Healthy Child with Dr Ranj Singh - Summer 2019

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Healthy Child with Dr Ranj Singh FEEDING FUSSY EATERS:

Preparing Kids’ Meals Without Tears


Sepsis Danger! Spotting The Warning Signs

A cause for concern, or a healthy sign?

Dental Care: Looking After Little Teeth

Healthy Eating For Children: Simple Swaps For Fitter Kids


Discussing the essentials For kids’ health with the TV doctor PREGNANCY


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SUMMER 2019 | £3.99 ISSN 1758-597X


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ecoming a new parent (whether that's for the first time or not) is all at once exciting and terrifying. Despite months of preparing the nursery, stocking up on supplies and baby-proofing the home, the overwhelming feeling when looking down at your bundle of joy is: ‘How on earth am I going to keep this little one safe and well?’ Of course, these thoughts are completely normal, which is why this issue of Healthy Child with Dr Ranj Singh has a real focus on newborn safety practices, including a spotlight on how to prevent sudden infant death syndrome (SIDS). New research published by The Lullaby Trust found that 219 deaths occurred as a result of SIDS in 2016 across England and Wales alone. In 2018, the NHS announced it would be offering boys in England the HPV vaccination for the first time—

an immunisation previously only available to girls. This offering poses a huge leap forward in further protecting boys from major life-threatening diseases and cancers. Find out why this progress is so important inside. Elsewhere, children’s nutrition and overall wellbeing is pushing its way into the collective consciousness of the nation—and for good reason. Ensuring children eat a healthy, balanced diet and take up appropriate levels of exercise is a vital step in reducing their risk of illnesses including diabetes and cardiovascular diseases in later life. How to implement these important lifestyle changes and learning how to support children in making good wellness decisions—plus so much more—can be found within these pages, so that your kids can grow up as happy and healthy as possible. hc

Dr Ranj Singh

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CONTENTS 29 Nutrition for Kids

Back to food basics with the essentials of a healthy diet, and tips for balancing your family consumption

32 Dealing with Fussy Eaters

It can be done! Just follow our simple tips and mealtime misery should be a thing of the past

Health Check

39 First Aid Tips for Common Kid Injuries

Don’t panic! Minor injuries from a bump on the head to a grazed knee will be easy to handle with our handy first aid hints

42 Far-Sighted Tips for Child Eyecare

It’s important to protect and maintain young eyes. Our guide makes everything clear

44 Sunglasses for Kids

Dr Ranj Singh, leading paediatrician on ITV’s This Morning and CBeebies’ Get Well Soon programme, talks to Kayley Loveridge about mental health issues in children, when to give over-the-counter medication to your little one and key advice for keeping children healthy and happy during the colder months

Pregnancy & Early Years

14 What's New? Kids' Health Today

All the latest facts and stats from the world of childrens' health

17 Eco-Friendly Baby Essentials

From nappies to cosmetics, the products you should buy if you want to save the planet as well as caring for your child

18 Wooden Toys

There's more to it than just nostalgia wooden toys have lots of good things going for them

20 Obesity in Pregnancy

The risks and solutions involved in being an overwieght mum-to-be

22 How Smoking Affects Your Baby

Why it really is time to stub it out if you want to ensure your child's health and safety

24 Skin Care for Kids

How childhood skin conditions can be helped by the right choice of products and treatments

26 Safe Infant Bathing

Bathtime can be fun, but it has its dangers. We serve up top tips for ensuring sudsy fun is safe fun too

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48 Gut Health in Children

The billions of bacteria in our children’s gut aren’t all bad—in fact, some are essential to growth and development

50 The Danger of Sepsis

Sepsis is the number one cause of preventable death worldwide—but what are the danger signs you must look out for?

53 Simple Swaps for Fitter Kids

Healthy eating can be simple and fun if you remember some of our simple swaps, so ditch dodgy diets for our tasty alternatives

56 Why Boys Need HPV Immunisation Good news as health authorities recognise the importance of HPV immunisation for boys. But why is it so vital?

59 Tackling Teething Troubles

Teething can be a troubling time, but our guide to little teeth takes you through all the vital information

62 Growing Up With Oral Health

Why avoiding tooth decay and promoting good oral health habits is increasingly hard

66 Managing Allergies and Asthma

Both conditions can affect quality of life, so how do you manage childhood allergy or asthma?

69 Hearing Protection for Kids

You've taken care of their eyes, but what about their sensitive ears?

IMAGES © Shutterstock

8 Healthy, Happy Kids

On the subject of eyecare, here’s why it’s important to protect against UV radiation

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celebrity 71 Sensitive Skin

How skin problems from eczema to nappy rash can be alleviated by a wide range of sympathetic treatments .

75 Sleeping Safely

With all the conflicting advice, how do you make sure your child sleeps safely?

78 Group B Strep

The warning signs and treatment options for this potentially dangerous infection

80 Warning Signs of Meningitis

It’s a potentially life-threatening condition that is often overlooked. What are the symptoms of meningitis, and why is important to act quickly when it’s diagnosed?

82 A Sticky Situation—Glue Ear

This common condition has some uncomfortable symptoms. What are the causes and treatments for glue ear?

86 Cystic Fibrosis and Long-term Health

There’s no cure for this debilitating genetic illness, but medical developments hold out hope of a brighter future for cystic fibrosis sufferers

Growing Up

88 Telling the Time

This notable stage of the learning process is a good time to teach your child valuable habits

90 Toys and Childhood Development

Playing is fun, but can also teach valuable lessons. We look at the development benefits of a range of toy types

93 Dietary Supplements for Children

In addition to the ‘five-a-day’ of fruit and veg, what are the micronutrients essential to development and where do you find them?

99 A Clean Home is a Healthy Home

These cleaning health benefits will make chores more rewarding for the whole family

102 Apps for Learning

Educational apps aren’t all of equal value—we give you some guidance on the ones that are more than just games

104 Imaginary Friends for Life?

Is it a worrying psychological quirk or a sign of creative flair? We look into the extraordinary world of children’s imaginary friends

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PUBLISHER & CEO Kevin Harrington

107 Managing Childhood Diabetes

How developments in medical technology are making it easier for children to cope

EDITOR Chris Jenkins Kayley Loveridge

110 Choosing Clothes for Kids

SUB EDITOR Elika Roohi Annalisa D'Alessio

Pretty or practical? Cheap or safetyconscious? Children’s clothes can be hard to shop for

113 Taking the First Steps

When baby grows out of bootees and needs proper shoes, you’ll be glad of our guidance in choosing the right kicks

114 Protecting Pets

They’re part of the family, but do we do enough financially to ensure the health and well-being of our beloved pets?

117 Softer Water, Better Health?

With mains water supplies often delivering ‘hard’ water to the home, what are the possible health and household benefits of a water softener?

118 Child Friendly Holidays

When you’re on holiday with small children, the last thing you want is added stress from an unsuitable destination. We have the essential travel tips

121 Baby, It’s Bright Outside

Ultraviolet radiation can be particularly dangerous to the eyes of babies. We come up with stylish solutions to sun damage

123 Fun in the Sun

When you head for the beach, do you think about the sunscreen you'll use? For the sake of your health and the planet's, you should read our revealing guide

124 Preparing for a Sibling

There’s a little brother or sister on the way— what should you do to get your older children used to the idea?

128 Air Quality in the Home

Outside air pollution is one major problem, but indoor air quality can be an equal health hazard. We survey the solutions

130 Choosing a School

Looking for tips on researching and choosing a school for your children? We have all the info

ART EDITOR Friyan Mehta FEATURES WRITER Hannah Foskett EDITORIAL ASSISTANT Anetha Sivananthan PRODUCTION DIRECTOR Joanna Harrington PRODUCTION COORDINATOR Ava Keane OFFICE COORDINATOR Adam Linard-Stevens PUBLISHED BY Celebrity Angels © 2019 All rights reserved

Healthy Child Celebrity Angels Suite 2, 143 Caledonian Road, London, N1 0SL Tel: 020 7871 1000 Fax: 020 7022 1694 For sales enquiries call: 020 7871 1000 COVER IMAGES Shutterstock; Photograph of Dr Ranj Singh Courtesy of Talent4Media All material in Healthy Child with Dr Ranj Singh magazine is wholly copyright and reproduction without the written permission of the publisher is strictly forbidden. The views expressed in this publication are entirely those of the authors and do not necessarily represent those of Celebrity Angels. The information in this publication is carefully researched and produced in good faith, however, neither the publisher nor the editors accept responsibility for any errors. The Celebrity Angels Series is published in the UK under licence by Damson Media Limited. Damson Media Limited is registered in England and Wales under registration no. 07869300.

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Healthy, Happy Kids

Images: Shutterstock; Courtesy of Talent4Media

Dr Ranj Singh, paediatrician on ITV’s This Morning, speaks with Kayley Loveridge about mental health issues in children, when to give over-the-counter medication to your little one and his key advice for keeping children healthy and happy during the colder months

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Q. What are the most common conditions you see in your patients time and time again? RS: The conditions we tend to see depend on two major factors: the age of the patient and the time of year. For instance, the most common issues we see with newborns are feeding issues, jaundice (which is very common in newborns and harmless for most of them) and constipation (more likely if the baby is formula-fed). Small children tend to present most commonly with fever, breathing difficulties, infections in general and skin complaints. Then as they get older, we will see an increased likelihood of injuries and accidents, behavioural and mental health issues, and possibly also substance misuse problems. During colder months the infections and respiratory illnesses tend to predominate, and during the summer months we tend to see more injuries as kids are out and about. Q. How can first-time mums know the difference between Braxton Hicks and labour pains?

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RS: Braxton Hicks contractions are sporadic contractions of the muscles of the uterus that tend to start around the second half of pregnancy. You may feel your womb tightening and your abdomen feeling hard, and then it relaxing again and going soft. They tend to last less than a minute and can happen several times a day. It’s not known why they happen, but it’s thought that they could be a sign your body is preparing itself for eventual labour. Braxton Hicks contractions are not the same as the contractions of actual labour, and there are some key differences: they are infrequent (often only once/twice per day), they are relieved with changing position or activity, they are short and don’t last longer than a minute, they are irregular and unpredictable, they are less painful than labour contractions and don’t increase in intensity or get closer together. If you are uncertain about which type of contractions you are having, or if you have any other signs (e.g. waters breaking, vaginal bleeding or a change in baby

movements) then you should contact your midwife straight away. Q. What can parents do if they suspect their child is suffering with anxiety or depression? RS: There is evidence that mental health issues are on the increase, especially amongst young people. Unfortunately, the availability of help for people in difficulty has not kept up with the demand, and many mental health services have struggled to cope with the number of people needing support which has led to either delays in getting care, or not being able to get treatment at all. Firstly, it’s important that parents keep the conversation about mental health difficulties (and any other difficulty) open with their child. Helping your child to look after and manage their health and stresses better is also important: keep an eye on diet and exercise, try to improve sleep, be mindful of things like social media and try to reduce any unnecessary pressures.

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Interview Mental health support for young people going through conditions like anxiety or depression can come from many places. Firstly, there are services available through the NHS, which could include things like counselling, talking therapies or medication—if appropriate. There may also be help available through your child’s school. Some schools have links with counselling services or local mental health support initiatives that they may be able to put you in touch with. Likewise, there are a number of charities that offer help and information (such as Young Minds, Mind, Anxiety UK) for both parents and their children. Finally, if things have reached crisis point, then Accident & Emergency is always there 24 hours a day to provide emergency help.

There is evidence that mental health issues are on the increase, especially amongst young people. Unfortunately, the availability of help for people in difficulty has not kept up with the demand, and many mental health services have struggled to cope with the number of people needing support

sleep environment is right: it should be comfortable, warm, dry, dimly lit or dark, and ideally free from electronic devices such as TVs. Secondly, it’s important to establish a proper bedtime routine: consistent sleep and wake times every night, a wind-down hour before bed consisting of electronic device-free time, perhaps a bath and a bedtime story/reading, all to get the brain prepared for sleeping. Also, try to avoid excessive amounts of fluids close to bedtime as your child will need to wake up to pass urine, especially caffeinated drinks which can keep them awake.

Q. Do you have any advice for parents on how to effectively calm panic attacks in young children? RS: Panic attacks are intense episodes of anxiety with accompanying physical symptoms that can make the sufferer feel extremely unwell. Sometimes they are associated with an underlying mental health issue (e.g. anxiety), or they may come out of the blue. Although they may feel awful or that something is wrong, panic attacks are not dangerous or harmful. The important thing to remember is that panic attacks will settle down and subside, so the first thing is to remain calm and support your child through them. Getting them to sit or lie down in a quiet, comfortable area may help. Speaking to them gently and reassuring them that they are okay and the feelings will pass may also be helpful. You could also try breathing exercises like asking them to visualise and calm their breathing down. Q. What are your top tips for dealing with sleep problems in children? RS: It’s all about good ‘sleep hygiene’. That starts with making sure that the

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ely Fever itselfit'sisursuarally harmful, n that your just a sig une system is child's imnm g fighti g somethin

Q. What exactly is a fever, and when should parents be worried? RS: A fever is a raised temperature (normal is around 36.5-37.5C), is most often due to an infection and is usually no reason to be worried. Most infections in children are viral and self-limiting, however, sometimes they may be due to bacteria and therefore may require antibiotics. Fever itself is seldom harmful (even when it is quite high) and is a sign that your child’s immune system is fighting something. There is also some evidence that it might actually be useful, so currently we only advise that you treat a fever (with medicines) if it is making your child feel unwell or distressed. Most fevers can be managed at home using 12 | Healthy Child with Dr Ranj Singh

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medicines, ensuring your child stays hydrated and is not over-dressed or too wrapped up. However, there are some instances when parents should seek further help: a fever over 38C in a baby under three months’ age, a fever over 39C in a baby between three to six months, a fever that lasts for longer than five days, if your child is showing any other signs of serious illness (e.g. difficulty breathing, a rash that doesn’t fade when you press it, a fit/convulsion), if your child isn’t getting better or is getting worse. Q. In your view, is it safe to give young children over-the-counter painkillers like ibuprofen or paracetamol? RS: Medicines such as paracetamol

Q. Almost one in four children are starting school already overweight or obese. What key things do parents need to know to help them tackle the problem effectively? RS: Firstly, the best way to manage obesity is to prevent it developing in the first place. That means educating children about healthy eating and exercise—something that both parents and schools should be responsible for. If a child is already overweight or obese, then dealing with it needs to be a team approach between families, healthcare professionals and school. Mealtimes need to be structured and meals need to be balanced with appropriate portion sizes for your child. Snacking needs to be kept to a minimum and the intake of fizzy or sugary drinks also reduced. It

Images: Shutterstock; Courtesy of Talent4Media

and ibuprofen are used for the treatment of pain and fever, and are safe and effective for the vast majority of children provided they are used appropriately. That means only using them for the right reason and following the dosage instructions. We currently don’t recommend routinely treating a raised temperature or fever unless it is making your child uncomfortable or distressed (or you have been advised to by a healthcare professional). There are a couple of instances where we would usually advise not to use ibuprofen because it may cause problems including if your child has severe asthma, if they have kidney problems, if they have stomach problems such as bleeding or an ulcer, or if they have chicken pox. If you have any concerns about using these medications, you should talk to your doctor to get advice.

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is a good idea to think about swapping sugar-heavy foods for healthier alternatives. At the same time, it’s a good idea to try to get your child involved in more physical activity. Doing things together as a family really helps motivate children and keep the whole family fit! Q. Could you explain what sepsis is, what can happen as a result and how parents can spot the symptoms? RS: Sepsis is a potentially lifethreatening condition that can arise from any infection. It’s relatively rare in children, but parents should be aware of possible signs and what to do. It happens when the immune system goes into overdrive and starts to attack the body itself, and is more likely with certain infections (e.g. infections in small babies, people with weak immune systems, infections that cause meningitis, urine infections in elderly people). Most infections will not develop into sepsis, but if they do they should be treated as soon as possible in hospital. If proper treatment is not given, then it could result in disability and possibly even death.

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Spotting sepsis in children can be tricky as there are no simple signs or tests. Parents should be on the lookout for signs that might indicate sepsis and feel empowered to speak to a health professional and ask: could it be sepsis? Signs of potential sepsis in children include fever or very low temperature, breathing very fast, a fit/ convulsion, a rash that doesn’t fade when you press it, excessive lethargy or drowsiness and feeling abnormally cold to the touch. Additional signs in small children/babies include: poor feeding, repeated vomiting and not passing urine. If a parent is worried that their child has an infection and signs of possible sepsis, then they should speak to a medical professional and seek advice immediately. Q. Finally, what five pieces of advice do you have for parents to keep their children healthy and happy during the winter months? RS: The winter months can bring a whole host of illnesses and injuries that affect children. My five tips for staying well would be:

1 Ensure your child keeps their immune system in top condition through a healthy, varied diet, exercise and adequate sleep. 2 If they do become unwell with a cough or cold, then practising good hand hygiene is important to prevent the spread of germs. 3 Whether at home or outside, preventing accidents is always important so be wary of hazards around the house and be careful in cold or icy weather outdoors. 4 Immunisation is one extremely important way to reduce illness, so make sure your child is up to date, especially when it comes to the annual flu vaccine (if they are eligible). 5 Mental health is just as important as physical health, so being aware of your child’s emotional and psychological needs is also important. Fostering a loving relationship with your child where they are able to open up to you and seek help is vital, and listening to their concerns and offering support and guidance is key to a happy and healthy childhood. hc Healthy Child with Dr Ranj Singh | 13

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Health Today

Three-quarters of children in the UK spend less time outdoors than prison inmates, which could be affecting their eyes, bones and immune systems. In fact, shortsightedness among young people in the UK has more than doubled in the last 50 years. Children are entitled to free sight tests from the NHS. Source: The Northern Ireland Childhood Errors of Refraction (NICER) study

What’s New?

Kids' Health children in the U.K. live in households that are unable to afford a healthy diet. Studies showed that 26 percent of Year Six students from deprived households are obese, compared to 11 percent in richer communities. These families would have to spend 42 percent of their afterhousing income on food, just to meet the government’s recommended Eat Well Guide. Source: The Food Foundation

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Images: Shutterstock

3.7 million

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Health Today

THE AVERAGE 10-YEAR-OLD has consumed as much sugar in their lifetime as the recommended limit for an 18-year-old. In 2018, children consumed more than a year’s worth of sugar in just six months, with sugary soft drinks being the main culprits. A third of children leaving primary school are now overweight or obese and a quarter of five-year-olds are suffering from tooth decay. Source: Public Health England


children and young adults in England and Wales are affected by Type II diabetes—a record number. Historically virtually unknown in children, the chronic condition is more aggressive in young people and is linked to obesity, blindness, heart disease and kidney failure. Source: Diabetes UK


is the year that the UK will extend the Human Papillomavirus (HPV) vaccine to boys aged 12 to 13 years. Currently, only girls and men who have sex with men (MSM) are eligible to receive the HPV vaccine, but from the 2019/2020 school year it is expected to help prevent more cases of HPV-related cancers in boys and girls. This includes protection against head and neck cancers as well as anal, penis and genital cancers. Source: NHS Choices

Banned Teething gels that contain the anaesthetic lidocaine will no longer be sold in supermarkets and high street shops in 2019. Only pharmacies will be allowed to sell the gels as they present a ‘very small’ risk of harm and there is ‘little evidence’ to suggest that they work. Alternative methods, such as teething rings or massaging the gums, are being advised. Source: Medicines and Healthcare Products Regulatory Agency (MHRA)

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Pregnancy & Early Years

Disposable Don’ts According to recycling charity Wrap, an estimated three billion disposable nappies are thrown away every year in the UK, accounting for three percent of all household waste. Most are incinerated or end up in landfill.

Save the Baby

Save the World It can be hard to have a baby and also save the planet, but with our guide to eco-friendly baby essentials you’ll be well on your way


hen you have a baby, you have a whole new world of buying decisions to make—clothes, food, sleeping items, utensils, car seats, toys—the list goes on. It’s tempting to go for the easiest and cheapest options, but what if you’re worried about what these (often plastic and non-recyclable) products are doing to the environment? Let’s look at some eco-friendly options. Washable nappies are an ecofriendly essential. Cloth nappies can be washed and reused, and even biodegradable nappies are preferable to disposables. Washable baby wipes are another obvious planet-saver—wet-wipes are made of a cotton-like fabric knitted

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together with non-biodegradable polyesters, and are an ecological nightmare. As many people don’t realise they are not meant to be flushed away, they accumulate in sewers and on riverbeds. Look instead for washable, organic or biodegradable types.

FURNISHINGS When you are furnishing the nursery, remember that in addition to creating a safe, healthy space, you can also look after the health of the planet by choosing sustainable furniture. Practically anything you need in the way of cots, high chairs and changing tables is available made from sustainably grown, responsibly harvested materials.

When you’re looking for mattresses and changing pads, avoid foams which contain harmful chemicals such as formaldehyde, benzene and toluene. Look for a nursing pillow stuffed with cotton rather than polyurethane foam and choose organic cotton or bamboo breast pads, which beat synthetics when you’re nursing. For baby clothing, soft organic cotton is the best choice and the most ecologically friendly, as it’s best for sensitive skin and is produced without the use of bleaching chemicals. For skincare, choose baby-safe products that are free of parabens, dyes and other irritating and toxic ingredients. Many mothers recommend coconut oil rather than proprietary products as a solution to nappy rash problems. Finally, to help you relax and get to sleep, look for ethically produced products manufactured without the use of petrochemicals or animal testing. Products such as heated wheat bags, herbal pillows, essential oils, organic fragrances and natural soaps will become part of your baby and mother care routine and will do the job without upsetting the ecological balance. hc Healthy Child with Dr Ranj Singh | 17

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Pregnancy & Early Years

Woodn’t It Be nice

Sociologist and design his toria F. Ogata w n Amy rote in her book Desig ning The Creative C hild that wood "is a famil iar and po etic substance, which does not sever the child from close contact w ith the tree , the table, the floor.”


e often hear complaints that older children are glued to their electronic devices such as tablets and smartphones, and are missing out on the simple but educationally important pleasures of playing with toys. But even at the earlier stages, are plastic, technological toys taking something away from our children’s development? Plenty of parents seem to think so, and are increasingly looking for simpler, more natural toys, particularly those using eco-friendly materials such as wood. In the earliest stages, children can enjoy wooden rattles, grasping toys and blocks, and from six months to a year they will take to stacking and shape puzzles. Once they start toddling, pusher toys are ideal, and from the age of about two they’ll enjoy simple toy vehicles and prams. In later years classic wooden toys, such as 18 | Healthy Child with Dr Ranj Singh

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jigsaw puzzles, building blocks and construction sets can help children with numeracy, literacy, motor skills and problem solving. Often hand-crafted from materials which are sustainably sourced and certified, wooden toys are environmentally sounder than plastics and electronics - as an organic, renewable substance, wood is biodegradable and can be recycled. If painted at all, wooden toys usually use non-toxic paints. When children are at the early ‘chewing’ stages, this is an obvious advantage.

NATURAL Plastic can be brittle, and once broken can be difficult or impossible to repair. It can also expose sharp edges. Wooden toys tend to wear naturally, and if broken can usually be restored. Once finished with, they can be recycled. The simplicity of wooden toys is another appeal – they offer a blank

slate on which the child can project his or her imagination. Wooden toys are also said to foster interactive play, rather than the solitary pursuit of electronic games. A final argument is that contact with wood is often said to be psychologically valuable. Finnish Doctor of Psychology Marjut Wallenius studied people’s reactions to different materials, and concluded: "It is especially interesting that the feel of wood is softer than other materials, not only experientially but also physiologically." His studies showed that touching aluminium, plastic or stainless steel caused a rise in blood pressure, while touching a wooden surface did not cause such a reaction. We all know that in later years it’s important to get children used to using digital technology, but it seems that to start off at least, the wooden toy provides a solid and natural grounding it’s difficult to find elsewhere. hc

Images: Shutterstock

It’s not just nostalgia–there are plenty of sound reasons why parents are again choosing wooden toys for their children

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Yes Bebe Ltd.indd 1

26/02/2019 11:18

Pregnancy & Early Years

By the numbers

Fifty perc ent of pregnant women are overw eight, and 25 percen t are obese.

Overweight & Pregnant Should You be Worried?

Being overweight during pregnancy can cause complications for you and your baby, but careful medical attention can reduce the risks

20 | Healthy Child with Dr Ranj Singh

HC6.Obesity in Pregnancy.indd 20

overweight) or 30 (considered as obese). Just make sure to follow this advice.

PRE-PREGNANCY Being seriously overweight or obese can actually reduce your chances of getting pregnant. This goes for men as well—being overweight or obese may contribute to fertility problems. Make a healthy lifestyle a family goal and work at it together. For anyone who’s planning to get pregnant, take the year beforehand to really pay attention to your health. Upping your fresh produce intake, taking a folic acid supplement, getting

active and going to regular check-ups will go a long way to improve your health.

KEEP MOVING So, you’re pregnant now—between morning sickness, swollen feet, crazy cravings and your all-around general exhaustion, keeping up with your health plan can feel like the last thing on your mind. However, doctors advise that if you can manage it, a low-impact exercise routine will do you a world of good. Practices like prenatal yoga, long walks, swimming or daily stretching

Images: Shutterstock


omen who are overweight or obese before they conceive have an increased risk of complications during pregnancy and birth, which can pose health problems for both the mother and baby in the long term. Being overweight while pregnant can lead to blood clots, gestational diabetes, premature birth, longer labour, an emergency caesarean section and a longer recovery postpartum. However, it’s still possible to have a happy and healthy pregnancy, even if your BMI lies above 25 (the point at which someone is considered

22/03/2019 10:26

Pregnancy & Early Years will keep you in good health. Speak with your obstetrician to make sure your plans are safe.

potential problem. Ask for it at the end of the first trimester, instead.


Your little one is here! You did it! However, there are still some risks for overweight and obese women to keep an eye on post-partum. Make sure to have the blood pressure of both you and your baby monitored for a few weeks after birth, especially if you developed high blood pressure or preeclampsia during pregnancy. Overweight and obese women are also at high risk of thrombosis, or blood clots, after birth. To reduce this risk, try to be active as soon as you feel comfortable. Make sure you maintain regular visits to your doctor and continue to follow advice on healthy eating and exercise. hc

While you develop your exercise routine, make sure you leave ideas of bodyshaming at the door. Intellectually, you know that you will gain weight during pregnancy; yet emotionally, it can be a challenge to keep on top of your fitness routine while you find yourself gaining weight—especially in the first trimester, when there’s no discernible baby-bump. Pregnancy is not the time to lose weight, says the American College of Obstetricians and Gynaecologists. No matter your size, you should expect to add pounds during these months, not shed them.



What is BMI?

BMI—or Body Mass Index— is a way of calculating if your weight is healthy, based on your height and weight. Generally, a BMI that falls between 18.5 and 25 is considered normal. Anything above that is classed as overweight, with obesity starting at a BMI of 30. If you’re interested in calculating your own BMI, visit the NHS website.

It’s essential to talk to your doctor about what a healthy weight gain during pregnancy will be for you. It helps to know your BMI, as this will inform what a normal weight will be, along with your recommended caloric intake. Women who are overweight should expect to add somewhere between 15 and 25 pounds during pregnancy; while women who are obese should gain 11-20 pounds. If you’re pregnant with twins, expect to add 31-50 pounds if overweight and 25-42 if obese.

REGULAR CHECK-UPS Regular check-ups with your doctor during your pregnancy can help you catch any medical issues that may arise, as well as making sure that you are gaining a healthy amount of weight. Generally, your care from your doctor should be the same as that of someone whose weight is classed as normal; however, you may wish to ask for a glucose tolerance test earlier. Overweight and obese women are at a high risk of getting gestational diabetes, and this test—usually given at the end of the second trimester—can help mums-to-be stay ahead of this

HC6.Obesity in Pregnancy.indd 21

Healthy Child with Dr Ranj Singh | 21

22/03/2019 10:27

Pregnancy & Early Years

Put t Out Currently, over 10 percent of women in the UK smoke at the time of delivery. With tobacco smoke linked to birth defects, Sudden Infant Death Syndrome and many other serious health problems, saying no to nicotine is one of the best things you can do for your unborn child

FACING FACTS When you smoke, you put thousands of harmful chemicals into your lungs and blood stream, including nicotine and carbon monoxide. This blood flows straight to your unborn baby and can restrict their vital oxygen supply. Essentially, every time you smoke, your child’s tiny heart will have to beat harder. Here’s why you should quit today: ✎ You will reduce the risk of complications in both pregnancy and

22 | Healthy Child with Dr Ranj Singh

HC7.Smoking.indd 22

birth, such as ectopic pregnancy (when the embryo becomes implanted outside of the womb). ✎ Your pregnancy and baby are more likely to be healthy as more oxygen enters your blood. ✎ You will reduce the risk of stillbirth. An analysis of 24 studies by the National Institute for Health and Care Excellence (NICE) found that the risk of stillbirth was 47 percent higher in women who smoked during pregnancy than in those who did not. ✎ Your baby will be less likely to be born too early and face the additional breathing, feeding and health problems that often come with being premature. ✎ Your baby will be less likely to be born underweight. Babies of women who smoke are, on average, 200g (about 8oz) lighter than other babies. This can cause problems during and after labour, such as infection and problems keeping warm.

✎ You will reduce the risk of cot death, or sudden infant death syndrome (SIDS). According to the Lullaby Trust, smoking could be linked to 60 percent of sudden infant deaths.

SECONDHAND SMOKE If your partner, or anyone else who lives with you, smokes, it can cause worse stresses than finding it more difficult to quit. Passive smoke can affect you and your baby, both before and after birth. Secondhand smoke can reduce your baby’s birth weight, increase the risk of cot death, and make your child more likely to be admitted to hospital for bronchitis and pneumonia during their first year. To reduce the impact of passive smoking, ask smokers to smoke outside and try to keep your distance.

TIME TO QUIT The first few days after stopping smoking are not going to be much

Images: Shutterstock


ith so much of our children’s safety being out of our control, protecting your baby from tobacco smoke is one of the best and simplest things you can do to give them a healthy start in life. It might be difficult to quit, and the sooner you do the better, but it’s never too late to give up or cut down. Taking steps to put yours and your baby’s health before your habit has immediate benefits.

25/03/2019 15:15

Pregnancy & Early Years

Did you know?

Every cig arette tha t you smok e contain s over 4,00 0 chemica ls that harm your unborn b aby Sourc e: NHS C hoices

fun. However, the annoying withdrawal symptoms are a sign that your body is beginning to recover, as the harmful gasses and chemicals are cleared from your body. It is not recommended by the NHS that you take 'stop smoking' tablets such as Champix or Zyban during pregnancy. Instead try nicotine replacement therapy (NRT), such as patches, chewing gum or mouth spray, which only contain nicotine and none of the damaging chemicals found in cigarettes. E-cigarettes are considered a healthier alternative to smoking, but not enough is known about their effects on pregnancy, so consult your midwife.

THINK AHEAD By stopping smoking now, you will also be benefiting your baby’s future life.

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Children whose parents smoke are more likely to suffer from asthma and other serious illnesses, and to require hospital treatment. There is also evidence to suggest that parental smoking is linked to psychological problems in childhood, such as reduced attention span, hyperactivity problems and negative behaviour. Put it out now, and you're doing one of the best things you can to give your child a healthy start in life. hc

Need help to quit? Dial 0300 123 1044 for the free NHS Smokefree helpline

Is it too late? Research published in the Journal of Obstetrics and Gynaecology found that expectant mums who gave up smoking in the first trimester of their pregnancy raised their odds of delivering a healthy full-term and fullsize baby to about the same as that of a non-smoker. Those who quit in the second trimester also improved their odds, but not as much

Healthy Child with Dr Ranj Singh | 23

22/03/2019 10:30

Pregnancy & Early Years

Caring for

Young Skin

The huge choice of skincare products, and concern about their contents, is prompting more parents to look for natural solutions to looking after their children’s skin


For instance, phthalates—commonly used as binders and plasticisers in cosmetics—have been linked with asthma, attention-deficit hyperactivity disorder, breast cancer, obesity and type II diabetes, while parabens—used as a preservative—are believed to penetrate the skin, accumulate in tissue and disrupt hormone functions. Triclosan, an effective antibacterial found in many soaps, can also affect 24 | Healthy Child with Dr Ranj Singh

HC43.Child Skincare.indd 24

Fast fact Castor oil was used in ancient Egypt as a protective balm, and skin creams made of beeswax, olive oil and rosewater were described by the ancient Romans

hormonal levels in animals. It’s not clear whether it has an effect on humans. These and other chemicals are often regarded as undesirable risk factors in cosmetics. Throughout history, cosmetics have been made with natural plant ingredients such as aloe vera, and even when the first commercially manufactured cosmetics were marketed, they were made in essentially the same way. Some cosmetics companies are now returning to this approach, so parents can confidently use treatments free of synthetic chemicals. Nuts are a rich source of natural ingredients—for instance shea nuts produce a butter which is an excellent moisturiser, as well as providing

ultraviolet protection and working as an anti-inflammatory, while kola nuts are said to stimulate blood flow. Grains such as millet are also commonly used, providing a source of skin-nourishing mineral salts, vitamins and unsaturated fatty acids. Natural oils include manketti oil, a natural deep moisturiser and antiinflammatory, while marula oil, rich in essential fatty acids, hydrates the skin and improves skin elasticity.


Boabab is one of Africa’s most important oils. Derived from the Adansonia Grandidieri tree, it’s a popular moisturiser. One of the most popular natural ingredients is coconut oil, which seems to be something of a wonder ingredient—it is an excellent massage oil and skin softener, and its protein content contributes to cellular health and tissue repair. Together with essential herbs, fruits and spices, these natural ingredients can provide a safe and eco-friendly alternative to chemical-packed cosmetics for you and your children. hc

Images: Shutterstock


osmetics companies have made some remarkable advances in dermatological science, but particularly when it concerns children’s skin, some parents are now moving towards products using only natural, organic ingredients. Though skincare products have to list all their ingredients, it’s sometimes difficult to know whether the chemicals used in them are completely safe—even when they are approved by regulatory authorities. Some parents would rather not take the risk of using products that contain substances such as preservatives and plasticizers.

22/03/2019 11:24

YARA BODY FOOD This beautiful blend of Shea Butter, Coconut Oil, Jojoba and Baobab is 100% natural and preservative free. A body food for hydrating and nourishing your child’s skin from birth. With regular use, the Yara Body Food can help manage skin conditions such as Eczema, Psoriasis and dry skin.

For more kid’s health news and features, visit

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05/03/2019 11:30 14:58 11:28 25/03/2019

Pregnancy & Early Years

Tub talk

Talk to your ba by while you was h them— it will help th em to relax and they 'll begin to understand more about bath tim e

Bath Time With more than 75 percent of under-fives who die in an accident doing so in the home, making bath time safe—as well as fun—is vital

26 | Healthy Child with Dr Ranj Singh

HC9.Safe Infant Bathing.indd 26

You will need ✎ A baby bath or clean washing up bowl filled with warm water. ✎ Two towels. ✎ Cotton wool. ✎ A fresh nappy. ✎ Clean clothes.

TOPPING & TAILING Instead of bathing your baby every day, you may prefer to wash their face, neck, hands and bottom instead. This is often called ‘topping and tailing’ and can be done by observing the following steps. ✤ Take off your baby’s clothes, except their vest and nappy, and wrap them in a towel. ✤ Dip cotton wool in warm water (making sure it doesn’t get too wet) and wipe gently around your

Images: Shutterstock


t’s not necessary to bathe your baby every day, but if it’s something that your little one enjoys doing with you, then there’s no reason why you shouldn't. The NHS advises not to bathe your baby straight after a feed or when they’re hungry or tired, and to make sure the room you’ll be bathing in is warm. While some babies have an affinity for water, others are not so inclined—to say the least. Here’s what you need to know to make bath time both easier and safer.

22/03/2019 10:32

Pregnancy & Early Years baby’s face from the nose outward. Use a fresh piece of cotton wool for each eye to avoid transferring any stickiness or infection. ✤ With fresh cotton wool, clean around your baby’s ears, but not inside them. Never use cotton buds to clean inside your infant’s ears. ✤ Wash the rest of the face, neck and hands in the same way and dry them gently with a towel. ✤ Remove the nappy and wash your baby’s bottom and genital area. Dry carefully, especially between the skin folds, and put on a clean nappy.

BATHING BABY The first and most important rule of bath time is to never leave your baby alone. Follow these basic steps when bathing your infant to help make sure your little one is as safe as they are clean. ✤ Check the temperature of the water with your wrist or elbow; making sure it’s warm, not hot. Mix it well. ✤ Hold your baby and clean their face softly with cotton wool and water. ✤ Supporting your baby’s head over the bowl, wash their hair with plain water. ✤ After gently drying your baby’s hair, remove their nappy and wipe away any mess. ✤ Lower your baby gently into the bowl or bath using one hand to hold their upper arm and support their head and shoulders. ✤ Keeping your baby’s head clear of the water, use the other hand to gently swish water over your baby, without splashing. ✤ Lift your infant out and pat them dry, paying attention to the creases in their skin.

SAFETY FIRST A child can drown in a matter of minutes, sometimes in as little as two inches of water. The Royal Society for the Prevention of Accidents (RoSPA)

HC9.Safe Infant Bathing.indd 27

reports that one in three accidental drowning deaths in young children (two years or under) involve bath seats. Infants can tip over in a bath seat and become trapped, or climb out to potentially fatal consequences. These seats should not be mistaken for safety measures. Most importantly, you should never leave your baby alone in the bath or in the care of another child. Place a non-skid mat beneath your baby bath or bowl to prevent it from slipping and use rubber covers on tap faucets so that your little one doesn’t accidentally get injured or turn on the water. Always test the water temperature before bathing and remember to empty the tub completely after each use. hc

Serious about suds

Plain water is best for your baby’s skin in the first month, and any oils or lotions meant for massaging their skin should be avoided in this period, too. When they’re a little older, use water and a mild baby soap that contains no added perfumes or dyes, as these can be irritating. You can use baby soap or mild, tear-free shampoo once or twice a week, if your baby’s hair is dirty. If they’ve developed cradle cap, gently loosen the scales with a soft-bristled baby brush while shampooing.

Healthy Child with Dr Ranj Singh | 27

22/03/2019 10:32

1-2-1 nutrition support E-learning topics such as introducing solid foods and managing fussy eating Helpful blogs, videos and recipes


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20/12/2018 15:04

Pregnancy & Early Years

The Best Start in Life

With the introduction of initiatives like the sugar tax, the debate on child nutrition is louder than ever. What exactly does a healthy, balanced diet include for young kids?


igures released by Public Health England (PHE) show obesity levels in 10- and 11-year-olds are at their highest since records began. A result of a combination of poor nutrition and insufficient exercise, this obesity ‘epidemic’ is a dangerous gateway to a host of other chronic ill-health conditions. Enforcing good eating habits and balanced nutrition from the start will promote healthy development. Research suggests a child’s early years are crucial for forming food preferences and tastes; according to experts, good habits established early on are more likely to be taken forward into later childhood and adulthood. But where to start? Read on for some tips on the different foods to give your child, as well as a few to avoid.

HC10.Child Nutrition.indd 29

Dairy proDucts

What's the deal with salt? Most foods already contain enough salt—there is no need to add any to your child’s food. Too much can give your toddler a taste for salty foods and contribute to conditions such as high blood pressure in later life Source: NHS Choices

For the first six months, breast milk is the only food babies need, and in the first 12 months, the only suitable alternative to breast milk is formula. Cows’ milk should only be introduced after the age of one. Once introduced, children should consume at least 350 millilitres of milk a day. The full-fat version is a great source of calcium—crucial in the development of strong bones—and vitamin A, which helps ward off infections. According to NHS Choices, semi-skimmed milk can be introduced from the age of two, and skimmed milk isn’t recommended for children under five as it doesn’t contain enough fat. Don’t give your child rice drinks until they are five or older. This is because of the levels of arsenic they contain. Babies and young children also shouldn’t eat mould-ripened cheeses. Healthy Child with Dr Ranj Singh | 29

22/03/2019 10:36

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Pregnancy & Early Years Dairy free? If your child has an intolerance to milk, speak with your doctor. So far as alternatives go, the NHS advises they be given unsweetened calcium-fortified milk alternatives—such as soya or oat ‘milk’—from the age of one, as part of a balanced regime.


A great source of many vitamins, fruits and vegetables are a truly essential food group for healthy development and nutrition. Introduce as many types as you can from an early age—no matter if frozen, canned or fresh—and include them in every meal. Don’t let your child snack on dried fruit, such as raisins, as the sugar these foods contain may lead to tooth decay. Fussy with veg? Some children don’t like cooked vegetables, but will happily nibble on raw vegetables. Try handing your little one a carrot or cucumber stick to try while you’re preparing a meal.


Foods such as pasta, bread, cereal, potatoes and rice provide energy, nutrients and fibre. It’s important to include this food group as part of a balanced diet. Don’t give your child—if under two— exclusively wholegrain starchy foods. This is because the fibre may fill them up before they have taken in enough nutrients from the rest of their meal.


This food group is essential for your child’s growth and development. Your child will need one or two portions of protein each day; meat, beans, pulses and eggs are a great source. Oily fish—such as salmon, sardines and mackerel—is also a great source of healthy protein and omega-3 fats. Don’t give your child whole nuts before age five. While a good source of protein, nuts carry a choking hazard. Boys should have no more than four portions of oily fish a week, and girls should have no more than half that. This is because oily fish carry low levels of pollutants that can build up in the body.

HC10.Child Nutrition.indd 31


Children under the age of two need the energy and vitamins provided by fat—this is why whole dairy products and oily fish are so important. Once your child turns two, gradually introduce a lower-fat diet. When they turn five, a low-fat diet—as recommended for adults—is most suitable. Top tip. To keep an eye on the amount of fat consumed, try the following: grill foods instead of frying them, skim fat off meat during cooking, buy lean cuts of meat, remove skin from poultry and use as little cooking oil as possible.


Keep the amount of sugar your child has to a minimum—and enforce regular tooth brushing to avoid premature tooth decay. From age five, it’s okay to give your child undiluted fruit juice or smoothies, but these should not exceed one glass served with a meal. Don’t give your child products with any added sugar. These include fizzy drinks, juice drinks, sweets, cakes and jam. Offer diluted juice—one part juice to 10 parts water—as an alternative. hc

Vitamins for children

While children will get most of the nutrients they need out of a balanced diet, sometimes they may not get enough vitamins A and C—especially if they are fussy eaters. The Department of Health (DoH) recommends all children aged 6 months to 5 years are given supplements containing vitamins A, C and D every day Source: NHS Choices

Getting enough iron

Iron is essentia l for your child ’s diet; it is foun d in meat, fis h and plant food s but is easier absorbed from the former. If your child do esn’t eat mea t, give them plen ty of iron-rich foods such as fortified cereal s, dark green ve getables and broad beans

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Pregnancy & Early Years


Fussy Eaters Accepting that mealtimes don’t always go to plan is the first step to helping your fussy eater grow

SHOULD I BE WORRYING? The general consensus is that children do not willingly starve themselves and are likely to grow out of this stage before their teenage years. If you’re worried that your child is not getting enough to eat, the NHS advises you to focus on what they are eating over the course of the week, instead of fretting about individual meals. If your child is active, gaining weight and looks healthy…well, then they’re getting enough.

BABY SEE, BABY DO Your child will copy and learn from you, so being a good role model could encourage them to try new things and take mealtimes seriously. Try to have

32 | Healthy Child with Dr Ranj Singh

HC11.Fussy Eaters.indd 32

similar meals and embrace a variety of foods, allowing them to assess any more ‘unknown’ options on your plate. Sitting down together and shutting off distractions will allow your child to associate mealtimes with food and security, but if you’re really stuck, cartoons could distract younger ones long enough to get them to eat.

PLANNING IS KEY Try to establish what your family will be eating each day so that there is no room for deliberation. Create a weekly meal plan with your child and give them options to be excited about, helping them to write these up on a whiteboard. Schedule three main meals for each day and limit snacking to once or twice a day, at consistent intervals. Preparing salad in advance to keep on the table before meals could encourage hungry little ones to sample some healthy veggies.

BRIBES OR REWARDS? If your child tries something new, make sure to praise them. For example, implementing a sticker chart could be a great way to reinforce positive eating habits over time. Nevertheless, placing too much emphasis on urging your child to eat will encourage the idea that eating is a chore or a competition. Restrict praise for when your child tries something new—the act of eating

Images: Shutterstock


ccording to a survey by healthcare company Abbott, fussy eating habits affect more than eight in 10 families across the UK. Often less about food and more about children exploring their environment and claiming independence, picky eating is actually part of a child’s development—but it can be frustrating to see your little one refuse anything that doesn't resemble macaroni and cheese. The way you deal with the situation impacts your child’s eating habits the most, and there are lots of tips and tricks to encourage your tot to enjoy a range of healthy foods.

22/03/2019 10:37

Pregnancy & Early Years

r child e u o y e r u s n E rom th f d o o f s e m consu in food groups— four maand vegetables, fruits rates, dairy— carbohydrnatives—and or alte oteins pr

Don't say... ‘You're not getting any pudding unless you eat all your carrots’ Eating savoury foods should not have to be rushed and endured to get to sweeter treats. Bribing your child will only make the struggle seem like a game.

‘Eat your broccoli please’ A study of university students whose parents had insisted they eat a certain food as a child found that 72 percent now didn't eat that food.

‘You’re such a fussy eater’ Being labelled as ‘fussy’ works as a great excuse to never have to try new things. If your child knows they aren’t expected to branch out of their comfort zone, they’ll start feeling that being fussy with food is just a part of who they are.

HC11.Fussy Eaters.indd 33

should be considered natural and pleasurable in itself.

GET YOUR FUSSY EATER INVOLVED A survey by the University of Alberta suggests that the best way to get your child to eat and enjoy healthier foods is to have them help with meal preparation. Squeezing oranges, picking beans, cracking eggs and growing cress are all fun ways for your child to get involved with their food and understand where it comes from. Before meals, ask your child to set the table and pick out the cutlery too.

EAT YOUR VEGGIES Making fruit and vegetables a big part of your child’s lifestyle can be challenging, to say the least. Use a crinkle-cut knife to chop foods into tiny, fun pieces; make veggie ribbons with a peeler; or pretend that broccoli stalks are mini trees ready to be eaten by your dinosaur family. Always keep healthy

Healthy Child with Dr Ranj Singh | 33

22/03/2019 10:37

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Pregnancy & Early Years snacks to hand—if your child is hungry enough, they’ll likely accept fresh fruit and other healthy options away from the dinner table. Introducing veg into your tot’s favourite dishes is a particularly easy way to start upping their intake. If your little one can sniff out a mushroom from miles away, blend or blitz them into pasta sauces, purées, dips and smoothies. After a while, you can start leaving them slightly chunkier, explaining why vegetables are so good for us.

Accept thAt your child is not An Adult Mealtimes should only last around half an hour; this will help your child concentrate on their food. Remember to be patient if they eat slowly. Even the fussiest of eaters will get there in the end. hc

Top tips for parents ✎ Focus on what your child likes, not what they don’t like.

✎ Make sure your child is hungry before mealtimes.

Pasta with tomato & hidden veg sauce

✎ Don’t cook an entirely new meal ✎

✎ ✎ ✎ ✎ ✎ ✎

if the original is refused—take the dish away and keep it for later. Make your own ‘junk food’ out of healthy meat and fish, and your own ice lollies from fresh fruit juices or purées. Get creative and make food look fun and appetizing. Continue to give fussy eaters new foods. Try putting foods in different dishes and letting your child serve themselves. Invite food-adventurous friends to encourage your fussy eater to join in. Be persistent and use repetition— it can take up to 10 attempts to get a child to eat a new food. Try to embrace the chaos!

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Children love pasta—here’s a veggie dish that even fussy eaters won’t refuse.

INGREDIENTS 1 tsp olive oil 1 large onion, chopped 2 celery sticks, chopped 2 carrots, chopped 2 peppers, seeded and chopped 2 cans chopped tomato with garlic 1 tbsp caster sugar 1 tbsp balsamic vinegar 300g dried pasta shapes Salt and pepper, to taste

preparation 1. Heat the oil in a large non-stick pan and gently cook the onion, celery and carrots until soft (about 20 minutes). Add the peppers and cook for 10 minutes more, then tip in the chopped tomatoes, sugar and vinegar. Simmer for at least 20 minutes. 2. Cook the pasta following pack instructions. Meanwhile, blitz the sauce with a hand blender until smooth, season and return to the heat to keep warm while the pasta cooks. Drain the pasta and toss through the sauce. Serve in bowls topped with shaved parmesan and rocket leaves (optional). Source: BBC Good Food

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22/03/2019 10:37

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Fussy Eater? I

f so, it’s usually a phase they soon grow out of, but it can be a worrying time. Here at PaediaSure Shake, we believe that facing fussy eating in a positive and creative way is an important aspect of encouraging healthy eating habits. These are valuable learnings for your child and it’s good to start from a young age as early food experiences can impact their eating patterns and habits.

WHAT CAUSES FUSSY EATING? Fussy eating is common in young children, with up to a third of children aged around two going through this stage. It can take the form of refusing to eat certain foods, a lack of interest in all food, eating slowly, or reduced appetite. There could be many individual factors that lead to fussy eating behaviours, here are a few of the most common reasons: ✤ Your child may be experiencing a growing sense of independence and refusing food could be an easy way of asserting themselves. ✤ A change in a child’s lifestyle or environment, for example; moving to a new house, the birth of a sibling, or starting school, may also result in the refusal of foods as the child finds a way to seek attention. ✤ Your child may be experiencing food ‘neophobia’, which is a term used to describe fear of new foods. If your child is unsure about a new texture or new flavour, it may take some perseverance until they agree to give it a go!

TOP TIPS TO TACKLE FUSSY EATING The fussy eating phase can be stressful for parents, particularly when coping with making the school run on-time, after-school clubs and other activities. There is plenty of guidance available to make meal times a little easier and put your mind at rest. Here are some top tips you may find useful!

✎ Keep a food diary Children are likely to have good and bad food days, so if your child doesn’t eat everything you give them each meal time it may be nothing to worry about. It’s important you look at what your child eats over a week rather than just a day to get an overall view of their

food intake and identify any gaps. Try to remember, what a child eats is more important than when a child eats. ✎ Get them cooking Get kids involved with dinner time. Do this by getting them to help you prepare meals, let them pick a recipe or choose a few ingredients when shopping. You may find they will be more likely to try them if they feel more involved, even if it’s just adding some chopped ingredients into a bowl. That way they’ll feel like they have contributed to creating their own meal. ✎ Make it fun Keep the littles ones engaged by making food fun and interesting. Use imagination to create new names for food, for example you could call

Date of preparation February 2019 ANUKANI190031

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When children are fussy eaters, it can be a worrying time for parents. Mealtime battles and concerns that inadequate nutrition could affect your child’s growth can upset family dynamics. A nutritional supplement may be just what’s needed in the short-term, while new eating habits are established. —Hayley Kuter, paediatric dietitian at Abbott

broccoli ‘mini trees’ or mashed potato ‘fluffy clouds’. Try making fun faces or objects from the food on the plate and a cookie cutter always comes in handy to create star sandwiches. ✎ Family time It can be convenient to have a separate meal time once the kids are in bed but taking care of the social element may also help with good eating habits. Sit down together as a family and talk about your child’s day or what’s planned for their weekend, taking the focus off what your child is or isn’t eating. The more positive associations children have with mealtimes, the more relaxed they will be. Above all, try to remember that most fussy eating phases will pass with time. Aim to remain positive and consider the whole experience as your child’s personal journey to exploring and developing their own taste palate. If you do become increasingly concerned and/ or notice any physical change in your child, such as weight loss or weakness, always seek advice from a healthcare professional.

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While you get them back on track, nutritionally complete supplements such as PaediaSure Shake can help to fill the gaps. If you’re trying to get that extra dose of goodness into your little one, PaediaSure Shake is a complete and balanced, milky nutritional shake that has been specially formulated for children aged 1-10 years. It’s available in three great-tasting flavours that have been tried, tested and approved by kids, and and contains 26 vitamins and minerals to support their growth and development. PaediaSure Shake is recommended for use as a snack, alongside or in-between meals.

Save £1.50 on PaediaSure Shake at with the code: PSURESAVE *Offer valid 25/02/2019 - 31/08/2019. One can per customer. Valid for redemption on 400g can only. Must be registered to

For more information on PaediaSure Shake visit PaediaSure Shake is made by Abbott, a company with more than 85 years of experience in specialist nutrition.

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11/02/2019 11:01

Health Check

First-Aid Tips

for Common Kid Injuries Whether you’re new to the world of caring for kid accidents, or maybe just need a refresher—our primer will help you get prepared, and your child stay calm, the next time they get hurt


hen you’re a parent, you’re also a cook, a chauffeur, a counsellor, a tutor, a handyman, a coach, and more. But perhaps the scariest role you’ll have to fill is that of an paramedic. You know how it goes—you turn your back for just a moment, and then suddenly your child is bleeding, burned or bruised. Here’s how to care for some common injuries at home when this happens.

In response to any minor signs of an allergic reaction, give your child Benadryl (diphenhydramine). If the reaction seems more severe, use an epinephrine injector, such as an EpiPen and go to A&E. Even if they seem better afterward, monitor their condition once the effects of medication wear off.



After a bump on the head, wrap an ice pack or a bag of frozen peas in a thin towel and hold it against the area to reduce swelling. You can also offer paracetamol for pain, although avoid ibuprofen—this drug may increase bleeding, which can be dangerous when there’s the potential risk of a brain injury. If the bump seems to be more severe, check to see if your child’s neck has also been hurt—this could be a sign

Most nosebleeds look worse than they are. Have your child tilt their head forward slightly, and then pinch their nose tightly just below the nasal bone with a tissue. Hold this position for ten to 15 minutes to stop the bleeding, and be patient! This step can take longer than you think. Don’t let your child lean back—if they do, blood may go down their throat and into their stomach, which can cause vomiting.

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of a much more serious injury, and you should call a doctor.


BURNS Hold the burned area under a cool tap for ten to 15 minutes to cool the skin, ease pain, and halt inflammation. Next, apply an antibiotic ointment to sooth the burn and help skin cells regenerate. Don’t use vitamin E or butter, both of which can be irritating, and never place ice directly on a burn, as doing so can cause tissue damage. hc

Playing Doctor

This tried and tested method helps children learn some basics about first-aid while providing some fun. The next time your child wants to play doctor, take the opportunity to teach them about how to care for injuries, falls and accidents. Your child will become an expert in no time—and have fun doing it.

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Sponsored Editorial

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Eye care made easy


t Asda we know that looking after your children’s health is fundamental to every parent. But when it comes to their eyes, there can still be some uncertainty or confusion about how best to ensure they are regularly checked and remain healthy. Asda’s 156 in-store optical departments are fully equipped to help with young eyes - you can be confident that you can arrange to have their eyes tested along with your weekly shop. All of our optometrists are fully qualified opticians covering the full journey from eye tests through to glasses wearing. With our extended opening hours across the weekends and bank holidays, and free parking, we are always on hand to offer our expertise and advice in an environment your children are most probably already very familiar with. Children’s glasses are available in a wide range of styles and colours, so make sure you try a few different styles before deciding on what is best. It is important that the frame chosen is the correct size and can be adjusted to fit well. This advice, and fitting, would be carried out by one of our Dispensing Opticians or Optometrists. They are also on hand to discuss contact lenses, if that is a route you wish to explore. Contact lenses can be especially good for children who enjoy sport, where it is often safer and more comfortable to wear contact lenses rather than spectacles. We understand that this could be a daunting prospect for many parents, as a lot of care and attention has to go in to ensuring the lenses are properly handled and cared for correctly – but we are on hand to talk you through the process and offer our expert advice.

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EyE tEsts We know that for you and your children that situations like visiting an optician can be stressful and scary, however, having your children’s eyes examined allows the Optometrists to ensure your child’s eyes are developing at a normal pace and are aligned with their peers. It’s really important to know that a full, comprehensive eye test is not carried out at all schools. We would recommend that all children have their first eye test before they start school, or earlier if you think they are having any difficulties. As children grow up their eyes change, and as such they need to visit an Optometrist more regularly than adults do. If any problems are left untreated, it might mean children will struggle at school. In some cases as they strain to see the board, it may even result in irreversible sight problems. You may not even be aware of your child having any difficulties, as they may not have any symptoms. Eye examinations by an Optometrist can pick up a range of eye problems including the three most common in children: short (Myopia) or long-sightedness (Hyperopia) squint or eye turn (strabismus) Lazy eye (Amblyopia)

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things easier for parents. This means that all our Optical Advisors are aware of children’s needs when visiting the Opticians. We have a fantastic range of children’s complete glasses all of which are FREE with a valid NHS voucher. Most importantly all of our children’s glasses come with scratch-resistant and antireflective coating, ensuring your child’s glasses stay protected. Thinner lenses and coatings are all included, so you can get your children’s glasses from us, knowing they will look great and be comfortable with no worry about cost.

stAying sAfE in tHE sun Children typically spend more time outdoors, and the lenses in their eyes are more transparent than those of adults. The danger is that this allows more ultra-violet radiation to reach the back of children’s and teenagers’ eyes. Just as sun cream is used to protect their skin, it’s a really good idea for children to wear protective sunglasses when playing outdoors. The great news is that at Asda Opticians you can get a pair of prescription sunglasses for only £15, which offer 100 percent UV protection and come with scratch-resistant lenses. If your child doesn’t need prescription glasses, we also have a range of fashion and polarised sunglasses available in-store.

The good news is that eye tests are completely FREE for children under 16 (or under 19 and in full time education) under the NHS. This can be carried out at all Asda Opticians.

WHAt if My cHiLd nEEds gLAssEs? At Asda Opticians we believe in making

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20/02/2019 09:21

Health Check

Eye care for kids

The far-sighted approach With around 80 percent of perception accounted for by the visual sense, it’s essential that your child’s eyesight is cared for

SCREEN BEFORE SCHOOL It’s recommended that children have vision screening when they start school. However, this doesn’t happen in all areas. If this does not happen where you live, take your child to an optometrist at your local optician for an eye examination. Most children should have their eyes examined at least once every two years. This can be done at a High Street optician and is free for all children under 16 years old (and those under 19 years old in full-time education). Testing before your child goes to school helps to identify poor eyesight, which can cause learning

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Test for healthy eyes

Sarah Joyce, Superintendent Optometrist at Asda, says:

✎ We know for you and your children that visiting an optician can be stressful and scary, but having your children's eyes examined allows the Optometrist to ensure your child's eyes are developing normally and are aligned with their peers ✎ A full comprehensive eye test is not carried out at all schools, so we recommend all children have their first eye test before starting school, or earlier if you think they are having difficulties ✎ As children grow up their eyes change, and as such they need to visit an Optometrist more regularly than adults do

and behavioural problems. This is especially true for young children, who may not be able to explain the difficulties they are having with their eyesight or may not even be aware they have a problem. Your child’s eyes may be checked: ✤ Within 72 hours of birth—this is called the new-born physical examination, and can be used to check for obvious physical problems ✤ Between six and eight weeks old—this is a follow-up physical examination to check for any obvious problems that were not picked up soon after birth ✤ At around one year old, or between two and two-and-a-half years old—you may be asked whether you have any concerns about your child's eyesight as part of a review of their health and development, and eye tests can be arranged if necessary ✤ At around four or five years old— this is called vision screening, to check for reduced vision in one or both eyes Source – NHS

SIGNS OF A PROBLEM A sight test is particularly important if there is a history of childhood eye problems, such as squint or lazy eye, in your family. There are a number of causes of eye problems in babies and

Images: Shutterstock


ision contributes around 80 percent of our sensory perception, and unsurprisingly, around the same proportion of what we are taught in school is visually based. So it’s essential for your child’s well-being and development that their eyes are properly cared for. Despite this, the Department of Education estimated in 2016 that there were around 1.6m children with undiagnosed vision problems in the UK. Campaigns like National Children's Eye Health Week, which falls during October half term, are a timely reminder of the importance of regular eye tests for children.

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Health Check children, and the sooner that vision problems are detected, the better the outcome. Conditions include cataracts (cloudy patches in the lens), squint (strabismus), where the eyes look in different directions, and amblyopia (lazy eye), where the vision in one eye does not develop properly. Of course, the most common are shortsightedness (myopia), where distant objects appear blurred, and longsightedness (hyperopia), where nearby objects are out of focus. All these can be treated more effectively if they are picked up earlier, and that could make a huge difference in later life. In older children, signs of a possible eye problem can include difficulty reading, headaches, poor hand-eye co-ordination and regularly rubbing the eyes. hc

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Eye protection Protection from ultra-violet light from the sun is particularly important in children, as the lens at the front of the eye is very clear. You should protect kids’ eyes whenever the UV Index rises to three or more, even on cloudy days. The Met Office website provides information on UV levels. Check that their sunglasses have a CE: UV 400 or British Standard Mark, as this will ensure they provide the right level of UV protection. There’s now a wide selection of sunglasses designed especially for kids. All should provide high UV protection, and other features can include polarised coatings, non-slip rubberised frames, wrap-around styles to reduce glare from the sides, floating foam inserts and of course a range of bright, colourful styles.

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Health Check

Sunny Delight 44 | Healthy Child with Dr Ranj Singh

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Images: Shutterstock

Sunglasses for children are more than a fashion accessory; they can be a health essential. But that doesn’t mean they can’t be stylish

22/03/2019 10:40

Health Check wrinkling of the skin, and may be a cause of skin cancer, UVB which is more dangerous than UVA and has been implicated as the major cause of skin cancers, sun burning and cataracts, and UVC, which is extremely dangerous, but which does not normally reach the earth's surface due to absorption in the atmosphere. World Health Organisation research shows that, by the age of 18, children will have absorbed 80 percent of their lifetime exposure to these dangerous frequencies of UV light. Despite these incentives to wear sunglasses and the fact that they spend more time outdoors than adults, Boots says that 70 percent of children in the UK still don't wear sunglasses. Fortunately, plenty of designers have an eye on the kids’ market, and are offering sunglasses that will promote eye health, as well as having oodles of style appeal and practicality. So here are our top tips for choosing and using sunglasses for the little ones:

✎ Set an example. Make sure you


hen the sun’s bright or glare makes it dangerous to drive, most adults will be sensible enough to wear sunglasses—but it’s just as important that children wear them in these conditions—in fact, possibly more essential. The danger from sunlight comes from its ultra-violet frequencies. There are three dangerous frequency bands—UVA, which is thought to contribute to premature aging and

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wear your sunglasses on sunny days, or even on overcast ones when there could be glare. ✎ Choose polycarbonate lenses. They will stand up to more wear and tear, particularly on the beach or when playing sports. ✎ Don’t go dark. Darker tints don’t automatically offer more UV protection—in fact, they can be less effective, as they cause the pupil to dilate, letting in more UV rays. ✎ Look for sunglasses that meet the British Standard for UV protection, EN ISO 12312-1:2013. This covers both requirements that manufacturers must comply with, such as checking that their products do not have sharp edges that may injure wearers, or cause vision impairments that prevent users from distinguishing traffic lights, as well as stating the

different levels of UV protection, and test methods for manufacturers to help the industry ensure efficiency and reliability. ✎ Look for the Ultra Violet Protection Factor (UPF). This rating indicates how much UV radiation is blocked by a material. For example, a material with a UPF rating of 20 would allow only 1/20th of the hazardous UVR falling on its surface to pass through. ✎ Don’t forget the corrective lenses. If your kids need prescription glasses, they should have prescription sunglasses as well. Most opticians offer this option. ✎ Stay in charge. You should look after the sunglasses when they’re not being worn, to avoid them being lost or left behind. ✎ Let your kids help choose. They will be more likely to wear and look after sunglasses if they like the design and find it comfortable. ✎ Look for flexible, close-fitting frames. Spring hinges and elasticated headbands prevent breakages and loss. Follow these tips for choosing and using children’s sunglasses, and the whole family will be able to stay in style and have fun in the sun without fear of UV damage. hc

Polarised Protection Polarised lenses don't offer additional UV protection, but do cut glare from horizontal surfaces. To test whether a lens is polarised, rotate it while looking at a reflective surface to see if the amount of glare changes.

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The monkey monkey® range has been developed with paramount importance placed upon the protection of children’s eyes. All provide 100% UVA/UVB protection and include a free case and cleaning cloth. They’re strong, durable and feature shatter and scratch-resistant UV400 lenses to keep your child’s eyes healthy and safe at all times. All styles are rigorously tested, meet the latest European standards and carry the CE mark, one of the most important safety and quality benchmarks. The collection is suitable for age 3 - 11 years. Wraparound goggles are also available for babies and toddlers.

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n i es

Protect their peepers! Sun’s out, sunnies on 3 ReASONS TO PROTecT YOuR cHILdReN’S eYeS AS weLL AS THeIR SKIN THIS SuMMeR As spring and summer approach, it’s important to keep your child protected and reduce their exposure to the harmful effects of UV light. Despite the fact youngster’s eyes are more vulnerable to damage from the sun than adults, parents are twice as likely to put sunscreen on their children, rather than make them wear sunglasses. Research conducted on behalf of children’s eyewear brand monkey monkey®, reveals that nearly half (46%) of mums and dads will always apply sunscreen on a sunny day, compared with just 23% who make their kids put sunglasses on. [1]


Here are the 3 reasons why you should protect their peepers: Children receive more annual sun exposure than adults because of the amount of time they spend outdoors. When it comes to eye health most parents don’t realise 80% of a person’s lifetime exposure to harmful UV light happens before the age of 18 (according to the World Health Organisation). [2]


Children’s eyes are not yet fully developed, so they have less natural protection from the harmful effects of UV light

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• Children’s pupils are larger than adults, meaning they let in more UV light. • Their crystalline lens is more transparent, meaning it is less efficient at filtering out UV.[3]

3 • • • •

Short-term temporary consequences of excessive exposure to UV light to children can be both harmful and painful, such as:

Bloodshot eyes Swollen eyes Hyper-sensitivity to light Sunburn of the eye, known as ‘photokeratitus’ that can cause vision loss for up to 48 hours [4]

Sources [1] Research carried out for monkey monkey® of 1,000 UK parents of 4-12 year-olds conducted by OnePoll in June 2018. [2] World Health Organisation – [ (SECTION CHILDREN REQUIRE SPECIAL PROTECTION)] [3] The Vision Council (SECTION PROTECTING YOUNG EYES)] [4] The Vision Council]

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11/02/2019 14:09

Health Check

A Happy and

Healthy Gut You’ve probably heard the term ‘gut health’ quite a bit over the past few years. But what does it mean exactly? And what can parents do to ensure their child has a healthy gut?

Choosing a quality probiotic for your child

Probiotics can be a great way to support gut health and general wellbeing, but there are so many available it can be hard to find the right one! Luckily, we have some top tips to pick the best supplement for your family. • Choose a probiotic specific to your child’s health issue, for instance poor digestion. • Ensure it is backed up by clinical research to support its efficacy • For extra convenience, you may prefer it to be shelf-stable, meaning it doesn’t require refrigeration OptiBac Probiotics 'For babies & children' meets all of these criteria, and is ideal for supporting your child’s overall health.


ut health is determined by the trillions of microbes living in your gastrointestinal tract. They contribute to a whole range of reactions in our bodies, including allergies and immune system strength. The microbiome starts to develop in the womb and is easily influenced in early years. Gut health in the first three to five years has far-reaching effects throughout adulthood, influencing conditions such as obesity, depression, diabetes and even cancer. Both lifestyle and nutrition can affect gut health in the long term.

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Avoid your child overeating, and maintain a high-fibre diet to promote digestive health. Try supplements containing immune system boosting probiotics such as L. acidophilus Rosell-52, B.infantis Rosell-33 and B.bifidum Rosell-71, as well as prebiotic Fructooligosaccharides (FOS) for natural fibre. These have been shown to reduce incidences of infant gut and respiratory infection. Keeping hydrated, active and happy will also have a significant positive impact on the microbiome.

Avoiding unnecessary use of antibiotics is also worthwhile - these drugs can be life-saving and should be used when needed, but kill bacteria indiscriminately, whether good or bad, so their impact on our body can linger long after the illness leaves. Finally, excessive hygiene may be counter-productiive. Swedish scientists recently found that children whose parents sucked their pacifiers to clean them, rather than boiling them on the stove, had stronger immune systems. In this case, a little saved time and effort really does benefit your child. hc

Images: Shutterstock

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For babies & children Contains a combination of extensively-researched friendly bacteria, including L. acidophilus Rosell-52 & B. infantis Rosell-33, especially for babies, children and pregnant or nursing mothers.

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Health Check

Shock to the System


epsis, often referred to as blood poisoning, is the result of the immune system over-reacting to an infection or injury. Each year, around 52,000 people die and 60,000 suffer permanent after-effects of sepsis in the UK. With early diagnosis, it can be treated with antibiotics, but if not treated immediately, sepsis can result in organ failure and death. Blood poisoning occurs when bacteria causing infection in another part of the body enter the bloodstream. The terms septicaemia and sepsis are often used interchangeably, but technically they aren't quite the same— septicaemia, the state of having bacteria in your blood, can lead to sepsis. The immune system usually works to fight any infection from bacteria, viruses or fungi, but for reasons which are not fully understood, it sometimes goes into overdrive and starts to attack organs and other tissues. This can happen as a response to any injury or infection, anywhere in the body. It can for instance result from:

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✤ A chest infection causing pneumonia ✤ A urine infection in the bladder ✤ A problem in the abdomen, such as a

burst ulcer or a hole in the bowel ✤ An infected cut or bite ✤ A wound from trauma or surgery ✤ A leg ulcer or cellulitis

Sepsis can be caused by a huge variety of different bacteria, such as streptococcus, e-coli, MRSA or C difficile. Most cases are caused by common bacteria which normally don’t make us ill. Because the symptoms of sepsis can easily be mistaken for those of other conditions, it’s particularly important to understand the warning signs in children. This year, Melissa Mead, who led high-profile campaigns to raise awareness of sepsis after the death of her son William in 2014, was awarded an MBE for her work. William died from treatable blood poisoning—Melissa had taken him to the GP several times and been told not

to worry, but William died just after his first birthday. A 2016 report into William's death called for better recognition by GPs of the signs and symptoms of septicaemia, and more training for NHS 111 helpline advisers. The then Health Secretary Jeremy Hunt apologised for failings in the system, and Melissa Mead went on to launch a campaign, with the UK Sepsis Trust, to help parents to spot signs of illness. As an ambassador for the charity UK Sepsis Trust, Melissa has created videos seen by 19 million people. Millions of leaflets urging parents to take their child to A&E or call 999 if their child is displaying symptoms were delivered to GP surgeries and hospitals across the country, and an awareness video, in which Melissa held up cards detailing the symptoms of sepsis, was a key part of the campaign, and quickly went viral.


Since then the World Health Organization has adopted a resolution to

Images: Shutterstock

Children can be vulnerable to sepsis, or blood poisoning, which kills 52,000 people each year in the UK alone. We advise on the vital signs and treatment

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Health Check


✎ Fast breathing ✎ Fits or convulsion ✎ Mottled, pale or blueish appearance

✎ Lethargy and sleepiness ✎ Cold to the touch ✎ Rash that does not fade when pressed

✎ Repeated vomiting ✎ Not feeding ✎ Does not pass urine for 12 hours improve sepsis care in all UN member states. A YouGov poll by the UK Sepsis Trust showed that awareness of the condition increased from 30 percent in 2014 to 70 percent in 2016. Sepsis has also featured in storylines in popular TV and radio programmes including Holby City, Call the Midwife, Coronation Street and The Archers. Dr Ron Daniels, CEO of the UK Sepsis Trust, praised Melissa's services for raising awareness of sepsis—he said: “Her capacity to turn her grief into something positive is an inspiration to us all.

"We need loved ones to trust their instincts and we need health professionals to listen to them. Of the 250,000 people affected by sepsis every year in the UK, 25,000 are children, but so many of these deaths are avoidable. Better awareness could save thousands of lives."

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People are more likely to develop sepsis after a viral illness like a cold, or a minor injury. But it can affect anyone, regardless of age or state of health. However, some people are more likely to get severe sepsis, including: ✤ ✤ ✤ ✤ ✤ ✤ ✤ ✤ ✤

The very young or very old Diabetics Steroid or cancer drug patients Organ transplant patients or those on anti-rejection drugs Anyone who is malnourished Sufferers from liver disease Anyone with an immune system disorder Post-operative patients Pregnant women or new mothers

To build awareness, World Sepsis Day is held on September 13th every year. In 2018, events included seminars for medical professionals, sport activities, photo exhibitions, fund-raising ‘pink picnics’, gala events, dinners, public events such as open houses in hospitals and healthcare facilities, and of course online events including

Source: UK Sepsis Trust

the Second World Sepsis Congress, and campaigns on Facebook, Twitter, Instagram and elsewhere. The best protection against sepsis is to get immunisations, wash hands well and often and clean and care for cuts and scrapes. But if your child shows the symptoms of sepsis, it’s vital to get medical care, and if antibiotics are prescribed, give all doses exactly as directed. Trust your instincts, and don’t be afraid to speak up—you know your child best. If your child seems sicker than usual to you, or has an infection that doesn't get better or gets worse, get medical help right away, and ask the doctor, "Could it be sepsis?" If you want to learn more about sepsis, visit the websites for the UK Sepsis Trust and World Sepsis Day, both of which are taking a lead in raising awareness and promoting the fight against this number one cause of preventable death worldwide. hc Healthy Child with Dr Ranj Singh | 51

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Health Check

s p a w S e l p Sim

For Fitter Kids

Obesity, diabetes and other health conditions are on the increase, but some simple diet changes can put your kids on the right path

Images: Shutterstock


e’ve all heard about the ‘obesity timebomb’ and the risks to health of conditions such as diabetes, but what can be done about it? Attention to diet is the key, and educating yourself about healthy eating is the most vital element in protecting your kids’ health. A Local Government Association report in 2018 concluded that more than 22,000 children would leave primary school dangerously obese that year. The number of 10- and 11-year-olds classed as severely obese in the final year of primary school is also nearly double that of those in reception years. The LGA warned that the severe child obesity rates contributed to a “

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billion-pound ill-health time bomb”. The serious health risks of severe obesity include diabetes, heart disease, stroke and cancer. Severe obesity can also shorten life by 10 years, equivalent to the effects of lifelong smoking.


With public health budgets being cut, it’s more important than ever that parents prevent their children becoming obese, and then becoming obese adults. Measures such as the sugar tax and food labelling may help, but a basic understanding of nutrition and healthy eating is all that's needed for a good start. The BDA, the Association of UK

Dieticians, advises that children need regular meals and snacks to get energy and nutrients, but their needs change with age. The BDA’s experts say that breakfast is the most important meal of the day, as a good meal improves concentration during the morning. Later in the day, eating together as a family and avoiding distractions encourages healthy eating. Serve water with meals to ensure good hydration, which improves memory and concentration. Each of the four main healthy food groups should be offered every day. They are: starchy foods; fruit and vegetables; milk and dairy; and meat, fish, eggs and beans. Healthy Child with Dr Ranj Singh | 53

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Health Check

SWEET TASTES Foods which are high in sugar and fat provide extra energy but few nutrients. Biscuits, cake, ice-cream, sweets, chocolate, crisps and sugary drinks should not be eaten frequently, particularly as they lead to tooth decay.

Each meal should be based on food from the first group, which includes bread, potatoes, pasta, rice and grains such as couscous or breakfast cereal, and scones, buns, muffins, crumpets or cereal bars for snacks. For children who are over five years old, wholegrain varieties are a better option as they are healthier and more filling.


We all know that we should have our ‘five a day’ of fruit and vegetables, but there are many ways to supply this; fresh, frozen, tinned (in own juice), dried, or as juice. Try to include both fruit and 54 | Healthy Child with Dr Ranj Singh

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vegetables in main meals, and use fruit as a snack or to make smoothies. If your child is aged four to six and attends a fully state-funded infant, primary or special school in England, they're entitled to receive a free piece of fruit or vegetable each school day. That provides one of their Five-A-Day portions and increases awareness of the importance of eating fruit and vegetables, encouraging healthy eating habits as they grow up. The milks and dairy food group provides children with protein and calcium which are essential for healthy bone development. Sources include milk, cheese, yoghurt and fromage frais. Non-dairy alternatives to cows’ milk can be given from the age of one but ensure these are fortified with calcium and unsweetened. Aim to provide three servings of calcium-rich food per day–for example, a 150ml glass of milk, a small pot of yoghurt and a matchbox-sized piece of cheese. Children under two should have full-fat milk and dairy foods, then semiskimmed milk can be introduced if they are growing well. Children over the age of five can follow a healthy diet suitable for the whole family. Meat, fish, eggs, beans and other non-dairy sources of protein like lentils and peas, and foods made from pulses like tofu, hummus and soya mince are excellent sources of protein and iron. A variety of these foods are needed two to three times a day.


A few simple substitutions will make it easier for the whole family to stick to a healthy eating plan, and ensure that children avoid health problems in later years. ✎ Replace fried foods with grilled, steamed or baked options ✎ Choose water or semi-skimmed milk instead of fizzy drinks and squashes ✎ Thrown out sugary cereals, go for porridge or wholegrain ✎ Cut down on salt, use herbs and spices instead ✎ Replace white bread with wholegrain ✎ Select leaner cuts of meat ✎ Swap creamy sauces for tomato or vegetable-based In addition to these diet changes, supplements can be helpful. Children aged six months to four years should be given a supplement containing vitamins A, C and D, and children over the age of one should be given vitamin D daily supplements, particularly in autumn and winter. Remember that eating is fun, so involve children in shopping, encourage them to choose different foods, get them interested in cooking, and encourage them to talk about healthy eating. The diet choices you make now will make all the difference to your kids’ health in later life. hc

Images: Shutterstock

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If the kids are going to snack, then let them do so on this deliciously fruity Apple and Banana Raw Fruit Bar. Not only is it one of their five-a-day, it’s also free from preservatives, with no added sugar.

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Health Check


Now the good news


he vaccine against HPV, Human Papilloma Virus, is routinely offered to girls aged 12 to 13 at secondary school and is free up until they turn 18. Take-up rate is more than 85 percent, and the girls' programme has already reduced the prevalence of HPV 16 and 18—the main cancer-causing types—by more than 80 percent, according to data from Public Health England. Hundreds of lives have been saved, but up until now, the same offer has not been routinely extended to boys. HPV is the name given to a large group of viruses, which can be caught through any kind of sexual contact with another person who already has it. HPV infections can be spread by any skin to skin contact, and are usually found on the fingers, hands, mouth and genitals.

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This means the virus can be spread during any kind of sexual activity, including touching. Most HPV infections cause no symptoms and are dealt with by the body’s immune system, but around a dozen varieties of the virus can lead to a variety of serious problems, including genital warts; cervical cancer for girls; and cancer of the anus, penis, mouth and throat for boys.

RISKS AND REWARDS Just because men cannot get cervical cancer doesn’t mean they shouldn’t worry about the disease, particularly considering the role they play in spreading the virus that causes it. Recent studies suggest that around 80 percent of sexually active people will carry HPV at some time in their life, and incidences of head and neck

cancer has continued to soar in men across the world. Health experts say that an increase in oral sex is in part responsible for the spread of HPV and for the dramatic jump in neck and head cancers, which tend to have poor long-term survival rates. In the UK, the HPV vaccine has been offered to girls since 2008 as part of the NHS childhood vaccination programme, with boys being said to benefit through “herd protection”—but of course there is a continued risk of infection for anyone who goes on to have sex with others who have not been vaccinated. “To be blunt, the case for giving the vaccine to boys as well as girls is now unequivocal as far as I am concerned,” said Professor Mark Lawler, of Queen’s University Belfast. “We have a chance to eradicate both these

Images: Shutterstock

There’s good news in the fight against cervical and other cancers, as an advisory committee has recommended that boys as well as girls should be offered immunisation against HPV

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Health Check conditions—cervical as well as neck and head cancers—and we should not be hesitating.”

CAMPAIGNING VOICES Campaigners in the UK have been pressing for the vaccine to be offered to boys to further reduce the risk of HPV infection, pointing to the success of similar programmes in other countries. Although there are obvious cost implications, campaigners argue that, in the long term, a ‘gender-neutral’ immunisation programme would be cost effective, and the Joint Committee on Vaccination and Immunisation has now accepted this approach. The JCVI has advised extending the programme to boys at the same age as girls, and the recommendation has been accepted by the English, Scottish and Welsh governments. The HPV vaccine will be offered to boys aged 12 to 13 in England, said Steve Brine, Parliamentary Under Secretary of State for Public Health and Primary Care. “The HPV vaccine for girls is already expected to save hundreds of lives every year,” said Brine, “and I am delighted that we will now be protecting even more people from this devastating disease by extending the vaccine to boys. “Any vaccination programme must be firmly grounded in evidence to ensure that we can get the best outcomes for patients, but as a father to a son, I understand the relief that this will bring to parents."

UPTAKE Other health bodies have welcomed the committee's recommendation, adding that boys had been insufficiently protected against HPV for too long. Dr Mary Ramsay, head of immunisation at Public Health England (PHE), said: “I'm pleased that

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adolescent boys will be offered the HPV vaccine. “Almost all women under 25 have had the HPV vaccine, and we're confident that we will see a similarly high uptake in boys.” And as Prof Margaret Stanley, from Cambridge University’s pathology department, said, immunising men would also give additional protection to women, as “it takes two to tango”. The HPV immunisation programme for boys is scheduled to begin in autumn 2019. Ask your school for further details, and if you have questions about HPV in adults, talk to your GP or practice nurse. hc

In Australia, girls PV have been offered H 07 20 immunisation since s a .A and boys since 2013 mong a result, the HPV rate 24 women aged 18 to percent dropped from 22.7 2005 n to 1.1 percent betwee ted to ec and 2015 and is exp fall further still. Healthy Child with Dr Ranj Singh | 57

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Health Check

Tackle Teething The milestone of a first tooth is a sweet one, but the teething period is just the beginning of a lifetime committment to dental care for you and your child


ood dental care for your child is a lifetime commitment, but of course the first step is the sometimes painful process of teething. Some babies are born with teeth already in place; some are late to teething; but most little ones will get their first teeth at around six months. Usually, the bottom front teeth appear first, followed by the top two, more incisors, canines, then molars at around 20 to 30 months. The process can go on for as long as two years.

TeeThing sympToms Baby teeth can erupt with no pain or discomfort, but most parents can expect bad tempers and crying during this period. Common symptoms to look out for include: ✎ Sore or red gums. ✎ One flushed cheek. ✎ Excess dribbling. ✎ Frequent gnawing or chewing It's also important to recognise symptoms that may not be to do with

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teething, such as congestion, sleep disturbance or rashes on the body, which could have other causes and may require medical attention.

easing pain If, though, you are satisfied that your baby's symptoms suggest teething, soothing remedies include: Chewing on something cold Putting a clean, wet cloth or flannel in a plastic bag to cool in the fridge and let baby gnaw on it. Chilled drinks A cold, sugar-free drink, or chilled puree or yogurt can provide quick relief. The NHS advises against the use of any type of frozen food, or indeed frozen teething toys. Teething rings This classic method works by applying pressure to aching gums. Teething rings or mitts can be cooled in the fridge for even more effective relief.

Look out for those free from harmful BPA, PVC and phthalates. Teething gels Teething gels often contain a mild local anaesthetic and antiseptic ingredients. Choose a teething gel specifically designed for young children - ask your pharmacist for assistance.

gRoWing Up Once the trouble of teething is over, you have to start thinking about long-term dental health. There’s a lot you can do to make sure that it’s as painless as possible for your child and for you. Smoking and drinking during pregnancy are of course not recommended for a wide variety of health reasons, not the least that they can lead to an underweight baby more likely to have poor teeth because of enamel not being formed properly. Remember that the adult teeth are already growing in the jaws, below the baby teeth, when your baby is born, so some babies whose mothers smoke Healthy Child with Dr Ranj Singh | 59

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Health Check and drink in pregnancy could have badly formed adult teeth too. You must maintain a healthy balanced diet while pregnant, making sure you get the right amount of vitamins and minerals your baby needs. These include calcium, which is particularly important to produce strong bones and healthy teeth. Good sources are milk, cheese and other dairy products.

CLEANING If you bottle feed your baby, never add sugar or put sugary drinks into the bottle, make sure to sterilise it properly, and clean your baby's teeth after the last feed at night, as some breast milk substitutes contain sugar. Try to leave an hour after the feed before cleaning your baby's teeth. Avoid giving the baby sweet things, or dipping their dummy into sugary treats, particularly before sleep. That way the baby will be less likely to develop a ‘sweet tooth’ in later life, and will be less prone to develop tooth decay. Try to avoid using a dummy, soother or pacifier, and discourage thumb sucking, both of which can eventually cause problems with how the teeth grow and develop. If your baby really needs a dummy, soother or pacifier, there are ‘orthodontic' ones that reduce the risk of these problems. Another aspect of dental care in the early years is the mother’s own dental health. This can often suffer during pregnancy, but of course it is as important as the baby’s. In fact, studies have suggested that you may be less likely to have your baby prematurely if you have healthy gums.

teething toys Nibbling’s extensive range of plastic-free teething toys, necklaces, natural wood teethers, dummy clips, pram mobiles and accessories offers parents and babies a much-needed break from teething tears. Perfect for tiny hands to hold, the 100% food-grade silicone teethers from Nibbling are soft enough for babies to chew, BPA-free and freezer, dishwasher and steriliser safe. The award-winning premium accessories combine fashion with practicality. With over 150 fashionable designs and colours combined with attractive yet safe materials, Nibbling is the must-have teething accessory and ideal baby gift.

cleaning and to help keep plaque and tartar from building up is essential. If you suffer from morning sickness, rinse your mouth with plain water to prevent the acid in your vomit attacking your teeth. Avoid sugary and acidic foods and drinks between meals to protect your teeth against decay. While there should be no problem with regular dental treatment during pregnancy, of course more serious procedures may involve risk. There are suggestions that old amalgam fillings should not be removed during pregnancy, and that new ones should not be put in. Different types of fillings are available and may be the safer option. Dentists prefer to avoid using X-rays during pregnancy, but for major treatments such as root canal surgery, this may not be avoidable. Your aim should be for enduring dental health for your baby and for you – after all, it’s one of the main areas in which we can take responsibility for our own long-term well-being. hc


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Images: Shutterstock

However, hormone changes during pregnancy may cause the mother’s gums to become sore, swollen, or even to bleed more easily. Keeping regular dental appointments for thorough

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Health Check

Oral care Images: Shutterstock

avoiding decay

Recent reports reveal shocking statistics about the state of our children’s teeth. What can be done to reverse the decay?

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Health Check


lsewhere in this issue we look at the teething period, and the importance of early dental care for babies and their mothers. But it seems that for many, good advice hasn’t been heeded. A recent NHS report showed that the number of children having teeth removed in hospital has risen almost a fifth in the last six years. The NHS figures show that there were more than 45,000 hospital operations to remove teeth from teenagers and children in 2017/18 - a rise of 18 per cent since 2012/2013. The severity of the tooth decay often means that the treatment has to be undertaken in a hospital under general anaesthetic, rather than by a dentist. In 75 cases, children had to have every single tooth removed - a 40 per cent rise over the period. Dentists agree that there are two main causes of this shocking rise in tooth decay among children - a sugary diet, and too little toothbrushing. The Local Government Association (LGA) urged ministers to introduce measures to cut sugar consumption, including labelling on food packaging. Ian Hudspeth, chairman of the LGA's community wellbeing board, said: "These figures, which have risen sharply, highlight the damage that excessive sugar intake is doing to young people's teeth. "The fact that, due to the severity of the decay, 180 operations a day to remove multiple teeth in children and teenagers have to be done in a hospital is concerning and also adds to current pressures on the NHS. "This trend shows there is a vital need to introduce measures to curb our sugar addiction which is causing children's teeth to rot. "There must be a reinvestment in innovative oral health education so that parents and children understand the impact of sugar on teeth and the importance of a good oral hygiene regime. And Mick Armstrong, the chairman of the British Dental Association said: "The Government says ‘prevention not cure’ is the mantra, but still treats dentistry as an optional extra.

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DENTAL ANXIETY To overcome a child’s nervousness about visiting the dentist ✎ Start visits early in life - this gets them used to the sights and smells of the surgery ✎ Explain the importance of oral health from an early age ✎ Always tell them in advance when they have a visit scheduled ✎ Answer questions with straightforward responses. Let them know they can also ask the dentist questions. ✎ Bring a favourite toy as a calming distraction ✎ Stay calm and follow the dentist’s instructions

in toothpaste. Fluoride is a naturally occurring mineral which has been added to drinking water for decades, and is generally regarded as a valuable aid in the fight against tooth decay. But there have been suggestions that it may be a neurotoxin. Nevertheless, even the American Dental Association firmly supports fluoridation of water, and won’t put its seal of approval on any toothpaste that doesn’t contain it. It’s recommended that children up to three years old should use a smear of toothpaste with a fluoride level of at least 1000ppm (parts per million), and after three years old, they should use a peasized amount of toothpaste that contains 1350ppm to 1500ppm. You can check the level of fluoride on the packaging of the toothpaste.


"Tooth decay remains the number one reason for hospital admissions among young children, but ministers have not put a penny of new investment into early years prevention. "In the NHS's 70th year, ministers need to offer more than unfunded gimmicks. We require a dedicated and properly resourced national effort to end the scandal of childhood decay." Dental development means that prevention is certainly better than cure, and getting into dental are habits early will pay dividends. The first permanent adult molars will appear at about the age of six, probably before the first baby teeth start to fall out at about six to seven. The lower front teeth are usually lost first, followed by the upper front teeth shortly afterwards. All permanent teeth should be in place by the age of fourteen, except the ‘wisdom' teeth, which can be expected to appear at any time between the ages of about 18 and 25.


There’s a debate about the use of fluoride to prevent tooth decay – some are opposed to the fluoridisation of the water supply, and others oppose its use

Cleaning the teeth should become a part of daily routine as soon as possible, and will probably require supervision until the age of about seven. Start off with a children’s toothbrush (if it makes it more fun for the child that the brush is colourful or has a character on it, that’s fine). Use a small smear of fluoride toothpaste. You will probably find it easiest to stand or sit behind your child, with one hand cradling their chin so you can reach both their top and bottom teeth. Once all the teeth are present, an adult toothbrush with a small head and soft bristles is recommended. Brush in small, circular, motions, concentrating on once section at a time. Don’t forget to brush gently behind the teeth, and onto the gums. Spit out after brushing – do not swallow fluoridated toothpaste - but do not rinse, so that the fluoride in the toothpaste stays on the teeth longer. Tooth brushing should be made part of your child’s daily routine, before bed, and at least one other time during the day. Some toothbrushes have a time function which will help your child keep up a consistent standard of brushing, and in later years an electric toothbrush is ideal and adds a fun element to dental care. hc Healthy Child with Dr Ranj Singh | 63

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Health Check reactions include antihistamines, and lotions and creams such as emollients to reduce itchiness. For some people with very severe allergies, immunotherapy may be recommended.


Managing a child’s allergies or asthma is the first step to reducing symptoms and making day-to-day life easier


hildhood allergies can be upsetting and confusing. Their cause is not always obvious, and they don't always respond to the most common treatments. But most can be managed in ways which help to make life easier for the child and parents. Allergies are very common—they're thought to affect more than one in four people—and are caused by a reaction of the immune system to a substance it wrongly regards as harmful. Common 'triggers' are pollen, dust mites, animal dander, foods such as nuts, fruits and shellfish, mould, insect bites and some household chemicals Most allergic reactions are mild,

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such as sneezing or a runny nose, but occasionally a severe reaction called anaphylaxis or anaphylactic shock can occur. This is a medical emergency and needs urgent treatment.

MANAGEMENT The most effective method of allergy management is to avoid the allergen that causes the reaction. A visit to an allergy clnic will help establish this 'trigger' substance. Food allergies, which can lead to serious anaphylactic responses, require you to check the list of ingredients whenever possible. Medications available to help control symptoms of allergic

PLANNING If you understand your child’s asthma, what triggers it, how to spot symptoms and what to do about them, you're less likely to need to go to hospital with an asthma attack. A written asthma action plan an regular asthma reviews will help manage the condition. You'll find lots of help on managing asthma, particularly in the school environment, at hc

Images: Shutterstock

Easing Allergy

Asthma, a common lung condition which causes occasional breathing difficulties, can affect people of all ages but often starts in childhood. It too can be triggered by allergy in fact allergic asthma is the most common type of asthma. Asthma responses can be triggered by allergens, and also by cold air, smoke, dust, fumes or even a strong smell. A flare-up of these symptoms, often known as an asthma attack, can be distressing, but proper management of the condition can reduce its effects and make it easier to live with. Some children will find their symptoms improve or even disappear as they grow up. Two types of inhaler are commonly prescribed for asthma suffers—a preventer and a reliever. Regular use of the preventer will reduce the need for the reliever, keeping down the overall use of medicine. It’s important that the condition is managed in childhood to prevent long-term damage to the lungs from attacks, though of course severe conditions can still require specialist treatment.

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You’ve probably never heard of retinoblastoma.

Around one child a week is diagnosed with retinoblastoma (childhood eye cancer) in the UK. The most common sign is a white glow in the eye visible in certain lighting or a flash photo. Other signs can include a squint , change in eye colour and the absence of red eye in one eye in a photo. Retinoblastoma is rare, but if you see anything unusual in your child’s eye(s), please take them to a GP or optician. Early detection can help save a child’s sight, eyes and life.

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99% of all allergens were recorded as being filtered out by Astex PRISTINE® fabric in tests by the departments of two US Universities. Astex are the only encasements registered as a Class 1 Medical Device and awarded the British Allergy Foundation Seal of Approval Pregnant women who suffer from allergies are far more likely to have babies who later develop allergies, so we recommend fitting Astex PRISTINE® encasements to your own bed during pregnancy.

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18/02/2019 11:05

Health Check

Making a Noise about

Hearing Protection

Is noise pollution damaging our kids’ hearing? We look at the dangers, and some possible solutions to Noise Induced Hearing Loss


ne of the less considered forms of pollution in modern society is noise pollution. We're surrounded by noise all the time, from road and air traffic, to amplified music from portable devices and live entertainment. This relentless barrage presents real health risks to children. Prolonged exposure to excessive noise can gradually cause conditions such as tinnitus (ringing or hissing in the ears), or even permanent hearing loss. Noise Induced Hearing Loss is the second most common form of hearing loss, after age-related types. Listening to any sound at a high volume—more than 85 decibels—for more than five hours a week can damage hearing permanently, and it’s thought that inner ear damage from noise exposure can leave your ears more prone to the aging process later in life. There is no cure for noise-induced hearing loss, as damaged hair cells in the ear cannot regenerate.


We can protect kids from Noise Induced Hearing Loss by active or passive means. Headphones for MP3 players, games consoles or smartphones should be volume-limited, typically to 85dB.

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Look for durable, flexible, comfortably cushioned designs, and consider wireless designs that eliminate the need for fiddly and dangerous cables. Outdoors, noise reduction earplugs with special audibility filters can be an option, and as these can also be water-resistant so are good for water sport events. Soft silicon earplugs, which just cover the ear entrance can also be effective, but can be tricky to fit. But as children grow so quickly, in many cases the most practical ear protection is the hearing defender. Hearing defenders, or ‘ear muffs’ for children are commonly available in age ranges from 0-2, and from 2-5. Design features usually include comfortable padding, hard-wearing cups, and a folding hinge to make the defenders easier to store and transport. Designs for younger children are often in single bright colours, while those for older kids feature funkier patterns, sturdier construction, larger earcups and higher noise tolerance levels. Choose hearing protection tailored to be comfortable, effective and practical for kids, and you’ll be looking after their hearing without having to make a noise about it. hc

protecting little ears The level of noise at events like weddings, sports, air shows, music festivals and parties can be harmful to a little one’s hearing. Repeated exposure to anything over 85db for long periods can result in Noise Induced Hearing Loss. But this is completely preventable, and as a parent you needn't feel restricted from taking the whole family along. Banz earmuffs safeguard young ears from the environment and protect from noise-induced hearing loss. They attenuate harmful loud noises without shutting out other ambient sounds. Banz are suitable from three months up, are fully tested to current BSEN standards, and are CE certified. Crafted from ultra-lightweight material in a low profile, the ear muffs have no protruding parts and are cushioned with foam to rest comfortably around the ears. With this snug fit, children are less likely to tear off their earmuffs. The headband is covered with high quality, soft leather, bringing all-around comfort for your child while protecting their hearing.

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Health Check

Dealing with

Baby’s Sensitive Skin A baby’s skin is extremely sensitive; environmental factors—like seasonal changes, too much washing and perfumed products—can irritate it and cause discomfort


ensitive skin can develop when the natural skin barrier is damaged and allows moisture to escape, leading to dryness and vulnerability to irritation. Although a baby’s skin is extremely delicate to begin with, factors including air conditioning, temperature changes, alcohol-based wipes and over-washing can all act as further irritants. Keep in mind that certain chemicals, fragrances and dyes in clothing, detergents and baby

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products can also all cause dryness, chafing and rashes. One very common condition is eczema, which causes the skin to feel itchy and appear red, dry and cracked on the face or behind the ears, and in the creases of the neck, knees and elbows.

EczEma In children, eczema tends to develop before the age of one. Although it is a chronic condition, it can sometimes improve significantly or even disappear

over time without treatment. Most babies eventually grow out of eczema, but speak to your GP or health visitor if you think your child has eczema. Eczema is not contagious, but management is advisable, as it will soothe discomfort as well as redness. Your baby may scratch the itchy patches and the eczema can get infected as a result, so it's worth taking steps to reduce irritation. In Asian and black Caribbean or African children, eczema may not affect

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Health Check creases, but may affect other areas. Advice from the NHS on soothing your child's eczema includes: ✎ Apply an unperfumed moisturiser to the sore area several times a day – for example, when you feed or change your baby – to help keep their skin moist. Gently smooth the moisturiser into the skin, don't rub it in. ✎ Avoid aqueous cream – it can cause burning, stinging, itching and redness. And avoid soap, baby bath and bubble bath as these can dry or irritate the skin. ✎ Try to keep your child's bedroom cool, as getting hot and sweaty can make their eczema worse. ✎ Steroid creams can stop eczema getting worse. They're safe as long as

they're used as directed by your GP or pharmacist. ✎ Try to identify and avoid anything that irritates the skin or makes the problem worse, such as soap powder, animals, chemical sprays and cigarette smoke. Avoid any of these if possible. ✎ Some fabrics can irritate the skin. Try to avoid wool and nylon and stick to cotton instead. ✎ Some foods, such as eggs and cows' milk, can trigger eczema symptoms, but you shouldn't make significant changes to your diet without first speaking to your GP. It may not be healthy to cut these foods from your diet, especially in young children who need the calcium, calories and protein from these foods.

✎ If you're breastfeeding a baby with atopic eczema, get medical advice before making any changes to your regular diet.

Nappy rash Most commonly caused by a soiled nappy, this rash can also develop if a baby’s skin isn’t properly dried after a bath. While most forms of the condition won’t require medical attention, parents can prevent—and treat— nappy rash by checking nappies frequently and changing them when soiled, washing the nappy area with a specialised cleanser, patting baby dry, applying Vaseline or talcum powder and using a clean cloth instead of baby wipes. hc

How to avoid skin irritation

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Images: Shutterstock

From bath-time and laundry to clothes and bedding, many factors may cause skin flare-ups. Try the following ideas to avoid skin irritation: ✎ When bathing your baby, make sure the water temperature is between 36-37C. Don't spend too much time bathing as this can reduce the skin’s natural oils. Softly pat the skin completely dry, making sure never to rub or aggravate sensitive skin. ✎ When choosing clothes and bed linen for your baby, opt for those made out of natural fabrics like cotton and linen. Wash bedding regularly to keep dust and mites at bay. ✎ Use personal washing products, soaps and laundry detergents tailored to delicate skin and baby clothes and made with naturally derived ingredients and essential oils.

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11/02/2019 14:38

Health Check

Co-sleeping creations


Safe & Sound When you’re being told to most definitely let your baby sleep on its back, and also never ever to do that, how do you know what’s right? We try to unravel the mystery of safe sleeping practices.


othing strikes so much fear into the heart of a new mother as the mention of SIDS (Sudden Infant Death Syndrome, or cot death). It’s particularly terrifying because scientists are currently unable to explain it completely. However, doctors do have some sound advice for parents looking to reduce risk.

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BACK OR TUMMY? Parenting blogs and books can offer wildly conflicting advice, but medical science states unequivocally that infants should sleep on their backs. There's no need to worry about what to do once your baby is old enough to roll over—at that point, they are big enough to no longer be at risk of cot death.

In many countries and cultures around the world, co-sleeping is a widely accepted practice, but in the UK, the idea can be a cause for concern. A recent survey of 2,000 parents by Sleepyhead revealed that over 70 percent of new parents were nervous to co-sleep. But after baby was born, over 59 percent did end up co-sleeping with their baby at some point within the first month. In Sweden, co-sleeping is an important part of family life, and Swedish-born Lisa Furuland-Kotsianis, the founder of Sleepyhead of Sweden, was keen to find something that would aid co-sleeping. For Lisa, being close to her baby during the night was a natural part of parenting. Lisa says that “The well-being and happiness of babies are the objectives and inspiration of all Sleepyhead of Sweden’s creations.”

SHARING, CARING The safest place for your baby to sleep for its first six months is in a cot in your bedroom, not in your own bed. It’s particularly important not to bed-share if you or your partner take sleeping medication, smoke, or have recently drunk alcohol.

NO SMOKING On that note, babies exposed to cigarette smoke before and after birth are at an increased risk of SIDS, so ban smoking in the house and don’t take your baby into smokey places.

SAFE SLEEPING It’s time to give up the habit of sleeping on the sofa, as this is linked to a higher risk of SIDS. It’s safest to put your baby back in their cot before you go to sleep. Healthy Child with Dr Ranj Singh | 75

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Health Check If you are breastfeeding, the advice is to have your partner stay up with you, breastfeed in a different position where you are confident you might not fall asleep, or feed the baby elsewhere. If you have twins, they can share a large cot, but not a small Moses basket– consider sleeping them at opposite ends of the cot, each with their own firmly tucked-in bedclothes or baby sleeping bag. All the safer sleep advice applicable to single babies should be followed whether twins are sharing a cot or not, and by the time they are big enough to roll over, they should be moved into separate cots.


TEMPERATURE Overheating can also increase the risk of SIDS, as can bundling up your baby when the room is too cold. Ideally,

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keep the temperature of the room around 18°C at night, and keep your baby comfortable using lightweight blankets or a well-fitted baby sleeping bag. Babies do not need to wear a hat indoors, and generally, babies who are ill need fewer rather than more bedclothes. Duvets and quilts are not recommended. In warm weather, you ca use a fan to cool the room, but don’t aim it directly at the baby. If the baby is bottle-fed, ensure a sufficient supply of fluids by offering cooled, boiled water to babies under six months, or just water from the tap for babies over six months. Fully breast-fed babies shouldn't need any extra water until they start eating solid food.

BREASTFEEDING It's generally accepted that breastfeeding is good practice, and even if you can't continue to breastfeed after a few days, any breastfeeding is better than none. Ideally, babies should be exclusively breastfed for at least six months—the Department of Health agrees with the World Health

organisation on this. The Department also recommends that breastfeeding is continued, with the addition of appropriate weaning foods, for as long as the mother and baby want. It was shown as long ago as the 1960s that breastfeeding lowers the chance of SIDS, and that babies under 3 months who died of SIDS were less likely to be breastfed. Since then, numerous studies have supported the protective effects of breastfeeding, with one overview report concluding that breastfeeding reduces the incidence of SIDS by approximately half. If you smoke, the advice is that breastfeeding is still the best way to feed your baby, but as stated, smoking does carry serious risks.

ASK A DOCTOR If your baby is unwell, seek medical help promptly. Babies often have minor illnesses that shouldn’t worry parents; however, it can be difficult to judge whether an illness is serious or not. It’s better to play it safe and ask a doctor if you have questions. hc

Images: Shutterstock

You should avoid using any soft or bulky bedding—firmly tucked-in sheets and blankets (not above shoulder height) or a baby sleep bag are the safetst choice. Be sure to remove any soft toys from the cot before sleep, and remove cot bumpers. Avoid using soft or bulky bedding such as quilts, pillows and duvets. Pillows can increase the risk of SIDS, and though they are commonly used due to concerns for plagiocephaly (or ‘flat head syndrome’), there are alternative techniques to address this condition with do not carry any associated risk. Babies should not be allowed to sleep in hard contained environments such as car seats. You should also avoid using second-hand mattresses, as there is some research suggesting SIDS is associated with mattresses brought in from another home. If you use a travel cot with a thin mattress, don’t be tempted to place folded blankets or a quilt under the baby to make them more comfortable, and make sure the cot is not positioned against a radiator, in direct sunlight, or near blind cords or other hazards.

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Health Check

Group B Strep

in Pregnancy & Babies A common bacterium, group B strep can be extremely dangerous to newborns. Find out how it is spread and how it can be prevented

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Did you know? Around 2 in 5 people have group B strep living in their body—this is usually in the rectum or vagina Source: NHS Choices

on to your child, talk to your midwife. You may need to have antibiotics administered into a vein during labour and stay in hospital for at least 12 hours after giving birth so your newborn can be monitored.

GROUP B STREP IN BABIES According to NHS Choices, symptoms of group B strep can develop up to two to three months after birth, though infection usually happens soon after a baby’s birth. If symptoms are detected, your baby will be given antibiotics into a vein. If caught early, most babies with a group B strep infection will make a full recovery.

GET TESTED The Enriched Culture Medium test— also known as ECM—is considered the best method of diagnosing and detecting group B strep carriage. It is offered by some NHS trusts as well as private clinics. The test consists of samples taken from the low vagina and rectum being sent off to a lab. The cells are incubated in an environment that is specifically designed to encourage the grown of group B strep. Results will take a minimum of 24 hours. hc

What are the signs? Fever. Irritability. Feeding difficulties. Lethargy. An unusually high or low temperature. ✎ Very fast or slow breathing.

✎ ✎ ✎ ✎ ✎

Images: Shutterstock


roup B streptococcus is a type of common bacterium—while it is normally harmless to adults and rarely causes symptoms, it can be very dangerous for newborns. The bacterium is carried by around 20-40 percent of adults—most commonly in the gut—and for up to 25 percent of women in the vagina. Group B strep is responsible for many cases of meningitis, sepsis and pneumonia in young babies, can result in lasting problems like hearing loss and can even be fatal. Group B strep is common in pregnant women—although it’s not routinely tested for, it can be detected during urine tests or a vaginal swab. The risks of a pregnant woman having group B strep include a slight chance of the condition spreading to the baby (although this only happens in about 1 in 1,750 pregnancies) as well as a very small risk of miscarriage. If you have group B strep and are worried about the possibilities of passing it

25/03/2019 10:26

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Group B Strep What expectant and new parents need to know


hen you’re expecting or a new parent, it’s important to know about Group B Streptococcus (Group B Strep or GBS) which can cause serious infection in newborn babies. Around one in four adults carry the bacteria, usually harmlessly, in their lower intestines and vagina. It doesn’t mean you’re sick, and it’s not a sexually transmitted disease (STD). The most common cause of severe infection in newborn babies, Group B Strep causes sepsis (blood infection), pneumonia (lung infection) and meningitis (brain infection). The bacteria may be passed from a mother to her baby around birth. Most infections show within 24 hours of birth, becoming less common with time (they are rare after three months). Most babies recover fully, but sadly not all. In the UK, on average: ✎ two babies each day develop group B Strep infection ✎ one baby a week dies from group B Strep infection

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one surviving baby a week suffers long-term health issues like cerebral palsy or hearing or vision loss.


80-90 percent of group B Strep infections in newborn babies can be prevented by testing the mother late in pregnancy and providing intravenous antibiotics during labour. The UK does not routinely test for group B Strep, unlike many other developed countries, but you can take a private test costing around £35. The simple swab test is usually taken between 35 and 37 weeks of pregnancy. A specific test for group B Strep, the ECM or Enriched Culture Medium test, is not available from all NHS hospitals, but is available privately from providers listed on

risk factors

Key risk factors for your newborn baby developing group B Strep infection are: ✎ you previously had a baby who had

✎ ✎

group B Strep infection group B Strep has been found in this or a previous pregnancy from a urine sample, or a vaginal or rectal swab your baby is born before 37 weeks of pregnancy you have a high temperature during labour

During ante-natal care ask your midwife or doctor for the leaflet about Group B Strep, co-written by experts from the Royal College of Obstetricians & Gynaecologists and charity Group B Strep Support. It can also be downloaded from

Find out more visit or call Group B Strep Support’s Helpline on 01444 416176.

27/02/2019 14:58

Health Check

The glass test

What Are the Signs? Most common in babies and young children, meningitis can be alarmingly serious if not treated quickly


hildren under three years old are 70 times more likely to contract bacterial meningitis—an infection of the protective membranes that surround the spinal cord—than adults. If not treated quickly, meningitis can have devastating complications and can lead to life-threatening blood poisoning, known as sepsis. Being aware of meningitis and making sure your little one’s vaccinations are up to date can help protect against this dangerous infection.

SYMPTOMS Not all causes of meningitis and sepsis are preventable through vaccination and symptoms can develop suddenly, so being able to recognise the signs is vital. The following can arrive in any order and some may not appear at all. ✤ A high temperature of 38C or above. ✤ Vomiting. 80 | Healthy Child with Dr Ranj Singh

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✤ A headache. ✤ A blotchy rash that doesn't fade when a glass is rolled over it. ✤ A stiff neck. ✤ An aversion to bright lights. ✤ Drowsiness or unresponsiveness. ✤ Seizures.

HOW IS IT SPREAD? Meningitis is caused by a bacterial or viral infection. Bacterial meningitis is rarer but more serious than viral meningitis and is the leading infectious cause of death in early childhood every year in the UK. Infections can be spread through sneezing, coughing, kissing and sharing utensils, cutlery and toothbrushes. Usually, meningitis is caught from people who carry these viruses or bacteria in their nose or throat but who aren't ill themselves. It can also be spread from someone with meningitis, but this is less common.

COMPLICATIONS Viral meningitis will usually get better without intervention and rarely causes any long-term problems. Most people with bacterial meningitis who are treated quickly will also make a full recovery, although some are left with serious, long-term problems. It's estimated that one person in every two or three who survives bacterial meningitis is left with one or more permanent conditions. These include: ✤ Hearing loss or vision loss (partial or total). ✤ Problems with memory and concentration. ✤ Recurrent seizures (epilepsy). ✤ Coordination, movement and balance problems. ✤ Amputation of affected limbs. ✤ Learning difficulties and behavioural problems.

VACCINATIONS Immunisation is the most effective prevention method. As meningitis and sepsis can be caused by a number of different infections, several vaccinations are available to offer some levels of protection. These vaccinations have successfully reduced the number of meningitis cases throughout the world and are routinely administered to babies from the age of eight weeks as part of the NHS vaccination schedule. hc

Images: Shutterstock


A classic symptom of meningitis is a rash that doesn't fade when a glass is firmly rolled over it—a sign of blood poisoning. However, this doesn't appear in all cases. If your instincts are telling you to act, don't wait until a rash develops

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Are you #VsMeningitis? Are you ready to Tackle Meningitis? Meningitis is a rare but serious disease that can have devastating consequences. It can be caused by lots of different bacteria and viruses, but it’s bacterial meningitis that kills more UK children under 5 than any other infectious disease. And it’s not just young children at risk – babies, toddlers, teenagers and young adults are at higher risk than other ages. It’s also not that easy to spot. To have the best fighting chance, follow the ABC of meningitis prevention:

ct fast: Trust your instincts and act fast when you see the early signs. Early signs include cold hands and feet, vomiting, fever, headache and muscle ache. In really young children, unusual crying, drowsiness or floppiness, refusing feeding and a tense or bulging fontanelle (soft spot) may also be signs. A rash that doesn’t disappear when a glass is rolled over it may sometimes be present - but not always, so acting quickly is crucial. At this point, it could be really serious.

e vaccinated: Check if your child is up to date with their vaccinations and consider additional vaccinations that may be available. There’s no single vaccine that protects against all types of meningitis. Some vaccines are offered by the NHS but eligibility will be age determined. If you’re not sure what your child is protected against, speak to your doctor. leanliness: Washing hands carefully before eating, after handling animals, spending time in crowded places, covering your mouth when coughing and sneezing and avoiding sharing of drinks, food, straws, lip balms and toothbrushes can reduce your risk of getting meningitis.

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Health Check

A Sticky Situation:

Does My Child Have Glue Ear? From symptoms to treatments, here's everything you need to know about glue ear


ne of the most common childhood conditions, glue ear is where the empty middle part of the ear canal fills up with a glue-like fluid, causing temporary hearing loss. Many things can contribute to glue ear, such as colds and flu, allergies and passive smoking. This sticky condition usually clears up within three months, but some children have ‘recurrent’ glue ear, and longterm symptoms can affect hearing and speech development, and can cause children to fall behind at school.

SYMPTOMS The most common symptom of glue ear is temporary hearing loss which can affect both ears at the same time. You might also notice your child complaining of an earache or ear pain, or saying that they can hear ringing or buzzing sounds. Remember, ear pain can also be a symptom of earwax buildup, an object stuck in the ear or a perforated eardrum. It can also be an indication of a dental abscess, tonsillitis or an ear infection, so it’s important to get your child checked by a doctor.

Signs your child is struggling to hear

Always take your child to the doctor if they are having hearing problems. They may be struggling to hear if they often: ✤ Speak more loudly or quietly than usual ✤ Are difficult to understand ✤ Ask people to repeat what they say ✤ Ask for the TV or music to be turned up loud ✤ Struggle to hear people far away ✤ Become easily distracted when people are talking ✤ Seem tired or irritable because it’s harder to listen

Images: Shutterstock

Source: NHS Choices

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Health Check

Diagnosis Your child’s doctor will generally use a small scope with a magnifying glass and light to search for fluid inside the ear canal and diagnose glue ear. This procedure should be painless. If your child has been suffering from glue ear for more than three months, they may be referred to a specialist for hearing tests that can help to determine how severe any hearing loss is and pinpoint its cause.

TreaTmenT Glue ear isn’t necessarily always treated—your doctor will usually wait and see if the symptoms become better on their own. This is because there is no effective medicine for glue ear and it typically clears up on its own within three months. However, you could be recommended the following: autoinflation A doctor may recommend this treatment while waiting for your little one’s symptoms to improve. Autoinflation can help fluid in the ear to drain and is done either by blowing up

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a special balloon using one nostril at a time, or by swallowing while holding the nostrils closed. As autoinflation has to be done several times a day, it is not usually recommended for children under three years old. Hospital treatment If your child’s glue ear symptoms are affecting their learning or development, or if they have already had severe hearing loss before contracting glue ear, they may be referred to a specialist in hospital. Children who have been diagnosed with Down’s syndrome or a cleft lip and palate may also be referred, as glue ear is more common and less likely to get better by itself in these instances. The two main treatments here are temporary hearing aids or grommets. In rare cases, surgery may be offered to remove some glands at the back of the nose—the specialist in hospital will help you to decide on the best treatment option for your child. grommets Grommets are small, temporary

It's not certain what causes glue ear Doctors believe it’s connected to the Eustachian tube not functioning properly—if this tube is blocked, air pressure inside the middle of the ear drops and fluid drains from the surrounding tissue to fill it up Source: Great Ormond Street Hospital

tubes that are placed in your child’s ear during surgery to help drain fluid away and keep the eardrum open. The surgeon makes a tiny hole in the eardrum and inserts the grommet into the space. It should fall out naturally within six to 12 months, as the ear gets better. Your child may have an anaesthetic, but these are safe and, as the hole in the eardrum is tiny, risk of infection is also very much reduced. hc

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13/02/2019 09:10

Health Check

Living with

Cystic Fibrosis Cystic fibrosis is a serious and life-threatening condition, but research gives hope for sufferers to live longer and healthier lives

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If a child is diagnosed with CF, siblings also need to be tested for the condition, and if a member of your family is diagnosed, it’s a good idea to have a carrier test. This can be done from a genetic sample using a special mouthwash, or from a blood sample.


The faulty gene means there are difficulties with the cells passing sodium, which builds up as thick mucus. In the lungs, the mucus buildup affects movement of the cilia, the hair-like projections which line the bronchea. This prevents mucus and debris from being removed from the lung, leading to breathing difficulties. CF can also affect any organ system that produces mucus in the body, including the sinuses, gastrointestinal tract, pancreas and liver, so CF sufferers can experience a wide range of symptoms including sinusitis, nasal polyps, osteoporosis (thin, weakened bones), arthritis and liver problems. They can also develop diabetes from

late childhood or early adulthood if the pancreas becomes severely damaged. As the pancreas becomes blocked with mucus, enzymes needed for digesting food cannot reach the stomach, so CF patients often need to take more than 50 tablets a day to help digest food and keep respiratory symptoms in check. Men with CF are usually infertile, and pregnancy can place a lot of stress on the body of a woman with CF. There’s also evidence that CF affects the heart and circulatory system, causing symptoms such as enlargement of the right side of the heart, and at this time there is little effective treatment for this condition.


Although there’s no cure for the condition, treatment can help control the symptoms, making it easier to live with and slowing the damage it causes. A combination of physiotherapy and medication can help control lung

Images: Shutterstock


ecent Hollywood movie Five Feet Apart did a lot to promote awareness of the serious and life-threatening condition Cystic Fibrosis, known as CF. Though it caused controversy with its depiction of a romantic relationship between two young sufferers of the condition, the film was welcomed for bringing to light some of the most serious aspects of the disorder. Cystic Fibrosis is a genetic condition which attacks the lungs and digestive system. There’s also evidence that it can lead to heart problems in later life. There is currently no cure, though treatments are improving all the time. CF is usually diagnosed in newborn screenings by a blood or sweat test. A faulty gene—the CFTR gene on chromosome 7—causes the condition. It’s carried by one in 25 of us, usually showing no evidence of CF or other symptoms. However, if both parents have the same faulty gene, there is a one-in-four chance that the child will develop CF.

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Health Check

infections and reduce the buildup of mucus. Children with cystic fibrosis usually need medication and physiotherapy every day. Physio sessions can be between 15 minutes and an hour long and may be needed more than once a day. Children with cystic fibrosis lose a lot of calories because they can’t digest food properly. They need a very high fat, high calorie, high protein diet and may need to take certain dietary supplements.


For older patients, self-care options such as home and remote monitoring mean that people with CF can use a pulsometer or lung function meter on themselves to monitor their own weight and wellness. Another possible treatment is The Vest, an advanced airway clearance system using an air pulse generator which rapidly compresses and releases the chest wall up to 20 times per second. However, this system is controversial, and the Association of Chartered Physiotherapists in Cystic Fibrosis does not recommend it as the sole airway clearance technique,

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particularly for children. Medication can include antibiotics for chest infections (sometimes administered intravenously), mucus thinners such as hypertonic saline, bronchodilators to widen the airways and reduce inflammation and enzyme supplements to aid digestion. Attacks known as pulmonary exacerbations can still lead to frequent hospitalisation, possibly for weeks at a time. If the lungs are severely damaged by repeated infections, a double lung transplant may eventually be necessary. Experts suggest that CF sufferers should never have contact—the ‘six foot rule’ should be maintained to minimise risks of cross-infection, hence some of the controversy surrounding the film Five Feet Apart. Certainly, the condition requires strict segregation to be in place at CF clinics and means that it’s impossible to organise support groups. However, more than half the people with CF in the UK will now live past 47, and babies born today are expected to surpass that. With more than 50 percent of the CF population in work or education and many people with CF having families of their own, the future is much brighter than before. hc

Managing symptoms Most school-age children with CF are relatively healthy and are able to join in all school activities. Make sure your child:

✎ Has regular appointments to monitor their condition

✎ Gets the treatment

✎ ✎ ✎

recommended by specialists including antibiotics, physiotherapy and other medication Gets the right nutrition, vital to help normal development and health Keeps up to date with routine vaccinations such as flu jabs Gets suitable exercise as part of their physiotherapy regime Avoids cigarette smoke which could make symptoms worse

Source: Cystic Fibrosis Trust

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Growing up

Time to Tell Teaching children to tell the time can be a challenge, but there are ways to make it fun too


ANALOGUE Telling the time is part of the national mathematics curriculum, so your child should get some help at school. A typical lesson plan for teaching children to tell the time involves drawing a large clock on a whiteboard and giving them a dummy clock on which they can move the hands.

1 2 3 4


Show the children a large clock on the whiteboard. Explain 'to' and 'past' the hour. Point out where quarter past, half past and quarter to are on the clock. Explain that each number on the clock is worth five minutes. Ask the children to count in fives as you point to the numbers on the clock. Ask the children to set their own clocks to whatever time you call out.

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It does no harm to help the learning process along yourself, and as the analogue clock face is divided into fiveminute periods, the most useful tip is to teach them the five times table. By Year 4 (ages 8-9), children should be able to read, write and convert time between analogue and digital, 12- and 24-hour clocks. An ideal first-buy watch for your child is a 'time-teaching' type. The main requirementis that it should have a clear, numbered face, and useful extras are a strong washable strap of the right sort of size, a sturdy metal buckle and some degree of water resistance.

LEARNING To help with the learning process, some watches are labelled ‘TO’ on one side of the face and ‘PAST’ on the other, with each minute and the quarter-hours individually labelled

Time Tip When you’re teaching your child to tell the time, make sure the clock in their room is analogue, not digital, and when it comes time to buy them a watch, let them choose the style and colour they like, or select a watch with a personalised strap

around the face; others are labelled using the 24-hour system, if that’s the way you prefer to tell the time. These options are available on watches, clocks and alarm clocks, so your child should always be able to use the same learning system wherever they are. Once they’ve mastered telling the time, your only remaining job is to get them out of bed in time to get to school in the morning! hc

Images: Shutterstock

ike tying shoe-laces and reciting multiplication tables, learning to tell the time is one of the signposts a child is growing up. But in these days when smartphones and tablets are becoming universal, and adults are less likely to wear a watch, how do you teach a child to tell the time? The analogue clock face can be confusing, particularly in an age when other measures like currency and weight have gone decimal. Maths teacher Mel Muldowney of says: “Without fail there will always be at least one student who, when working with time, will work in multiples of 100. For example, they do their calculations based on 100 seconds in a minute or 100 minutes in an hour and, once reminded, will wonder why they've done it.”

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19/03/2019 09:58

Growing up

Taught by Toys: How Toys Aid Child Development Young children learn predominantly through play, so it makes sense that toys are a significant part of the journey

Too many toys?

Images: Shutterstock

Research le d by the U niversity Toledo fou of nd that w hen childre were in a n room with fewer toy they susta s, ined enga gement and show ed more so phisticate d and creati ve manner s of playing

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Growing up


hat occurs during the first five years of life can have a substantial impact on how well an infant learns and grows throughout their lifetime. As your baby and their emerging abilities develop, so should their playthings. Here’s how toys can assist your little one’s development from birth.

Zero to six months Babies have much to discover about the world around them and every new experience is an opportunity for them to learn. At this young age, toys actually stimulate a baby’s sense of sight, touch and sound, while also developing their imagination and dexterity. A toy simply being colourful will make it a fascinating stimulus for your infant’s brain and vision. Encouraging your baby to play with the right toys can also improve their muscle memory and coordination, develop their motor skills and encourage reaching developmental milestones quicker. Your baby will appreciate looking at rattles, baby books, textured balls and toys that make music. By giving them age-appropriate toys that are safe and stimulating, you’ll help them to discover their senses.

12 to 24 months As your baby grows, they’ll learn to hold small toys and transfer objects from hand to hand. For little ones, toys or objects in the house that can be filled, dropped, shaken or taken out will cause stimulation and help your tot to understand cause and effect and object permanence. Larger toys such as balls or pull toys will accommodate their desire for movement—developing motor skills and spatial awareness. From around 12 months, children will learn about the world by playing with ‘pretending’ toys: dolls, kitchen sets, building blocks, toy cars etc. They are also constantly investigating and will enjoy being creative. Non-toxic art supplies, simple board books and wood puzzles will encourage

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eye coordination, logical thinking and problem-solving and teach your toddler more about colours, shapes and symmetry. Plenty of play at this age should give your little one a good foundation for school learning.

Toy safety

three to five years Children at preschool age have longer attention spans and are eager to experiment. It’s time for them to begin learning about letters, numbers and language, and there are plenty of toys that encourage this type of learning. Alphabet puzzles, picture books and matching games will help your child to learn and have fun at the same time, which will increase their retention. Preschoolers are still fine-tuning their physical skills and need to use their large and small muscles by throwing and catching, playing with ride-on toys, using plastic bats, bowling pins and similar toys. They like to play with friends, can take turns and share their toys with older children—a learning experience that will build empathy and relationships. At this age, plenty of creative supplies will help them to express themselves and consider the world around them. Toys are clearly important for developing individuality, social skills and a positive attitude toward learning.

What’s gender got to do With it? The inundation of advertisements promoting dolls for girls and trucks for boys helps toy companies make a profit, but these ‘stereotypes’ may also limit your child’s development. In a study, undergraduates found that ‘feminine’ toys were more likely to encourage nurturance and domestic skills, and ‘masculine’ toys were more likely to support the development of spatial, scientific and intellectual skills. Investing in fundamental toys—such as building blocks—and encouraging your child to play with a variety of things could assist growth in multiple areas. hc

Toys must be safe by law, but controlling how they’re used and deciding whether they’re ageappropriate are both important in preventing accidents. Consider these toy safety tips when buying for your child: ✎ Look for the ‘CE’ symbol, which shows a toy meets regulatory requirements. ✎ Look for the voluntary British Toy and Hobby Association’s ‘Lion Mark’. ✎ Buy toys from reputable sources and check their age range. ✎ Some children, particularly those under three, are more vulnerable and less able to cope with certain toys—follow your instinct. ✎ Avoid toys with loose fabric or hair that sheds, toys with small or detachable components, and those that have sharp points or finger traps. ✎ With toys such as chemistry sets, it’s important to supervise children during play and to follow instructions. ✎ Encourage children to play with one toy at a time and to put toys away when finished. ✎ Toys that you previously deemed safe may become unsafe due to wear and tear—check the quality of toys frequently. Source: The Royal Society for the Prevention of Accidents

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Growing up

Adding Value Could your children benefit from nutritional supplements? We find out how to top up on essential vitamins, minerals, acids and gut bacteria


e all know the importance of ‘five-a-day’ and a healthy balanced diet, but what do you do if your busy lifestyle or the temptations of fast food mean that your children aren’t getting all the trace substances they need? There are four main groups of “micronutrients” essential to the proper working of the human metabolism—vitamins, minerals, fatty acids and amino acids. As vitamins can’t be synthesized in sufficient quantity in the body, they normally come from food. There are 13 essential vitamins, each with complex functions around proper growth and development, so deficiency in any of them can have serious health implications. Fortunately, since the chemistry of vitamins was determined in the 1930s, it’s been possible to synthesize them and supply them as supplements, in many forms including tablets, capsules, drinks and bars.

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Fast Fact Babies who are being breastfed should be given a daily vitamin D supplement of 8.5 to 10 micrograms, whether or not the mother is taking a Vitamin D supplement herself. Source: Department of Health

VITAMINS It’s quite common to find that young children don’t get enough vitamins, particularly vitamins A and C. Vitamin A, naturally present in carrots, potatoes, spinach and broccoli, is particularly important for babies and young children, as it strengthens the immune system, helps vision and keeps skin healthy.

Vitamin C is essential for general health and the development of the child’s immune system and also has a function in the absorption of iron. Natural sources include oranges, kiwi fruit, strawberries and peppers. Vitamin D is found naturally in only a few foods, such as oily fish and eggs, though it is added to some foods such as fat spreads and breakfast cereals. Sunlight is an important factor in Vitamin D production, but too much exposure to the ultra-violet portion of sunlight carries its own dangers. The Department of Health recommends vitamin supplements containing vitamins A, C and D for babies and children aged six months to five years old, unless they're getting more than 500ml (about a pint) of infant formula a day.

MINERALS There are also several minerals essential for the healthy human metabolism; the most common are calcium, phosphorus, potassium, Healthy Child with Dr Ranj Singh | 93

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Growing up

natural calcium

sodium and magnesium. Ten or more other minerals are necessary in trace amounts. Like vitamins, inorganic minerals have specific functions in the human metabolism; for instance, copper helps to produce red and white blood cells and is important for infant growth, brain development, the immune system and strong bones. Selenium has functions in the immune system and in reproduction, and zinc helps with cell development and carbohydrate processing. Your kids should be getting a good supply of minerals from a healthy balanced diet, but if necessary, a wide range of nutritional mineral supplements are available.

Fatty acids Essential Fatty Acids, or EFAs, are a form of ‘good fat’ which also function as essential nutrients. They’re sometimes referred to as ‘vitamin F’. Because the body can’t make them, EFAs must be

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obtained through the diet. EFAs are essential for the structure and function of every cell in the body and have many functions including managing the absorption of vitamins and minerals, supporting growth of the skin, hair and nails, aiding nerve functions, producing hormones, managing growth and development and supporting the immune system. There are two main groups of EFAs, saturated and unsaturated, and three major types of unsaturated fatty acids: Omega-3, Omega-6 and Omega-9. Of these, Omega-6 and Omega-3 are essential as the body can’t make them, but Omega-9 can be manufactured from other fatty acids. Just to complicate things even further, there are two further classifications of fatty acids, monounsaturated or polyunsaturated. Polyunsaturated EFAs include the essentials linoleic acid (LA) and alpha-linolenic acid (ALA).

It is very important both to have a balanced diet and to use the correct supplements to complement your diet. Osteonorm Natural Calcium Citrate is a family owned business, producing 100 percent natural calcium supplements. Made from egg shells, it is the most natural form of calcium. Egg shells contain calcium in its elementary form, which is much more natural for your body than synthesized versions. Egg shells also contain 27 other trace elements, which makes their composition very similar to our own bones and teeth. The egg shell powder used in Osteonorm tablets is made exclusively using egg shells from organic, grass fed, happy hens. Calcium levels in young children, especially if your child is lactose intolerant, can be hard to maintain, so it’s important to make sure they have sufficient calcium intake. Osteonorm for Kids helps maintain healthy levels of calcium. It can be used from the age of one. In Osteonorm for Kids there are only three ingredients—egg shell powder, dried raspberries and raspberry juice. This gives Osteonorm for Kids its sweet taste, which children love. Osteonorm for Kids helps with bone growth and development, and for children who are teething, it's perfect to help reduce pain—and during teen years, it's also great for promoting bone metabolism.

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Growing up EFA deficiency has become common because of modern diet and lifestyle, and environmental factors. Some people also have difficulty converting LA and ALA to other necessary substances, so they can suffer from EFA deficiency diseases. The key sources for EFAs are: ✎ Vegetables and vegetable oils— Key sources of linoleic acid, rarely requiring supplements ✎ Eggs, fish and meat—Sources of the Omega-3 acids EPS and DHA, as well as arichidonic acid ✎ Nuts, vegetables and seeds— Sources of alpha-linoleic acid ✎ Corn, peanuts and olive oil— Sources of gamma-linoleic acid, which is often deficient in the diet

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smaller doses, and to increase the dose gradually over several weeks.

AMINO ACIDS Amino acids are the main components of proteins, including DNA, so it’s no exaggeration to describe them as the building blocks of life. There are 20 amino acids divided into two categories; essential, including histidine and leucine, and non-essential, including alanine and arginine, which are produced in the liver. Amino acids play a role in breaking down and reordering proteins in the diet, building cells, repairing tissues, producing enzymes and regulating blood sugar. They also play a role in the immune system, metabolism and digestion. Most of our amino acid requirements are met through a healthy diet including meat, eggs, fish and dairy. Plant-based proteins are valuable but are often low in one amino acid or another. Amino acid supplementation is

increasingly popular, particularly with athletes who see it as helpful in muscle repair. To address mood, energy, sleep and other wellness issues, supplements for tryptophan, phenylalanine and glutamine have also become common.

GUT HEALTH It’s no good taking all the vitamin, mineral and essential acid supplements in the world if your system isn’t digesting them properly, and to that end, it’s a good idea to consider a gut health supplement. Bacteria such as Lactobacillus and Bifidobacteria are naturally found in a healthy gut and have many functions including the synthesis of fatty acids and vitamins. A balanced gut environment, or microbiome, is essential to aid digestion, the immune system and the central nervous system, and probiotic supplements formulated for children will contain these and other strains of healthy bacteria. hc

Images: Shutterstock

A healthy balanced diet should supply all these EFAs, but a diet full of junk food and lacking in fresh vegetables, fish and dairy may well be deficient. EFA deficiency can be a contributory factor in many diseases including diabetes, eczema, atherosclerosis, hypertension, eczema, immune dysfunction, heart disease and inflammatory conditions such as rheumatoid arthritis. Clinical trials have found supplementation of gamma-linoleic acid (GLA) particularly helpful in cases of arthritis and other joint conditions. Omega-3 EFAs are also thought to play a role in mental health and are being researched for their possible role in the treatment of depression, bipolar disorder, Alzheimer’s, dementia, cognitive impairment, dyslexia and attention deficit disorder. It’s hard to establish recommended rates of intake for EFAs, but it seems safe to consume as much as 50g per day, though with some possible sideeffects such as stomach upset, which often lessen with continued use. The best advice is to consume EFA supplements with food, to start with

22/03/2019 11:00

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06/02/2019 10:41

Growing up

A Clean Home is a Healthy Home

These cleaning health benefits will make chores more rewarding for the whole family


Images: Shutterstock

aintaining a clean living space is common sense when it comes to hygiene, but it can have a positive effect on your family’s physical and mental health, too. Here are six surprising benefits of keeping a clean home.

productivity and bring control to your life. You might even discover a new sense of gratitude for your environment—a mindfulness practice that has been proven to increase positive emotions, strengthen the immune system and aid sleep.



In a recent study, women who described their home as 'messy' or 'chaotic' showed higher levels of cortisol—the body’s main stress hormone. As a busy parent, cleaning can give you a sense of accomplishment, increase

Carpets, bedding and surfaces can all harbour allergens, with continuous exposure worsening hypersensitivity and posing a health threat. One in 11 children in the UK has asthma, so you should vacuum at least once a week and regularly clean surfaces

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s and w o l il p , s t e e Dirty sh an create skin pajamas cso make sure to infections, ding frequently wash bed hot water with and sweep entryways. Invest in an air purifier to banish pollen, dust mites, smoke and other unwanted particles.

SAFE AND SOUND According to the Royal Society for the Prevention of Accidents, more

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hen little ones are the focus of your attention, keeping a home clean and freshly scented can seem like a pipe dream. Yet, as little ones start to crawl and explore the home, keeping floors and surfaces clean couldn’t be more important. It’s best to store cleaning products out of reach of young hands – in a child-proof high cupboard if possible. Making sure the cupboard is filled with fast-working, highly effective products like the Ultra Power range from Flash which will save you time and ensure the best possible clean. Flash Ultra Power Anti-bac Spray blasts through 100% of dirt, grease and grime on worktops and is antibacterial, while Flash Ultra Power Concentrated Multisurface Gel has twice the power of regular Flash All Purpose Cleaner liquid to leave floors sparkling clean and shiny… at least until the kids have made their next messy moves!

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For many, a real home doesn’t just need to look clean, it needs to smell great too. Febreze, with its OdourClear technology – that doesn’t just mask smells, but neutralizes and eliminates them - is the perfect brand to help you achieve a fresh scented family home. Many people worry about the use of air fresheners in their home. Febreze uses only 100% natural, nonflammable propellant. The OdourClear technology is made up of stink-ending complexes that come from everyday ingredients, like cyclodextrin (from corn starch) and citric acid (found in citrus fruit). Whether you need to remove smells after nappy changes with Febreze Air Freshener or eliminate set-in smells from your sofa or other hard-to-wash fabrics with Febreze Fabric Refresher, there’s always a delightful scent from Febreze that will leave your home smelling amazing.

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Growing up

Clean with confidence

accidents happen at home than anywhere else. Having a dirty oven is a fire hazard, as is having clutter in the house that will work to spread flames and block exits. As your infant grows, disorder could cause physical accidents and give precariously stacked objects the potential to be dangerous.

Goodbye Germs Places that you frequently touch, such as doorknobs, taps and keyboards, are breeding grounds for contamination. The kitchen also offers a focus for pests and microorganisms that come with raw foods or unwashed dishes, and the bathroom is another high-risk area. Wipe down surfaces regularly to lower the potential for sickness within your family. With adventurous little ones in the house, non-toxic cleaning products are worth considering.

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Get physical If getting to the gym regularly isn’t an option while caring for a child, release those endorphins by bringing out the vacuum or scrubbing the shower. A study from a Canadian university revealed that physical household chores are just as good as gym workouts. In fact, cleaning five times a week for half an hour reduces your risk of death by 28 percent and your risk of heart disease by 20 percent.

a job for two With a little imagination, every household chore can be turned into a game. Involving your child will not only teach them why cleaning is important for their health, it will also become precious parent-child time. ‘Real life’ play has been shown to have a positive impact on a child’s emotional wellbeing, too. hc

Fast-working, highly effective products like the Ultra Power range from Flash will save you time and ensure the best possible clean. Flash Ultra Power Anti-bac Spray blasts through 100 percent of dirt, grease and grime on worktops to kill bacteria, while Flash Ultra Power Concentrated Multisurface Gel leaves floors sparkling clean and shiny. Flash Ultra Power Magic Eraser is the perfect way to clean grubby marks off surfaces. Just wet, squeeze and rub over marks, and watch them disappear. For many, a real home doesn’t just need to look clean, it needs to smell great too. Febreze’s OdourClear technology doesn’t just mask smells, but neutralizes and eliminates them, using only 100% natural, non-flammable propellant. Flash and Febreze products are thoroughly tested to be safe for intended use. For details of all the ingredients in Flash, Febreze and other P&G products, you can visit

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Growing up

An App-le

Images: Shutterstock

for Teacher

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Growing up

Screen time for kids can certainly be productive, given all the possibilities out there—however, educational apps aren’t always what they appear to be. We look at the essentials for digital learning


label on their product,” says Dr HirshPasek. “Using scientific research as a guide, we can help parents begin to evaluate the morass of stuff that exists in the app store.”

ablets and smartphones might be ideal learning tools for children—particularly since they don’t require keyboard skills— but there’s real concern that excessive time spent using digital devices can cause harm. Over half of UK adults surveyed think that technology and mobile devices can foster problem-solving, learning skills and creativity, yet parents are worried about the potential impact devices can have on sleep, energy levels, social skills and mental health. The temptation may be to leave the kids to entertain themselves with a screen—but is this good for them?


Becoming Brilliant—What Science Tells Us About Raising Successful Children by Roberta Michnick Golinkoff and Kathy Hirsh-Pasek is available in paperback from APA Life Tools and as an audiobook from Audible.


The jury’s still out, but the Royal College of Paediatrics and Child Health recently concluded there’s not enough evidence of screen harm to recommend UK-wide time limits. However, they noted that over-use can cause sleep disruption, and devices should be switched off an hour before bed. Perhaps the solution is to take control over the type of screen usage, rather than the amount. Rather than Facebook, games and videos, educational apps could be the healthy way to feed your child’s digital desires. There are some 180,000 apps which claim to be educational on Apple’s AppStore alone, most aimed at children and even babies. But a recent study by educational psychologists Drs Kathy Hirsh-Pasek and Jennifer M. Zosh questions whether most of these apps actually have educational value.


Educational psychologist Dr HirshPasek’s report for the journal Psychological Science says many apps marketed as ‘educational’ are basically

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The report suggests that even when an app has content that looks like it should be educational, like letters or numbers, it doesn’t mean that it has true educational value. Many feature distracting enhancements. “While these ‘bells and whistles’ might be fun, research suggests that these kinds of distractions actually take away from, rather than enhance, learning,” the researchers explain. There are four basic functions a good app should embrace, the report suggests.

✎ Involvement—Not just tapping or the equivalent of sugary foods, at best harmless but empty, at worst distracting. The report suggest app features that parents and teachers should avoid, as well as those they should seek out to find high-quality educational apps.

✎ Avoid apps that keep children’s

✎ ✎

✎ ✎

attention through passive activities, like repetitive swiping Avoid apps that feature a lot of distracting "bells and whistles" Avoid apps that present children with knowledge in a vacuum – look for meaningful connections Avoid apps that don’t involve social interaction Avoid apps that tell your child what to know - look for guided exploration

“We want parents to know that claims about educational content are completely unregulated—any app developer can slap the ‘educational’

swiping but engaging intellectually

✎ Concentration—Exclude noise, movement or side games

✎ Relatability—Encourage children to connect new information with their daily lives ✎ Interaction—Educationally effective apps encourage social interaction Not all apps will necessarily incorporate all of these four pillars, but those that do are more likely to lead to significant learning outcomes. In the end, if what an educational app promises seems too good to be true, it probably is, the researchers say. "Many apps make dramatic promises—from teaching advanced concepts to infants or even changing your child’s brain," notes Dr. Zosh. "Parents should use common sense and remember that an app—even an educational app—is just an app, not a miracle." hc Healthy Child with Dr Ranj Singh | 103

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Growing up

Friends for Life

Images: Shutterstock

Should you be worried if your child has an imaginary friend? New studies suggest that they’re a healthy and positive sign of potential

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Growing up


mma’s three-year-old, Ben, has a friend called George. George comes to visit when Ben’s big brother won’t play with him; Ben talks to George, plays games with him and usually wins. Sophie, aged five, has a winged horse called Glitter, whose foals sleep in her bed, while four-year-old Henry has a whole gang of friends called Mr Nobody, Mrs I Don’t Know and Invisible Man. He talks to each in different voices and often invites them over for tea. What all these friends have in common is that they’re the inventions of bright and lively children who are exploring emotions and ideas using a concept that psychologists call 'paracosm', or what most of us would call 'imaginary friends'. Parents often worry when their children develop these imaginary friends, but it’s a very common phenomenon, and usually nothing to worry about. The imaginary friend can be a personified object such as a teddy bear, though often it’s an invisible companion. In most cases, the level of invention involved just shows how imaginative the child is; contributors to Mumsnet report imaginary friends who apparently live in their children’s tummies, have their own children, have to have their own seat in the car, live under the bed, hold long conversations or have their own dietary requirements. Eldest or only children are more likely to invent imaginary friends, boys invariably inventing male friends, while girls tend to have friends of either gender.


Developmental psychologist Marjorie Taylor of the University of Oregon studied the phenomenon in the 1990s. Her exploration of the relationship between imaginary companions and children’s social and cognitive development into adulthood challenges negative views of imaginary friends. Taylor’s studies were prompted by her experience with her own

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Marjorie Taylor’s influential book, Imaginary Companions and the Children Who Create Them, countered a lot of the stereotypes often attributed to children with imaginary friends, concluding that up to two-thirds of children have them, typically between the ages of three and eight

old Amber, who had an imaginary friend called Michael Rose. Taylor thought he was another child in Amber’s daycare class, until she was told that Michael Rose owned a barn full of giraffes. Taylor started professionally studying imaginary companions in the late 1980s, after attending a lecture by Harvard University psychologist Paul Harris. In his study, he presented an empty box to children and asked them to imagine that there was a monster inside. He raised the question whether children believe their imaginary friends are real. The study countered many historical attitudes to imaginary friends—that they were harmful or evil, signs of social deficit, or even aspects of mental illness or demonic possession.


The assumption that children who invent invisible friends might be lonely or have social problems isn’t supported by research. In fact, these children tend to be less shy, engage in more laughing and smiling with peers and do better at tasks involving imagining how someone else might think. Psychologists say it’s no cause for concern and can be a valuable coping mechanism during life transitions such as adjusting to a new home, school or sibling. It’s a technique for children to practice fledgling social skills in an environment where they’re in control— and sometimes for them to shift the blame for bad behaviour.

But do the kids know it’s a fantasy? Psychologist Kimberly Eckert says that creating and sustaining an imaginary friendship is a sophisticated cognitive skill. “Kids can separate what’s real life and what’s fantasy life. They know it’s pretend play,” she says—indeed most of the children interviewed in Taylor’s studies volunteered the information that their friends were ‘made up’.


Imaginary companions usually disappear by the time kids head off to school, when they usually grow out of the phase, though there are accounts of teenagers who retain them from childhood or who first develop them as teens. Having said that, the true paracosm—a detailed imaginary world, often involving its own geography, history and language—can be an experience that continues into later life. In an article in the International Handbook on Giftedness, Michelle RootBernstein writes about paracosm play as an indicator of high levels of intelligence and creativity, which may "supplement objective measures of intellectual giftedness ... as well as subjective measures of superior technical talent"— in other words, research suggests that creative kids, those most likely to become artists or programmers, have the most paracosmic activity. Indeed, adult writers often speak of their characters ‘taking on a life of their own’. So, if your child does have an imaginary friend, it’s probably a good sign and shouldn’t be discouraged. If you ask the child about their friend, you may learn something about their own interests, wishes and concerns. If it’s not too much trouble to set an extra place at the table or to leave space on the sofa, feel free to play along, but let your child be in charge of this unique and magical expression of their imagination. But don’t be afraid to put your foot down if behaviour becomes disruptive— for instance if they make a mess, it should be up to the child to clean it up, not their imaginary friend. hc Healthy Child with Dr Ranj Singh | 105

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22/02/2019 16:49


Coping and Hoping Dealing with childhood diabetes can be tough for parent and child, but will improving health technology make it easier to manage?

Top Tips for Managing Diabetes in Children ✎ Don’t pressure your child to do their own injections before they are ready. ✎ When they are, encourage them to take responsibility for their injections. ✎ Even when your child does their own injections, offer to do them yourself if they want you to. ✎ Monitor their technique to avoid them developing bad habits. ✎ Don’t inject into a site that they’ll use immediately, for example, don’t inject your child’s leg just before they play football.

Images: Shutterstock


ype 1 diabetes, a genetic condition in which the body’s immune system attacks the insulincreating cells in the pancreas, can affect anyone. The health implications are serious, as insulin is crucial in extracting energy from glucose—if the body doesn’t have enough insulin, energy levels drop and glucose in the blood builds to dangerous levels. Type 1 diabetics have to regulate their insulin level with injections of insulin. While this can manage the condition well, it’s a burden, particularly for kids, whose active lifestyle can make it difficult to impose an insulin management regime. Organisations such as www. have advice, manuals and training videos on how to handle injections for babies and children, and how to encourage their transition to

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doing it themselves once you and they are confident enough.


Using a disposable or refillable insulin pen, injections may be necessary four or more times a day, but there are more high-tech solutions that can make life easier. One is the insulin pump, which gives doses of rapid-acting insulin throughout the day and night. The dose can be adjusted according to eating patterns, or if blood sugar levels rise too high. The disadvantage of the conventional insulin pump is that children can find it a burden, as it is attached to them all the time. However, technology is improving constantly, and the latest insulin pump systems are more comfortable, lightweight and controllable. Some

are two-part systems with the pump small enough to be concealed under clothing and attached comfortably via an adhesive pad to any suitable part of the body. The pump delivers a basal dose of insulin throughout the day, while a separate wireless control handset displays blood glucose levels and can be used to control additional doses, display alerts and download reports. The advantage of two-part wireless systems is that they can be more comfortable to wear throughout the day, and as they don’t feature entangling wires, they can be worn while playing sports. In some cases, they are waterresistant, so your child can even wear them while bathing or swimming. So, while a cure for Type 1 diabetes remains elusive, technology may make it easier to manage for adults and kids alike. hc

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Hello Sunshine With summer around the corner it’s time to start thinking about a fresh new wardrobe to suit the sunshine (we’re hopeful!). whether you’ve booked a getaway or are enjoying time at home, we’ve got everything you need to take the kids through the season.

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Multi-colour stripe romper from £4.00 View more online: Tesco Stores Ltd r2.indd 1

01/03/2019 13:23

Blue neon spot jumpsuite from £9.00

Sun, Sea, smiles short set from £5.00 Dino drone short set from £5.00

2 pack floral playsuit from £10.00

Blue woven playsuit from £8.00

That’s not my flamingo romper rom £6.00

Mermaid ombre swimsuit from £7.00 Dino short set from £5.00

Purchase in-store at Tesco

Available in selected Extras & Superstores. Subject to availability.

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Parenting In Association with Tesco F&F

Images: Shutterstock

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110 | Healthy Child with Dr Ranj Singh

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Parenting In Association with Tesco F&F

Dress for Success Choosing the right clothing can make babies, children and their parents happier and healthier


uying clothes for babies and children can be a daunting task, particularly if it’s your first time. There are so many factors to consider—cost, fit, durability, safety and looks among them—that it can be hard to know where to start. For the first six months, concentrate on the essentials, and buy small quantities as you need them. Babies grow so quickly that they will outgrow most clothing as soon as it’s the right size to wear. To prolong its use, baby clothing should be bought at least one size larger than the baby needs at the time. It may look too large to start with, but this won't last long. When the baby is older, select clothing for the season when it will be the correct size. You can save money by buying out-ofseason clothes for the following year.

SeaSon changeS Make sure the clothes are appropriate for the season to avoid problems of cold in winter or overheating in summer. Warm onesies, socks, booties and hats are necessary for winter, but just because they look cute doesn't mean they’re suitable for summer. Onesies can be long- or shortsleeved, depending on the weather and can be layered under other clothing during cold weather. Cotton and synthetics are generally softer and more comfortable than wool. When you need to change nappies, it’s important to be able to remove outer clothes easily, so go for designs with elastic fasteners or Velcro rather than zips or buttons. It’s easier to dress

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in layers or two-pieces rather than onepieces for easy nappy changing.

Safe and Sound Safety is of course a priority—avoid anything with drawstrings, beads, sequins or any small pieces which may present a choking hazard. Easy laundering is another consideration—you can quickly accumulate a huge pile of laundry if your baby goes through a couple of outfits a day. Knitted clothes aren’t ideal, as they must be cold washed and hung to dry. Cotton has to be handled carefully too, as it can shrink if overheated. The Global Organic Textile Standard (GOTS) label means that every aspect of clothing production, from the chemicals used to the conditions in factories, meets stringent health and safety standards—for instance, GOTS certification guarantees that organic and artificial fibres are processed separately, that chemicals such as formaldehyde are not used, that bleaching is done with oxygen rather than chlorine and that certain types of dyes and solvents are not used. The GOTS standard also controls ecological and social criteria through the entire textile supply chain.

colour wayS If you buy unisex clothing, you have the possibility of reusing it if you have another baby. If you’re fed up of the traditional ‘blue for boys, pink for girls’ colour choices of some manufacturers, there’s now an excellent choice of gender-neutral brands for babies and children. There’s plenty of choice of colours, spanning monochrome to classic tones

or bold, fun styles, and prices to suit any budget, from independent brands to major retailers. For older children, sizing and fit are of course still crucial—take the child’s height and weight measurements with you when buying and continue to err on the larger side. The main factor in your choice should be practicality. Well-made, hardwearing clothes needn’t be expensive, and ironically, expensive clothes aren’t necessarily hard-wearing. Concentrate on soft, breathable fabrics which won’t cause itching or irritation, and for playwear, go for the most durable designs, with high-quality fabrics. Always check the workmanship— the quality of seams and stitching will give you an idea of how well items will last. This is particularly important for schoolwear, which you will want to last for a while.

Pretty Practical Choose designs which won't show stains, such as dark colours, or bright shades rather than pastels. Basics like T-shirts, shorts, sweaters and jackets with plain colours or limited patterning will outlast trendy designs and will be easier to mix and match. Consider shopping online if you are pushed for time and can find designs you like, but check the store’s return policy should the item not fit or not be well-received. Most importantly, make sure you consider what your child likes. Choosing clothes they love makes the fight to get them dressed that much easier and makes sure that you will get the best value from your clothing choices. hc Healthy Child with Dr Ranj Singh | 111

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4 REASONS TO CHOOSE INCH BLUE Made from soft leather, allowing feet to breathe and move without restriction Elasticated ankle, easy to put on and ensures shoes really do stay on Non-slip soft soles, ideal for toe gripping babies Original designs, hand-made in the UK PROUDLY CELEBRATING


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The discount code expires 31st August 2019. Not valid on previous purchases and no cash alternative is offered. Cannot be used in conjunction with any other offers. Discount code HCDR10 is to be entered in the basket on

13/02/2019 10:58


Taking the

first steps

r e b m e m e R

Learning to walk is a tremendous milestone in your baby’s life, but finding the perfect pair of walking shoes can be an overwhelming task for new parents


ongratulations, your baby has learnt to walk around at home with little or no support, and enjoys being outside. It’s now time to delve into the vast and confusing world of children’s footwear and select a supportive pair of shoes for your growing toddler.

Images: Shutterstock

A perfect fit Poorly fitting shoes can actually affect your infant’s foot bone development and muscle functionality. As little feet grow rapidly, it’s important to have your baby’s foot size measured and to purchase new footwear every quarter of the year. A general rule is to ensure that there is enough room for you to squeeze your little finger between your child’s heel and the heel of the shoe. There should be wiggle room in the toe-box for the shoes to move and rest comfortably, without being too big.

trendsetter According to the Royal College of

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Avoid used shoes A new shoe will adapt to your toddler’s developing foot, offering them more comfort and support than second-hand options.

Paediatrics, early walking babies should wear lightweight and flexible shoes that allow for natural foot movement and flexibility. Choose soft, breathable materials such as leather, cloth or mesh—your fast-moving tot will not enjoy the restrictions of clunky shoes—and seek out a toe-box that is wide and naturally follows the shape of the foot. There should be flexibility at the ball of the foot, but the shoes should have a stiff, padded heel to hold both the shoe

at the et swell Babies’ fe shoes e day, so end of th morning d in the e purchase ht in th l too tig may fee . evening

and ankle upright. Options that lace up or have Velcro fastenings will ensure a snug fit and will be easier to put on. You should also check that the bottom of the shoe has traction to prevent your little one from slipping and skidding. Go for non-slip leather or rubber soles, with grooves or bumps that will give your baby good stability.

suitAble And sAfe Once you’ve settled on the perfect pair of shoes, watch your baby closely for any signs that they are struggling to walk or that their shoes are uncomfortable. Check the feet frequently for any redness or indentations on the toes. Your toddler will likely need supportive walking shoes from the age of one—if your baby is crawling indoors, woollen socks, socktops, booties or soft pre-walking shoes are enough to keep their feet warm and protect them from rough surfaces. Wider fitting, soft shoes will give your pre-walking baby the most comfort and flexibility. hc Healthy Child with Dr Ranj Singh | 113

22/03/2019 11:04


Protecting Your Pets You’ve insured your house, your car and your health, but what about your pets? We consider the common-sense financial reasons for taking steps to protect Scrappy and Mr Tiddles


Like all insurance, pet insurance is a safety net to help you to cope with unexpected expenses, in this case, primarily, veterinary bills. The cost of pet insurance depends on the age of the pet and whether it has any pre-existing conditions. Cats, dogs, horses and ponies are easy to insure, though pedigree animals, which may be prone to hereditary or congenital conditions and are more likely to be 114 | Healthy Child with Dr Ranj Singh

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stolen may cost more. Exotic pets such as lizards, snakes and birds require specialist cover—and due to their short life-span, it’s rarely thought to be worth insuring gerbils, rabbits and hamsters, though cover is available. Venomous animals are difficult to insure, but you may want to take out public liability insurance covering them. Older animals can cost more to insure, but as they are often more likely to need medical attention, it is still worth considering cover. Some insurers will only let you take out a new policy if your pet is under eight or nine years of age, or younger for some special breeds No insurance policy will cover you for regular treatments including inoculations, but when looking for a suitable policy, it’s worth considering the value of certain types of additional cover, for instance: ✎ Loss or theft (which may include the cost of advertising a loss)

✎ Treatment for behavioural problems ✎ Death by illness or injury ✎ Dental care ✎ Third party liability cover (usually for dogs) ✎ Kennel or cattery fees, in case you are hospitalised ✎ Emergency cover when abroad ✎ Breeding risks related to pregnancy You will also have to choose whether to insure for accident only, or illness as well; on an annual or lifetime basis; and possibly for a particular condition, or number of treatments per year, or a combination of the two. Most policies specify a maximum to the vet fees covered, and many have an excess (the amount of a claim you agree to cover yourself). You might be able to save yourself some money by microchipping your cat, having your pet spayed or neutered, or taking out multi-pet insurance. hc

Images: Shutterstock


ets are just as prone to disease and injury as we are, yet they don’t have an NHS— other than a few overworked and underfunded charities, the owner is responsible for any pet health and welfare expenses. And health treatment can be expensive. According to the government’s Money Advice Service, the average claim for treatment costs is £750, and costs for treating severe conditions can run into thousands.

22/03/2019 11:04

Pet insurance with bags more Get


of Co-op Food vouchers with a new pet policy Ts & Cs apply* When new customers buy directly from Co-op Insurance Services. Offer ends 20/06/19.

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Pet insurance from Co-op Insurance Services is provided, underwritten and administered by Allianz Insurance plc. The policy has limitations and exclusions, so please speak to our call centre or view our policy documents online for more details. Additional exclusions may be placed on the policy for your pet. If applied, these will be shown on your pet’s Certificate of Insurance. Applicants for insurance are subject to normal underwriting criteria. Pet insurance is available for pets over the age of 6 weeks, or 8 weeks if from a licensed breeder. Cats must be under the age of 10. Dogs must be under the age of 8, or 5 if a select breed. *£20 worth of Co-op Food vouchers available to new customers who buy a pet insurance policy directly from Co-op Insurance Services on or before 20/06/19. Policies must start on or before 20/07/19. A new customer is someone who has not had a pet insurance policy with Co-op within the last 12 months. Your policy must be in force for a minimum of 30 days. Policies bought via cashback sites are excluded. Vouchers will arrive within 75 days of your policy start date. Vouchers accepted in Co-op Group Food stores and participating independent co-operatives. For full Ts&Cs visit Promoter: Co-op Insurance Services. Product Ts & Cs apply. ^ First year only, offer may be withdrawn at any time. New customers only. Allianz Insurance plc is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority under register number 121849. Co-op Insurance Services is a trading name of Co-op Insurance Services Limited; registered in England and Wales with registered number 4390. Registered Office: CIS Building, Miller Street, Manchester M60 0AL. Co-op Insurance Services Limited is authorised and regulated by the Financial Conduct Authority under register number 779364. Co-op Insurance Services is not part of the Allianz (UK) Group. Calls may be monitored or recorded for security and training purposes. Calling us on an 03 number will cost no more than a call to an 01 or 02 number,irrespective of whether you call from a landline or mobile. If you have ‘inclusive minutes’ with your package these calls are normally included,however you may wish to check with your service provider. Lines are open: 8am-8pm weekdays and 9am-1pm Saturdays.

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06/03/2019 10:52


What other parents say and it doesn’t just affect children:

Soft shoulders, knees & toes 1 in 5 children suffer from eczema. Did you know it can be made worse and even caused by hard water?

“My son has been growing out of his eczema, but since we have had our Harvey Water Softener it has certainly reduced. My wife also suffers with dry skin and has seen an improvement.” Adrian, Didcot, Oxfordshire. “A specialist at the hospital suggested hard water was the cause of my eczema after moving to a hard water area. I had dry, sore infections that meant I couldn’t do washing, cleaning or even bath my son. I lived with the painful condition for 10 years and didn’t think anything could help. I spent so much money on creams and treatments, but a water softener completely cured it for me.” Carly, Southampton

Eczema and hard water Baby’s soft, sensitive skin needs looking after. Something you think is helping, can actually be hindering. Hard water has been considered to be an affecting factor to eczema. When washing with hard water, bubble bath, body wash and soap don’t lather as well. Some of the product leaves residue on your baby’s skin, making it dry, itchy and in need of extra moisture. So, what if there wasn’t a need to use all those products on your little one?

What the experts found With the help of The University of Sheffield and King’s College London, a study proved hard water damages the skin, by raising the risk of infection and potentially contributing to the development of eczema. The high levels of minerals in hard water (calcium and magnesium ions) bind to detergents, making them insoluble, so they stick to skin. Skin is then more sensitive to irritation. When researchers used softened water, they found it reduced these negative effects.

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Using softened water can even lower the risk of eczema developing on skin in the first place. Imagine that - a life without all the trauma eczema brings. It’s not something your family have to suffer with. Softened water can alleviate the effect hard water has on precious skin. The benefits go beyond caring for eczema. Enjoy appliances that last longer, limescale free surfaces and cheaper bills from using fewer products. There will be more bubbles to play with at bath time, what’s not to love? Why not try our free demonstration and feel the difference of softened water for yourself? Take advantage of our 3 month trial. Visit or call 01483 910138. Eczema is a complicated condition with signs and symptoms that are different for everyone. A water softener may unfortunately not be the answer in some cases.

08/02/2019 15:11


A Hard Look at Water With over 13 million homes in the UK situated in a hard water area, water softeners can make washing and cleaning easier–but what exactly can this mean for your child’s health?


water softener is a unit that softens mains water by removing minerals such as calcium and magnesium—the causes of limescale build-up in your kettle. The benefits of softened water are said to be numerous, a major one being in dealing with the skin condition eczema, which is said to be encouraged by water impurities. According to the NHS, eczema affects at least one in every five children, and with increasing research suggesting that common irritants exacerbate the condition in children, should we be taking a harder look at our water?

HARD WATER AND ECZEMA While most infants eventually grow out of eczema, it is a very common, and often debilitating, condition that causes the skin to become dry, sore and inflamed. Hard water is said to damage the natural skin barrier and increase its sensitivity to irritants found in everyday products like soap

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or washing powder. It also deposits a ‘scum’ layer onto the skin, making it necessary to use more products to feel clean.

PROVE IT Interestingly, a Nottingham University study found that primary school children living in hard water areas were 50 percent more likely to have eczema than those living in soft water areas, and another Nottingham study resulted in 66 percent of participating families buying a water softener for their home, after 91 percent of the children surveyed reported less itchiness when using softened water. Over 80 percent of parents said that the water softener had reduced the severity of their child’s eczema and 67 percent of participants were using less emollients and steroid creams. While more research remains to be done, the potential of water softeners remains intriguing. hc Source: The University of Sheffield and King’s College London

Should I drink it?

Water softeners are not the same as water purifiers, and there is substantial debate about whether softened water should be consumed. Largely, this is due to the concern that drinking it will slightly increase the level of sodium in your diet

Other benefits for the family

✎ Smoother hair using less cleaning product

✎ Softer and cleaner laundry ✎ Less time spent cleaning scale and water stains

✎ Reduced damage to kitchen utensils and appliances

✎ Reduced soap build-up in cleaning devices

✎ Reduced damage to hot water heaters, pipes and faucets

✎ Lower monthly energy costs

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22/03/2019 11:05


Destination: The Perfect Family Holiday

Family holidays are the highlights of childhood memories, but jetting off with small children in tow can add stress to your well-earned break— particularly if the destination doesn’t meet your family’s needs


When travelling with children, there are many things to consider—like where in the world you’re actually going. As much as you may love the beach, scorching sands aren’t ideal for small children who dehydrate quicker than adults and need more protection from the sun. Your little one is also likely to resent a long-haul flight, so consider beginning with a less ambitious, low-stress journey when your child is younger. If you do 118 | Healthy Child with Dr Ranj Singh

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decide to go somewhere hot, ensure that your party is confident about sun protection measures and heatstroke prevention.


Now that you’ve settled on a location, you’ll need to think about the most suitable accommodation for your family. If your child is a fussy eater or is used to eating at specific times of the day, a selfcatered villa may be your best option. If they need lots of stimulation, a resort can offer kids’ clubs, play equipment and family-friendly entertainment. Check to see if the location caters to lots of young families and don’t be afraid to ask about the child-friendly facilities on offer. For example, it may be important for you to have a travel cot, a stair-gate, or babysitting services. Activities should be ageappropriate and any pools should have physical safety barriers.


When holiday hunting, be aware that

Child friendly destination ideas ✎ Norfolk Holiday Parks, UK ✎ Bluestone National Parks, UK ✎ First Choice Holiday Villages, Spain and Greece

✎ Thomson Family Resorts, Balearic Islands

✎ Olympic Lagoon Resort, Paphos ✎ Walt Disney World, Orlando ✎ Santa Holidays, Lapland and Finland

many operators are recognising the need for a more flexible family holiday. You can find specific trips intended for single parents, those travelling with grandparents, families that include children with special educational needs and disabilities, or groups with large age gaps between young members. hc

Images: Shutterstock


dapting your getaway priorities from soaking up the sun to locating the nearest playground—all while desperately trying to find something that your little one is willing to eat—can be stressful. While some operators are quick to use the term ‘family friendly’, this doesn’t necessarily mean that the facility has undergone the correct checks or meets your personal requirements as a parent. Here are some things to consider when choosing the perfect child-friendly holiday destination.

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BANZ® has been helping parents to protect precious little eyes, skin and ears for over 15 years. Banz’s original Australian designed wrap-around sunglasses for infants and kids is where the journey started! BANZ® have a UV rating of 400, which block out the entire spectrum of harmful rays and are 100% safe and free of any toxic chemicals. BANZ® feature a soft silicone nose & brow piece which is embedded into the frame for not only added comfort but to seal out all harmful rays. The frames are made from polycarbonate which makes them virtually shatterproof and the neoprene adjustable strap allows a perfect fit. Protecting little ones f rom environmental dangers is easy with BANZ® complete line of protection products. Tested to the highest safety standards worldwide, BANZ® products combine safety you trust with styles you will love!

To shop Banz® visit & receive an exclusive 25% discount & f ree P&P using code BUBZEE25 BanzWorld Eye Protection.Rev2.indd 1

18/02/2019 11:04


Baby, it's Bright Outside Ultra-violet light can be particularly dangerous to babies' eyes. We look at the smartest ways to keep them safe in the sun


e've looked elsewhere in this issue at the ways in which children's eyes are more vulnerable to damage from the sun than adults'. Fortunately, it's not difficult to get kids to wear sunglasses, as there are stylish, hardwearing models available which have fashion appeal and a sense of fun. But the dangers of UV exposure can be even greater for babies, and let's face it, you won't be able to explain to the tinies why it's essential to protect their eyes.


Images: Shutterstock

Because the cornea, lens and fluids are clearer in babies, and the pupil is bigger, allowing more light to reach the retina, UV light penetrating the eye can cause several short-term or long-term vision problems: ✎ Corneal sunburn or photokeratitis ✎ Pterygium, a growth on the white of the eye ✎ Macular degeneration, a leading cause of vision loss in older people ✎ Cataract, clouding of the lens ✎ Skin cancer around the eyelids Even on dull days, up to 80 percent of UV light can break through cloud cover, and in the conditions commonly encountered on holiday, such as snow or water, reflected light can present a danger to young eyes—particularly blue eyes, which are more at risk than brown.


to look for lightweight, durable, fitted designs that wrap around to prevent ingress of UV from the sides and which protect against both UVA and UVB light. Commonly available in a range of sizes, from 0-2 and from 2-5, baby sunglasses usually have adjustable elasticated headbands rather than earpieces, flexible frames and 100 percent UV protection. Also available are waterproof swim goggles with anti-fog properties, corrective lenses and even ski goggles with doublelayered, shatter-proof lenses and toughened frames. So, if you pick the right protection and make sure it's used when essential, there's no reason why you can't protect little eyes against the dangers of UV from day one. hc

BANZ for BABIES Before the age of around eight, children's super-delicate eyes lack a filter to block the sun's ultraviolet radiation. Inferior sunglasses without UV protection do more harm than no protection at all, as behind the tinted lens the iris opens up to allow in more potentially damaging light. Designed in Australia and tested by experts, free of toxic chemicals and 100 percent safe, Banz' UV rating of 400 blocks out the entire spectrum of harmful rays, providing ultimate comfort and protection for babies and kids. Banz' soft silicone nose and brow piece is embedded into the frame for comfort and to block harmful rays. The polycarbonate frames are virtually shatterproof, and the adjustable neoprene strap allows a perfect fit. Maintaining high levels of protection required to comply with rigid standards, Banz' expertise is supported by major investment and 16 years of supplying UV protection in 39 countries throughout the world.

The key to finding eye protection the little ones will be comfortable with is

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ORGANii sun range is suitable for the whole family from babies to adults and those with fair or sensitive skin. Containing Titanium Dioxide and Zinc Oxide to create a non-whitening mirror on the skin protecting the whole family from UVA and UVB rays.

SPF 30 Sun Cream

SPF 15 Facial Sun Cream

SPF 20 Sun Milk


SPF 50 Sun Milk


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Moisturising After Sun Cream

Available from organic health stores, pharmacies and online.

28/02/2019 16:10


Fun in the Sun

All sun creams aren’t the same—there’s a debate going on about which type is most effective and safest for the environment

Images: Shutterstock


hile it’s now well understood that ultra-violet rays can cause damage to the skin and that sun protection is an essential health issue, there’s still some debate about what types of sun protection are the most effective and healthy for adults and kids. While no single product can offer complete protection from sun damage, it’s worth knowing that sunscreens fall into two main categories. Chemical types absorb ultra-violet rays, while mineral sunscreens, usually containing titanium oxide or zinc oxide, reflect the harmful rays away from the skin. Zinc oxide paste has been used as sunscreen for thousands of years, but with the introduction of chemical sunblock, mineral types, though just as effective, fell out of use as they tend to leave white streaks. Also, they aren’t very suitable for use as sprays, as zinc oxide and titanium oxide can

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cause lung damage if inhaled. However, modern nanoparticle technology has revived the fortunes of mineral sunblocks, which can now be made with smaller particles of reflective agents, leaving less visible streaking.

ENVIRONMENT Ingredients in chemical sunscreens can cause significant damage to the marine environment, particularly coral reefs, and it’s estimated that 25 percent of sunscreen ingredients we use end up in the sea. Some states are banning the use of certain chemicals in sunblocks— Hawaii has implemented a ban on oxybenzone and octinoxate, effective from January 2021, and Key West in Florida has followed suit. Other chemicals, such as octocrylene, octisalate, avobenzone and homosalate have also been identified as potentially dangerous to eco-systems, and there are suggestions that they

The British Associati Dermatologists reco on of m ends using sunscreen witm Sun Protection Fact h a minimum of 30, wh or of a 97 percent of UVBich blocks put that into context, rays. To blocks 93 percent, an SPF 15 50 blocks 98 percednt.SPF can penetrate human skin and disrupt hormone functions. On balance, it seems that mineral sunscreens offer the sensible choice for both health and environmental reasons—but if you’re not convinced, there are alternatives even to these, in the form of organic sunscreens made using seaweed extracts. But perhaps the one argument that may sway you is that mineral sunscreens are effective immediately on application, unlike chemical sunscreens, which take around 15 minutes to be absorbed into the skin. When you have active kids who just want to get out on the beach, that might just make all the difference to your choice of sunscreens! hc Healthy Child with Dr Ranj Singh | 123

22/03/2019 14:37


A t n a W ’t n o D ‘But I ’ ! ) r e t s i S r (o r e h t Baby Bro I

f you’re wondering when you should tell your child that they’re going to have a new baby brother or sister, the answer is, as soon as you tell anybody else, even if your child is too young to understand. Secrets have a habit of slipping out, and you don’t want a friend or family member unwittingly asking your child if they are excited about their new sibling. Depending on your child and their age, this huge change can be hard to

124 | Healthy Child with Dr Ranj Singh

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handle. Here’s how to make things a little bit easier for them and for you.

THE BIG MOMENT Sit your child down and explain the arrival of the new baby in ageappropriate terms—for example, they might gain more understanding if you say the baby will arrive ‘near Christmas’ rather than ‘in seven months’ time’. Describe how the baby is growing inside mummy, and invite your child to ask any questions

they may have—a child who wants to know more will usually ask, whereas younger children may not have much interest or understanding. You’ll need to explain that the newborn won’t become a playmate straight away. Emphasise this by telling your child that they can help you with the many needs that the baby will have, making them feel involved. Other great ways to encourage your child to take an interest in the pregnancy include:

Images: Shutterstock

You’re apprehensive, you’re armed with a new toy and the words ‘sibling rivalry’ are going round and round in your head—it’s time to tell your child they’ll soon have a little brother or sister

22/03/2019 11:20


Did you know? Sibling rivalry is more common among children who are the same gender and close together in age Source: BetterHealth Channel

✎ Reading age-appropriate books about childbirth or becoming a sibling. ✎ Going through your older child’s baby pictures and explaining that they used to do all the things that the new baby will be doing. ✎ Continuing to give your child plenty of attention and ensure that they spend time with family members, such as dad or grandma, who might be looking after them while mum rests or recovers. ✎ Visiting friends who have infants. ✎ Taking your child to sibling birth classes. These are usually offered at hospitals to provide explanations on how a baby is born, lessons on how to hold a baby and opportunities for children to discuss their feelings. ✎ Thinking of potential baby names together. ✎ Going to the doctor so that your child can hear the baby’s heartbeat.

BRINGING BABY HOME As your due date draws nearer, make sure your older child knows what to expect and where they will be when

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the day arrives. If the birth is going to require you to change your child’s routine, introduce these upheavals in advance. Try to always keep your child’s bedtime consistent, but if you need to move them into a new bedroom or cot for example, allowing them plenty of time to adjust will make the change feel exciting, rather than like they’re being replaced. When the new baby arrives, have someone bring your older child for a visit as soon as possible—allow someone else to hold the baby too, so that you can have cuddles. You could also consider giving them a gift from the baby, such as a T-shirt that says ‘Big Sister’ on it. Speaking of gifts, your child’s home will likely become disrupted by friends and family members showering your newborn with attention. Remind visitors to spend time with your older child and encourage them to talk about something other than becoming a sibling. Of course, your child needs special

time with you, too—try to set aside time each day for them to have your undivided attention, and include them as much as possible in daily activities concerning the baby. Depending on their age, a big brother or sister can entertain the baby during a nappy change, help to push a pram or rock a cot, sing to the baby, and help dress or bathe them under your supervision. If your child expresses no interest in the infant, don’t force it. It can take time for your child to feel okay about this big change, just make sure to reassure them and remind them that you love them just the same as before.

ACTING OUT Even adults can find it difficult to accept change, so remember to cut your child some slack if they’re acting out or regressing—this is definitely normal. Some children may relish having newfound responsibilities and others may literally ask you to send the baby back to the hospital. Your child may also revert to speaking in baby talk, sucking their thumb or wetting the bed at night, and this very normal—eventually, they will adjust. Instead of bending the rules, encourage your child to talk about their feelings surrounding the new baby. Jealousy could be a sign that your child needs more one-on-one time with you. Try not to feel like you’ve let your child down, just give them time and be understanding. hc Healthy Child with Dr Ranj Singh | 125

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he air in your home may not be safe. Indoor air can contain more than 900 potentially harmful chemicals (www.myhealthmyhome. com), causing respiratory, allergic and heart disease. The Royal College of Physicians attributes 9,000 UK deaths to indoor air quality annually. Professor Jonathan Grigg of the Royal College of Paediatrics and Child Health is leading a major study on the issue (RCPCH, Effects of indoor air quality on children and young people’s health, 19/06/18). He said: ‘The potential for indoor-generated air pollution to cause major health effects in children cannot now be ignored.’

What is indoor air pollution?

Indoor air pollution is a build-up of chemicals from sources including the stove, toiletries, cleaning products, paints, soft furnishings, building materials and mould. Fortunately, you can find out if your air is healthy and improve it if it’s not.


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Carbon dioxide: A build-up of CO2 indicates ventilation problems, and can cause headaches, confusion and fatigue.

✎ Formaldehyde: Formaldehyde, found in plywood and MDF, paints, plastics, cosmetics and synthetic fabrics, and as a by-product of cigarette smoke, gas stoves and space heaters, is a known carcinogen, and is associated with asthma, depression, dementia and skin irritations. ✎

Volatile organic Compounds (VoCs): Emitted by products with a nice smell, like cleaners, candles and air fresheners, VOCs are also found in alcohol wipes, mattresses and drycleaning, and cause allergy symptoms like rashes, stuffy or runny noses and irritated eyes.

temperature and humidity: Overly dry environments can cause eye and skin irritation, while damp homes are prone to mould. Cold homes can cause respiratory illness and depression, and overheated homes are also a growing problem. Two weeks after Airtopia’s visit, you’ll receive an easy-to-understand report on your air quality, and recommendations to solve any problems we find. The result? A positive impact on your family’s health.

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Clearing the air O

utside the home, irritants such as traffic pollution, smog, ozone and pollen can all degrade air quality. Many of these are lessened indoors, but unfortunately other irritants, including volatile chemicals, can be an even greater problem in your home. In 2018, London Mayor Sadiq Khan commissioned a report on indoor air quality in London’s schools. The Indoor Air Quality Report found that the average person spends over 90 percent of their time indoors, but tends to be far less aware of indoor air pollution than outdoor air pollution.

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The report concluded that the UK has the highest prevalence of childhood asthma out of all European countries, with indoor air quality playing a particularly crucial part, as it “may affect the health, performance and comfort of school students and staff.”

CAUSE AND EFFECT Of course, conditions can be just as bad in the average household, with allergens such as moulds and house dust mites worsening symptoms usually associated with asthma including wheezing and shortness of breath. The likely risks depend a great deal

on the age of the building. Older houses can contain various types of airborne mould, lead in house-dust and even arsenic in Victorian wallpapers. But modern houses can be equally at risk— from fragrances, chemicals from fireretardants, paints and other substances. Other indoor problems include natural emissions of radon gas which can produce radioactive particles; dust mites, a major cause of allergic reactions; formaldehyde, which is used in the manufacture of wood products such as MDF and particle boards; and pet hairs and skin particles. Even if you don’t have a pet in the house, these and other pollutants can be tracked in from

Images: Shutterstock

Outdoor air pollution is a serious problem, particularly in urban areas, but poor air quality can affect health and comfort in the home too. We look at what you can do to improve conditions indoors

22/03/2019 11:20

Parenting outside, and because modern houses are often sealed by double-glazed windows, the pollutants can’t get out. Children, asthma sufferers and the elderly may be particularly sensitive to indoor pollutants, but anyone may suffer long-term effects on health after long exposure. Fortunately, there are plenty of steps you can take to improve air quality in your home.

EXCLUSION Your first aim should be to prevent pollutants getting into your home. A large door mat at every entrance will encourage visitors to wipe their feet, and will remove a lot of pollutants even if they don’t. A policy of removing shoes and leaving them on a rack by the door will prevent a lot of pollutants being tracked around the house, and wearing slippers in the house also reduces wear and tear on floor coverings. Though formaldehyde is a naturally-occurring chemical, exposure to high concentrations of man-made formaldehyde vapours can produce symptoms such as headaches, eye irritation, asthma, breathing difficulties, nose bleed, sore throat, fatigue, insomnia, joint pain, nausea and vomiting. Formaldehyde emission from wood products will reduce over time, but remember it is also found in air fresheners, paints, plastics, pesticides, cosmetics, leather goods, adhesives, resins and synthetic fabrics, so eliminate these from the home where possible. It’s also a combustion byproduct of cigarette smoke and of fuelburning appliances like gas stoves and space heaters, so make sure these are properly vented.

REMOVAL A good way to reduce air pollutants is to remove them from surfaces, and here, a good vacuum cleaner is essential. Good models often incorporate HEPA

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(High Efficiency Particulate Air) filters. Consisting of mats of randomly arranged fibres, HEPA filters should capture 99.97 percent of particles that have a size greater than or equal to 0.3 µm, so they are good for removing lead particles, pollen, pet dander and dust mites. This is of particular benefit to asthma and allergy sufferers. Regular vacuuming should concentrate on high traffic areas, not forgetting walls, carpet edges and upholstered furniture, where dust accumulates. Follow up by mopping with plain water and a microfibre mop, and wash out vacuum filters regularly. It’s also worthwhile to fit extractor fans, to use in the kitchen when cooking and the bathroom when using aerosols.

maintain the atmosphere’s moisture content at a healthy level, can also display real-time air quality. A combined air purifier and humidifier will do both without spreading bacteria, dust or wet patches. For the wellbeing of you and your children, good air quality is an essential requirement, and one that can offer you all benefits in terms of health, mood and even lifespan. hc


PURIFICATION Air purifiers and humidifiers can really help to improve air quality. Purifiers (again often incorporating HEPA filters) can remove most allergens from the air, and models with a high CADR (Clean Air Delivery Rate) can clean a room’s air in minutes. Some have real-time colour or numerical displays of allergen levels. Humidifiers, which will automatically

Houseplants are a great way to scrub your air clean. A NASA study concluded that fig trees, ferns, bamboo, spider plants and ivy are among the most effective.

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The School of Life


ociety today values academic achievement more than ever, and success in life can be defined by exam results and university placements. So, it’s become more important, and more challenging, than ever to find the right school for your children. Whether you are settled where you live, or whether you are willing to move in order to get your children into the catchment area of a good school, it can be difficult to find comprehensive information.

ADMISSIONS A good first source is the website, which has information on subjects including admission criteria, application procedure and waiting lists. This website will also help you to find your local authority’s information on applications, Ofsted 130 | Healthy Child with Dr Ranj Singh

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reports, league tables, exam results, special educational needs policy and curriculum. This works well if you know what location you are looking for. It’s sometimes helpful to look beyond the Ofsted reports, which can be unrevealing, and to consult the Ofsted Parent View website for a wider range of opinions.

SCHOOL MAPS A more comprehensive source of information if you are undecided on location is a ‘schools map’ type website. Here, local primary, secondary and independent schools are all displayed with Ofsted ratings and catchment area as you hover your mouse over a map. You can then dig down for more information including school league tables, transport links, local amenities, points of interest and even houses for sale in the area.

If a school has converted into an academy, it’s often possible to find ‘pre-academy’ ratings on a school map website; you can then compile a shortlist of possibilities to help you make your final decision. Here are our some of our top tips for navigating through the school selection process. ✎ Remember you have to supply a list of choices of primary school—The Good Schools Guide advises parents to include at least one where you are virtually sure of getting a place, even if it isn’t you first choice. Otherwise, you risk being offered an undesirable, under-subscribed school some distance away. ✎ Bear in mind that becoming an academy will not necessarily improve a school’s standards. In 2017, research by the Education Policy Institute found the lowest performing primary and secondary schools were in academy groups. ✎ If you are looking for a grammar school, remember they do not all have ‘grammar’ in their name. Likewise, many schools with ‘grammar’ in their name are actually fee-paying independent schools. ✎ If you think you can’t afford a private school, enquire about meanstested bursaries or scholarships. Almost a third of pupils educated in the private sector receive financial assistance. ✎ If you think your child is educationally gifted, ask for the school’s policy on gifted pupils, and contact the charity Potential Plus UK (formerly the National Association for Gifted Children) for help and advice. hc

Images: Shutterstock

Choosing a school for your children can be as stressful as doing an exam—here’s our revision guide to help you score top marks

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