Baby's and Beyond Issue 3 - October 2014 by Media Xpose

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October - December 2014

Giving birth with girl power Baby skin care â&#x20AC;&#x201C; an evolving science What is birth etiquette all about? Pool protection protocol A sun-smart summer www.babysandbeyond.co.za

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CONTENTS Features

Giving birth with girl power

Take the ‘s’ out of stress

Baby skin care – an evolving science

T he financial implications of having a child

Making Finn

Know your rights

Hush, little baby…

What is birth etiquette all about?

Universal interventions for bullying

A strong foundation

Television and your child

Holiday time

Where dreams are made

The dummy debate

The critical first 1 000 days

Arm yourself against medical bullies

An incredible journey

Pool protection protocol

Regulars 20 Health: A sun-smart summer

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38 Health: The low down on middle ear infections 40

Dad’s Diary: A passionate love affair

46 Health: Treating ADD and ADHD 80 Grab some grub: Butterfly chicken Portuguese/North African Style 81 Grab some grub: Fruit ice creams with Jelly Baby surprise 83

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Baby’s and Beyond

CREDITS babys beyond

October - December 2014

Editor: Emma Dawson editor@babysandbeyond.co.za

and

October - December 2014

Giving birth with girl power Baby skin care – an evolving science What is birth etiquette all about? Pool protection protocol

Editorial Contributors Barbara Eaton Claire O’Mahony Craig Wilkinson Dr Beverly Evangelides Dr Marco Knappe Erica Lötter Jude Pollack Peter Hewett Suzette Cloete Tanya Hanekom

Content Coordinator: Melanie Taylor artwork@mediaxpose.co.za

A sun-smart summer

Design: CDC Design carla@cdcdesign.co.za

www.babysandbeyond.co.za www.babysandbeyond.co.za

ISSN 2311-5467

Project Manager: Elroy Van Heerden elroy@babysandbeyond.co.za

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Advertising Sales: Lorraine Beneke lorraine@babysandbeyond.co.za Ehrin Manuel ehrin@babysandbeyond.co.za Alison Davids alison@babysandbeyond.co.za A-eeshah Davids aeeshah@babyandbeyond.co.za Chief Financial Officer: Shaun Mays shaun@mediaxpose.co.za Accounts Assistant: Melany Smith accounts1@mediaxpose.co.za Website: www.babysandbeyond.co.za Printing and Distribution: Paarl Media Paarl www.paarlmedia.co.za

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404 Commerce House, 55 Short Market Street, Cape Town, 8001 PO. Box 15165, Vlaeberg, 8018 Tel: 021 424 3625 Fax: 086 544 5217 E-mail: info@babysandbeyond.co.za Disclaimer: The views expressed in this publication are not necessarily those of the publisher or its agents. While every effort has been made to ensure the accuracy of the information published, the publisher does not accept responsibility for any error or omission contained herein. Consequently, no person connected with the publication of this journal will be liable for any loss or damage sustained by any reader as a result of action following statements or opinions expressed herein. The publisher will give consideration to all material submitted, but does not take responsibility for damage or its safe return.

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ED’S NOTE A time for giving As the newly-appointed editor of Baby’s and Beyond, I’ve had a busy but extremely fulfilling month putting together this Summer Edition, jam-packed with great reads. It’s been a pleasure working with our contributors and advertisers, and a delight to discover the scope of knowledgeable professionals and service providers who not only love the magazine but are also happy to contribute to its content to bring you, our dear readers, some great advice, information and interesting points of view. With the weather getting warmer, the days longer, and the promise of holidays approaching, we cover some important summer-related topics in this issue. Allergies, while not just a summer infliction, can be exacerbated by the change of season – particularly those related to pollen and grasses. Understanding allergies (p26) provides advice about determining whether or not it’s an allergy you or your child is suffering from. Thinking of your summer holiday? Don’t miss our tips for planning a relaxing break with your kiddies (p54), or information about how to keep children safe from drowning (p71). Another hot topic is protection from the harsh African sun and ensuring you have a sun-smart summer (p20). On another topic, I was fascinated to talk to Susan Newham-Blake, author of Making Finn, about same-sex parenting and her journey to fulfilling her dream of being a mom (p24). These days, with the number of divorcees, single parents and blended families, the conventional notion of a nuclear family headed by two parents biologically related to the children is no longer the norm. Same-sex headed families are just one of the many reflections of modern society. And talking of families, for many of us December is a time for holidays, lavish meals, gifts and time spent with our nearest and dearest. But spare a thought for those less fortunate. Thankfully, South Africa has many angels looking out for those in need. One organisation that ensures children from impoverished or high-risk backgrounds get the best possible start in life is Cotlands (p69). Another is SOS Children’s Villages (p65), which proves miracles happen when people work together. I applaud these truly remarkable people who care for those in need and work hard to make a significant difference in the lives of others. As this issue goes to print my mind is already churning with ideas for the next edition. I invite you to write to me (editor@ babysandbeyond.co.za) to share your news, views and your stories. In the meantime, I wish you a safe, happy and healthy holiday season with your loved ones. Emma

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FEATURE

Giving birth

with girl power

Giving birth can, and should, be a woman’s most precious and cherished memory. Or it can be a painful, harrowing experience that’s only dredged up when trading horror stories with other moms at play group. A bit of girl power from a midwife or doula can make all the difference. In the modern maternity system, it’s all too easy to forget that birth is an emotional and spiritual rite of passage for women, with beeping monitors, bustling nurses and routine interventions taking the shine off what should be a positive and uplifting experience. Having a beautiful birth experience can be as easy as going back to our roots, when women relied on other women to guide and support them through childbirth. Jude Pollack, founder and director of

Genesis Clinic in Johannesburg, believes women should consider bringing a midwife and/or a doula onto their birthing teams. A midwife is a trained health professional who helps deliver the babies of healthy moms who’re having normal, uncomplicated, low-risk pregnancies. A doula is a skilled ‘childbirth companion’ who offers emotional and physical support to moms throughout their labour. ‘Together,’ Jude explains, ‘they’re a mom’s best chance of having a beautiful, safe, natural birth.’

First-hand experience Carlyn Ferreira gave birth naturally to her son Levi (now 4) and daughter Noa (now 13 months) with a midwife and doulas at her side. Both times – first a water birth at Genesis Clinic’s active birthing unit in Johannesburg, and the second in her own home – the experience, she claims, was truly phenomenal. She credits these great birth experiences entirely to the women who supported her. Carlyn began her first pregnancy under the care of a gynaecologist, never imagining she’d have anything other than the usual www.babysandbeyond.co.za

FEATURE hospital delivery. It was during her antenatal classes that she discovered a clinical hospital birth wasn’t her only birth option. ‘I realised that I wanted a more personal pregnancy and birth experience, one where I could sit and chat to my caregiver about anything, without being rushed or pressured, and later could give birth in a way that felt right for me,’ she remembers. Thanks to midwife, Karen van der Merwe, and doulas, Michelle Walton and Sally Baker, that’s precisely the experience Carlyn had. ‘Levi’s birth was so calm and positive,’ she recounts. ‘Karen was with me constantly from the beginning of labour right to the end, guiding me through it and helping me to give birth as naturally as possible.’ While her midwife was taking care of all the necessary medical checks, Carlyn’s doulas or ‘childbirth companions’ were ensuring that mom was taken care of. ‘They were such a wonderful support emotionally,’ Carlyn explains. ‘I was doted on by both doulas. I felt very connected to Sally, who knew exactly what I was going through. She was a quiet, reassuring support for me and my husband, Joe. And after the birth Michelle did all my postnatal visits and popped in for tea to see how I was doing.’

Benefits of girl power If you’re having a healthy, uncomplicated pregnancy, there are good reasons to bring a midwife and/or doula into the labour room with you, even if you’re planning a hospital birth. ‘Midwives and doulas play a huge role in creating a calm and supportive environment for labouring moms,’ says Jude. ‘And, when moms feel relaxed, calm and supported, their labour is quicker, easier, and they have less need of drugs and medical interventions. We also find that moms who have positive birth experiences are less likely to get postpartum depression, will bond better with their babies, and have a higher breastfeeding rate.’

What does a midwife do? ‘A midwife will manage your prenatal care and checks, and advise you about all aspects of pregnancy, birth and caring for your newborn,’ Jude explains. ‘She will help you to deliver your baby naturally, whether in a hospital, clinic or at home, with minimal drugs or medical interventions. If needs be, she will refer you to a gynae or obstetrician. After the birth, she will see to your postnatal care and monitor your baby’s progress.’

Why you might want a midwife? • You want a more personal birth experience. • You want emotional and practical support before and after your baby’s born. • You want to feel empowered and in control during the birth. • You want a natural birth experience where you aren’t rushed and where you’re encouraged to give birth in a way that feels best for you, be that squatting, on all fours, or in water. www.babysandbeyond.co.za

• You want minimal medical intervention, such as foetal monitoring, labour augmentation, epidurals, episiotomies, and assisted deliveries (forceps).

What does a doula do? A doula is not a medical professional, so she can’t make any medical decisions or actually deliver the baby. What she does do, though, is offer emotional support and care for the mom. ‘She’s rather like a mom for the expectant mom,’ Jude notes. ‘While others are focused on safely delivering the baby, the doula is entirely focused on mom and her wellbeing. She looks after your needs, from ensuring your favourite music is on the CD player to defending your birthing wishes if another practitioner tries to bully you into accepting unnecessary procedures. ‘She doesn’t replace your husband or partner, but rather offers another element of support for both parents. She’s an advocate for the mom, a nurturer, and is a constant encouraging presence during the birth.’

Why you might want a doula? • You want emotional support during your pregnancy and throughout the birth. • You want someone who’ll help both you and your partner to understand what is happening in pregnancy or labour, especially if complications arise. • You want to use drug-free pain relief, such as massage or relaxation techniques. • You want someone to ensure your birthing wishes are respected, and to advocate for you during the birth, communicating with medical staff if needed. ‘I tell moms who are petrified and don’t know what to expect of their upcoming births that it’s all about getting your mind set right from the beginning,’ says Carlyn. ‘A midwife or a doula can help you get into that positive space before, and can keep you there throughout the birth.’

Midwives and doulas in hospitals You don’t have to give birth at home to enjoy the support of a midwife or doula. Though still in the minority in South Africa, some progressive hospitals do allow private midwives to deliver babies, and will let doulas accompany parents into the labour ward and even into the operating theatre for those having C-sections. Some gynaes also offer subsidiary midwife/doula services to their patients.

Useful links Doulas of Southern Africa (www.dosa.co.za), for more information and a list of practising local doulas. The Society of Midwives of South Africa (midwivessociety.co.za). Mother Instinct (www.motherinstinct.co.za/), for a list of private midwives. Active birthing hospital, Genesis Clinic (www.genesisclinic.co.za).

FEATURE

Take the ‘s’ out of stress Exam stress is usually not so much about the paper itself but more about the thought of having to write an exam. Dr Beverly Evangelides provides some tips to help students cope with the pressure. As the examination period approaches you may feel the pressure of the exams getting to you. It is quite normal to feel some anxiety about exams. While some people find that a bit of pressure encourages them to do some serious work, for others this often results in a fear of failure that defeats them even before they put pen to paper. ‘Exam stress is usually not so much about the exam paper itself but more about the thought of having to write an exam that puts pressure on students,’ explains Dr Beverly Evangelides, National Academic Coordinator for ADvTECH Schools Division. If you are spending too much time worrying about your studies and exams, and have feelings of low confidence and self-esteem, feel panicky and depressed or anxious, then you know you will not be in a good learning space. These troubled feelings and symptoms relating to your studies and exams are caused by stress. It is a warning sign that your body and mind are feeling the pressure and asking for attention. Anxiety creates a kind of ‘noise’ or ‘mental static’ in the brain, blocking our ability to retrieve what is stored in memory and also greatly impairing our ability to comprehend and reason. The key to understanding how anxiety inhibits cognitive and physical performance lies in understanding how emotions affect the rhythmic activity in the nervous system. The good news is that exam stress can be avoided and parents have the power to help their children manage and deal with these stressors. Firstly, learn to recognise when you are stressed. Don’t be afraid to take a break and have a conversation with someone who knows about the pressure you’re under. This will allow you to put things into perspective. Put together a study timetable focusing on the times of day that you are most alert. We all have slightly different body clocks, so decide if you work best as a night owl or a dawn lark. Plan in advance. Draw up a realistic revision schedule that could turn your heavy workload into something manageable that will ultimately also

help you manage your nerves. We all have different revision styles; some of us like to sit at a tidy library desk whilst others prefer to sit on the floor with their laptop. Wherever you feel calm, in control and comfortable is the best place for you to work through your revision schedule and in so doing alleviate exam stress. Build rewards and treats into your timetable – anything you can look forward to – for sticking to the timetable. Plan something exciting to celebrate the end of the exams with your friends and family that will make you even more motivated. Never cram your work into one day as this will add fuel to the tension and stress fire. You will not remember your work and your brain will strike a blank when it comes to the exam. Take regular breaks – every 45 to 60 minutes is a good timeframe within which to work. Breaks must be at least 10 to 15 fifteen minutes long. During your breaks, do something relaxing such as reading a book or going for a short walk. Taking your mind off your current work will help you come back to it feeling refreshed. It can also help if you reward yourself after each revision session. Eat fresh fruit and veggies while studying. On the morning of the exam have a proper breakfast. Fuel your brain as well as your body – no one can think straight on coffee and chocolate, so avoid the caffeine. Ensure that you get eight hours’ sleep before your exam. Wind down completely before you go to bed and don’t revise under the duvet – this is your sanctuary, not your desk. You need to remember that although this test feels like the most important thing in the world, it isn’t worth the physical strain that you’re putting on your body. When you’re feeling the effects of exam anxiety and your brain feels blank, have a drink of water and breathe deeply and slowly. This will allow your body to rehydrate and to stop the effects of the stress response. Ultimately, don’t lose sight of the fact that there is life after exams. Things might seem intense right now, but it won’t last forever. www.babysandbeyond.co.za

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Credit: Johnson’s Baby

FEATURE

Baby skin care – an evolving science It’s no secret that moms know best, but sometimes it’s nice to have that extra bit of reassurance. Johnson’s Baby has just unveiled its Triple Baby Protection campaign to give moms more peace of mind. By Emma Dawson www.babysandbeyond.co.za

FEATURE Your baby’s skin is not just amazingly soft it is also an essential shield that offers protection from the outside world. But newborn skin is different to an adult’s as it is about 30% thinner, loses moisture faster and is more prone to dryness. This means it is more vulnerable to allergens and irritation and should only be cleansed with gentle, mild products formulated for baby skin.

Triple Baby Protection Aimed at reassuring parents that it’s safe to use Johnson’s Baby products from the day their babies are born, the Triple Baby Protection campaign promises that Johnson’s only uses safe ingredients that are proven to be appropriate for babies and that have passed rigorous safety checks. The second promise is that all products are mild on babies’ skin. Johnson’s Baby’s formulations are rigorously developed and tested to minimise irritation of baby skin and eyes. The third promise is effective products. Johnson’s Baby products are designed to respect the skin barrier to support healthy skin development. In a nutshell, the Triple Baby Protection commitment provides caring protection, combining safety, mildness and effectiveness to support babies’ healthy skin development. For moms, this offers trust and peace of mind.

Safety assurance Each of Johnson’s Baby product formulations has to pass a five-level safety assurance process. Ingredients are constantly re-evaluated to reflect new scientific developments, as well as consumers’ views and concerns. The five-level process includes partnering only with suppliers that meet Johnson’s required safety standards and stewardship principles; ensuring products are safe by using accredited toxicologists and independent safety experts; and clinical evaluation of products to make sure that ingredients work and that together these ingredients are well tolerated. The final two steps are in-use testing – how the products are used in families’ homes – and continual evaluation by speaking to consumers, scientists and regulators about the brands.

Babies skin vs adult skin An infant’s skin is physiologically different from that of older children and adults in terms of structure, composition and function. At birth, baby skin undergoes a dramatic transition from an aqueous to a dry terrestrial environment. After birth and over time, neonatal skin continues to develop. At a microscopic level, baby skin cells are smaller and the collagen fibres are thinner than in adult skin, making it more permeable and more prone to dryness. Baby skin also has a higher pH than adult skin, and a baby’s body surface to volume/weight ratio is higher than that of adults. This increases baby

skin’s vulnerability to applied substances and to sun exposure. Baby skin also has a higher rate of trans-epidermal water loss than adult skin. So although infant skin is able to absorb more water than adult skin, it loses water at a faster rate. And, as a baby’s immune system is developing, he has a greater chance of developing irritations and infections. For these reasons, baby skin is more vulnerable to the environment than adult skin. If not properly cared for the skin becomes susceptible to diseases such as nappy dermatitis, atopic dermatitis and other skin infections.

What causes skin barrier disruption? Healthy skin is soft, smooth and flexible. But various environmental agents, such as excessive or hard water, harsh soap or detergents and other substances, can threaten healthy skin by increasing protease activity. Although these enzymes are natural and needed for the exfoliation of skin cells, if their activity is increased beyond normal levels they can wear down the skin barrier. When the barrier is compromised, contaminants can enter and cause inflammation, allergies and other disease.

Are preservatives bad? Contrary to some popular thinking, preservativefree skin care products can be unsafe and potentially hazardous to the skin. In certain products preservatives are a necessary ingredient to ensure the integrity, purity and quality of the product during its use. They also protect against the development of microorganisms, including bacteria, mould and fungi. When it comes to the preservation of topical products, creams that contain water must contain preservatives to prevent contamination. However, ointments with no or very little water content do not necessarily need to contain preservatives.

Is water alone best to care for baby skin? Water alone is not an ideal baby skin care regimen for two essential reasons: it is not an effective cleanser and it can be drying. Water alone does not remove all of the impurities that can be found on baby skin. Some impurities are fat soluble and need to be removed by surfactants (surface-active agents).

Complete care A complete baby skin care regimen involves optimally-formulated products to enhance the skin barrier including bath products, wipes and oils. In a recent clinical study on baby skin care regimens, Garcia-Bartels et al investigated the long-term effect of Johnson’s Baby products twice-weekly on skin barriers in newborns. They found that the skin barrier develops either better or equally using a twice-weekly skin care regimen compared to bathing with water alone. www.babysandbeyond.co.za

FEATURE

The financial

implications

of having a child Having a baby is a major milestone, and a decision that will affect practically every aspect of your life, not least of all your finances. Emma Dawson chats to Peter Hewett, from the Financial Planning Institute, about the financial implications of having a child.

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FEATURE From pregnancy to baby Emma Dawson (ED): What are the most expensive costs associated with having a baby? Peter Hewett (PH): Some key expenses to keep in mind relate to the basic paraphernalia needed to settle your child into his new home – a pram, car safety seat, a cot, clothing and a host of smaller items. This cost should not be underestimated and often equates to many thousands of Rands. Then there are the costs associated with hygiene and feeding – simple items such as nappies, creams and other basic care products, as well as general medical care, vaccinations and feeding formulas. These can add immense strain to your budget and it’s critical that you make adequate provision for them, too. The costs would differ from family to family but as a guideline it would make sense to have at least R6 000 available for the initial purchase of essentials and to have a monthly budget provision of around R2 500 (excluding the cost of medical aid). Pre-delivery costs can become quite expensive, from gynaecologist visits to nutritional health supplements for the mother. ED: What can expecting parents do to cut down on these without compromising their families’ health? PH: Generally speaking, if you belong to a medical aid scheme you will be covered for the majority of the prenatal costs such as standard tests, scans and the actual delivery cost itself. However, it’s important to note that there are a number of supplements that should be taken during pregnancy that are generally not covered by medical schemes. Then of course, there is the cost of adding a dependent to your medical scheme which, depending on the scheme you are on, the comprehensiveness of the cover provided could easily cost you between R300 and R1 000 per month. ED: What, in your opinion, is the best way for parents to plan for their family’s financial wellbeing when expecting a new baby? PH: According to research from various sources, almost half of all pregnancies are unplanned. This being the case it is critical to ensure that you start building a nest egg as soon as possible after you start working. This would need to be provided for over and above your normal retirement-type savings because these savings are generally not accessible until you reach retirement age. A simple unit trust investment suitable to your specific risk appetite is often the most appropriate savings vehicle as it enables access to various types of growth assets at a very small monthly contribution and also provides the flexibility to access the funds at any stage should the need arise. The selection of the most appropriate investment should be left to an advisor, who should be appointed as soon as possible after your start working. ED: When should you start saving for your child and what is the importance of a budget for your family? Can you give examples of some simple areas where families could cut back to grow their savings? www.babysandbeyond.co.za

PH: In most cases new parents prefer to make an investment in their child’s name and this can be initiated the minute you have a birth certificate. The first year or so after having a child is normally quite disruptive from a budget perspective but as soon as you have the available monthly cash flow, it would make sense to start saving for your child’s education. Cutting out on personal entertainment expenses is normally quite easy in the first year or two after having a child – purely because your child will take up all of your spare time and more! Cutting out luxury items and not over-spending on items that are perceived as ‘baby necessities’ but that are actually just ‘baby status symbols’ is also important as these savings, if appropriately invested, will significantly improve your ability to provide your child with a good education. Keep in mind that ‘saving is simply delayed spending’ and with the cost of education increasing at more than double the inflation rate, you are likely to need to spend a significant amount on your child in the future. ED: What medical insurance option is the best, bearing in mind expenses such as paediatrician visits, vaccines, and doctor and dentist visits as your child gets older? PH: A fully-comprehensive medical scheme offered by a recognised and reputable company is always the best option. The most comprehensive options, incorporating a savings component to cover some of the co-payment costs would be preferable but many of these options are extremely expensive and unaffordable to the average couple starting a family. However, there are a number of alternative options available through most schemes that provide cover for the most significant and likely medical risks that also permit the accumulation of a savings component to help cover the incidental, day-to-day expenses you are likely to incur. These options are normally more affordable and better suited to the average family. If you have adequate available monthly cash flow in your budget to cover all of the normal day-to-day incidentals, doctor’s visits and vaccinations, a hospital plan may be the most suitable option as this would cover the cost of most major medical expenses. The medical aid industry is a very complex environment and the most suitable option would differ from family to family. It’s imperative to obtain the professional advice of a registered financial advisor that is also registered with the Medical Schemes Council. ED: In the event of an unexpected pregnancy, are there any financial planning options that parents can use in a short space of time to ensure that they are financially ready? PH: The best approach is to immediately contact a financial advisor to assess your current budget and your asset and liability structure to see if there is a way to improve your cash flow in the short-term. This could include cancelling unnecessary subscriptions, consolidating some of your debt or even selling certain non-essential assets. This process should be approached cautiously to ensure that the immediate

FEATURE plan is supported by a longer-term plan to achieve your ultimate longer-term objectives and to put you back into the position that you were in before making significant adjustments to your lifestyle.

The school going years ED: What should parents expect to pay from preprimary through to the secondary-education phase, bearing in mind escalations? PH: Taking account of the cost of an average model C school, the cost of schooling over a 12-year period, adjusting for annual increases and inflation, would equate to around R200 000. Your average private school would cost around three and half times that when calculated on the same basis. ED: What expenses relate to extra-curricular activities? PH: Extra-curricular activities would vary from child to child and it is important to assess what schools offer as part of their standard extra-curricular programme. However, while it’s important to ensure that your child is active, there are many very inexpensive activities on offer. For standard activities, the additional costs would be the purchase of the required attire and sporting equipment.

Effective budgeting as a family is the only way to ensure any chance of long-term financial freedom.

ED: And the costs for boarding school? PH: Although boarding school is an option, and in some instances a necessity, the costs of board and lodging would be partially offset as these costs are not incurred at home. Costs differ from school to school but at R4 000 per month, escalating annually at 10% and adjusted for inflation, you’re looking at around R680 000 for a normal 12-year school career.

ED: How about expenses related to school excursions and tours? PH: As with extra-curricular activities, these costs can be managed but it would make sense to budget for them in advance. Most schools have certain regular excursions and are able to provide a good indication of what these costs are likely to be each year.

Tertiary education ED: What are the average costs of a tertiary education and the associated costs, such as travel, accommodation, books and extra-curricular activities? PH: This cost would vary dependent on the university, whether it is via correspondence or full-time tuition, and whether or not it includes board and lodging. ED: How long before a child begins his tertiary education should parents begin their financial planning, and what are some of their options? PH: Planning for tertiary education follows the same lines as planning for schooling. ED: What plans are best for short and long-term planning? Is saving the only option or should parents incorporate certain basics to ensure an amount of disposable income is available for the family’s adhoc needs? PH: Effective budgeting as a family is the only way to ensure any chance of long-term financial freedom. During the early stages it is advisable to ensure that you cover the various risks that your family may be exposed to, such as the risk of the death or disability of a bread winner. Over time this needs to be complemented by savings to provide for shortterm and ad-hoc needs, and ultimately by savings that are structured to deliver longer-term returns to cater for life events such as retirement. This can be achieved over time by the implementation of a strict budget and with the support of a comprehensive long-term financial plan implemented by a competent financial advisor. ED: Although it is advisable for parents to start planning for their child’s tertiary education early, not everyone does. For parents starting late, what options do they have to assist them in being financially ready for their child’s tertiary education? PH: As mentioned above, in the case of an unexpected pregnancy there are various ways in which cash flow can be enhanced to provide for such expenses. Additional alternatives include financing student debt and applying for bursaries through various corporate institutions.

Peter Hewett CFP® is the Financial Planning Institute’s Financial Planner of Year 2014. For more tips on financial planning and to find a Certified Financial Planner®, visit www.fpi.co.za or contact 011 4706000.

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HEALTH

A sun smart

summer

With temperatures rising and long summer days ahead, the Cancer Association of South Africa (CANSA) offers advice and research about being sun smart with infants, toddlers and children. 20

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HEALTH It takes just one blistering sunburn during childhood to more than double your chances of developing melanoma later in life. Children should not be getting sunburned at any age, especially since there are very effective sun protection methods to use.

Sun exposure protection for infants – 0 to 6 months Infants under six months of age should be kept out of the sun. Special care should be taken from 10:00 until 15:00 when the Ultraviolet (UV) radiation of the sun is at its most intense. Application of sunscreen for infants younger than six months should also be avoided as they’re only recommended for children and adults. Babies have a higher surface-area to body-weight ratio compared to older children and adults as their skin is less mature. Both these factors mean that an infant’s exposure to the chemicals in sunscreens may be much greater, increasing the risk of side effects from the sunscreen. Here are some things to keep in mind when outside with infants: • Keep the infant in the shade as much as possible. • Consult a paediatrician before using a sunscreen. If it is absolutely necessary to apply a sunscreen, use only a small amount and do not then assume that the infant is well protected. • Make sure the infant wears clothing that covers and protects sensitive skin. Use common sense; if you hold the fabric against your hand and you can see through it, it probably does not offer enough protection. • Make sure the infant wears a hat that provides sufficient shade at all times and provides protection for the whole face, ears and neck. • Watch the infant carefully to make sure he does not show any warning signs of sunburn or dehydration. These include fussiness, redness and excessive crying. • Hydrate! Give the infant formula or breast milk if out in the sun for more than a few minutes, and don’t forget to use a cooler to store the liquids. • Take note of how much the infant is urinating. If it is less than usual it may be a sign of dehydration and that more fluids are needed until the urine flow is back to normal. • Avoid combination sunscreens containing insect repellents like Deet. Young children and infants may lick their hands or put them in their mouths. Insect repellents should not be used on infants.

Special care should be taken from 10:00 until 15:00 when the Ultraviolet (UV) radiation of the sun is at its most intense.

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• If you notice that an infant is becoming sunburned, get him out of the sun immediately and apply cold compresses to the affected areas. Seek medical assistance if necessary or in doubt.

Sun exposure protection for babies – 6 to 12 months Liberal amounts of sunscreen should be applied for babies of six months or older before they are allowed in the sun for short periods of time. Avoid exposing babies to the sun during peak hours and dress the baby in protective clothing, a hat with a brim and sunglasses. Here are some guidelines to keep in mind, in addition to what to do for infants: • When choosing a baby sunscreen, pick a broadspectrum sunscreen with an SPF of at least 15, but preferably SPF30 or higher. • Apply sunscreen generously, and reapply every two hours – or more often if the baby is spending time in the water or perspiring. • To avoid irritating skin and eyes, consider using a sunscreen that contains only inorganic filters, such as zinc oxide and titanium dioxide. • Sunscreen milks or creams formulated for sensitive skin usually contain titanium dioxide or zinc oxide and are less likely to contain alcohol or fragrances that might irritate the skin. • It is recommended to first test the sunscreen on a small area of the baby or toddler’s skin to check for any skin reactions. As with all products, use of any sunscreen should cease immediately if any unusual reaction is observed. • Babies with dark skin need sun exposure for longer periods and to more of their body to get adequate vitamin D. While skin cancer, including melanoma, can occur in dark skin populations, the risk is lower. This is largely as a result of higher concentrations of melanin naturally formed in this skin type that acts as a natural protection against UV radiation. There is currently no evidence that suggests sunscreen use on babies or children with naturally very dark skin further reduces their long term risk of developing skin cancer. • Babies and children with naturally very dark skin should still protect their face and eyes from over exposure to UV exposure by wearing a brimmed hat, close fitting wrap-around sun glasses and using shade where available when UV levels are high.

Sun exposure protection for toddlers and pre-school children Plan daily activities to keep toddlers well protected from the sun. Aim to minimise time (or take particular care) outside during the middle hours of the day during summer. Make use of a combination of sun protection measures: • Let children wear clothing that covers as much of their skin as possible. Choose cool, loose fitting clothes and wraps made from densely woven fabrics. Some fabrics have an ultraviolet protection factor (UPF) rating. The higher the UPF, the greater

HEALTH

Get children to wear broad-brimmed hats to protect their faces, necks and ears.

the protection provided by the fabric. If possible, choose fabrics that are at least UPF15, but preferably UPF50. • When direct sun exposure is unavoidable, broad spectrum sunscreen (SPF30 or higher) may be applied to any small areas of skin that cannot be protected by clothing (such as the face, ears and backs of hands). Sunscreen should be applied 15 to 20 minutes before going outside and reapplied every two hours or more often if it has been wiped or washed off. It is best to first test the sunscreen on a small patch of skin to ensure there are no reactions. It must be remembered that sunscreen is the last line of protection. • Get children to wear broad-brimmed hats to protect their faces, necks and ears. Choose a fabric that will crumple easily when they put their heads down.

Consider the hat’s size and comfort, the amount of shade it provides to the face, and if it will obstruct vision, hearing or safety. If the hat is secured with a long strap and toggle, ensure it has a safety snap, place the strap at the back of the head or trim the length so it does not become a choking hazard. • Teach children to seek shade as far as possible. • Consider using a cover for the car windows. Clear auto glass (side windows) usually blocks almost all UVB radiation, but only 21% of UVA radiation. • Provide kids with sunglasses, if practical, to protect their eyes. Look for sunglasses that are labelled at least UV400 and that are a close fitting, wraparound style that covers as much of the eye area as possible. Some infant sunglasses have soft elastic to keep them in place. Toy or fashionlabelled sunglasses do not meet the requirements for sunglasses and should not be used for sun protection. • Check the children’s clothing, hat and shade positioning regularly to ensure they continue to be well protected from ultraviolet radiation. Don’t forget that these guidelines also apply when your children are at school. Sources Skin Cancer Foundation, US Food and Drug Administration, Mayo Clinic, Cancer Council Australia, Centrer for Disease Control & Protection, Harvard Medical School www.babysandbeyond.co.za

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FEATURE

Credit: Tammy Gardner

Susan, Roxi and their delightful little boy, Finn.

Making Finn While getting pregnant in the traditional sense is natural for young, healthy heterosexual couples, there are a surprising number of ways to have a baby for those that are older or, for one reason or another, fall outside this demographic. As society, law and religious tolerances expand to accept the rich variety of family constellations in the 21st century â&#x20AC;&#x201C; acceptance beyond the traditional mother/father familyrun household is growing. By Emma Dawson

Like most people, I was aware that there are a number of ways to make a baby. Natural sex, artificial insemination and in-vitro fertilisation (IVF) instantly come to mind, but I was transported to a world unbeknown to me while chatting to Susan Newham-Blake, a writer, editor, and the author of Making Finn. Susanâ&#x20AC;&#x2122;s childhood dream of becoming a mother did not diminish with the revelation, alarming both to herself and her bewildered family, that she is gay. Having made peace with her identity and having finally found a beloved partner, she faced a daunting problem: with no sperm around, how would she make babies? And so began her unconventional journey to parenthood with some agonising decisions along the way. Should she accept help from a close and willing friend or go the anonymous sperm donor route? What are the legal and psychological implications of her options? How will her child be affected? www.babysandbeyond.co.za

FEATURE Examining assumptions Same-sex parenting has received a lot of bad press over the years, but a report published by the American Psychological Association (APA) – APA on Children Raised by Gay and Lesbian Parents: How Do These Children Fare? – concludes that there is no scientific evidence that parenting effectiveness is related to parental sexual orientation. The conventional notion of a family makes many presumptions: that there will be two parents, that they will be one of each gender, that they will be romantic partners, they will live under one roof, and they will both be biologically related to the children they raise. However, in the real world, a nuclear family headed by two biological parents is far from the norm if you consider the number of divorcees, single parents and blended families that exist. Same-sex headed families are simply one of these many reflections of modern society. In fact, same-sex families take exactly the same form as heterosexual nuclear families – two parents who are romantically involved and invested in raising children together.

Making Finn When Susan was five years’ old, her mother decided to share the facts of life with her and her older brother. At the time she and her brother found this hilarious but at the age of 34, and faced with what she was about to undertake, making babies proved to be less of a laughing matter. To Susan, wanting children, like being gay, didn’t feel like a choice but rather a condition. It was not something she could fight or rationalise. While Susan did consider adoption, it was not her first choice. ‘First prize was to have my own baby, to be pregnant and to give birth, no matter how complicated it all might turn out to be,’ she explained. And challenging it was… Crossing ex-boyfriends off the list of possible sperm donors, Artificial Insemination (AI) became the most suitable option. Hours of Googling later, Susan found a reputable fertility clinic in South Africa that offered to help women who did not have access to fertile sperm – either because of male fertility problems or because they were single or in a same-sex relationship. Arriving at the Cape Fertility Clinic, Susan and her wife, Roxi, discovered that insemination is either done with someone you know or with sperm from an anonymous donor – a strictly confidential process. In South Africa donors only donate anonymously and give up all parental rights. However, in England anonymous donation is illegal and only allows identity

We went through so much just to get to the stage where most people begin. www.babysandbeyond.co.za

release donation where donors have to release their identity when the children conceived turn 18. England has subsequently suffered a drop in donors, forcing British people to go abroad to purchase sperm. In South Africa, very little is known or shared about anonymous donors. Children would know nothing about one half of their biological roots, other than hair and eye colour; height and weight; and a brief summary supplied by the donor describing himself. There were 13 donors for Susan and Roxi to choose from but, after much deliberating, none of them sounded ‘just right’. The exercise sent them reeling. They went back to the drawing board and once again considered asking someone they knew to be the donor. However, after consulting a lawyer, a clinical psychologist and reading realms of research, Susan settled on purchasing sperm from an identityrelease donor in the States. By doing so, she was able to use an anonymous donor and be protected from any legal problems, and allow their child to have the option of finding out more about his genetic heritage. A long and daunting process finally resulted in the sperm being safely delivered to her doctor’s clinic. ‘We went through so much just to get to the stage where most people begin,’ Susan says. Susan’s second AI attempt was a success and their delightful little boy, Finn, finally arrived. Since then, Roxi carried their second son, Jet, using sperm from the same donor. To read Making Finn, a delightful, honest, warm and witty book about two women’s quest to create a family, visit http://susan-newhamblake.com/buybook/.

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Understanding

allergies

Like many people, you may find it difficult to tell whether your symptoms are caused by allergies or not. And, adding to possible confusion, a runny or stuffy nose and other symptoms may not be caused by an allergy at all. A number of other factors, such as irritants, infections, injuries or deformities of the nose can cause symptoms similar to allergies. To treat the symptoms you need to understand the real cause behind them, since treatment differs for different conditions.

Understand your symptoms Beyond itching, sneezes and sniffles, allergies can have many symptoms you wouldn’t expect, such as stomach pain, diarrhoea or ear infections. Recognising typical signs of the most common allergies is a prerequisite to getting the right diagnosis, appropriate help and optimal symptom relief. By limiting the exposure to the relevant triggers (allergens) you can improve your own well-being.

Allergies add up, but which are they? Most people with allergies are allergic to more than one thing and greater exposure to allergy triggers is more likely to make symptoms worse. Since allergy triggers (such as dust mites, furry animals and pollen) add up, symptoms may appear only when exposed to two or more allergy triggers at the same time. This means that what may seem like the obvious trigger – for example pollen – may just be the tip of the iceberg.

right diagnosis and early treatment of allergies can also help prevent potentially serious complications of allergies from developing, such as ear infections, sinusitis and asthma.

Ask your doctor about a blood test A blood test will help your doctor determine if you are allergic, what you are allergic to and may even rule out allergy. A blood test is quick and simple and is made available to your doctor. It’s quantitative and measures the amount of allergy antibodies in the blood, which is an indicator of allergic sensitisation. Based on a physical examination, your case history and the blood test results, your doctor will be able to make a proper diagnosis and decide on a treatment for you. A blood test can assess hundreds of allergens, such as weeds, trees, pollen, mold, food and animal dander. Adults and children of any age can have a blood test, and it can be performed irrespective of skin condition, medication, symptom, disease activity and pregnancy. Any doctor can take the blood sample and request the test, which is covered by medical aid.

Do you suspect allergies behind your symptoms? Allergies are very common and we often treat the symptoms without finding the cause! Visit www.isitallergy.co.za and complete your allergy profile to find out more.

Testing for allergies How do you know whether your symptoms are caused by allergy or not and, if so, to what exactly? Knowing what’s causing your symptoms is important since treatment differs for different conditions. The

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FEATURE

Pregnant workers are well protected by the law in South Africa and the Unemployment Insurance Fund provides short-term relief to workers, subject to certain conditions, unable to work because of maternity or adoption leave, among other reasons. By Emma Dawson

Know

your rights

There’s no doubt that having a baby is an exciting time, but one that’s fraught with challenges and big life changes. It’s worthwhile being well prepared and aware of your basic employment rights as early as possible.

Maternity leave The dismissal of an employee on account of her pregnancy, or intended pregnancy, or any reason related to her pregnancy, is automatically unfair. This includes the refusal to allow an employee to resume work after she has taken maternity leave in terms of any law, collective agreement or her contract. An employee is entitled to at least four consecutive months’ maternity leave, which may commence at any time from four weeks before the expected date

of birth, unless otherwise agreed; or on a date from which a medical practitioner or a midwife certifies that it is necessary for the employee’s health or that of her unborn child. An employee may not return to work for six weeks after the birth of her child, unless a medical practitioner or midwife certifies that she’s fit to do so. In the sad event of a miscarriage during the third trimester of pregnancy, or if she bears a stillborn child, she’s entitled to maternity leave for six weeks after the miscarriage or stillbirth, whether or not she had commenced maternity leave at the time of the miscarriage or stillbirth. Employees must notify employers in writing, unless the employee is unable to do so, of the date on which she intends to commence maternity leave; and return to work after maternity leave. This www.babysandbeyond.co.za

FEATURE notification must be given at least four weeks prior to the commencement of the maternity leave; or if it is not reasonably practicable to do so, as soon as is reasonable. In South Africa, while you’re entitled to four consecutive months’ maternity leave, your employer is not legally obliged to pay you. However, you can claim from the Unemployment Insurance Fund (UIF). Application to the UIF for maternity benefits must be lodged within six months of the birth of the baby, and benefits will be paid to a female contributor during pregnancy, confinement or the period thereafter to a maximum of 121 days. If there’s a miscarriage or a stillborn child, the benefits are paid for a maximum of six weeks after the miscarriage or still birth.

Adoption benefits While the UIF provides for adoption benefits at the same rate and duration as maternity benefits in South Africa, sadly the Basic Conditions of Employment Act (BCEA) makes no provision for adoption leave. To apply for UIF, benefits applications must be made within six months of the date of the order for adoption. The adopted child must be younger than two years, and only one contributor of the adopting parents can apply for benefits. Additionally, the child must be adopted in terms of the Child Care Act, 1983.

Family responsibility leave Family responsibility leave applies to an employee that has been in employment with an employer for longer than four months, and who works for at least four days a week for that employer. During each annual leave cycle, employees are entitled to three days’ paid leave, which the employee is entitled to take when the employee’s child is born or when the employee’s child is sick.

Breastfeeding at work If you’re not already aware, women are entitled to breastfeeding breaks at the workplace once they return to work after maternity leave. These breaks can either be used to breastfeed a baby, or to express milk, and the time must be paid. In terms of the Code of Good Practice on the Protection of Employees during Pregnancy and after the Birth of a Child (which forms part of the Codes of the BCEA), arrangements should be made for employees who are breastfeeding to have breaks of 30 minutes twice per day for breastfeeding or expressing milk for the first six months of the child’s life. The area must be clean with space to sit, and provide privacy, access to clean water and somewhere to safely store expressed milk. Cleanliness, accessibility and security are key – a toilet is not suitable for this purpose!

Protecting employees If practical for an employer, a pregnant employee can insist on less strenuous work if she can prove her job negatively impacts on her or her child’s health, or if she works night shift. Likewise, she’s protected against working in a hazardous environment or with hazardous equipment or materials – either during pregnancy or while breast feeding. The ins and outs of this are complicated so it’s worth reading up on the Code of Good Practice on the Protection of Employees During Pregnancy and After the Birth of a Child. Remember, this is a very precious and important adaptation time for both you and your baby. Don’t be tempted to work from home during your maternity leave, if at all practical. Use the time to tend to your new-born baby and rest whenever you can. You are protected by law and your job will be there waiting for you after your maternity leave. Sources: www.labour.gov.za; www.mywage.co.za

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FEATURE

Hush,

little baby… In a baby’s life, sleeping is a big deal and one of a mother’s greatest concerns. When the child turns 21, it’s still her biggest concern but for different reasons. By Erica Lötter, sleep trainer and founder of Momslifeline

A lack of sleep affects the whole family – from the youngest to eldest. When we are sleep deprived we do not function to the best of our abilities, and are perhaps not the best parent, wife or friend. Parent’s tolerance levels are low and this filters through everyday life at home and at work, crèche or school. Self-soothing is a skill and something we need to allow our kids to learn. It is not something that we can teach them but we can create an environment that is positive for acquiring the skill. Most people know they have a problem, particularly when one parent has moved out of the bedroom and the child has taken over, or mom’s sleeping in another room so as not to disturb her partner. Perhaps these moms are crying for no reason and there are regular arguments about how to resolve the situation, or over other petty issues. Momslifeline assists parents to get back on track and getting a baby or toddler to sleep. The most common issues, when it comes to getting babies to sleep are expectations, the inability to self sooth, not linking sleep cycles properly, a lack of nutrition to enhance sleep and developmental issues.

Sleep training If sleep training is considered, it’s important to ensure that your baby or toddler is in perfect health and that there is nothing medically wrong with the child. A visit to your pediatrician will confirm that there’s nothing physically wrong and no reason why your child should not sleep through the night. While there are many opinions about sleep training, it’s important to maintain realistic expectations as to what sleeping through means. A consultation with a sleep trainer may reflect that there’s no big problem. Although the child isn’t sleeping continuously for 11 hours, he may wake up and ‘talk or play’ by himself and then go back to sleep. In this case, the child does not need you to be able to go back to sleep

when he’s ready. The mistake most parents make is going to the room and trying to force the child to go back to sleep, resorting to rocking, bottles and bouncing. Do this a couple of times and you create an expectation for your baby that every time he wakes up he’ll be rewarded with your company and the rocking, stroking and bottles. Add repetition to this and you create a habit. Your child will then wake up based on the expectation of the reward, or because his body has now unlearned its ability to self sooth. When contemplating sleep training, ensure that trainers do not use drugs (herbal or pharmaceutical) to assist the process. Ask lots of questions and raise all your concerns. Make sure trainers do not replace current bad habits with others that you’ll still have to break at a later stage. If you opt for sleep training, it’s important to realise that your child will cry. Babies don’t like changes and during sleep training there are lots. He will cry, but it’s what you do when he cries that’s important. Trainers at Momslifeline believe that a child shouldn’t cry for more than three minutes continuously without seeing his parents. Make sure the sleep trainer gives you a detailed explanation of what she’ll do during training and ensure you are comfortable with the process. Sleep training is an emotional and difficult time. Be sure you trust the trainer you’ve chosen. If done correctly, it should take between four and five days of sleep training to see a big improvement in your child’s sleeping habits. If the process is consistently applied, your child will settle in to the new routine within two weeks. However, it’s important to realise that as quickly as you can change current behavior, it also only takes a couple of days for the good habits to be broken and replaced with the bad. Be consistent! For advice on sleep training, visit www.momslifeline.co.za. www.babysandbeyond.co.za

FEATURE

What is

birth etiquette all about?

To assist the woman – who could be your wife, partner, friend or daughter – to achieve a gentle and safe labour and birth, it is very important to understand what she will be experiencing and to learn more about labour and birth. By Suzette Cloete, CEO & founder of Origin Birth Clinics Labour and giving birth is a sacred and intense experience, during which very important brain chemicals are released, enabling women to labour and give birth in their own time. These chemicals not only prepare, help and guide a woman’s body through labour but also prepare the baby for the journey from the womb. A woman in labour experiences an altered state of consciousness – the blue print for birth includes a mind-space of total focus, trust and knowing, and a deep connection with the baby. In fact, what we are saying is that if a woman finds herself in an environment that is conducive to labour and birth (a home-like environment) and is left alone and feels safe, calm and in control of her labour, these brain chemicals will ensure that she can successfully labour and give birth to her baby,

without any medical intervention. This does not mean that she has to do this alone and without the emotional or physical support of a midwife and/or doula, or of a family member or partner. But this means that she can – just because she’s a healthy woman. However, if this women is not in an environment that is conducive to labour and birth (for example a strongly lit hospital room full of strangers and medical equipment), not feeling in control of her birth, not feeling safe and calm, these brain chemicals cannot be secreted and inevitably this woman will not be able to labour and birth without medical intervention. As a support person to a woman in labour, this makes your task extremely important in ensuring that she can secrete these incredibly important chemicals.

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FEATURE The important hormones

Oxytocin

The most important hormones are Melatonin, Oxytocin, Endorphins and Prolactin.

Oxytocin is known as the love hormone because of the role it plays in orgasm (released during orgasm), social recognition, pair bonding (the strong affinity that develops between a two people), trust and empathy. During labour oxytocin produces the strong contractions of the uterus necessary for childbirth, as well as bringing on the contractions that lead to separation of the placenta from the uterus and its release as the afterbirth. When oxytocin levels are high, strong contractions occur that reduce the chance of bleeding, also reducing post-partum haemorrhage, effectively protecting women in labour. Oxytocin stimulates the nurturing and maternal instincts in a mother to her child, helping to ensure she’ll take care of her baby. That immediate ‘in love’ feeling is brought on by a huge surge in oxytocin that the mother releases after the birth. It also contributes to the euphoria and receptiveness to her baby that a mother usually feels after an unmedicated birth. This peak, triggered by stretching sensations of the birth canal as the baby is born, does not occur when an epidural is in place. Administration of an epidural has been found to interfere with bonding between ewes and their newborn lambs. During labour, the baby also produces increasing amounts of oxytocin and, in the minutes after birth, both mother and baby are bathed in an ecstatic cocktail of hormones. These hormones ensure that their relationship gets off to the best possible start and is cemented for life. After birth, oxytocin helps us exhibit mother-like behaviour and the emotional and physical transition to motherhood. From the first weeks of pregnancy, oxytocin helps us to be more emotionally open and more receptive to social contact and support. Another very important function of oxytocin after the birth is to ensure the ‘let down’ of breast milk. When a woman breastfeeds, her baby’s sucking stimulates nerves in her nipple. These nerves carry a message to the brain and oxytocin is released. Oxytocin flows through the bloodstream to the breasts where it causes tiny muscle cells around the milk glands to squeeze milk into the milk ducts. This is known as the let-down reflex or the milk ejection reflex.

Melatonin Melatonin is produced by the pineal gland, a small endocrine gland located in the centre of the brain. The melatonin signal forms part of the system that regulates the sleep-wake cycle by chemically causing drowsiness and lowering the body temperature. So melatonin makes us sleepy and relaxes us, preparing us for sleep. Production of melatonin is inhibited by light to the retina and permitted by darkness. This explains why research proves that most women go into labour in the middle of the night and why so many labours slow down or stall in a hospital setting. The function of melatonin during labour and birth is to enhance the production and secretion of oxytocin. Melatonin works together with oxytocin to make the uterus contract. The best place to give birth for a low risk women is in a dark and familiar place that feels like home, dark enough and warm enough to secrete melatonin. From this we, as a women’s support person during labour and birth learn, that a quiet, dark and familiar, home like environment, is the best place for her to give birth.

What should we do to encourage the secretion of Melatonin? • Ensure that the room is dark enough for melatonin to be secreted. Ask the hospital staff to allow you to use a bedside lamp (even if you have to take your own) instead of the bright lights in the room. • Ensure that the room is quiet by eliminating disturbing noises and sounds like a television, people talking in the background, or children making a noise while playing. Close the door to the hospital room if the noise in the passage is interfering. • Ensure that the room is warm. A warm room is important as melatonin makes our body temperature drop and no one can feel sleepy if they are cold. If she wishes to labour and/or birth in a bath, make sure that the water is kept warm (36 and 38°C) all the time.

Once a baby is born, the mother will release a massive search of Oxytocin, making her fall in love and bond with her baby. Ruth Ehrhardt.

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What should we do to encourage the flow of oxytocin for mother and baby? In her book, The Basic Needs of a Woman in Labour, Ruth Ehrhard comments that Oxytocin is a very shy hormone that requires specific conditions before it can be secreted. These conditions include:

A sense of security If a woman in labour feels afraid or scared her labour will stop until she feels safe again. Ruth Ehrhardt states that although these days most women choose a

FEATURE hospital because they believe it is the safest place to give birth, they may find that when they arrive their bodies react in a way which tells them that they are indeed not feeling safe. The unfamiliar room, bright lights, foreign smells, talking to strangers, filling out forms, making payment and the presence of medical equipment can inhibit the flow of oxytocin and make it impossible for a woman to relax and labour in her own time. It is a fact that if the fight-orflight hormones are activated by feelings of fear or danger, contractions will slow down.

The thinking brain needs to switch off We should allow a labouring woman to access the part of her brain that will guide her instinctively through labour and birth, by secreting the necessary hormones. Therefore her thinking brain or neo-cortex must switch off. According to Ruth Ehrhardt, we stimulate the neo-cortex during labour by talking to the labouring woman about logical things, such as telling her by how many centimetres she’s dilated, or asking her to remember when her waters broke. By engaging her in conversation and logical thoughts we slow down the release of oxytocin. Therefore, it’s important not to talk to the woman unless she speaks to you, ‘not waking her up’ from her labour state. Besides darkness and warmth, no observers should be admitted into the labour room. Being observed also stimulates the neo-cortex and can make us anxious, self-conscious, uncomfortable, and ‘on guard’. Cameras can have the same effect. It is therefore important to establish whether the woman in labour will feel comfortable if you take photographs during labour and stop immediately if you see that you are ‘waking her’ from her state of labour. Keep the number of people in the room to a minimum and keep strangers out. Additionally, make sure you have healthy snacks available as hunger, which also causes the body to release fight-or-flight hormones, can stop labour from progressing.

Oxytocin/adrenalin antagonism A woman in labour who is scared or anxious, cold or stressed will secrete adrenalin, the fight-or-flight hormone. Adrenalin suppresses oxytocin and it can stop labour completely or make the labour longer and more painful. That is why it is so important for everyone who is present during labour and birth to be very conscious of their own level of adrenalin, which is contagious. If one person feels anxious the other people in the room will soon start feeling the same way and secreting more adrenalin. If you cannot remain calm it is best to leave the room until you have your fear under control. Keep an eye on others in the room that might feel anxious or stressed and gently encourage them to leave or go for a walk. Do this with caution so as not to anger or upset anyone. Anger brings about more adrenalin.

Beta-endorphin Beta-endorphin is one of the endorphin hormones that is released by the brain in times of stress or pain, and is a natural equivalent to painkilling drugs like pethidine (often given to women in labour). During labour, beta-endorphin helps to relieve pain and contributes to the ‘on another planet’ feeling that women may experience when they labour without drugs. Levels of beta-endorphin are reduced when drugs are used for pain relief. Very high levels of beta-endorphin can slow labour by reducing oxytocin levels, which may help to ‘ration’ the intensity of labour according to our ability to deal with it. Moderate levels of betaendorphin help us to deal with pain in labour, as well as encouraging us to follow our instincts. As part of the hormonal cocktail after the birth, beta-endorphin plays a role in bonding between mother and the baby, who is also primed with endorphins from the birth process.

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FEATURE Beta-endorphin also switches on learning and memory, perhaps explaining why we remember our labour and birth in such amazing detail. Like oxytocin, endorphins are also released during lovemaking and breastfeeding and can induce euphoria. In fact endorphins are present in breast milk, which explains the natural high that babies can get after a breastfeed. This hormone also helps the body to release prolactin, underlining the elaborate interplay between these hormones of labour, birth and breastfeeding.

Prolactin Prolactin is most noteworthy for its effects after the birth. It’s the major hormone of breast milk synthesis. Suckling by the newborn baby increases prolactin levels. Early and frequent suckling from the first days makes the breast more responsive to prolactin, which in turn helps to ensure a good long-term supply of milk. Like the other hormones, prolactin has effects on emotion and behaviour – it stimulates ‘aggressively defensive’ behaviour in breastfeeding mothers. When prolactin is combined with oxytocin, as it is soon after birth and during breastfeeding, it encourages a relaxed and selfless devotion to the baby that contributes to a mother’s satisfaction and her baby’s physical and emotional health.

When a woman’s in labour • Don’t rush her to get ready to leave for the hospital, rather gently encourage her to pack her suitcase and make her a cup of tea or a snack while she is packing. • Discuss her needs with hospital staff. • Do not ask her questions that will stimulate the neo-cortex. Do not engage in conversation with her, unless she asks you a question. • If you have to speak to someone in the room speak very softly or have the conversation outside. • When entering or exiting the room, do so quietly. • Do not cheer her on or tell her what to do. • Do not treat the woman in labour as a patient. Pregnancy is not an illness. • Be prepared to do what it takes, to give the woman the best labour and birth experience that she can possibly have.

A woman in labour experiences an altered state of consciousness … a mind-space of total focus, trust and knowing, and a deep connection with the baby. www.babysandbeyond.co.za

Labour is like sleep because we need the same conditions to ‘fall into labour’ as we need to ‘fall asleep’. Ruth Ehrhardt. Birth etiquette: The newborn It is imperative that the mother and her baby are never separated from the moment the baby is born and that immediate skin-to-skin contact is initiated while both mom and baby experience the cocktail of hormones in their brains and bodies. A multitude of studies show that mothers and babies should be together, skin to skin (baby naked, not wrapped in a blanket) immediately after birth, as well as later. The baby is happier, the baby’s temperature, heart and breathing rates are more stable and more normal, and the baby’s blood sugar is more elevated. Not only that, but skin-to-skin contact immediately after birth allows the baby to be colonised by the same bacteria as the mother. From the point of view of breastfeeding, babies who are kept skin to skin for at least an hour with the mother immediately after birth are more likely to latch on well without any help, especially if the mother did not receive medication during the labour or birth. • There is no rush to cut the cord. Wait at least one hour before cutting the cord so that the baby can receive the 40ml of iron rich blood from the cord. • Babies are not to be bathed immediately after birth as the vernix (yellow cheesy substance) needs to be absorbed through the skin. They can be gently dried off to leave as much of the vernix on their skins as possible – it exhibits antioxidant, skin cleansing, temperature-regulating and antibacterial properties. • Babies do not have to be weighed and measured immediately after birth. The skin-to-skin bonding with the mother should take precedence. • The mom and baby along with the father/partner should be left alone after the birth to bask in this glorious event. The birth hormones in mom and baby need to flow undisturbed and ‘cement’ their relationship for life. This does not mean that there should be no one to attend to the new family if they need something, but that they should be given privacy to rest and bond with their newborn. Science is increasingly discovering what we as mothers know – that the way we give birth affects both ourselves and our babies for the rest of our lives. It is therefore important to ensure that you do all you can to ensure that a woman has an ecstatic and gentle birth – one that takes her beyond herself, the gift for a lifetime.

ADVERTORIAL

Gloves

in a bottle

It is rated the number one sheilding lotion in the USA We spoke to owner of MedLoyd Healthcare, Rob Oosthuizen about this incredible product

Q. WHAT MADE YOU DECIDE TO BRING GLOVES IN A BOTTLE (GIAB) INTO SOUTH AFRICA ? A: The unique technology associated to GIAB in that it is not a “conventional or traditional moisturiser” but rather a SHIELDING LOTION that offers, within a single lotion, unbelievable dry skin care as well as skin protection against moisture depleting irritants. The fact that GIAB is internationally recommended and used by more than 9000 dermatologists and medical practitioners was proof enough for us that it was an exciting “new technology” dry skin care product that really worked. It is rated as the number 1 selling shielding lotion in the USA as well as the best selling shielding lotion for John Bell and Croyden, the flagship outlet for the Lloyds Pharmaceutical Group in the UK. Q: WHAT EXACTLY IS A SHIELDING LOTION? A: A shielding lotion is fundamentally a lotion that assists in locking in the natural moisture and oils of the skin whilst simultaneously assisting in locking out the moisture depleting irritants that we come into contact with on a daily basis. ie house hold solvents, soaps, detergents, dirt, grease, grime, chemicals, etc Q: What is the principal difference between a shielding lotion and a conventional moisturiser? A: A “conventional” moisturiser generally attempts to add ARTIFICIAL moisture to the external layer of the skin. A shielding lotion however assists in locking in the natural moisture and oils of your skin whilst simultaneously assists in locking out moisture depleting irritants. Q: How does Gloves In A Bottle, this unique product, offer a solution to dry skin conditions: A: Traditional moisturisers in so many ways simply masks a dry skin condition. In order for any moisture to improve a dry skin condition, it needs to penetrate below the second major layer of skin. In reality, and for the most part, the only moisture that is going to reach this level is your own moisture. : Gloves In A Bottle not only assists in

protecting all 7 layers of our skin from moisture depleting irritants, but also allows the body to naturally and optimally nourish these 7 layers of skin from the inside out and not from the outside in. In a nutshell, Gloves In A Bottle ‘keeps the good stuff in and the bad stuff out.” When using Gloves In A Bottle, deep rooted dry skin care is achieved and within just a week of consistent use, the most amazing and long lasting results are achieved. Additionally, GIAB is so designed so as to not wash off through the conventional washing of the skin and comes off through natural exfoliation. A single application thus lasts 4 -12 hours and this allows for prolonged natural skin nourishment and protection that would not otherwise be achieved. GIAB offers South Africans a totally new concept to dry skin care and protection and we are not only thrilled with the results, but also with how well it has been received by the public. Q: Any new exciting developments for Gloves in A Bottle in the future ? A: Yes definitely, up until now only GIAB Regular has been available in South Africa. We have just launched two additional GIAB products called Gloves In A Bottle Natural Super Hydrating and Gloves in A Bottle Natural +SPF15. Although we anticipate these to be available on shelf in the very near future, they are readily available for secure on line purchasing through our dedicated GIAB website www.glovesinabttle.co.za . These amazing options are made from natural ingredients that further promotes the creation of natural moisture and oils and are for those who have very sensitive and severe dry skin conditions. The SPF version offers exactly the same as the above, but additionally offers sun protection factor for those who enjoy the outdoors. Q: Where can our readers find this awesome product? A: You can buy online www.glovesinabottle.co.za or purchase country wide through selected pharmacies such as Dischem, Link, Alphapharm, Pharmacy At Spar etc Available at selected leading pharmacies

HEALTH

The low down on middle ear infections

It is often difficult to know when children have ear infections, particularly if they do not complain of earache or run a fever. If in doubt, visit your local audiologist for a quick tympanogram, which tests middle ear pressure and movement. If necessary your audiologist can refer you for further medical management.

Where does the infection occur? The middle ear is a space behind the eardrum. The eardrum creates a seal between the outer ear and the middle ear. The middle ear ventilates itself through the eustachian tube, which connects the middle ear to the back of the sinuses. If the eustachian tube becomes blocked then the middle ear cannot equalise pressure or drain fluid into the sinuses.

How can ear infections be prevented?

Middle ear infections (otitis media) are one of the most common illnesses among children under the age of five. During the infection the child’s middle ear is filled with fluid, causing a distortion in the sound reaching the child’s inner ear. As a result your child may experience a temporary hearing loss.

How does it present? 1. Increased irritability or crankiness 2. Complaining of earache (although it is important to remember that your child may not complain of earache, especially if the fluid has been present for some time) 3. Pulling or tugging at the ears 4. Fever (usually low) 5. Poor appetite 6. Poor sleep, waking during the night 7. Discomfort when lying down 8. Smelly pus discharge (this will happen in the case of a severe and unresolved infection) You may see one or more of the above symptoms. If in doubt, rather check it out.

Why should I be concerned?

Who can diagnose an infection? Audiologists, GP’s, paediatricians and ENT’s can diagnose the presence of fluid in the middle ear system.

When will my child outgrow ear infections? Most children outgrow middle ear infections by the age of five. Tanya Hanekom is an audiologist practicing at Sandton Hearing & Balance at Mediclinic Sandton, Bryanston. Tanya obtained her degree in SpeechLanguage Pathology & Audiology from the University of Witwatersrand, and her Masters’ degree in Communication Pathology (Audiology) from the University of Pretoria. For more information, visit www.sandtonhearing.co.za

Credit: Tanya Hanekom

When a child suffers from chronic middle ear infection their hearing abilities will most likely fluctuate from normal to a mild or even moderate loss. It is important to remember that this is temporary, only lasting as long as the infection lasts. However, the child runs the risk of developing poor listening skills, speech and language development delays, as well as learning, attention and behavioural problems.

Children’s eustachian tubes are shorter and narrower than adults’ and part of the reason why they’re more prone to ear infections. Children are also not adept at successful nose blowing, which allows the sinuses to remain blocked. The regular use of saline sprays or other nasal sprays as recommended by your GP or paediatrician ensure the sinuses remain clear and healthy. This facilitates natural drainage around the eustachian tube, which in turn keeps the middle ear systems healthy. Prolonged breastfeeding, avoiding large crèches, avoiding cigarette smoke, controlling allergies and maintaining a healthy diet are other ways to try and prevent middle ear infections from occurring.

dad’s diary

A passionate

love affair

Craig Wilkinson has had an 18-year love affair with his daughter, Blythe.

Blythe. I adore her. Our passionate love affair has lasted 18 years and shows no sign of waning. Still when I hear her voice, or her name comes up on my phone, a smile starts at the centre of my soul and wells up through my being. It wasn’t love at first sight though. The night we first met neither of us was at our best. The details are a bit vague in my mind now but I do remember her crying bitterly and me being thoroughly exhausted. Before the night was over though, she was in my arms. Two days later she moved in and we’ve been together ever since.

Joy and vulnerability Being Blythe’s father has made me more vulnerable than I thought possible and brought me more joy than I ever imagined. Nothing had prepared me for the range of emotions and challenges I have experienced being Blythe’s dad. What a deeplyprivileged and sacred journey it has been and continues to be. What follows is a smattering of the experiences I have had and lessons I have learnt being Blythe’s dad. When Blythe was three years’ old a vigilant doctor www.babysandbeyond.co.za

Credit: Craig Wilkinson

Craig Wilkinson, author of ‘DAD – The Power and Beauty of Authentic Fatherhood’ discusses his love affair with his daughter, Blythe.

dad’s diary picked up that she had a small hole in one of the walls of her heart and would need corrective surgery. The surgeon kindly allowed me to hold her in my arms as we placed the mask over her face that put her to sleep for the operation. Thanks to modern technology it went very quickly and was a great success. Sometime later I heard Blythe explaining to a friend that her heart was broken but her daddy fixed it. I cried. Deep emotion welled up in me as I realised what I meant to her as her father. I was the one who could fix anything, her hero. I was the one whose love for her and treatment of her, whose life and actions and words would impact most deeply on her young heart and mind and soul. My life mattered deeply to her and that made it matter more to me too. I needed to be there for her, to give her my best so that she could grow up to be her best. When Blythe was just over two years’ old I spotted her reaching out curiously towards a red hot heater. I quickly said to her ‘don’t touch that it’s hot’. She gave me an imperious look and said ‘I like hot’. Blythe has a strong will and I have tried to constantly show her that I love her unconditionally while at the same time setting appropriate boundaries. I adore her and love to show her this quite extravagantly, not with material things but with lavish displays of affection and constant words of love and affirmation. It has been so easy to do as she shows me so much love in return.

Different phases As she has grown up the nature and tempo of our interaction and displays of affection have gone through different phases. I have learnt to discern the slowly changing needs of her heart and to match how I show my love to her with what her heart and maturing mind needs. When she was younger I used to stroke her head at bedtime and stop only when I heard the deep, even breathing of sleep. If I stopped a moment too soon she would murmur for me to continue. She would often ask me to come and stroke her head. As she has grown older these requests have become less and less. We used to walk arm in arm through malls and now sometimes I notice that she needs a bit of distance between us as we walk, particularly when there are boys her age about. Though my adoration of her has not changed at all, I let her set the pace in how I display it to her. Blythe would often climb into the shower with me and I used to wonder when the appropriate time would be for her to stop showering with her dad. I decided to completely leave it to her, to not even mention it. Slowly as she approached puberty she began to get a little more private until one day I realised she was no longer showering with me. There was no discussion, no issue, just a slow and very natural change.

The birds and bees When Blythe turned thirteen I had a long discussion with her about passing from being a girl to becoming a woman. We developed a lexicon of words and terms to help define this passage. One of the words we used to describe this time was ‘wogirl’. It meant www.babysandbeyond.co.za

halfway between being a woman and being a girl. It also played on the expression ‘whoa girl’. Wait. There is no hurry to get involved in certain activities reserved for later in life. It was a beautiful discussion about life, womanhood, boys, sex, drugs, dangers, joys, pleasures, boundaries, and the plethora of challenges and delights that awaited her. We used the analogy of an enchanted forest that she was walking through into womanhood and all the challenges and joys she would face and how to deal with them. I said to her that my role is like Merlin the wizard, there whenever she called on me to offer wisdom, whatever magic I could conjure, and to fight for her with every fibre of my being. The day Blythe first got her periods she called to tell me. I had tears in my eyes at the privilege of having her share this intimate womanly experience with me, a man with rather little experience in such matters. Being able to talk about anything and everything with your daughter is critical as a father.

Quality time I have worked hard at creating experiences and making special memories with Blythe. One December holiday we decided to work through the alphabet of activities, to do something that started with each letter of the alphabet. A for acting, B for bat and ball, C for camping, D for dancing, and so on. For Z we couldn’t find a zebra to ride so we ended up running madly across a Zebra crossing. It turned out to be a lot more challenging than we thought but we managed to work our way through 26 activities. It created fun and joy, required imagination, action and effort but mostly it enabled us to spend great, quality time together and make beautiful memories. I have learnt the importance of dedicating time to spend exclusively with Blythe. Sometimes though, it means doing things that really wouldn’t be my first choice of how to spend a few hours. For instance Blythe loves shopping, I really don’t. Far more important than my dislike for shopping is the fact that Blythe loves it and it creates a way for us to spend time together. I have spent countless hours scouring malls and waiting outside change rooms while Blythe tries on enough garments to outfit an entire fashion show. Spending this time together has created great opportunities to impart wisdom and strength into Blythe’s life. On one shopping expedition the mission was to buy a jacket for Blythe. As the day progressed, and the number of jackets remaining to be tried on in the mall diminished to none, I noticed Blythe getting quieter and quieter and more and more withdrawn. On the way home in the car, sans jacket, I asked her what was wrong. She said that the jackets all made her look fat. What an opportunity to share with her how beautiful she is, how women throughout the world felt 5kg bigger and dotted with cellulite every time they entered a brightly lit changing room. By the time we got home Blythe was her normal happy self, and had gained important insight into life, self-esteem, the media, and one more of the challenges of being a woman.

dad’s diary

Affirmations and validations It is so important to know your daughter. What her favourite colour is (Blythe’s changes regularly), her fears, passions, likes, dislikes. Knowing her lets her know that she matters, that what she thinks and feels is important. It affirms her and validates her. It gives credence to who she is and creates in her the confidence to be herself. I have tried to always encourage Blythe to be everything she is. And she is many things – tomboy, budding model, athlete, compassionate nurturer, daughter, sister, friend, sensitive soul, brave adventurer. For her to fully develop into all that she was created to be, she needs to explore the many facets that make up who she is and be completely at peace with herself. We all long to be seen, to be truly known and deeply valued, and for a girl to be seen and known and cherished by her dad goes a long way to creating an unshakable foundation of self-esteem.

Becoming a woman Girls become women. No great revelation but somehow for a dad, quite a challenge. That cute little girl you wanted to protect forever from the big world suddenly fills out and develops women parts and starts to dress differently and, horror of horrors, boys start to look at her. Once a friend of Blythe’s older brother, Luke, hugged Blythe for longer than the requisite nano-second and I felt deeply primal feelings beginning to well up within me. As this lecherous young man, positively reeking with impure thoughts, clung lasciviously onto my daughter the desire to remove his head from his shoulders with my bare hands all but overwhelmed me. I realised that perhaps I was being slightly irrational and that it was after all a simple hug. He went on his way blissfully

unaware of the near death experience he had just had and I grew some more as a father. I have had to learn to celebrate Blythe’s emerging sexuality, to not be critical of makeup and short skirts, the occasional wearing of high-heeled shoes and the subtle and not so subtle changes attendant to becoming a woman. For a dad the boyfriend issue always looms menacingly on the horizon. Blythe’s first real boyfriend came rather sooner than I had planned. I was grateful that she told me all about him and wanted me to meet him to see what I thought. Apart from shaking his hand perhaps a little harder than was necessary it went well. It’s very important that all prospective boyfriends are fully aware that if they do anything to hurt your precious girl it could well be the last thing they ever do. It’s also important however for them to like you and want to hang out with you. It’s an artful balancing act between being welcoming and at the same time threatening. If they consider you cool but dangerous you’ve got it just right. Ultimately I realised that I had to trust Blythe. I could not possibly be there all the time to ensure that she behaved in a manner becoming of a young lady; but what I taught her, the love I showed her and the values I managed to impart to her would always be with her. These would be her guide. My theory goes something like this: if my daughter is absolutely secure in the unconditional adoration of her dad she will not be vulnerable to any inappropriate or over-zealous expressions of affection from young men. I’m sticking to it. Plan B is dismemberment without trial for the offending party, which would probably not be very constructive in the broader scheme of things.

Being available I have realised the importance of simply being available. As a divorced father this takes on a particular significance as Blythe does not always sleep under the same roof as me. I make sure that I call her every day, and I make sure that unless it is really impossible I always take her calls. There are times when I call her and I can just sense that she is not in the mood for talking, other times it’s impossible to get her to stop. I let her set the pace. The times when she wants to speak at length are crucial; she needs to know I’m there for her, that nothing is more important than her heart and that if she needs to speak about anything, no matter how trivial, I am there. I am unashamedly in love with Blythe. I tell her all the time and I show her constantly. I have love songs I sing to her (very badly!) and although she acts embarrassed when I do, I know she likes it.

Craig Wilkinson lives in Cape Town, South Africa, with his wife, Martinique, and his two children, Luke and Blythe. Craig has pioneered a number of commercial and non-profit projects and entities. He has worked extensively in the non-profit sector in the areas of experiential education, socio-economic development and the development of men and fathers, as well as a consultant to the corporate sector in training, strategy and human resource development. An avid hiker, mountain biker and fitness buff, Craig has a passion for the restoration of men to true masculinity and authentic fatherhood. He is the author of ‘DAD – The Power and Beauty of Authentic Fatherhood’, and founder of Father A Nation (FAN), a NPO that restores and equips men to be great fathers. He believes that if we can heal men we can heal the world. Craig studied commerce at Wits University, qualified as an ACIS and completed a course at Harvard University on Strategic Perspectives for Non Profit Managers. He is an author, speaker and facilitator.

www.babysandbeyond.co.za

FEATURE

Universal interventions for

bullying

The high prevalence of bullying increasingly making media headlines is having detrimental effects on our young people’s social, physical and psychological well-being, which directly impacts on their academic performance. By Dr Beverly Evangelides, National Academic Coordinator, ADvTECH Schools Division

A new manifestation of bullying in the digital world has given perpetrators leverage to remain anonymous, minimising the risk of being caught. Both bullying and cyber bullying are ultimately relationship issues and require relationship-focussed solutions. Evidence suggests that whole-school (universal) interventions are the most effective non-stigmatising means to reduce bullying.

What is bullying? • B ullying is a pattern of repeated, deliberate and intentionally cruel behaviour. • Bullying is intended to harm, induce fear through intimidation, threat, or overt or covert aggression. • Bullying is rarely a one-time occurrence. • Bullying may involve three protagonists: bully, bullied and bystander. • Bullying is not about anger – it’s not conflict to be resolved. It’s about contempt – a powerful feeling of dislike towards someone who is considered to be worthless, inferior or undeserving of respect. Contempt comes with three apparent psychological advantages that allow students

to harm others without feeling empathy, compassion or shame. These may include a sense of entitlement that they have the right to hurt or control others, intolerance towards difference, and a freedom to exclude, bar, isolate and segregate others (Barbara Coloroso, 2008).

Different types of bullying • O vert or direct bullying. This can be physical – taking something that belongs to someone else and destroying it; or verbal, such as name calling, joking and teasing. • Covert or indirect bullying includes gossip (spreading rumours or stories), social alienation (purposeful exclusion), intimidation (threatens or intimidates for desired effect) and cyber bullying (sending messages, pictures or information using electronic media, which may include computers, cell phones, tablets or devices, social media sites, instant messaging and websites – covert but direct). The proliferation of cell phones and mobile devices has led to growth in cyber bullying. It is less easy to www.babysandbeyond.co.za

FEATURE identify but potentially just as harmful as other forms of bullying. Technology cannot solely take the blame – the cyber bully and the culture of acceptance play a significant role. There is no bystander or witness to intervene. It is a direct form of bullying that can be largely undetected and continue over a lengthy period of time as there are no visible bruises, no ruffled clothing and no exclusion from the group – just a silent, powerful and malicious intent to deplete selfesteem.

Some myths and facts Myth: People are born bullies. Fact: Bullying is a learned behaviour and behaviours can be changed. Genetics may predispose a child to be big, but only experience teaches him/her to be aggressive or hostile. Children who witness repeated acts of intolerance, force and bullying are likely to adopt the prejudices and coercive behaviours. Myth: Bullying is a school problem, teachers should manage the problem. Fact: Children who bully tend to come from homes where aggression is a favoured problem-solving method. Negative emotional attitudes (lack of warmth and involvement) are common, and children are encouraged to fight back when harassed (Glover et al., 2000; Roberts & Moretti, 2000). The solution cannot be left to teachers alone. It requires the coordinated efforts of schools, communities and parents. Myth: Bullying is just a stage, a normal part of life. I survived the ordeal and so will my children. Fact: Bullying is socially unacceptable behaviour and is in no way considered to be ‘normal’. Accepting the behaviour gives the bully the power to continue disrespecting others. Myth: If I tell someone it will just make it worse. Fact: Research shows that when bullying is responsibly reported to an adult in authority or a trusted peer and they become involved, bullying will stop. Myth: Hit the bully back! Stand up for yourself! Fact: Research shows that hitting back may escalate the problem to a situation where the risk for serious physical harm may increase. Myth: Bullying will most likely go away when it is ignored. Fact: Ignoring bullies reinforces to them that they can bully without consequence. They can get away with it!

Tell-tale signs How do I know if my child is being bullied? Pay attention to any change in behaviour that is noticeably different in frequency, duration and intensity. Step into the shoes of your child/student and listen beyond words, and look beyond the actions. Some tell-tale signs may include: • Frequent bruises or scrapes inconsistent with explanation. • Frequently dishevelled with torn or missing clothing. • Frequently missing belongings, money or lunch and arrives home hungry. • Emotional – cries, timid, nervous, anxious, withdrawn and sullen. www.babysandbeyond.co.za

• F requent stomach aches, headaches, always tired, has sleeping problems. • Frequently ill, absent, excuses for staying at home. • A noticeable decline in academic performance at school. • An abrupt lack of interest in school or outright refusal to attend school. • Withdraws from social activities both in family and friendship circles. • Rushes to bathroom on returning home as too afraid to go to the bathroom at school. • Change in behaviour after receiving a phone call, SMS or email – becomes sad, angry or scared. • Reluctant to disclose what’s happening.

Intervention strategies Breaking the cycle of violence involves more than identifying and stopping the bully. Students need to know that they do have choices and that they need to evaluate their choices. Individual interventions need to be developed for students who have been directly involved in bullying, as either victims or bullies. It is not only the victim that requires attention but the bully and, in some instances where evident, the bystanders too. Immediate intervention involving all parties is beneficial as this action alleviates the bullying incident from festering into something huge.

Behavioural/response approaches Teach students they have three approaches to choose from: • Aggressive – behaves just like the bully. Fighting back makes bullying worse by 70%, therefore it is unhelpful (Rosenthal, B. 2008). • Passive – walk away and ignore the bully – no eye contact, pretending it doesn’t bother you or telling the bully to stop. • Assertive – stand up for your rights while not violating the rights of others, telling a trusted friend (32%) or an adult at school (34%) made things better. The first two points are the least effective strategies. Students are to be encouraged to choose, adopt and practise the assertive approach. In conclusion, every child has the right to be educated in a safe and secure environment free of fear and harassment. Schools and parents need to become involved in the lives of their students/ children and continue to build capacity for action. A collaborative school-family-community partnership is ideal. It takes just one bullying episode to demoralise a school community and to poison a learning- and teaching environment. We all have to work together to create a safe, caring, respectful and bully-free zone. For more information, visit www.bullying.org. References Coloroso, B. (2008): The Bully, the Bullied and the Bystander. Collins Living Edition. Glover, D, Gough, G, Johnson, M, & Cartwright, N. (2000): Bullying in 25 secondary schools: Incidence, impact and intervention. Educational Research, 42, 141 – 156. Rosenthal, B. (2008): Bullying. Greenhaven Press.

HEALTH

Treating

ADD and ADHD

Over the years there have been many debates and controversial discussions about what Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are, as well as how they’re diagnosed and treated. By Claire O’Mahony, Educational Psychologist, Sandton Psychology Centre The definition of attention-deficit/hyperactivity disorder (ADHD) has been updated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This revision is based on nearly two decades’ research showing that ADHD, although a disorder that begins in childhood, can continue through adulthood for some people.

Changes to the disorder ADHD is characterised by a pattern of behaviour present in multiple settings (school and home) that can result in performance issues in social, educational or work settings. As in DSM-IV, symptoms are divided into two categories of inattention, and hyperactivity and impulsivity, which include behaviours like failure to pay close attention to details, difficulty organising tasks and activities, excessive talking, fidgeting, or an inability to remain seated in appropriate situations. Children must have at least six symptoms from either (or both) the inattention group of criteria and the hyperactivity and impulsivity criteria, while older adolescents and adults (over the age of 17) must present with five.

Treatment options There are a number of treatment plans available to parents when making the appropriate decision for treating their child for ADD/ADHD. Nutritious meals, play, exercise and learning better social skills are all part of a balanced treatment plan that can improve performance at school, improve your child’s relationships with others and decrease stress and frustration.

Pharmacological treatment Stimulants such as Ritalin, Concerta and Adderall are often prescribed for ADD. However, while these medications may help your child concentrate better or sit still, there is a general debate as to whether or not medication is a ‘quick fix’. What about the longterm effects and immediate side effects of appetite suppression, insomnia and an overall change in the child’s personality? Some parents have found medication to be the best result for their child, while others look for alternative treatments and see pharmacological treatment as the last resort.

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HEALTH Homeopathy There are many other effective treatments that can help children and adults with ADD/ADHD to improve their ability to pay attention, control impulsive behaviour and curb hyperactivity. According to Homeopath, Dr Raakhee Mistry, homoeopathy has often been used effectively to assist with ADD and ADHD. But unlike conventional medicine, there is no one particular homoeopathic medicine for these conditions. The ADD and ADHD symptoms for a particular child, and factors that aggravate or ameliorate the symptoms, are taken into account when selecting the remedy for the child. Homoeopathic medicines do not numb or block symptoms, but work with the body to re-establish a state of equilibrium. When the patient is in this equilibrium state, the symptoms ease and the patient is able to function better. The aim of homoeopathic treatment is not to keep a patient dependent on medicine, but rather to bring the patient to the space where he/she can maintain this equilibrium state. Many homoeopaths also incorporate other modalities into their treatment, such as supplements, herbs and probiotics. A child’s restlessness and ability to concentrate has also been linked to the state of the child’s gut.

Nutrition Good nutrition can help reduce ADD/ADHD symptoms. Studies show that what, and when, you eat makes a difference when it comes to managing ADD/ADHD. Here are some tips: • Scheduling regular meals or snacks, no more than three hours apart, will keep your child’s blood sugar level, minimise irritability and support concentration and focus. • Try to include a little protein and complex carbohydrates with each meal or snack. These foods will help your child feel more alert while decreasing hyperactivity. • Check your child’s zinc, iron and magnesium levels. Many children with ADD/ADHD are low in these important minerals. Boosting their levels may help control ADD/ADHD symptoms. Increasing iron may be particularly helpful. One study found that an iron supplement improved symptoms almost as much as taking stimulant medication. • Add more omega-3 fatty acids to your child’s diet. Studies show that omega3s improve hyperactivity, impulsivity and concentration in kids (and adults) with ADD/ADHD. www.babysandbeyond.co.za

Omega-3s are found in salmon, tuna, sardines and some fortified eggs and milk products. However, the easiest way to boost your child’s intake is through fish oil supplements.

Tips for supporting your child’s treatment To encourage positive change in all settings, children with ADD/ADHD need consistency. It is important that parents learn how to apply behavioural therapy techniques at home. Children with ADD/ADHD are more likely to succeed in completing tasks when they occur in predictable patterns and places, so that they know what to expect and what they are supposed to do. • Follow a routine. It is important to set a time and a place for everything to help a child with ADD/ ADHD understand and meet expectations. Establish simple and predictable rituals for meals, homework, play and bed. • Use clocks and timers. Consider placing clocks throughout the house, with a big one in your child’s bedroom. Allow plenty of time for what your child needs to do, such as homework or getting ready in the morning. • Simplify your child’s schedule. Avoiding idle time is a good idea, but a child with ADD/ADHD may become even more distracted and ‘wound up’ if there are too many after-school activities. • Create a quiet place. Make sure your child has a quiet, private space of his/her own. A porch or bedroom can work well, as long as it’s not the same place that the child goes to for a time-out. • Set an example for good organisation. Set up your home in an organised way and make sure your child knows that everything has its place. Role model neatness and organisation as much as possible.

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A strong foundation We all want the best for our children, but what exactly is that? While Hanna Kok, from Brain Gym in South Africa, doesn’t claim to be an expert on what’s right for you or your child, she is an expert in empowering people to create lives that are exciting, meaningful and fun. We all want to give our children optimal physical, emotional and mental development. In the early stages of life – from conception to age seven – it’s important that we focus on emotional and physical development. Let me explain. Our child’s brain goes through several developmental stages and it is important that we don’t skip any stage by accident because one phase builds onto the next. Dr Paul MacLean speaks about the Triune Brain, which consists of three areas: The Reptilian Brain or survival brain (the brainstem and cerebellum), the Limbic System (the emotional brain), and the Cortex (the thinking brain). All information comes from the body into the Reptilian Brain. From there it flows into the Limbic System before reaching the Cortex. When we don’t feel safe, or we are stressed, our limbic system gives the Reptilian Brain the command to prepare for fight, flight or freeze. Our brain goes into survival mode and all non-essential higherbrain functioning switches off by up to 86%. We pick up any sound and movement, as these could indicate possible danger. This means we cannot concentrate and learning becomes physiologically impossible. For a child to be able to learn properly later in life we need to ensure that his Reptilian Brain and Limbic System are properly developed and at ease, allowing information through to the Cortex. This also applies to us as adults! The Reptilian Brain is the first brain to develop. It has its major development spurt from conception up to 18 months, continuing up to the age of seven. For the Reptilian Brain to develop optimally a child needs order, routine, regularity (this makes young children feel safe), and large muscle movement using both sides of the body because then both brain hemispheres are stimulated.

A sense of balance Large muscle movements stimulate the development of the vestibular system – our balance organ. The more our vestibular system is stimulated through tumbling, turning, climbing, and other gross motor activities while growing up, the more we have

a sense of balance. Developing great physical balance gives us a strong foundation for emotional and mental balance later in life. Large muscle movements also develop our proprioceptors – the communication system between our muscles and our brain – so that we know the position of each of our limbs. It plays a big role in our muscle control. We can only develop fine motor movement after we have developed enough strength and control in our large muscle groups. For example, before we can learn to write we need control and strength in our torso, shoulders and arms. Touch is also very important as this stimulates the production of the Nerve Growth Hormone. The next phase is the development of our other senses. We need the three-dimensional world (not TV screens, computers and tablets) to develop our vision and auditory skills properly. Only the real world can teach us smell, taste and movement.

Forming relationships The Limbic system starts developing at about 18-months old and continues to the age of seven. At this stage we learn to form relationships with ourselves, the people around us and our environment. We also learn how to deal with our emotions (the terrific twos). Emotions play an important role with our ability to remember things – the more we learn to feel safe, the less likely it is that we’ll go into survival mode. For young children’s optimal development they need stimulation from exploring the threedimensional world. Minimise time in front of the TV, computer and other electronic gadgets, and forget the flash cards or wanting your child to read and do maths early. There is enough time for that later. Let your child move, have free play and down time without organised activities. Time on the jungle gym, in the pool and on the swing are what children need for optimal brain and physical development in preparation for school later. For more information, visit www.braingymsa.co.za or www.makealife.co.za. www.babysandbeyond.co.za

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Television and your

child The first years of children’s lives are critically important to their lifelong development. Barbara Eaton, from ADvTECH Schools Division, considers the effect of TV and electronic media on brain development.

The American Academy of Paediatrics recommends no TV under the age of two. The Australian government recommends that children under two should be banned from watching TV and all other forms of electronic media. France has banned all TV for children under the age of three. So why are these countries taking such a radical view when 67% of South Africans poled by The Baby Expo believe that TV is okay for babies? From various research projects it appears that there’s overwhelming evidence that TV and electronic media are bad for babies and children under the age of three, as it puts brain development at risk. Dr Dimitri Christakis, a paediatrician and the director for the Centre of Child Health, Behaviour & Development at Seattle Children’s Hospital in the US, has shown that brain development is inhibited by TV because it provides too much sensory input that is too fast for the baby’s brain. Not only does this not aid the development of those important synapses, it actually reduces attention span and

neglects to activate the important regions of the brain, such as problem solving and language. The more TV watched by the age of three, the more likely the child is to have attention problems by the age of seven. Each hour of TV watching before three increases this likelihood by 10%. On the other hand, each hour of cognitive stimulation provided by reading to the child, talking and playing with blocks reduces the likelihood of attention problems by 30%. Fascinating studies on baby mice exposed to TV as opposed to those developing normally, show the TV-exposed mice as having hyperactive behaviours, showing more risk taking behaviour and having poor attention and poor memory. Six months after a study was conducted in America with 200 children aged 18 to 24 months, results revealed that those who had interaction with adults during block play showed above average language development compared to the control group who scored below average on language development. Because of the time spent interacting with parents, TV time for the first group lessened. www.babysandbeyond.co.za

FEATURE Preschool children who watch little TV have better imaginations and can invent stories and play scenarios that are not dependent on TV characters or plots. So, would you allow your little one to engage in an activity that is likely to change the way his brain develops or damage his body through inactivity?

Older children and TV As well as the negative indications listed above, TV can sabotage your child’s acquisition of reading. We know that children who love reading do better in school but most children stop reading books that are not assigned by school by Grade 6. Only 2% are reading at an advanced level by Grade 8. Research shows that the more children watch TV by the age of eight, the less they read after this age. Books are more work and can’t compete with the ease of TV/video. If children watch very little TV until the habit of reading is ingrained, reading can then compete with electronic media, as long as it is used sparingly. So what about programmes like Sesame Street? Don’t they teach letter recognition and early reading? Yes, they can assist those children who have plenty of parental interaction and support, but not as effectively and as quickly as for those children whose parents read to them. Additionally, the links between obesity and the persistent TV watcher are also well researched but there are many factors involved, such as how long children are sitting for, and what other physical activities they’re involved with. Is the child snacking and, if so, on what? What food and beverage advertising is your child exposed to? Children with TV’s in their bedrooms are more likely to be obese as they watch for longer unsupervised periods and usually lying on their beds. Children who eat meals in front of the TV will generally want to snack as soon as the TV is on, leading to higher consumption of sugary and high-fat foods.

As TV temporarily changes brain chemistry, it can become addictive and no parent wants to encourage addiction of any sort. So what should responsible parents do about TV/ DVD’s/computers and iPads? • Play with your child and interact as much as possible on a verbal level, especially reading aloud. You can do this well into their teens as you can read content that is well above the child’s reading ability, such as the classics! • Do not allow your child, under the age of three, to watch TV/DVD’s at all and severely limit other screen time to a few minutes a day. • Take the TV out of the bedroom. • Have firm rules about when and what TV can be watched. One hour a day, and that is already 10% of their day, is more than enough for a child of six or younger. • School age children should only watch after their homework is complete. It is hard to reactivate the brain after flopping in front of the TV as soon as you get home. Encourage a healthy, low-sugar snack and some active play before homework. • Know exactly what your child is watching and either watch with them or discuss the programme later. • If you are at work and you cannot supervise what is happening at home, disable your TV until you are present. Boredom is a wonderful stimulus to creativity. • Don’t permit watching TV until the child falls asleep on the couch. Your child is not learning to fall asleep naturally and this could cause problems later. Be aware that there is a significant amount of violence and sex in programmes not especially designed for children and you do not want your child to develop poor values. Children who see less TV become sexually active at an older age. • Set a good example by reading, talking, engaging in hobbies or playing board games. Save the TV until after the children are in bed. The old adage of ‘moderation in all things’ is good to remember.

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Holiday time

It’s that time of year again and organising a holiday to suit the whole family may be a daunting task. However, with some careful planning everyone can have a relaxing break. By Emma Dawson

When planning your holiday the first things to consider are where you want to go, what you want to do, how far you want to travel and by what means, whether there are health requirements and, of course, your budget. Climate and childcare facilities are two other important considerations. Young babies are easy to transport (in a car seat, sling or pram), they sleep a lot and are easily entertained. This means you could consider a babyfriendly hotel or self-catering venue from which to spend your days exploring or relaxing. Babies won’t care where they are as long as they’re with you and their needs are met. Toddlers, on the other hand, love excitement and holiday options are wide open, but remember to look into safety features and potential hazards where you’ll be staying. Are swimming pools fenced, are stair gates installed, are there split levels or balconies? For older children, going away with friends or cousins can add to the fun and excitement.

Getting to your destination Will you be driving or flying? It’s always advisable to speak to your GP or paediatrician about long-haul travel with a young baby. It’s also worth considering a short-haul trip for your first holiday to see how everyone fares. Airlines are geared for parents travelling with babies and children, so give them a call when you’re making your plans. For young babies, sky cradles are available on a first-come, first-served basis, so request one when making your booking. Also request baby or kiddies’ meals when booking, and if you take milk or food on board, the cabin crew will warm it for you. However, when taking liquids on-board international flights don’t forget to check the rules with your chosen airline. Children are extremely vulnerable to injury in vehicles. Ensure that they are either wearing seat belts or are securely fastened into their car seats. Never allow a child to stand or move around in the www.babysandbeyond.co.za

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Where to go and what to do? car, or sit on your lap. Also, never share a seatbelt with a child – they will be crushed between your body and the seatbelt if you’re in an accident. In addition to ensuring that you and your children are appropriately buckled up, also make sure that your car and anything you’re towing has been serviced and that you’ve checked your oil, water, wheels and tyres before embarking on a road trip. If you’re hiring a car, take the appropriate car seats or booster seats with you or request them when making your booking. Also make sure you have removable shades for the windows to protect your baby and toddlers from the sun. If you’re planning a long trip, schedule frequent breaks to rest and allow everyone to stretch their muscles. Don’t forget to take plenty of toys and activities to occupy your children while travelling. www.babysandbeyond.co.za

Toddlers love the beach. A simple bucket and spade will keep them occupied for hours, as will rock pools, collecting shells and building sandcastles. However, remember never to lose sight of your children and ensure you’re with them if they go into the water. Adequate sun protection is another must. City sight-seeing isn’t going to fascinate your toddlers, but the zoo, aquarium and petting farms will be firm favourites. Don’t forget to take a pram or baby carrier for when their little legs get tired. Game parks are strict about minimum age requirements for children, so always check this before making your booking. Also consider how long your child will happily sit in the car looking for animals. For a more social experience, family resorts and child-friendly hotels are geared for kids, offer childcare facilities, kids’ clubs and are often all inclusive (another big consideration).

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While self-catering may be more flexible and cost effective, unlike at a hotel or family resort, someone has to cook and wash up! However, the benefits of self-catering accommodation are that there’s generally more space, no set eating times, and more options for ‘getting away from it all’. Camping is another good experience for children and a great way to enjoy the simplicity of nature. It can also be a wonderful adventure and learning experience. Planning successful, enjoyable camping trips when your children are young will set them on the path to a lifetime of outdoor adventure.

Health considerations When away from home and the normal eating and sleeping routine, children may be more prone to illness. While they acclimatise to their new environments – air, water and possibly the food – they

may be vulnerable to infections and upset tummies. Speak to your GP before you go. Motion sickness may also be a factor. While keeping the kids occupied in the car is a priority, if your children are suffering from motion sickness, don’t allow them to read or do any other activities while the car’s in motion. Rather get them to close their eyes or focus on the horizon. If travelling abroad, make sure the whole family has the required immunisations for the country you’re visiting.

Have fun Always book your holiday through a reputable supplier and, where possible, pay with a credit card for peace of mind. And, lastly, don’t forget to create memories – take your camera or video camera to capture the fun.

Travelling with children

– New South African immigration laws From October1, 2014, all minors (children under the age of 18), no matter what their nationality, are required to produce unabridged birth certificates with their passports when checking-in for flights leaving or entering South Africa. This does not apply to domestic travel within South Africa. If your child was born after March 14, 2013, you

should have been given an unabridged birth certificate when you registered your child’s birth. For children born before this date, you can apply at your nearest Home Affairs Department. You’ll need your child’s ID and R75 in cash. Unabridged birth certificates may take up to eight weeks to process.

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dreams

Where are made

Creating your baby’s nursery can be a fun, creative process but there are many considerations to take into account before beginning. Unchecked, costs can escalate but with some careful planning your baby’s room doesn’t need to be ‘cost the earth’. By Emma Dawson Most importantly, there’s no right way to create the perfect baby’s room – your personal choice, budget and space will largely dictate the outcome. However, there are a few key considerations to take into account, such as ensuring the room is safe, healthy, practical and warm.

Budgeting It’s easy to go overboard with all the ‘bells and whistles’ and to have a perfectly colour-coordinated nursery with everything that opens and closes. However, top of mind should be functionality and practicality. If your baby is sick you don’t want to be worrying about expensive linen being ruined, but rather about looking after your child. Family heirlooms and hand-me-downs from friends are a great way to save money, provided you check that these items are still in good working order and are safe to use. While it’s ideal to have a dedicated room for your baby, this isn’t always possible when the second or

third child comes along. Whatever the practicalities, ensure that the room is comfortable – you’ll be spending a lot of time here feeding, changing, and getting your baby to sleep.

Planning Before you purchase anything measure the room, windows and door openings and make a rough sketch of the area. Keep these measurements in your wallet so that you have them when you go shopping. Essential furniture items include a cot, baby changing table, a comfortable chair, a night stand or table, and a clock if you’re planning to breastfeed. A rocking or feeding chair would be nice to have near a window that you can look out of while feeding. Talking of windows, consider a block-out blind or backing for curtains to protect your baby’s eyes and to keep the room dark enough for sleeping during the day if the room gets full sun. Storage is another big consideration. You’ll need double what you think you will, and don’t forget to www.babysandbeyond.co.za

FEATURE Safety When planning your baby’s room, think safety first. • Don’t put shelves above the cot – either the shelf or items on the shelf could fall and hurt your baby. • Keep the cot as sparse as possible to prevent smothering and overheating. • Paint should be non-toxic. • Don’t put the cot next to the window where there may be drafts, or near curtains or anything hanging, such as blind pull cords that may be a choking hazard. • Fit safety locks to windows. • Keep mobiles high enough and out of reach once your baby becomes more mobile. • When it comes to linen, choose natural fabrics. Bedding shouldn’t have buttons or anything else sewn on to it that could be a choking hazard. The same applies to furniture and curtains. • Any rugs or mats should be slip-proof. • Childproof plug covers are another good idea. • If you need to use a heater in your baby’s room, do so with caution. Wall-mounted panel heaters are safe and energy efficient. • C hoose a cot with vertical slats that your baby can’t get his head stuck in, or climb. • A void putting a lamp on shelves or the edge of a table. It’s likely to get pulled off once your baby’s crawling.

Decorating

plan for toys as your baby gets older. Using baskets on shelves near the changing table will help with storage space for baby essentials if cupboard and drawer space is limited. Also consider multifunctional furniture or something with longer legs that allows you to store boxes underneath. Storage benches that double up as a toy chest and a seat are perfect for small nurseries.

There’s no right way to create the perfect baby’s room – your personal choice, budget and space will largely dictate the outcome. www.babysandbeyond.co.za

Keep it simple and decide on a single focus for the room early on. This is often the cot. Select the furniture before you begin decorating – it’s easier to match paint and fabric to the furniture than the other way round. Choose tranquil, neutral colours that are calming. Work out a colour scheme. Otherwise, if you choose a theme for the room, the colours will largely be dictated by the theme. If you don’t know the gender of you baby, choose neutral colours like cream, yellow, beige, pale green or grey. Consider using wall decals or stickers rather than wall paper or painted pictures on the walls as these are cheaper and easier to update as your child grows. The right lighting will help to soothe your baby to sleep, and some parents find soft lighting useful for night feeds. You can create lighting that best suits you by using a dimmer switch, night light or even a lava lamp. Blinds are also a good way of controlling light in the room during the day.

Adding the detail Once the large furniture items have been installed or assembled, all the safety check boxes ticked and the walls painted or papered, it’s time to choose pictures, mobiles, linen and soft toys. Don’t forget to keep nappies, wipes, ointments, bibs, receiving blankets, a bin and a toy or two near to your changing table. It’s very exciting planning your baby’s room and the best time to do this is during your pregnancy. You won’t have the time or inclination once your baby has arrived and you’re sleep deprived.

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The

dummy debate

Whether you call it a dummy, soother or pacifier, the debate about its use is one of the most contentious issues in the childcare arena. Emma Dawson considers the pros and cons of these compelling arguments. Although many parents use dummies to soothe their babies, some parents are completely opposed to them. Others are sure they won’t use one before their baby is born but change their minds when faced with a crying baby. While there are good reasons both for and against the use of dummies, it is a hotly-contested issue and ultimately boils down to personal choice.

The pros Besides providing parents with a modicum of peace, there are a number of good arguments for the use of dummies: • Some babies derive great comfort from sucking and, if a dummy is not provided, will resort to sucking their fingers or thumb. It’s claimed to be easier to wean babies from a dummy than from their thumbs (although removing a dummy can instigate thumb sucking in some babies who still have the desire to suck on something). • It’s also claimed that dummy sucking protects against Sudden Infant Death Syndrome (SIDS), although research doesn’t indicate why. Possible

explanations point towards dummies helping to keep the airways open during sleep and babies sleeping less deeply because they are sucking. It’s recommended that babies are given their dummies when they’re put down to sleep, but not put back into a baby’s mouth if it falls out once asleep. • The sucking reflex instigated at birth releases chemicals that reduce stress. A dummy provides comfort and helps to sooth a baby to sleep and to get back to sleep after waking during the night. • Dummy sucking produces saliva that helps to reduce plaque build-up on growing teeth and may ease pain during teething.

The argument against dummy use Equally, the disadvantage of using dummies has its support. Many experts don’t disapprove of dummy use, but there are a few drawbacks to consider: • Research suggests there may be a link between dummy use and ear infections as a result of bacteria moving from the mouth into the tubes between the ears and throat. As babies become more www.babysandbeyond.co.za

FEATURE •D ummies may lead to disturbed sleep for parents whose babies wake up and need to have their dummies put back in their mouths to go back to sleep as opposed to babies who are only given a dummy to help soothe them.

Dos and don’ts for dummy use • Keep dummies clean and sterilise them as you would all of your baby’s bottle teats. • Throw away damaged or cracked dummies and try to replace them every few weeks. • Never dip the dummy in honey, jam or sweet drinks as this can lead to tooth decay. • Orthodontic dummies and dummies with air holes in the shield are generally recommended. • Try limiting soother use to key times, such as during spells of colic or just for settling, as prolonged use has been linked to middle ear infections and other problems. • Consider waiting for your baby to need a soother rather than automatically giving it to your baby. • Try to wean children off their soothers before their first birthday (it is much easier to do it then, than at two to three years’ old) and definitely before permanent teeth come through (usually at the age of six). • Don’t let using a pacifier become a habit.

When it comes to weaning

susceptible to ear infections over the age of six months, cutting back before this time may reduce the propensity to infection. • If introduced too early, using a dummy can prevent your baby from sucking well during breastfeeding and helping mothers to build up a good breast milk supply. This could confuse a baby learning to suckle and may cause feeding problems. It’s recommended only to introduce a dummy at about a month to six weeks of age once breastfeeding is established. • Research reveals that when used after the age of 12 months, dummies can be linked to speech problems – particularly when children don’t have the opportunity to babble enough when little and for those who talk with their dummies in their mouths when they’re older. • Parents can mistakenly offer a dummy when the baby needs feeding. • When used for too long, dummies have also been associated with dental problems – affecting the development and indentations in the palate – or with tooth decay and receding gums if dummies are dipped in sweet products such as honey. www.babysandbeyond.co.za

Although there’s no ‘right age’ to wean your baby off a dummy, it’s advised that the sooner you do it the better. It’s far easier to wean a baby off a dummy than it is to wean a toddler. However, depending on your child’s age, some careful planning, creativity and perseverance may be required. • Plan ahead. Don’t plan to do away with the dummy when there’s another big event underway such as potty training, moving house or the birth of a sibling. • Be patient, prepare to weather the storm and expect to have a few sleepless nights. Try to begin weaning over a weekend so that if there are sleeping problems it’ll be less disruptive and both parents are available to help. • Prepare your child for what you’re planning and begin to limit ‘dummy time’. Perhaps introduce a replacement to the dummy, such as a soft toy or blanket. • Remove the dummy once your child has fallen asleep so that he gets used to waking up without it. • Point out older girls and boys, who don’t use pacifiers, to your child – pre-schoolers love being more grown-up. • Encourage your child to give all his/her soothers away to a person who is important to them, such as a grandparent or a new baby. • Keep things in perspective. It may feel cruel, but with perseverance it will pass. The best judge of whether or not to use a soother is you. If your baby is struggling to feed and gain weight, you may consider reducing or eliminating the dummy to see if feeding improves. However, if you have a generally contented baby who occasionally derives comfort from extra sucking, then there should be no problem.

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Credit: Cotlands

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The critical first

1000 days

It is imperative that babies receive the required stimulation, nurturing and nutrition during the first 1 000 days – a life-defining period in anyone’s life. As a well-read mum it may come as no-surprise to you to learn that the first 1 000 days of your baby’s life will determine his physical, emotional and cognitive health for the rest of his life. During this crucial period the brain forms and refines a complex network of connections. The process of forming connections is natural, but experiences and our environment also promote network development. Researchers believe that this period of life – from conception to a child’s second birthday – can define everything from his chances of developing certain diseases such as diabetes, to determining academic success and future relationships. If conditions are adverse at any stage of early development, problems can occur later. It is imperative that all babies receive the required stimulation, nurturing and nutrition during this lifedefining period. In the rural and urban communities that Cotlands serves, children have limited, if any, access to good nutrition, resources and age-appropriate stimulation that enable them to reach their developmental milestones. Often children in these high-risk environments are in survival mode, further hindering their ability to learn and grow. As a result many of these children enter school developmentally delayed. Children who do not receive the necessary stimulation in these early days will lack the foundation they require to succeed in formal schooling. This results in them starting school at a great disadvantage, leading to children not finishing school. This in turn leads to high levels of unemployment among young adults struggling to earn an income and unable to break the cycle of poverty. And, there are broader societal consequences when their children are born into the www.babysandbeyond.co.za

same disadvantaged community, repeating the cycle. Cotlands has created programmes to maximise on this crucial window of opportunity and to address the developmental gaps experienced by children in under-resourced communities. The Cotlands birth to two-year programme equips mums with the tools to stimulate their children in ways that enhance their development. The programme helps children strengthen muscle and eye coordination, improve speech and brain development. Mums are taught the importance of good nutrition and where possible Cotlands partners with other organisations to provide families with nutritious food parcels. Stimulation to improve development does not necessarily require special equipment or expensive toys. Instead children require a range of experiences that should occur naturally in the environment, including being physically held, swaddled, exposed to textured objects, tasting new food, smelling flowers, looking at different objects and different facial expressions, listening to a caregiver’s voice and music. While it may seem common sense for some, it isn’t so for many caregivers in under-resourced communities. Mothers in these areas are often unaware of the importance of early stimulation as they themselves did not receive these cognitive and emotional opportunities. Cotlands actively works with mums to ensure their children are given every chance to reach their full potential, and wants to create a better society with everyone contributing to making South Africa a great place to live and work in the future. If you’d like to contribute to Cotlands, visit www.cotlands.org.

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Arm yourself against

medical bullies

If you’re a mom wanting to give birth naturally in South Africa you might find yourself facing some opposition, and not just from women around you. Jude Polack, director of active birth hospital, Genesis Clinic, provides advice on dealing with ‘medical bullies’. Standing up for yourself can be hard at the best of times. Doing it when you’re pregnant and have the life of your unborn child to consider is particularly daunting, especially when you’re up against a doctor or caregiver who’s intent on changing your mind.

That’s because in South Africa’s private healthcare arena, the decision to ‘go natural’ is often one that moms have to rigorously defend. Based on the experiences of moms who come to us at Genesis Clinic after being discouraged by their doctor www.babysandbeyond.co.za

FEATURE against natural birth, there are three clues to alert you to the fact that you’re dealing with a potential medical bully. The first is a doctor who warns you that your baby is too big or that you’re too small to deliver naturally. They’ll start hinting about this early on, preparing moms for a change of game plan. ‘Just start getting your mind around the possibility that you might need a Caesarean,’ they’ll say. But the doctor who tells you early in your pregnancy that your baby is going to get stuck is flat-out lying to you. There is no way to tell, even from an X-ray, that a woman’s pelvis won’t distend and disengage sufficiently for her baby, and ultrasounds can be off by as much as 400g. In my practice, I’ve seen tiny women giving birth to babies over 3.5kg without trouble, while bigger moms needed help delivering babies just over 2kg. Another common sign of medical bullying happens quite late in the pregnancy, at about 36 weeks. The doctor will start priming you that your baby hasn’t engaged or dropped down, which will unfortunately necessitate a Caesarean (C-section). However, a large percentage of babies will only engage once labour starts, particularly in second pregnancies. In fact, most second or third babies will only engage the day before or even once labour has started.

This isn’t just the day that a baby will be born ... it’s also the day that a mom is born.

The third clue you have a medical bully on your hands is when your doctor tells you halfway through your pregnancy that your amniotic fluid is drying up or calcifying. However, this typically only starts to happen once mom is two to three weeks overdue.

We’re being deceived To put it bluntly, women in South Africa are being deceived. They’re being given one-sided information aimed at pushing them into making decisions that suit the medical fraternity which, in the case of private healthcare in South Africa, is significantly skewed towards performing C-sections. The World Health Organisation says that a Caesarean rate above 15% is unjustifiable, yet private hospitals in South Africa have rates as high as 68% (National Perinatal Mortality and Morbidity Committee Triennial Report, 2008-2010). Disregarding elective C-sections, why is the rate www.babysandbeyond.co.za

so high? People joke and say that doctors in South Africa do Caesareans so that they’re not interrupted on the golf course. Convenience does come into it, but it’s more complex than that. Did you know that gynaes and obstetricians pay upwards of R40 000 a month on medical insurance, a premium that goes up significantly should insurance have to pay out for malpractice? It’s therefore understandable why some doctors would rather do a hundred unnecessary Caesareans than risk losing one baby or mom in a real emergency. For these doctors, C-sections seem like the safest obstetric procedure from a legal standpoint. Currently, government is working on capping medical malpractice pay outs, which might well have a significant impact on the number of C-sections pushed onto unwilling women in years to come. Until then though, what can moms do to get the best chance of having the safe, natural birth they want, without the bullying?

Getting the birth you want If you want to give birth naturally the most important thing you can do is to begin with the right caregiver. From the very beginning, have an in-depth discussion with your doctor. Find out what his or her C-section rate is and what his or her philosophy about natural birth is. Arm yourself with information about the pros and cons of both routes; don’t just rely on what you’re told. If your doctor is clearly not on the same page as you then you should consider finding a new caregiver. I’m always amazed how moms will swop hairdressers, nail technicians and insurance companies if they’re not getting the service they want, but they’re terrified of changing doctors. This is a very special time in your life; it’s your right to find a caregiver who will help you to enter motherhood in the way you choose while safeguarding you and your baby’s life. You should also consider finding a midwife or doula, even if you are planning to give birth in a hospital. They will come to your appointments with you, support you and stand up for you, while ensuring you get a safe experience. Currently, private hospitals don’t allow midwives in the labour room with moms, and only a handful allows doulas. However, with consistent pressure from moms this will change. Women need to put pressure on hospitals and doctors to start offering them the birthing experience they want. There is no reason why all hospitals shouldn’t have active birthing units, giving moms the beautiful experience they want, with the safety net for the 10 to 15% of moms who’ll experience complications. I always remind women that this isn’t just the day that a baby will be born ... it’s also the day that a mom is born. This is a huge rite of passage for a woman; she should be allowed to make this journey in the way she chooses, and with a caregiver who is mindful not only of mom’s and baby’s safety, but also of her hopes of how she wants to bring her child into the world.

FEATURE

incredible

journey

Abandoned at birth by his teenage mother, Lizo Tom’s incredible journey has brought him full circle. He now gives back to the organisation that gave him a chance at life.

Lizo Tom is a 29-year old fundraiser for SOS Children’s Village in Mamelodi. He is articulate, well-adjusted, calm, friendly and a very well-educated young man. His passion for music and singing is infectious. But what most people don’t know is that Lizo has been on an incredible journey that started when his teenage mother abandoned him at birth at a hospital in Port Elizabeth. Lizo’s story has taken him from Port Elizabeth in the Eastern Cape, through various caregivers to the love of an SOS family, and to musical journeys and magical places, so that one day he could give back to the organisation that gave him the very best chance of a fulfilling life.

Lizo was born in Port Elizabeth in 1985. His mother gave birth to him prematurely at seven months. Frightened at the prospect of having a baby to care for, especially one that was premature and frail, Lizo’s mother ran from what seemed so overwhelming, leaving her baby in the incubator at the hospital and fleeing. She gave her child a fictitious name, Lizo Tom, to ensure that no one could trace her or her family. Lizo’s recollection of his early years is sketchy. What he does know is that a kind nurse took him in and cared for him until he was a healthy, bouncing toddler. Unfortunately, she couldn’t keep Lizo and he was taken to a place of safety. Then, at the age of three, Lizo found his way to the SOS Children’s Village in Mamelodi from a referral by a social worker. He travelled almost 1 000km from Port Elizabeth to his new home and family. ‘I have no idea who the nurse is that took me in or how I got to the SOS Children’s Village,’ Lizo says. ‘All I know is that the nurse and social worker gave me a chance at life and I will be eternally grateful for what they did.’

And the music plays… ‘I consider myself exceptionally fortunate to have ended up in the SOS Children’s Village. I got a home, a mother and brothers and sisters – something I wasn’t used to. They also gave me the opportunity to get an education, which started in the Mamelodi Village Kindergarten,’ he remembers. www.babysandbeyond.co.za

Credit: SOS Children’s Village

Premature and abandoned

Lizo Tom is a 29-year old fundraiser for SOS Children’s Village in Mamelodi.

During his school career, Lizo developed a passion for music. He had a sweet tenor voice that gave goose bumps to those who listened. It was then that he realised that music would dominate his life’s work. As a youngster he would sing to anyone who would listen. He sang in the school choir and at village events. His dream came true when he was asked to audition for the Pretoria Youth Choir. ‘I was bowled over when the Pretoria Youth choir asked me to audition. When I was selected it felt like I was in the clouds and I never wanted to come down. The Pretoria Youth Choir is where I received my first formal voice training. It was also the first time I was on a big stage. I loved it,’ he exclaims. Talent combined with passion, determination to succeed and hard work paid off for Lizo when he was invited to join the South African Three Tenors in Sweden in 2003. They toured Norway, Finland and Amsterdam.

FEATURE On his return home in 2004, he enrolled at Funda Music College in Soweto. The following year he travelled to Japan with a group, Rainbow Stars, to perform in a World Peace Concert. In 2008 he returned to Japan with the same group for another concert. Focusing on voice training, Lizo also studied at the Ochrim School of Music and finally settled at the State Theatre where he worked for a number of years, performing in many shows and concerts. Lizo’s achievements and opportunities in the music world are inextricably linked to the love, support and guidance that he received from his extended SOS family.

Giving back ‘I often thought about my brothers, sisters and mother at the SOS Children’s Village and wondered what happened to them. I contacted the village director to ask if we could have a reunion with all the former and present children to celebrate the mothers and the sacrifices they made to raise us. The village director agreed with the proviso that I had to raise the funds for the reunion. This is where my journey back to the village started and where I took my first tentative steps in fundraising,’ Lizo explains. ‘I began assisting with the fundraisers at the village to give back to the organisation, but primarily to

motivate the children and my fellow brothers and sisters. I had a burning desire to show them that history is exactly that, history, and that it does not have to dictate your destiny or your future. I wanted to raise money to give other children the incredible opportunities that I had during my time at the SOS Children’s Villages.’ Lizo was appointed corporate fundraiser for the SOS Children’s Village in Mamelodi in March 2012. ‘There are so many more children who have come through the SOS Children’s Villages that have become happy, contributing adults with an important role to play in society. I am so delighted that I can tell this story. Things could have been very different for me and so many other orphaned and abandoned children were it not for the intervention of SOS Children’s Villages.’ Lizo’s SOS family and experience remains a deeplyentrenched part of his life. ‘Donors and sponsors can make a world of difference in the lives of South African children who are at risk of losing, or who have lost, parental care. My story may have started as one of tragic realities and loss, but it evolved to one of hope and the unwavering love of a family. As South Africans we can make this the reality for thousands of other children,’ Lizo concludes. To support SOS Children’s Villages, go to www.sosvillages.org.za

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FEATURE

Pool

protection protocol

Drowning is one of the leading causes of death in children under the age of five, third only to car accidents and burns. While a swimming pool is a wonderful way for a family to socialise and relax, there is always an inherent danger. All pool owners are responsible for ensuring that their swimming pools are safely secured to prevent accidents. This can be done by using a safety net, a pool fence or a pool cover to prevent children from gaining access to a pool without adult supervision. Each option has its pros and cons.

The pool safety net First invented 42 years ago in Zimbabwe, the swimming pool safety net has saved countless lives. It is a simple, cost effective way to secure a swimming pool, while not detracting from the poolâ&#x20AC;&#x2122;s aesthetics and still allowing a view of the water. Safety nets have developed over the years and are generally fitted with a central tension system and float that assist the user to fit and remove the net with minimal effort. These nets can be operated by one person and shouldnâ&#x20AC;&#x2122;t take more than three minutes

to remove and just five minutes to replace for an average size pool. They offer an exceptional degree of safety and, in over 40 years, no reports of drowning where safety nets are installed have been reported. A safety net is a versatile option that can be custom fitted to any pool size or shape. It is designed with an open mesh so that crawling babies or toddlers are supported off the water on the netting should they fall into the pool. Their arms and legs become entrapped in the netting, preventing forward movement on the net. It is uncomfortable and will usually result in the child crying and alerting an adultâ&#x20AC;&#x2122;s attention. A crawling baby will be suspended off the water. As children get older, heavier and more mobile, they may come into contact with the water but will be able to push themselves up and away from the water. Safety nets have an expected lifespan of six

A safety net is a versatile option that can be custom fitted to any pool size or shape.

FEATURE

Below: The solid safety cover uses minimal fittings and attachments and is ratcheted into place and kept under tension. Below right: Pool fencing provides a means to secure the area that a pool is in rather than the pool itself.

to eight years in the sun. They are the most costeffective way of securing a swimming pool and have an excellent track record in drowning prevention.

Pool safety covers Another option for securing your pool is the solid safety cover. This cover is manufactured from PVC and supported in place by poles at regular intervals across the pool. The solid safety cover uses minimal fittings and attachments and is ratcheted into place and kept under tension. Designed to support the weight of two adults and a child, it also helps keep the pool clean and free of leaves and debris, reduces water evaporation and chemical use. The solid safety cover is not as versatile as the safety net and can only be used on certain pool shapes and sizes. It’s also heavy and requires two people to fit and remove it. However, it does provide a high degree of safety and there are fewer fittings and components attached to the paving. It also offers more functionality in that it helps reduce maintenance and running costs. A solid safety cover is more expensive than a safety net and its life spans four to five years. The solid safety cover is another excellent way to secure a pool.

Pool fencing

Adult supervision is essential It is important to always remember that any safety product is a back-up only to adult supervision. When in use, a safety net or cover offers the best levels of protection. When off the pool, users are generally aware and take greater steps to monitor and supervise children in their care. The cover or net is replaced once the pool is vacated. Fencing offers a more constant security system but can result in a false sense of security. A child may access the pool area through an unlocked or open gate, or climb over or under the fence. A layered approach to safety is key, and implementing at least two safety measures to protect the pool is ideal. Constant supervision and a pool cover or safety net, door locks, a fence and a door or gate alarm should all be considered.

Drowing – a silent killer A safety net or any pool cover can never be a substitute for adult supervision. It is there to provide a last line of safety should a child wander off unsupervised. It only takes seconds for a child to drown. Drowning is a silent killer. In 2012 in South Africa, Netcare reported that it attended to 218 drownings or near drownings. This statistic is from just one emergency response operator. NGO, Childsafe, reports that 326 children drown every year because of a lack of vigilance, and the Medical Research Council has released statistics that over 3 000 people died from drowning in the last five years – this is more than one death by drowning every day of the year. A decision taken to secure a swimming pool is a decision taken to protect a child’s life. For a free quote or advice about securing your pool, contact Aqua-Net on 0860-AQUANET. www.babysandbeyond.co.za

Credit: Aqua-Net

The third option is a pool fence. Pool fencing is traditionally made using galvanised steel, with alternatives now made from fabric, wood, plastic and glass – all of which need be erected to a minimum height of 1.2m, with no means for a child to climb over or under the fence. It should be a smooth vertical surface, secured into the ground, and the gate must be lockable and self-closing. Pool fencing provides a means to secure the area that a pool is in rather than the pool itself. Many people feel that a fence provides a higher degree of safety than a net, but many drownings still happen in pools that are fenced. The main benefit of a pool fence is that there is no fitting or removal

required to access the pool. As with all the safety products available, pool fencing requires regular maintenance but, depending on the material used in its construction, should last in excess of 10 years.

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Grab some grub

Butterfly Chicken Portuguese/ North African style Serves 4 With our multi-cultural heritage we have developed a taste for robust flavours, and this chicken definitely delivers on that. The coconut milk keeps all the flavours in balance and the Coriander Pesto not only seasons the breast meat, but also keeps it moist.

Ingredients 1 large fresh chicken 2T (30ml) Ina Paarman’s Braai & Grill Seasoning 2T (30ml) Ina Paarman’s Coriander Pesto 4 thin slices of lemon olive oil 2 bay leaves

Brush-over Sauce

Method

Mix together the two Marinades and coconut cream and keep to one side. 10 minutes before braaing, place the chicken in the microwave and pre-cook, open, on medium for 10 minutes. This simplifies the braaing of the chicken and avoids raw meat inside and overcooked skin on the outside.

To prepare chicken butterfly-style, cut it open along the backbone and flatten the carcass by pressing on the breast-bone with the heel of your hand.

Braai the chicken over a slow fire for 30 to 45 minutes, basting with the brush-over sauce from time to time.

¼ cup (60ml) Ina Paarman’s Peri Peri Marinade ¼ cup (60ml) Ina Paarman’s Lemon Marinade ¼ cup (60ml) coconut cream

Loosen the skin over the breast. Season the breast meat with Braai & Grill Seasoning and squeeze about a tablespoon of the Coriander Pesto on to each breast, under the skin. Spread the pesto over both breasts. Cover the pesto with lemon slices and carefully pull the skin back over the lemon.

Recipes and pictures courtesy of

Season the bird all over with Braai & Grill Seasoning and drizzle with olive oil. Place the bay leaves in a shallow ovenproof dish that will fit into your microwave. Place the chicken into the dish, skin side up. Leave to stand at room temperature or refrigerate if preparing in advance.

Leave the cooked chicken on a wooden board covered with foil to rest for 10 to 15 minutes before serving. Garnish with fresh bay leaves and lime or lemon wedges.

Grab some grub

Fruit Ice Creams

with Jelly Baby Surprise Makes ± 20 large scoops

The great advantage of this recipe is that the ice cream does not melt easily, and is an outstanding source of bone-building calcium, vitamin A, D and E, as well as the vitamin C in the fruit.

Tools measuring cup 2 medium-size mixing bowls electric beater or wire whisk spatula food processor, liquidiser, hand held blender or fork 2 airtight containers ice cream scoop small sharp knife

Basic Ice Cream ½ cup (125ml) water 2 cups (500ml) fresh whipping cream 1 x 250g Ina Paarman’s Lemon Cheesecake Mix

Mango Variation 2 ripe mangoes, peeled, flesh cut away, or a 410g tin of mango slices, drained

Strawberry Variation 400g strawberries, washed with green stems removed, reserve 5 small strawberries to use as a garnish

To Serve 2 x 150g jelly babies ice cream cones www.babysandbeyond.co.za

Method To prepare the basic ice cream, put the water and one cup of cream into a medium-size mixing bowl. Sprinkle the Cheesecake Mix over and beat with an electric beater or wire whisk until smooth. Using the same beaters whip the remaining cup of cream until just firm in another medium-size mixing bowl. Using a spatula, fold the whipped cream gently into the basic ice cream mixture. Divide the mixture between two bowls. Pulverise the mango pieces in a food processor, liquidiser or with a hand-held blender or mash very well with a fork. Add the mango pulp to the one bowl and mix it through. Reserve five of the best strawberries to use for a garnish. Pulverise the remaining strawberries, in the same way, no need to first wash out the processor or whatever tool you are using. Add the strawberry pulp to the remaining bowl of basic mixture. Scrape both mixtures into separate airtight containers and freeze overnight until firm. Add a tablespoon of jelly babies to each cone to weigh them down a little and to serve as a surprise after the ice cream has been eaten. Scoop ice cream balls into cones and serve.

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Giving birth with girl power Baby skin care – an evolving science What is birth etiquette all about? Pool protection protocol A sun-smart summer www.babysandbeyond.co.za www.babysandbeyond.co.za

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ADVERTORIAL

Salty

Solutions By Dr Marco Knappe, Otolaryngologist

In South Africa, the treatment of respiratory conditions often aims at drying up the excess mucus produced in nose and bronchi and typically includes an antibiotic. This sadly places us among the nations with the worst antibiotic resistance pattern. Parts of the world with significantly lower resistance rates employ other remedies with equal if not better success and fewer negative consequences. One of the most important of these is hypertonic saline, which is used in nebulised form or directly in nose and sinuses as spray or rinse. Gradually, its use is gaining popularity among patients and doctors in our country for many reasons.

Efficacy Saline with a concentration above 0.9% is termed hypertonic. It has a moisturising effect on the membranes of the respiratory tract, cleaning them from dust, pollen or microorganisms. It also dissolves thick, sticky mucus allowing it to flow more easily from the nose. Another significant effect is that of reduced inflammation in nose and bronchi, reduction of swelling and increased blood flow to the lining of the airways. Most importantly, it improves the self-cleansing ability of respiratory membranes. Microscopic hairs covering the membranes transport mucus and particles out of nose, sinuses and lungs (mucociliary clearance). Larger pieces of phlegm or foreign objects are coughed or sneezed out. Both these mechanisms are supported and enhanced by the use of concentrated saline in nose, sinus and bronchial membranes.

Safety Solutions used for nebulisation or nasal rinsing/ spraying contain only water, salt and often bicarbonate of soda (baking soda), a natural component of our body fluids and effective liquefier of phlegm (mucolytic). No known side-effects exist for any of these ingredients. Even prolonged or frequent applications cannot lead to overdosing and accidental ingestion (swallowing) is harmless. Use of hypertonic saline together with other prescribed medication is safe and does not lead to any undesirable drug interaction. It can also be used as carrier liquid for other nebulised medications. All age groups, from infants to elderly patients, can be safely treated without risks. Its use during pregnancy and breast feeding is completely safe and actually recommended as first line (before you try anything else) treatment for respiratory ailments.

Prevention Regular use in healthy individuals decreases the number of irritants causing allergies thereby reducing their effect on the body. As a result, less medication is necessary to control allergic symptoms. Equally, viral or bacterial loads on the nasal membranes can be decreased. This leads to fewer respiratory infections, which are usually less severe with fewer complications. Pollutants trapped on the lining of the airway are successfully rinsed out and their effect on the patientâ&#x20AC;&#x2122;s health minimised. Low levels of humidity, whether caused by climate or air conditioning, lead to dry membranes that are less able to fulfil their protective role. Hypertonic saline not only directly moistens, but also has a prolonged effect of mucus production on the membranes.

First line therapy Most respiratory ailments are minor, self-limiting conditions. Most infections are caused by viruses for which no cure exists. Hypertonic saline applied as spray, rinse or nebulisation is an ideal supportive treatment. It assists the immune system in dealing with, and eradicating, the intruding germ. In many instances, it is the only management necessary, whilst in other cases it can be combined with additional medication, or intervention, such as physiotherapy. This allows patients and parents to safely start treatment and often deal with the illness entirely on their own. Consequently, visits to health practitioners are reduced and reserved for more serious or nonresponsive conditions. The use of unnecessary or even harmful investigations and medication is reduced and antibiotics, in particular, can often be completely avoided. This helps defuse the increasing problem of antibiotic resistance, which affects all of us individually and society as a whole. Dr Marco Knappe qualified as a medical doctor in 1989. As intern and medical officer he worked at several hospitals in different provinces of South Africa. He specialised as an otolaryngologist at Tygerberg Hospital, University of Stellenbosch between 1995 and 1999. Since 2000 he has been in private practice in Cape Town at N1City Hospital and Cape Gate Mediclinic.