021

Why it’s important to care for your skin during and after pregnancy

The skin is our largest organ and it serves a number of essential functions. During and after pregnancy a woman may experience changes in her skin. In order to protect herself and her baby, certain skincare ingredients need to be avoided during these periods while others need to be introduced to nourish and care for the skin’s new needs. When selecting skincare products for yourself during pregnancy, and for your baby after birth, it’s important to understand that our skin serves a vital function in our relationship with our babies. What role does the skin play when it comes to mom’s relationship with baby? Skin-to-skin contact is usually referred to as the practice where a baby is dried and laid directly on their mother’s bare chest after birth, both of them covered in a warm blanket and left for at least an hour or until after their first feed. Skin-to-skin contact provides an appropriate and affordable, yet high quality alternative to technology. There is a growing body of evidence that indicates skin-to-skin contact after the birth helps babies and their mothers in many ways: It calms and relaxes both mother and baby. It regulates the baby’s heart rate and breathing, helping them to better adapt to life outside the womb. It stimulates digestion and an interest in feeding. It regulates temperature. It enables colonisation of the baby’s skin with the mother’s friendly bacteria, thus providing protection against infection and boosting baby’s immunity. It plays an important role to help prevent postpartum depression. It stimulates the release of hormones to support breastfeeding and mothering. It stimulates the release of the oxytocin hormone (“cuddle” and pleasure hormone) in both mother and baby. What makes human skin so special? Human skin is a complex living material but in biomechanical tests it reveals its homogeneous nature. Our environment can directly influence who we are: the skin reacts immediately and directly to the outside environment. The skin is colonised by a diverse milieu of microorganisms, most of which are harmless and some very beneficial to their host. The primary role of the skin is to serve as a physical barrier, protecting our bodies from potential assault by foreign organisms or toxic substances. The skin is also an interface with the outside environment and as such, is colonised by a diverse collection of microorganisms. Symbiotic microorganisms occupy a wide range of skin functions and protect against invasion by more pathogenic or harmful organisms and may play a role in educating T cells in the skin, priming them to respond to pathogenic counterparts. In utero, foetal skin is sterile, but colonisation occurs immediately after birth. Microbial communities of the skin and other sites are established and stabilised during the first years of life especially with skin-to-skin contact with mommy or daddy as a newborn explores its environment and matures its immune system. During puberty, changes in sebum production parallel the levels of lipophilic bacteria on the skin. Physiological and anatomical differences between male and female cutaneous environments – such as sweat, sebum and hormone production – partially account for the microbial differences seen between the sexes. Environmental factors specific to the individual, including occupation, clothing, skincare regime and antibiotic usage may regulate colonisation by the skin microbiota. The importance of using specific products on both mother and baby to sustain the effect of skin-to-skin contact Mommy and baby care, hygiene and skincare products are potential factors contributing to the variation of skin microbiota. For example, the use of products that are not pH balanced will alter the conditions of the skin barrier and may either encourage healthy skin flora growth rates or cause it to deteriorate. Understanding the ingredients in skincare products that may affect skin health Particular compounds and molecules need to be applied to skin in order to assist and supplement a homeostatic balance at all times, even when the skin is exposed to the atmosphere with social and environmental stressors. A product with measurable quality, safety and efficacy standards should be considered. Bottom line: don’t settle for just anything when choosing a skincare brand and product, as not all products are created equally. Do your research and choose a product that proves its efficacy by using scientific evidence. Do some research on ingredients, and ensure the products you are using contain ingredients that are safe and effective. Look for a product that understands this scientific rationale and will optimise your skin-to-skin contact with your baby Offering a wide range of skincare solutions for the entire human race, with no exception to mommies-to-be and babies, Biomedical Emporium understands that skincare has to work both on a cellular and a molecular level. Their latest skincare range is the Maternology series for pre-conception and pregnancy, and the Biosimilar BioBaby series for baby. During the process of trying to fall pregnant, IVF treatments and pregnancy itself it is important for a woman to change her skincare regime. The Maternology range helps prepare the mother’s skin for the skin-to-skin contact after baby is born. Many biochemical changes take place during pregnancy. Some women get a beautiful glow during pregnancy due to the elevated hydration and skin moisture retention levels along with the amplified exposure to vitamins and minerals via placental fluid transport. Unfortunately, for other expecting mothers, the increased and fluctuating hormonal activity during the first trimester can have the opposite effect, and may result in an increase in sebum production that may lead to acne and the expression of pigmentation. Skincare during pregnancy should be simple and easy due to the skin being much more sensitive and reactive. The following product ingredients should also be avoided during pregnancy: Retinoic acids. Beta Hydroxy Acids. Any peroxide-containing ingredients. Artificial colour-stained products and products containing fragrances. Skin-staining products (refrain from using self-tanning products during pregnancy). Avoid skin lightening or bleaching ingredients such as hydroquinone-containing products. Avoid mechanical exfoliation as this may deteriorate the skin’s barrier function. The Biomedical Emporium Maternology range is simplistic, easy, and safe to use. The ingredients are rich in vitamins and

February 5, 2021

Pregnancy and the Immune System

The role of nutrition in strengthening the immune system has been the focus of many studies over the years1. The immune system is your body’s natural defence system. It is an intricate network of cells, tissues, and organs that work together to defend your body against invaders, invaders that can include bacteria, viruses, parasites, or even fungus, all with the potential to make us sick2. Your immune system works all year round to ward off all kinds of illnesses2. But what happens to the immune system when you fall pregnant? Are there ways to naturally boost your immune system during pregnancy? The immune system and pregnancy are very much interconnected, with your immune system undergoing some very intense changes when you are pregnant3. So fascinating are the highly orchestrated changes in the immune system throughout pregnancy that the Stanford University School of Medicine conducted the first-ever study into the meticulously timed immune system changes in women that occur during pregnancy. The results, which were published in 2017, revealed that there is an immune clock of pregnancy and that the timing of immune system changes follow a precise and predictable pattern in normal pregnancy. These results may be a step towards understanding why some babies are born prematurely and how this can be prevented, by researching why someone’s immune system is not adapting to pregnancy the way it is expected to4. While these immune system changes can help you to fall pregnant, stay pregnant and deliver your baby, they ironically can also make you more susceptible to illness3. This is because changes in hormone levels and immune system function can make you more vulnerable to infections and complications. During pregnancy, different parts of your immune system are enhanced while others are suppressed5. These changes also help protect your baby from your body’s defences and means that during pregnancy, your immune system has to work harder since it’s supporting two of you. This makes you susceptible to certain infections5. These changes in the immune system during pregnancy make pregnant women (and women up to two weeks postpartum) more prone to severe illness from flu which is why many healthcare experts recommend that pregnant women get the flu vaccine6. Consuming the right nutrients is important at every stage of life, but it is especially critical during pregnancy, as pregnant women need to nourish both themselves and their growing babies6. Vitamins and minerals support maternal and foetal growth at every stage of pregnancy and are required to support critical functions such as cell growth7. Hannelise Rademan, a Registered Dietitian currently volunteering at Worcester Provincial Hospital in the Western Cape, reiterates that vitamins and minerals can be seen as building blocks to strengthen your immune system. “These building blocks include vitamins A, C and D, minerals such as zinc and omega-3 fatty acids,” she says8. When you are pregnant, a healthy diet should include the right balance of carbohydrates, proteins, and healthy fats, as well as micro-nutrients like iron, folate, calcium, and vitamin9. Many health experts globally recommend that all pregnant women take a prenatal vitamin and folic acid supplement. This is advised to fill nutritional gaps and also to prevent birth defects like spina bifida7. A prenatal vitamin, such as PregOmega Plus, which is South Africa’s No.1 prenatal choice10, not only contains 500 micrograms (mcg) of folic acid, but also added Omega 3, Calcium, Zinc, Vitamin D, Vitamin C, Magnesium and other vitamins and minerals which all have a myriad of benefits for both the mother and her growing foetus, some of which are mentioned below11. Calcium’s key function is to ensure the proper growth and structure of teeth and bones. Low calcium intake throughout life, and particularly in periods of rapid growth such as pregnancy, increases the risk of osteoporosis later in life, particularly after menopause11. During pregnancy, women require an additional 15mg of vitamin C per day. Vitamin C is an essential micronutrient for ensuring good dental health for the pregnant woman and her foetus, as it plays an important role in the development of healthy gums11. Vitamin D has an important function in assisting the body to absorb calcium and phosphorus. It is also an important nutrient for optimal immune function, maintaining healthy skin and muscle strength. Vitamin D deficiency in a pregnant woman is an important risk factor for the development of osteoporosis later in life11. Magnesium is a micronutrient that plays a role in regulating the function of other minerals including calcium and potassium11. It is associated with a maintenance of overall good health and plays a role in helping to metabolise carbohydrates, fats and proteins as well as contributes to the reduction of tiredness and fatigue12. Zinc plays a role in regulating how genes and genetic traits are replicated in the DNA11. It also importantly plays a role in the maintenance of immune function and contributes to normal cognitive function12. Omega-3 fatty acids play a role in the maintenance of overall good health13 and are important components of cell membranes, including the membranes of cells which form the eye, and the central nervous system11. Rademan recommends the we should stock up on a variety of foods according to their nutritional benefits. These include8: Vitamin A: Sweet potato, Kale, Broccoli and Bok Choy, Spinach Vitamin C: Red Peppers, Berries, Citrus Fruits Vitamin D and Omega-3 Fatty Acids: Fatty Fish (Salmon, Trout, Sardines, Anchovy) Zinc: Lean Meat, Chicken, Whole Eggs, Fatty Fish, Wholegrains and Pumpkin Seeds Magnesium: Green leafy vegetables (e.g. spinach and kale), figs, avocado, banana and raspberries, Nuts and seeds, black beans, chickpeas and kidney beans, peas, broccoli, cabbage, green beans, artichokes, asparagus, brussels sprouts, salmon, mackerel, tuna) “It is also important to keep in mind which foods not to consume in excess during pregnancy, including too many Vitamin A rich foods”, says Hannelise8. While a healthy diet can certainly boost your immune system, remember too that plenty of sleep, moderate exercise and staying hydrated is also very important9. “Sleep is the time our bodies need to rest and repair, particularly in deep sleep,” she says8. Speak to your doctor or a dietician about your nutritional needs and a suitable supplement

February 4, 2021

What to eat during pregnancy

A healthy diet is important for everyone, but now you are pregnant, choosing the right food is more important than ever before, as your baby is relying on you to provide all the nutrients they need to grow and develop.

February 4, 2021

Pregnancy and Medical Aid

Motherhood and pregnancy are times of great anticipation and joy. Each experience is unique but what is probably high on the agenda is that you have a trouble free pregnancy, a healthy baby and then know and anticipate the cost involved for pre-natal check-ups and the birth. ‘Choosing the right medical aid is critical in ensuring the healthcare needs of you and your loved ones are taken care of. More so, when you’re looking at expanding your family. For those who are on a medical scheme or wish to join one, here are some important points to consider when you fall pregnant,’ says Lee Callakopen, Principal Officer of Bonitas Medical Fund. When you are already a member of a medical aid scheme When should you advise your medical aid of your pregnancy? If you are already a member, you can access the out-of-hospital maternity benefits without advising your medical aid that you are pregnant. However, please ensure that your doctor uses the correct ICD-10 codes on your claim to ensure that it is processed correctly. Bonitas pays for maternity benefits in addition to savings and day-to-day benefits, which help members get the care they need during pregnancy while limiting out-of-pocket expenses. Remember that pre-authorisation is needed for the delivery of the baby, which can usually, be done from 20 weeks onwards. Pre-authorisation will help you understand the benefits you have available on your plan and ensure that you are aware of what is covered. Bonitas members can also register for the Bonitas baby bag once pre-authorisation is obtained. The baby bag is packed with of useful goodies for the baby to make parenthood a little easier. When do you advise the medical aid that your baby has been born and needs to be added onto your medical aid? For our members, the baby needs to be registered within 30 days from the date of birth to ensure there is no break in cover and that your child will be covered from the first day of life. Are there Designated Service Providers (DSPs) in terms of gynaes and hospitals for childbirth? We strongly advise members to use DSPs to get maximum value and avoid co-payments. We agree special rates with these providers, which are covered within a member’s benefits so that they can focus on taking care of their health and wellbeing during pregnancy. What is normally covered in the maternity benefit? This differs from scheme to scheme and according to the plan you are on. Bonitas pays for up to 12 maternity consultations (paid for from a separate benefit), an amniocentesis, antenatal classes, 2x 2D ultrasounds and the delivery. In addition, there are additional benefit for newborn hearing screening tests and childhood vaccination. Does Bonitas cover the cost of a Caesarian birth? Yes, medically necessary Caesarians are covered on all plans. Some expectant mothers do prefer home births – is this covered? Yes the cost for a home delivery is covered. Are all the childhood vaccinations covered by Bonitas and if so, are there any conditions attached ie where the vaccinations should be done? Vaccines are covered as per the EPI schedule on immunisation. Please note this benefit is available on specific plans. The vaccines can be done at any clinic or pharmacy. If an administration fee is charged by these providers, it will be paid from your savings or day-to-day benefits. The vaccines covered are as follows: The Bonitas Babyline – a dedicated children’s health advice line In 2016, Bonitas introduced Babyline – a 24-hour children’s health advice line manned by paediatric trained registered nurses. They are on the other side of the phone to assist with any parental concerns, vaccination schedules and health related issues, 24/7, 365 days of the year. How does Babyline work? Bonitas parents, or their caregivers, simply call the Babyline number on 0860 999 121 to speak to paediatric trained nurse. Through a series of questions asked regarding the health issue, parents will be provided with professional advice on what to do next. Depending on the symptoms, the advice might be to head straight to the ER or to see a doctor or specialist. The nurse will advise which healthcare provider is the most appropriate, given the health issue. The services offered by the Babyline include: Home care advice Clinic/primary care/GP referral for the same day Clinic/primary care/GP referral for the following day After-hours care within the next six hours Immediate referral to the ER The Babyline service is available to members across all the Bonitas plans, for children under 3 years. Joining a medical scheme when you are already pregnant It is very common for women to apply to join a medical aid scheme when they fall pregnant. But according to the Medical Schemes Act 131 of 1998, medical aid schemes are entitled to impose a 12-month condition specific waiting period for any pre-existing medical condition, such as pregnancy. These waiting periods must be imposed for specific pre-existing conditions to protect the interests of current members of the scheme. When a waiting period is applied to pregnancy, then the pregnancy and birth will not be covered but your baby will be covered from the first day of life – if you register them on your medical aid within 30 days. This will allow you to ensure the needs of your child and the healthcare will be covered. Bonitas has different plans and expectant mothers will be able to select the one most suitable for their needs. Informing the medical aid of your pregnancy Prospective members need to inform their medical aid upon application or within 30 days after you complete the application. What is the policy regarding a member joining Bonitas when they are pregnant? What sort of cover can they expect, if any? The pregnancy would be considered pre-existing and therefore not covered. The baby will be covered if registered within 30 days post-delivery. What happens if someone signs up for medical aid not realising they are already pregnant? At what point is

February 3, 2021

Tips to reduce heartburn during pregnancy

During pregnancy, you may have expected swollen ankles and morning sickness, and even having to invest in a bigger bra. But where does this burning indigestion come from?1 The fact is that heartburn affects up to 85% of pregnant women2, with many women experiencing this uncomfortable feeling throughout all three trimesters of their pregnancy3. Heartburn (also called gastroesophageal reflux and acid indigestion) can feel like a burning sensation that starts behind your breastbone and travels up your oesophagus (the tube connecting your throat to your stomach). These acids can even make it all the way up your throat1. During pregnancy, the increase in the hormone progesterone causes the valve between the stomach and the oesophagus to relax3, which accounts for why heartburn is more frequent during pregnancy3. Here are some diet-related tips that might help! Hannelise Rademan, a Registered Dietitian currently volunteering at Worcester Provincial Hospital in the Western Cape, says that following a healthy, nutritious diet which includes adequate fibre such as wholegrains, fruit and vegetables, is very important. Ideally, your diet should be low in fat4. “Limit fried foods, cream sauces, gravies, fatty meats, pastries, nuts, potato chips, butter and margarine,” she says, and adds that moderate portions of protein should be included to stimulate a hormone called gastrin to aid digestion and increase valve (known as LES or lower oesophageal sphincter) pressure4. As your uterus expands with your growing baby, it places pressure on your stomach, which also increases the likelihood of acid reflux, especially if your stomach is full1. Drinking liquids at the same time as eating your food can create a full “sloshy” stomach environment primed for heartburn1. “Fluids may be better taken between meals to avoid distension (or swelling) of the stomach and carbonated beverages should be avoided,” Rademan says4. “Avoid large meals that increase gastric pressure, and rather eat smaller meals throughout the day”4, she says. This helps to avoid overwhelming the stomach and allows it to empty more quickly. Rademan recommends that during acute bouts of heartburn, eat small frequent meals of soft and bland foods4. Fatty meals, coffee (both decaffeinated and regular), chocolate, peppermint and spearmint, garlic and onion are all foods that can exacerbate heartburn and should be avoided4. This includes acidic and spicy foods that create more stomach acid than blander alternatives, and should be avoided by those suffering from heartburn1. Although smoking and drinking alcohol should not be part of pregnancy regardless, these can also negatively affect valve pressure and increase heartburn4. Lifestyle adaptations can also be helpful to alleviate symptoms of heartburn4. These include not eating for within 3 to 4 hours before going to sleep at night, staying upright and avoiding vigorous activity after eating and not wearing tight-fitting clothing4. Some natural and alternative remedies that may help relieve symptoms include ginger and lemon water or chewing gum4. Eating yogurt or drinking a glass of milk or even adding a tablespoon of honey in a glass of warm milk might also help ease symptoms or heartburn5. Gelusil Plus® is an antacid suspension that can be taken to relieve heartburn in pregnancy3,6. This treatment has a dual mode of action that neutralises stomach acid whilst creating a barrier to reduce acid reflux into the oesophagus6. Heartburn is common and uncomfortable during pregnancy, but it should subside once you give birth and your hormone levels return to normal. While you may not be able to prevent heartburn altogether, simple lifestyle changes, such as eating small meals, avoiding spicy or fatty foods, and sleeping with your head and shoulders elevated, might help ease the symtoms1. For more information about Gelusil Plus® which has been proven to be suitable and effective to relieve symptoms of heartburn during pregnancy6, go tohttps://pregomega.co.za/gelusilplus/. This editorial has been commissioned and brought to you by iNova Pharmaceuticals. Content in this editorial is for general information only and is not intended to provide medical or other professional advice. This article includes views and opinions of the named Healthcare Provider and not reflect the views of iNova Pharmaceuticals, nor is it intended as medical advice. For more information, speak to your healthcare provider. Scheduling Status: S0 Proprietary name and dosage form: Gelusil Plus® Suspension. Composition: Each 10 ml suspension contains: Sodium alginate 500 mg, Sodium bicarbonate 267 mg, Calcium carbonate 160 mg. Registration number: 43/11.10/1124. The claims made in this material are for medical information and educational purposes only. Marketed by: iNova Pharmaceuticals (Pty) Ltd Co. Reg. No. 1952/001640/07,15E Riley Road, Bedfordview. Tel. No. 011 087 0000. www.inovapharma.co.za. Further information is available on request from iNova Pharmaceuticals. IN1267/20 References: Healthline – Heartburn in Pregnancy (2019) at https://www.healthline.com/health/pregnancy/heartburn-during-pregnancy#takeaway (website accessed on 8 October 2020) Lindow, SW. An open-label, multicenter study to assess the safety and efficacy of a novel reflux suppressant in the treatment of heartburn during pregnancy. Int J Clin Pract. 2003 Apr;57(3):175-9. Meteerattanapipat, P. and Phupong, V. Efficacy of alginate-based reflux suppressant and magnesium aluminium antacid gel for treatment of heartburn in pregnancy: a randomized double-blind controlled trial. Sci. Rep. 7, 44830; doi: 10.1038/srep44830 (2017). Q&A with Registered Dietitian Hannelise Rademan – 5 October 2020 (unpaid) American Pregnancy Association. Heartburn during pregnancy – Causes and treatment (2015) at https://americanpregnancy.org/pregnancy-health/heartburn-during-pregnancy/. (Website accessed on 7 September 2019) Gelusil Plus approved package insert, August 2015

February 3, 2021

Chicco Baby Hug 4-in-1 Air

The Baby Hug 4-in-1 by Chicco has been one of the most award-winning nursery items in Europe for the past two years running. Exclusive to Chicco, it has become a staple in nurseries across the world for its multi-functional, highly versatile features – making parents lives so much easier. Baby Hug is known for being a reclining chair, a highchair, a crib and a relaxing floor chair all in one. It also doubles as a co-sleeper (with an additional mattress). With a foot pedal, parents can adjust the Hug to any height. With a lift of a lever, they can adjust the tilting of the bassinet to any level, making it perfectly adaptable to any situation. The Hug comes with a mobile toy bar that plays day and night music, has a nightlight and toys for sensory development. In 2020, the Baby Hug now comes in a brand new variant – the Baby Hug 4-in1 Air. With new mesh sides to the bassinet, the Hug now offers much better ventilation for the child, ensuring breathing is never stifled and over-heating never occurs. In a gorgeous Stone colour, and black and white toy bar with new aesthetic features, the Baby Hug Air is not only versatile and convenient, but highly stylish too. The Baby Hug Air is available now at leading retailers including Baby City, Baby Club by Clicks, Takealot, Loot, Babanino, Baby Boom and The Kid Zone. Prices vary per retailer.

January 18, 2021

9 signs you may have Postpartum depression

Also known as Postnatal depression, this condition can often be mistaken for something referred to as the ‘ Baby Blues ’. Both of these conditions involve feeling depressed, horrible mood swings and start a few days after giving birth. The difference between Baby Blues and Postpartum depression As a new mom , the combination of a lifestyle change, lack of sleep and rapidly fluctuatinghormones can result in the Baby Blues within two weeks of giving birth. However, these feelings should start to go away after around two weeks – when your body starts to adjust as do your hormones. It is important to be kind to yourself during this time. Although many women have gone through labour and birth, it does not make the process easy. Feeling out of sorts, overwhelmed and down are understandable. Sometimes Baby Blues turns into something more, and that is something that you need to look out for. Symptoms of postpartum depression According to the American Psychiatric Association, here is a basic checklist to watch out for: Sadness Fatigue, or a decrease of energy Impaired concentration and decision making The inability to feel pleasure A tendency to blame yourself, to feel guilty or worthless Sleep disturbances Agitation or restlessness Appetite disturbances or weight loss Recurring thoughts of self-harm If you read through this list and found yourself identifying with a few or all of these symptoms -it is very possible that you have Postpartum Depression . Again, this is a physical condition that is treatable. It is not your fault and you are not a bad mother for having it. In fact, between 10 to 15% of mothers worldwide suffer from Postnatal depression , with many more in countries with higher poverty levels. Without intervention, Postnatal depression can last for years. Getting help Regardless of your personal support system, there are support structures out there that can help you through this difficult time. If your Postnatal depression is compromising your ability to look after your child, or you have any thoughts of self-harm, it is important to know that there is something you can do if you reach out to the right places. The following organisations offer assistance, and are trained to help you. Adcock Ingram Depression and Anxiety Helpline 0800 70 80 90 SADAG Mental Health Line 011 234 4837 Suicide Crisis Line 0800 567 567 You can also speak to your GP, Gynaecologist or midwife about what you are feeling. Joining a support group, or a mother and child class can help with feelings of isolation – you will be surprised how many other mom’s may be going through the same thing as you.

January 7, 2021

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