Healthy Child with Dr Ranj Singh: Winter 2023/24 by Magazine

HEALTHY CHILD WITH DR RANJ SINGH

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Healthy Child with Dr Ranj Singh IN ASSOCIATION WITH

MYOPIA

Why is Short Sight in Kids On the Rise?

PREGNANT PAUSE

Dealing With Common Health Conditions

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RIDE! SWIM! SLEEP!

THE LAW AND YOUR FAMILY

Exercise and Rest for Child Health

Great Advice From Family Law Experts

CHILDCARE

The Best Options in Care and Learning

DISCUSSING THE ESSENTIALS FOR KIDS’ HEALTH WITH THE TV DOCTOR

WINTER 2023/24

DR RANJ SINGH

WINTER 2023/24 | £4.20

SPONSORS

PREGNANCY

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WELCOME

hello!

... and welcome to the latest issue of Healthy Child, with me, Dr Ranj Singh

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e read a lot these days about ‘ultra-processed’ foods and how they might be bad for us – but sometimes convenience and cost (especially right now) take precedence. In this issue we’re going to be looking at how diet can affect health, particularly for kids, and how you can make better dietary and nutritional choices. Plus, there are other health issues affecting children that could be a concern – for instance, why is there an epidemic of myopia, or short-sightedness? Is it the fallout from lockdown and staring at screens all day? We find out the facts and tell you how to spot if your child is struggling and needs help. There’s plenty more in this issue of Healthy Child, from ideas about childcare and education to exercise tips and sleeping advice. And don’t forget the website at www. celebrityangels.co.uk, which is an invaluable source of news and advice. I’ve seen what the NHS has to cope with from both sides – see my interview later on! – so I know that while times are tough, there are dedicated professionals working to keep our children protected and healthy 24 hours a day. I hope that you will also find Healthy Child a help as you tackle health and wellbeing issues, and that the more you learn, the more you will appreciate what it takes to keep our kids safe and well! ■ Dr Ranj Singh Guest Contributor

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CONTENTS

Contents SPECIAL FEATURES 10 Interview Celebrity guest editor Dr Ranj Singh talks to Chris Jenkins about issues from processed foods and allergies to exercise and mental health

HEALTH TODAY 14 Health Today All the news on child health issues from vapes and virtual wards to diet and supplements 16 No Laughing Matter A proposed ban on the recreational use of nitrous oxide or ‘laughing gas’ stems from health fears for younger users

18 Food, Poo and You Kids are fascinated by poo – now there is an exhibition that tells them all about food and digestion in an epically entertaining journey 22 The Great Toilet Adventure Toilet training can be one of the most challenging aspects of raising kids, but it should go smoothly if you follow this helpful advice 28 BOGOF to Unhealthy Food We all know that some food is unhealthy, but how can people be steered towards a better diet? One idea is to limit ‘BOGOF’ offers

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CONTENTS

PREGNANCY & EARLY YEARS 32 Pregnancy & Early Years All you need to know about managing pregnancy and the first months of baby’s life 34 Pregnancy Problems Even the smoothest pregnancy can include some health issues. We look at some of the most common problems and how to deal with them 37 Epilepsy: Cracking the Code Unexplained infant epilepsy leaves many questions about the child’s future health. Now genome therapy may suggest a new approach 44 Getting Childcare Right Choosing a nursery is just part of the challenge of getting childcare right. So how do you navigate all the rules and regulations and make sure that you are doing the best for your children?

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49 School of Skincare Here’s the new thinking in treatment for irritated skin in infants

IMAGES: Dreamstime, The Board of Trustees of the Science Museum/Drew Forsyth

50 Emollients and Skincare Skincare is an essential in maintaining child health, but what role can emollients serve? 55 Teeth and Smiles Teething time can be trying, but with a little help and advice even the most fretful baby should come out all smiles HEALTH CHECK 56 Health Check All you need to know about the issues concerning the health of children today 60 20/20 Vision What is 20/20 vision and how can we maintain it? It starts with an informed attitude to eye health 64 Why Fish is the Dish Fish should be a part of any healthy diet, but it’s particularly valuable for developing children. Lauren Woodley, company nutritionist for Birds Eye, tells us why

70 Eating Meat-Free A meat-free diet might be good for the planet, but is it healthy for your children? We look at vegetarian and vegan options

87 Water Way to Go! Swimming is one of the most healthy activities for kids (and their parents) – so what’s stopping you getting in the swim?

76 The Milky Way Milk intolerance, or more accurately lactose intolerance, is a familiar condition in some adults and children, but what are the causes and solutions?

92 You Don’t Snooze, You Lose Why is sleep so important to kids’ health, and how can you make sure you and your children get a restful night’s slumber?

80 The Miracle of Millet Widely produced for human consumption around the world, millets are a source of nutrition we might all consider for our family breakfast

98 On Two Wheels Cycling is one of the healthiest and most affordable exercises for children, so how do you get them into it and make sure they’re safe on two wheels?

83 Allergic Reactions Childhood coughs, tickles and sneezes can be caused by allergies. What brings them on and what are the solutions?

102 Sounder Sight Short-sightnedness or myopia in children is a growing problem, but there are some ingenious solutions to address the issue

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CONTENTS

GROWING UP 106 Growing Up All you need to know about the issues affecting children’s health as they grow up and develop

120 All Part of the Game? Video games are fun for all ages, but can lead to serious addiction problems in children and adults. Now an specialist NHS clinic aims to help out

110 Teaching by Example Formal education has become a minefield of examinations, assessments and stress for both pupils and parents. Are there better approaches to teaching?

124 Stressing the Point Raising children can be stressful, but talking to them about their own stresses can be just as hard. Here are some thoughts about easing the burden

PARENTING 118 Parenting All you need to know about helping your children through adolescence and early adulthood

127 The Law and Your Family For many years family law and particularly cases involving children have been conducted in obscurity. Now a new scheme aims to shed more light

SUB EDITOR Emmanuel Berhanu

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PRODUCTION Ray Walsh

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PUBLISHER & CEO Kevin Harrington EDITOR Chris Jenkins

CONTRIBUTORS Richard Wentworth Thomas J Roberts Patricia Savage

Healthy Child with Dr Ranj Singh Celebrity Angels 143 Caledonian Road London N1 0SL Tel: 020 7871 1000

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All material in Healthy Child with Dr Ranj Singh is wholly copyright and reproduction without the written permission of the publisher is strictly forbidden. Products and services included in this publication do not imply endorsement by Dr Ranj Singh. The views expressed in this publication are entirely those of the writers and do not necessarily represent those of Celebrity Angels. The information in this publication is carefully researched and produced in good faith, however, neither the Publisher nor the Editors accept responsibility for any errors. The Celebrity Angels Series is published in the UK under licence by Damson Media Limited. Damson Media Limited is registered in England and Wales under registration no. 07869300.

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INTERVIEW

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INTERVIEW

Caring and

Helping Chris Jenkins talks to Dr Ranj Singh, celebrity guest contributor to Healthy Child, about the importance of good diet and exercise for kids, current issues in child health care and the importance of inclusion

THERE’S BEEN A LOT OF DISCUSSION RECENTLY ON THE HEALTH IMPLICATIONS OF ULTRA-PROCESSED FOODS. WHY IS THIS PARTICULARLY RELEVANT FOR CHILDREN? RS Whilst many of us will have heard of ‘processed’ foods, the term ‘ultraprocessed foods’ has become popular relatively recently. It describes foods that are modified to such an extent that you wouldn’t normally be able to recreate them at home in your own kitchen. Often they contain additives and substances to enhance flavour or prolong shelf-life. The issue with these is that there is some evidence that they may be harmful to health, and there is a particular concern when it comes to children. Why? Because lots of children’s favourites, like fruitflavoured and carbonated drinks, sweet snacks and even formula milk, fall into the classification of being ‘ultra-processed’

and people are worried about the longer-term implications of this. While there is not always an easy solution given how widespread they are, the general recommendation is that we should all try to cut down on these foods where realistically possible. So, if in doubt, try to go for wholefoods rather than processed, and try to prepare as much at home as you can (within your ability and budget obviously!). ALLERGIES HAVE BEEN PEAKING IN THE SUMMER – WHAT CAN WE DO TO DIAGNOSE AND TREAT THEM IN CHILDREN? RS While ‘summer allergies’ tend to be related to the environment (especially things like pollen), allergies in general are more common in children – particularly food allergies. Allergic conditions will often run in families, so it’s no surprise if various members suffer with things like asthma,

eczema and hay-fever. In many cases the cause may be obvious. For example, your child may have reacted after eating or touching something for the first time. At other times it may not be so obvious. In either situation, speaking to a healthcare professional and getting allergy testing may be helpful. This usually involves a blood or skin-prick test to check for reaction to various common things and can help guide us on what to avoid or whether any treatment might be needed when your child reacts. Most can be managed with simple antihistamines and being careful about coming into contact with the culprit. However, it’s important to know how and when to treat your child’s allergy – especially if they have been given something like an adrenaline injector pen. Fortunately, when it comes to food allergies, many kids will grow out of them so it may not be a lifelong consideration. »

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INTERVIEW

WHAT FORMS OF EXERCISE DO YOU RECOMMEND FOR CHILDREN? RS Exercise is great for children’s physical and mental wellbeing and there really isn’t one particular thing that is superior to the rest. What’s important is getting your children to be as physically active as they can and to continue those habits into adulthood. Aerobic activities like walking, running, cycling, playing sports games, dancing and swimming are all great because they not only strengthen the body but are also beneficial for the cardiovascular system. And they don’t have to involve expensive club or gym memberships. There are lots of free or low-cost activities available which the whole family can get into. The key is to find something that you all enjoy and are likely to keep doing – that way it doesn’t feel like a chore! ANDY BELL OF THE CENTRE FOR MENTAL HEALTH RECENTLY SAID “CHILDREN’S MENTAL HEALTH IS NOW ACKNOWLEDGED AS A MAJOR CONCERN BY GOVERNMENTS, SCHOOLS, AND THE PUBLIC... BUT DEMAND FOR HELP VASTLY OUTSTRIPS SUPPLY. THE RESULT IS THAT CHILDREN’S NEEDS 12

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ESCALATE UNTIL THEY REACH CRISIS POINT AND NEED MORE INTENSIVE SUPPORT AT A HIGHER COST.” WHAT CAN BE DONE TO FIX NHS CHILD MENTAL HEALTH SERVICES? RS The crisis in children and young people’s mental health has been a growing issue for a long time. Unfortunately, the pandemic seemed to escalate things as demand grew and services increasingly struggled. The need for better mental health support has never been greater, but sadly there is no magic answer that is going to instantly solve this problem. Most solutions rely on better funding, resources and staffing which are not easily available. However, what is pretty much universally recognised as a good idea is early intervention: offering support before things become a bigger issue. Having better access to support, for example early support hubs in the community and increased mental health professional presence in schools, would definitely help. This is going to require time, planning and investment and should definitely be a priority on any government agenda. DEMAND FOR CARE FOR CHILDREN WITH TYPE 2 DIABETES AT PAEDIATRIC

UNITS ACROSS ENGLAND AND WALES HAS INCREASED BY MORE THAN 50 PER CENT IN THE LAST FIVE YEARS. THE NHS SPENDS £10BN A YEAR TREATING DIABETES. WHY CAN’T WE SEEM TO GET TO GRIPS WITH CHILDHOOD DIABETES? RS Type 2 diabetes, which is mainly related to lifestyle factors, is on the increase across the population. However, the increase in children developing what was traditionally known as an ‘adult-onset’ condition is seriously worrying – especially the implications over the long term. The reasons for this increase are complex, but undeniably, diet and exercise play a crucial role. The diet of a child today is potentially full of processed ingredients and is high in sugar and fat. Couple that with reducing levels of physical activity (especially over and since the pandemic), and you have the perfect storm for lifestyle-related conditions. Tackling this problem is going to require effort by government, the food industry, schools and individuals, but it needs to be taken more seriously. WHAT ARE SOME OF THE MOST COMMON HEALTH QUESTIONS YOU GET AT #ASKRANJ ON BBC MORNING LIVE? RS BBC Morning Live is the BBC’s new

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INTERVIEW

IMAGES: Dreamstime, Hodder Children’s Books

daytime magazine show which has proved a bit of an instant hit because of its accessible, warm tone and useful takehome for the audience. Every day we will also tackle a health issue or item, and this could range anywhere from menopause to mental health. Since getting timely medical advice and care is so tricky at the moment, we strive to answer as many of our viewer questions as we can and we get asked about a whole range of different things. However, topics that have been particularly prevalent include: long COVID, ME/CFS, fibromyalgia, thyroid issues, bone and joint health, skin problems and menopause. No matter what the query, we will do our best to come back with something helpful! YOU RECENTLY SUFFERED A BOUT OF FOOD POISONING AND HAD TREATMENT FROM THE NHS – WHAT WAS IT LIKE FROM THE OTHER END OF THE STETHOSCOPE? RS Being a patient is never easy – especially for doctors! And being a patient in hospital right now is difficult for everyone simply because of the pressures on the NHS. However, my treatment has always been incredible, and it serves to remind me of how lucky we are to have a NHS that is there when we need it most. That’s not to say it doesn’t have its faults. Being on the other side really gave me an appreciation for what it is like for my patients. I learned how simple things like people introducing themselves, being given information about what is going on, proper signposting in hospitals so that you don’t get lost trying to find the department (like I did!), and being able to collect medication easily aren’t always done correctly. So that makes me more wary when I’m treating people and makes me want to do better. Thankfully I recovered from my severe food poisoning because of the great care I received, and for that I’m really grateful. WHAT CAN YOU TELL US ABOUT YOUR WORK WITH THE EVELINA CHILDREN’S CHARITY? RS The Evelina London is a worldrenowned children’s hospital in South

London, and is part of the Guy’s & St. Thomas’ NHS Trust. It serves the health needs of the local region, particularly through its A&E where anyone can get urgent and emergency care, but is also a centre of expertise for referral from across the UK and the world. It really is a wonderful place that does some incredible things for sick children. The Evelina London Charity aims to raise vital funds to improve services, help drive research, make the hospital environment better for children and their families, and invest in innovative equipment and technology to provide the best care for kids. I’ve helped raise funds for them over the years through various projects, ranging from campaigns with brands to appearances on TV shows. In fact, my little stint on ITV Catchphrase alone helped raise over £10,000! HOW HAVE YOUR LIVE EVENTS SUCH AS PERFORM IN THE PARK BEEN GOING? RS Perform in the Park is a brand-new children’s theatre festival held in London. It offers everything from live shows to fun activities, and special appearances from people across the world of TV, theatre and entertainment as part of the Evenings In The Park series for older kids. So they’ve got everyone from Jason Manford and Ugo Monye, to Joe Tasker and Dr Alex. I’m doing a session as well where the audience will get to learn about my journey from medicine to TV to theatre, wth some funny stories along the way. Plus they’ll also get to ask me anything they like. I might even throw in a little live musical performance – so watch this space! WHAT ABOUT YOUR BOOK WRITING CAREER? RS Over the last few years, I’ve been really fortunate to have written several books (mostly for children and young people) and 2023 has been a busy year! In May I released How To Be A Boy (And Do It Your Own Way) which is a positive, inclusive and empowering guide for boys and young men to discover whoever they are and be their best selves. In fact, it’s all about being a decent and kind human

being! It covers everything from identity to sexuality to mental wellbeing, and everything that young people have to deal with these days. It’s the book that everyone should read and it’s had some great feedback! I’ve also just released my latest picture book Superfamily Like Ours, aimed at pre-school-aged kids, which is all about celebrating different kinds of families. The main character, Rohan, is actually based on my nephew who is autistic. It’s a really lovely little story about how people can come from different kinds of family unit, but all of them are just as special and amazing as each other. And don’t worry, there will be more books coming – including a big announcement in 2024!

ARE THERE ANY OTHER PROJECTS YOU PLANNED THAT YOU WOULD LIKE TO TELL US ABOUT? RS We are slowly heading towards the festive season (yes, we’re already talking about Christmas!) and I’m really excited about this year’s pantomime! I’m going to be playing the part of the Spirit Of The Bells in Dick Whittington in Nottingham this year and I cannot wait. I’ll be performing alongside the brilliantly hilarious Shane Ritchie and a fantastic cast. You can expect lots of jokes, music and special effects, and of course, lots of festive cheer. I adore pantomime because it’s something the whole family can enjoy together and it’s wonderful seeing little ones’ faces as they experience this magical world. If you haven’t got your tickets, grab them soon, as they sell fast! ■

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Health Today What’s new in children’s health

DANGER VAPES IN SCHOOLS A BBC investigation has shown high levels of dangerous chemicals including lead and nickel in illegal vapes confiscated in schools. Vapes collected in Baxter College in Kidderminster were tested by an independent laboratory which showed them to have more than twice the allowed levels of lead, and nine times the amount of nickel. While vaping is regarded as a safer alternative to smoking tobacco, authorities worldwide are beginning to worry that the appeal of vaping to children means that they are being exposed to chemicals in unknown quantities. While the chemical composition of vapes, or e-cigarettes, is supposedly controlled, there is a thriving market in illegal vapes, many of them flavoured and packaged to appeal to children as young as 12 or 13. Some vapes also contain high levels of nicotine as found in cigarettes. Exposure to chemicals such as lead can affect the development of children’s nervous systems, says the World Health Organisation. In the BBC’s investigation, the Inter Scientific laboratory, in Liverpool, which works with vape manufacturers to ensure regulatory standards are met, analysed 18 vapes, finding that most were illegal and had not gone through any kind of testing before being sold in the UK. Lab co-founder David Lawson said: “In 15 years of testing, I have never seen lead in a device. None of these should be on the market – they break all the rules on permitted levels of metal. They are the worst set of results I’ve ever seen. Of particular concern were “highlighter vapes”, designed with bright colours to look like highlighter pens, where the amounts of the metals found were: ✤ Lead – 12 micrograms per gram, 2.4 times the stipulated safe exposure level

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✤ Nickel – 9.6 times safe levels ✤ Chromium – 6.6 times safe levels The metals are though to come both from the heating element in the vapes, and also from the e-liquid itself. The lab tests also found compounds called carbonyls, which break down into chemicals such as formaldehyde and acetaldehyde when the e-liquid is heated, at 10 times the level in legal vapes, some with levels higher than are found in cigarettes. Theoretically, the Medicine and Health Care Products Regulatory Agency (MHRA) sets regulations for manufacturers on vape ingredients, packaging and marketing, and registers e-cigarettes and e-liquids. But the MHRA does not check claims made by manufacturers, and has no power to investigate unregistered products. Trading Standards agencies, which would theoretically investigate unregistered products or cases when sales are made to underage customers, say they do not have the manpower to handle the number of cases. It is illegal to sell vapes to under-18s, but a YouGov survey in March and April for Action on Smoking and Health suggests a rise in experimental vaping among 11- to 17-year-olds, from 7.7%, last year, to 11.6%.

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HEALTH TODAY

MORE CHILDREN TREATED ON VIRTUAL WARDS

Relax and Support

Tens of thousands of children will be able to receive hospital-level care at home thanks to an expansion of virtual wards, chief executive Amanda Pritchard announced on the 75th anniversary of the NHS. The hospital at home service – already the largest of its kind in the world – has expanded to cover children in every region of England from July after successfully treating more than 6,400 children over the previous year. NHS chief executive Amanda Pritchard said the world-leading NHS virtual wards programme has “provided peace of mind” to parents who have used them during trials, including in Blackpool, Dudley and Dorset.

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The services will treat a range of conditions like respiratory illness, such as asthma, and heart conditions, allowing kids to get the care they need from the comfort of their homes. Virtual wards allow patients to get hospital-level care at home safely and in familiar surroundings, helping speed up their recovery while freeing up hospital beds for patients that need them most and reducing the burden of travel for families.

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Eating nutritious Brunswick Sardines is one step towards a healthy lifestyle. Other healthy lifestyle guidelines include achieving and maintaining a healthy body weight, and doing regular physical activity. Enjoy a variety of foods, emphasising cereals, breads, other whole grain products, vegetables and fruit. Eat fish, lowerfat dairy products, leaner meats and food prepared with little or no fat, include a small amount of unsaturated fat each day, and limit trans fats. www.brunswick.ca

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HEALTH TODAY

No Laughing Matter

ou may have seen the evidence of nitrous oxide abuse without realising what you are seeing; those little silver canisters discarded in piles in parks and outside clubs are the detritus of ‘laughing gas’ abuse. But what is it, and why is the government so concerned with its health effects, particularly among the young? Nitrous oxide (N2O) is a commonly used inhaled anaesthetic in dental procedures. The gas is also used for filling balloons, in whipped cream dispensers and elsewhere. But the small gas canisters or ‘whippets’ are abused as a recreational drug, usually by emptying the canister into a balloon and inhaling. The gas usually gives an instant effect of feeling euphoric and relaxed, but can also cause sound distortion and hallucinations. In 2020/21, nitrous oxide was the third most commonly used drug among 16-to-59-year-olds in England and Wales. Nitrous oxide can also cause paranoia and loss of judgement, and because its effects are short-term, users often dose themselves repeatedly, which is particularly dangerous if used in combination with

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other drugs. There also appear to be longterm effects of N2O abuse, including nerve damage related to vitamin B12 deficiency. A study of patients under 20 years of age who were diagnosed with N2O-induced degeneration of the spinal cord showed symptoms including limb numbness, limb weakness or unsteady gait. Some patients showed low vitamin B12 levels, but responded to treatment with B12 supplements, though some had persistent sensory damage. DAMAGE The study concluded that chronic N2O abuse can cause permanent neurological damage if not treated promptly, and that clinical staff should be aware of the various presentations of neurotoxicity related to N2O abuse. Nitrous oxide appeals particularly to the young because it’s cheap and easy to obtain, though as of 2016, it is covered by the Psychoactive Substances Act and is illegal to supply for its psychoactive effect. However, the government thinks this is not enough, and for health and

public nuisance reasons, has made clear its intention to ban the sale of nitrous oxide except in specific circumstances. A statement says: “It is clear that nitrous oxide has a negative effect on individuals and communities. It is the third most commonly misused drug, with particularly concerning rates of use by school age children and younger adults. “In their 2023 review, the Advisory Council on the Misuse of Drugs concluded that the overall harms were insufficient to merit control. “However, there have been anecdotal reports of an increase in social harms such as drug driving and littering of discarded canisters, alongside widespread availability of nitrous oxide for illegitimate use and the risk of neurological harm it presents to users when consumed in extreme volumes. “We know that some of these harms are felt acutely by communities, and as a result the Prime Minister announced in the government’s Anti-Social Behaviour Plan, published on 27 March, that we will be taking decisive action to ban nitrous oxide by making it a Class C drug under

IMAGES: Dreamstime

A proposed ban on the recreational use of nitrous oxide or ‘laughing gas’ stems from health fears for younger users

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HEALTH TODAY

the Misuse of Drugs Act 1971. While we are clear that it is necessary to control nitrous oxide, the government nevertheless recognises that there are legitimate uses for nitrous oxide in the many sectors, including medical, industrial and catering. We intend to ensure that those wishing to use nitrous oxide for legitimate purposes can do so lawfully and without undue burdens. “This consultation seeks to understand the full range of legitimate uses of nitrous oxide and proposes three options for how to approach a regime of control. “This will enable us to ensure that we minimise the burdens placed on those who seek to use and handle nitrous oxide for legitimate purposes.” VICE Widespread recreational use of the drug throughout the UK was featured in the 2017 Vice documentary Inside The Laughing Gas Black Market, in which journalist Matt Shea met with dealers of the drug who stole it from hospitals. While casual use is understood by most recreational users to be a route to a “safe high”, many are unaware that excessive consumption has the potential to cause neurological harm which, if left untreated, can result in permanent neurological damage. In Australia, recreational use became a public health concern following a rise in reported cases of neurotoxicity and a rise

PROPOSALS The government is considering how best to balance enabling the legitimate use of nitrous oxide while ensuring that it is not misused for its psychoactive effect. It is not the intention to unduly burden legitimate users, nor to inadvertently criminalise those wishing to use nitrous oxide for legitimate purposes. The government is of the view that in order to effectively implement a sufficient level of control, a licensing regime may be required. You can respond to the current consultation by completing the online survey at www.homeofficesurveys.homeoffice.gov.uk/s/EKNTX3/ or emailing nitrousoxideconsultation@homeoffice.gov.uk. in emergency room admissions, and in the state of South Australia legislation was passed in 2020 to restrict canister sales. A significant issue cited in London’s press is the effect of canister littering, which is highly visible and causes a high level of complaints from communities. The government has taken the decision to control nitrous oxide as a Class C drug under the Misuse of Drugs Act 1971 (“the 1971 Act”). Control under the 1971 Act means that it will be unlawful to possess, supply, import, export or produce the substance, unless an exemption applies (for example, for use in healthcare) or the person undertaking the activity holds an appropriate licence. Nitrous oxide also has widespread legitimate and beneficial uses, including in medical, dental, and veterinary settings. It is also used as a fuel additive, a food additive and a food extraction solvent, and

has many other widespread uses in different industrial processes. The government wishes to minimise the effect of controlling nitrous oxide on those who seek to use it for perfectly legitimate purposes, while restricting its availability to those who intend to misuse it. This consultation will be used by the government to understand the full range and scale of legitimate uses of nitrous oxide to enable the design of a legal framework that permits its use for legitimate purposes once it becomes a Class ‘C’ controlled drug under the 1971 Act. For the purposes of this consultation, ‘legitimate use’ refers to uses of nitrous oxide which is not for its psychoactive effect in a recreational capacity. EXCEPTIONS Control of a drug under the 1971 Act makes it unlawful to possess, supply, produce, import or export the drug, unless a relevant exception or authorisation applies. Under the 1971 Act, if you are convicted of possessing a Class C drug you could face up to two years in prison, an unlimited fine or both. If you are convicted of supplying a Class C drug, you could face up to 14 years in prison, an unlimited fine or both. The current consultation sets out proposals for licensing or exempting import, export, possession, production, or supply of nitrous oxide for legitimate purposes, and any final legislation will be accompanied by an impact assessment setting out the full costs and benefits of the policy. For young N2O abusers, though, it seems that the laughing will soon have to stop. ■

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HEALTH TODAY

Food, Poo and You Kids are fascinated by poo – now there is an exhibition that tells them all about food and digestion in an epically entertaining journey

peration Ouch! Food, Poo and You opened at the Science and Industry Museum in Manchester in July, and runs until June 2024. From incisors to intestines, the extraordinary exhibition presents the outrageous adventure as a journey through our bodies, embracing silliness in the name of science as visitors are shrunk, swallowed, squeezed through and spat out of a giant digestive system. This is the first time hit BBC Children’s TV show, Operation Ouch!, has been brought to life as an exhibition. Stars of the show, Dr Chris van Tulleken, Dr Xand van Tullekan and Dr Ronx Ikharia are renowned for their ability to engage, educate and

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entertain young viewers by conducting outrageous experiments, and the trio have provided unique inspiration for the exhibition. On visiting the exhibition themselves, the Doctors immersed themselves in the lively, interactive and playful adventure, taking part in key highlight experiences, including: h The Big Flush, a once-in-a-lifetime experience of travelling like a poo and being flushed down a giant toilet. Put on a ‘poo hat’ before passing through the pan! h Journeying through a super-sized set of interactive teeth. h Taking part in the world’s only interactive

‘pooduction’ line—’make’ a poo and discover how our bodies absorb nutrients and expel waste. h The doctors’ elusive ‘cupboard of everything’ and interactive lab, brought to life from the screen for the first time. h A specially designed soundscape heightening the feeling of being immersed inside the human body. h New stories from young people living with a range of digestive conditions, along with the modern-day medicine helping to treat them. h Meeting Larry the Vomiting Robot, designed to help scientists understand how far sick splatters (and how norovirus particles are distributed), on display for

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HEALTH TODAY

the first time as part of an exhibition, along with fascinating objects from the Science Museum Group’s collection.

IMAGES: © The Board of Trustees of the Science Museum/Drew Forsyth

The rib-tickling exhibition goes under the skin to explore the science inside our bodies. From tongue to bum, it investigates some of our funniest functions and uncovers the job of each digestive organ in helping to keep us healthy, breaking the taboo around poo by proving it’s helpful to understand and discuss how our bodies work. The three Doctors are an integral part of the experience. They pop up digitally throughout the exhibition, appearing onscreen to help visitors understand more about the science of digestion, as well as featuring across illustrations and other elements of the exhibition content. SOLIDS The exhibition includes plenty of opportunities for play but is underpinned throughout by solid science that aims to empower visitors to understand more about the inner workings of their own bodies and the role of science in supporting digestive health. Steven Leech, Curator of Exhibitions at the Science and Industry Museum, says: “We’re smashing taboos with this exhibition, proving that it’s not only fun to talk about everything from burps to belly rumbles and projectile vomit to poo, it’s essential in understanding and maintaining a healthy relationship with our bodies. ‘It’s a truly spectacular show of supersized science and one that we hope will leave people feeling entertained, empowered, and impressed with their grossness!’ Drs Chris and Xand say: “This exhibition is our most epic experiment yet! Find out how your food gets mashed, pulped, squeezed and absorbed, and soak up the sights, sounds and even the smells of your incredible digestive system! “Our bodies are amazing, and one of the first questions kids often ask is the biology of how we put food in and something else comes out! If we can understand that process, we’ve learned something that’s fundamentally important to life. » celebrityangels.co.uk

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HEALTH TODAY

EXPERIENCE Director of BBC Children’s & Education, Patricia Hidalgo, says: “We know that there is nothing more engaging than a real-life experience. That’s why we want to bring our BBC Children’s much-loved TV brands into the real world, to deliver unforgettable experiences that educate and entertain young brilliant minds.’ The exhibition is supported by Principal Sponsor, Andrex. Matt Stone, UK and Ireland marketing director of parent company Kimberly-Clark, said: “We’re really proud to be sponsoring the Operation Ouch! exhibition. It’s a fantastic, hands-on and fun way for families to really understand what’s happening inside their bodies and what comes out. The 20

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more knowledge kids have and the more comfortable they are with the topic, the better the choices they can make when it comes to their health and hygiene.”

TICKETS Tickets for Operation Ouch! Food, Poo and You are available to book at www.scienceandindustrymuseum.org.uk/operation-ouch, priced at £10 for adults, £9 children, senior and concessions, with children aged three and under going free. It will run at the Science and Industry Museum until June 2024, before embarking on a national and international tour. Free companion tickets are available for disabled people who require a personal assistant or carer to accompany them on their visit to the museum. If you need any further support to help plan your visit, please check the museum’s accessibility information or speak to a member of the team on 033 0058 0058 (line open 9.00–17.00 daily) or email info@ sciencemuseumgroup.ac.uk.

IMAGES: © The Board of Trustees of the Science Museum/Drew Forsyth

“So, as well as being brilliantly entertaining and of course absolutely disgusting, this exhibition is full of really amazing and essential science.’ Dr Ronx says: “Whoooo, poo is my absolute favourite subject, and to be honest the only way to teach you about the digestive system is to make you part of it! “Like everything with the human body, digestion can be tricky to understand or talk about. This exhibition breaks it all down into digestible chunks! From your mouth to your bum and everything in between, it activates all your senses and doesn’t shy away from anything! It’s an awesome journey that will leave you a mixture of epically entertained, grossed out and fully fascinated by poo!’

FAMILY FUN Operation Ouch! Food, Poo and You has been developed by the Science and Industry Museum and produced in collaboration with BBC and 141 Productions, part of All3Media’s Objective Media Group. A series of special ‘Experitots’ sessions, designed for children aged 0–4, will also run in the exhibition, as well as relaxed sessions adapted for visitors who prefer an adjusted environment, such as reduced capacity and sound levels. The museum and BBC have also partnered to bring a retail range of interactive, informative and entertaining Operation Ouch!-themed toys, including an exclusive Mr Grumbles plush teddy bear, as well as games, kits and experiments to help visitors continue to explore our brilliant bodies at home. ■

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HEALTH TODAY Toilet training: In association with Andrex

The Great Toilet Adventure Toilet training can be one of the most challenging aspects of raising kids, but it should go smoothly if you follow this helpful advice

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give your kid all the key skills they need to leave nappies and potties behind and go to the toilet on their own (at home and even at school!) It’s important to note that many children give no sign they are ready to potty or toilet train – most will be ready to start training at about 18 months, so don’t wait for them to make the first move! Certainly between 18 and 30 months it is best for health if they move out of wearing nappies, and there’s an argument that the longer you leave it, the harder it will be for them to master potty skills. But obviously potty training is a process, not a sudden event. PREPARATION Potty training can normally start when the child can sit up, usually around six months. It’s said that there are 40 skills a child has to learn to become potty trained, so this is not going to happen overnight. Children with special needs such as delayed speech, autism or a physical disability may find the process more challenging and will need more support.

Although some children progress straight to using the toilet with the help of a children’s toilet seat and step stool, in most cases the transition will be from nappies to a potty. Get a basic potty which is low to the ground to make it easier to use, and it does no harm to have more than one. Once a child is passing some soft poo every day, make sure they get plenty of waterbased drinks on top of any milk to keep their bladder and bowel healthy. Make sure you change nappies or pull-ups as soon as they are wet or soiled to teach the child that it is normal to be clean and dry. Once they are able to stand, do nappy or pull-up changes standing up, and talk them through the process so they begin to learn the vocabulary of toilet use. Get them used to not wearing a nappy with regular, short periods without, including up to 30 minutes after they’ve done a wee or poo. PRACTICE Good times to try a ‘potty sit’ include shortly after they wake up, after mealtimes, and of course any time you see that they need to go, such as if you see them straining to poo. As they get used to the process, they will learn words or signs that they can learn to help communicate their needs to you, and good personal hygiene habits such as the correct way to use toilet paper for wiping, handwashing and drying. Once they are ready to stop using nappies, dress them in clothes that are easy for them to get on and off, so they can take the lead with using the potty. Research shows that rewards such as sweets or sticker charts may help your child, but encouragement and support are the best motivations. ■

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he moves from nappies to potty and from potty to toilet are big milestones in child development, and learning these habits and skills is a matter of teamwork. Given the right lead, children should take to toilet training naturally, but it’s essential that parents and carers all know what they’re doing. When is the right age to start potty training, and what are the signs they are ready? As with all developmental milestones such as sitting up and toddling, there’s no set age for this – every child is different – but there are some general guidelines. Toilet training can be tricky and you may experience toilet training resistance. That’s why Andrex wants to give parents and kids everything they need to know about toilet training, all in one place at GoTime by Andrex (www.andrex.co.uk/gotime). With interactive books for kids to play, downloadable toilet training charts for your bathroom at home, even kid friendly toilet paper, all approved by child experts, there will be some ups and down, but GoTime will

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HEALTH TODAY Toilet training: In association with Andrex

Overnight It can take toilet-trained children months or even years to become dry at night. The main sign that your child is becoming dry overnight is a dry nappy first thing in the morning. When you notice this starting to happen, you can try stopping nappies at night. Bedwetting is common, even in school-age children. If your child wets the bed, there are things you can do about it when you and your child are ready. If you or your child are getting upset or worried about the bedwetting, it’s a good idea to speak to your GP. You should also speak to your GP if your child has bedwetting that has started again after a long period of being dry, snoring or restless sleep that happens at the same time as bedwetting, or constipation.

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s p p � e h a k a a t m e h T ! n e t l i u to �raining f Let’s get toilet �raining! Our fun, interac�ive game makes your child �he star of �he sto�y and helps �hem lea�n how to use �he big toilet all on �heir own. Play �he game, meet our fu��y f�iends and let’s help Bunny wee and poo!

Scan for your free GoTime app

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n a d l l u Hygi P t c ene e f � W y , h � c l Pe o a i n e p � h e s i d a e r nt c fo lean! Hypoallergenic and fragrance free

Fun and colou�ful puppies patte�n

Ex�ra gen�le for delicate skin

Helps li�le ones use just enough eve�y �ime

NEW

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Cut out and use at home

3. Then wipe all around.

4. Pants back up and �lush, �lush, �lush.

2. Do a wee or a poo.

oilet S s to t t e p n i e p s s �rainin g hap 1. Lid goes up. Pants come down.

5. Wash your hands and off you �ush.

Scan for your free GoTime app!

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R e ward C ha�t

Scan to download your GoTime app

I washed my hands

I did a wee

I’m wea�ing big pants

I used toilet paper to wipe I �lushed �he toilet

I pulled my pants up and down

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HEALTH TODAY

BOGOF to Unhealthy Food We all know that some food is unhealthy, but how can people be steered towards a better diet? One idea is to limit ‘BOGOF’ offers

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(‘there’s disgusting’) to unhealthy meal deals, with plans to restrict multi-buy offers for food with a high fat, sugar or salt content. The Welsh government’s proposals to tackle obesity and diabetes include a ban on temporary price drops and multi-buy offers on the unhealthiest foods. The plan is to introduce the legislation in 2025. The regulations will ban lunchtime deals such as a sandwich, drink and snack for a set price, as well as restricting certain other combinations which have fat or salt levels above a certain amount. But some retailers have raised concerns about the timing of the announcement, as food

prices remain high and food price inflation is still rampant. The proposed restrictions will also do away with: h Temporary price cuts on unhealthy foods h Two-for-one offers on unhealthy foods h Promotion of unhealthy foods as ‘impulse buys’ at checkouts The regulations will apply to all businesses employing over 50 people. Similar changes have been proposed for England, but are currently being blocked by the government, and in Scotland, proposed restrictions on the promotion

IMAGES: Dreamstime

besity and dental problems are growing health issues among children, primarlily caused by unhealthy diet. Nutritional deficiencies can also occur when their diets include an excess of foods that are high in fat, sugar and salt, often in the form of treats (chips, chocolates, lollies, soft drink) or in food that has been processed (such as take-away food). But with supermarkets pushing these items with the likes of BOGOF (Buy One Get One Free) deals, how can people be steered towards a healthier diet, particularly for children? Now the Welsh have said ‘Ych a fi’

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HEALTH TODAY

of junk food were put on hold during the Covid pandemic. The proposed Welsh regulations are not universally popular, with other suggestions including adding more prominent health warnings on unhealthy food. Filco supermarkets director Matthew Hunt described the timing of the proposals as “ludicrous”, saying “It is notable Rishi Sunak has recently been talking about relaxing this legislation, that it in itself is inflationary and not the right time to be taking this approach especially when food inflation in particular is as high as it is. “What should be avoided at all costs is the creation of confusion caused by different governments not being aligned with what is included and excluded.” PROMOTIONS The Welsh Retail Consortium commented: “We are particularly concerned over possible plans to restrict price promotions and to restrict products in meal deals. Promotions within categories allow retailers and brands to compete to attract customers, improving competition and keeping prices down.”

The Welsh government says that there is strong public support for action to help people make healthier food choices. According to Public Health Wales data, 60% of people in Wales are overweight, and one in four children are obese by the age of five. The number of people in Wales with type 2 diabetes is also at a record level. Deputy Minister for Mental Health and Wellbeing Lynne Neagle said: “This legislation will take forward our commitment to improve diets and help prevent obesity in Wales. “Our aim is to rebalance our food environments towards healthier products, so that the healthy choice becomes the easy choice.” Dr Ilona Johnson, consultant in Public Health for Public Health Wales, said:

In England, rules banning multi-buy deals on foods and drinks high in fat, salt, or sugar – including buy one get one free deals – will be delayed for another two years until October 2025. The policy had already been subject to a delay until October 2023. This will now be extended to allow the government to continue to review the impact of the restrictions on the consumers and businesses in light of the unprecedented global economic situation. “We know that from the evidence that policies targeting the food environment are effective and a strong legislative framework is an important step in helping us to shift the balance towards healthier choices and healthier people.” Welsh Conservative spokesman for mental health, James Evans said: “Obesity is a pressing issue across the western world that is a costly drain on the limited resources of our precious Welsh NHS and it is a shame that is has taken the Welsh government this long to address the problem. “However, during the cost of living pressures we are all facing, we need castiron assurances from the Welsh Labour government that they do not intend to ban meal deals and that any new regulations will not increase the average weekly cost for shoppers.” Economies across the world have been affected by higher-thanexpected global energy and goods prices, leading to increased costs across supply chains. Delays in introducing legislation mean that for now, shoppers will be continue to take advantage of multibuy offers on all on foods, unhealthy or not. ■

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Pregnancy and Early Years Fertility, neo-natal and infants

SIGHT-SAVING DRUGS FOR PREEMIES Premature babies are to be routinely offered a “life-changing” treatment to prevent blindness on the NHS for the first time. The drug, ranibizumab, could save the eyesight of babies born with a condition known as retinopathy of prematurity (ROP), which affects blood vessels in the retina, creating damaging scar tissue and causing blindness. Currently, laser treatment is the standard of care, but some premature babies are too unwell and fragile to receive laser treatment, which also carries a risk of leaving scarring on the retina and permanently damaging vision. The new routine option is to be made available across England as an alternative to laser treatment for some forms of ROP. The drug is administered into the eye using a precise injection system that does not cause any scarring, which is particularly important in babies with ROP in the central, most sensitive part of their vision. The drug temporarily stops the action of a growth protein called Vascular Endothelial Growth Factor (VEGF), which reduces or reverses the growth of the abnormal blood vessels.

UK’S FIRST EVER WOMB TRANSPLANT Doctors in the UK have carried out the country’s first-ever womb transplant, hailed as the ‘dawn of new era’ in fertility treatment. The 34-year-old recipient’s 40-year-old sister, who already has children, donated her womb to her younger sibling, who was born without a uterus. Six months on, the recipient is having periods and is preparing to eventually have her own embryos implanted, already created via IVF with her own eggs. Professor Richard Smith, one of two lead surgeons during the operations, said it had been a “massive success”, describing the joy he shared with the sisters. The surgery was carried out in early February at Oxford’s Churchill Hospital by a team of more than 30 staff in a 17-hour operation. The surgery was funded by Womb Transplant UK at a cost of £25,000, which included paying the NHS for theatre time and the patients’ hospital stay. The transplant is expected to last for a maximum of five years before the womb will be removed so the recipient can stop taking immunosuppressant drugs. The procedure can only benefit women who have functioning ovaries, but not a womb, around 1 in 5,000 women in the UK. Other countries, including Sweden and US, have already carried out womb transplants, ultimately resulting in successful births.

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ROSPA WARNS ABOUT BLIND CORDS At least 35 young children across the UK have died because of looped cords on blinds since 2001 – that’s one or two children each year. Eighty percent of the UK’s population have blinds in their homes, but over 70 percent have never received blind cord safety advice, according to the latest research from the Royal Society for the Prevention of Accidents (RoSPA). This comes after the recent National Child Mortality Database data revealed that looped blind cords and chains have killed nine UK children between April 2019 and March 2022. Further information on blind cord safety can be found at www.rospa.com.

Free From Allergens Koko Kids Free From M!lk is produced from coconut milk, making it free from the 14 major allergens, including dairy, oat, soya and almond. Despite being made from coconut, it tastes similar to dairy milk, with essential vitamins and minerals. www.kokodairyfree.com

For the Whole Body

Childcare Solutions

QV Bath Oil’s whole-body moisture replenishment helps relieve dry, itchy skin by helping to prevent moisture loss. This safe, non-slip formula is suitable for sensitive skin. The pH balanced, low-irritant formulation is free from fragrance, colour, lanolin, and propylene glycol. www.qvskincare.co.uk

Grandir UK is home to multiple nursery and preschool brands across England, delivering outstanding childcare solutions to families with babies, toddlers and preschool children for over 25 years in Essex, Hertfordshire, Hampshire, Leicestershire, London, Midlands, Surrey, Sussex and South West. www.grandiruk.com

IMAGES: Dreamstime

Melt in the Mouth Tonstix are a unique child-friendly, melt in the mouth lozenge with honey, Vit C and Zinc that can be used by all children, from toddlers to tweens when struck with sore throats and coughs. Available in Boots UK stores nationwide, Tonstix can provide some comfort to irritated little throats caused by seasonal ailments. https://tonstix.com

Dream Team Meet your toilet training dream team! With a fun puppies pattern and easy three-sheet perforations, Perfect Pull helps little ones use just enough every time. Finish with Hygiene Wipes – they’re hypoallergenic, fragrance free and extra gentle for delicate skin. www.andrex.co.uk

Everyday Health SpongeBob SquarePants Vitamins have been developed to support the everyday health of kids. All products are Vegan and contain no added sugar. SpongeBob Multivitamin Fizzy Drinks has 12 essential vitamins in a tasty tropical drink which is fun and easy to make. The Chewables range includes Multivitamins with Probiotics, Brain Formula, Immune Support and Vitamin D for kids 3-12 years. www.hollandandbarrett.com/shop/ brands/spongebob-squarepants

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Pregnancy Problems

Even the smoothest pregnancy can include some health issues. We look at some of the most common problems and how to deal with them

regnancy is a complicated process, and the changes it makes to your body mean that it can involve a good deal of discomfort and inconvenience. Even the smoothest and most healthy pregnancy can involve many of these issues, but they aren’t usually any cause for alarm, so long as you know how to deal with them, and you discuss them with your maternity team to make sure they are being safely dealt with. COMMON PROBLEMS One of the most common problems caused by hormonal changes is constipation. This can occur even at the early stages of pregnancy. The best ways to prevent constipation are: h Eat high fibre foods such as wholemeal bread, cereals, fruit and vegetables, beans and lentils h Exercise regularly to maintain muscle tone h Drink lots of water h Avoid iron supplements, which can cause constipation Cramps are another early symptom. They often occur at night and are experienced in the legs and feet. Gentle exercise is helpful; try bending and stretching your foot up and down 30 times, then rotating your foot 8 times one way then 8 times the other way. You can also try pulling your toes up towards the ankle or massaging the calf muslces hard.

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Another symptom of hormonal changes is faintness. This is caused by lack of blood flow to the brain, and obviously can be a danger if you feel so faint that you collapse. Take care when rising from a sitting position, and if you feel faint while standing, quickly sit down and wait for the faintness to pass. You can also feel faint while lying on your back, though, so try lying on your side. In any case it’s better not to lie flat on your back in later pregnancy or during labour, and you should avoid going to sleep on your back after 28 weeks as it has been linked to a higher risk of stillbirth. HOT FLUSHES Feelings of hotness and sweatiness are other symptoms of hormonal changes. Wear loose clothing made of natural fibres, keep your room cool with a fan, and wash frequently to keep yourself feeling fresh. The need to pee frequently or urgently is another common issue which can start early and remain throughout the pregnancy. It’s caused by the baby’s head causing pressure on the bladder, so it’s difficult to reduce it, but it may help if you cut out drinks in the evening. It’s important, though, to stay hydrated with water, not alcoholic or caffeinated drinks, during the day.

During and after pregnancy, you may also have incontinence problems, If a cough, sneeze, laugh or sudden movement leaves you with a leakage of urine, the cause may be because the pelvic floor muscles around the bladder have loosened to prepare for the delivery of the baby. This is temporary and can be aided by exercises. Ask your midwife for advice. In later pregnancy, it may help to rock backwards and forwards while you’re on the toilet as this lessens the pressure of the womb on the bladder so you can empty it properly. If you experience pain while urinating or see any blood in your urine, you may have a urine infection which will require treatment. Your GP will advise you about UTIs (Urinary Tract Infections), but a first step is to drink plenty of water. »

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PREGNANCY PRECAUTIONS

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You should not take any medicines while pregnant without asking your midwife, doctor or pharmacist whether they’re safe in pregnancy. If you sunbathe while pregnant, you may find you burn more easily. Protect your skin with a high-factor sunscreen and don’t stay in the sun for a long time.

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Most women gain about 10 to 12.5kg (22 to 28lb) in pregnancy, although weight gain varies a great deal from woman to woman. How much weight you gain during pregnancy may depend on your weight before you were pregnant. If you are worried about your weight, talk to your midwife or GP. They may give you advice if you weigh more than 100kg (about 15.5st) or less than 50kg (about 8st). It’s important not to try to lose weight when you’re pregnant by eating less. You need to maintain a healthy diet during pregnancy. You are more likely to get stretch marks if your weight gain is more than average in pregnancy.

with back pain, as can a firm support mattress or a board under your existing mattress, and you can take a painkiller such as paracetamol unless your GP or midwife tells you not to. SKIN AND HAIR Skin and hair changes caused by hormonal issues may seem concerning, but they are usually nothing to worry about. Your nipples and areolae may darken, and you may develop darker skin in patches or all over the body, particularly noticeable on birthmarks, moles or freckles. A dark line down the middle of the stomach, known as the linea nigra, may develop – like the other changes it will normally fade after the birth, though there may be some remaining darkening of the nipples. Swollen veins, known as varicose veins, are another common symptom in pregnancy. They are most usually found in the legs, and while they can be uncomfortable, they are harmless, and should fade after the birth. It can help if you avoid standing for long periods of time, try not to sit with your legs crossed, keep your weight under control and sit with your legs up as often as you can to ease the discomfort. Try sleeping with your legs higher than the rest of your body using pillows under your ankles or putting books under the foot of your bed. You can also try compression tights, which won’t prevent varicose veins but can ease the symptoms. STRETCH MARKS Stretch marks are very common and do not just affect pregnant women. They can happen whenever the skin is stretched, for example during puberty or when putting on weight. Hormonal changes in pregnancy can affect your skin and make you more likely to get stretch marks. They happen when the middle layer of skin (dermis) becomes stretched and broken in places. Whether or not you get stretch marks depends to an extent on your skin type, as some people’s skin is more elastic than others. You are more likely to get stretch marks if your weight gain is more than average in pregnancy. ■

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PREGNANCY WEIGHT GAIN

BACK PAIN Back pain in pregnancy is very common, particularly in the early stages. As the ligaments in your body naturally become softer and stretch to prepare you for labour, strain on the joints of your lower back and pelvis can cause back pain. If you have severe back pain avoid lifting heavy objects and wear flat shoes to evenly distribute your weight. If you are carrying anything, such as bags of shopping, make sure the weight is evenly distributed. Keep your back straight and well supported when sitting – look for maternity support pillows – and get plenty of rest, particularly later in pregnancy. Your GP or midwife should be able to refer you to an obstetric physiotherapist at your hospital who can give you advice and may suggest some helpful exercises, such as bending your knees and keeping your back straight when you lift or pick something up from the floor, and moving your feet when you turn to avoid twisting your spine. A massage or a warm bath may help

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Epilepsy Cracking the Code Unexplained infant epilepsy leaves many questions about the child’s future health. Now genome therapy may suggest a new approach

cause of epilepsy is possible, it can take a long time, leaving families waiting for answers. An international study, published in The Lancet Neurology, sequenced the genomes of 100 babies under the age of one with unexplained seizures from four countries (England, USA, Canada and Australia), using expertise and genomic infrastructure from each. The research used rapid genome

sequencing (rGS), which looks for changes across the entire genome, or DNA structure, to investigate the impact of immediate genetic diagnosis on care for the first time. Across all children enrolled in the study, 43 per cent received a diagnosis within weeks. This diagnosis then went on to impact treatment in nearly 90 per cent of those cases and it guided treatment options in over half of patients. »

IMAGES: Dreamstime

esearchers at University College London and Great Ormond Street Hospital have collaborated with institutes across the world to use rapid genome sequencing to provide a diagnosis for children with unexplained epilepsy and significantly benefit their care. Epilepsy in children ranges in severity and can leave families and carers with many questions about their child’s future health. While genetic testing to find the

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GENE-STEPS The Gene-STEPS, Shortening Time of Evaluation in Paediatric epilepsy Services study is the first collaboration launched through the International Precision Child Health Partnership (IPCHiP), an international consortium between UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital, Boston Children’s Hospital, Murdoch Children’s Research Institute with the Royal Children’s Hospital and The Hospital for Sick Children (SickKids). Dr Amy McTague (UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital), who led the UK team, said: “It’s incredibly exciting to share the results from the first phase of this IPCHiP project and, importantly, it is fantastic that this research has provided powerful evidence for the clinical benefits of rapid genomic sequencing in young children with new-onset epilepsy. “Through a global collaboration of expert researchers, we have shown 38

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how this testing can be used, across four different healthcare systems, to rapidly diagnose children with epilepsy, finding an answer in over 40 percent and guiding treatment in over 50 percent of these children. “This has the potential to impact many families across the world and provide much needed information to clinical teams in charge of their care. We are incredibly grateful to every family that took part in this study, research like this is only possible because of them.” CAUSES There are currently more than 800 known different genetic causes of infantile epilepsy, and many have similar symptoms during early childhood. Unlike more targeted genetic testing that is often used to confirm a suspected diagnosis, genome sequencing looks for any changes in a person’s DNA that may explain a medical condition, analysing the entire genome. This allowed researchers to not

only provide a rapid diagnosis for many families, but also have an immediate impact on clinical care – allowing for faster access to correct treatments, full-informed decision making and often further clinical investigations. In this study, rGS was used to deliver ‘trio’ sequencing, testing both parents and the child, to more quickly understand whether gene changes in the children were inherited or new to the child. These insights allow families to understand how the results impact their lives and their plans for any future children. The international research team is continuing to follow-up with clinicians and study participants to understand how rGS has influenced children’s development long-term. The GOSH team are also hoping that they will be able to bring this test into clinical service, giving families across the country access. Investigator on the project, Professor Helen Cross (Director of the UCL Great Ormond Street Institute of Child Health

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PREGNANCY & EARLY YEARS

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PREGNANCY & EARLY YEARS

WHAT IS EPILEPSY? Epilepsy is a condition that affects the brain, causing repeated seizures. Anyone can have a one-off seizure, but it doesn’t always mean they have epilepsy - people are usually only diagnosed with epilepsy if their doctor thinks there’s a high chance they could have more seizures. Epilepsy can start at any age and there are many different types. Some last for a limited time, but for many people, epilepsy can be a life-long condition. Source: Epilepsy.org.uk

and Honorary consultant in paediatric neurology at GOSH), said: “The results highlight how this worldwide collaboration is already enabling us to combine collective knowledge and research expertise to benefit children around the world. Through support in the UK from the NIHR GOSH Biomedical Research Centre and GOSH Charity, we have been able to demonstrate the power that rapid genetic sequencing can have for children with epilepsy. “Embedding research into all aspects of care at GOSH, through the partnership with the UCL Great Ormond Street Institute of Child Health, enables studies such as this one to bring cutting-edge technology and developments into clinical practise.”

rapidly develop a rGS pathway within an established clinical genomics facility. Professor Thomas Voit (Director of the NIHR GOSH BRC and Professor at UCL Great Ormond Street Institute of Child Health), said: “This paper highlights the impact that funding translational research and international collaborations can have on families and our clinical practice. At the NIHR GOSH BRC we are proud to continue to support research through the North Thames Genomics Laboratory Hub to understand how integrating rapid genetic testing into routine care can benefit families around England.” PATIENT STORY Leo Bush was born prematurely on the 24th of October 2021, and, despite early positive signs, he rapidly began to develop serious symptoms including seizures. Despite lots of invasive testing and attempted treatments doctors struggled to understand the problem. At six weeks old he was transferred to GOSH for specialist treatment and almost immediately enrolled in the IPCHiP study. Approximately two weeks after giving samples of their blood for testing, the family were told that Leo had a very rare genetic diagnosis of BRAT1-related neurodevelopmental disorder caused by

inheriting a faulty copy of the gene from both his parents. The mutation causes a very severe form of intractable epilepsy in children. There is currently no treatment for the condition and management of symptoms is incredibly difficult. Babies with this genetic epilepsy rarely survive beyond first six months of life. Leo was 79 days old when he passed away in Andy and Sofie’s arms on January 10th 2022. Leo’s dad, Andy, said: “It was completely and utterly heart-breaking but getting a diagnosis provided us with a reason. It allowed us to start processing. The diagnosis made an impossible situation easier. We may not ever find a cure for BRAT1 but having a diagnosis – an answer – was, for us, so powerful.” Sofie, Leo’s mum, said: “We really want to build the understanding people have of how powerful a genetic diagnosis can be. We also know how lucky we were to be at GOSH and be part of this research project – we desperately want to see tests like this rolled out more widely so that everyone has the access we did. The test was so simple – just a blood test. After so many invasive procedures that provided no answers, it was so powerful to us that the information we needed came from a simple blood test for Leo.” ■

GOSH The UK arm of the study was partfunded by Great Ormond Street Hospital Children’s Charity (GOSH Charity) and the National Institute for Health and Care Research (NIHR) GOSH Biomedical Research Centre with support from Young Epilepsy. The collaboration utilised expertise and infrastructure from the Translational Research team at the North Thames Genomics Laboratory Hub (NT GLH), as well as data teams from within the GOSH Digital Research Environment to celebrityangels.co.uk

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02/11/2023 10:31

Grandir UK’s nursery Open Day events taking place in the Spring and Autumn.

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Getting Childcare Right Choosing a nursery is just part of the challenge of getting childcare right. How do you navigate the regulations and make sure you are doing the best for your children?

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IMAGES: Dreamstime

n these times of rampant inflation and a cost of living crisis, one of the elements which is contributing most to the problems of working parents is the cost of childcare. In some cases, childcare has become so expensive that parents aren’t earning enough to be able to afford it. This is preventing many mothers from returning to the workforce, where they are desperately needed as there is also a shortage of workers. At the same time, nurseries are considering closing because they can’t charge enough to pay their expenses. Recruitment is getting harder as jobs in other areas such as retail can offer better salaries, and regulations mean that it’s harder to recruit from abroad. The UK has one of the most expensive childcare systems in the world, and current childcare costs can prevent parents from returning to work or increasing their hours as their earnings may not even cover the childcare fees. This is particularly a problem for parents on low incomes or where a family has more than one child at nursery under the age of three. CHILDCARE In March 2023, the Chancellor announced that working parents of all preschool aged children over the age of nine months will be entitled to 30 hours of free childcare per week in term-time in England. Currently, parents who work more than 16 hours a week and earn less than £100,000 are entitled to 30 hours free childcare per week for children aged three to four in term-time, but from April 2024, working parents of two-year-olds will be able to access 15 hours of free childcare. From September 2024, 15 hours of free childcare for working parents will be extended to all children from the age of nine months, and from September 2025, working parents of children under the age of five will be entitled to 30 hours free childcare per week. The Budget announcement recognises that affordable childcare is needed immediately from when parents are wanting to return to work after maternity leave or shared parental leave.

The current offering of Tax-Free Childcare for eligible families with children 11 years or under means the government will pay in £2 (up to £2,000 per year) for every £8 you pay into an online childcare account. This can run alongside the current 30 hours of free childcare if you’re eligible for both. Providing more hours of free childcare should open the door for more parents to return to work or increase their working hours, which is good news for the economy generally. This leaves the question of what happens to parents of primary school aged children. They should not be left out, as local authorities and schools have been promised more funding for what is known as “wraparound care”. The government expects that by September 2026 most primary schools will be able to provide their own before- and after-school care. Parents on Universal Credit are set to get further support too. WRAPAROUND CARE As the name suggests, wraparound care refers to childcare that wraps around the conventional school day. Often referred

SPOILT FOR CHOICE. 97% of nurseries are judged to be good or outstanding, and 24% of nurseries and preschools are judged to be outstanding, compared with 17% of childminders. (Source: OFSTED)

to as ‘breakfast clubs’ or ‘after-school clubs’, wraparound care sessions take place on-site at the school, and are an opportunity to extend social and learning opportunities for the children in its care. The sessions usually cost a nominal fee per day and are charged by the session. Wraparound care can also refer to holiday childcare which is held throughout the school holidays and are usually themed to provide an active and wide-ranging timetable to keep children stimulated and entertained. »

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Chancellor Jeremy Hunt has announced that wraparound care will be available at all primary schools, so parents can drop their children at school from 8am and pick up at 6pm. He said he wants to increase the supply of wraparound care at all primary schools, meaning that by September 2026, all school-age parents would be able to drop their kids off at school for 10 hours, enabling them to work. Currently, only a third of schools offer wraparound care, he said. The Chancellor explained the childcare reforms were designed to tackle the barriers to working for parents. He said: “These reforms will increase childcare availability and reduce costs. I don’t want any parent with a child under 5 to be prevented from working if they want to.” Around £289 million of ‘start-up’ funding has been allocated to the reforms, although no detail on provisions for its long-term funding have been announced, and it has not yet been made clear whether this would be compulsory for schools. 46

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FUNDING Historically, government funding for the free childcare hours has not been sufficient, and nurseries have often had to resort to charging a fee for “extra” services to make ends meet. From September 2023, the staff-to-child ratio is changing, so that one member of staff will be allowed to look after five two-year-olds, up from four two-year-olds which is the current rule. While this may reduce expenses for some nurseries, it’s not likely to reduce costs for parents, as nurseries are unlikely to be able to reduce their charges, In any case, the staff ratio changes are optional, and some nurseries have already said they do not wish to reduce the ratio. The staggered approach to additional childcare entitlements is intended to give childcare providers time to prepare for the changes, and the hourly rate paid to childcare providers by the government is set to increase. But childcare in the UK will certainly continue to be a contentious issue, and there’s a lot more to it than

simply choosing the best nursery for you and your children.

EYFS In England, the Early Years Foundation Stage (EYFS) statutory framework sets the standards that all childcare providers must meet for learning, development, health and safety. The latest EYFS framework has been in force since 1st September 2021, and OFSTED will continue to carry out inspections on the quality and standards of provision. The EYFS seeks to provide quality and consistency, a secure foundation, equality of opportunity and a secure foundation for all children, in all early years settings.

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IMAGES: Dreamstime

NURSERIES There is no right or wrong time for your child to start at a nursery. It very much depends on the needs of you and your family. What is important is ensuring that you have enough time to prepare your child and yourself for the changes ahead. It’s a good idea to visit several nurseries and ask questions in person about the childcare provided. It might help to take a friend and/or your child on the visits to help you decide. What to look for: h Trained and experienced staff, ready to learn and respond to your child’s individual needs h Busy, but relaxed, children who seem happy and purposeful h Safe and clean premises - welcoming and friendly with outside play space h Cultural sensitivity and responsiveness to children’s home life h A staff team and group of children who reflect local ethnic and cultural groups h Fun activities planned each day with children’s interests and enthusiasms in mind h Planned exercise and quiet times to relax h A big welcome for you and your child

Providers must also support children in the following four ‘specific areas’ and apply the three ‘prime areas’ through these: h Literacy h Mathematics h Understanding the world h Expressive arts and design Childcare providers do not need to prescribe a particular teaching approach, such as Montessori, but practitioners must stimulate children’s interests, responding to each child’s emerging needs and guiding their development through warm, positive interactions coupled with secure routines for play and learning. Each child must be assigned a key person to ensure that every child’s care is tailored to meet their individual needs. They must seek to engage and support parents and guardians in guiding their child’s development at home. Registered providers other than childminders and childcare on domestic premises must obtain an enhanced

criminal records check for every person aged 16 and over who works directly with children, lives on the premises or works on the premises. The manager of a childcare setting registered with OFSTED must hold an approved level 3 qualification or above and have at least two years’ experience in working in an early years setting, or other suitable experience. At least half of all other staff must hold at least an approved level 2 qualification. At least one person with a current paediatric first aid (PFA) certificate must be on the premises at all times. The certificate must be renewed every three years. Other parents’ experiences of a nursery can also be very useful. It’s advisable to take up at least two references. Childcare providers should be happy to give you names of other parents to speak to about the service they provide. Do remember that what works for one family may not always be suitable for your needs. ■

QUALITY CONTROL Nurseries and any other organisations looking after children under the age of eight years usually have to be registered with OFSTED (the Office for Standards in Education, Children’s Services and Skills). OFSTED visits all registered childcare services and makes sure that standards are being met and that children are safe. You can check OFSTED’s grade and report for the childcare providers you are considering at www.ofsted.gov.uk. Learning and development requirements are set down by the EYFS (see boxout). The seven areas of learning and development must shape educational programmes in early years settings. The ‘prime areas’ are: h Communication and language h Physical development h Personal, social and emotional development. celebrityangels.co.uk

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01/11/2023 12:24

D VOTE T UC PROD ONTH! HE M OF T e

n gazi y Ma b a By B

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- visit magicalwool.com and buy today -

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School of Skincare It seems that we all have something to learn about how to take care of irritated skin in infants. Here’s the new thinking on inflammation treatment

MAGIC Alternatives such as Magical Wool dispense with the plastic packaging, replacing it with biodegradable packaging which decomposes in 2-6 weeks (the wool itself decomposes in three months). So it’s already better for the environment. But how is it better for your baby? Magical Wool, or ‘fat wool’, is natural sheep’s wool. The specialised wool contains wool wax, also known as Lanolin, which is the main active ingredient that treats and heals inflammation. It has a soothing effect on the skin and supports the affected area to remain dry by drawing away moisture (a crucial element for the skin to ‘breathe’ and for the inflammation to heal much quicker than most creams) Magical Wool has the same effects as

common treatments, healing inflammation of the skin such as nappy rash, sore nipples, surface wounds and minor burns, but without any mess, chemicals or harmful ingredients. In direct contact with the inflammation, the small woolly hairs stimulate blood circulation, while the Lanolin does its work. For nappy rash, the wool is applied inside the nappy, which is closed. For breastfeeding mothers, a piece of the wool is placed in the bra so the wool sits tightly on the nipple area. There’s no need for any barrier creams or lotions – in fact these would prevent the wool from absorbing moisture. So, is ‘magical wool’ the perfect ecofriendly solution to skin inflammation? Find out more on the website at www.magicalwool.com. ■

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kin irritations such as nappy rash are among the most common and distressing of infant conditions, and there are loads of products out there aiming to deal with them. But are the traditional creams with their synthetic ingredients good for your baby, or for the planet? It’s estimated that 120b units of plastic packaging are discarded each year worldwide, and that includes a lot of baby products. Some of this packaging might be in the oceans or landfill for 450 years. So, there must surely be a more eco-friendly way to deliver baby products. Equally important, of course, is the content of those products. Many contain potentially harmful chemical such as sulphates, synthetic fragrances, parabens, liquid paraffin, formaldehyde, and even asbestos, which is found in some talcum powder. None of these are things you would ideally want anywhere near your baby’s skin. So what’s the alternative?

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PREGNANCY & EARLY YEARS Skincare: In association with QV

Emollients

and Skincare

Skincare is an essential in maintaining child health, but what role can emollients serve in helping with skin conditions?

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PREGNANCY & EARLY YEARS Skincare: In association with QV

IMAGES: Dreamstime

aving any kind of skin condition, whether mild or severe, can have a huge impact on your quality of life if you can’t get it under control. Often it feels like a constant battle, avoiding known triggers and managing flare-ups. In children, conditions such as eczema, contact dermatitis, psoriasis and dry skin, can be recurring irritation, made worse by a constant cycle of itching and scratching. Emollients can help you to manage these conditions and break the itch-scratch cycle. Emollients, also known as moisturisers, are very important for promoting and maintaining healthy skin and for managing dry, itchy, flaky, and cracked skin. Emollients can be either water- or oilbased products that trap natural moisture in the skin and simply soften, smooth and rehydrate dry skin and can help to decrease the unpleasant sensations associated with itching. Emollients come in different formulations including cleansing products and leave-on products and are generally considered effective and safe.

safflower oil. Used on the whole body in larger amounts that other treatments, they can be used with while using other treatments, instead of soaps and detergentbased wash products, instead of shampoos for children aged under 12 months, or as a single product for all purposes or a combination (offering alternatives if one emollient causes irritation or is not acceptable).

WATER So how do they work? The outermost layer of skin, called the stratum corneum, needs to have about 20-30% water content to function at its best. If the water content drops too low, the skin cells start to dry out and shrivel up, causing small cracks to open up in the skin. Not only does this make the skin appear dry, dull, and flaky, but it also weakens the skin barrier, making it less adept at protecting you and your child from irritants, allergens and pathogens. Emollients can help by filling the spaces between cracks, smoothing the rough and flaky skin. They also help support the skin barrier. Because emollients tend to be light oils, water can’t easily cross through, so when they’re spread in a layer over the skin, they help keep water on the inside from escaping, preventing it from drying out further. As well as helping with the look and feel of dry skin, emollients can help reduce itch, which often goes hand in hand with dryness. Some common emollient ingredients include light liquid paraffin (or paraffinum liquidum), squalene, dimethicone and

QV PRODUCTS QV is a range of soap-free, dermatologically tested cleansers and moisturisers specifically developed for sensitive skin. The QV range is suitable for use with eczema, psoriasis, dermatitis and a range of dry skin conditions. Each product contains a mixture of moisturising ingredients that help to increase skin hydration and reduce water loss. Everything that goes into QV products has been carefully considered to help reduce potential irritants and increase its skinfriendly credentials, as common ingredients such as soap, colour and fragrance can be irritating to the skin. QV is free from sodium laurel sulphate, fragrance, colour, lanolin and propylene glycol. Products include QV Bath Oil, a soothing bath treatment for the relief of dry, itchy skin by helping to prevent moisture loss; QV Skin Lotion, a light, moisturising, all-over body lotion which helps relieve and soothe dry skin, acting as a protective barrier and providing everyday relief for dry skin; QV Gentle Wash, a soap-free alternative cleanser for the treatment of dry, scaly skin

and relief of symptoms of atopic or infantile eczema and psoriasis; and QV Cream, a rich, protective moisturising cream with five moisturising ingredients, which replenishes the skin and helps to hydrate dry areas for 24 hours. It contains squalene, a natural component found in the skin’s oil. Areas prone to dryness like the elbows, knees and hands are particularly suited to QV Cream which is highly effective after showering, bathing, shaving, exposure to harsh climatic conditions and at night. FRIENDLY Finally there’s QV Intensive Ointment, designed to soften and protect dry and sensitive skin. This highly emollient intensive balm not only helps to rehydrate your skin, it also helps to seal in moisture to your skin. With five active ingredients to moisturise and hydrate the skin, locking in moisture its water-free formulation won’t sting when applied to inflamed or cracked skin. It protects and soothes dry and sore skin to promote healing, and is ideal for drier areas such as elbow and knees. Suitable for infants, children and the elderly, its lowirritant formulation is free from fragrance, colour and lanolin to suit sensitive skin types, and it is vegan friendly, containing no animalderived ingredients. QV Skincare products are available on prescription, and can be bought over the counter in your local independent pharmacy, or retail outlets including Well Pharmacy, Chemist 4 U, Chemist Direct, and on Amazon. ■

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Sensitive skincare for every skin day QV is a range of soap-free, dermatologically tested cleansers and moisturisers specifically developed for sensitive skin. Australian made and owned, QV Skincare was built on a foundation of hard work and innovative thinking. The gentle, pure formulations of QV Skincare have ensured that it has risen to become one of Australia’s favourite skincare brands for all types of skin, and the #1 sensitive skincare brand, recommended by healthcare professionals.1 Starting from humble beginnings, QV Skincare is the brainchild of Ego Pharmaceuticals (Ego), which was founded in 1953 by young chemist, Gerald Oppenheim, and his wife, Rae, a nurse. It was in response to a request from the dermatology ward of Melbourne’s iconic Queen Victoria Hospital, that Gerald Oppenheim created a specialist skincare product that would later become known as QV Bath Oil (named in honour of the hospital).

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Our First Products Favoured for its soft, gentle formula, QV Bath Oil became extremely popular, and three short years later was made available for sale in Australian pharmacies, cementing the QV name and brand in the minds and hearts of Australians looking for a gentle way to cleanse and moisturise their skin. Although emollient bath additives are somewhat neglected in the standard management of eczema in children,2,3 QV Bath Oil remains an important part of the QV range of products that are suitable for use with eczema, psoriasis, dermatitis, and other dry skin conditions. In today’s range, there’s a product to suit every skin type and all times of day, from light moisturisers to intensive ointments.

Developed for sensitive skin the QV range is suitable for use with eczema, psoriasis, dermatitis and a range of dry skin conditions. QV is free from: SLS (Sodium Laurel Sulphate) Fragrance Colour Lanolin Propylene glycol

How does QV work? Each product contains a mixture of moisturising ingredients that help to increase skin hydration and reduce water loss.

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Each QV product delivers a different level of hydration, depending on the skin’s needs. From Light Emollients like QV Bath Oil and QV Skin Lotion, to Heavy Emollients such as QV Intensive Ointment.

Light emollient

For dry skin

QV Bath Oil

QV Skin Lotion

Soothing bath treatment for the relief

A light, moisturising, all-over body lotion

of dry, itchy skin by helping to prevent

helps relieve and soothe dry skin. QV Skin

moisture loss. QV Bath Oil’s whole-

Lotion acts as a protective barrier, and

body moisture replenishment helps to

provides everyday relief for dry skin. It’s easy

restore the skin’s natural suppleness and

to apply to all parts of the body at any time,

healthy glow and leaves skin feeling soft

but for best results, apply after washing.

and smooth after leaving the bath.

RRP: 250mL £6.49 | 500mL £9.99

Medium emollient

For very dry skin

BEST SELLER

A soap-free alternative cleanser for the

QV Cream is a rich, protective moisturising

treatment of dry, scaly skin and relief of

cream with 5 moisturising ingredients.

symptoms of atopic or infantile eczema

It contains squalene, a natural component

and psoriasis. The pH balanced formula

found in the skin’s oil, and is ideal for

gently cleanses while hydrating sensitive

areas prone to dryness like the elbows,

skin to help ensure skin is left feeling clean

knees and hands. Highly effective after

and soft, not tight and dry. With added

showering, bathing, shaving, exposure

glycerine for increased skin hydration.

to harsh climatic conditions and at night.

RRP: 250g £6.49 | 500g £9.99

RRP: 100g £4.99 | 500g £11.99 | 1050g £22.99

QV Gentle Wash

Heavy emollient

QV Cream

For extremely dry skin

QV Intensive Ointment Extremely dry and sensitive skin can feel soft and protected with QV Intensive Ointment. This highly emollient intensive balm not only helps to rehydrate your skin, it also helps to seal in moisture to your skin. RRP: 450g £10.99

Find QV Skincare products at your local pharmacy or online at:

References: * IQVIA sell in data - therapeutic skin market - Australian pharmacy - July Mat 2011 to Mat June 2022 inclusive (12 years.) 1. ACA Research, Sponsored by Ego Pharmaceuticals, OTC Skincare, n = 330 (Pharmacists, GPs and Dermatologists across Australia). June 2021. 2. Santer M, Ridd MJ, Francis NA, Stuart B, Rumsby K, Chorozoglou M, et al. Emollient bath additives for the treatment of childhood eczema (BATHE): multicentre pragmatic parallel group randomised controlled trial of clinical and cost effectiveness. BMJ. 2018 May 3;361:k1332. 3. Items which should not routinely be prescribed in primary care: an update and a consultation on further guidance for CCGs. National Health Service (NHS) England. NHS Clinical Commissioners: The independent collective voice of clinical commissioning groups. 28 November 2018, Version 1. NHS England Gateway publication number: 08625.

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HELP BRING HAPPY BACK

Dentinox Infant Colic Drops.

Activated Dimeticone. Indication: For the gentle relief of wind and griping pains in infants. Facilitates eructation. Can be used from birth onwards. Always read the label.

Dentinox Teething Gel.

Lidocaine Hydrochloride 0.33% w/w, Cetylpyridinium Chloride 0.1% w/w. Indication: Relieves the pain of baby’s teething and soothes the gum. Always read the label. For short-term use of no more than 7 days, where non-medicinal methods have not provided relief. For children from age 5 months.

Dentinox Cradle Cap Treatment Shampoo.

Sodium Lauryl Ether Sulpho-succinate 6%, Sodium Lauryl Ether Sulphate 2.7%. Indication: For the treatment of infant cradle cap and general care of infant scalp and hair. Always read the label.

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PREGNANCY & EARLY YEARS

Teeth and Smiles

Teething time can be trying, but with a little help and advice even the most fretful baby should come out all smiles

hen it comes to teething, all babies are different. But your baby will probably get their first tooth coming through at some time during their first year. Some babies are born with their first teeth. Others start teething before they are four months old, and some after 12 months. But most babies start teething at around six months. Baby teeth sometimes emerge with no pain or discomfort at all, but you may notice:

h Sore and red gums h Mild temperature of less than 38C h A flushed cheek h A facial rash on their face h Dribbling, gnawing and chewing h Fretfulness h Poor sleep The bottom incisors (front teeth) will usually be the first to come through, usually at around five to seven months. The top front teeth tend to come through at about six to

eight months, and the top lateral incisors (either side of the top front teeth) at around nine to 11 months. The bottom lateral incisors (either side of the bottom front teeth) usually come through at around 10 to 12 months, while the first molars (back teeth) normally appear at around 12 to 16 months, and the canines (between the lateral incisors and the first molars) at 16 to 20 months. The second molars will come through at around 20 to 30 months, and most children will have all of their ‘milk’ teeth by the time they are between two and three years old. SOOTHING For over 60 years Dentinox has been making a wide range of treatments for your baby’s minor ailments, helping you bring gentle relief to your baby. Dentinox Teething Gel can help relieve your baby’s teething pain where non-medicated methods have not provided relief.1 Paracetamol or ibuprofen can also be given to relieve teething symptoms in babies aged three months or older, though children under 16 years old should not have aspirin. As soon as your baby’s teeth are coming through, start brushing them with a fluoride toothpaste and register your baby with a dentist. ■ 1 Lidocaine Hydrochloride 0.33% w/w, Cetylpyridinium Chloride

IMAGES: Dreamstime

0.1% w/w. Indication: Relieves the pain of baby’s teething and soothes the gum. For short-term use of no more than 7 days, where non-medicinal methods have not provided relief. For children from age 5 months. Always read the label.

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01/11/2023 17:18

Health Check The latest thinking on child wellness

SOCIAL MEDIA NOT TO BLAME FOR ANXIETY? In a Trondheim Early Secure Study research project, Norwegian researchers followed 800 children over a six-year period in order to look for correlations between the use of social media and the development of symptoms of mental illness. Perhaps surprisingly, the conclusion was that Increased use of social media did not lead to more symptoms of anxiety and depression.

COULD SUPPLEMENTS SAVE SIGHT?

“We have collected data every other year, from the year in which the children were ten years old until they turned 16 years of age. This enabled us to follow the children during the transition from childhood to adolescence. Symptoms of anxiety and depression have been identified through diagnostic interviews with both the children and their parents,” explained Professor Silje Steinsbekk.

The outcome was the same for both boys and girls, and regardless of whether the children published posts and pictures via their own social media pages or whether they liked and commented on posts published by others.

Premature babies given a supplement with a combination of omega-3 and omega-6 fatty acids have better visual function by the age of two-and-a-half, according to a study at the University of Gothenburg. The study, published in The Lancet Regional Health Europe, covers 178 babies born before the 28th week of pregnancy at the neonatal units of the university hospitals in Gothenburg, Lund, and Stockholm between 2016 and 2019. Around half of the children were given preventive oral nutritional supplements containing the omega-6 fatty acid AA (arachidonic acid) and the omega-3 fatty acid DHA (docosahexaenoic acid). The study looked at children’s visual development at two and a half years of age, and researchers found that the combination supplement halved the risk of babies contracting the sight-threatening eye disease ROP (retinopathy of prematurity).

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The study concluded that increased use of social media did not lead to more symptoms of anxiety and depression, nor did those who developed more symptoms of anxiety and depression over time change their social media habits.

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HEALTH CHECK

CHILDHOOD INACTIVITY AND HEART DISEASE Hours of inactivity during childhood could set the stage for heart attacks and strokes later in life, according to research in Finland. The study found that sedentary time accumulated from childhood to young adulthood was associated with heart damage, even in those with normal weight and blood pressure. “All those hours of screen time in young people add up to a heavier heart, which we know from studies in adults raises the likelihood of heart attack and stroke. Children and teenagers need to move more to protect their long-term health” said Dr. Andrew Agbaje, Study Author, University of Eastern Finland.

Seeing Clearly MiSight® 1 day - Child-friendly 1-day contact lenses proven to slow the progression of shortsightedness in children.1 To find out more and book an eye test, visit www.bootsopticians.com Reference: 1. Chamberlain P, et al. A 3-year randomized clinical trial of MiSight® lenses for myopia control. Optom Vis Sci. 2019;96(8):556–567

Soft and Safe Pioneers of chemical-free sleep, Cottonsafe® bring you their Organic Wool Children’s Mattresses. Nurturing the hypoallergenic and breathable properties or wool and cotton, they are 100% free from chemicals, fire retardants, or any other nasties whilst ensuring the softest and safest night’s sleep for your little one. www.cottonsafenaturalmattress.co.uk

Exotic Tastes Foco canned beverages are made with premium quality Asian fruits, herbs and nutritious vegetables. Exotic and refreshing, this range of Thai soft drinks are exported around the world and are rapidly gaining popularity in the UK. chadhaorientalfoods.co.uk/ brands/foco

Protein Packed As nutritious as they are delicious, Birds Eye’s sustainably-sourced Omega 3 fish fingers are a great fish finger for the whole family, packed with protein for healthy bones and muscles, and other important nutrients such as iodine, selenium, omega-3 and Vitamin B-12. www.birdseye.co.uk

Stylish and Cool All Specsavers children’s glasses are designed specifically for kids’ faces. These stylish round glasses are made from acetate plastic in a cool, shimmering blue. All kids’ glasses come with single vision lenses, a scratch resistant treatment, case and cloth. www.specsavers.co.uk

Ride and Grow Bike Club is the kids bike subscription service that gives you access to premium quality kids bikes that you can exchange for the next size up as your child grows. Subscriptions are affordable, starting from as little as £4.99 per month. www.bikeclub.com

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03/11/2023 17:29

Children’s eyecare

our child’s eyes are special and in their early years their vision helps them learn about the world around them. At school about 80% of what is taught is presented visually. Being able to see clearly is therefore incredibly important to your child’s overall development. Most very young children have their eyesight assessed as part of their routine development checks. While these are very important, they aren’t as thorough as a complete eye test by a qualified optician. So, we recommend that your child has their eyes tested from an early age. Testing before your child goes into full-time education means that any problems that they may have are

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identified early, setting them up for a happy and fulfilling school life. Poor eyesight can cause learning and behavioural problems, which might be blamed on other things. This is especially true for young children, who may find it difficult to explain the difficulties they are having with their eyesight or may not even be aware they have a problem. The sooner vision problems are detected, the better the outcome. Conditions such as squint and amblyopia (lazy eye) can be treated more effectively if they are picked up earlier, which could make a huge difference to your child.

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At Specsavers we recommend that children have their first eye tests at around three and a half years old. The NHS will cover the full cost of an eye test for all children under 16, as well as those under 19 in fulltime education. We know that eye tests can be a little overwhelming for some children, especially if it is their first time. That’s why we’ve made the process as enjoyable and child friendly as possible. Children’s eye tests are a little different from those for adults. We use specially designed charts that allow children to recognise shapes or pictures, or even to match letters, rather than the traditional charts that you may be familiar with. This means that we can test children’s eyes even if they are unable to read or recognise letters. As well as checking the eyes, Specsavers opticians also evaluate the muscles and associated structures to ensure they are healthy too. Our opticians are specially trained to test children’s eyes. They know that the test room can feel a little intimidating to a young child so will use techniques to make it feel as welcoming as possible. You will, of course, be able to stay with your child throughout the test so you can see everything that happens. If your child needs glasses, Specsavers has a huge range of robust glasses styles featuring characters from kids’ favourites such as Disney, Harry Potter, Marvel and Peppa Pig. All glasses in the kids and teens ranges are free with an under-16s NHS optical voucher.

Signs your child might need an eye test It’s often difficult to tell whether your child has sight problems, which is why regular eye tests are so important. There are a number of things to look out for:  Straining their eyes or tilting their head to see better  Frequent eye rubbing  Losing their place while reading, or using a finger to guide their eyes  Sensitivity to light and/or excessive tearing  Falling behind in school  Complaining of headaches or tired eyes  The presence of a ‘turn’ in the eye or a misdirection of the eyes  Consistently sitting too close to the TV or holding a book too close  Avoiding activities which require near vision, such as reading or homework, or distance vision, such as participating in sports or other recreational activities  Closing one eye to read, watch TV or see better  Avoiding using a computer or tablet because it hurts their eyes  A ‘white reflex’ in photographs. This is similar in appearance to red-eye, except it’s white. It is extremely serious – if you notice it, you should seek medical attention immediately.

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HEALTH CHECK

20/20 Vision What is 20/20 vision and how can we maintain it? It starts with an informed attitude to eye health

In fact, 20/20 vision does not mean perfect eyesight, but average eyesight; if you have 20/20 vision, you can see clearly at 20 feet what most people see at that distance. If you have 20/100 vision, it means that you must be as close as 20 feet to

see what a person with normal vision can see at 100 feet. Conversely, some people have vision that’s better than 20/20, for instance 20/15 vision or 20/10 vision. This means that you can see something 20 feet away (like a line on an eye chart) that most

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e’re used to hearing the phrase ‘20/20 vision’, meaning perfect eyesight, but what exactly does it mean and what are the main eye health problems which can affect vision?

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HEALTH CHECK

SPECSAVERS Specsavers’ Clinical Services Director and optometrist Giles Edmonds says: “It is difficult to pinpoint exact causes of shortsightedness but it does tend to run in families. Short-sightedness may be linked to focussing on nearby objects, such as books and computers, for long periods of time during childhood.1

people can only see clearly when they’re 15 feet away (20/15) or 10 feet away (20/10). Only about 35% of all adults have 20/20 vision without glasses, contact lenses or eye surgery. With correction, about 75% of adults have 20/20 vision. In fact, the phrase ‘20/20 vision’ is used mainly in the USA – in Europe, optometrists measure visual acuity in metres, with a top number referring to the distance at which the chart is viewed (20 feet or 6 metres) and a bottom number referring to the distance at which a person with ideal vision can see a letter clearly. So, if you have 20/40 (or 6/12) vision then you’ll just be able to see something from a distance of 20 feet that a person with perfect eyesight will be able to see from 40 feet. SNELLEN Most visual acuity tests use the familiar letter chart, known as the Snellen test, developed by Doctor Hermann Snellen in the 1860s. The first line consists of one very large letter, while subsequent rows have increasing numbers of letters that decrease in size. A person taking the test covers one eye from 6 metres or 20 feet away, and reads aloud the letters of each row, beginning at the top. The smallest row that can be read accurately indicates the visual acuity in that specific eye. The symbols on an acuity chart are formally known as “optotypes”.

The largest letter on the eye chart often represents an acuity of 6/60 (20/200), a value that is considered “legally blind” in the US. Many individuals with extreme short-sightedness, or myopia, cannot read the large letter without glasses, but can read the 6/6 (20/20) line or 6/4.5 (20/15) line with glasses. By contrast, legally blind individuals have a visual acuity of 6/60 (20/200) or less when using the best corrective lens. Computer monitors are suitable for displaying optotypes, and to prevent subjects just memorising the test chart, there are digital chart products which will randomise the letters displayed. If you want to create your own Snellen chart, you can do so using smart phone and tablet apps. CHILDREN Serious vision problems during childhood are rare, but routine eye checks are offered at birth, between 6 and 8 weeks old, at around 1 year and at around 4 to 5 years to identify any problems early on. Vision screening often happens at school, and can include checks such as pupil reflex and colour blindness as well as the familiar Snellen tests. A High Street optician will carry out a refraction test to check if your child needs glasses and, if so, what prescription they need. Children can have an eyesight test

Research has found that children are twice as likely to be short-sighted now than 50 years ago, which could also be linked to the increase in digital screen use during childhood and the fact that children also spend less time outside.2 We recommend that children have their eyes tested before they start school so any problems can be picked up early. Poor eyesight can cause learning and behavioural problems, which might be blamed on other things. This is especially true for young children, who may find it difficult to explain the problems they are having with their eyesight. www.specsavers.co.uk 1. https://www.nhs.uk/conditions/shortsightedness/ 2. https://journals.plos.org/plosone/ article?id=10.1371/journal.pone.0146332

at any age. They do not need to be able to read, or even speak. An eyesight test is particularly important if there’s a history of childhood eye problems, such as squint or lazy eye, in your family. Before some tests, your child may be given special eyedrops that widen their pupils so the back of their eyes can be examined more clearly. Although your child should have regular eye tests as they grow up, it’s still important to look out for signs of any problems and get advice if you have any concerns. ■

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Quick & e the whoasy fish finger recipes le fami ly will love! Fish Finger lasagne Ingredients: • 200g Garden Peas • 1 pack of 30 Birds Eye Omega 3 Fish Fingers • 1 large carrot (finely chopped) • 2 large leeks (finely chopped) • 50g unsalted butter • 60g plain flour Method: 1. Preheat the oven to 180°C. Meanwhile, cook the peas as per pack instructions. 2. Place the fish fingers on a baking tray and bake until crispy and golden. Meanwhile heat half the butter in a saucepan until bubbling. Add the carrots and cook for 5 minutes, then add the leeks and continue cooking until soft. Season with a pinch of salt and pepper.

3. Add the rest of the butter and flour and cook out for a minute until smelling of biscuit. 4. Pour in the milk gradually, beating it in with a wooden spoon, until you have a thick sauce. Bring to a simmer and cook for a few minutes then add most of the parmesan. 5. Use a little oil to grease a medium sized baking dish and add a layer of the sauce. Place the first layer of lasagne sheets on top.

Fish Finger Pie Ingredients: • 1 pack of 10 Birds Eye Omega 3 fish fingers • 4 large potatoes Method: 1. Wash and peel the potatoes then cook in boiling water until tender, drain. 2. Cook the fish fingers and peas as per pack instructions. 3. Assemble the pie by putting the cooked fish fingers in the base of the dish, then

Fish Finger Tacos

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800ml semi-skimmed milk 100g parmesan cheese (grated) 6 lasagne sheets 400g fresh spinach A pinch of salt & pepper for seasoning

6. Top with another layer of the sauce, half the fish fingers, spinach, peas. Top with lasagne sheets and repeat again, topping with a final layer of lasagne sheets, sauce and sprinkling of parmesan. 7. Bake for 30 minutes until pasta is cooked and lasagne is golden and bubbling.

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• 240g peas • 2tbsp grated cheese

top with the peas and then cover the top with the mashed potatoes, sprinkle with grated cheese. 4. Place under grill for 5 minutes to melt and brown the cheese, or you can put it in the oven for approximately 20 minutes at 200°c.

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Ingredients: • 1 pack of 10 Birds Eye Omega 3 fish fingers

• 1 pack of tacos • Toppings of your choice.

Method: 1. Sprinkle Mexican spices on the fish fingers. 2. Cook fish fingers as per instructions on pack

3. Heat the tacos in the oven as per instructions on pack. 4. Load tacos with the fish fingers. 5. Add your favourite toppings, e.g. cheese, sour cream, lettuce, salsa etc.

For more fish finger recipes, head on over to www.birdseye.co.uk/fishfingerrecipes

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HEALTH CHECK

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HEALTH CHECK

Fish Why

is the Dish

Fish should be a part of any healthy diet, but it’s particularly valuable for developing children. Lauren Woodley, company nutritionist for Birds Eye, tells us why

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he dietary benefits of fish are many and varied. It’s recommended that we eat fish at least twice a week, including one portion of oily fish to reap its multiple nutritional benefits. The common ‘Western’ diet is too high in unhealthy fats, salt, sugar and energy, and too low in vitamins, minerals and essential fatty acids. Recent figures show 1 in 10 children in Reception and more than 1 in 5 (nearly 1 in 4) children in Year 6 were living with obesity. Obesity is a very complex condition with numerous causes and risk factors. Children, like adults, do not simply develop obesity due to individual choice on diet, exercise and lifestyle. Instead, a complex web of societal and biological factors underpins our inherent human vulnerability to weight gain. Eating a healthy, balanced diet is vital for good health because our bodies need to get the right nutrients from food to function properly, whatever our age. Children, like adults, need a balanced diet which includes a suff icient variety of foods and drinks, in appropriate amounts, to provide the energy and nutrients needed

for health. Key nutrients for children are:  Carbohydrates – for energy  Protein – for growth, repair and maintenance of the body as proteins are our building blocks  Fat – specifically good quality, healthy unsaturated fats

FRESH VS FROZEN Frozen fish counts just as much towards the recommended weekly 2+ portion intake as fresh fish. This is because the freezing process locks in fish’s goodness – including the protein, omega-3, vitamins and minerals. As access to locallycaught fresh fish is very locationdependant, some fish species have short catching periods, and fresh fish availability can be variable, frozen fish is a great option. Frozen fish also helps to reduce food waste – avoiding throwing away money and negatively impacting the planet.

 Calcium – for healthy bones and teeth  Iron – for healthy blood and oxygen transport around the body  Vitamin A – for healthy eyesight  Vitamin C – for immune health and healthy body tissues  Vitamin D – for the growth and maintenance of bones and teeth, healthy muscles, and immune health  Omega-3 fatty acids – for normal brain and heart function Fish is a great source of protein. Different species contain different amounts of protein per 100g, but very roughly on average fish provides approximately 19.5g of protein per 100g. How much protein we need varies by the individual, with needs dependent on body weight, in addition to other factors such as activity, childhood age and gender. Protein has a number of important roles in the body, including muscle growth and maintenance, and maintaining normal bones. It’s especially important that children consume enough protein, as it’s required for the normal growth and development of their bones. »

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HEALTH CHECK

Of the other key nutrients found in fish, the amount present is dependent on fish species. For example, omega-3 is found in pollock and oily fish including salmon and mackerel, and is an ‘essential’ fatty acid. ‘Essential’ nutrients are those you need to consume in the diet, as our bodies cannot make these themselves, and children and adults in the UK should be aiming to eat more omega-3 in their diets. Other key nutrients found in fish species in varying amounts include selenium, iodine and vitamin D. Selenium helps to maintain a healthy immune system and thyroid function, as well as maintaining normal hair and nails, while iodine contributes to normal child growth, normal cognitive brain function, and normal thyroid function. Vitamin D is the so-called ‘sunshine vitamin’, as it’s made in the skin in the presence of sunlight at certain times in the year. However, vitamin D deficiency is an increasingly recognised issue in the 66

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UK. Vitamin D has many important roles in the body, including maintaining muscle function, immune system function and normal bones and teeth, therefore it’s good to consume dietary sources of vitamin D to top up your levels. Salmon and basa are tasty sources of vitamin D that can be incorporated into child-friendly meals. We can get our recommended portions of fish by eating fresh, tinned or frozen fish. The freezing process locks in the nutrients in fish, hence frozen fish is nutritionally just as good as fresh fish. The recommendation in the UK is the same for children and adults – at least 2 portions of fish a week, including 1 of oily fish. A smaller portion may be appropriate for younger children, and consuming a variety of fish species is ideal to maximise the goodness children gain from fish. CHILD DEVELOPMENT Fish is a nutrient-dense, healthy food – so it’s valuable for everyone, but some of the

key nutrients found in fish are particularly valuable for child development. These are protein, iodine and omega-3. Certain fish species are good sources of essential omega-3 fatty acids. As humans, we aren’t able to produce omega-3, which is why it’s important to incorporate these essential fatty acids in a healthy diet – across our life spans. Getting omega-3 from whole foods is the most effective way to ensure optimal intake. It’s well known that fish and other seafood can contain high levels of omega-3, and that it’s one of the easiest ways to up your weekly intake. Oily fish contains the highest levels of omega-3, so are a great source of these essential fatty acids. Types of oily fish rich in omega-3 include salmon, mackerel, and sardines. White fish generally contains significantly lower levels of omega-3 compared to their oilier counterparts, but some species are still good sources of omega-3, including pollock. Omega-3 is

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HEALTH CHECK

Fussy Eaters

system in children specifically. Iodine and vitamin B12 are found in cod, pollock and haddock. Vitamin B6 is found in haddock and salmon, and additionally salmon provides all-important vitamin D. BALANCED DIETS If you have difficulty getting your kids to appreciate the value of a balanced diet, try to explain it to them in terms of what it helps them to do. Proper nutrition gives them energy to play, do sports, and enjoy their free time after school. It fuels their brains, making it easier to understand and enjoy their school lessons. It keeps their bodies healthy, allowing them to do all the things they wish to do, and to the best of their abilities. As children get a little older, they tend to become more self-aware and conscious. Therefore, you can also explain how a balanced diet will maintain a healthy weight, and keep skin, hair and nails healthy. »

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Some children don’t immediately take to the taste or texture of fish, and some parents don’t know how to prepare it. It’s a good idea to start kids on white fish such as cod which tends to have a milder flavour than oily fish. You can also add other flavours to help mask a fishy flavour, for example by choosing coated or reciped fish, adding fish into potato and herb flavoured fish cakes, or even using fish in spicy tomato-based stews. Frozen fish tends to have less of a fishy smell than fresh fish, but the fresher the fish – recently caught or quickly frozen – the less the smell. While fish loins or fillets can be cooked straight from chilled or frozen in the oven, airfryer or microwave, fish fingers and coated fish, or even tinned fish which is ready to eat, are other options. Look for recipe inspiration such as fish pies online. A balanced fish meal will be ½ plate of veg, ¼ fish and ¼ carbohydrate side. But there are plenty of variants you can try! For recipes, inspiration and more nutrition guidance, head to www.birdseye.co.uk.

extremely important for child development, as it is shown to support the normal growth and development of children and help to maintain normal brain function. It’s also important for expectant mothers to consume enough omega-3, from fish and seafood, and omega-3 contributes to the normal development of the eye and brain of the foetus and breastfed infants. We know from research that many children’s gateway to enjoying fish is through coated fish such as ‘fish fingers’. Even if your child is a fussy eater, you can mix up the types of fish fingers you serve, to maximise the spread of nutrients your child eats from fish - cod one day, haddock another. Some of the key nutrients found in fish are valuable for maintaining a normal immune system. These are the mineral selenium and vitamins D, B6 and B12. Vitamin D is especially valuable for children, as has been shown to contribute to the normal function of the immune

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HEALTH CHECK

A useful analogy you can use when explaining balanced diets to younger children is that of a car. To keep a car working properly it needs fuel (the energy food gives us), water (proper hydration), its parts in tip top condition (eating enough proteins, fats, carbohydrates, vitamins and minerals minerals for healthy bones, muscles, tissues etc, and for its systems to work effectively (vitamins and minerals are the ‘managers’ of our bodies). The trick to getting veggie goodness into your little one may be creative hiding of vegetables or making vegetables more attractive. Grated beetroot, carrots and even courgette can be hidden in cakes and bakes (providing moisture, taste and nutrients), while pureed vegetables can be incorporated into pasta sauces, fish cakes, burgers, croquettes... even homemade pizza base sauce. Otherwise, try making vegetables either fun finger food (making smiley faces with carrot sticks, tomatoes, cucumber, etc.) or

turning them into favourite treat foods such as courgette fries as a delicious alternative to normal potato fries. FIVE A DAY As a reminder, for Five-a-Day, a ‘portion’ is 80g of fresh, canned and or frozen fruit and vegetables, 30g of dried fruit, 150ml fruit/ vegetable juice or smoothie (only 1 per day), or 80g beans and pulses (again, only 1 portion per day). The variety of foods that falls into 5-a-day provides scope to easily add variety to your child’s diet - try adding beans and pulses into a Bolognese sauce, sprinkling dried fruit over breakfast cereal, or adding a handful of frozen veg to soup. Even if it’s the same fruits and vegetables every day, so long as your child eats their five portions then this is sufficient. They will still be consuming a range of vitamins and minerals, and some fibre, and although it’s advisable for people to eat a wide range of fruits and vegetables, even just eating the same five is better than not eating five a day!

While fish, vegetables and fruit are essential elements of a healthy diet, and nutritionists tend to promote a ‘food-first’ approach to nutrition, dietary supplements can sometimes be useful to ‘top up’ nutrient levels for children with a very limited diet, or who are fully vegan. Concerning veganism, certain nutrients are harder to get from a vegan diet – owing to lower levels of the nutrients in plant foods, fewer food sources of nutrients, or harder-to-absorb nutrients. It’s best to get supplement advice from a GP or Dietician if your child does eat a limited diet, to ensure their specific needs are met. However, for all of us, a vitamin D supplement across winter is a great idea – given the majority of us become deficient in this vital nutrient. Look for child-friendly supplements, as children’s vitamin D needs can differ to those of adults. Again, ask for advice from a GP or dietician if you need guidance on the most appropriate supplement for your child. ■

Key Nutrients in Fish While all fish are nutritionally valuable, levels of different nutrients vary according to species. That’s why it’s worthwhile not only making sure that there is enough fish in children’s diets, but that you also vary the different types of fish to get the best balance of nutrients.

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✤ Cod: Protein, selenium, iodine, vitamin B12 ✤ Pollock: Omega-3, protein, selenium, iodine, vitamin B12 ✤ Haddock: Protein, selenium, iodine, vitamins B6 and B12 ✤ Salmon: Omega-3, protein, selenium, vitamin D, vitamins B6 and B12

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08/10/2021 12:48

HEALTH CHECK

Eating Meat-Free A meat-free diet might be good for the planet, but is it healthy for your children? We look at vegetarian and vegan options

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intensive than plant-based foods. The industrial meat system requires a huge amount of land to sustain itself. Forests, particularly in South America, are deliberately slashed and burned every year to graze cattle and grow enough crops to feed billions of farmed animals. The climate impact of meat is enormous – roughly equivalent to all the driving and flying of every car, truck and plane in the world. When forests are destroyed to produce industrial meat, billions of tonnes of carbon dioxide are released into the atmosphere, accelerating global warming. Fallen trees are left to rot or are burned, creating further emissions.

Healthy trees are essential for absorbing carbon from the atmosphere. If we cut them down, they can no longer help us in the fight against climate change. By clearing forests, destroying habitats and using toxic pesticides to grow animal food, the industrial meat industry is contributing to the extinction of thousands of species, many of which haven’t even been discovered yet. ARGUMENTS So there are plenty of good arguments for adopting a meat-free (or at least reduced) diet, for the sake of your health, your children’s, and that of the planet. But of course it’s not as simple as that. »

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ooked at objectively, there are lots of very good reasons to give up eating meat. The ‘factory farming’ industry is often regarded as cruel, with animals restricted to pens or cages and kept and transported in distressing conditions; and eating of red and processed meats has been associated with diseases including bowel cancer. Moreover, the process of raising livestock for food is incredible wasteful of the planet’s resources – animal feed requires land to grow, which has a carbon cost associated with it. All told, beef is more resource-intensive to produce than most other kinds of meat, and animalbased foods overall are more resource-

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HEALTH CHECK

once cooking came in, about 500,000 years ago, meat became a regular component of the human diet. There’s even an argument that eating prepared meat, as it’s easier to chew than vegetables, made it possible for the human skull to evolve a smaller jaw and hence larger brain capacity. Possibly as a result of this, there are dietary components humans need that they just can’t get from vegetables. Vitamin B12, for instance, is an essential

OMNIVORES But the human organism, whether we like it or not, evolved as an omnivore, eating both vegetable matter and other animals. Scientists believe that it was about 2.6 million years ago that meat first became a significant part of the pre-human diet, and it’s entirely possible that without an early diet that included generous amounts of animal protein, we wouldn’t even have become human—at least not the modern, verbal, intelligent humans we are. Being a herbivore is easy, as fruits and vegetables are no challenge to collect, but they’re also not terribly rich in calories. Underground storage organs, root foods like beets, yams and potatoes, are more nutritional, but require preparation before they’re fit to eat. Animal prey that has been killed and prepared by slicing, pounding or flaking provides a much more calorie-rich meal with much less chewing than root foods do, boosting nutrient levels overall, and 72

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nutrient, found almost exclusively in meat, fish and dairy products. Other nutrients found mainly (though not exclusively) in meat include Vitamin D3, the muscle building creatine, the antioxidant carnosine, omega 3 fatty acid DHA, heme iron, and the sulphur compound taurine. So, if you eliminate meat from your or your child’s diet, you must also supplement the diet so that you continue to receive these essential nutrients. ■

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Vegetarians and vegans avoid eating meat. So, what is the difference between a vegetarian and vegan diet? Generally, vegetarians choose not to eat animals because they oppose treating them cruelly. They don’t consume the flesh of any animal, including pigs, chickens, cows, sheep, and fish. They may also avoid foods that contain animal-derived ingredients such as gelatine (found in some sweets) and rennet (found in certain cheeses). Someone who doesn’t eat land animals but does consume fish is most often referred to as a “pescatarian”, but strictly speaking, as fish are animals too, a ’real’ vegetarian would not eat them. In addition to avoiding eating all animal flesh, vegans avoid consuming dairy products such as milk, cheese, ice cream, yogurt, eggs, or any other foods that are derived from animals – sometimes even honey. Being vegan is often not only a way of eating, but also a way of life – a philosophy that animals exist for their own reasons and have the right to be treated with respect, and that humans shouldn’t exploit animals, but should leave them in peace to lead their own lives.

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01/11/2023 14:41

SPONSORED EDITORIAL

BEAT THE BEDTIME BATTLES WITH SLEEPEEZEE’S NEWEST MATTRESS RANGE, LITTLE BEDZ

leep is more important than you think, and for the average child, their busy lives of school, running around with friends and going to their favourite activities take its toll. By the end of the day, their bodies need a break and sleep helps with this. Both the mind and body need sleep to rest and rejuvenate for the day ahead, but on average most children don’t get enough of the recommended 9-12 hours each night. Although not every child is the same and some children need more sleep than others to help them grow and stay healthy. Sleep can be a challenge for many people, young and old. But to sleep better, its often recommended to find the right mattress for you. Sleepeezee’s brand new kids beds range, Little Bedz, can help with just this. Made and manufactured for your little ones, Little Bedz provides cosy and bounce proof comfort, offering complete support on both sleep and play mode. Carefully designed for the growing needs of children, the range offers exceptional support and comfort whether you’re buying their first bed or upgrading an existing one. Little Bedz ticks all the boxes for a good night’s sleep, with a sprinkle of Sleepeezee magic. Its pocket spring technology adjusts accordingly to your child’s body shape, meaning their mattress grows with them, providing maximum support all the way up to their teenage years. Little Bedz also combine traditional techniques with innovative designs to provide children with a safe place to sleep soundly. The new range even offers anti-allergy properties so your kids can finally enjoy a cool, clean night’s sleep on the mattress of their dreams. Sleepeezee’s brand ambassador and former Olympic champion, Dame Jessica Ennis-Hill commented: ‘Sleep is so important for all

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members of the family. For me, the key thing has always been creating a routine for my two children around bedtime, making sure it’s a positive experience for everyone. Ensuring a mattress is both super comfortable yet supportive is key to promote growth and ensure your child gets a good night’s sleep’. Sleepeezee is committed to delivering exceptional customer service and offers a ten-year guarantee on all its mattresses, including Little Bedz. This means your kid’s mattress will grow with them and last. Each Little Bedz mattress comes with free delivery within 2-4 weeks, excluding standard website surges to specific regions. The range includes the Glow model, a single bed offering starting from £279 and the Shine model, a small double competitively priced from £309. Both mattresses are available to purchase with a standard divan, or Sleepeezee’s new Storeaway divan which has hidden storage along the side of the bed, providing a comfortable and convenient bed for your kid’s room.

To learn more about Sleepeezee’s Little Bedz range or to purchase one, visit: sleepeezee.com/product-category/kids-beds/

01/09/2023 11:17

HEALTH CHECK

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You Don’t Snooze, You Lose

Why is sleep so important to kids’ health, and how can you make sure you and your children get a restful night’s slumber?

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01/11/2023 15:56

HEALTH CHECK

ost of us know how important sleep is to our health, but the 24/7 nature of the modern world means that getting a good night’s sleep continues to be difficult. It can be particularly difficult to persuade kids to switch off their mobiles, tablets and laptops and concentrate on getting the sleep which is so vital for their health and development. Scientists have long stressed the importance of healthy sleep habits, recommending at least seven hours each night for adults. For children, the recommended levels of sleep per 24 hours change according to age:

Age Group

Age Range

Recommended hours of sleep per 24 hours

Infant

4-12 months

12-16 hours (including naps)

Toddler

1-2 years old

11-14 hours (including naps)

Preschool

3-5 years old

10-13 hours (including naps)

School-age

6-12 years old

9-12 hours

Lack of sleep is linked to increased risk in numerous health conditions, including diabetes, stroke and cardiovascular disease. So how can we make sure our children develop good sleeping habits which will serve them well in later life? SLEEP LOSS The pattern of human sleep is determined by what is called the circadian rhythm, an internal biological clock which keeps us alert during the day and prepares us for sleep at night. Circadian rhythm depends on light to keep it healthy, and the problem with modern life is that spending more time indoors makes people receive less natural light exposure, potentially damaging our chances of sleeping well. In addition, young people appear prone to acquiring poor sleeping habits after heavy nights all week and trying to catch up with sleep at the weekend. This can have many negative health consequences in later life.

Over 17,000 medical studies of sleep have been undertaken, with many linking a lack of sleep to health problems such as obesity, heart disease, and stroke. One study in 2018 found that disorders such as sleep apnoea are common in people at risk of stroke, and another found that compared to people who slept 6-9 hours a night, people who slept fewer than 6 had a 20% higher risk of heart attack. These studies also found detrimental effects of sleep deprivation to include: h Hallucinations, temporary psychosis or symptoms resembling paranoid schizophrenia h Lethargy and lack of motivation h Moodiness and depression h Lack of cognitive ability during the day h Impaired sex drive h Premature skin ageing h A weakened immune system h High blood pressure h Certain types of cancer

of hours before bed, in order for people to ‘wind down’ effectively. Having a hot bath before bed or reading a book for an hour are tried and tested relaxation techniques. The blue light emitted from the screens of televisions, laptops, tablets, and mobile phones confuses the pineal gland and upsets melatonin levels, so watching telly or scrolling through social media is to be avoided, particularly for children. If you often have to get up in the night, keep a small torch by your bed and don’t switch on lights, as this will affect your circadian rhythm. »

A PERFECT NIGHT Establishing a regular routine of sleeping and waking is essential for promoting a good night’s sleep, so that you can work with your body’s circadian rhythm. Although you may crave a one-off late night, long lie-in, or daytime nap, this will not help you in the long run. Going to bed and waking at the same time every day will mean that your body recognises the cycle and will work with you. The brain’s pineal gland produces the hormone melatonin on cue from lower light levels – so when dusk falls, the body prepares for sleep. Conversely, when light levels rise in the morning, the circadian rhythm wakes you up ready for another day. That’s why, although schedule is important, you can’t rely on it alone. You have to make sure that your body is ready for sleep, but that your sleeping environment is right too. Relaxation is an incredibly important way to prepare the body for sleep. Stimulation of the mind or body late into the evening will disturb your sleep patterns, and as a result, a period of total relaxation is ideal preparation for falling asleep. Medical experts point to turning off electronic devices such as phones a couple

✤ Control light and sound. Make sure not to have any electronic devices with standby LEDs in the bedroom. Shut doors to reduce noise from fridges and other electrical items. Use heavy curtains to block out sunlight in the summer. ✤ Control temperature. The ideal bedroom temperature for getting to sleep is 15.6–19.4°C. ✤ Replace ticking clocks with digital ones. ✤ Keep your bedroom tidy and uncluttered. ✤ Don’t let pets sleep on the bed. As long as the owner and animal are healthy there’s no reason why the animal shouldn’t sleep on (not in) the bed, but of course, if they move around they can disturb the owner’s sleep. Try putting a pet bed in the room rather than letting them sleep on the bed.

Environment The environment you are sleeping in is essential to a good night’s sleep. There are some simple things you can control to help you get to sleep easily.

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HEALTH CHECK

BEDTIME A suitable bed, mattress and bedclothes are essential for a good night’s sleep. For children, the recommendations are: ❖ For babies, a crib mattress. Some mattresses for toddlers have a waterproof side so make sure you read instructions ❖ For older children, a foam mattress can be comfortable, quiet, affordable and portable ❖ For grown children, an innerspring or encased coil mattress provides the best support and durability

Sleepeezee Sleepeezee’s brand new kids’ beds range, Little Bedz are made just for your little ones. Carefully designed for the growing needs of your children, the range offers exceptional support and comfort whether you’re buying their first bed or upgrading an existing one. Handmade and expertly crafted at Sleepeezee’s factory in Kent, the Little Bedz range has been designed as a bed that’s worth going to bed for. Forget bedtime battles, as with their solid structure, Sleepeezee’s affordable new range is designed to last longer and make bedtime fun again.

https://sleepeezee.com

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❖ Hybrid mattresses combining layers of foam and coil systems can be more expensive, but combine comfort and supportiveness

EXERCISE Daytime exercise is another important factor in preparing the body for a good night’s sleep. Not only does it keep you fit, but exercise is also known to relieve stress and reduce anxiety, which are common causes of sleep problem. Anything that raises your heart rate will do, so to reduce stress, try five minutes of aerobic exercise. For kids, outdoor activity is ideal, and for adults, try relaxation techniques such as taichi, yoga, or meditation. They lower blood pressure, calm the nervous system, and reduce levels of stress hormone cortisol. Exercise and weight loss have many more benefits, one of which is an improvement in breathing and a reduction in the severity of sleep apnoea. The more regular exercise you get, the more it will benefit your sleep patterns. Do remember not to exercise within three hours of going to bed. In contrast to the idea that a late-night workout will tire your body out and help you to sleep, it actually leaves you dehydrated and releases stress hormones. ■

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sustainable . safe . sleep Safer sleep for the whole family Natural Chemical Free Hypoallergenic Sustainable

save 15% use code HEALTHY15

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04/08/2023 11:18

Did you know there are chemicals in your baby’s mattress? All mattresses made using foams and other synthetic materials are treated with fire retardant chemical sprays – including cot, cot bed and children’s mattresses. But what’s the problem? The chemicals are there to protect us, right? Exposure to flame retardants have been shown to negatively affect motor skills, learning, memory, and hearing in developing babies and young children, they have been linked to an increase in hyperactivity, behavioural problems and have adverse effects on the immune system. So, what are we doing at Cottonsafe® Natural Mattress to reduce children’s exposure to these chemicals? We made it our mission to remove all chemicals from our mattresses, becoming the first company in the UK to produce a 100% chemical free mattress that met the stringent UK Fire Regulations. Using naturally fire-retardant fibres we create beautifully comfortable, long-lasting products that are not only safe, but hypoallergenic, thermoregulating and sustainable.

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04/08/2023 11:18

HEALTH CHECK

On Two Wheels

Cycling is one of the healthiest and most affordable exercises for children, so how do you get them into it and make sure they’re safe on two wheels?

ycling is an affordable, environmentally-friendly way to get about – and it keeps you fit. It’s a great way to encourage children to develop independence and physical ability, and it’s something the whole family can do together. The first essential is to make sure that your child’s bike is the right size for them. Avoid the temptation to buy one with the idea that they will grow into it – once they’ve outgrown it, pass it on. According to the Royal Society for the Prevention

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of Accidents, a common factor in cycling accidents involving children is loss of control. This is why bike size is important. If a bike is too big and a child can’t touch the ground with the ball of their foot, then the bike is too large for them to control safely. Equally, don’t get a bike that’s too small as this will make pedalling very tiring and steering clumsy. Good places for children to learn to ride a bike are cycle paths, gardens, parks and playgrounds. Avoid steep hills and areas close to busy roads.

STARTING OFF A common first buy is a ‘balance bike’, a small starter bicycle for pre-school children which, like the original bicycles, has no pedals: the rider ‘scoots’ along the ground, pushing off with alternate feet, and can lift both to coast. With a balance bike or one with stabilisers, steady your child as they start to pedal and run with them, holding the saddle. Gradually let go, but stay alongside them so they think you are still supporting them. Make sure they

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01/11/2023 16:07

HEALTH CHECK

CYCLING SAFETY Every year over 3,000 cyclists are killed or seriously injured in the UK. Here’s some advice from ROSPA, the Royal Society for the Prevention of Accidents. ❖ Buying a bike from a reputable shop where they can advise on the best type of bike and make sure it’s the right size for you or your child. ❖ If buying a second-hand bike, check its condition and features carefully. ❖ Get kids some cycle training. To find out what’s available in your area contact your local council’s Road Safety Team. ❖ ROSPA recommends that children wear cycling helmets. This is a sensible way of protecting the head, especially with ‘loss of control’ accidents. The advice is not to buy a second-hand one; you can’t be certain it is undamaged, and even minor cracks that come from dropping helmets can affect their integral strength.

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❖ When cycling, wear bright clothing, preferably something fluorescent and reflective, to help other road users to see you more easily. Always use lights and reflectors in the dark and in poor visibility.

❖ Check your bike regularly to make sure it is in a safe condition. Check brakes and brake blocks or discs to ensure safe stopping in wet and dry weather. Clean and oil moving parts to keep the bike working smoothly. Tighten nuts and bolts to prevent any parts working loose. Make sure lights are working properly and that reflectors are clean. Replace any batteries that don’t give a bright light. ❖ Plan routes carefully. Use cycle paths and quiet roads as much as possible; this will make your ride more enjoyable as well as safer. Your council may have a map of local cycle routes. ❖ Take extra care at junctions and give timely, clear signals. Roundabouts are particularly dangerous for cyclists. Always obey traffic lights and signals. ❖ Give lorries and larger vehicles plenty of space and avoid riding along the inside of them, especially near junctions – the driver may not be able to see you. Lorries turning left at a junction present a particular problem to cyclists, as they have a difficult job manoeuvring and have blind spots in their mirrors. www.rospa.com

use brakes to stop and encourage them to look around before they set off, while riding, and before they stop. Games, such as following a course or weaving in and out of objects, can be a good way to help children gain control skills. A first pedal bike should be bought at the age of around three to five. Cycling UK suggests avoiding gimmicky designs or those with TV characters on them – these are just distractions which mean that less has been spent on the basic engineering quality. At the age of four to six, you can introduce a bike with larger wheels, maybe 14- or 16-inch, and from the ages of six to nine, you’ll be looking at bikes with 20-inch wheels, and perhaps three gears. From the ages of eight to 12, you’re looking at paying more like adult prices, maybe £300 for a decent model, and for features like 24-inch wheels, aluminium frames, V-brakes, and off-road tyre treads. ■ celebrityangels.co.uk

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HEALTH CHECK

Sounder Sight Short-sightnedness or myopia in children is a growing problem, but there are some ingenious solutions to address the issue

hort-sightedness, or myopia, is a common eye condition that causes distant objects to appear blurred, while close objects can be seen clearly. It affects up to one in three people in the UK, and for reasons which aren’t clearly understood, is becoming more common. Myopia in children usually starts from the ages of six to 13 years, and can grow worse during growth spurts in puberty. It’s important to treat even mild cases of myopia, as childhood is the prime time to treat it to stop it from worsening. But of course myopia can also occur in adults. Specsavers clinical services director, Giles Edmonds, says: ‘‘While we recommend that adults have an eye test at least every two years, children should

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also attend for examinations regularly. With about 80% of what is taught in school presented visually, being able to see clearly is incredibly important to a child’s overall development. CAUSES The main cause of myopia is when the eyes grow slightly too long, meaning that light is not properly focussed on the lightsensitive retina, the layer at the back of the eye. The result is that distant objects appear blurred. It does seem to have a genetic component, as it seems to run in families. However, it’s clear that it can be made worse by focusing on nearby objects such as books or computer screens for prolonged periods during childhood.

Giles Edmonds adds: ‘Eyes can often become strained when focusing on screens for a long period which, while not usually serious, can be uncomfortable. Similarly, if children’s eyes are fixated on a single object for a long period of time, especially small digital screens, this can also cause eye strain. Symptoms to look out for include eye discomfort, headaches, sore or tired eyes, difficulty focusing, dry eyes, blurred or double vision, and increased sensitivity to light. “Specsavers advises students to follow the 20:20:20 rule, looking away from their screen or white board every 20 minutes at something 20 feet away for at least 20 seconds to help relax the eye muscles.” Some of the common signs of myopia in children are:

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01/11/2023 16:13

HEALTH CHECK

h Needing to sit near the front of the class at school because they find it difficult to read the whiteboard h Sitting close to the TV

Other Issues Children or adults can develop other eye conditions associated with short-sightedness, such as: ✤ Squint – a common childhood condition where the eyes point in different directions ✤ Lazy eye – a childhood condition where the vision in one eye doesn’t develop properly ✤ Glaucoma – increased pressure inside the eyes ✤ Cataracts – where cloudy patches develop inside the lens of the eye

It’s worth visiting the opticians for an eye test at least every two years in case there are any other undiagnosed sight conditions which should be looked at. Eye tests for children under 16 or those under 19 and in full-time education are free on the NHS. It’s been suggested that the coronavirus lockdown, with its emphasis on children using computer screens at home, has contributed to the development of myopia. So one measure to reduce the likelihood of myopia is to encourage more outdoor play, so the eyes spend more time focussed on distant objects. Studies show that children who spend an hour outdoors each day can reduce their risk of developing myopia by 14 percent. TREATMENTS Myopia has traditionally been corrected with single vision spectacles or contact lenses, which provides clear vision but does not slow or stop myopia from progressing. Innovations in myopia treatment include special contact lenses which not only help provide clear vision, but also have a proven ability to slow down the eye elongation by reducing the signal that’s telling the eye to grow too long, resulting in slowing down the progression of myopia. ■

Boots Opticians Figures show in the UK, a sixth of 12-to-13 year olds, and over a quarter of 15-to-16 year olds and young adults now have myopia.1 Myopia can progress rapidly in children, so it’s important to book an eye test as soon as possible if you suspect your child may be experiencing difficulties with their eyes. Boots Opticians offer a variety of solutions to help treat and slow down myopia in children, including MiSight contact lenses or glasses fitted with Stellest lenses. Both MiSight® 1 day contact lenses and Essilor® Stellest® lenses have solutions that have a proven ability to slow down myopia progression in children when worn as instructed by your optician. They work by changing the way light rays bend into the eyes and help to reduce the signal that’s telling the eye to grow too long, resulting in slowing down the progression of myopia. Find out more at www.boots.com/myopia or contact your local Boots Opticians store 1The dramatic rise of myopia in young people, Higher Education Policy Institute, August 2021

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✤ Retinal detachment – where the retina pulls away from the blood vessels that supply it with oxygen and nutrients, a condition requiring immediate medical intervention

h Complaining of headaches or tired eyes h Regularly rubbing their eyes

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Managing short-sightedness in children at

Myopia, also known as short-sightedness, is a common condition that makes seeing objects at a distance appear out of focus. It usually starts in childhood , but can also start in adulthood, and can impact the ability to see things at a distance clearly, such as watching TV or seeing details on a whiteboard in the classroom.

Myopia, typically occurs when the eyeball grows too long in childhood, and can rapidly worsen, particularly in younger children, because their eyes grow at a faster rate1,2. Whilst the number of people with myopia is growing, there are things you can do to manage myopia and aim to slow down it’s progression.

References: * Compared to a single vision one-day lens. ** Aesthetic finish

1. Zadnik K et al. Factors Associated with Rapid Myopia Progression in School–aged Children. Invest. Ophthalmol Vis Sci. 2004; 45(13): 2306 2. Morjaria P. How myopia develops. Community Eye Health. 2019;32(105): 4

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Kyla Black BSC(Hons) MCOptom, Head of Professional Services at Boots Opticians explains “Early detection and treatment is key. When a myopia patients prescription increases, there is an increased risk of other eye conditions and visual impairments later in life, such as glaucoma and cataracts. Myopia can progress rapidly in children, so it’s important to get your child’s’ eyes

tested regularly, at least every 2 years, from the age of three”. As well as offering free NHS eye tests for children under 16, or those under 19 and in fulltime education, Boots Opticians also offers a choice of both glasses lenses or contact lenses that can help slow down the progression of myopia in children.

MiSight® 1 day contact lenses

Essilor® Stellest® lenses

Designed with children in mind, MiSight® 1 day contact lenses are easy for children to apply, wear and remove3. These one-day contact lenses use unique ActivControl® technology - a special optical design that can provide clear vision while also reducing the signal that’s telling the eye to grow too long. This can help to control the worsening of myopia4. A seven-year clinical trial reported that in the first three years MiSight® 1 day contact lenses reduced the worsening of short-sightedness in children by 59% on average, compared to those using single vision contact lenses*4.

Essilor® Stellest® lenses are Essilor®’s best solution to fight your child’s myopia. The Essilor® Stellest® lens consists of a single vision zone and a myopia control zone made with Highly Aspheric Lenslet Target (H.A.L.T.) technology. The single vision zone ensures clear vision in all gaze directions. The H.A.L.T. technology, which is a unique constellation of invisible** lenslets, create a volume of non-focused light in front of the retina and following its shape. This signal helps to slow down the eye elongation, therefore slowing myopia progression. Essilor® Stellest® lenses are clinically proven to slow down myopia progression by 67% on average, compared to single vision lenses when worn at least for 12 hours per day every day5. At Boots Opticians Essilor® Stellest® lenses come with a 12 month prescription guarantee. If your child’s prescription changes within 1 year you can claim a like for like replacement pair of glasses6.

Speak to your local Boots Optician about MiSight® 1 day contact lenses.

Visit boots.com/myopia to find out more about how Boots Opticians can help you manage short-sightedness in children and to book an eye test.

3. Sulley A et al. Wearer experience and subjective responses with dual focus compared to spherical, single vision soft contact lenses in children. Optom Vis Sci. 2019; 96(E-abstract): 195252. 4. Chamberlain P et al. A 3-year Randomized Clinical Trial of MiSight Lenses for Myopia Control. Optom Vis Sci 2019; 96:556-567.

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5. Bao J, et al. Spectacle lenses with aspherical lenslets for myopia control vs single-vision spectacle lenses: a randomized clinical trial. JAMA ophthalmology. 2022;140(5):472-8. 6. Terms & conditions apply. Ask you local Boots Opticians for details.

15/09/2023 12:35

Growing Up Childcare and education news

TALKING ABOUT FEELINGS This year’s Empathy Day, held in June, aimed to celebrate and grow empathy’s power to create a better world, particularly for children. Shining a light on the role of books in raising an empathy-educated generation, Empathy Day inspired children to learn more about empathy, have transformational experiences through stories, and to put empathy into action. This year, the free online festival for children and families, streamed throughout the day on June 8th, featuring a brilliant line-up of authors and illustrators, aiming to give children the tools, confidence and knowledge to harness this very special power.

With the message that empathy consists of three interactive elements – thinking, acting and feeling – the day featured free expertly created resources for children and young people including a 2023 Family Activity Pack with activities to do at home, a 2023 Read for Empathy Collection of 65 books for 3-16-year-olds, selected by an expert judging panel and Empathy Shorts, exclusive and free empathy-boosting short stories by top authors including Chris Riddell, Rob Biddulph, Rashmi Sirdeshpande, Joseph Coelho, and Cressida Cowell. Empathy Action Month runs every November, providing a month-long opportunity for schools, libraries and families to focus on putting empathy into action, using the Empathy Resolutions they set during Empathy Day. Find out more at www.empathylab.uk.

NHS SPECIALIST CLINICS FOR OBESE CHILDREN Thousands more children and young people who are severely obese will receive intensive support from the NHS, with 10 new specialist clinics set to open across England. The new services will launch this year, bringing the total to 30 clinics that are able to provide expert help to children and their families which can prevent long term conditions including Type 2 diabetes. Around 3,000 obese children and young people aged between two and 18, will receive help to lose weight, treatment for complications as well as tailored care packages developed with their family, which could include diet plans, mental health care and coaching. Backed by £18 million over the next two years, the boosted rollout doubles the ambitions set out in the NHS Long Term Plan to introduce 15 new clinics in England. The expansion comes alongside figures showing that hospital admissions of obese youngsters under 17 has nearly tripled in a decade – going from 3,370 in 2011/12 to 9,431 in 2021/22. Research shows that the number of children living with severe obesity doubles from the start of primary school to the end of primary school – with latest data showing that one fifth of children aged 10-11 years are obese in England.

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Children’s Laureate Joseph Coelho launched the festival with a nationwide assembly, featuring special guests Cressida Cowell, Chris Riddell, Jacqueline Wilson, plus a new and exclusive poem.

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GROWING UP

CHILDCARE SUPPORT CHANGES

Sensory Stimulation

The government has announced that financial support available to parents to help with the cost of childcare is increasing. These plans include major changes to make it easier for parents with childcare responsibilities to move into or take on more paid work. Currently, in England, all parents and carers of 3 and 4-year-olds are entitled to 15 hours a week childcare support with registered childcare providers. Eligible working parents and carers of children aged 3-4 can also get an additional 15 hours childcare support, bringing their total up to 30 hours a week. Some parents of 2-year-old children may also be entitled to 15 hours support. Hours can be used per week for 38 weeks of the year (during school term time). You may be able use your hours for up to 52 weeks if you use fewer than your total hours per week. You can use Tax-Free Childcare or Universal Credit for Childcare whilst claiming your 15 or 30 hours of childcare support. Starting from April 2024,

existing childcare support will be expanded in phases. By September 2025, most working families with children under the age of 5 will be entitled to 30 hours of childcare support. The changes are being introduced gradually to make sure that providers can meet the needs of more families. This means that from April 2024, working parents of 2-year-olds will be able to access 15 hours childcare support, and from September 2024, 15 hours childcare support will be extended to working parents of children from the age of 9 months to 3-year-olds. From September 2025, working parents of children under the age of 5 will be entitled to 30 hours of childcare a week. Like the existing offer, depending on your provider, these hours can be used over 38 weeks of the year (during school term time), or up to 52 weeks if you use fewer than your total hours per week. Find out more at www.childcarechoices.gov.uk

Unleash boundless imagination with Bilibo by Moluk, £27.99! This versatile wonder invites children to sit, spin, sled, scoop, and invent countless adventures. Winner of the Toy of the Year award, it’s suitable for indoor and outdoor play. Made from durable, recyclable plastic, it’s easy to clean and transport. Plus, it provides sensory stimulation when spinning and doubles as a comfy seat, a winner all-round. www.sensoryplayground.co.uk

LEARNING VALUES Discover Atom Learning — an innovative educational technology company dedicated to enhancing academic outcomes for children aged 7-11. By breaking revision and exam prep into bitesize sessions, they make time for rest and fun. Help your child keep perspective and value the learning process. Learn more about stress-free exam prep at www.atomlearning.com.

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Healthy Exam Preparation with Atom Learning

Atom has mas sively helped my daughte r’s motivatio n. She enjoys it , I enjoy it. If she’s happ y, she’s willin g to do the wo rk!

Atom Learning wants to help children love learning and reach their potential. Here are Atom's tips to help your child feel calm and confident about their upcoming test.

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Start early

Calming strategies

Start revision well ahead of test day. Last-minute

Teach your child strategies to stay focused in the

cramming causes stress and overwhelm. Instead,

exam room. Don’t get derailed by difficult questions

create an achievable revision plan with your child to

– make a note to return to them later. Try box

help them make small gains and stay motivated.

breathing to help clear their mind.

Little and often

Spot the signs

We learn best in bitesize chunks. 10–11-year-olds

Be ready to spot the signs that your child is

should spend no more than 2.5 hours a week on

experiencing exam stress. Check in with your child

home learning. Break it down into daily sessions of

often. Talk to their GP and teacher for advice.

20–30 minutes. Build in plenty of time for breaks, rest and fun.

Keep perspective

Growth mindset

Make sure your child knows that trying their best is all you ask. Everything will be OK even if the

A growth mindset is the belief that our abilities are

exam doesn’t go as expected. Find strategies to

not fixed. Instead, we can develop over time with

stay calm yourself, even when it feels like a lot is

hard work and support. People who value learning

riding on their results.

are more likely to enjoy long-term success than those who only value the outcome (such as a top grade or a place at a specific school).

No surprises We’re programmed to fear the unknown. When we

Praise the process

know what to expect, we’re more likely to be confident and focused. Make sure your child is

Your child’s mindset is influenced by the type

familiar with the layout and timings of the test

of praise they get. To encourage a growth

papers and how to pace themselves.

mindset, praise your child for reaching milestones

We recommend 1–2 practice tests each week in the

and learning from mistakes. Celebrate their progress together.

lead-up to the exam. On exam day, your child will be able to focus on showcasing their knowledge.

Head to atomlearning.com to learn more about how to make exam preparation stress-free.

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GROWING UP

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Teaching by Example Formal education has become a minefield of examinations, assessments and stress for both pupils and parents. Are there better approaches to teaching?

hat with the after-effects of the pandemic lockdown, an increased emphasis on exam results and qualifications, and OFSTED assessments driving teachers to despair, it’s never been harder to negotiate the minefield of formal education. From choosing the ‘right’ school to helping with homework and dealing with exam stress, parents and pupils are finding it harder to keep up with the demands of the education system. One approach is to look at private

tutoring in addition to formal education. In a busy classroom, full of distractions, children can sometimes miss important information, and as the class progresses, children can get left behind, afraid to ask for help. These gaps in learning can have long-lasting effects, particularly in English and mathematics. Private tutoring, which can take place at home, in after-school classes or online, can often help students catch up and restore their confidence. The first step is to recognise when

they need help. Students struggling with learning gaps might respond to being overwhelmed by being disruptive in class. Children and teens often find it difficult to admit they are uncomfortable with the workload in front of them, especially when they see their classmates coping when they feel overloaded. They may react with frustration, anger, or emotional outbursts. If your child is usually well-behaved and has been recently misbehaving, it is important to discuss their learning and behaviour with a trusted teacher. »

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The longer it takes to address this behaviour, the more danger there is that the pupil is missing key concepts and will struggle even more to catch up later. STRUGGLE But some children can struggle silently in class, and signs of unease may first show themselves at home, through changes in mood or self-esteem. Another obvious sign is if they are having difficulties with homework. Most homework assignments will have a specific time allotted – if your child is taking an hour to complete a 15-minute assignment, it’s an early sign that there is a problem that needs to be addressed. There’s often a problem that the parent cannot help directly with homework because they don’t understand it themselves! – modern mathematics is a key area in which this can be the case. School reports and exam results will often be the confirmation that the child needs extra help. Once a problem has been identified, parents can work with teachers to address the problem, or if they feel for any reason that the child is not getting enough attention in school, they may opt for home

tutoring or support from a professional tutor. Professional tutoring is highly focused teaching that can identify gaps in learning and address them specifically. Qualified tutors will have the time and skills to teach a student the concepts they have missed, before helping them catch up and keep up in class. Part of the result is that the pupil starts to enjoy learning again, building their confidence in school classes. TUTORING In a professional tutoring programme, either in person or online, qualified teachers will conduct an assessment of the pupil’s abilities and will identify any learning gaps. A tailored learning programme will then be developed for each child specific to their needs to help them catch up and keep up in class. Whether this tutoring takes place in the home, in small groups after school, or as part of an online programme, the aim is to give the one-to-one support that children may not always be receiving in large classes in school. Learning mathematics is one of the most essential elements of child education, but some parents struggle to help. According

to Further Education News, as many as 47 percent of 2,000 mums and dads of children under 16 polled said that mathematics is the hardest assignment of all. Just one in four parents believe they can confidently answer questions about algebra, while equations leave 35 per cent completely stumped, and even basic multiplication tables leave 14 per cent scratching their heads according to the research. Maths can be a harder subject for parents than for some children, because there’s a lot more to it these days than just adding and subtracting – indeed some of the ‘modern maths’ questions posed to kids at school might not even look like the sort of maths their parents understand. Fortunately, there are all kinds of ways you can help. Here are a few of the ways parents (and grandparents!) can help with maths teaching at home. NUMBERS FIRST. Basic numeracy is the building block of all mathematical learning. You don’t need any special equipment to start with – a collection of blocks, coins, buttons, or toys is enough to teach the simple 1-10.

Losing Interest A study by OnePoll showed that as many as 52 per cent of mums and dads of children under 16 polled believe children are expected to learn too much in school. The average time children do homework before losing interest was revealed to be 23 minutes. Mathematics, English and History were found to be the subjects children have a particular low attention span for, and the study showed that 61 per cent of parents rely on the internet to search for answers when helping their child with their homework.

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DEVICES For older children, smartphones or tablets can be the ideal teachers, with educational apps providing a measurable method of education. In a study, educator Laura Outhwaite found that “Children aged four to five years who used maths apps for 30 minutes a day over 12 weeks, either instead of a small-group, teacher-directed mathematical task or as an additional activity during free play, made two to four months’ greater progress in mathematics compared to their peers.” (The Use of Interactive Maths Apps to Support Early Mathematical Development in UK and Brazilian Primary School Children, PhD Thesis, University of Nottingham 2018).

VALUES NEXT. The next stage is to show that objects don’t all have to be the same to be counted together – mixing different objects expands the thought processes and introduces the subjects of multiplication, subtraction and division. Combine maths lessons with other subjects such as cooking, where proportions, fractions and shares can be introduced.

IMAGES: Dreamstime

FLASH CARDS. This basic teaching tool works better for some kids than for others. For some, counting objects on a card helps, while for others, having separate physical objects works better. Try both to establish which works best. GAME THEORY. There’s no way around it, maths can be dull if you don’t look for the fun in it. Look for educational games online and in app stores, and make up your own indoor and outdoor games such as problem-based treasure hunts. An abacus is a useful maths teaching tool which can also pass as a toy. DAILY ROUTINE. Incorporate maths teaching into daily life and set goals for your kids. Everywhere you go can be a maths

lesson – count cars on the street, boxes on shop shelves, people in queues – set simple problems such as dividing up a bag of sweets. So, home tutoring and professional tutoring are alternative ways to get your kids back on track in education. But there are also methods to bring out skills in areas they didn’t know they had a talent for, such as music. PLAY AWAY Fostering a talent for music can be difficult as classes and facilities are often cut in cash-strapped schools. But if your kids show a serious interest in learning music, it’s worth investigating different methods of education, such as the Kodály, Orff, Suzuki and Dalcroze systems. First introduced in Hungary, based on the work of Zoltan Kodály in the 1930s, the Kodály Method is a way of developing musical skills and teaching musical concepts beginning in very young children, using songs, hand signs, pictures, rhythm symbols, and syllables. The Kodály method emphasises use of the singing voice, along with tonal instruments such as xylophones and recorders, and the method progresses to include playing, composition, improvisation and reading and writing music. Find out more about the Kodály music teaching method at www.kodaly.org.uk. Developed by Carl Orff, the composer of Carmina Burana, the Orff approach has a

lot in common with the Kodály technique, also incorporating elements of play, singing, dancing, and acting, and starts off using percussion instruments such as xylophones, metallophones, and glockenspiels. Orff teachers design their own lessons, adapting them to suit the size of the class and age of the students. A teacher may for instance choose a story to read in class, then ask students to choose instruments to represent a character or a word in the story or poem, adding sound effects as it is read. Learn more about the Orff approach at www.orff.org.uk. Japanese violinist Shinichi Suzuki modelled his system on a child’s innate ability to learn their native language. The Suzuki method uses listening, repetition, memorization, and building vocabulary. Parental involvement is common – parents often learn the instrument along with the child, acting as musical role models, and maintaining a positive learning atmosphere. The Suzuki method was originally developed for violin, but is now also applied to piano, flute, and guitar. Find out more at www.britishsuzuki.org.uk. The Dalcroze method, also known as Dalcroze Eurhythmics, was developed by Swiss teacher Emile Jaques-Dalcroze, and starts with ear training, or solfege, to develop the inner musical ear. The Dalcroze method emphasises multi-sensory learning techniques, so music is taught through tactile, kinesthetic, aural, and visual senses. Find out more at www.dalcroze.org.uk. ■

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Parenting Development and family news

SUMMER SEES RISE IN BITES AND STINGS

KIDS TO GET FLU VACCINE Millions of children in England will be offered a flu vaccine from September, as the NHS steps up its life-saving vaccination programme to protect the country against deadly viruses ahead of winter. School aged children will be able to get the flu vaccine at school or at community clinics, and those with long term health conditions can also get the vaccine at GP surgeries. Children aged two and three years will be able to get an appointment with their GP practice. The NHS winter flu and covid-19 vaccination programme provides vital protection to those eligible and their families over winter, keeping people from developing serious illnesses, and helping to minimise hospitalisations during busy winter months. The NHS will start by prioritising flu vaccinations for children, to prevent children from getting seriously ill from flu and ending up at hospital, and to break the chain of transmission of the virus to the wider population.

Visits to the NHS website’s insect bites and stings page tripled this summer. Analysis by NHS England, which runs the NHS.uk website, found monthly visits to the insect bites and stings page reached 261,364 in June 2023 – triple those seen in June 2022 when there were 86,984 visits, and more than double the number in June 2021 with 102,934. The biggest spike was from 12 to 18 June 2023 when there were 91,630 weekly visits to the page – equivalent to one view every seven seconds. Insect bites or stings are not usually serious and get better after a few days, but they can cause infection or serious allergic reaction. Dame Ruth May, NHS England’s chief nursing officer, said: “We often see a rise in insect bites and stings during the summer months, but the number of people seeking advice from the NHS website has really spiked this year, suggesting there has been a significant increase. “The NHS.uk website is available 24 hours a day offering advice on a range of conditions including bites and stings. It provides tips on easing swelling and itching, as well as helping people identify more serious symptoms needing urgent medical attention.”

Deputy Chief Medical Officer Dr Thomas Waite said: “I’d encourage all eligible people to come forward for their flu and Covid jabs as soon as they’re offered them. They can be lifesaving. Administering vaccines to children in September and adults in October will protect people throughout the winter months.” The nasal flu vaccine is the most effective vaccine for children aged 2-17 years but if this is not suitable the GP or practice nurse may be able to offer a flu vaccine injection as an alternative.

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TV COMIC EXPLORES EXTREME PARENTING

Comedienne Katherine Ryan is to explore ‘extreme parenting techniques’ in a new TV series, Katherine Ryan: Parental Guidance. The show will observe the comedian as she juggles being a parent and a stand-up performer, and will see her investigating a range of parenting techniques. She says: “Parental Guidance gives plenty of food for thought while putting comedy front and centre.” The producers say that the series will look at “unconventional parenting techniques and ‘alternative’ lifestyles from potty training at eight months to co-sleeping”. Canadian Katherine had a relationship with American comedian Alex Edelman and gave birth to her first child, a daughter, at the age of 25. In 2019, she entered into a civil

partnership with Bobby Kootstra. The ceremony took place in Denmark in the presence of her eldest daughter. The two had dated in Canada as teenagers and were reunited when Ryan returned to her home town while filming an episode of the TV show Who Do You Think You Are? Her second child, a son, was born in June 2021, and her third child, a daughter, was born in December 2022. Four hour-long episodes are being filmed by Expectation, the production company that also worked with the comic on her Amazon Prime stand-up showcase series. Katherine Ryan: Parental Guidance - currently a working title - will air on the freeto-view W channel and UKTV Play platform in 2024.

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IMAGES: Dreamstime, Expectation TV

RIGHT FOR YOUR FAMILY Choosing the right family lawyer for your case is absolutely crucial. It can make the difference between getting an outcome that you are happy with or realising too late that you made the wrong decision. Our divorce and Family Law department has a reputation for excellence and are members of a variety of prestigious organisations and our Children Law team boasts some of the country’s leading experts. You can be assured that each of our lawyers have unrivalled experience in both building and implementing a strategic action plan which will move your case forward to a positive conclusion. www.mcalisterfamilylaw.co.uk

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All Part of the Game?

undreds of gamers including children and their family members have been treated by the NHS National Centre for Gaming Disorders. Data reveals that 745 people have been referred for treatment at the UK’s only gaming clinic since it opened in October 2019. Gaming disorder means a person struggles to control how often they play video games, which can be up to fourteen hours a day or more, with some cases resulting in avoiding school or work, breakdown in family relations, general withdrawal from society and even violence. The numbers of gamers getting treated increased by more than half from 2021 to 2022, while family members of

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those suffering from a disorder receiving treatment increased by 46 percent. NHS consultant psychiatrists, psychologists, psychotherapists, and family therapists working at the clinic offer treatment to people aged 13 and over suffering from a gaming disorder, as well as their family members. Depending on patient need they can be offered a range of treatments including family consultations, individual or group therapy, parent workshops, ongoing parent support groups, and family therapy. ONLINE The national centre is based in London, but treatment delivery is mainly online making it accessible to the whole of

England without patients having to travel for treatment. Anybody thinking they or their child may benefit from support can be referred into the clinic by their local NHS or can go online to the gaming clinic website to self-refer themselves. NHS National Centre for Gaming Disorders founder and director Professor Henrietta Bowden-Jones said: “Gaming disorders can have a significant impact on children and their family to the extent it can take over and stop them from living their normal daily life. “From avoiding school or work, engaging in violence, to family breakdowns, the harms to those suffering can be significant; but there is help from the NHS for those who need it. “We also know as with other addictive

IMAGES: Dreamstime

Video games are fun for all ages, but can lead to serious addiction problems in children and adults. Now an specialist NHS clinic aims to help out

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and mental health disorders, the earlier they are identified and treated the more successful the outcomes will be for both the individual but also for the wellbeing of the family members who are also impacted negatively by someone’s excessive gaming. “If you are struggling with your mental health do seek help from the NHS – you can contact your GP or refer yourself online to our world leading talking therapies service or if you are in a crisis, you can call your local helpline 24/7.” Minister for Primary Care and Public Health Neil O’Brien said: “Technology can be hugely beneficial – from developing problem-solving skills, to socialising and helping people ‘switch off’ and relax. “As with anything, too much of it is a bad thing – and we know gaming can be addictive. There are ways to prevent gaming addiction, which include recognising the warning signs and monitoring your online activity if and when you’re worried.

“This gaming clinic is a great example of the wider work happening to fight and help treat addiction across the UK, including investing an extra £2.3 billion a year by 2024 to expand mental health services to enable better access to vital support.” TREATMENT The average age of a gamer seen by the clinic is 17, with children aged between 13-14 and 16-17 also representing a higher number of the patients seen. Treatment length varies based on patient need, ranging from a one-off session to family therapy lasting over a year, the average treatment time is around three months representing 12 treatment sessions. Lisa from the Midlands contacted the NHS gaming disorder centre last year following escalating issues with her 14-year-old son Ryan. Ryan, previously having no diagnosed mental health condition, had become addicted to games to the extent it was

impacting his life. Gaming disorder caused increased aggressiveness while playing games resulting in strained family relations. To get support with help managing Ryan’s condition Lisa joined the gaming clinics parents’ workshops, attending six sessions with a qualified psychologist, as well as attending follow-up one-on-one counselling sessions with her husband. Since attending the sessions Lisa’s own mental health has improved as well as having improved relations with her son with new strategies to help manage his condition. Lisa said: “I highly recommend the National Centre for Gaming Disorders for anybody who thinks they may need support for either themselves or a loved one struggling with a gaming disorder. “The group sessions helped me feel like I wasn’t alone and by sharing stories with people in similar situations, I also didn’t feel judged, instead feeling supported and comfortable in seeking support. “Through both the group and individual sessions I not only felt listened to, but I also learned some invaluable strategies for helping my child which has made a real difference in helping improve management of the disorder. “Anybody who thinks they may need support should come forward for care.” ■

NCGD The National Centre for Gaming Disorders is a multidisciplinary clinic in the UK that provides treatment for people in England, aged 13 years and over, who have difficulty controlling their video game use and the impact it has on their lives. It also offers parents, guardians and family members support alongside the person gaming. www.cnwl.nhs.uk/nationalcentre-gaming-disorders

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Stressing the Point Raising children can be stressful, but talking to them about their own stresses can be just as hard. Here are some thoughts about easing the burden

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hottest trends, the temptations of drugs, self-image and sexual identity, obsessive behaviours such as gaming addiction, and more. So every child has different stress points, but common themes often emerge. The Children’s Society suggests that these stress point can in fact be used as an opportunity to develop emotional resilience and learn to handle difficult situations later in life. The anxieties that these stresses lead to can cause emotional and even physical harm, so it’s important to know how to cope with them, both as a child and as a parent. Though you may not be able to change what is causing them stress, helping children to cope with it is one

of the ways parents and guardians can help most. SIGNS The Children’s Society explains that it isn’t always easy to recognise the signs of stress in children; apart from anything else they may choose to hide the signs of stress. But there are some pretty obvious signs, such as moodiness or irritability, changes in eating or sleeping habits, or persistent minor health issues such as headaches or stomach aches. While it’s important to recognise these signs and offer help and support, some children and teenagers will not accept help at this stage. Even a negative

IMAGES: Dreamstime

ith all the stresses of adult life – paying the bills, juggling work and home life, health and relationships – it’s sometimes easy to forget that kids suffers from stress too. In fact, with the current crisis in mental health services for children and teens, it’s obvious that society is putting children and teens under more and more pressure, from exams, social media, self-image and the traditional worries of adolescence. Children stress about different things, but there are some themes which seem to come up over and over again; school issues such as bullying, peer pressure to dress in the latest style and follow the

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response is something, and at least it makes the child aware that you are approachable and willing to help when they feel more comfortable to discuss their stress points. Showing a more vulnerable side can help – being open about your own stresses can help strike up a conversation – though don’t try to turn it into a competition! Most people, children included, are worried they are the only one that behaves or feels a certain way when they are stressed, so it always helps to show them that they are not alone. It’s important to acknowledge that you may not be able to solve the causes of their stress; this is something they may have to do themselves, with the help of others, or just in the course of time. The important thing is to allow the child or young adult to be heard. Sometimes, letting them talk through their feelings goes a long way to helping them come to terms with them, and sometimes it can turn out that their worries are groundless. Don’t judge a child’s ideas – the way you deal with a problem may be nothing

The Children’s Society The Children’s Society is a national charity working to transform the hopes and happiness of young people facing abuse, exploitation and neglect and supporting them through their most serious life challenges. Established for 140 years, its aim is to build a society where hope is alive in every child. www.childrenssociety.org.uk like the way they would, so don’t scorn their opinions or just tell them they’re wrong in their thoughts or opinions. EXERCISE In cases where talking doesn’t seem to offer immediate relief, or indeed is triggering further stress, it’s a good idea to

look for other forms of stress relief. Exercise is often described as the best medicine, and if a child or teenager is inactive, it gives them more time to concentrate on negative thoughts. Exercise will clear the minds and distract them from their problems, and can take many forms, from a simple walk in a park to organised team sports. In many cases, the physical activity alone, or the sense of camaraderie in team sports, is enough to move focus from stress factors and promote a much healthier outlook. The new perspective offered by outdoor exercise often has a valuable emotional benefit. While mobile phones and other digital devices are often associated with stressgiving social media, they do also have something to offer stressed children and teens. Apps such as Breathe2Relax, a portable stress management tool, Calm, an app for meditation and sleep, and Headspace, a ‘mindfulness’ app, will help your kids train their minds for a healthier, happier life by reducing daily anxieties and stresses. ■

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The Law

and Your Family For many years family law and particularly cases involving children have been conducted in obscurity. Now a new scheme aims to shed more light

The Law Society of England and Wales warns that in 13 out of the 42 designated family judge areas in England and Wales, the wait is double the recommended target of 26 weeks. CAFCASS, the Children and Family Court Advisory and Support Service,

currently has over 30,000 open children’s cases, with over 50,000 individual children affected. Children involved in private family law cases who are waiting for decisions on living arrangements after their parents have separated also face similar delays. »

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here’s a crisis in the UK’s family law system. Thousands of children are being left in limbo as a result of care proceedings and parental separation cases taking more than a year to resolve.

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PROCEEDINGS There are currently more than 80,000 children caught up in private family law proceedings, according to court statistics. In 2022, the case duration in private family law was 44.9 weeks. “What is often missed in the debate around the unacceptable backlogs in our family courts is the impact on children. They are suffering the very real consequences of months and sometimes years of uncertainty about their future, preventing them from having the stability they need to thrive,” said Law Society president Lubna Shuja. “Our members are telling us of instances where court delays are leading to increased tension between parties. This is undermining a collaborative and childcentred approach to family separation.” The Law Society is calling on the government to restore early legal advice in family law cases to help parents better understand their rights and their options for resolving issues involving children.

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PRIVACY Certainly family law can be complex. For reasons of privacy cases involving children are often held in private, so normal rules of reporting do not apply. For some time, it’s been argued that this lack of transparency can act against the interests of concerned parties, so a trial scheme has now been put in place which aims to shed some light on family court proceedings. In January 2023, the Transparency Implementation Group Reporting Pilot launched in Cardiff, Leeds and Carlisle. The aim of the pilot is to introduce a presumption that accredited media and legal bloggers may report on what they see and hear during family court cases, subject to strict rules of anonymity. The ability to report is being piloted to make sure it can be done safely and with minimum disruption to those involved in the cases, and the courts. This will be done through judges in these courts making a ‘Transparency Order’, which sets out the rules of what can and cannot be reported.

The President of the Family Division, Sir Andrew McFarlane said: “The reporting pilot in Leeds, Carlisle and Cardiff marks the start of the judiciary’s ongoing work to make transparency in the Family Court a reality. Openness and confidentiality are not irreconcilable, and each is achievable.” BLOGGERS Sir Andrew continues: “Following the publication of the Transparency Review in October 2021, and over a year of discussions with practitioners, journalists, legal bloggers and other stakeholders, accredited media representatives and legal bloggers in the pilot areas will be able, not only to attend and observe family court hearings, but also to report publicly on what they see and hear. “Reporting must be subject to very clear rules to maintain both the anonymity of the children and family members who are before the court, and confidentiality with respect of intimate details of their private lives.”

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PARENTING

McAlister Family Law McAlister Family Law is Beyond Law Group’s award-winning specialist Family and Children Law Practice. Family law is all that we do – it is our passion. We recognise that all families are different and come in different shapes and sizes. We also recognise that family life is a journey and can take different twists and turns. It is when the turns happen that we are there to provide support, guidance, and solutions. Our lawyers are specialists, not generalists and it is this which sets our practice apart from most other law firms. Our team boasts six specialist divisions including divorce and finance, children law, unmarried property disputes, new age families and international law.

IMAGES: Dreamstime

The Reporting Pilot is the pilot scheme for one of the main recommendations from the President of the Family Division’s Transparency Review, which was published in October 2021. The family justice system exists to help families avoid disputes as far as possible but also, if disputes or problems should arise, to enable them to resolve those problems quickly and with the minimum of pain caused to those involved. If at all possible, the parties are encouraged to resolve their disputes out of court, for example through mediation – on the grounds that they are more likely to stick to any agreement if they themselves have had a role in formulating it. DIVORCE When disputes do come to the courts, the cases are dealt with by magistrates and judges specially trained to deal with issues affecting families. These disputes often involve very difficult circumstances, for example relationship breakdown or child contact. Judges and magistrates work to make the circumstances of family disputes

less adversarial and hearings can often be quite informal with, for example, all parties sitting around a table. “Public” work is the term used for cases when local authorities take action to remove children from their parents’ care because they are being hurt in some way. Such cases can lead to children being adopted, and these are also dealt with by a family judge. Lots of people who become involved in a family court case have never been to court before and don’t know what to expect. The Family Court works like any other court by following rules, and by making decisions based upon evidence after every person involved has had a chance to see the evidence and to have their say. Although the Family Court is less formal than some courts (no wigs and gowns for example) there are still rules and procedures that you might not know about, and for that reason, it’s advisable to consult a specialist family court solicitor if you are involved in any family court cases. ■

The practice is led by Amanda McAlister who is herself divorced, is a parent and step-parent and therefore understands first-hand the challenges that a relationship breakdown can bring. Our purpose is to deliver life changing results for our clients, and it is our success in achieving positive outcomes that has led to our success. All aspects of child and family law can be complex and confusing. The reason being, when a relationship breaks down or a new one begins, it can be a very emotional time. The ability to think straight can be challenging and searching for answers online can produce more questions than answers. Seeking initial advice from a specialist family lawyer early on can make a significant difference to the outcome of a case. McAlister Family Law offers a free initial consultation to all readers of Healthy Child magazine and can be contacted on 0333 202 6433.

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BECAUSE CHILDREN DO HAVE A VOICE BECAUSE CHILDREN DO HAVE A VOICE MCALISTER FAMILY LAW IS ONE OF THE COUNTRY'S LEADING FAMILY AND CHILDREN LAW PRACTICES MCALISTER FAMILY LAW IS ONE OF THE COUNTRY'S LEADING FAMILY AND CHILDREN LAW PRACTICES

McAlister Family Law is Beyond Law Group’s specialist child and family law practice. Our award-winning team is totally passionate about the rights of McAlister Family Law is Beyondthat Lawnot Group’s specialist children, and we strive to ensure only their voice is child heardand at allfamily times law but practice. Our award-winning team is totally passionate about the their relationship with all family members is maintained where safe to dorights so. of children, and we strive to ensure that not only their voice is heard at all times but their relationship all family members is maintained whereyears safe of to experience do so. Led by Managingwith Partner, Amanda McAlister, the team have

in advising and representing parents carers, grandparents and step-parents Led McAlister, the team have years of experience and by areManaging the knownPartner, leadersAmanda in the field. We deliver life changing results not only to in advising and representing parents carers, grandparents and step-parents adults of all nationalities, ages and backgrounds but also to children them and are the known leaders in the field. We deliver life changing results not only to selves. adults of all nationalities, ages and backgrounds but also to children them selves. Many legal practices advocate being able to offer children law services, but few have secured endorsement by the Law Society as accredited specialists. The Many practices being able toisoffer children law services, but few reasonlegal being, the test advocate for such accreditation extremely high and involves being have secured endorsement by the Law Society as accredited specialists. The able to demonstrate a high level of skill in all child law related cases. reason being, the test for such accreditation is extremely high and involves being able to demonstrate a high levelinofadvising skill in all and childrepresenting law related cases. We have years of experience children, parents, carers, grandparents and stepparents and we are the known leaders in this field. We have years of experience and representing children,ages parents, We deliver lifechanging results in notadvising only to adults of all nationalities, and carers, grandparents and stepparents and we are the known leaders in this field. backgrounds but also to children themselves. We deliver lifechanging results not only to adults of all nationalities, ages and backgrounds but also to children themselves. | 0333 202 6433 Contact us: hello@mcalisterfamilylaw.co.uk Contact us: hello@mcalisterfamilylaw.co.uk | 0333 202 6433

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