babys beyond and
January - March 2015
Tick tock biological clock Future proofing our children Help! My baby’s choking Exercising while pregnant Fathers matter www.babysandbeyond.co.za
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CONTENTS Features
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10 13 16 18 22 25 28 30 36 38 48 54 64 62 68 72
Teaching children about money Twins – behavioural genetics Adoption, an incredible gift of love The importance of play Let children be children Financial security Tick tock biological clock Creating emotional balance Getting a good night’s sleep Future proofing our children Managing stress and anger What makes a woman a mother? Watch them grow The signs of sexual abuse Fussy, picky eaters Prevent drowning
Regulars 8 32 41 45 50 57 60 66 77 80 81 86 88
Health: Supplement basics for children Health: Help! My baby’s choking Health: Facing the fa[c]t Health: Exercising while pregnant Dad’s Diary: Fathers matter Health: Preventing infectious diseases Health: All about lactose Health: Adolescence leaves its marks Kicks for kids Grab some grub: Roast spiced leg of lamb Grab some grub: Nutty chocolate brownies Book Review: Kids’ Market Day, True Grit Junior Edition News: Classical concerts, Mom2Be chocolate shake www.babysandbeyond.co.za
CREDITS Editor: Emma Dawson editor@babysandbeyond.co.za Editorial Contributors Alma Torlage Andrea du Plessis Barbara Eaton Craig Wilkinson Dr Etti Barsky Gabriel Eksteen Gavin Sutton Hanna Kok Joanna Wilson Nolene Rust Prem Govender Shelton Kartun Suzette Bester-Cloete Content Coordinator: Melanie Taylor artwork@mediaxpose.co.za Design: CDC Design carla@cdcdesign.co.za Project Manager: Elroy Van Heerden elroy@babysandbeyond.co.za Cover picture: Twinkle Star Photography Model: Kouthar Vanessa Whatney Pictures: www.shutterstock.com babysandbeyond @babysandbeyond
Advertising Sales: Ehrin Manuel ehrin@babysandbeyond.co.za Lorraine Beneke lorraine@babaysandbeyond.co.za Alison Davids alison@babysadnbeyond.co.za Tamzin Whatney tamzin@babysandbeyond.co.za Aeeshah Davids aeeshah@babysandbeyond.co.za Chief Financial Officer: Shaun Mays shaun@mediaxpose.co.za Accounts Assistant: Melany Smith accounts1@mediaxpose.co.za Subscriptions and Distribution: Melany Smith subscriptions@mediaxpose.co.za Printing 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 The importance of education
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s I write my editor’s letter, the world remembers Mandela on the first anniversary of his death. Madiba was a great politician, showing immense leadership in steering the anti-apartheid struggle, in negotiating the transition from apartheid to democracy, and later in bringing about partial reconciliation between black and white South Africans. He was also a great believer in education and life-long learning. ‘Education is the most powerful weapon that you can use to change the world,’ is one of his famous quotes. He was adamant that every person should be educated: ‘Education is the great engine of personal development. It is through education that the daughter of a peasant can become a doctor; that the son of a mineworker can become the head of the mine; that a child of farm workers can become the president of a great nation. It is what we make out of what we have, not what we are given, that separates one person from another.’ It’s sadly no secret that the state of education in South Africa is sorely lacking. The Human Sciences Research Council claims that the quality of education and learning in South Africa fares severely in comparison to various other poorer countries. This is despite about 7% of South Africa’s gross domestic product – 20% of the total state expenditure – going into education. The primary focus of many parents is to provide their children with quality education so that they are better equipped to compete in today’s tough work environment. There is also increasing recognition that education is key to South Africa’s future prosperity. One of Baby’s and Beyond’s primary aims is to provide informative articles that educate and provide advice for our readers. In this edition, our pages are brimming with content that delivers on this promise. Just some of the articles focused on education include teaching children about money (p10), whether or not to separate twins at school (p14), the importance of play (p18), letting children be children (p22), and how to ‘future proof’ our children (p38). Other hot topics include a highly-informative article on what to do if your child is choking (p32), the worldwide epidemic of childhood obesity (p41), how to exercise safely while pregnant (p45), and, in my opinion, an absolute must-read about the impact of fatherhood (p50). As the new school year begins, I wish you a happy, healthy, education-rich year, filled with fun, learning and positive experiences that will shape great leaders for the future of South Africa.
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Health
Supplement basics
for children
Nutritional supplements are playing an increasing role in helping to ensure optimum nutrition. However, it is important to understand the role they play in supporting optimum nutrition and good health. Andrea du Plessis, Nutrition Expert at Vital Health Foods, explains.
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HE topic of nutritional supplements is guaranteed to raise very relevant questions, which include: • Are nutritional supplements essential? • Can we rely on food to provide optimum nutrition? • Are supplements safe? • How do you identify quality supplements? • Do they provide a sensible way of optimising nutritional intake? Or do they encourage complacency and unhealthy eating habits? • When and how should supplements be taken? These are all pertinent questions and, as parents and healthcare professionals, we want to be sure we’re making the right choices and recommendations concerning the health of the next generation.
Are nutritional supplements essential? In babies and young children nutritional requirements are naturally increased to support their growth and development. Most parents choose nutritional supplements that they believe best serve these
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increased demands. The question is whether we can rely on food alone to provide our bodies with optimum nutrition? A recent report suggests that we are far from achieving that. A survey carried out across the US, UK and Western Europe reveals some shocking dietary inadequacies with between 25 and 75% of people in these regions not achieving the recommended intake of the B Vitamins, Folic Acid and Vitamins A, C, D and E. Another survey shows poor results for the intake of calcium among adolescents in the US, with 10% of boys and 25% of girls not even achieving 50% of their adequate intake of this essential bone-building mineral. In communities where access to nutritious foods is not restricted and where many processed foods are fortified with essential vitamins and minerals, these figures are alarming. All these nutrients play key roles in the growth and development of young children. It is worrying to think what the nutrient intakes across South Africa may look like, especially with the
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Health very high intake of refined starches, fats and sugar from the ever-popular and low-cost potato chips, puffed maize crisps and sweetened soft drinks.
Can we rely on food to provide optimum nutrition? The recommended five portions of fresh fruit and/or vegetables per day make most people uncomfortable as this is not easily achieved. The most shocking fact to consider with this recommendation is that even five portions per day are not likely to provide optimum nutrition. This leaves most mothers feeling disheartened especially those making an effort to incorporate pureed vegetables into their family’s favourite spaghetti bolognaise or stews and soups. What is wrong with this picture? If it is nearly unrealistic to get to this goal of five portions of fruit and vegetables per day, how can our bodies naturally need so much? Reviews of the nutritional composition of fruits and vegetables indicate a decline in the nutrient density, which represents the relative concentration of nutrients per mass of raw food. Contributing factors include food processing, depletion of soil nutrients, as well as prolonged storage of fruits and vegetables, manipulated via temperature and hormonal control.
Are supplements safe? Multivitamins are generally safe as they contain small quantities of a variety of essential vitamins and minerals. It is highly unlikely to ingest excessive doses of individual nutrients by taking a daily multivitamin according to the dosage instructions.
Can multivitamins substitute a healthy balanced diet? No. Multivitamins aim only to supplement or ‘top up’ our dietary intake as they contain small amounts of a variety of essential nutrients naturally found in our foods. Unprocessed, natural foods contain many nutrients that are not found in sufficient quantities in multivitamins, such as dietary fibre, protein, carbohydrates, essential fatty acids and antioxidants.
Who needs a supplement? Certain groups of people are particularly vulnerable to nutritional deficiencies as they may have increased requirements or restricted dietary intakes. They include: • Infants: During the rapid growth phases infants need optimal daily nutritional intake to boost growth and development. • People with food allergies or intolerances: Dietary restrictions because of food allergies or intolerances, such as lactose (dairy) intolerance or wheat sensitivities, may result in insufficient intake of essential nutrients. • Children with learning difficulties: These children can benefit from taking omega 3 fatty acids and other nutrients that support the optimal development of the brain and nervous system. www.babysandbeyond.co.za
Did you know? A recent survey reveals that only one in five people eat five portions of fresh fruit and vegetables per day.’ • Adolescents: Adolescents have increased nutritional requirements during their rapid growth phases, as well as to maintain physical activity. • Chronically ill: Requirements for many nutrients are increased during illnesses because of altered metabolism and possibly restricted nutritional intake.
What should be supplemented? Do supplements provide a sensible way of optimising nutritional intake? Or do they encourage complacency and unhealthy eating habits? This is an important aspect to consider as research shows supplementation cannot replace the total nutritional value of a healthy balanced diet. The role of supplements in supplementing a healthy diet and eating habits should be established early in a child’s life. • Multivitamins provide a wide spectrum of essential vitamins and minerals to help optimise nutritional intake. • As it’s hard to obtain sufficient levels of the omega 3 fatty acids required to support the growth and development of the brain and nervous system, supplementation is recommended. • Calcium is the most important structural mineral in bones and teeth. Regular intake during the growth phases is essential to help the growth and development of bones and teeth. • In cases of iron deficiency, supplementation is indicated. • Frequent bouts of colds and flu during winter are known to compromise dietary intake, with subsequent compromises in growth during these important developmental years. Apart from ensuring optimal nutritional intake, immune support supplements can help reduce the risk and duration of respiratory infections.
Top tip The quality of supplements is difficult to determine by the consumer. It is important to look out for good manufacturing practice or pharmaceutical quality standards that ensure products are manufactured and tested according to international pharmaceutical quality and safety standards. Vital Health Foods, www.vital.co.za
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Education
money
Teaching children about
By Barbara Eaton, academic development coordinator for the Pre-Primary Schools at CrawfordSchools, Trinityhouse and Junior Colleges
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Education
Parents of children under the age of three should be careful to keep money away from their little ones as it’ll probably go straight into their mouths! However, from the age of three, we need to begin teaching important lessons that raise financially competent children.
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HE first step is learning to wait for something we want. Young children find this hard and adults who cannot delay gratification will not set a good example. Little ones can be taught to wait a while for a turn on the swing, an ice cream or a toy. This ability to delay gratification also correlates with later school success. www.babysandbeyond.co.za
When you go shopping do not automatically buy something for your child. Explain the shopping plan beforehand and then stick to it so your child does not associate shopping with goodies for them, too. It’s no good using the excuse that you have no money if they know you have a credit card! Helping mom or dad draw money from the ATM can give the impression that money is freely available at the touch of a few buttons. Be sure to explain that you work hard for this money! Once the child begins to receive money for birthdays, pocket money or chores, create three money boxes/jars – one for saving, one for spending and one for giving. The latter includes gifts for families and friends, as well as for charity. All money received must be divided accordingly and the child should be helped to set reasonable goals and manage their assets. Saving for a bike on R10 pocket money a week is too much for a young child so you could make agreements that when the savings reach a certain goal, you will fund the difference. A five year old can start to learn the values of coins. Keep your loose change until you have sufficient for sorting, matching, counting and calculating. From six you can begin to teach the difference between needs and wants. While writing a shopping list, discuss whether you really need those chocolate biscuits or you just want them. Help the children to discuss this in terms of their own desires. Let your child see that you also set saving goals and are prepared to wait for something that is not essential. Comparing prices can also be taught while shopping. Look at the prices of two items, such as sugar, discuss the quality and, if comparable, choose the cheapest. Discuss bulk buying and show why you choose to buy 48 toilet rolls at a time rather than six. Use the price-check websites to compare and discuss the prices of bigger purchases when opportunities arise. These lessons will have to be gently and continually taught for proper understanding. Pre-teens can begin to learn about serious saving, long-term goals and compound interest. The best way to teach the latter is to do the calculations with them. How much more interest can you earn over five, 10 and 15 years? As post matrics they are going to want a university education, a set of wheels, or a gap year overseas, so why not get them involved in saving for one of these? Wealthy parents should be careful not to provide everything too easily. Their children need more help to manage money as they will never have experienced what it is to go without. If your child is to live in digs during his university years it is an excellent opportunity to teach budgeting and managing on a set income. Do not be tempted to top up the funds unless serious hunger is involved! Once the first job is attained, help your young adult to seek financial advice on saving for retirement. All this talk about money could be misinterpreted. The most important thing to teach your children as they grow is that money does not buy happiness, it buys choices. It’s what you do with those choices that makes you happy. ADvTECH Schools Division, www.advtech.co.za
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EDUCATION
Twins
– behavioural genetics
Whether they are identical or not, twins have shared their environment for nine months and are used to having each other around. But does this mean that we should treat them identically? By Barbara Eaton, academic development coordinator for the pre-primary schools at CrawfordSchools, Trinityhouse and Junior Colleges
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ATCHING a video of twins clinging to, and stroking, each other as they were washed after birth re-enforced for me that twins have a bond like no other. But should they be treated identically? In my opinion the answer is a resounding no, but there isn’t one formula that suits everyone. As a pre-primary principal for many years I have known numerous sets of twins and a couple of sets of triplets. Each needed as much individual management as do single children. They need to develop their own personality and to have their specific needs met. Twins are hard work when they are tiny as they are unlikely to wake, feed or cry at the same time. Don’t be afraid to let one twin cry a little, they seldom wake each other up and by rushing to prevent this or you will exhaust yourself. Things get easier as they begin to sit up and take notice of the world around them as they have each other for company and entertainment. Toddlers are always a handful but if sensible boundaries are in place from the start, ‘twin chaos’ is unlikely to happen. Establish a good bedtime routine as early as possible and attend to one child at a time so each gets your attention and affection. Get out so they meet others and so that you all have a break from home. If they are walking, use reins or a leash to prevent them wandering in different directions while you shop, or take one child at a time if you have a nanny or partner to leave the other with. This also gives each child more individual time. I think it wise to dress identical twins differently, or at least buy the same clothes in different colours. If you do this from birth there won’t be a problem when a
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teacher requests different clothing or hair styles to tell them apart. It also helps relatives, friends and their peers to treat them as individuals, not clones. Once they are in school uniform they will simply look like the rest of their peers. When old enough, let them choose their own clothes. Give them their own cots, beds, and plates to demonstrate their individuality. Twins and triplets attract attention from others but in my experience what they really crave is individual attention. From the beginning, parents should try to identify their differences and encourage them to grow up with their own personalities. From two years’ old, let them mix with others individually, not just as a pair, so they can make their own friends. If they have to constantly rely on their twin they will find it difficult to separate. There is usually one twin who is more dominant than the other. If left to their own devices socially and emotionally it can lead to one dominant and one submissive twin and a situation that’s unhealthy for both.
Twin language About 40 to 50% of twins communicate with each other in a ‘language’ that outsiders do not understand. This could be because they have had insufficient adult language modelling. Ensure that you talk to your twins about anything and everything from birth. If they persist with their own language be aware that it could be because of phonological delay. If they are unintelligible to adults by 24 months get advice from a speech therapist. Twins and multiples do present with more language difficulties than single children. Early remediation with speech difficulties is important.
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EDUCATION
The good twin and the naughty twin To get attention children resort to different types of behaviour. This is their ‘language’ and we need to interpret what they’re trying to say to us. Usually it’s a cry for attention, even if it’s negative attention. The ‘good’ child is also trying to get your attention. Try not to react immediately to the child who is behaving badly as this reinforces the action. First compliment the child who is behaving well and then deal with the troublemaker. Spend some quality time with each child individually, doing something of their choice. If possible, let Dad take one child and Mom the other and then swap next time. Childhood is a time to build memories and nothing does this as well as special time spent with a parent. If their interests are different, read them different stories, buy them different toys and take them on different outings.
To separate or not at school? Starting ‘Big School’ is the same for twins as for other children, a mixture of excitement and trepidation. Your twins should have visited their school, know where the classrooms and bathrooms are and who their teacher is. If you intend to separate them for the first time, they should be accustomed to doing other things apart, such as play dates and outings. Separation depends on many factors, not just the children. If you have a choice of schools, try and select one with more than two classes per grade as this will give you more opportunities. For play group and Grade 000/00/R the children will probably feel more secure if they are in one class but not if one twin is dominant as the other will not have the opportunities to develop.
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I worked with one set of three-year-old twins who we separated after a month because the dominant twin didn’t allow the submissive child to do anything on his own. Within a very short time this little man just blossomed and his dominant brother seemed greatly relaxed without the need to manage his sibling all day. For Grade 00/00/R ask the advice of the teachers who already know the twins well and then in Grade 0/R separate them so that their individuality and talents can blossom. Obviously you will discuss this with the teachers and principal and together choose the teacher who suits each child. If the opportunity to discuss the needs of your twins is not given, research the options and send your request in writing. As the children move up the school, having them in different classes may cause you more headaches but it’s a small price to pay to have your twins educated as individuals and not constantly compared or referred to as ‘the twins’. Teachers make different demands about homework and projects so you may have two sets of homework to cope with. Please allow your children to choose the extra-murals that interest them. There are situations where separating the children may not be wise. If there are extenuating circumstances at home (severe parental illness, divorce or death), twins may function better by being together. If one teacher is known to be much better than another, opt for the good one for both children. Once the taxing early years are over, you can bask in the blessing of twins. After all, you’ve raised two children in the time it usually takes to raise one and may not need to repeat the process. ADvTECH Schools Division, www.advtech.co.za www.babysandbeyond.co.za
FEATURE
Adoption, an incredible act of love
Pregnancy is a word that can mean great joy or great despair. If you’re facing an unplanned pregnancy, Adoption SA advises studying all the options and making an informed decision.
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OMEN struggling to fall pregnant or those reaching the latter years of their child-bearing age often consider the irony of having spent so many years in their youth avoiding getting pregnant, only to spend an equivalent number of years, and often a lot of money, trying to become pregnant. But facing an unplanned or crisis pregnancy can be difficult and emotional. If you’re pregnant there are many things to consider; and arming yourself with information about your options is the first step to making informed and well thought out decisions. An informed decision means that you have studied all your options, understood the consequences of each decision, analysed your and your child’s wellbeing, and made a choice that reflects what you’ve learned and discovered about yourself, your situation, and your needs.
The test is positive The home pregnancy kit confirms your worst fears. While you love children and want to be a mom someday, the timing couldn’t be worse. Perhaps you haven’t completed your studies, or you don’t have the financial resources to support a child. Your boyfriend feels the same way. What can you do and who can help you make the right decision?
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Many social workers, psychologists, doctors and members of the clergy are trained in option counselling. Some aren’t. At this crucial point in your life it would be very helpful to talk to someone who can clearly explain your options to you, as well as the short- and long-term emotional, physical and financial consequences. It’s critical that the person you talk to is objective, able to consider your needs and should not judge you on your choices. A good option counsellor will tell you that your options include: • Keeping the child: to be raised by the birth mom and/or dad and/or their family. • Giving the child up to foster care: placing the child in a temporary home until the birth mom feels able to resume full-time parenting. • Adoption: delivering the child and then giving it to an approved adoptive family on a waiting list to receive a baby. • Abortion: terminating the pregnancy at an abortion clinic or doctor’s surgery within the first four months of gestation.
You are not alone Women have been experiencing so called ‘crisis pregnancies’ for thousands of years. However, while www.babysandbeyond.co.za
FEATURE the associated emotions may not have changed much in all this time, the available options and the structures that exist to support a woman’s choices have. A study about pregnancy rates among school-going learners reveals that in 2008, 6.3% of all female learners in South Africa were registered as pregnant. So many young women are faced with this difficult situation each year and are not aware that they have access to someone who can guide them through their options to find the right solution.
Giving life If you are facing a crisis pregnancy, have considered all your options under the guidance of a compassionate counsellor, and have decided to make your child available for adoption, read on for important advice and insight into what this loving choice will mean for you and your partner, your child and the people who will finally be able to complete their family. If you are thinking about adoption, either facing a crisis pregnancy or wanting to adopt a child, you should be aware that many resources are available, offering expert assistance and guidance about the process. The National Adoption Coalition’s ‘AddOption’ programme is a centralised, unified hub, complete with a website and call centre to provide information and guidance for birth and prospective adoptive parents about the adoption process. It also provides an extensive database of adoption professionals across South Africa. ‘AddOption educates and creates awareness about adoption as an option when facing a crisis pregnancy, on becoming an adoptive parent, or extending a family through adoption,’ explains Pam Wilson, spokesperson for the National Adoption Coalition.
What is adoption? Adoption is a legal process that culminates in a biological mother and father signing over the parental rights of their child to another person or couple. The adoptive parents become the child’s parents and the same rights apply as if the child had been born to them. An adoption is facilitated by an adoption accredited child protection organisation or an accredited adoption social worker in private practice, and can be open or closed. In open adoptions, the birth mother has the opportunity to select the adoptive parents from a list of eligible candidates. She may request a meeting to finalise her selection and enter into an adoption agreement that accommodates some of her wishes, within the limits of the relevant legislation. This could mean that she can request updates on the child’s progress and remains in contact with the adoptive parents. However, she would not be able to contact the child unless the child requests contact with its birth mom once he/she reaches the age of consent at 18. In a closed adoption the birth mother does not www.babysandbeyond.co.za
know the identity of the adoptive parents and entrusts this choice to the adoption agency. In either case, the birth mother can choose to make her details available should she wish to be contacted by the child once they have reached the age of 18. From the time the birth mother agrees to the adoption and the papers have been filed in court, she has 60 days during which to change her mind and withdraw her consent. Whether or not the couple experiencing the crisis pregnancy is married, the biological father has the right to give or withhold his consent to the adoption. His input will be sought and documented as part of the legal procedure. The birth mother will have the ongoing and unconditional support of the social workers assigned to her, and may even elect to stay in a caring environment designed for expectant mothers where her medical and pre-natal needs are met. On the other side of the spectrum, all adoptive parents are put through a rigorous screening process to determine their suitability to adopt. Once they have been registered as adoptive parents they will be placed on a list with adoption agencies until they’re selected to fulfil their dream of becoming parents.
Adoption Myths Dispelled My family and friends will judge me if I carry a child then give it away. Our society, guided by our progressive Constitution, promotes freedom of choice. There will always be those who judge others. However, giving a child up for adoption is not abandoning it but loving it enough to allow it to have the kind of life you are not able to give it in your present circumstances. This is to be admired and in adoption circles is acknowledged as an ultimate act of love. The child will hate me. Social Workers and psychologists encourage adoptive parents to explain to children at a very early age that they are adopted and to do this in a caring way that helps the child understand the circumstances around the birth mother’s decision. They are typically able to embrace this as part of their life story and are given guidance to ensure a healthy self-image. Adoptive parents receive counselling before receiving a child to facilitate this understanding and self-acceptance throughout the child’s life. My life will be ruined forever. Making this choice will allow a birth mother to return to her life path and have the opportunities that wouldn’t have existed if she had kept the child. There are enormous emotional implications associated with giving a child up for adoption, but a caring system exists to help the mother through the difficult time and to make peace with her decision. The emotional implications of abortion or abandonment as alternatives are likely to be more long-term and intense. If you’re considering adoption or facing a crisis pregnancy, call 0800 864 658 toll-free and speak with an AddOption adviser. Your call will be handled in the strictest of confidence. For more information about adoption, visit www.adoption.org.za.
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Education
The importance of
play
By Barbara Eaton, academic development coordinator for the pre-primary schools at CrawfordSchools, Trinityhouse and Junior Colleges
When it comes to brain development, time in the classroom may be less important than time on the playground! To appreciate the value of play for a child, this research provides interesting reading. 18
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HE experience of play changes the connections of the neurons at the front of your brain,’ says Sergio Pellis, a researcher at the University of Lethbridge in Alberta, Canada. ‘And without play experience, those neurons aren’t changed,’ he adds. ‘It is those changes in the prefrontal cortex during childhood that help wire up the brain’s executive control centre, which has a critical role in regulating emotions, making plans and solving problems. It’s play that prepares a young brain for life, love and even schoolwork,’ he maintains. ‘The function of play is to build pro-social brains – brains that know how to interact with others in positive ways. To produce this sort of brain development children need to engage in plenty of www.babysandbeyond.co.za
Education so-called free play – no coaches, no umpires, no rule books,’ Sergio notes. Animals and some birds engage in play, not to learn survival skills as was previously believed, but to develop pro-social brains that enable them to interact with others. They, and humans, share very similar play behaviour, abiding by similar rules requiring participants to take turns, play fair and not inflict pain. This interaction, learned early, is essential to the human ability to socialise with others. It also has the added bonus of leading to better academic results. Why then are we moving towards restricting children’s opportunities to play and focussing more and more on desk/computer-based academics? Parents need to appreciate that in allowing their children plenty of opportunities to play, with others and alone, they are laying the foundations for academic success.
A whole body experience This play is not to be electronically focussed. All of our senses are crucial for learning. A two-dimensional world of TV and computers is just not activating the sensory systems sufficiently, leading to difficulties with learning later on. Children need active, experiential play so we need to get them out and about, exposing them to sensory-rich opportunities as often as possible. Learning is a whole body experience, not just for the head! Young children work hard at play. They invent scenes and stories, solve problems and negotiate their way through social roadblocks. They know what they want to do and they work and plan to do it. Adults must not be too quick to interfere in this process. There is a tendency to ‘bubble wrap’ children so they have little opportunity to work things out for themselves. This hampers them both socially and academically. So what should parents do? From an early age children need access to materials that will stimulate their sensory systems, such as water, sand, things that make a noise, books with pictures they can relate to and toys of different textures. The contents of your saucepan and plastics cupboard will give hours of creative play while teaching concepts of matching, size, shape, texture and sound. Things that bounce, roll and change shape when pressed or pulled help develop spatial skills and visual acuity.
Freedom to imagine Children must be free to move around once they are mobile, obviously with safety in mind, but do not fear the odd mouthful of grass or your child being dirty. Allow them to dig in the garden, pick flowers and when they are older, make mud cakes and grass ‘soup’ for their fantasy games. In the pre-school phase children need basic toys, not those with roles defined by the media as the latter limit imagination and the opportunities to plan and create. Provide the child with a good set of plain wooden bricks, a few non-battery operated
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cars, a soft doll or two, a teddy, some plastic plates and cups and a big ball. Old blankets or sheets for making houses and tents and some boxes and crates will provide the basics for endless creative and imaginative play. Play dough, some crayons and big sheets of paper (not colouring books) and some paints will amply provide for creativity. Some play rooms look like toy shops and children become overwhelmed by the choice, tending to mix the toys in a random fashion and are then overwhelmed by the complexity of tidying up. There are commercial organisations that give parents the impression that unless they are buying educational toys on a regular, even monthly, basis, they are not doing the best for their child. More important than a new plastic toy, is facilitating fantasy play. The Russian psychologist, Lev Vygotsky, informs us that children rise above their average behaviour through play. Play is the work of children and it is through fantasy play that children make sense of their world. They must pretend and take on roles to understand. The more time children spend in dramatic play, the more they advance in terms of intellectual development and their ability to concentrate. Curb the extra murals and allow uninterrupted time and space for fantasy play. Props can be simple and minimal – pretending a block is a cell phone and a box is a racing car, your tablecloth is a cloak and teddy is a superhero. This symbolic thinking will lead to creativity in writing at a later stage.
Learning through play Children also cope with emotions such as anger, fear and jealousy through playing out the scenarios with toys and friends. They become more self-disciplined as they discipline teddy: ‘You can’t have another sweet teddy; they’re bad for your teeth’. They develop resilience as they play out being left when Mom goes to work or big brother teases them. They imitate teacher and consolidate concepts as they teach them to younger siblings or their toys. Rules and routines imposed by parents are practised through play. The toy is bathed, read to and put to bed over and over again, and the routine accepted and internalised, diminishing bedtime battles. As children get older, the dynamic process of play becomes more varied and complex, reflecting the social and cultural contexts in which children live. They learn new skills and venture from their comfort zones in competition with others. Children master their egos and learn to live with everyday experiences. They formulate plans and rules and learn to negotiate their way through conflict. All these skills – learned through play – are essential to the development of individuals who can master academic challenges and live comfortably in their society. So, encourage your children to play by allowing them the freedom, time and space to do so; and choose a pre-school centre that believes passionately in play-based learning. ADvTECH Schools Division, www.advtech.co.za
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FEATURE
Let children
be children
Our children are growing up in a vastly different world to the one we inhabited as children. It is a great deal murkier, with some children facing extremely challenging situations at a very tender age. Alma Torlage, from SOS Children’s Villages, considers the lives of South African children and the challenges that lowerincome households face.
‘T
HE general state of child welfare in South Africa is that the majority of children who fall into the “needy” category are those whose parents cannot provide for them,’ explains Alma Torlage from SOS Children’s Villages. ‘And for parents that are around and able to work, they often don’t have anyone to look after their children. This leaves many with no other choice than to leave the kids alone at home under the supervision of the eldest sibling or alternatively to leave them in the care of someone they don’t trust.’ One of the biggest concerns we face in South Africa is the increasing incidence of child headed households. ‘As the HIV pandemic takes its toll we find more and more families where the parents are completely absent from the lives of their children, often leaving the eldest sibling to carry the torch. In most cases this child would be no older than 16, a tragic reality of a youth that is lost and a burden of responsibility that should never have to fall on the shoulders of one so young,’ Alma points out. ‘With no education or job opportunities, and in an act of sheer desperation, often the eldest female in a child-headed household will sell herself for sex as a means to put food on the table. This is a heart breaking
reality that happens far too often,’ says Alma. SOS Children’s Villages has made it one of its goals to provide a plate of food to every child within a child-headed home in an effort to prevent the unthinkable from happening. ‘At SOS Children’s Villages we provide children who have lost parental care or those who are at risk of losing parental care, with secure homes, with a quality education and a loving family environment. We also run a Family Strengthening Programme (FSP) that aims to provide short-term care to children that are at risk of losing the care of their families. The purpose is to enable children to grow within a safe family environment. We currently have 5 780 children that are younger than 18 years of age receiving support from the programme.’ Education is another big concern, with many teenagers and young children not attending school in the absence of guidance from an elder. ‘SOS Children’s Villages encourages children to make the right decision and to pursue an education. There are so many kids who decide to continue with school despite the fact that they face various adversities in their daily lives. Some of these children go as far as reaching university levels, bettering themselves and their communities in the process and making us so incredibly proud,’ Alma enthuses. It would be a shame to assume that children without parents or proper guidance are incapable of making a success of their lives. ‘We have countless examples of children who are warm-hearted, helpful to others and determined to make the best with what they have, despite the tough times.’ The situation is improving every year. ‘We feel very positive about the future in South Africa. There are so many opportunities and facilities that offer time and effort to make a difference in the lives of our children, leaving a large percentage of kids in a very fortunate position – this is at the heart of what we do and strive for at SOS Children’s Villages,’ Alma concludes. To support SOS Children’s Villages, SMS the word SOS to 42975 to make a R30 donation, or visit www.sosvillages.org.za
History will judge us by the difference we make in the everyday lives of children.’ Nelson Mandela
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FEATURE
Financial
security
A child’s safety is among the greatest concerns for any parent. However, few implement the necessary processes to ensure their child’s financial security. Prem Govender, CFP® and former FPI chairperson, chats to Emma Dawson about planning for a child’s financial security in the event that both parents should die.
L
OSING a parent is an exceptionally difficult time for any child and, in the unfortunate event that both parents should die, the impact is immeasurable. Not having financial security further compounds the situation and could have catastrophic consequences for your child’s future. Emma Dawson (ED): While people often plan their life goals they don’t seem to be as diligent about planning their financial goals to ensure that their families are financially secure. Why is it important to set financial goals? Prem Govender (PG): Sadly people often don’t realise that there’s a financial aspect or cost to attaining life goals. Although the goals that people
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do set are quite varied, it’s essential to ensure that they contribute to financial independence. Planning without taking this important factor into account means your goals won’t materialise. The trick to successful financial planning is to plan around, and for, your lifestyle. It is important to not deviate too much from this plan from year to year. For example, if you’d like to go abroad every four years for the cricket world cup, the only way you’ll achieve this is by diligently saving towards it. ED: Every parent thinks about their children’s future but few actually implement the necessary processes to ensure their children’s financial security. What are some of the common misconceptions?
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FEATURE PG: Most parents want the best for their children, and particularly for their education. Given the state of public education in South Africa it’s no surprise that parents are increasingly making huge sacrifices to send their children to private schools. However, unless you plan for this cost it’s not going to happen. Additionally, there is the possibility that death or illness can rob parents of providing the best for their children. It’s essential that parents carry sufficient risk benefits, like death and disability, to ensure that their dreams for their children don’t die with them. ED: What should parents consider to ensure their children are financially secure should something happen to them? PG: First, determine how much the children would need to live on from the time of a parent’s death to the time that they become financially independent. Although affordability would be a consideration, this sum will be based on the family’s current lifestyle and financial goals. A CERTIFIED FINANCIAL PLANNER® or CFP® professional can assist you in determining the amount to insure. All risks should be covered (death, disability and critical illness) as each impacts an individual’s ability to provide for his or her family. And, if the parents are self-employed or do not belong to a pension or provident fund, then they would also need to insure against loss of income in the event of accident or death. This is critical to the family’s survival if the breadwinner is unable to work. For a small monthly fee, known as a premium, it is possible to ensure that your children can fulfil their dreams and ambitions despite the demise or illness of a parent. However, this is not the only provision that parents need to make. There is always the possibility that both parents can die, leaving minor children without a guardian. The best thing that parents can do for their children is to leave a properly drafted will, clearly spelling out who would become the guardian. This should also specify who controls the children’s inheritance (usually trustees in a testamentary trust), bearing in mind that children under the age of 18 are regarded as minors and incapable of managing their own finances. If parents don’t stipulate this then the Master of the High Court decides who will raise the children and any inheritance is held in the Guardian’s fund until the child turns 18. A simple, well drafted will is all it takes to ensure that your children are left in the care of people chosen by their parents. Parents should also make provision for an executor or executrix who will wind up the estate according to the will. If the parents nominate each other to receive policy proceeds, but both parents die, then technically these proceeds will get paid to the Testamentary Trust. But, it must be remembered that in such an estate the trust will be formed at the end of the winding up process. Since the average
estate takes between nine and 12 months to finalise, arrangements may have to be made with the administrator of the estate to release sufficient funds for the upkeep of the minor children until the trust is operational. ED: Who are the professionals that can help with this process? PG: For financial planning, the ideal person would be a CFP® professional trained to identify and protect the needs of both the parents and the children. They will help the family with a financial plan that is tailored to their lifestyle and meets their specific needs. A CFP® professional is also able to draft a fairly comprehensive will reflecting the family’s needs and circumstances. However, it must be remembered that wills can become contentious documents. In the event that either or both spouses have been married before and have children with a different mother or father resulting in different custodial arrangements, the will can be particularly contentious. In this instance it may be best to seek the advice of specialists in the legal fraternity for expert advice. Wills can also become complicated when parents impose clauses that are tantamount to ‘ruling from the grave’. While these clauses are generally frowned upon, parents may have a very good reason for doing this and may need to consult with the relevant experts. ED: What should you consider when choosing a guardian? PG: I am of the view that the ideal people to replace parents (the natural guardians) are family members or friends that the children are familiar and comfortable with. Remember that the guardian takes the place of both mother and father and would be responsible for deciding how the child is raised and the schools they should attend, among other things. It makes sense that these decisions would be better received by the children if they come from someone they already know and trust. Ideally the people that feature in your will should be informed so that they are not taken by surprise when the will is read. I also believe that when children are old enough to understand, parents should have a conversation with their children about what would happen to them should either or both parents die. ED: Is there anything else that parents should be aware of to ensure they are safeguarding their child’s financial future? PG: Ideally, they will teach their children how to handle money and the importance of saving. Children learn by the example and guidance of their parents. It is important that parents are disciplined about spending and saving, and setting a good example for their children.
Prem Govender, CFP®, is the former chairperson of the Financial Planning Institute (FPI). For more information about financial planning, or to find a CERTIFIED FINANCIAL PLANNER® professional, visit www.fpi.co.za or call 011 4706000.
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FEATURE
Tick
tock
Is there ever a ‘right time’ to have a baby? For those who have waited until later in life to conceive, our biological clocks play a major role in fertility. By Emma Dawson
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N our twenties we were discovering ourselves, pursuing some higher form of education, focusing on beginning our careers, or perhaps scratching the itch of the travel bug that’s bitten. We wanted to party all night and sleep all day. We may have been less sure of ourselves but wanted our independence and the freedom to do with it as we pleased. By the time we reached our thirties, we may have had one or two more serious relationships and had our hearts broken a couple of times. But we were more at ease with ourselves, smarter, sexier and having the time of our lives. We may just have been looking for a deeper meaning to life. Our focus was about getting somewhere in life. If you had a partner at this stage he may well have been even less interested in starting a family than you were. Then, suddenly, you’re in your mid-thirties and the ‘golden window’ for procreation has passed you by. You’re considered ‘old’ in terms of child bearing ideals and the ticking of your biological clock is stronger than ever as your eggs diminish by the day. You panic.
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However, delaying becoming a mother until your life has more balance, your career is better established and your lifestyle is more stable is not necessarily a bad thing. The down side is, of course, that your eggs are no longer as abundant and of a good enough quality; your partner’s sperm may not be as virile; and getting pregnant may, in itself, be far more of a challenge in your latter child-bearing years. With marriage rates down and divorce rates up, the age of mothers when their first child is born has risen, and having fewer children has increased. Additionally, many women remain childless. Almost a quarter of women in their mid-forties don’t have children – a figure that’s doubled in a generation.
Tick-tock goes the biological clock However, there’s no getting around your biological clock.
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FEATURE In your 20s your body is primed for pregnancy. Irregular cycles of teenage years have normalised, ovulation is more predictable and eggs are still plentiful and of a good quality, ideal for fertilisation. The risks of pregnancy-related complications are low and your body is younger, stronger, fitter and better able to withstand the physical changes of pregnancy and demands of labour. Mentally, woman in their 20s may lack life experience but make up for it in enthusiasm for motherhood. They’re less likely to overthink the pregnancy and are more likely to be less anxious about having the baby.
Waning fertility While women in their 30s were climbing the corporate ladder and gaining life experience, their limited supply of eggs are also maturing. Getting pregnant in your 30s becomes more difficult, or may take longer than it would have in your 20s and, after 35, waning fertility becomes more noticeable. In fact, 35 marks the official starting point of ‘high-risk’ pregnancies.
Older and wiser From a medical standpoint, rounding the corner to 40 causes the greatest concern. Not only is it more difficult to get pregnant, but a woman’s highest-quality eggs are drastically diminished or been depleted. Menstrual cycles may be getting increasingly irregular and the risks of chromosomal abnormalities and miscarriage heighten. Although this may be the most difficult time to conceive, those that do have an increased chance of multiple pregnancies (adding to the ‘high-risk’ issues). It’s also in this age group that chronic conditions are exacerbated (blood pressure, diabetes, or the chances of gestational diabetes), and stiff, sore joints and varicose veins may get worse. Energy levels are also not as they were in your 20s and 30s. The up side of having a baby in your 40s are greater financial stability, life experience that translates into more patience and flexibility, and selfconfidence that ensures women are more in control of their pregnancy, healthcare, labour and the baby’s delivery. A woman in her 40s has also learned coping strategies that ultimately lead to better parenting.
The science As a woman ages her fertility declines and her eggs become increasingly unable to develop into a baby. To get pregnant it is not as much the total number of eggs that matters but also the quality of the eggs. Eggs need to successfully fertilize and must kickstart the cell divisions needed to form an embryo. Not all eggs are capable of this, but having an ample supply means a woman has an adequate ‘ovarian reserve’, improving her chances of a pregnancy. A woman is born with about one million eggs, but by the time she has her first period the numbers have fallen to less than 400 000. These remaining eggs lie dormant inside a woman’s ovaries, waiting to become activated.
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When egg quality is poor, it sets the stage for impaired fertility. Additionally, low-quality eggs may have internal defects – problems with their chromosomes or with their energy production – that prevent them from producing healthy embryos. As a woman ages, her eggs accumulate defects. One common issue is that chromosomes within eggs do not move properly as an egg matures and the embryonic cells divide, leading to defective embryos. This explains the higher incidence of miscarriage and birth defects in pregnancies of older women. The odds of having a baby with Down Syndrome are one in 1 000 for women in their 20s, increasing to one in 100 for women in their 40s. By the time women enter their 40s most of their eggs will be of poor quality. This does not mean a woman in her 40s cannot get pregnant; it is just that her odds are severely diminished. By the same token, there are younger women who, due to medical conditions, have a poor ovarian reserve. Surviving cancer patients and women undergoing premature menopause are just two examples.
Aging fathers And the biological clock doesn’t only tick on the woman’s side of the bed! Like all systems in the body, the male reproductive organs are also not spared the ravages of time. And, just because new sperm is made daily, doesn’t mean that male fertility remains untouched. Hormone levels change and, while sperm remains fresh, the reproductive system works less efficiently. There’s also evidence that the DNA of sperm weakens as a man ages – just because he can make sperm, doesn’t mean it is high quality. As men age, the volume, motility (the ability of the sperm to move towards the egg) and quality of their sperm continually decreases between the ages of 20 and 80. The risk of miscarriage is twice as high for women whose male partner is over 45 years’ old than for those whose partners are under 25, and children with fathers over the age of 40 are five times more likely to have an autism spectrum disorder than children fathered by men under the age of 30. Overall, the risk is highest when both parents are over the age of 35.
Reproductive assistance One positive factor on your side if you’re over 35 and hoping to get pregnant is the range of assisted reproductive technologies (ART) now available mean that there’s never been a better time in history to get pregnant later in life. While in-vitro fertilisation and artificial insemination success rates fall significantly when women over the age of 35 use their own eggs, the chance of success using donor eggs remains high (50%) for women in their 40s. When using eggs from women in their 20s and 30s, the risk of miscarriage and chromosomal problems is consistent with the age of the egg donor.
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FEATURE
Creating
emotional balance
Brain Gym South Africa’s Hanna Kok discusses the importance of bonding with our babies as soon as possible, even while in utero, to develop the child’s emotional stability.
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UR emotional brain scans life for danger. As soon as we perceive something as a threat, our body goes into survival mode and switches off our ‘higher human qualities’ by up to 86%. This means that we react instead of respond and are easily distracted instead of concentrating on the task at hand. The difficulty is that we often misinterpret things as a threat. If we can give our children emotional stability in the crucial developmental years, then it will be easier for them to keep emotional balance and go less frequently into survival mode. Creating emotional stability and a sense of safety beings in the womb where much of a child’s character is formed.
Emotional development in the womb A child knows how her parents reacted when they found out that we were expecting. If she was unwanted (rejection) then that is recorded in the subconscious, establishing a base for misinterpreting many things as rejection. It is important that we bond with our babies as soon as possible. Some mothers struggle with this during pregnancy because they are afraid of a miscarriage, for example. The child doesn’t understand that – it just experiences rejection/abandonment. If we are hoping for a girl but our child is a boy (or vice versa), this is experienced as feeling not good enough. If the mother experiences a lot of stress, then the baby is stressing too. For the baby’s sake, it is really important that the mother is as joyous and peaceful as possible during her pregnancy. Even after the birth, a young child is very sensitive to the mother’s emotions, and the more relaxed the mother is, the more the child will thrive. The following information describes an ideal situation. Of course, if a child or mother’s life is in
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danger medical (emergency) procedures should be followed, Let’s ask ourselves: ‘Does my child really need to be born by caesarean? Is there really a danger to the mother and/or child?’ Listen to what your heart says when you have to make that decision for you and your child. Birth is our first major change and becomes the blue print for how we will handle change for the rest of our life. With a natural birth, the child initiates the birth. With a planned caesarean or an induced birth, the baby is denied this opportunity. In my practice I have seen that this can cause issues with time and timing, later in life. Also of great importance is keeping our new-born baby close to one of the parents after birth. To illustrate the importance of this imagine the following scenario: Here you are as a baby in your mother’s womb. You hear her voice and feel her movements all the time. Then after you’re born you’re alone or surrounded by strangers, in an incubator or baby ward. You’d probably wonder where your mother is, has she abandoned me? In my practice I have seen many cases where this separation has caused abandonment and self-esteem issues. As your baby gets a little older she likes to be with you and carried. This makes her feel safe. If you can, carry your child in a sling, a pouch in front of you or, when she is a little heavier, put her on your back. Babies can sleep very comfortably when being carried. If you read this article and know you had a less ideal situation, don’t feel guilty and don’t worry. The damage can be undone. You can talk to your baby, ask for forgiveness. Forgive yourself, too, for your mistakes. You did what you thought was best at that time. You can also get professional help if you want it. For more information, visit www.braingymsa.co.za; www.makealife.co.za . www.babysandbeyond.co.za
health
Help! Picture: Gavin Sutton
My baby’s choking By Gavin Sutton
Gavin Sutton, paramedic and COO at Be Safe Paramedical South Africa, provides some sage advice and a step-by-step guide of what to do if your child chokes.
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N my 20-odd years as a paramedic in South Africa and abroad I have seen babies and toddlers swallow objects that would make most people run a mile… bugs, spiders, toys, a piece of cheese from a mousetrap and, just for good measure, the mouse! As ghastly as it sounds, when it comes to little ones, this is simply a part of fully enjoying the new found skill of crawling and exploring… Sound familiar? In most cases, little people have the uncanny ability of simply letting nature take its course and, surprisingly, most of these strange objects find their way out (usually from the opposite end to which they entered) without any complications. However, every now and then an object is just too big even for a ravenous little explorer and may become lodged in the airway, which of course is not a good thing at all. When this happens, most parents are so caught up in
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the moment that we (yes, I’m a dad too) forget the basic first aid techniques that are scientifically proven to improve the chances of dislodging the object from the airway. Grabbing your child by his feet, turning him upside down and shaking him vigorously, isn’t a good idea. There’s a slight chance of dislodging the object but more chance that the brain and neck will come off second best. So, what should you do? For infants, a combination of back slaps and chest thrusts are endorsed by every international resuscitation council in the world. How do we do this? Let’s take a closer look.
Signs of chocking in infants: • Inability to cry • Ineffective cough, or silence
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health
What to do
(for babies less than one year old) Step 1:
After each back blow turn the baby slightly to the side to see if the object has become dislodged. If you are able to see the object clearly, keep the baby in the downward position and use your little finger to remove it carefully. It is crucial that this is done very carefully to avoid forcing the object back into the airway. Step 3:
Place your baby in a face down position on your leg. Support his face with one hand. The face down position is important when performing the next step because should the object dislodge, gravity will pull it downward and out of the airway. Never blindly stick your finger in the baby’s mouth to try and remove an object you cannot see. The chances are you are going to push it further down the airway, making it even more difficult dislodge. Step 2:
If after the five back blows you are unable to dislodge the object, gently turn the baby face up and keep supporting him on your knee, and with the head in the same downward position. Place two fingers on the breast bone, just below the nipple line and perform five quick chest thrusts. You should compress down to a depth of at least 4cm or a third of the depth of the baby’s chest. After each chest thrust take a very quick look to see if the object has become dislodged. If it has and is clearly visible, turn the baby towards its side with its face slightly down and remove the object with your little finger as per step two. Once again, be careful not to force the object back into the airway. Continue with a combination of back blows and chest thrusts, as above, until the object is dislodged or the baby loses consciousness. If there is a loss of consciousness, activate the emergency medical services by phoning 10177 from a landline or 112 from a mobile phone (or better still, get someone else to go make the phone call) and continue with CPR described below.
Pictures: CPR Kids
Proceed to deliver five back blows between the baby’s shoulder blades with the heel of one hand. The idea is to provide enough force to loosen and dislodge the object. It requires a reasonable amount of force, like when you are trying to get that last little bit of tomato source out of the bottle by turning it upside down and knocking on the underside of the bottle.
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health
CPR (Cardiopulmonary Resuscitation)
Make sure that the fingers placed under the chin does not press against the soft tissue of the neck as this may further obstruct the airway.
CPR for an unconscious choking infant is performed to achieve two objectives: • To dislodge the foreign object obstructing the airway • To circulate blood containing the oxygen that is still available in the circulatory system towards the brain Step 1: Take a quick look into the airway once it is opened. Check if there is any obvious breathing, chest movement or any signs of life. If you physically see the obstructing item, turn the baby gently on his side and sweep the object out with your little finger. Once again, it is important not to do a blind finger sweep as this may first the object back into the airway. Step 3:
Place the baby on a firm surface, preferably on the floor. It’s a good idea to keep your phone close by as, in most instances, the emergency medical dispatcher from the ambulance service will keep the call active. This is to talk you though the procedure should you need extra help, and also to keep you informed of the progress of the responding paramedics. Step 2: Start chest compressions. With the baby on his back, place two fingers on the breast bone, just below the nipples and compress the chest 30 times. The depth of compressions should be at least 4cm or a third of the depth of the baby’s chest. The rate of compressions is fast (almost two compressions per second).
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Pictures: CPR Kids
Tilt the baby’s head back slightly to open the airway. Do this by placing one hand on the forehead and the fingers of the other hand under the baby’s chin (on the chin bone). The open airway position on babies is only a very slight head tilt backwards. We refer to this as the sniffing position.
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health Final thoughts
Step 4:
Provide two breaths following the 30 chest compressions. Tilt the baby’s head back (sniffing position), as per step two. Have a quick look to see if you can see the object causing the airway obstruction. If you do, follow step two, above, to remove it. Place your mouth over the baby’s nose and mouth and provide two gentle breaths. The breaths must not be forceful at all and must only provide enough volume so that you can physically see the chest rise and fall.
G
avin is a paramedic and previous head of training for the Western Cape Emergency Medical Services. He is currently the chief operating officer at Be Safe Paramedical South Africa. www.be-safe.co.za
Resume with 30 chest compressions as per step three. Continue with cycles of 30 compressions and two breaths until the emergency services arrive to take over care. The most important thing to remember is to avoid interruptions. In other words, try and make sure that your pattern of 30 compressions to two breaths is flowing continuously. Switching between breaths and compressions must not be delayed, unless you physically see the obstruction and are able to remove it as per step two.
Picture: Gavin Sutton
Pictures: CPR Kids
Step 5:
I receive a lot of questions from concerned parents about the dangers of performing CPR without any training. The truth is that I have never seen anyone die as a direct result of following the above choking and CPR procedure. However, I have seen a great number of lives saved by the average untrained person who has stepped up and done something. I believe there is even greater truth to this, especially when you are trying to save the life of your own child. The important thing is to never give up and to try and keep going for as long as you can. I have been on scenes where we were able to resuscitate a child after 30 minutes of continuous CPR. Sounds unreal doesn’t it? In most resuscitation cases I believe it is the work that is done on the patient before we (the paramedics) arrive that has the greatest influence on the outcome of a patient. Only you can make that difference. I wish you safety, happiness and all the amazing adventures that parenting brings.
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feature
Getting a
good night’s sleep By Emma Dawson
S
O, you expected sleep deprivation to come with having a baby, but you possibly didn’t expect it to happen until you’d actually had the baby! For many women, it’s almost as hard to get a good night’s sleep during pregnancy as it is when you’re a new parent. Sleep problems begin in the first trimester with frequent waking thanks to an increased need to go to the bathroom. Other sleep disruptions occur because of physical and emotional stress related to the pregnancy. Additionally, higher levels of progesterone are associated with sleepiness, and disrupted sleep at night may cause sleepiness during the day. During the second trimester, as the foetus moves above the bladder, sleep may improve thanks to fewer trips to the loo at night. However, the baby’s growth and your emotional stress may still prevent good quality sleep. It’s most likely that the biggest disruptions to your sleep will occur during the third trimester. The most common factors include discomfort from your growing belly, heartburn, leg cramps, restless legs, nasal congestion, and the return of a frequent need to urinate because the baby’s moving around.
Tips for sleeping soundly while pregnant Some of these tips may help you get a better night’s sleep but if disturbances are sever, chat to your doctor.
Pillows, pillows and more pillows Pillows can be used to support both your belly and your back. A pillow between your legs helps to support the lower back and makes sleeping on your side easier. Try different shapes and sizes, such as the wedge-shaped pillow and the full-length body pillow. Use a pillow to elevate your head and upper body, which allows gravity to put less pressure on your diaphragm and helps you breathe more easily. Nutrition A glass of warm milk or foods high in carbohydrates (bread or crackers) may cause drowsiness, while high protein snacks will keep blood sugar levels up and can help to prevent bad dreams, headaches, and hot flushes. However, there is a risk that late-night snacking can cause reflux or heartburn, which will keep you awake and cause discomfort. Experiment with what works best for you. Relax Relaxation techniques, such as yoga, massage, deep breathing, visualisation, meditation or a warm bath, can all help to calm your mind and relax your muscles. Exercise Regular exercise during pregnancy promotes physical and mental health. Besides increasing energy levels during the day and improving mood, exercise can also help you sleep more deeply. However, avoid exercise within four hours of going to bed. Medication Generally all medications (including over-the-counter medications) should be avoided during pregnancy. However, in severe cases, some are considered safe to help you sleep better but never take any medication (herbal, homeopathic, over the counter or prescription) without first consulting your doctor as they may be harmful to your baby. Turn to your side Sleeping on your side reduces the pressure on your uterus, helps you to breathe better, and relieves back ache. It’s also documented that sleeping on your left side increases the amount of blood and nutrients that flow to your baby. Keep cool Your body temperature rises during pregnancy so if you bedroom is too warm or stuffy you may have trouble sleeping. Experiment with the temperature of your room (air con, fan, opening windows) for the best night’s rest.
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Picture: Origin School for Entrepreneurs
Education
Future proofing
our children
We are bombarded with statistics and rhetoric about the state of our education system but there is arguably little that anyone can do to change how their children are educated. Suzette Bester-Cloete, founder of the Origin School for Entrepreneurs, provides an alternative to mainstream education. 38
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Education
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S parents, our lives are filled with work commitments and helping our children with the extraordinary amount of homework they receive. Between extra-curricular activities and trying to find a moment to connect with your child, there is the weighty responsibility of future-proofing your most precious asset that even the World Economic Forum agrees our education system is not doing. Two entrepreneurs have taken it upon themselves to create a school that addresses this situation by immersing children in entrepreneurial education and enterprising activities. Its aim is to provide an environment of teaching and learning that offers a solid foundation in basic skills and adds the characteristics, knowledge and abilities to create entrepreneurs. With their combined experience in business and education, Suzette Bester-Cloete and Lisa Illingworth have created an alternative to public schools and private institutions. In a world where the future is becoming less and less stable, how do we prepare our children with the www.babysandbeyond.co.za
skills set to make them good business people and good citizens? The answer is that a skills set is not enough to ‘future-proof’ our children, we need to raise young people with behaviour traits that make them adaptable in their thinking, aware of opportunities that may be presented as problems, and belief that they have the ability to affect their circumstances not have their circumstances dictate their reactions. In her book, The Blessing of a Skinned Knee, Wendy Mogel explains how children who are encouraged to perform tasks, independently of their parents, develop a strong internal locus of control. She points out that we are raising an entitled generation that is used to being praised for mediocrity and who expect others to provide for them, whether it be parents or managers at work. Parents can change this simply by assigning tasks, praising the completion of the task without judging how it was performed and, in turn, develop self-motivated individuals who have the intrinsic need to achieve. Coincidently, instilling these behaviors in children also makes them entrepreneurially inclined. Innovators such as Henry Ford and Steve Jobs display these distinctive characteristics that provide the ability for them to adapt themselves in the wake of uncertain futures and turn what others would see as problems into an enterprising opportunity. An entrepreneur has been wired, through education in entrepreneurial studies or through ‘time in the trenches’, to be adaptable, perceptive and reflective about their failures and to be tenacious in the face of risk. ‘While visiting a number of private and public schools, I saw a gap in education for real-world skills to be taught to children in a way that is meaningful and would prepare them for life,’ Suzette recalls. In early 2014 she began Origin School for Entrepreneurs. Lisa Illingworth joined the Origin team in mid-2014, bringing with her a background in teaching and curriculum design. ‘Suzette and I have built the school on a four-pronged approach. We identified behavioural traits of successful entrepreneurs that underpin the knowledge and skills that we give our learners, we give them theory that forms the academic foundation, and provide them with opportunities to experience entrepreneurial activities and apply what they learn,’ Lisa explains. The school combines a Cambridge curriculum with entrepreneurial studies to provide the first business school for children ranging in age from three to 12 years’ old. ‘Too many children are labelled ADHD and ADD when in fact they’re just wired differently and need innovative ways of being taught, and a creative classroom where they feel valued. Ask any successful entrepreneur how well they fitted into the standard education system. Innovators need an environment that encourages thinking out of the box rather than assessing competency on conforming to a traditional set of archaic standards,’ Lisa concludes Origin School for Entrepreneurs, www.schoolforentrepreneurs.co.za
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HEALTH
Facing the fa[c]t… With childhood obesity reaching epidemic proportions internationally, the World Health Organisation has identified this weighty issue as a target for intervention and is focusing on evidence-based strategies to tackle the problem. approximately 17% of two to 19-year-old children. In South Africa 5% of two to 14 year-olds are obese, although the age groups are not comparable.’
Lifestyle factors
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NTERNATIONALLY, childhood obesity has reached epidemic proportions with an estimated 44-million infants and children under the age of five years’ old now classified as overweight or obese. Of these, 23% of girls and 10% of boys between the ages of 10 and 14 years’ old fall into these categories. According to Joanna Wilson, a registered dietitian specialising in paediatric and maternal nutrition, South Africa is following these global trends. ‘Our most recent data suggests that one in four girls and one in five boys between the ages of two and 14 years’ old are now overweight or obese,’ she points out. ‘For a country that prides itself in an outdoor lifestyle and healthy living, these statistics come as a nasty shock. Additionally, there is an increased likelihood that childhood obesity is carried into adulthood, posing a risk of cardiovascular disease and diabetes over the long term,’ she continues. Adding to this, Gabriel Eksteen, a registered dietitian at the Heart and Stroke Foundation SA, comments: ‘The percentage of overweight children has increased by 8% from 2005 to 2012, while the percentage of obese children has stayed relatively constant. South Africa has the highest obesity figures in sub-Saharan Africa, which comes as little surprise. Our overweight and obesity figures are similar to those of most developed countries. Obesity prevalence alone in the US is still much higher, at www.babysandbeyond.co.za
The cause for this growing problem is multifaceted and thought to include factors such as pre- and postnatal nutrition, nutritional programming, ongoing nutrition, physical activity levels, and environmental and family influences during childhood. ‘Today’s lifestyle encourages increased sedentary behaviour – in particular television and screen time – and frequent intake of highly-processed convenience food and drinks that are high in fat and/or sugar, and low in fibre,’ Joanna notes. The publication of a recent report, The Healthy Active Kids Report Card 2014, a joint initiative between several organisations including the Medical Research Council, the Heart & Stroke Foundation, Discovery Vitality, and a number of universities reveals that on average South African children are physically active for just 20 minutes per day – far below the recommended one hour. Additionally, it highlighted excessive sugar intake among our children, much of which is accessed from sugary fizzy cool drinks. ‘Our statistics appear to be worsening fast,’ Joanne warns. ‘Obesity is a complex disease with many different physiological, psychological and environmental contributing factors. Although genetics are often blamed, this only reflects a small part of the obesity puzzle,’ Gabriel adds. ‘Recent research also points to a relationship between a mother’s weight, her pregnancy weight gain, and subsequent childhood obesity. So a mother who was malnourished before and during pregnancy may give birth to a child who has a low birth weight or is stunted. Early malnutrition
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HEALTH during infancy can also predispose infants to weight gain and chronic diseases later in life. Genetic, maternal and infancy factors may not be the main contributors to obesity, but they certainly set the stage for many individuals.’
Identifying a problem As overweight and obesity is now common rather than an exception, identifying overweight children can be a challenge. ‘Parents should take note of rapid weight gain without a similar trend in linear growth. Changing body proportions, for example a thicker waistline or no longer being able to fit into age-appropriate clothes, may be indications for screening measurements to be taken. A doctor, registered dietitian or clinic staff will be able to measure weight and length or height, and will calculate Body Mass Index. These measurements will be plotted on relevant growth charts and will identify if a child is well in proportion, overweight or obese,’ Joanne maintains.
Prevention rather than cure Of course, prevention is better than cure. Parents need to be aware that their children are growing up in an obesogenic environment and that vigilance is needed to prevent unhealthy weight gain. However, if overweight or obesity has already been identified, the strategies for prevention and treatment are largely shared. Joanne explains: ‘First, both the quantity and the quality of the diet must be addressed. This means limiting highly-processed convenience food, reducing refined carbohydrates, sugary drinks, breakfast cereals, and other treat food to an absolute minimum, and replacing these with fruits and vegetables, lean meats and legumes, whole grains, and dairy products. ‘The ChooseMyPlate model developed in the US provides a helpful visual representation of the proportions of each food group on the plate and in the diet in general. Most of us don’t realise that fruits and vegetables should take up approximately half of our total food intake! This model is useful for parents in guiding meal and lunchbox planning, and when serving meals. Children also need to be encouraged to regulate their own intake and should be allowed to eat according to their appetites. Strategies of coercion and rewarding to increase a child’s intake are not helpful and override their innate ability to self-regulate. Over time this may contribute towards overeating.’
A healthy environment In addition to the type of food on offer, it is crucial to foster a healthy environment for children. Sharing family meals, more than three times per week, has been associated with reducing overweight and obesity among children. Conversely, meals eaten in front of the television tend to increase both the pace of eating and volume of the food being eaten. Stocking the fruit bowl, fridge and cupboards with fresh, healthy items rather than convenience snacks and food that are high in fat, salt and/or sugar, and
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Children are growing up in an obesogenic environment and vigilance is needed to prevent unhealthy weight gain. low in fibre reduces temptation for children and adults, prompts the intake of healthier snacks and meals, and establishes a healthy ‘norm’ for children to learn from. Adding to this, Gabriel comments: ‘Besides teaching children about healthy eating from an early age we also need to look at how our children interact with food and how we use food for bargaining, creating positive and negative associations with meals and food types. This does not mean that you can’t give your children sweets and treats. On the contrary, depriving them completely can also create problems. But treats should be seen as just that, treats. Wherever possible, create healthy habits and choose healthier options. As parents it is our responsibility to educate ourselves about what is in the foods we buy by reading labels and avoiding excess sugar, fats and salt.’ Another tip from Joanne about educating children about healthy eating is to involve them in shopping and preparing food from an early age. This is thought to increase their ability to make healthier choices both now and in the long term. Limiting screen time has become a priority in many countries as a means to reduce sedentary behaviour and prevent obesity among children. This time usually spent indoors can be replaced with outdoor activities. ‘Our environment plays a role in the types of foods that are affordable, accessible and that we ultimately choose. The food industry provides a multitude of palatable, highly-processed, energydense, and nutrient-poor foods. These foods are aggressively marketed towards children in the form of TV adverts, sporting events at schools, and in the dreaded till-aisle at the supermarket,’ says Gabriel.
Lead by example Parents must not underestimate the impact they have as role models in shaping positive change and healthy habits in their children. A family approach to health, in which no one individual is singled out, will benefit each member of the family. Good nutrition, physical activity and creating opportunities for learning are the cornerstones of a healthy lifestyle. Families feeling overwhelmed and in need of guidance should contact a registered dietitian with experience in paediatric weight management for expert, individualised advice. Joanna Wilson, www.eat-live-play.com; Heart and Stroke Foundation SA, www.heartfoundation.co.za or 0860 1 HEART (43278) www.babysandbeyond.co.za
Picture: Preggi Bellies
Health
Exercising while
pregnant
When it comes to debunking the myths about exercising while pregnant, Preggi Bellies’ training director and partner, Dr Etti Barsky, MBBCh, MSc Sports Medicine, offers this advice.
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HERE are many myths and misconceptions about exercise during pregnancy, with the main concern being that the pregnancy could be jeopardised or that the baby’s wellbeing will be affected. The possibility of miscarriages, premature labour and foetal malformations have had everyone concerned. However, there is no research data that supports any of these fears. In fact, what has come to light is that being sedentary during your pregnancy poses more of a risk to your health than being active. The concern comes from the knowledge that when you exercise, blood gets sent to your working muscles and diverted away from your organs. This is actually one of the reasons why your mom always told you www.babysandbeyond.co.za
not to swim after you had eaten because you’d get tummy cramps! However, unlike this pearl of wisdom that is actually true, the myth about decreased blood supply to the uterus, and hence compromised blood supply to your baby, is not. Thanks to many physiological adaptations, while blood is being sent to your muscles when you train, the blood being sent to your uterus is of a very high quality in terms of the levels of oxygen and nutrients being sent to your baby. Research shows that placentas of women who trained in their pregnancy are of a better quality than those of women who don’t.
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health Another myth that prevails is that you can’t do abdominal exercise while pregnant. With the hormonal changes of pregnancy and your evergrowing uterus, your abdominal muscles weaken, stretch and finally separate to make room for your baby. This is called Abdominal Diastasis or Diastasis Recti. Studies show that all post-partum women have a degree of abdominal diastasis. This separation is exaggerated in a situation where the pressure in the abdomen/tummy increases, such as getting up from a lying position in your bath or during sit-ups in your exercise classes, for example. The way to control the degree of separation is to continue exercising, but in such a way that you are strengthening the muscles and not overloading them. As with most things in life it’s about balance. In fact, exercising during pregnancy has numerous benefits. Here are a few of them: • You tend to gain less weight, and lose the weight faster once you’ve had your baby. • Pregnancy-related complaints such as low-back and pubic bone pain happen less frequently. • Your chances of medical complications of
pregnancy, such as pregnancy-induced diabetes, varicose veins and haemorrhoids, are also reduced. • There is evidence that women have a shorter and less complicated labour with a decreased need for surgical intervention. • You can be assured of a faster recovery after either a vaginal delivery or caesarean section. • You will most certainly benefit from better energy levels and a better mood! International guidelines recommend that in the absence of any medical or obstetric complications, a pregnant woman should exercise on most if not all days of the week. The exercise routine should combine cardiovascular training with strength training for maximum benefit. Additionally, exercises should be done right up to the due date. It has been found that if you stop training before 32 weeks your body deconditions and you will not derive any benefit. Also, it is crucial to continue training regularly after 32 weeks so that uterus remains used to the stimulation. It is therefore advisable to train with a program that has the expertise to guide you right to the end. For more information, visit www.preggibellies.co.za.
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to South Afric a
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FEATURE
Managing
stress and anger
Shelton Kartun, founder, CEO, counsellor and facilitator at The Anger and Stress Management Centre, explains the difference between anger and stress, and provides tips for when things get too much.
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HERE is a lot of confusion between anger and stress because they are so closely related and because one can give rise the other. Anger is a normal, natural emotion in response to any situation we don’t like (the trigger) that causes us to react. Stress, on the other hand, is an experience we are having that negatively impacts us, often giving rise to feelings of not coping or being overwhelmed. While we may not be that aware that we are stressed or overly angry, there are some key indicators that provide clues that we need to address things. Often problems don’t get sorted out because we bottle things up or avoid situations and don’t communicate, or communicate in the wrong way
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by shouting and swearing. Parents must remember that they model behaviours for their children, and it’s mutually beneficial to learn practical tools to manage anger and stress. This way we ensure that we teach children the correct way to deal with challenges and to stay calm.
Anger and stress indicators Some anger and stress indicators include frequent shouting, screaming, swearing, outbursts, throwing things, smacking children, moaning and complaining, frustration and irritability, anxiety, withdrawal, poor sleep patterns, increased eating, smoking and drinking, road rage, high blood pressure, aches and pains, or headaches. There is definitely a sense of a www.babysandbeyond.co.za
FEATURE change of personality, a loss of control, helplessness and an inability to cope.
Stop and calm down Both anger and stress release adrenalin that produces many physical and mental changes in the body. We become tense, super-charged to ‘attack’, as well as irrational and irresponsible. The only way to recover oneself and reduce the adrenalin levels is to immediately stop your desired reaction in that split second and force yourself to implement some calming down strategies. These include taking time out by going to another space, deep sustained breathing, counting backwards in your head from 100, talking to yourself – telling yourself to relax, calm down, stay in control or perhaps let it go. Other calming down ideas that are also great for reducing stress include walking, listening to music, getting into nature, doing some exercise or a hobby.
Triggers One of the ways we can avoid getting so stressed or angry is to become more aware of being triggered, how things are impacting us and how we are reacting to these things. Often we have high expectations of others and like things done our way. When this does not happen we are triggered. Sometimes we perceive things negatively and get worked up unnecessarily. Other times it may be because of different points of view, for example on how to raise and discipline a child. It is far better to calm down and let the intensity of your anger reduce. Then work out what you need from the other person or your child and communicate it nicely, in the same way you would like to be spoken to. If you are going to do something to upset the other person, you will be the one creating a conflict, which you will then have to sort out so it is not really worth it.
Stressors Many stresses are self-imposed, such as spending beyond your means and getting into debt, leaving things to the last minute and then rushing, being messy and disorganised so that you can’t find things. Stress can also be situational, such as month end or moving house, or because of a major event (death, divorce or unemployment). Stress can be managed and it is useful to list all the things in your life causing you stress and then commit to a plan of action where you work out what you can change that will make a difference.
Stress in children Children also experience high levels of stress from parents, so we must be careful with our demands and expectations on them. Studying and exam times are stressful. Siblings can create stress. Bullying can cause stress. Arguments and shouting will also stress children, as will problems in your relationship or in blended families. If you experience anger or withdrawal from your children, this may be indicative of stress and unhappiness or mild depression.
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Resilience When you are stressed, if you can’t change something then you need to change the way you think about it. Avoid stressful thinking, such as ‘I can’t cope’ or ‘there’s nothing I can do’. Rather tell yourself ‘it’s challenging but I will cope’ or ‘there’s always something I can do’. Sometimes we have to accept what is so we can come to terms with it and bounce back. This is called resilience. Early warning signs that we are getting stressed, anxious or angry, include subconscious habits such as pacing, foot tapping, scratching your hair or fiddling with things. Changes in body language also offer clues, such as crossing arms, becoming flushed in the face, tearfulness or running away from things. To cope, we need to learn to identify our triggers, use the calming down strategies, and tools that work well for us. Adults need to think more positively and communicate their needs assertively, and to let go so that they can resolve conflict. We have to accept that we cannot have everything our own way and that everything is not always going to be to our liking. Fighting, anger and stress do not serve us positively. They impact negatively on our health and well-being, and can damage relationships, particularly with those we love. Children need to recognise the changes that take place in their bodies, to articulate what they are feeling and to talk about things. Calming down by taking time out is a valuable tool that should be used by everyone in the family.
Setting boundaries Not only should parents model the right behaviour for their children, but they shouldn’t argue or fight in front of their children, smack children in anger, or say ugly things to them. Setting boundaries is very important for children and results in better behaviour. If there is a problem behaviour or non-compliance that needs addressing, try and give the child targets for better behaviour and reward them for achieving these, rather than constantly punishing them. Give children choices and responsibility for their actions. Educate and instil values so they grow up into fine adults, with higher levels of emotional intelligence and able to deal with their emotions and stress.
Get help If things are getting too much it is important to get help to manage your stress or anger. Don’t be too proud to speak to a professional and, even more importantly, don’t deny there’s a problem and blame others or feel the problem will go away. It usually gets worse. The Anger and Stress Management Centre (with branches nationally) specialises in these areas and provides the practical tools you need to manage emotions like anger or stress so that you feel happier and in control again. Specialists will teach you how to express yourself through assertive communication and improve your relationship with your partner and children. For more information, contact The Anger and Stress Management Centre at www.angerstress.com.
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DAD’s DIARY
Fathers
matter
Craig Wilkinson, author of DAD – The Power and Beauty of Authentic Fatherhood and the founder of Father a Nation, shares his deep insights about the importance of being an active and engaged father.
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YEAR after my divorce, my son, Luke, decided to come and live with me. At the age of 12 he was a big, strong boy, tall and solidly built. He played rugby, loved riding motor bikes and was a real boy in every way. Yet I also noticed a tenderness and vulnerability in him. More than that there was a cry, a yearning for masculine nurture. He had questions that I needed to answer. His young developing masculine soul needed to draw from a man and that man was me, his father. For several weeks after moving in with me Luke would creep into my bed late at night and just hold on to me tightly. It’s hard to explain what passed between us during those prolonged poignant hugs,
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but it was profound and beautiful. I didn’t have to say anything; he was drawing substance from me, almost by osmosis. I was his rock, his anchor. I was the source of masculinity and strength for his developing manhood. No matter what I was experiencing inside, no matter what challenges I was facing, I was Luke’s dad and he needed me.
The impact of fatherhood This was a revelation to me. I realised the impact that I, as a father, could have on my son. I realised that there was a window of opportunity for me to give Luke what he needed and I realised that my
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DAD’s DIARY
The deepest search in life, it seemed to me, the thing that in one way or another was central to all living, was man’s search to find a father, not merely the father of his flesh, not merely the lost father of his youth, but the image of a strength and wisdom external to his need and superior to his hunger to which the belief and power of his own life could be united.’ Tom Wolfe their world view. It imparts to them their very sense of self, the inner fabric that equips them for confidence and success or fear and failure. Fathers are the most powerful and important men in their children’s lives. Every boy longs to be mentored by his father; every girl longs to be adored by her dad. A father is his daughter’s first romance and his son’s first hero. He is their first, most important experience of who and what a man is.
A window of opportunity
willingness and ability to do this would quite possibly be the single biggest influence on his development as a man. I realised then that fatherhood matters deeply, profoundly and undeniably, and that a man who becomes a father needs to take this responsibility-laced privilege very seriously. In raising my daughter I had a similar realisation. Although what girls need from their fathers differs slightly from what boys need there is a lot of overlap and ultimately they need their fathers just as much as boys do. As fathers what we expose our children to and what we teach them through our lives, words, actions and interactions, helps to form so much more than
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Every father has a window of opportunity to provide input into his children’s lives. And, like most windows of opportunity, they eventually close. The more input a father makes into his children’s younger years the greater will be his influence in their later years. Too many fathers wake up late and try to discipline a teenager who is already showing signs of bad behaviour. Fathers need to get involved immediately and stay involved for the rest of their lives. Being the most important man in someone’s life is a privilege that comes with profound responsibilities. Your children will come to you to answer the deepest questions of their hearts. Throughout their developing years they will ask you a thousand times and in a thousand different ways to answer key questions about themselves that no-one else can answer quite like you can. Answer well and you will lay an unshakeable foundation for your children’s emotional well-being and character. Answer badly or don’t answer at all and you will wound them and quite possibly set them up for a lifetime of emotional struggle.
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DAD’s DIARY Damage and destruction It is astounding how many adults carry hurt from their relationship with their fathers. Many are not consciously aware of it, but most men and women carry a father wound. Some of these wounds are blatant and debilitating, such as when physical or sexual abuse has taken place, but most are subtle, resulting from fathers who were present in body but not effectively engaged in their children’s lives. Very few men set out to deliberately harm their children, yet most men fail to give their children all they need. And they do so mainly because they didn’t receive what they needed from their own fathers. The wounds inflicted by most fathers don’t destroy but they damage. They affect the ability of their children to be fully alive. They erode their self-esteem and subtly but significantly affect the important life choices they make as adults. The reality is that every father influences the lives of his children forever. That’s a given. Whether this impact is for good or for harm is the choice every father has to make.
Someone aptly said that it’s hard to know which is more painful: a father that you’ve never seen and never known, or a father that you’ve seen and never known. Passive fathers are effectively absent fathers and their children share the pain of those who are fatherless.
Social implications
Dedication and commitment
The world is crying out for men who will step up to the plate and be great fathers. Research on the social implications of absent or passive fathers reveals some frightening facts. The statistical links between absent or abusive fathers and every category of emotional and social dysfunction are direct and undeniable. Young people who grow up with absent fathers are at significantly greater risk of falling into substance abuse, promiscuity, early pregnancy, abuse, violence and crime. The greatest predictor of social pathology in children is fatherlessness, greater even than poverty. In Fatherless America (Basic Books) David Blankenhorn says, ‘It is no exaggeration to say that fatherlessness is the most harmful demographic trend of this generation. It is the engine driving our most urgent social problems.’ It’s easy to view the damage done by absent, passive and abusive fathers as something that only affects people from poor or dysfunctional communities but the reality is it cuts across all communities. Whether rich or poor, educated or not, and regardless of culture or ethnicity, children need actively engaged fathers. When fathers are absent children are wounded. It’s as simple as that. And a father does not need to live apart from his children to be absent. Many fathers live in the same house as their children but are effectively absent in mind and heart. It is entirely possible to grow up in a household with two parents yet still have an orphaned heart.
True fatherhood requires serious intent and consistent action. Being a great father doesn’t just happen. It takes deliberate commitment. It cannot be outsourced or delegated; it must be handled personally. Just as a safe can only be opened by the key specifically designed for it, you as a father hold the key to unlock the potential in your child’s life. Fatherhood offers a chance for men to lay foundations of self-belief and conscious, principled behaviour that will affect not only the lives of their own children but generations to come. Every man has the potential to be a great father and every child deserves to have one. The wonderful thing about being a dad is that we all get to be a hero. Of course, this means that we have to live up to some pretty high expectations. But that’s okay, because every dad has it in him to be a hero to his children. And if we get it right we leave our children with a priceless gift. Impressed into their psyche and souls is the knowledge of a man as a strong, loving sanctuary, a place where there is safety and fun and affirmation. And they will live their lives out of this reservoir of grace and strength. Our sons are more likely to grow up honourable men, treating women with respect and caring for their own families. Our daughters are more likely to grow up as women of stature, making good choices and building strong families of their own. For more information, visit www.craigwilkinson.co.za.
Craig Wilkinson 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 is a TEDx speaker and can be booked to speak at events or facilitate seminars by emailing craig@fatheranation.co.za.
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Feature
What makes
a woman
a mother?
Becoming a mother is far more complex than just being handed a baby. Suzette Bester-Cloete, CEO of Origin Family-Centred Maternity Hospitals, discusses the importance of labour for a mother and child to bond.
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FEATURE
S
O often women think that the presence of a baby is what makes a woman a mother; and women who get pregnant for the first time believe that they become mothers when the baby makes its appearance at birth. However, this is far from the truth and, as with many other complex processes in our bodies where hormones and neurotransmitters play a role in bringing something about (our first period, the development of our breasts or the appearance of our first pubic hair, for example), becoming a mother is far more complex than just being handed a baby. There are very important reasons why we have to experience labour and if you understand this phenomenally simple yet profound fact, you will realise why women should choose to have a natural birth rather than an elective C-section. We asked the question, ‘What makes a woman a mother?’, to women who experienced natural births and to those who had elective C-sections. After four elective C-sections, Sonia, 42, said: ‘After the C-sections, at the moment the babies were handed to me, I felt excited about seeing them for the first time. However, I did not instantaneously love them. I did not immediately feel that this baby was mine and that we had a bond. On average, it took me two weeks and a lot of skin-to-skin contact and cuddling the babies after each C-section to develop that ‘in-love’ feeling. I was surprised by this and thought there must be something wrong with me as I expected a mother to immediately feel love for her babies. On the other hand, Jannien, 40, said this about her two natural births: ‘I was in labour for approximately 12 hours before my babies were born. The minute they were given to me I felt an overpowering surge of emotions and love for them. I felt as if I could never let them go and would give my life for them. It was instantaneous!’
Mother-child bonding So why the different reactions from these two woman? The main reason is that Jannien experienced labour and Sonia had an elective C-section scheduled at approximately two weeks before she reached full term, as is customary. Jannien went into labour and received a cocktail of hormones preparing her for labour and birth that would simultaneously make her a mother the minute the baby was born. However, Sonia still had about two weeks before reaching the full term of her pregnancy, and still managed to stop on her way to the hospital to purchase the last few items for the baby’s arrival, without secreting a single hormone. What did these two women experience after giving birth and being at home with their new born babies? Jannien felt tired and overwhelmed by her emotions on the third day after the birth, but this soon passed. At the end of her second week at home Sonia felt intense sadness, irritability and loneliness, which was diagnosed as post-natal depression. Although women who have given birth naturally do experience post-natal depression, a study from the National Yang-Ming University in Taiwan of more than 10 000 mothers in the country found that those who www.babysandbeyond.co.za
did not have a Caesarean were a third less likely to experience post-natal depression. The research also revealed that within the Caesarean group women were 48% more likely to experience depression if they had a planned procedure, rather than an emergency C-section.
The power of oxytocin Why do women who give birth naturally instantly feel that there is a strong bond between them and their babies and why are they less likely to experience post-natal depression? During labour Jannien secreted a cocktail of hormones, oxytocin being the most important of the birth hormones. Oxytocin has been called the love hormone, the mothering hormone or the calm and connectedness hormone. In fact these descriptions pretty much sum up oxytocin perfectly as it is present during sexual intercourse, orgasm, labour, birth and breastfeeding. Oxytocin helps us create bonds with other people, such as between a mother and baby, or a woman and her partner. Furthermore Oxytocin is typically associated with helping couples establish a greater sense of intimacy and attachment, and ensures that we bond as pairs. It’s also an indispensable part of childbirth and mother-child bonding. After birth, mothers can establish intimacy and trust with their babies through gentle touches and even a loving gaze. They can also pass on oxytocin to their babies through breast milk. We know that a woman’s oxytocin levels are the highest that they will ever be just after giving birth. For this very reason, Jannien felt the intense and instant bond with, and love for, her babies, while it took Sonia two weeks to experience these feelings. Jannien had high levels of oxytocin while giving birth to her baby, while Sonia didn’t secrete this hormone. Oxytocin was first observed to have a connection to depression through its effects on mothers suffering from postpartum syndrome. Researchers found that some new mothers were dealing with depression on account of low levels of oxytocin. In fact, they were able to predict postpartum during the pregnancy if the expectant mother had low levels of oxytocin. Mothers who have C-sections are less likely to breastfeed, for many reasons. Often mother and baby are separated, which means a delay in getting baby to breast. The mom is dealing with pain, fatigue, possibly stress, and even trauma. Additionally, the incision itself makes it difficult to find a comfortable position in which to nurse. You might argue that the only difference is the fact that Jannien managed to form an immediate bond with her babies while it took Sonia two weeks, but it is unfortunately not as simple as that. During these two weeks certain factors can lead to the bonding between mother and baby being compromised. We have seen instances where women had to be hospitalised with post-natal depression, having to be separated from their babies and having to take medication. They never bonded with their babies and some women feel that they lost something forever. Origin Birth Clinics, www.originclinics.co.za
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Health
Preventing
infectious diseases By Emma Dawson
Before vaccinations were available many children died or developed severe complications from infectious diseases. Even with today’s modern medical facilities, the World Health Organisation claims that immunisation still saves three million lives a year.
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OUTH Africa’s Department of Health (DoH) strongly advises parents to protect their children from infectious diseases by getting them vaccinated between birth and 12 years’ old. The DoH maintains that immunisation is safe and although some side effects may occur, they are usually mild and clear up quickly. Contact your clinic for advice if you are concerned. However, it probably hasn’t escaped your attention that there’s much controversy surrounding
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vaccinations with many parents, and even some healthcare professionals, citing a surprising number of possible risks associated with vaccines. In the pro corner, there can be no doubt that if everyone followed vaccination schedules infectious diseases would be eradicated. Other reasons for vaccinating are that every major health authority in the world recommends immunisation, vaccinations are a powerful prevention tool, and that the benefits outweigh the risks.
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Health However, on the down side, those not in favour of immunisation say that we may not understand the impact of the ingredients in the vaccines, and that some vaccinations are thought to cause autism spectrum disorders and SIDS (although there is no conclusive evidence to prove this).
What are vaccinations and why are they given? Babies and young children are particularly vulnerable to infectious disease, and vaccinating enables the body to develop its own immune response to that particular disease. This means that if your baby is ever exposed to that disease, the body already has its defence system in place.
What diseases are children vaccinated against? According to the DoH, vaccinations for the following diseases are strongly recommended: Tuberculosis (TB) TB is a contagious infection that commonly affects the lungs. People with active TB often contaminate the air (for up to several hours) with bacteria when they cough or sneeze. If another person breathes the bacteria in, they may become infected. Every year TB kills about three million people worldwide. Symptoms include coughing, night sweats and generally feeling unwell, with decreased energy and appetite being the most common symptoms. The BCG vaccination is given to more than 80% of the world’s children. Poliomyelitis (Polio) Polio is a highly contagious, viral infection that affects nerves and can produce permanent muscle weakness, paralysis and sometimes death. Polio is caused by a virus spread by digesting contaminated material. For the majority of polio infections there will be no symptoms and, of the infected people with symptoms, most will have mild symptoms including fever, headache, a sore throat and vomiting. Extensive vaccination has almost eradicated polio in developed countries but cases still occur in regions with incomplete vaccination such as sub-Saharan Africa and Southern Asia. Rotavirus Gastroenteritis Rotavirus is one of the most common causes of diarrhoea in children and spreads quickly and easily, infecting nearly every child before his or her fifth birthday. Diarrhoea from rotavirus can quickly lead to dehydration, resulting in hospitalisation and even death for children who do not receive timeous treatment. Symptoms begin with fever and vomiting, followed by watery diarrhoea that typically lasts five to seven days. If fluid losses are not replaced, dehydration develops causing weakness and listlessness. In South Africa approximately six children die every day from severe rotavirus and approximately 600 000 children die worldwide each year.
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Diptheria Diphtheria is a contagious sometimes fatal infection of the upper respiratory tract. The bacteria that cause diphtheria are usually spread in droplets of moisture coughed into the air. Symptoms include a sore throat, chills, general feeling of illness and fever. The lymph nodes in the neck may swell. Diphtheria is readily preventable by means of vaccination. In children younger than five who are not vaccinated the mortality rate can be as high as 20%. Tetanus (Lockjaw) Tetanus results from a toxin produced by the anaerobic bacteria Clostridium tetani. Tetanus bacteria may enter the body through wounds contaminated with soil, faeces and skin punctures. Symptoms include muscles that contract and become rigid. Spasms usually begin in the jaw and throat, followed by the neck, shoulders, face, and then the abdomen and limbs. Worldwide about 50% of people who have tetanus die and, to date, preventing it is far better than treating it. Tetanus rarely develops in people who have completed a primary series of tetanus vaccinations and have had vaccinations every 10 years as recommended. Pertussis (Whooping Cough) Pertussis is a highly contagious infection, caused by the bacteria Bordetella pertussis, which results in fits of coughing that usually end in a prolonged, highpitched, deeply indrawn breath (the whoop). The disease is divided into three stages. The first lasts for one to two weeks, which includes mild cold-like symptoms (sneezing, runny nose, hacking cough at night and a general feeling of illness). The second stage lasts for two to four weeks when coughing fits develop followed by the whoop. The cough often produces large amounts of thick mucus. The third stage lasts two to four weeks. The cough decreases and then stops. Complications of pertussis can include pneumonia, ear infections and, in rare instances, brain damage. Haemophilus Influenza Type B (Hib) Haemophilus influenza type B (Hib) can cause infection in the respiratory tract and, spreading via the bloodstream, can infect the joints, bones, lungs, skin, face, neck, eyes, urinary tract and others organs. These bacteria may cause two severe often fatal infections: meningitis and epiglottitis. The bacteria are spread by an infected person sneezing or coughing respiratory droplets into the air, which are then inhaled by someone else. Symptoms depend on the part of the body affected – for example, meningitis may present with fever, headache, stiff neck and vomiting. Hepatitis B (Hep B) Hepatitis B is generally more serious than hepatitis A and is occasionally fatal. Hepatitis B can be spread through contact with saliva, tears, breast milk, urine, vaginal fluid and semen, and a pregnant woman infected with hepatitis B can transmit the virus to her baby during birth. Symptoms can be mild or severe and include decreased appetite, nausea,
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Health vomiting (acute), or as serious as fatal liver failure (chronic). Hepatitis B becomes chronic in 5 to 7% of people. Pneumococcal Infection Pneumococcus bacteria are dispersed into the air when infected people cough or sneeze and are then inhaled by someone else. The most common infections caused by pneumococcus are pneumonia, meningitis, sinusitis, and middle ear infections. Symptoms depend on the part of the body affected. The most common symptoms are fever, coughing, headache, a general feeling of illness and ear pains. Measles Measles is a highly contagious viral infection that is most common in children. It is spread mainly by airborne droplets of moisture coughed out by an infected person, or by touching items contaminated by such droplets. It is contagious for several days before and after the rash develops. The infected child first develops a fever, runny nose, hacking cough and red eyes. Tiny white spots appear inside the mouth followed by a sore throat. A mildly itchy rash appears three to five days after the start of symptoms. Starting around the ears and spreading to the trunk, arms and legs, the rash starts off as flat red areas that soon become raised. The child may develop a very high temperature (40°C). Worldwide, measles infects about 20-million people annually, causing about 200 000 deaths, primarily in children. Complications can be severe and include pneumonia, encephalitis (infection of the brain) and middle ear infections. Additional vaccines that you can opt to buy at your own cost include mumps, rubella and Varicella (chicken pox). While the MMR (mumps, measles and rubella) vaccine has received much bad press and is rumoured to be linked to autism, there is no evidence to substantiate this.
What are the possible side effects of vaccinations? As vaccinations continually improve, the likelihood of side effects decreases. However, there are a few common side effects, noticeable within 24 to 48 hours of the vaccination. They include: • Redness, warmth and swelling at the site of the injection • Increase in body temperature • Sleepiness • Irritability and persistent crying • Disinterest in food • Body rash
Vaccinations • Birth: OPV 0 and BCG • 6 weeks: OPV 1 and DPT 1 and HepB 1 and Hib 1 • 10 weeks: OPV 2 and DPT 2 and HepB 2 and Hib 2 • 14 weeks: OPV 3 and DPT 3 and HepB 3 and Hib 3 • 9 months: Measles 1 • 18 months: OPV 4 and DPT 4 and Measles 2 • 5 years: OPV 5 and DT
Abbreviations • BCG: Bacillus Calmette Guerin vaccine • OPV Oral polio vaccine • DPT: Diphtheria, pertussis and tetanus vaccine • DT: vaccine against diphtheria and tetanus (lock jaw) only. • HepB: Hepatitis B vaccine • Hib: haemophilus influenzae B vaccine Immunisation is available at all primary healthcare clinics and centres as well as secondary and tertiary level healthcare facilities. Always take your child’s Road to Health Chart/ Booklet to the clinic with every visit to ensure that all the immunisations are up to date. For more information, visit www.health.gov.za.
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HEALTH
All about
lactose P
EOPLE often confuse lactose intolerance with milk allergy. Lactose intolerance is more prevalent in adults while babies and children are more susceptible to cow’s milk allergy. Although cow’s milk allergy and cow’s milk intolerance are different conditions, the terms are often used interchangeably, resulting in confusion.
What causes cow’s milk allergy? Milk contains many different proteins that can cause allergic reactions. The main proteins are casein and whey. Casein is the curd on top of the milk that forms when milk is left to go sour. It accounts for about 80% of the protein in milk and is relatively heat stable. Whey, on the other hand, is the watery part of the milk. It makes up 20% of the milk and can be broken down by heating, which is why some cow’s milk allergy sufferers may be able to tolerate boiled or long-life (heat-processed) milk.
What is lactose intolerance? Lactose is the sugar found in milk, and lactase is an enzyme that breaks down lactose so that it can be absorbed by the gut. If lactase levels are low, milk sugars cannot be digested and accumulate in the gut causing bloating, diarrhea, gas, nausea and abdominal pain. Lactose intolerance is very rare in babies, becoming more common in older children and adults. People with lactose intolerance have varying degrees of the deficient enzyme. Those with absolutely no lactase cannot tolerate even small amounts of milk products, while those with low levels may still be able to eat or drink a small amount without getting symptoms. Some dairy products have lower lactose levels than milk, so yoghurt and cheese may be tolerated by some sufferers. There are also low-lactose and lactose-free milks available, as well as lactase enzyme replacements that can be added to milk products or eaten prior to consuming milk products.
Milk allergy reactions About 40% of reactions to cow’s milk are known as immediate reactions, occurring within minutes or up to two hours after exposure. Reactions may be mild or life threatening and include hives, flushing, swelling, itching, nausea, vomiting, wheezing, difficulty breathing and collapse (anaphylaxis).
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Delayed reactions may start several hours to days after consuming cow’s milk products, and symptoms include vomiting, diarrhea, abdominal pain, poor growth and eczema.
How is the diagnosis made? Immediate allergic milk reactions can be tested for, even in young babies, by doing blood tests and/ or skin prick tests. If these results are uncertain then an oral food challenge may be performed where a doctor or nurse gives increasing amounts of milk to the individual. This is usually done in hospital so that they’re able to treat severe reactions should they occur. The other types of milk allergy cannot be tested this way and an elimination test is performed. This should demonstrate the relief of symptoms when milk is removed the diet and a recurrence of symptoms if reintroduced.
Managing the allergy or intolerance Children and adults with cow’s milk allergy should work with a dietician to achieve a nutritious and complete diet. Calcium supplements should be prescribed for those on milk-free diets, and parents need to read food labels and learn to recognise terms such as whey, lactose, casein, casemate, lactalbumin and lactoglobulin. In the case of children suffering from severe reactions, caregivers and the school should be provided with an ‘action plan’ in case of a reaction.
Will my child outgrow the milk allergy? Most children develop tolerance in early childhood, dependent on the type of allergy, the time of diagnosis, antibody level at the time of diagnosis and the protein to which the child is allergic. Children who are allergic to casein are less likely to outgrow their allergy. Source: www.allergysa.org www.babysandbeyond.co.za
FEATURE
The signs of
sexual abuse
While the statistics we hear about child sexual assault in the news are terrifying, it’s claimed that these numbers are grossly underestimated as a result of under reporting. Nolene Rust, a qualified forensic worker and a registered counsellor specialising in play therapy, highlights the warning signs of sexual abuse.
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EXUAL abuse is easily one of the most stressful things a parent can go through. But, it’s also something that victims and their families can get healing from. Current statistics of reported abuse cases reveal that most abuse is perpetrated by children, known as child-on-child sexual abuse. It is also not uncommon for this abuse to take place between children who are known to each other (at school, family, family friends, even in the church community).
What is considered as harmful sexual play between children? Harmful sexual play between children is playing that: • Uses force, threat or intimidation • Is not voluntary • Takes place between children who are not of the same age, stature or developmental phase • Makes a child feel scared or ashamed • Takes place in secrecy • Is aggressive and meant to hurt the child • Imitates adult sexual behaviour • Holds the goal of more than only acquiring information • Interferes with normal daily functioning • Exposes a child to facts that are above the child’s cognitive abilities to understand and that aren’t fitting for the child’s age • Includes touching or any physical contact that the child experiences as intrusive
When should I be concerned? Warning signs that should trigger concern for parents include: • Infections • Pain when going to the toilet • Wetting or soiling underwear (after being toilet trained) • Nightmares • Concentration difficulties • Personality changes (sudden withdrawal or aggressive behaviour) • Suddenly fearful of toilets
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• Sudden fears for specific places or faces • New separation anxiety • Complains of tummy pain or headaches, for which there is no physical explanation • Advance sexual knowledge for the child’s age • Overly focused on sexual organs (of others or the child’s own) • Engages other children in sexual play
What to do? If you are concerned about any of these points, getting your child assessed by a professional specialising in these types of assessments may give you peace of mind. You need to find a professional person (psychologist or social worker) who conducts pre-forensic or social-emotional assessments. In cases where your child has already told you of abuse, it’s wise to take your child directly for a forensic assessment. Forensic assessments are conducted by a professional person trained in sexual abuse investigations. Their role is to investigate and find facts to prove or disprove the likelihood of abuse, and then render a report to the courts. Keep in mind that reporting suspicions of abuse or knowledge of abuse is mandated by law. Failure to do so is a criminal offense.
Nolene Rust is a qualified forensic worker and a registered counsellor specialising in play therapy. For nine years, Nolene has worked with families and children in welfare organisations, hospitals, in schools, and in the private sector. Her work includes advocating for children’s rights and working with abused and neglected children in a child protection and counselling capacity. Nolene is a regular speaker on radio, presents seminars, is involved with Jelly Beanz (NGO), and is vice president of OPSSA.
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FEATURE
Watch them
grow
Children love being outdoors, covered in dirt and mud, and gardens are a great way to channel their natural curiosity into a fun activity. By Emma Dawson
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NLIKE many activities, gardening is not limited to a particular age group. Older children can help plan and design the garden, prepare the soil, plant seeds, weed, water, and harvest vegetables. Younger children can do most, if not all of these garden chores, too. Even toddlers can help plant seeds and water growing vegetables. Gardening is educational and social and provides an opportunity to learn and experience the world in your own back garden. Playing in the mud, learning about underground ecosystems, watching plants grow with sunlight and rain and some tender care, and getting the gratification of growing food to eat at the end of the process are just some of the benefits of involving your children in growing your own veggies.
Instant gratification The best veggies to grow for almost instant gratification are radishes, baby carrots and lettuce – all of which germinate from seed in just days, giving children a chance to see how straight their seed lines were! What’s great about these veggies is that you can pick and eat them while they are still young, shortening growing time even more.
For the raw munchers One of the best parts of gardening is being able to eat raw veggies straight from the plant. Cherry tomatoes are a given, as are sugar snap peas and herbs (mint, parsley, chives). They’re all great for munching as you go and provide a sensory blast every time you walk past the plants.
No fuss gardening For the easiest-to-grow veggies try green beans – they reseed easily and grow like a jungle with little or no care. Also plant potatoes – the ones you’ve forgotten in the bottom of the veggie rack that have
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begun to sprout. Once in the ground you can forget about them. When they’re ready to harvest it’s like digging for buried treasure!
Planning your garden Get your children involved. Build up their background knowledge by reading books and visiting urban farms or vegetable gardens open to the public. Plan the garden with your children. Use graphs and picture charts to plan ideas, make lists of materials needed and encourage children to draw pictures of what the garden should look like. Take your children shopping for seeds and seedlings. Let them pick their favourite colours and veggies. Plan a good variety of sensory plants.
Why grow your own? Spending time in the garden with your children gets children outdoors to explore and observe what’s growing. They soak up Vitamin D and as they get older and do more physical tasks (composting, raking and weeding) they’ll get good exercise while gardening. Gardening provides a great introduction to eating healthy foods, and how vegetables are grown. Children will learn (and taste) the difference between home-grown vegetables and the mass-farmed store-bought variety. As children get older, you can discuss GMOs and sustainability, and how growing your own food helps reduce your carbon footprint. Additionally, children learn patience as they watch plants transform from seeds into seedlings, then into plants, and finally vegetables. They also learn responsibility. Without water plants wilt, and without weeding, gardens become overgrown. Watching the process of a seed transform into a plant and finally sprout vegetables provides the perfect opportunity for children to learn about germination. As the sun shines, you can teach them how plants convert light into fuel through photosynthesis. Transplanting seedlings allows children to look at roots and learn how they absorb water, and digging in the dirt turns up earthworms – an opportunity to teach them about how worms support healthy gardens. There is nothing like the taste of fresh produce straight from the garden. Many children balk when parents serve them vegetables. Yet, when little ones help grow their own, they’re much more likely to eat them. Gardens are a great way to channel children’s natural curiosity into a fun activity. www.babysandbeyond.co.za
FEATURE
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Health
Picture: Bio Oil
Adolescence
leaves its marks P
REGNANT women are not the only ones at risk of developing stretch marks. Research indicates that adolescents are also affected, with up to 70% of girls and 40% of boys developing stretch marks during puberty. While not a cause for concern as a medical condition, stretch marks can cause distress, particularly at a time when teenagers are feeling selfconscious about the changes in their bodies. Stretch marks (medically known as striae) occur when the body expands faster than the skin covering it, resulting in internal tears in the deep dermis. When these tears heal, they form scars known as stretch marks. ‘In adolescence, stretch marks are related to sudden and dramatic growth spurts. They tend to occur between 12 to 18 years of age, although we see them in children as young as 10,’ comments dermatologist, Dr Ayesha Moolla. Stretch marks usually form where the body rapidly changes – the buttocks, breasts, thighs and calves. Although anyone that experiences rapid gain is at risk of developing stretch marks, the likelihood varies according to skin type, age, genetic disposition, diet and the hydration of the skin. ‘Even body building can be a factor as the sudden gain in muscle mass can lend itself to stretch mark formation,’ notes Dr Moolla. Perhaps surprisingly, young skin is more likely to develop stretch marks. ‘When the collagen bonds within the skin are fairly rigid, stretch marks are more likely. As you get older, your skin tends to become more lax, allowing more flexibility,’ she points out. Local consumer research conducted by Ipsos and Seventeen Magazine for Bio-Oil, found that three quarters of respondents were concerned enough to try various methods to improve the appearance of their stretch marks. Respondents associated their stretch marks with feelings of insecurity and embarrassment, referring to them as ‘ugly’. Dr Moolla emphasises that, ‘recognising striae early is crucial. The condition may respond better to products and prescription treatment that is applied to newly-developed striae. Once the striae are older they are more refractory to treatment.’
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The emotional effect of stretch marks and other changes can be more distressing than the physical aspect. ‘Nobody volunteers for adolescence to begin. One morning, upon wakening, a teenager might find that a new phase of her reproductive life has begun. It is an emotionally challenging time overall and something as small as a stretch mark might add to their distress,’ explains gynaecologist, Dr Jana Roussouw. ‘Adolescents are the highest risk group for eating disorders and body image disorders, often because a preoccupation with body shape and size develops from the rapid body changes,’ warns clinical psychologist, Maropeng Ralenala. ‘Stretch marks are an example of physical changes during puberty that are much misunderstood and can cause great distress, self-blame and lead to a dysfunctional preoccupation with weight and physical appearance,’ she adds. Experts agree that prevention is better than cure when it comes to stretch marks. Dr Moolla suggests: ‘Maintain a healthy weight, eat a balanced diet rich in food and nutrients that are good for skin health. Drink plenty of water. Twice a day, massage areas that are prone to stretch marks using good quality oil such as Bio-Oil. The massaging action allows the skin to become more pliant and more hydrated.’
Preventing stretch marks during adolescence • Maintain a healthy weight • Exercise improves circulation and keeps skin elastic and more able to stretch • Eat a healthy diet (including foods that are rich in Vitamin E and C, zinc and silica) • Stay hydrated (drink two litres of water a day) • Avoid sugar, which is linked to less elasticity in the skin • Massage can increase circulation and nutrient supply to the skin, helping it stay supple • Massage Bio-Oil into areas prone to stretch marks twice daily For more information, visit www.bio-oil.com. www.babysandbeyond.co.za
FEATURE
Fussy, picky eaters
Are mealtimes characterised by arguments and stress? With childhood days are often marked by phases of fussiness and tantrums, Abbott Laboratories offers some advice to parents who discover they have a fussy, picky eater.
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OU may have noticed that your child, who was once easy to feed, has suddenly become fussy about food and rejects most of the ‘healthy’ food items that you give him. He may also take an unusual liking to a certain food and want it in every meal. At some point most parents face challenges from their children about eating. A child may refuse to eat, play with food, eat less than usual, dislike vegetables, fruit, meat or milk, dislike chewing, demand the same food at every meal, prefer junk food to healthy food, make a mess at the table or throw tantrums at mealtimes. These behaviours can surprise and trouble parents who want to ensure healthy eating habits.
Eating problems and life stages 3 to 5 years • Children frequently develop food fads; they may request the same food for days or weeks on end, and temporarily refuse to eat. • Children get distracted easily and may take a long time to finish their meals. • They have a tendency to spill liquids and spread food on the table. • They may refuse to eat green vegetables, fruits or healthy snacks in favour of fast food. • They may neglect mealtime to have more playtime. • Children may object to the shape, colour or texture of a food and may decide not to eat certain types of foods. • Eating junk food, full of energy and fat but few nutrients, is a big problem for children of this age group.
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• They may develop a dislike for certain types of food and may refuse to eat them. • Pre-school children may become picky eaters (also known as ‘fussy eaters’, ‘choosy’ and ‘problem eaters’) and avoid certain foods, or eat only a limited number of foods. • Picky eaters seem to show little interest in food and may refuse to consume all the food on their plates. 5 to 7 years • Children in this age group tend to focus on personal challenges and may resist their parents’ insistence about healthy eating. • They may refuse to eat some foods, go on binges during which they eat only a certain food, or become classic ‘picky eaters’. • During this stage, as in earlier development, children are learning independence and one way to be independent is to control their eating. 7 to 9 years • For children in this stage, the influence of friends and peers is important and they prefer to eat what their friends eat. • They may favour non-nutritious snacks. • Serious eating disorders, although rare, can develop from eating habits established at this age.
Why do children act this way? Causes may include a natural tendency to imitate a parent’s (or someone else’s) picky eating; a reaction to punishment; a reaction to ‘food rewards’ given to ensure food consumption; past history of physical www.babysandbeyond.co.za
FEATURE reasons for difficulty in eating; changes in appetite associated with overall growth; extreme sensitivity to taste, smell and texture of foods; or a dislike for the colour or texture of a certain food. What are the potential consequences of picky eating?
Deficiency disorders The food we eat contains a variety of nutrients, all of which have different functions in the body. Milk is rich in calcium; green leafy vegetables are high in iron and meats and eggs are good sources of protein. If a particular food is missing from the diet, some nutrients may become deficient in the body. For example, if a child avoids milk, he misses an excellent source of dietary calcium. A child who refuses to eat fruits and vegetables may, in the long run, develop vitamin and mineral deficiencies, such as anemia or vitamin A deficiency. For these reasons it is important to include a wide variety of foods in the diet.
Poor eating habits Research shows that the best time to develop healthy eating habits is during childhood. This is the time when the child develops tastes for food. Picky eating at this stage may cause a child to develop poor habits and avoid foods, and it may be difficult to get a child to eat these foods later in life. Picky eaters typically eat small meals and have a poor appetite. In some instances, this may lead to growth retardation, lack of concentration and mental performance, and low immunity. Low levels of iron and zinc are linked to decreased appetite in picky eaters. Researchers have observed that supplementation of iron and zinc results in improved growth and improved appetite (in terms of both energy intake of the snack and report of appetite). As such, parents should encourage their children to eat iron-rich foods such as green leafy vegetables, egg yolks, and red meats like beef and lamb and also chicken and fish.
Low Immunity A child’s immunity is of great concern to parents, especially during winter when there’s increased risk of infection.
Dental cavities Once children develop permanent teeth it is important for them to learn extra dental care so that their permanent teeth last them lifetime. Picky eaters’ preferences for sweets or chocolates may cause dental problems including cavities in teeth.
Low energy levels Childhood is time for learning and exploring and, to do this, children need to be healthy and active. They need an adequate supply of energy provided by good nutrition. A child who doesn’t eat right may be inactive and sluggish. They may tire easily and lack
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interest in sports and activity. Studies have shown that children who eat a healthy breakfast are more active and alert than children who do not.
Obesity Picky eaters may prefer foods rich in fat and energy and may be more prone to become overweight and obese. Obesity results from consuming more calories than are used, and is epidemic in the modern world. Obese children often become obese adults, which may lead to many associated diseases later in life.
Need help feeding your picky eater? Mealtimes should be relaxed and fun for the whole family. This not only helps to ensure that your children get the nutrition they need, but also brings you closer as a family. To make meal times fun, follow these simple guidelines: • Step by step: Introduce only one new food at a time instead of serving a completely new meal. • Small to big: Serve small portion sizes when introducing new foods, gradually moving to bigger portions. • Be positive: Some children have negative associations (ie ‘hospital food’) with some foods. Try to alter the form and texture of that food to change the association into something more positive. • Make meals healthier: Try to improve the nutritive value of the food your child enjoys. For pizza, try whole-wheat varieties and add vegetables; add fruit to cereal or vegetables to pasta. • Do not bribe: Resist giving your child sweets and fried foods to encourage him to eat. • Make mealtimes relaxed and fun: Avoid watching TV and other distractions that may lead to overeating or losing interest in food. Talk to your child about the day and share your own experiences so that your child looks forward to mealtimes. • Encourage children as they grow: Encourage self-respect and self-acceptance. Never criticise a child’s body type. • Involve your child: Take him to the supermarket or let him choose the menu once a week. This teaches decision-making and increases involvement in the preparation of meals. Let your child set the table or help you clear after the meal. • Make a schedule: Serve meals at consistent intervals and times and discourage unscheduled eating times. Work with your child to establish the mealtime schedule. • Set a good example: Eat healthy foods with enthusiasm. Never talk about disliking healthy foods in front of your child. • Education: Look for opportunities to teach your child the benefits of healthy eating and an active lifestyle. • Keep a watchful eye and stay calm: If you notice your child is preoccupied with being ‘thin’, introduce discussion of the hazards of eating disorders. If the problem persists, see a doctor. www.babysandbeyond.co.za
FEATURE FEATURE
Prevent
drowning By Emma Dawson
According to the Child Accident Prevention Foundation of Southern Africa, drowning is one of the greatest causes of accidental death in young children, second only to car accidents. With this in mind, it’s worth paying attention to experts’ advice regarding water safety and the prevention of drowning.
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HILDSAFE, a campaign run by the Child Accident Prevention Foundation of Southern Africa (CAPFSA) and Safe Kids Worldwide, promotes optimal health and development of all children in South Africa. Part of this campaign addresses water safety and the prevention of drowning. Children down in buckets, baths, ponds, lagoons, canals, vleis, swamps, the sea, dams, rivers, in paddling or swimming pools and even in drains; and not only when swimming, but often as a result of falling into water fully clothed.
Drowning can be prevented. Children should learn how to swim as early as possible, and it’s equally important for them to be trained in survival skills such as floating and treading water. But even then, constant supervision is always necessary.
Legislation Over the past three years there has been much talk about the implementation of a bylaw in the City of Johannesburg that would see pool owners being required to net, cover or fence their pools. ‘A misconception arose nationally that this bylaw would roll out to the rest of the country. At present the only national safety requirement is that pools must be
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restricted from access by any member of the public. This forms part of the national building regulations,’ explains Andrew Reed, Aqua-Net’s director. While some building inspectors, municipalities and housing estates have their own bylaws that require more onerous levels of pool safety, this is an exception rather than the norm. A couple of months ago, the City of Johannesburg decided to withdraw its swimming pool safety bylaw. ‘In the interim work has been undertaken to develop an SABS standard for swimming pool safety nets and covers. This new standard will incorporate the American ASTM specification as the benchmark for any swimming pool safety cover or net. Any safety net or cover will need to be installed to a specific standard that ensures it offers the required levels of safety,’ Andrew explains. ‘It is hoped that this new standard (soon to be made available for public comment) will be incorporated into the national building regulations and referenced for the building or installation of swimming pools. This will see more focus being placed on swimming pool safety nationally.’ Adding to this, Andrew comments: ‘An Aqua-Net or any pool cover or fence is no substitute for adult supervision – it’s only there to provide a last line of safety should a child wander off unsupervised. It takes just seconds for a child to drown.’
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FEATURE
It takes just seconds for a child to drown. A silent killer In 2012 in South Africa, Netcare reported that its paramedics attended to 218 drownings or near drownings – a statistic from just one emergency response operator. NGO, Childsafe, reports that 326 children drown every year because an adult turned his or her back! Additionally, the Medical Research council reports that more than 3 000 people have died from drowning in the last five years – that’s more than one death by drowning every day of the year. ‘As operators in the swimming pool industry I believe that it is our responsibility to ensure that a message is conveyed to the public about the risks that exist around owning a pool. If a pool is being built or maintained for a family with children the pool owner should be made aware of the risks and given options on how best to secure their pool.
Golden rules • A child should never swim alone. Children who cannot swim should stay away from places where they can drown. • Buoyancy aids, such as inflatable wings and tubes, are only aids. Don’t rely solely on their protection. • Warn against boisterous play in or near water. A dam wall or the area around a swimming pool is no place for riding a bicycle. • Children should practice coping in water while wearing their clothes. • Children should never dive or jump into water they are unacquainted with, or when people are in their way. • Swimming pools must be properly fenced and have a childproof lock on the gate. The gate must never be left open. • To fully protect a child, add a professionallyinstalled pool safety net or cover to your pool. Even then, know where your child is at all times. • Is the neighbour’s pool adequately fenced? And the gate always closed? • Remember to empty paddling pools when not in use.
Myths and facts Be aware of the signs and remember that the appearance of a drowning can vary widely. Myth: Drowning children will shout for help. Fact: Drowning children are physiologically unable to call out. Their mouths alternately sink below and reappear above the surface. While their mouths are above the surface of the water they need to exhale and inhale before they sink again. There isn’t enough time to cry out.
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Myth: Drowning children wave their arms to attract attention, or will thrash about in the water. Fact: Drowning children cannot wave for help. Physiologically, a person who is drowning cannot perform voluntary movement such as waving or moving towards a rescuer. Envisage the surface of the water as a platform. Someone who is drowning often presses down on the surface and tries to use it as leverage to get their mouth above the water’s surface to breathe. So what an onlooker sees are arm movements that can appear to be playful swimming. Children will not kick wildly either. They remain upright in the water with no evidence of a supporting kick. They are quiet, focused only on breathing and show no signs of violent struggle. A child’s struggle is quick – 20 seconds – whereas adults struggle for 60 seconds. Myth: Drowning children are unsupervised children. Fact: 50% of all child drownings occur 25m or less from an adult who was distracted for only a few seconds. Myth: My child has had swimming lessons so he won’t drown. Fact: No child is ever drown-proof, no matter how good his swimming skills. A few swimming lessons are no guarantee when it comes to drowning prevention. Myth: Water wings and floatation aids will prevent drowning. Fact: Water wings give a dangerous and false sense of security, often making children think they are stronger swimmers than they actually are. Flotation aids can also suddenly deflate. Childsafe aims to reduce and prevent intentional and unintentional injuries of all severity through research, education, environmental change and recommendations for legislation. For more information, visit www.childsafe.org.za. TopStep, established by Power Plastics, is a one-stop education resource for all things related to pool safety and drowning prevention. The initiative is born from the need to urgently address South Africa’s child drowning statistics through education and awareness. For more information, visit www.topstep.co.za. Aqua-Net, offers an array of swimming pool safety nets and covers, with options to suit every need and budget. After 40 years in business, the Aqua-Net is claimed to be the easiest safety system for securing your pool. For information about products, pool safety and securing your pool, contact www.aquanet.co.za.
Did you know that within just 30 seconds a young child can drown without a sound in just 4cm of water? www.babysandbeyond.co.za
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Kicks for kids
and
Colouring
school
Sadly the holidays are over, but going back to school is exciting. You’ll meet your teachers, make new friends, see your old friends, play the sports you love and learn lots of interesting new things.
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KICKS FOR KIDS
Find all the
words
ACROBAT BIG TOP CLOWN FUN GYMNAST HORSE JUGGLER MAGICIAN PARADE RINGMASTER ROPE WALKER TICKET TRAPEZE TRICK UNICYCLE
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B P G G L E R T P E
I O U U N I C R A D
G T J E L C Y A R A
A C A G I C I P E Z
G R M C L O A H R E
Y O R R N W N O O T
M B I E T E S R P R
N A N T I L A W E I
A T G S C K E R K C
S T M A K E T F U N
This is zigzag word search puzzle. Words go left, right, up, down, not diagonally and can bend at a right angle. There are no unused letters in the grid, every letter is used only once.
Find your way
Help every pencil find the way to the picture in the middle of the maze and color all the eggs!
b
Answers
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KICKS FOR KIDS Draw a line from dot number 1 to dot number 2, then from dot number 2 to dot number 3, 3 to 4, and so on. Continue to join the dots until you have connected all the numbered dots. Then colour the picture!
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Join the
dots then colour
Answer
Match the pairs spot the odd one
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d
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Grab some grub
Roast Spiced Leg of Lamb Serves 6 This Indian inspired dish is marinated overnight in a spiced sour cream sauce. The meat becomes beautifully tender and the sauce imparts a great flavour.
Ingredients 1.6 to 1.8kg leg of lamb (see Chef’s Tip) 1 x 200ml Ina Paarman’s Tikka Curry Coat & Cook sauce 1 x 250ml sour cream 3 onions cut into wedges 6 peeled whole garlic cloves fresh rosemary twigs Ina Paarman’s Rosemary & Olive seasoning 4 potatoes cut into wedges (optional)
Method Trim off and discard surplus fat, as well as strips of the parchment-like white skin from the lamb to allow the marinade to penetrate. Place the meat into a glass or ceramic dish. Mix the Tikka Sauce with the sour cream and pour it over the lamb. Use a basting brush to encourage the marinade into all the nooks and crannies. Turn the lamb over, making sure every bit is well coated. Cover with cling film and refrigerate for 12 to 24 hours. Remove the lamb from the fridge about 45 minutes before you plan to cook it to bring it to room temperature. Prepare a bed of onion wedges and garlic in a roasting pan. Stuff the meat, here and there, with tufts of rosemary (see picture). Transfer the meat to the pan and rest it on the onions. Scrape all the sauce into the pan. Season the meat generously with the Rosemary & Olive seasoning. Roast open at 180ºC for 30 minutes and then turn the oven down to 160ºC. Cook slowly at this temperature for an extra 1½ to two hours. If using the potatoes, toss them with a little oil, season and roast with the meat for the last hour. Transfer the meat to a carving board, cover lightly and leave to rest for 10 minutes. Rub the sauce through a sieve and serve on the side. Garnish the roast with lemon wedges and fresh coriander leaves. Serve with rice pilaf and sambal salads.
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Chef’s Tip: Ask the butcher not to cut the shank bone as it serves as a handy ‘handle’ to hold the meat while carving. Ask him to fillet out the hip or pelvic bone for you – this makes carving totally painless.
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¼ cup (60ml) melted butter ½ cup (125ml) milk 1 x 550g Ina Paarman’s Chocolate Brownie Mix 100g pecan nuts, roughly chopped
to box instructions. 4 Mix according to package instr 5 Top unbaked mixture, once in t with chopped pecan nuts. 6 Bake for 30 - 35 minutes. 7 Cut into small squares once cooled.
Grab some grub
Nutty Chocolate Brownies Makes 24 to 30
You will need: 22cm square tin Medium mixing bowl Electric beaters Measuring jug Scissors Spatula Chopping board Sharp cooks knife Oven gloves This is one of my favourite variations of our brownies! 2 extra-large eggs at room temperature ½ cup (125ml) canola oil ¼ cup (60ml) melted butter ½ cup (125ml) milk 1 x 550g Ina Paarman’s Chocolate Brownie Mix 100g pecan nuts, roughly chopped Adjust oven rack to the middle position and preheat oven to 180°C.
“ of mTyhfis is variataiov of brownoiue r s! Prepare a 22cm square tin according to box instructions. Mix Brownies according to package instructions. Once in the tin, top the unbaked mixture with chopped pecan nuts. Bake for 30 to 35 minutes. Cut into small squares once cooled.
Recipes and pictures courtesy of
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Book Review Kids’ Market Day by Samantha Scarborough (RRP, R130) This book is a lifeline for parents helping children to come up with ideas for pre-primary and junior school market days. Aimed at inspiring entrepreneurship from a young age, each of the 30 projects has a step-by-step guide to work from to ensure that market day is fun and profitable. In keeping with the ‘waste not’, ‘want not’ revolution, most of the projects call for materials found around the home that are either upcycled or recycled. All of the projects are easy and fun, and have a hand-crafted, handmade focus. A lovely touch is that each creation offers a guideline on the time it will take to complete, as well as tips and comments from the young entrepreneurs featured in the book. It also includes ideas for attracting buyers to your stand.
True Grit Junior Edition by Bear Grylls (RRP, R145)
Pictures: Random House Struik
If you’re a Bear Grylls fan or just have an adventurous spirit, then this book is for you. One of the world’s toughest adventurers, Bear shares true stories of survival against all odds, and the death-defying bravery of his heroes who have inspired and shaped his life. Packed with 19 short stories, this book tells the tales of men and women – adventurers, explorers, soldiers and spies – all of whom share one common denominator: the refusal to quit. Full of facts and gems of general knowledge, this book offers a glimpse into the history of exploration and how ordinary people step up and become extraordinary. Most importantly, Bear uses each story to remind us of what it is to be resilient and how these lessons can be used in our own lives.
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Mom2B
Classical concerts for moms and tots E
ARLY childhood education is probably the most important investment in a child’s life and their ability to succeed in subsequent years relies heavily on its success. Exposure to classical music and music education is proven to be greatly beneficial to the development of the young brain and to promote neuroplasticity in the same way that multilingualism does. Aside from the neurological benefits, musical activity is also a stimulating social experience in a group context where little ones can play and learn. Established in 2010, Biblioteek is a creative platform for musicians, directors, composers, choreographers and designers to collaborate and explore the reinvention of classical music in South Africa. At the helm of this production company is well-known soprano, Magdalene Minnaar, who is passionate about developing a bigger, younger and more diverse classical audience. Magdalene has developed interactive storytelling concerts for little ones – babies of all ages, as well as pre-school children – where children learn about instruments, music and how these stimulate the imagination. And, parents get to enjoy excellent music without having to worry about their small children in a stiff concert environment. For most people, the opportunity to see and hear a musical performance live is a powerful sensory experience. The awe that such an experience inspires in young children has often been referenced in professional music circles as a catalyst for an interest in the sophisticated art of performance and music in later life. A portion of proceeds from Little Maestros concerts is channelled into Biblioteek’s own music project in Khayelitsha – Ukhayelitsha Music Project – where 12 dedicated children are currently learning to play instruments. Upcoming Little Maestro Concerts: • 10 February 2015 – Peter & The Wolf (with Louisa Theart & Ensemble) • 10 March 2015 – Strings ’n Things (with Juliet String Quartet) For more information, visit www.biblioteek.co.za
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introduces chocolate delight flavoured shake
N
ATIVA, marketer of Mom2B Pregnancy Shakes, has introduced a chocolateflavoured shake to its existing strawberry and vanilla flavours to give moms and moms-to-be a great nutritional reason to indulge in the dreamy delights of chocolate. The chocolate-flavoured shake joins the Mom2B range of pregnancy shakes, pregnancy supplements and pregnancy omega capsules that are formulated to assist in the provision of nutritional, vitamin and mineral requirements of moms and their babies before and during pregnancy, and while breastfeeding. This affordable and convenient meal supplement can be taken once or twice a day. It’s good for moms and babies, high in vitamins B5, B6, B12, biotin, folic acid and zinc, as well as vitamin B1, B2, B3, vitamin C, D, E, iodine, iron and magnesium. The shakes offer a great source of calcium and phosphorus, and are low in fat and high in fibre. However, they’re not suitable for people with milk protein allergies or for infant feeding. For more information, visit www.nativa.co.za.
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