HEALTHY CHILD WITH DR RANJ SINGH
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Healthy Child with Dr Ranj Singh
Keep Your Kids Safe On The Internet
The Ultimate Guide to Pregnancy Planning
Your Best Pregnancy Diet
The Ideal Regime For You And Your Baby
Best Care For Bumps And Grazes
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Make Th Snack eir s Super Healt hy
GUEST EDITOR DR RANJ SINGH
Discussing the essentials for kids’ health with the TV doctor
AUTUMN 2019 | £3.99 ISSN 1758-597X
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4 | Healthy Child with Dr Ranj Singh
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Dr Ranj Singh
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here’s a lot to worry about when you’re a parent or about to become one— sometimes it can feel as if there’s nowhere to turn for reliable information about health and safety matters. With fake news and disinformation causing confusion and headlines about shortages appearing every day, it’s quite common to feel that it’s too much to cope with. The good news is that there are essential resources out there, ranging from the NHS to charities—and now there’s a new website, Minute4Kids, where you can find informative podcasts on a whole range of health and welfare issues. Find out more about it on page 98. Elsewhere in this issue we’re going to be tackling some of the most pressing issues in pregnancy, babycare and child health. What can you do about fertility problems—is IVF the only way out? Are you worried about vaccinations? We’re busting some of the myths about protection against childhood diseases. How can you keep your kids healthy and well-fed in a world full of junk food and sugary snacks? We look at ways you can make your own baby food and provide your children with tasty, nutritious school lunches. We’re also looking at the rise in cord blod banking, the surprising sources of many childhood injuries and the best ways to keep your kids safe online. All this and more in the packed pages of Healthy Child, telling you all you need to know to help your kids grow up to be safe, happy and healthy. hc
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Toys For Teaching
Monitor Your Minors
How should your baby’s motor skills be growing, and how can you encourage them? See here for the latest thinking Babies and children really can learn from their toys, and now there are plenty that are fun as well as educational Worried about your sleeping babies? Keep an ear and eye on them with this selection of high-tech solutions
Dr Ranj Singh, leading paediatrician on ITV’s This Morning and CBeebies’ Get Well Soon programme, talks to Chris Jenkins about developments in fertility treatments, the importance of childhood vaccination, the worrying decline in oral health and the dangers of air pollution and allergy
Pregnancy & Early Years 12 What’s New? Kids’ Health Today
All the latest facts and statistics from the world of children’s health
15 Vacuum Free Feeding
Are a lot of feeding difficulties down to the way bottles are designed?
17 Post-Partum Hair Loss
It can be unexpected and distressing, but hair loss after giving birth isn’t uncommon
32 Cord Blood Banking
Why are more and more parents opting to freeze their babies' blood and tissue?
Eye Care, You Care
Preventing Pram Problems
The Sporting Life
34 The Ultimate Guide to Fertility
Many couples find it hard to get pregnant, but there’s plenty you can do to understand the problems and improve the situation
41 Secondary Infertility
Even if you have conceived once, there’s no guarantee it will be easy the second time around; secondary infertility presents its own problems
42 Make Your Own Baby Food
You don’t have to be a culinary genius to make your own baby food, and there may be advantages in terms of cost and your baby’s dietary health
18 Your Pregnancy Diet
Is it true that you have to eat for two? Not entirely, but our guide to the best diet to ensure a healthy pregnancy
22 Managing Kids’ Medicine
It can be hard to manage medication for kids, particularly if they suffer multiple conditions, but here are some ways to ease the burden
24 Vitamins, See?
We all know that vitamins are essential to growth and development, but have we been getting the right stuff?
28 Winter Warmth
Nothing’s more essential to health than keeping your house warm, but how do you do it without spending a fortune?
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How medical science is improving outcomes for babies born before term Why it's essential to look after young skin if you want it to remain smooth and supple Equally important is the health of your children’s eyes. We look into the measures you should take to protect young peepers There are a lot of myths about safe sleeping procedures, but we bring you the facts about safer slumber Health fad, or diet essential? Is the trend against gluten based on science or superstition? We break down the facts There are so many types of pram, buggy, stroller, pushchair and baby carriage out there, it’s no surprise that it’s difficult to choose the right type Confused by car seats as much as you were puzzled by prams? Again, we have all the answers in this great guide to the regulations, choices and options Kids are accident-prone, it’s true, but there are plenty of things you can do to make their lives safer It can be dangerous for kids participating in sports from ball games to horseriding. But you might be surprised to find out the most dangerous sport of all…
IMAGES © Shutterstock
6 Keeping Kids Healthy and Happy
All in the Mind?
109 Keeping in Touch
112 Parasite Peril
Are Our Kids Getting Sicker?
Mental health provision for the young is under the spotlight, with shortages affecting the well-being of kids all over the country. Though smoking is on the decline, kids can be particularly badly affected by second-hand smoke – how do you keep them safe? A recent report compares children's health in the UK with other European countries why do we come off so badly?
With the UK losing its measles-free status, are we forgetting the importance of vaccination?
Growing Up 89
We open wide and find about the long-term benefits of orthodontic treatment, and why there’s more to it than just maintaining a sparkling smile
It's important to keep your child's teeth clean, but are you setting the best example? Children can be particularly prone to skin irritations such as eczema, but with a little background knowledge you can learn to deal with this and other common conditions
Sense and Learning
Is the multi-sensory approach to learning a new way to unlock the potential in all of us? With the help of Dr Ranj Singh, an exciting new website is bringing you bite-sized podcasts with all the information you and your kids need on health issues that matter
101 The Vital Vitamin
Why is Vitamin D so important, what happens if we’re short of it, and what can we do to get it? Our guide to this dietary essential explains just why you should catch the ‘D’ train
Parenting 103 Feet, Don’t Fail Me Now
Going back to school can be tough enough without your footwear letting you down—we look at the top trends in sturdy shoes
105 Tough Togs for Tots
Weatherproof clothing for school and play is top of the agenda when the summer wanes— we look at some of the most practical choice
107 The Lunch Bunch
How do you pack a healthy lunch box for the kids without turning them off their food?
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When the kids are out and about, do you worry about keeping in touch? Now there’s a new type of technology which makes it easy Ticks, fleas, ringworms—all sorts of nasty creepy-crawlies are waiting to feast on our children’s tender flesh. What can be done to keep them safe from the blood-sucking hordes?
116 Pet Parents
We love them, even though they're not clean—with more and more of us keeping pets, how do you maintain a clean and healthy home?
119 A Dog’s Dinner
Feeding your pet healthily is one of the main responsibilities of animal care. What should we look for in their diet?
121 A Christmas Break
Fancy going away for Christmas? You’d better decide whether you want snow and Santa, or sea and sun
123 Live and Learn
Support for children with learning difficulties can make all the difference to realising their potential.
126 Keeping Safe Online
Kids think of the internet as a wonderland of potential, but they might not understand the risks. We look at ways to protect them as they wander the ‘wild west’ web
129 Lovely Laundry
It sound straightforward, but keeping your laundry clean is not only a health essential, it should also be a part of your household economy drive. We hang out a few essential tips
celebrity PUBLISHER & CEO Kevin Harrington EDITOR Chris Jenkins SUB EDITOR Elika Roohi ART EDITOR Jason Craig EDITORIAL ASSISTANT Robyn White 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 and Happy
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Dr Ranj Singh, paediatrician on ITVâ€™s This Morning, talks to Chris Jenkins about the shortfall in mental health provision for young people, advances in fertility treatment, the importance of vaccination in preventing the spread of childhood diseases and lots more
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Q. There has been a lot of discussion recently about the lack of provision of mental health services for the young. What do you think is needed, and what can we do to monitor our children’s mental health? RS: Children and young people’s mental health services have been chronically underfunded, much like other areas of the service, and in many places sadly funding continues to be cut. This means that those in need struggle to get help, and there is increased pressure on schools, families and other services to pick up the slack. While there is no replacement for specialist mental health care, there are things that we can all do to reduce the chances of getting to a point where that help is needed. This includes early intervention when there is an issue to prevent it getting worse, support in schools for children in need, help for parents to teach them how to support their children at home, and using newer technologies (e.g. apps) to provide help and support.
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Q. Recent news regarding advancements in fertility treatment has provided hope to older prospective mothers, yet equally there have been suggestions that fertility treatments can sometimes be exhausting and expensive, with little prospect of success. What do you feel is the future of fertility treatment? RS: The fertility industry is a huge market with so many different options available to people hoping to get pregnant. However, it must be remembered that the chances of success are still relatively low, and for many of the ‘treatments’ there may not be very much evidence that they actually work. This is an industry that’s in urgent need of better regulation to prevent exploitation of people desperate to get pregnant. I hope that in future, fertility techniques on offer will be more evidence-based and there will be better rules and regulations to prevent customers being taken advantage of. We may find in the future that the NHS is able to
offer less and less of these therapies, and therefore better regulation is even more important. Q. Apart from obvious steps like stopping smoking, what advice would you give to women pregnant for the first time to ensure they have a safe, smooth and comfortable pregnancy? After birth, do you have any tips to make the first few months easier, and to cope with conditions such as hair loss? RS: Firstly, look after your general health prior to becoming pregnant, which includes taking pre-pregnancy vitamins like folate (if the pregnancy is planned). Then try to maintain a healthy lifestyle during your pregnancy, which obviously includes cutting out things like smoking, keeping alcohol to a minimum, ensuring you eat well and get a bit of exercise. It’s vitally important to be registered with a GP and midwifery service so that you can have all the relevant tests, monitoring and scans
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to keep you and your baby well. As much as it is important to look after yourself physically, you should also pay attention to your mental health. Try to use your support network around you or speak to a health professional if you are worried or struggling—especially after the birth of your baby when your mental wellbeing is really important. Make time for yourself and your baby in the first few months, pay particular attention to your sleep and nutrition and don’t be too hard on yourself if things don’t work out as you imagined. Every baby is different and sometimes the best plans don’t always work out! Q. How important would you say it is to keep up with vaccination programmes? Is there any sound reason as to why parents should be reluctant to have their children vaccinated against common childhood diseases?
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It’s vitally important to be registered with a GP and midwifery service so that you can have all the relevant tests, monitoring and scans to keep you and your baby well RS: One of the biggest advances in child health worldwide, after improved nutrition, sanitation and the advent of antibiotics, is vaccination. Currently it is one of the best forms of protection against preventable diseases and is recommended by multiple health organisations worldwide, including the WHO. It is vitally important that we keep up these vaccination programmes otherwise disease which have been eliminated will
re-emerge—the UK lost its measlesfree status in 2019 for this very reason. Some of these conditions can become extremely serious and even result in death, so all parents should consider getting their children vaccinated fully. I understand that some may be reluctant because of fears over adverse effects, but much of this hesitation is funded by fake vaccine news spread on the internet. Vaccinations are very safe for the majority of people and that is why the majority of health professionals recommend them. If you have questions make sure you go to a reputable, approved source for information. Q. Oral health in the UK seems to be going in reverse, with reports of rampant decay and extractions in children – what can we do to encourage children to follow good oral practices, and what can orthodontics do to correct some of the most common problems?
Images: Shutterstock; Courtesy of Talent4Media
Interview RS: Sadly, dental health seems to have become neglected somewhat and many parents aren’t aware of the importance of looking after their children’s teeth or getting them checked regularly. The increased consumption of sugary food and drinks amongst young children has also played a huge part. Currently dental extraction is the most common reason for a child under 5 to be admitted to hospital for a general anaesthetic and that should serve as a wake-up call. As well as limiting sugary food and drinks, make sure that you get children practising brushing using a soft brush as soon as teeth start coming through, and take them to the dentist before their first birthday to get them used to it.
Stress and anxiety are major causes of distress in young people, but social media only contributes a small amount
can’t police the internet or stop young people using it, but we can give them the skills to cope and provide them with a source of help and support if they ever need it. Q. Bringing up a child with learning difficulties can present particular challenges. What sort of help can parents hope to get from the state, and what more could be done to improve the situation for them and their children?
Q. Social issues can cause children a great deal of stress and anxiety. Can we lay the blame entirely at the feet of social media? What can we do to encourage the healthy use of the internet and ensure children are kept safe online? RS: Stress and anxiety are major causes of distress in young people, but social media only contributes a small amount. There is so much more in a child’s life that can have an impact on them, including: home environment, school environment, poverty, relationships and friendships, parental health and peer pressures. The internet can worsen issues, but can also be a source of great comfort, support and information, so we should not treat it as the bad guy. What we should do is educate children as to the benefits and potential dangers of being online, including asking for help when they feel troubled. This can start at home, but will hopefully be continued at school with the introduction of mandatory PSHE lessons. Part of the aim of these lessons is to teach about online safety and also dealing with things like cyberbullying. We
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It is vitally important that we keep up vaccination programmes otherwise diseases which have been eliminated will re-emerge where certain services, equipment or treatment may not be readily provided, but that depends very much on the individual child’s needs and what provision there is in your area. Your
paediatrician should be able to help in finding what is available and suitable to you and how you can get it. Other than that, we can all play a part in advocating for children with extra needs to make sure that services are as good as they can be, which may mean getting involved in campaigns etc. Q. There’s been a lot of talk recently about poor air quality caused by pollution, increases in asthmatic conditions and the effect of secondary smoking on children. Is there anything we can do to help? RS: There is actually good evidence that increased pollution contributes to various respiratory conditions, especially asthma. Children with asthma who live in areas where
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RS: Any parent or family who has a child with extra needs will tell you that it poses lots of challenges, and sometimes can be very hard work, but is rewarding beyond belief. So having a child with learning difficulties doesn’t necessarily mean that you will struggle, but you may have to adapt various parts of your life because of their extra requirements. Fortunately, in the UK, children with special needs are usually under the care of a specialist paediatrician from early in life as well as a range of other health professionals (e.g. physiotherapists, occupations therapists, speech and language services), depending on their individual needs. There may also be some special provision from schools too. In addition, there are various charities that can offer information and support. There are occasions
Interview there is a lot of traffic pollution are more likely to have exacerbations, and these can be severe. Firstly, it’s especially important for these children and families to be on top of their treatment and know when to step it up or seek further help. Secondly, we have a societal responsibility to reduce the amount of air pollution we produce (especially near schools) either by adapting vehicles to make them greener or not using them altogether. I’m very much for making areas around school as traffic-free as possible. Schools can help by installing more ‘green-walled zones’ to improve air quality and reduce pollution getting to them, and there have been many successful pilots of this. Q. Is a clean home a healthy home? Should we try to keep everything spotless, or is there something to be said for the ‘Dirt is Good’ philosophy for developing healthy immune systems? RS: The jury is still out on this one, but it is likely to be a matter of balance. Cleanliness and hygiene are really important to prevent the spread of disease. We all know how quickly children can pick up and spread infections, and some—like the flu—can be really serious for the whole family. Hygiene is also really important in limiting diarrhoeal and vomiting illnesses too, which can have a massive impact on households. However, at the same time, we need to allow our children to be exposed to everyday challenges so that their immune systems are primed to cope. This doesn’t mean keeping your children dirty, but perhaps not being too obsessive with sterilising everything (apart when it comes to things for small babies) or keeping everything spotless. It’s about being realistic.
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Q. Is childhood obesity really the epidemic we have been led to believe? What’s a sensible approach to diet and exercise that we will actually be able to get kids to stick to? RS: Childhood obesity is probably one of the greatest challenges we face in terms of long-term child health at present and mustn’t be underestimated. One in five children entering primary school are overweight or obese which rises to one in three when they leave it. We have a window of opportunity there to do something and we must start early. It’s important to get children learning about healthier choices from a young age, but you don’t have to deprive them of ‘treats’. It’s all about eating sensibly and in moderation, which includes giving appropriate
portion sizes. We should work to reduce excessive consumption of sugary and fatty foods though, and at the same time to increase physical activity levels. This can be done in a fun, engaging way at both school and home. The daily mile is an excellent example of getting kids more active in school. Similarly, parents should try getting involved in outdoor activities with their children which is good for the whole family. We also need to do something about the obesogenic environment that families live in. That means making healthier food cheaper, helping families to make better choices, curbing advertising and promotions on unhealthier food and educating people on what may or may not be better for them. This also means supporting less well-off families so that they have access to the same things as others. hc
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rs Health Today
100% sugar sweets will be banned if proposals by Public Health England are approved. High sugar content sweets—which include favourites such as Jelly Babies, Sherbet Lemons and Parma Violets—could be taken off shelves under proposals intended to combat child obesity and tooth decay. The goodies most affected would be boiled sweets, fudge and liquorice allsorts, which are mainly sugar.
Kids' Health adults and children died from asthma attacks in England and Wales in 2018, and charity Asthma UK blames air pollution and a lack of basic care, such as inhaler checks. Deaths from asthma in England and Wales are the highest they have been in more than a decade, having increased 17 percent since 2013. In 2018, 20 children aged under 14 died from asthma, up from 17 in 2017 and 13 the year before.
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children’s lives are being negatively affected by their use of social media, a report in The Lancet concludes— but mainly because it stops them from sleeping and exercising. The study examined 12,000 teenagers at school in England over three years, from the ages of 13 to 16. Nine out of 10 teenagers use social media and there is growing concern about its impact on mental health and wellbeing, but evidence still remains contradictory because of a lack of long-term data. The researchers suggest that parents should ban social media use after 10pm and encourage more physical activity.
of savoury snacks such as olives, pasties, sausage rolls and quiches are ‘dangerously high’ in salt and saturated fat, reports Action on Salt, and many do not have any colour-coded health labels. Professor Graham Macgregor said, “Reducing salt is one of the most cost-effective measures to protect health.”
years is the difference in life expectancy between a boy born in 2018 in one of the most deprived areas of Scotland and a boy from the most affluent areas. The gap for girls is 9.6 years, as shown in figures published by National Records of Scotland (NRS). Life expectancy in Scotland has been the lowest of any UK country since 1982, and the NRS report puts this down to poor general levels of healthcare.
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3 major social media companies— Google, Facebook and Pinterest—have been approached by the American Academy of Pediatrics to help combat vaccine misinformation online. Childhood diseases such as measles are spreading in the US due to a decrease in vaccination rates, and paediatricians are worried that their efforts are no longer enough. The AAP says there is plenty of evidence that vaccinations are safe, but misinformation online is putting children’s health and even lives at risk. Healthy Child with Dr Ranj Singh | 15
Enhanced vent system
Enhanced bottle design clinically proven to reduce windy colic with Dr Brownâ€™sÂŽ unique 100% vacuum-free vent system Prevention is Better Than Cure!
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Colic - frequent crying with no apparent cause - is a distressing condition affecting many babies. But could the solution lie in a better understanding of feeding bottles?
nfantile Colic can affect around half of babies, and though it has no long-term consequences it can be distressing for the three months or so it is likely to last. Characterised by excessive crying in an otherwise healthy baby, colic can be
caused by several issues, but 78 percent of healthcare professionals agree that the most common cause of colic in young babies is digestive or feeding problems, including swallowing air and trapped wind. Fiona-Jane Kenworthy, Marketing Manager at Dr Brown’s, says: “Infantile colic can be very stressful for families, and often parents are reluctant to offer young babies medicines. An anti-colic bottle is a natural clinically proven way of helping reduce wind related colic, as it removes the air bubbles in the feed.” Conventional feeding bottles come in two types—unventilated or partially ventilated. In both cases, high negative pressure is generated in the oral cavity as well as in the bottle when fluid is removed by sucking—the exact opposite of the positive pressure which occurs during physiological breast feeding. In partially ventilated bottles the negative pressure may build more slowly, but is still present.
PRESSURE Negative pressure causes a break in the baby’s seal with the teat and air is swallowed along with liquid, causing the windy colic symptoms. Negative pressure may also be transmitted to the middle ear via the Eustachian tube, leading celebrityangels.co.uk
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Pregnancy & Early Years
Dr Brown's Dr Brown’s® has over 20 years’ experience in helping parents combat windy colic and has recently launched a new enhanced design bottle – Dr Brown’s® Options+ AntiColic Bottles. Not all vented bottles are created equal. Dr Brown’s Options+® unique internal vent system continues to create 100 percent vacuum-free feeding, which is clinically proven to help reduce windy colic. This is what makes Dr Brown’s® the number one choice of UK health professionals for the relief of colicky symptoms. The new breast-like teat shape is correctly contoured for a proper latch and a more natural bottlefeeding experience—perfect for switching from breast to bottle and back again! Each teat is super soft and specially engineered to offer the same consistent natural flow. Dr Brown’s® Options+� grows with baby, allowing easy removal of the vent system when baby no longer experiences feeding problems or parents want the convenience of a teat-vented bottle. Prevention is better than cure!
to middle ear infections. In contrast, a fully vented bottle has an open pathway for air, leading from the threads between the bottle neck and the teat collar, to an internal reservoir connected to the ambient air. With fully vented bottles, pressure remains positive thoughout the entire emptying of the bottle, similar to the positive pressure present in breast feeding, preventing the swallowing of air and negative pressure on the middle ear. It sounds too easy to be true, but this simple change to your feeding practice could be all you need to solve the problem of colic and put an end to the misery for baby and parent. hc Healthy Child with Dr Ranj Singh | 17
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Pregnancy & Early Years
Gone Tomorrow ?
Why do women suffer from post-pregnancy hair loss, and what can be done to stop it? The solution lies in better understanding of scalp health
HAIR AND NOW The average person has 100,000150,000 strands of hair, the fastest growing tissue in the body after bone marrow. We all lose a certain amount of hair, perhaps 50 to 100 strands every day, but this is normally replaced by regrowth.
or general thinning. It doesn't always happen, but there's no way to prevent it when it does. The good news about post-partum shedding is that it is temporary, and a good scalp health routine will soon have you back to full hair health - and you can take steps to avoid secondary types of hair shedding caused by stress, lack of sleep or poor nutrition..
That gives the clue to the cause of postpartum hair loss, which is hormonal. In pregnancy, high oestrogen levels can make hair stay in a growth phase and look particularly glossy and healthy— when oestrogen levels drop, all the hair that should have been shed over the nine months of pregnancy can fall out at once leading to either bald patches,
So what are the top tips for promoting scalp health and recovering from post-partum hair loss? ✤ Eat well—a balanced diet rich in protein and iron ✤ Take supplements—vitamins B-6, C and E, calcium, zinc and selenium are beneficial
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✤ Add nutrients—collagen, keratin and ✤ Sleep well—regular sleep is important for hormone balance, blood pressure and weight control, all factors in scalp health ✤ Get a short cut—it will make your hair easier to handle while it is recovering ✤ Don’t pull the hair back into a bun ✤ Don’t use high-heat dryers and straighteners, and comb gently with a wide-tooth comb ✤ Massage the scalp—it’s safe to do this every day ✤ Exfoliate the scalp once a week using a scrub, brush or glove ✤ Use a modern pH balanced thickening shampoo and conditioner ✤ Try volumizing spray or mousse products to improve appearance If hair loss continues for more than a few months, it’s possible that there is another underlying cause, such as alopecia aerate, and it’s time to see a trichologist, but most cases of postpartum hair loss will recover in six to twelve months. hc
any women don’t know that post-partum hair loss is very common, so when it happens to them, they don’t automatically associate it with their recent pregnancy. Some types of hair loss, typically male and female pattern baldness, become permanent and are inevitable, but post-partum hair loss affects up to 50 percent of new mothers, and can be worrying if the cause isn’t understood. With post-partum hair loss, a new mother’s hair can come out in handfuls. This usually happens when the baby is around three months old. It can be delayed if the mother is breastfeeding until around three months after the end of feeding.
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Eating For Two?
Is it true that when youâ€™re pregnant you have to eat for two? We examine this and other myths and give you some useful pointers for healthy eating before birth
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Pregnancy & Early Years bacteria and parasites, which can cause foodborne illnesses. Even if you don’t feel sick, some bacteria—such as listeria and toxoplasma gondii—may still cause health and development problems for your baby. For this reason, official advice suggests avoiding foods that carry a high risk of harbouring these and other unwanted bacteria.
Pregnancy support charity Tommy’s says: “It is unlikely that the lack of folic acid will have affected your baby’s development as the risk is small, but if you’re worried about not having taken folic acid during the early months of your pregnancy, talk to your doctor or midwife.”
s it true that you have to eat or two when you’re pregnant? Well, like many of these hand-me-down myths, it’s not entirely true, but there is a grain of sense in it. Though you may be tempted to eat more when pregnant, that’s not really the best approach to take. Your body becomes more efficient during pregnancy and is able to absorb more of the nutrients you eat, so consuming twice as much doesn’t double your chances of having a healthy baby – in fact, it could mean excessive weight gain for you, which can put you at risk for pregnancy complications. Medical advice says that if you are a healthy weight, you need no additional calories in the first trimester, 340 extra calories a day in the second trimester, and about 450 extra calories a day in the third trimester. It doesn’t take much to add enough calories for the last trimester – maybe a couple of glasses of low-fat milk and a handful of sunflower seeds or a tuna sandwich. If you’re overweight or underweight, you will need more or less than this depending on your weight gain goal. Of course the exception to this rule
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LEAFY GREENS The NHS advises pregnant women to take folic acid supplements to prevent birth defects. But this vital nutrient can also be obtained through a healthy diet. During pregnancy, eat plenty of leafy greens—such as spinach and kale—to increase your folic acid intake. As a general rule, it is vital to wash all fruits, vegetables and salads to remove all traces of visible dirt and soil. is when you are having more than one baby - then it is quite possible that you will have to increase your calorie intake. What’s more important, though, is the makeup of your diet. There are certain dietary precautions all pregnant women should take to safeguard the health of their unborn child. It might not be immediately obvious why doctors recommend some foods and warn against others, but in most cases the answer is to reduce the risk of food poisoning, and to increase levels of beneficial compounds such as folic acid. During pregnancy, parts of a woman’s immune system are suppressed. This suppression makes both you and your baby more vulnerable to viruses,
FISH You can eat most types of fish when you are pregnant as fish is both good for your health and your baby’s development. There is no need to limit the amount of white fish or shellfish you eat while pregnant or breastfeeding— just don’t eat raw shellfish.
Healthy Child with Dr Ranj Singh | 21
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CHEESE Hard cheeses such as Cheddar, Parmesan and Stilton are safe to eat in pregnancy, but pregnant women should avoid mould-ripened soft cheese, such as Brie and Camembert. They should also avoid soft, blue-veined cheese such as Roquefort and Gorgonzola, which are prone to listeria infection. Even a mild form of the illness can lead to a miscarriage or stillbirth. For more information on the symptoms of listeria, visit the NHS website. 22 | Healthy Child with Dr Ranj Singh
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MILK & YOGHURT Stick to pasteurised or UHT milk (otherwise known as ‘long-life’ milk). If only unpasteurised milk is available, boil it first. Avoid drinking goat’s or sheep’s milk, or eating foods made from them, such as soft goat’s cheese. All types of yoghurt, including bio, live and low-fat, are safe to eat, but ensure that any homemade yoghurt is made with pasteurised milk.
EGGS Lion Code eggs—those with a lion logo stamped on their shell—carry a very low salmonella risk and are safe for pregnant women to eat partially cooked. If they are not Lion Code, ensure the eggs are cooked through to avoid disease. Always fully cook non-hen eggs, such as duck, goose and quail eggs.
RAW OR UNDERCOOKED MEAT Do not eat any raw or undercooked meat—including meat joints and rare steaks—because of the potential risk of toxoplasmosis (a parasitic disease that can be harmful to the foetus). Cook all meat thoroughly, especially poultry, pork, sausages and mince. Many cold meats, such as salami, prosciutto, chorizo and pepperoni, are not cooked, they’re just cured and fermented. This means there’s a risk they contain toxoplasmosis-causing parasites. It’s best to check the instructions on the pack to see whether the product is ready to eat or needs cooking first. For ready-to-eat meats, you can reduce any risk from parasites by freezing cured or fermented meats for 4 days at home before you eat them. Freezing kills most parasites and makes the meat safer to eat. If you’re planning to cook the meat— for instance, pepperoni on pizza—you don’t need to freeze it first. If you’re eating out in a restaurant that sells cold cured or fermented meats, they may not have been frozen.
However, if pregnant or trying to conceive, you should avoid shark, marlin and swordfish. You should also limit tuna intake to no more than two tuna steaks, or four medium-sized tins of tuna, a week. This advice is due to the high mercury levels found in these types of fish. You should also limit your oily fish intake to no more than twice a week, as it may contain pollutants like dioxins. Oily fish includes salmon, herring, trout and mackerel. In addition to this, experts recommend to not take any fish oil supplements or supplements containing vitamin A, as these may harm your baby.
Pregnancy & Early Years If you’re concerned, ask the staff or avoid eating it. Wash all utensils completely and wash and dry your hands after handling raw meat to stop the spread of germs.
After 12 weeks, the baby’s neural tube will have closed and so it is not necessary to take folic acid, but it is safe to take all the way through your pregnancy if you are taking a pregnancy multivitamin tablet that contains it (although expensive pregnancy multivitamins are not strictly necessary if you have a balanced diet as you only need folic acid and vitamin D).
PÂTÉ According to medical advice, during pregnancy it is not safe to eat pâté— including vegetable pâté—as it may contain listeria. In addition to this, make sure to avoid any liver products, as they contain high levels of retinoids such as Vitamin A, good for you in normal levels, but potentially harmful in excess.
PEANUTS Current advice is that it’s fine to eat peanuts during pregnancy, unless of course you’re allergic to peanuts yourself. There’s no evidence that eating peanuts, or foods containing peanuts, while you’re pregnant affects whether or not your baby develops a peanut allergy. The government used to advise pregnant women with a family history of allergies, such as asthma, eczema or hayfever, to consider not eating peanuts. This advice changed in 2009 because of the lack of evidence that eating peanuts increases your baby’s risk of allergy, even if you have a family history of allergies.
CAFFEINE High levels of caffeine consumption during pregnancy can result in babies having a low birth weight, which can cause health complications later in life. You don’t need to cut out caffeine completely, but you shouldn’t have more than 200 milligrams a day (about two cups of instant coffee). To cut down on caffeine, try decaffeinated tea and coffee, fruit juice or mineral water instead of regular tea, energy drinks, coffee or cola.
HERBAL & GREEN TEA The Food Standards Agency (FSA) advises to drink herbal and green teas in
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FOOD SAFETY moderation during pregnancy—no more than around four cups every day. Always seek advice from your doctor if you are unsure about which herbal products are safe to consume. Experts advise avoiding the herbal remedy liquorice root, as it may cause developmental issues. The NHS’s Eatwell Guide, which can be downloaded from the website, gives sensible advice on food intake which applies to pregnant women as well as to everyone else. It says that while fruit and vegetables are a good source of vitamins, minerals and fibre, most of us still are not eating enough fruit and vegetables, which should make up over a third of the food we eat each day, chosen from fresh, frozen, tinned, dried or juiced. We should all aim to eat at least five portions of a variety of fruit and veg each day, and fruit juice and smoothies should be limited to no more than a combined total of 150ml a day. Folic acid is a vitamin that helps in the early formation of your baby’s neural tube, which turns into the brain and the spine. Because of this, it is recommended that women who are trying for a baby take folic acid before they become pregnant then continue for the first 12 weeks of pregnancy.
Finally, remember that food preparation while pregnant is as important as the sort of food you eat. NHS advice is to ✤ Wash fruit, vegetables and salad to remove all traces of soil ✤ Wash all surfaces and utensils after preparing raw foods ✤ Store raw foods separately from ready-to-eat ✤ Use a separate knife and chopping boards for raw meats ✤ Heat ready meals until they’re steaming hot all the way through, particularly important for meals including poultry ✤ Follow these guidelines and you’ll be getting your baby off to a good start in life, and improving your diet too! hc
Healthy Child with Dr Ranj Singh | 23
Pregnancy & Early Years
MEDS AT SCHOOL
The Department for Education’s Statutory Guidance and Departmental Advice (best practice) on “Supporting pupils at school with medical conditions“ says that a school can only accept prescribed medicines if they are in-date, labelled and provided in the original container as dispensed by a pharmacist with clear instructions for administration, dosage and storage.
When children have complex health needs, how do you manage their medication? Technology might just have the answers
2018 survey from the Royal College of Paediatrics and Child Health, carried out through the charity WellChild, showed that parents providing care at home for a child with complex health needs estimated they spend an average of 3.4 hours administering medicine a day. The WellChild survey consulted with more than 200 families who care for children with complex health conditions, asking them to share their experiences of how they manage routines and give medicines at home. The families said that the most challenging aspects of medicines management were: ✤ 55 percent - Acting as coordinator in sharing medicines records between health professionals 24 | Healthy Child with Dr Ranj Singh
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✤ 45 percent - Coordinating the multiple carers looking after my child’s medicines ✤ 28 percent - Finding adequate information on children’s medicines ✤ 26 percent - Not having a welldesigned and accurate medications chart/plan to work from They also said that over a 12-month period, they had an average of 11 errors or ‘near miss events’, including: • Missed or miscalculated medicines • Wrong or mistakenly prescribed medicines • Incorrectly labelled medicines • Running out before next prescription is due • Out of date/expired medicines • Miscommunication between caregivers • Misreading medicines charts
APPS AND VAULTS The RCPCH, working with WellChild, the Neonatal and Paediatric Pharmacists Group (NPPG) and Comic Relief’s Tech For Good programme, is developing a smartphone app to tackle the main problems of medicine management for kids; and other companies are concentrating on appliance-based solutions such as a programmable medicine ‘vault’. The medicine vault is a sort of smart medicine chest, designed specifically to hold medicine bottles, packets, sachets, spoons, syringes and so on in one compact, convenient, child-resistant container. A programmable timer with a front-panel display shows the name and dose of each medicine as it is needed, and a countdown timer and audible alarm alert the carer when it’s time to administer the medicine. Other features include a night light, history record and emergency rest. Using a portable system like this, parents can go on a day out, or leave their children at school or with carers, secure in the knowledge that all the necessary medicines and information are to hand— one more little worry taken care of. hc
Fortunately, technology is coming to the aid of stressed parents who need help managing their children’s medicines.
STORAGE TIMER FOR CHILDRENâ€™S MEDICINES Mistakes are easy to make when parents are tired, confused or sharing childcare. Benefits
Features and functions
Promotes recovery by ensuring children receive medicine at the correct time Peace of mind for parents by reducing risk of overdosing Easy to understand whether medicine can or should be administered Convenience of having medicines and spoons together in one place Safely storing medicine out of childrenâ€™s reach
Child resistant container Programmable timer for one or several medicines with alternating option when necessary. Indicates name of medicine(s) and dose. Countdown timer Clear red/green lights indicate whether it is safe to administer medicine Audible alarm Nightlight Portable storage for bottles, sachets, blister packs, spoons/syringes and medicine instructions
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Pregnancy & Early Years
Thereâ€™s a lot of confusion around requirements for vitamins in pregnancy, but the reality might be simpler. Follow our guidelines for insight into the essentials
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f you ask the NHS for advice about vitamins in pregnancy, the answer is straightforward: “You’ll get most of the vitamins and minerals you need by eating a healthy, varied diet.” But—and there’s always a but—“when you’re pregnant you also need to take a folic acid supplement. It’s recommended you take a daily vitamin D supplement too—especially in the winter months (October - March) when you don’t get enough from the sunlight.” However, the NHS doesn’t go so far as to suggest that pregnant women need a huge selection of prenatal vitamins such as B1, B2, B3, B6, B12, C, D, E, K, as well as supplements for iodine, magnesium, copper, selenium and zinc—all commonly found in expensive multi-vitamin products. If you do need supplements for an y of these, you needn’t pay out for them— NHS advice is “Ask your GP, midwife or pharmacist about supplements—your GP may be able to prescribe them to you. If you’re on income-related benefits, or under 18, you may be entitled to free vitamins via the Healthy Start scheme.”
BEST START A study in 2016 concluded: “For most women who are planning to become pregnant or who are pregnant, complex multivitamin and mineral preparations promoted for use during pregnancy are unlikely to be needed and are an unnecessary expense—the marketing of such products does not appear to be supported by evidence of improvement in child or maternal outcomes. Pregnant women may be vulnerable to messages about giving their baby the best start in
life, regardless of cost.” So why does the NHS make an exception for folic acid, and for Vitamin D? Folic acid is known to reduce the risk of spina bifida, a birth defect of the spine and spinal cord, which is often associated with hydrocephalus—an accumulation of fluid around the brain. Spina bifida can also affect mobility, along with bowel and bladder control. Pregnant women are advised to take 400 micrograms of folic acid per day until the end of the first trimester (12 weeks). The other essential, Vitamin D, is important for regulating the amount of calcium and phosphate in the body, both of which are needed to keep bones, teeth and muscles healthy. All adults, including pregnant and breastfeeding women, need 10
micrograms of vitamin D per day. In the right conditions, our bodies can obtain this vital vitamin from sunlight. It can also be found in a small selection of foods including oily fish (like salmon, mackerel, herring and sardines), red meat and eggs. It’s the lack of naturally occurring vitamin D that leads the NHS to recommend taking daily supplements. As for what to avoid, National Institute of Health and Care Excellence (NICE) guidelines recommend that pregnant women avoid taking vitamin A supplements. Both NICE and the 2016 review found that consuming too much vitamin A during pregnancy may harm your unborn baby and could cause birth defects in worst-case scenarios. For that reason, pregnant women should also avoid liver, and fish liver oil products. hc
What is Folic Acid?
Folate (folacin, or Vitamin B9) is found in many foods. The man-made form of folate is called folic acid. Folate helps the body form healthy red blood cells and neural tubes, and since there are no longterm stores in the body, you need to eat around 200 micrograms a day, which you should find in a healthy balanced diet.
Healthy Child with Dr Ranj Singh | 27
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HAPPY CUSTOMERS We caught up with Dallas and Lesley, who had their boiler replaced with E.ON’s Affordable Warmth scheme. They told us “life’s so much better now we have the new boiler. We’ve got instant hot water and nice warm radiators. We would certainly recommend E.ON to other people, it was a very straightforward process.”
“The Affordable Warmth boiler offer has been launched to support people who are struggling to afford replacing their broken or faulty boiler. We urge anyone who falls within the eligibility criteria to get in touch to find out more.”
LONG TERM SAVINGS What’s more, you could also reduce your home’s future energy bills too. Because an older, less economical boiler can be incredibly expensive to run, a new A-rated boiler could save you money in the long run. Although the cold winter weather may still feel like a way off, being prepared is never a bad idea. After all, who wouldn’t want to spend less time worrying about heating their home, and more time enjoying cosy evenings in with the family? To see if you’re eligible, and find out more, visit eonenergy.com/boiler240 or call 0333 202 4942. Calls to landlines and mobiles are charged at your local rate.
Warm in Winter
Keeping your home warm is one of the top essentials for family health. We check out some top tips and find out about a new scheme
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So here are a few simple tips for keeping your house warm and healthy this winter without spending a fortune. ✤ Curtain call Let the sun in during the day for free warmth, and close curtains at night for efficient heat insulation – check for leaks or gaps to make the most of this simple trick ✤ Good timing You can save money by setting your
water heater to come on earlier, but at a lower temperature. Make sure to set it to switch off during the day if the house is going to be empty. Thermostatic radiator valves and smart thermostats controlled via an app also offer potential savings ✤ Sofa so good Positioning a sofa, drying clothes or curtains in front of a heater can stop warmth from circulating – give your heater room to breathe and you'll enjoy more efficient heating
n Britain, people typically switch their central heating on in October and use it every day until March or April. This coincides with the winter cold, the clocks going back, and for anyone in receipt of a State Pension, the Winter Fuel Payments. But since heating homes accounts for over 70 percent of household energy consumption, reducing this figure without compromising on warmth can cut energy bills, and help meet the UK government's carbon reduction commitments.
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Health Today ✤ Sausage party Simple DIY tricks like making a ‘sausage dog’ draught excluder for doors could save you up to £25 per year, according to the Energy Saving Trust. Self-adhesive rubber seals should be fitted around all doors and windows ✤ Old lags Make sure your water tank is properly lagged or insulated. Keeping water warmer for longer could reduce your energy costs by up to £150 per year according to The Energy Community ✤ Relect on this Placing reflective panels behind your radiators can reduce the amount of heat escaping through walls, and improve overall efficiency These simple tips can save you a decent amount through the year, but how can you make major savings without reducing the warmth, comfort and health of your family? The best solution for keeping warm during winter—and during the other cold days of the year—is to have a house that is well insulated with a good radiator system. It’s healthier to live in
a warm environment that’s drier—and it’s better for the house, too. And yes, it is possible to get a healthy, warm indoor environment even in a building that was originally built when people sewed their kids into long woolly underwear for the winter. We hear a lot about how old houses tend to be less energy-efficient, and how we must all do more to save energy and protect the environment. But that can be difficult when you have an inefficient
heating system or a draughty home. If your kids are complaining that they’re cold at night, or you spend your time huddled around an inadequate heater wearing woolly hats and socks, there's now a government-backed scheme to help you with the costs of bringing you home up to standards. The new Affordable Warmth scheme is another name for the rather less manageable Home Heating Cost Reduction Obligation, or HHCRO.
● Here are some examples of what you might be able to save after energy-saving home improvements: ● Cavity wall insulation Could save you up to £140 a year
● Loft insulation Could save you up to £180 a year
● New boiler Could save you up to £310 a year
Source: www. energysavingtrust.org.uk
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Health Today SAVINGS The Affordable Warmth scheme will make energy-saving home improvements like new boilers and insulation available to people on low incomes and/or on certain benefits. The aim is to keep homes warm all year round, and to reduce heating bills. There are three types of energy-saving improvement that you may be entitled to under the Affordable Warmth scheme. These are: ✤ A new boiler Your boiler accounts for around 60 percent of your annual energy costs, so installing a new energy-efficient boiler could save you a lot of money. ✤ Loft insulation Heat rises, so if your loft isn’t insulated, you could be losing up to a quarter of your heat through your roof. Better loft insulation will hold in more heat, saving you money. ✤ Cavity wall insulation Most homes built after 1920 were built with a gap or cavity between the inner and outer layers of the walls. Filling this gap with insulation holds in more heat, so you save money again! You could be eligible for any or all of these upgrades, depending on your circumstances and your home. If you’re eligible, any or all of these improvements could be completely free, and they could save you up to hundreds of pounds a year in heating costs. The upgrades will be carried out by qualified professional installers who are affiliated with the Affordable Warmth programme. Only authorised installers can carry out the work, which is your guarantee that the work will be done professionally, and at no cost to you. After you apply and it appears that you may qualify for the upgrades, an authorised assessor will conduct an
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HHCRO Home Heating Cost Reduction Obligation, or HHCRO, is one of three targets set by the government, obliging energy suppliers to improve the energy efficiency of households of those on low incomes or on certain benefits. This is called the ECO (The Energy Companies Obligation). Find out more at www.ofgem.gov.uk/ environmental-programmes/eco.
in-home assessment and an authorised installer will carry out the work on your home.
scheme called The Green Deal. The savings you can expect after the upgrades will depend a lot on your home, and your current heating system. People in larger, older homes with inefficient heating systems will make the biggest savings after upgrading, but people living in smaller and newer homes could benefit from cost savings too. It doesn’t matter if you’re a home owner or a tenant, both can qualify for free energy-saving home improvements, though social housing tenants are not eligible for Affordable Warmth assistance.
The Affordable Warmth scheme is designed to offer help to those who need it most. Generally speaking, that means people on low incomes, and/or those on certain benefits. To find out if you may qualify, simply apply online, and you’ll know instantly whether you may qualify for help or not. If it looks like you qualify, a qualified assessor will carry out a free assessment of your home to confirm your eligibility. Even if you don’t qualify for Affordable Warmth assistance, you could still get help with energy-saving home improvements through a different
The best news is that you will normally not receive a bill for any of the work. Under ECO, the energy companies have allocated money to pay for these upgrades - if you need to contribute towards the measures you will be told before commencement of installation. With the Affordable Warmth scheme, you’ll save money on heating, and more importantly, warmer homes are drier and healthier to live in, as well as more cosy and comfortable for you and your kids. Find out more about the scheme today at www.affordablewarmthgrants.co.uk. hc Healthy Child with Dr Ranj Singh | 33
The Bank of
Mum and Dad Would you think of freezing samples of your child’s blood and tissue? Why is cord blood banking becoming a popular option for concerned parents?
While donations of cord blood to the public banks dropped from 4,634 in 2014 to 2,573 in 2018, numbers for private storage have risen.
GOING PRIVATE Private tissue storage can cost thousands of pounds, so why are parents going for this potentially expensive option? The answer is that they think that the cord blood and tissue may be a vital element of treatment in case the child becomes ill in later life. Cord blood and tissue, rich in stem cells, can be frozen in liquid nitrogen and stored for around 25 years in case
they could be used to treat the child for a range of life-threatening diseases. The regulator, the Human Tissue Authority, confirms that there are several private establishments in the UK licensed to process either cord blood or tissue. Some 27,028 blood and tissue units were banked privately in 2018, compared with 16,965 units in 2014. In 2011, The Royal College of Obstetricians and Gynaecologists (RCOG) and Royal College of Midwives (RCM) stated that “there is not enough evidence at present to recommend routine private cord blood collection and banking unless there is a medically-indicated reason”,
hen a baby is born, the placenta and cord blood are normally discarded—but a recent BBC report using information obtained under the Freedom of Information Act reveals that freezing and storing this tissue is becoming a popular option. According to the report, the number of umbilical cord tissue units processed privately almost doubled between 2014 and 2018, rising from 6,289 to 11,950. There was also an increase in the number of cord blood units processed, going from 10,676 in 2014 to 15,078 in 2018.
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Health Check and said “It is vital that the obstetrician or midwife are not distracted from the immediate care of the mother and baby during the third stage of labour… there is also the issue of the timing of the clamping of the cord as this will have an effect on the collection of cord blood.” But both bodies are currently reviewing their position.
DONATION Guy Parkes, head of stem cell donation and transplantation for NHS Blood and Transplant, said: “Public cord blood banking is an altruistic, lifesaving act. Private cord blood donation is completely different to public donation. “We aim to collect a certain amount of cord blood donations each year because that provides the best way of finding a match for the majority of patients.
“Public support for cord blood donation is very high and we continue to meet our collection targets.” So is cord blood banking a sensible precaution, or a matter of private companies exploiting parent’s insecurities? It’s a bit like taking out insurance—you’re only glad you did it when it’s called on to help. There is pressure for the NHS to provide a cord blood banking service to anyone who wants it, but considering the costs involved and the other demand son NHS facilities, it’s not something we are likely to see being offered in the near future. For the meantime then, private companies do seem to be at the cutting edge of cord blood banking services. hc
Find ou blood ba t more about co r n Blood an king from the d NHS d Transp at www lant web .n Anthon hsbt.nhs.uk, an site y Nolan d the blo charity od cancer at www.an
Part of the issue is that the National Institute for Health and Care Excellence (NICE), the World Health Organisation (WHO) and the RCM now recommend the practice of delayed cord clamping (waiting until the cord stops pulsating before cutting it), which is thought to have health and developmental benefits, but which may not be compatible with the practice of cord blood banking. So it’s possible that parents may have to make a choice between the benefits of delayed cord clamping, and those of cord blood banking. But what are the arguments for cord blood banking? The BBC report quoted one parent, diagnosed with a mutation of the BRCA1 gene which increases the chances of breast cancer. Though stem cell therapy cannot
currently treat her condition, she banked her cord blood at a cost of £2,700 plus £100 a year for storage, in case it could be useful in treating a condition in her child. A private bank will store units solely for use by the donor or their family, in the hope that if one of them becomes ill with a stem cell-treatable disease such as blood cancer or immunodeficiencies, the perfect match unit will be of help. But mothers can also choose to donate cord blood to the public stemcell bank, the NHS Cord Blood Bank, or one run by a charity such as the Anthony Nolan Trust. These donations are made available for public use, not kept specifically for individuals.
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Pregnancy & Early Years
Sowing the Seeds
It isn’t always as easy to get pregnant as it may appear. Fortunately there’s plenty that you and modern medicine can do to improve the odds
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percent, and this rate continues to fall in a woman’s 40s, until she reaches menopause, typically between ages 48 and 55. Women are born with 1 to 2 million eggs, and those are as many as she will have in a lifetime. By the time of first period, the egg supply could have dwindled to 300,000. The average woman’s fertility peaks at the age of 24. “If a woman ovulates 500 times between the ages of 12 and 52, and if not all of those eggs are considered
to be healthy, what you’re left with is a select few eggs that are truly viable for pregnancy,” says Alan Copperman, M.D., director of Reproductive Medicine Associates of New York and codirector of the Division of Reproductive Endocrinology and Infertility at The Mount Sinai Hospital in New York City.
Odds On And human reproduction isn’t efficient— the odds on conception are only really good for one week in your cycle.
etting pregnant may appear to be a straightforward process, but in fact it’s nowhere near as easy as it seems. Each month, on average, a woman only has a 15 to 20 percent chance of conception—for women in their 20s, their chances of getting pregnant within a year are 78 to 86 percent. For women 30 to 34, their chances of getting pregnant within a year are approximately 63 percent. For women aged 35 to 39, the chances of conception within a year declines to 52
Pregnancy & Early Years Still, women under 25 have a 96 percent chance of conceiving in a year if they’re trying each month. If the man is under 25, the odds drop to 92 percent, because many fertility issues among younger couples are on the man’s side. Some are easily treatable and don’t require help from a specialist unless conception is taking longer than one year. A couple is not diagnosed as having fertility issues until they have been trying unsuccessfully to conceive for over a year. Even then, as many as 50 percent of all pregnancies end in miscarriage, most often before a woman misses a period or knows she’s pregnant.
GET YOUR BODY READY There is plenty that can be done to encourage and prepare for pregnancy.
Diet Cut out unhealthy food, including processed foods, sugars and starches. Introduce more fresh produce and lean meats into your diet.
GO TO WORK ON AN EGG Ovulation occurs when a mature egg is released from one of the ovaries and moves down the fallopian tube. When the egg is not fertilised, it gets shed during menstruation, along with the lining of the uterus that built up to accommodate a potential foetus. It’s an oversimplication that women ovulate on the 14th day of their cycle, based on the myth that all women have 28-day cycles. Yes, some women do have very regular, four-week cycles. But it’s also quite normal for cycle length to vary between 21 to 40 days—even just for one woman! And while ovulation falls in the middle of the cycle, it doesn't fall reliably between the first and last day. To gain an accurate idea of when you’re ovulating, you can take your own basal body temperature (BBT), which is the lowest body temperature attained during rest. For best results, take it as soon as you wake up every morning, using a thermometer that measures
accurately to two decimal places. Tracking these temperatures will give you an accurate idea of when you’re ovulating, as you will see a sustained increase of 0.2 degrees
Numbers game Women in the UK are having children later in life than their mothers were. The majority of women now become mothers between the ages of 30 and 34. The oldest woman to give birth naturally in the UK was 59. The youngest was 12. One in ten women fall pregnant while relying on the contraceptive pill. The number of women in their 30s having abortions has overtaken the number in their teens. Source: Chemist-4-U
Birth control Stop taking birth control pill several cycles before trying to get pregnant. If you are using an IUD, schedule an appointment with your doctor to have it removed.
Medication If you are on any medication, you and your doctor will need to discuss whether or not you should continue taking it for the time being.
Supplements Start taking folic acid supplements.
Drinking and smoking Stop drinking and smoking.
The same ... diet, smoking and exercise tips apply to the male partner!
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can cause problems just as often. A male fertility test will assess your partner’s sperm, checking to see if the sperm concentration is above or below 20 million sperm cells per millilitre of ejaculation fluid.
No luck, now what?
If you’ve been trying to conceive without result for twelve months, it’s time to make an appointment with your doctor. They will discuss what may be happening and possible next steps. Your doctor will perform a routine exam, making sure that everything is fine with your reproductive system. Conditions such as Polycystic Ovarian Syndrome (PCOS), endometriosis, fibroids or even a cyst on your ovaries can cause complications with fertility and difficulty in getting pregnant. It’s also time for your partner to visit the doctor for a male fertility test. While infertility issues tend to be considered a female problem, falling sperm counts
Before you take the leap to consider IVF (In Vitro Fertilisation), there are medical treatments which could help, including clomiphene citrate, metformin, bromocriptine and recombinant FSH injections such as Gonal F or Puregone. One of the easiest and best things women trying to get pregnant can do is to take a daily supplement of folic acid. The NHS recommends taking 400 micrograms of folic acid every day before you get pregnant and through the end of your first trimester.
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Glass half full If a specialist recommends fertility treatment, there are several options,
including IUI (directly inserting sperm into a woman’s womb). This is usually used when a single woman or female couple is trying to have a baby on their own, if one partner has HIV or the woman is unable to have vaginal sex. IVF, In Vitro Fertilisation, is normally considered after failing to get pregnant for two years. In IVF, an egg is removed from the woman’s ovaries and fertilised with sperm in a laboratory. The fertilised embryo is returned to the woman’s womb to grow and develop. IVF can be done with your eggs and your partner’s sperm, or eggs and sperm from donors. IVF is the most expensive but also the most effective fertility treatment. It can be disruptive, as it requires hormone injections which can have side-effects. Younger women are more likely to have a successful pregnancy. IVF isn’t usually recommended for women over the age of 42 because the chances of a successful pregnancy are thought to be too low. hc
Celsius on those days. Your BBT can also tell you when you’re pregnant, sometimes even before a pregnancy test. Eighteen consecutive days of elevated temperatures are an indication of pregnancy.
HERE FOR LIFEâ€™S NEXT STEPS
bloom - an inclusive Information resource for all people interested in starting or expanding their family.
www.merckbloom.com UK&IE/NONF/0919/0049 September 2019
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Here for Life’s Next Steps Making the decision to start a family is exciting, but it can be quite overwhelming. There are a lot of decisions to make and this may make you feel a little concerned or confused. bloom will provide you with all the information that you need to help support you on your journey. You can find information that is helpful for each stage of your pregnancy journey -family planning, diagnosis, eligibility and treatment.
FAMILY PLANNING -
There are a few things that you can both try to increase your chances of becoming pregnant and having a healthy pregnancy. You are more likely to conceive if you are both in good health and we can provide examples of things you can do to boost your chances of success.
If you are having trouble getting pregnant, you are probably going to be wondering why. There are lots of reasons for infertility, some a little more complex than others. Whatever the cause, it is not necessarily permanent and also does not mean that you will never have a child – it might just mean that you need some specialist help to become pregnant.
FERTILITY TREATMENT -
Thanks to scientific advances, there are a lot of different fertility treatment options available these days, but not all of them will be suitable for what you need. We can offer several treatment options for men and women for you to discuss further with your doctor.
www.merckbloom.com BLOOM - A VALUABLE INFORMATION RESOURCE FOR PEOPLE WHO ARE FAMILY PLANNING, EXPERIENCING FERTILITY ISSUES, INVESTIGATING SURROGACY OR SPERM DONATION
UK&IE/NONF/0919/0049 September 2019
UK&IE/NONF/0919/0049 September 2019
BABY #2: WHERE ARE YOU? Missing newly minted smiles, tiny baby cuddles and yes, even those sleepless nights? Do you look at your wonderful child and know they’d be an even more amazing big sibling? Sometimes, you know when it’s time to try for another baby to complete your family. But what if that quest for a second child eludes you? What, after wrangling some alone time as a couple, month after month, nothing happens? Sound familiar? You’re not alone. Around one million people in the UK experience secondary infertility, where someone has had one pregnancy in the past, but is having difficulty conceiving again. But when should you seek help? Professor Child suggests a fertility assessment if you’ve been having regular unprotected sex and you’re not pregnant after six months – and this is especially important for women aged over 35.
The comprehensive fertility assessments run by The Fertility Partnership clinics are very straightforward. Over one or two short appointments, a number of blood tests are conducted; an ultrasound checks your ovaries, uterus and counts your antral follicles; and a full review of your medical history is taken. Dads are included too, as semen is tested. This in-depth assessment provides you with the reassurance to keep trying, or identifies any issues that need addressing.
And there’s some good news: couples undergoing IVF who already have a child see higher pregnancy rates than others undergoing treatment. The new smiles and sleepless nights may be back…
So, if you’re experiencing problems conceiving baby #2, contact your nearest Fertility Partnership clinic today.
Professor Tim Child, Medical Director, The Fertility Partnership, the UK’s largest fertility care provider, explains: “Fertility changes with age, so as we leave starting a family later in life, this factor is increasingly seen when looking to conceive a second or third child. Lifestyle also plays a significant part. Weight, exercise, smoking, alcohol consumption and stress all affect your fertility. A woman can also develop a condition such as endometriosis at any age, which impacts the chances of conceiving. So even over a few short years after a child is born, a woman or man’s fertility could be a lot lower.”
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Pregnancy & Early Years
A US stud y revealed that in 1995, 1.8 m illion wom en suffered from secon dary infert ility; in 2006, it w as 3.3 mil lion. Toda it accounts y, for six out of 10 infertil ity cases.
When You’re Struggling for a Second Secondary infertility—the inability to become pregnant or carry a pregnancy to term after already having a child—can be surprising and stressful
f you have already had one child, surely there’s not going to be a problem having another? Not necessarily. And unfortunately, when women struggle to conceive after already having a child, it’s a less visible problem. Many people have never heard the term ‘secondary infertility’ and fewer understand it, dismissing the issue with thoughts of “well, at least you already have one.” Secondary infertility is defined by doctors as the inability to conceive or carry to term a second or subsequent child, and according to new research, it’s on the rise.
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Why is it happening? "The main reason is age,” said Londonbased fertility expert Zita West. “Women are having babies later.” Exhaustion also plays a part. “The sleeplessness of life with a small child can’t be underestimated,” she said. “You might still be breastfeeding, you might be sharing a bed with a toddler, you might be holding down a job at the same time. Basically, there’s not a lot of sex happening.” But there might also be medical causes underlying secondary infertility issues. “The thyroid is always something we check. Birth can put the thyroid out of kilter,” West says.
A hidden anguish While women with secondary infertility may be looked on by those with primary infertility as less unfortunate, the condition has its own heartaches. Most people think that if you can have one child, you can have another—a misconception that leads to hurtful statements from neighbours and co-workers wondering when you’re going to give your little one a sibling. Infertility is, in all its forms, a private, hidden anguish. Nobody wants to discuss the finer points of their reproductive system in public. And the desire to have a child can, if thwarted, be overwhelming. How can that be articulated to the casual inquirer?
Seek support Fortunately, infertility specialists are becoming more aware of the problems of secondary infertility and learning to deal with the stress it can create. If you’re suffering from it or suspect you might be, visit your doctor to get an official diagnosis, and seek emotional support from your partner, family and friends as you figure out next steps. There’s support to be had from charities such as The Fertility Network, and specialist clinics where you can find out more about areas such as in-vitro fertilisation (IVF), egg and sperm donation, fertility preservation (such as egg freezing) and other reproductive health and fertility issues. hc Healthy Child with Dr Ranj Singh | 43
Pregnancy & Early Years
he weaning process, when you start introducing your little one to solid food, is an exciting time in your baby’s development, so you might enjoy having a more direct hand in your choice of food rather than just relying on shop-bought solutions.
The Big Six The World Health Organisation strongly advises beginning the weaning process 44 | Healthy Child with Dr Ranj Singh
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at six months, as babies will be more capable of feeding themselves and weaning will support their development by providing additional nutrients. At six months, the teething process begins, with the average baby acquiring their first teeth, which makes introducing solid food timely. If your baby was born premature, it is essential you seek guidance from a Doctor or GP prior to introducing solid foods to your baby.
At six months there are three indicators for weaning—the first is when your baby is able to adopt a sitting position and keep their head steady, the others are when your baby can swallow food and co-ordinate their eyes, hands and mouth to view food and independently place it into their mouth. The first principle of weaning is giving your baby the opportunity to become accustomed to the notion of
Food for Thought
At the age of six months it’s time to introduce your baby to solid foods. But have you thought about home-made rather than shop-bought?
Pregnancy & Early Years eating. Single ingredient foods are a great way to start, and these can incorporate options such as cereal, fruit or vegetable purées. All that’s needed to formulate these mini nibbles for your baby are a saucepan and a blender. Recipes that are made by you for your child means you can keep track of exactly what’s going into your baby’s diet and avoid potential additives, which can diminish the nutritional content of baby food.
Recipe Rules Babies are often naturally inclined to sweeter tastes, so start by adding savoury flavours to your baby’s mealtimes to encourage them to widen their tastes and be drawn to eating more vegetables. A blend of root vegetables such as celeriac and carrots creates a nutritious fusion of flavours, and a splash of formula or breast milk can be mixed into the puree to promote the development of healthy bones.
taste and texture
Avocado or butternut squash blends are perfect examples of meals that will enable your child to engage visually with their food, drive their natural inquisitiveness at this stage of their development and slowly familiarise them with new textures.
Whatever recipe you decide to go with, it’s essential that the final result appeals to all of your baby’s senses and especially their visual sense, to spark an interest in food. Choose recipes with vibrant colours, for example orange, purple or green to both foster an interest in their meals and get them to finish them. Furthermore, to save both money and time, remember you can cook your baby food in bulk. Be sure to wash all vegetables and fruit thoroughly in warm water to remove dirt and bacteria, and begin by steaming or boiling the vegetable you would like to use. Fruits with their soft textures can skip the steaming or boiling stage and go straight into the blender. For babies in their final stage of teething, aged between 23 to 31 months, you can provide a thicker meal consistency. Quickly pulse the blend to do so and reach your desired thickness for your child’s meal. hc
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Pregnancy & Early Years
Baby Bircher BBC Good Food’s five star rated weaning recipe Baby Bircher is rich in protein and its ingredients promise a varied selection of textures. Bircher muesli was developed by Swiss nutritionist Maximilian Bircher-Benner at the turn of the last century as a way of getting more raw fruit into his patients’ diets. Though recipes vary, the basis is usually rolled oats which are soaked for at least an hour (sometimes overnight). For adults, you could add additional fruits such as raisins or blueberries.
½ or 1 small apple 25g rolled oats 1tsp of chia seeds 75ml of baby milk
1.Puree the apple by placing it into the blender. 2. Place the oats, chia seeds, baby milk and pureed apple together. 3. Refrigerate the mixture for an hour to allow it to soak. 4. Remove from the fridge and serve. The seeds should have absorbed the milk to form a soft and gel-like texture.
Orange Delight This lentil and sweet potato purée recipe from BBC Good Food is not only vibrant in colour, but is also fortified in iron and protein, along with being high in healthy fibre.
A lump of butter Pinch of ground coriander (optional) 50g of red split lentils, rinsed thoroughly 375g of sweet potatoes 1-2tbsp of yogurt (optional) 1. Melt the butter in a saucepan and follow by adding coriander if desired and cook for a minute. 2. Mix in the lentils and sweet potatoes and add water into the pan to just cover them. 3. Bring to boil and simmer for 15 minutes with the saucepan covered until the lentils and sweet potatoes are soft. 4. Drain the saucepan and mash together. 5. Serve in a bowl and top with yogurt (optional). 46 | Healthy Child with Dr Ranj Singh
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Pregnancy & Early Years
Moving Just Fine Developing motor skills helps your child to be independent and sets them up for the future. How can we encourage these essential abilities?
f you have concerns that your child’s gross motor skills of crawling, sitting, walking and so on are not developing, you should ask for a recommendation to an occupational therapist, who can improve functional skills in areas such as play, learning, movement, performing tasks, and developing independence and organisation. But another type of ability, the fine motor skills involved in picking up, holding and manipulating objects, is equally essential in a range of activities such as eating and drinking independently, dressing, holding a pencil and eventually hand-writing and other educational essentials. Development of these fine motor skills also ties in to hand-eye co-ordination, in activities such as throwing and catching; so, ability in sporting activities depends very much on good development of fine motor skills.
Early learning specialist Dr Marcy Guddemi notes, “Many children are arriving at kindergarten lacking the basic fine motor skills needed to hold a pencil celebrityangels.co.uk
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Many children are arriving at kindergarten lacking the basic fine motor skills needed to hold a pencil and write. This lack of dexterity in their fingers and hands can be attributed to the increased use of touchscreen technology and decreased use of crayons, paints, pencils, scissors, clay and other manipulatives in their daily lives. and write. This lack of dexterity in their fingers and hands can be attributed to the increased use of touchscreen technology and decreased use of crayons, paints, pencils, scissors, clay and other manipulatives in their daily lives.” So what can be done to encourage these skills as early as possible? There are many products designed to be easy for children to handle and to encourage the development of fine motor skills—for instance pencil grips, training scissors and, particularly useful, cutlery with soft easy-grip handles designed to
teach the correct three-fingered grip. Along with these tools there are plenty of ways to encourage development of fine motor skills with no special equipment. ✤ Teach the finger-and-thumb pincer
movement using small objects such as pieces of cereal ✤ Choose toys with dials, switches and knobs to encourage manipulation skills ✤ Use shape-sorters and building blocks to encourage stacking and manipulation ✤ Build concentration and cognitive reasoning by filling and emptying a bin full of toys ✤ Provide chalk, crayon and paints for creative expression ✤ Play games that need both hands to encourage co-ordination ✤ Provide specially-designed cutlery at mealtimes to encourage use of utensils By the age of two, a child should be able to use gross and fine motor skills together, for instance in passing a toy from hand to hand. As your child develops, you’ll find that the milestones of these fine motor skills become just as notable and joyful as the more obvious gross motor skills. hc Healthy Child with Dr Ranj Singh | 47
Pregnancy & Early Years Construction toys One step up from the building block, preschool building sets on themes such as farms, trains and road layouts are compatible with basic blocks and offer much more potential for imaginative and group play
Educational toys used to have a reputation for being worthy but dull—not any more. The latest colourful exciting toys are tops with the kids and their parents
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How many triangles can you find in this diagram?
Wooden vehicles Wooden cars and trucks with freerolling wheels are suitable for children from nine months to four years old, and teach sensory, fine motor, gross motor, problem-solving, language, social and emotional skills.
Building blocks From ages three to five, children will enjoy using large size easy-to-clean building blocks to develop counting skills, fine motor skills, and creative thinking. Some of the better known makes come in bright colours and have different elements such as windows and wagon bases. Make sure you get a storage box to pack them all away neatly at the end of the day!
The traditional colour cubes are inexpensive and help with shape, colour
For older children, pocket puzzles can range from colour and shape sorting to geometric challenges, building puzzles, maze games, chase and escape activities, right up to travel games with magnetic boards and pieces and sophisticated IQ testers. hc
Colour and number cubes
and size differentiation skills, basic counting, thinking ability and hand, eye and brain coordination. Look for types which are highly polished and coloured with safety paints.
There are 27 in total: 16 small triangles, 7 medium triangles made from small triangles, 3 large triangles made from 9 small triangles, and 1 large triangle.
here’s been a backlash against flashy, electronic toys which don’t have much education value, and a realisation that many traditional toys were popular for good reason—they teach motor skills, shape and colour recognition, and numeracy, as well as stimulating a child’s imagination and social development. So though digital devices such as tablets offer many educational apps, old-fashioned games, puzzles and building toys are now back in favour, often using recycled materials, safe paints and safe-play designs to make them entertaining, educational and friendly to the environment. Let’s have a look at some of our favourite categories of early years toys.
A kit of stencils and colourful pencils and paper will help kids make a start on creative drawing while making it easy to produce pleasing results. Look for sets made using non-toxic material free of the plastic component bisphenol a (BPA), where the carrying case doubles as a mini desk and travel case.
Healthy Child with Dr Ranj Singh | 49
Never miss a moment Our Smart Video Baby Monitor comes with an app so you can keep an eye on your little one, wherever you are.
Smart Video Baby Monitor Be part of bedtime, every time Watch and record live video on our smartphone app Soothe your baby with help from Alexa or Google voice Play lullabies from the camera with a simple command Help your little one drift off Listen and talk to your baby over HD audio From
ÂŁ129 .99 Your baby should sleep in the same room as you for the first six months. Always place your baby on their back to sleep.
See all of our monitors at shop.bt.com/healthychild BT.indd 1
Pregnancy & Early Years
Be Seen, Be Safe
A baby monitor is a great way to keep an eye on your newborn when you can’t be in the same room. But what are the best types to look for?
t’s normal to be anxious for your baby’s health as a new parent, but you can’t keep an eye on them 24 hours a day. Well, maybe you can… as usual, technology suggests solutions, with all sorts of baby monitor devices helping you to keep watch over your baby while they’re asleep and you’re busy with other things. In the first six months, it’s recommended that your baby sleeps in a separate cot in your bedroom, so a baby monitor may not be vital. When they move into their own room, though, a monitor allows you to keep a check on them at any time.
NOISES OFF Basic baby monitors which transmit sound only have an obvious drawback— they won’t tell you if your baby is in distress unless they’re making a noise. So video versions have become much more popular, particularly since the almost universal use of broadband and wi-fi has made them much easier to install and operate. Of course the requirement for a celebrityangels.co.uk
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baby monitor may depend on the size of your house—you may not feel the need for one if you’re in a small flat, but you probably will if you are in a house where baby is sleeping upstairs while you are downstairs. Not all baby noises require attention, of course—you’ll learn to tell the noises that mean they need feeding or are in distress, as opposed to regular night-time gurgling which wouldn’t normally need attention. Don’t make the mistake of checking every little sound if all you are doing is disturbing the baby’s sleep. The video option gives you a much better way of keeping a check on how soundly baby is sleeping, so you can tell whether they need attention, or whether you would be best off not disturbing them. Some monitors include sensor pads to go under the baby’s mattress and alert you if they stop moving. Remember though that a baby monitor, though a useful tool, isn’t a substitute for careful attention— technology is wonderful, but it will never be a complete substitute for parental supervision. hc
BT smart baby monitor The new BT Smart Video Baby Monitor helps you stay connected with your little one, wherever you are. You can watch your baby anywhere in live HD video, straight from the app. With the ability to take snapshots and record too, you won’t miss a single smile, snuffle or belly roll. With voice integration, you can ask Alexa or Google Voice to play a lullaby, report back on the temperature of the baby’s room or turn motion detection on and off. Plus you can adjust the camera to pan, tilt and zoom, using the app or parent unit. So you can get the best view of your little one, whatever their movements. And whether you’re inside or outside of your home, listen and talk to your baby over HD audio with two-way talk back. Never miss a moment with the BT Smart Baby Monitor.
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Pregnancy & Early Years
Premature birth can be distressing for parents and babies, but medical advances mean the outlook is better than ever before
DEFINITION A ‘premature’ or ‘preterm’ baby is defined as one that is born before 37 weeks of pregnancy. Around seven percent of births (60,000 a year) in the UK are preterm, and there are different categories levels of prematurity, each carrying their own risks: Extremely preterm (less than 28 weeks) accounts for five percent of preterm births in the UK Very preterm (28 to 32 weeks) accounts for 11 percent of preterm births in the UK Moderate to late preterm (32 to 37 weeks) accounts for 85 percent of 52 | Healthy Child with Dr Ranj Singh
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risk, as can multiple pregnancy (twins, triplets or more). The average length of pregnancy for twins is 37 weeks, and for triplets it’s 33 weeks. In some cases of premature birth (about 25 percent), the delivery is planned by induced labour or caesarean section because the mother and/or baby are suffering life-threatening complications such as pre-eclampsia, kidney disease or growth restriction.
DEVELOPMENT Premature birth at less than 22 weeks gives almost no chance of survival
22 weeks is around 10% 24 weeks is around 60% 27 weeks is around 89% 31 weeks is around 95% 34 weeks is equivalent to a baby born at full term preterm births in the UK. Medical advances mean that we are getting better all the time at treating preterm babies, but the chances of survival still depend very much on gestational age (week of pregnancy) at the time of birth. Complications such as infection or cervical incompetence can increase the
But given the improvement in neo-natal care, why is premature birth a problem? During the nine months of pregnancy, the baby’s body is developing to allow them to live independently; if they are born prematurely, some parts of their development will not be complete, and they may have difficulty in surviving or developing fully. Generally, the earlier the birth, the higher the risk of problems. Some extremely premature babies do very well and develop into healthy children, but one in 10 of all premature babies will have a permanent disability such as lung disease, cerebral palsy, blindness or deafness; one in two of premature babies born before 26 weeks of gestation will have some sort of disability (including mild disability such as requiring glasses for reading); and in children born before 26 weeks’ gestation, while around 20 percent have no problems, 22 percent
are of premature babies has improved enormously, even in the last couple of decades; a recent World Health Organisation study showed thet since 1997, survival for babies born at 22-31 weeks has increased by six percent, while survival without sensory or neuromotor disabilities increased by just over seven percent. Pierre-Yves Ancel, professor of public health at the French National Institute of Health and Medical Research and co-author of the research, said “Not only has survival improved, but survival without these severe disabilities.” Equally important, the level of support given to the parents of premature babies has also improved, with charities like Tommys.org offering help and advice.
Pregnancy & Early Years
Symptoms Before 37 weeks of pregnancy, watch for the following symptoms which could be signs of premature labour, and if you experience them, contact your hospital
✤ An increase in pelvic pressure within the vagina or rectum
✤ A fluid discharge which could
mean your waters have broken
✤ Bleeding or loss of the mucus plug
✤ Rhythmic or constant cramping pain in your abdomen or lower back
suffer severe disabilities such as cerebral palsy, blindness or deafness; 24 percent have a moderate disability such as low IQ/cognitive scores in the special needs range, and lesser degrees of visual or hearing impairment; and 34 percent have a mild disability such as a low IQ/ cognitive score or sight problems. Studies show that the risks of preterm celebrityangels.co.uk
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birth are slightly higher for certain ethnic groups such as Black Caribbean and Bangladeshi. In some cases, a cause of preterm birth can be shown, but more often than not it is unknown or unclear. Research into possible causes and preventative measures is centred on several promising lines of enquiry:
Did you know?
The avera human g ge length of est days, or 4 ation is 280 only abo 0 weeks, but u of women t four percent a birth on ctually give their exp ected date
✤ A protein called elafin could be used to tell which women are most at risk of going into early labour ✤ Researchers are working on a cheap saliva test which could identify women at risk of giving birth prematurely ✤ Drugs normally used to prevent heart disease may delay preterm birth While research continues, there is hope that just as outcomes for premature babies have improved over the years, understanding of the causes and likelihood of the condition occuring could improve the prospect for mothers and their premature babies sooner rather than later. hc Healthy Child with Dr Ranj Singh | 53
FOR DELICATE SKIN
ADVENTURES Epaderm Junior for all ages including babies joins the Epaderm family of emollients at Superdrug. Epaderm’s fragrance, colouring and SLS* free formula is recommended by doctors and parents. Epaderm Junior cares for dry skin, eczema and psoriasis, freeing you and your little one to plan the next adventure.
MOISTURISES AND SOFTENS SKIN for the management of dry skin conditions
Dry Skin * Sodium Lauryl Sulphate
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Taking Care of Young Skin Skin care regimes aren’t just for the adolescent or senior—it’s just as important, if not more, to look after kids’ skin
t might not look that different, but children’s skin has many characteristics that make it different from an adult’s. Children have thinner and more delicate skin than adults, so it can be more sensitive to injury and irritation. When you take into account the action-packed activities of childhood, such as swimming, camping, sandpits and generally messy play, it becomes clear that even though they’re blessed with the glowing complexion of youth, your child’s skin needs just as much care as yours. Here’s where to start.
LIMIT EXPOSURE TO IRRITANTS Children’s skin can be particularly sensitive to irritants in the air around them. Aerosol products such as furniture polish or air-freshening sprays, pet hair and dander and wool or synthetic clothing are all things that can irritate your child’s skin. Try to keep these household irritants to a minimum by avoiding the use of aerosol products around children, vacuuming weekly, keeping pets out of the bedroom and choosing mainly cotton or cotton blend clothing for your child. Before your child wears new clothing, put it through the wash with a sensitiveskin-friendly detergent free of dyes and perfumes.
Don’t forget the lips!
Just one blistering sunburn in Apply a li p your youth with sunsc balm KNOW WHEN TO re can double SEE A DOCTOR your child en to ’s your chance If you child’s skin is very irritated when the lips y go of developing and itchy, or if they have frequent outside. melanoma, rashes, it’s prudent to consult a according to the doctor. It may be something that can American Academy be fixed easily, such as an allergy to of Dermatology. To prevent sun damage, something in the home, but it might be a encourage your child to stay out of direct skin condition such as eczema that will sunlight when the sun is the strongest, require special treatment. from around 10 a.m. to 4 p.m. Cover them in protective clothing when they’re playing WOUND CARE outside and apply a sunscreen with an In cases of wounds, there are six simple SPF of at least 30. tips to remember: celebrityangels.co.uk
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nder Kids rue more five ae to skin pron es and rash ema ecz
✤ Wash your hands to prevent infection and if possible, wear medical gloves ✤ Stop any bleeding, using a clean cloth and direct pressure if necessary ✤ Clean the wound using cool tap water, bottled water or baby wipes—avoid using alcohol, hydrogen peroxide or similar as these can be irritant ✤ Apply antibiotic cream, reapplying one to three times a day ✤ Bandage to prevent infection, encourage healing and prevent picking ✤ Check for signs of infection such as crusting, discharge or odour. hc
Remember all these tips and your child will adopt life-long, skin-safe habits! Healthy Child with Dr Ranj Singh | 55
The Eyes Have It Around 80 percent of vision problems worldwide are avoidable or curable. Here’s how to keep your child’s peepers in tip-top condition
REGULAR CHECKS Take your child for an eye test at least once a year to catch any developing problems. Complaints about headaches, inability to see the board in school, or other eye-related problems should prompt an immediate examination. Scientists say about 80 percent of our sensory input comes from sight, so we need to protect our eyes throughout our lives.
SCREEN TIME Staring at screens for long periods will cause eyestrain or tired eyes. To help protect your child’s eyes, try the following: • Set a timer for their screen use • Encourage them to focus on the distance every 20 minutesor so • Avoid using screens in brightly lit areas • Encourage them to hold their digital devices at a distance • Remind them to blink regularly hc 56 | Healthy Child with Dr Ranj Singh
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e risks, Despite th ent erc only 58 p ave h ts of paren n wear re their child s on a sunglasse sis regular ba
AVANT-GARDE OPTICAL Most of us are aware of the dangers of ultraviolet radiation to the skin but many will not realise the effects it can have on the eyes, where it can promote changes in many tissues causing cataracts, ocular tumours and macular degeneration in later life. According to the World Health Organisation, "Up to 80 percent of a person’s lifetime exposure to UV radiation is reached before the age of 18", and 80 percent of ultraviolet radiation reaches the earth between 10am and 2pm, with levels at their highest during the summer. Children have larger pupils and the lens of a child’s eye absorbs much less ultra-violet radiation than that of an adult. With 10 percent of all skin cancers occurring on the eyelids, where sun cream is not usually applied, protecting children’s eyes is especially critical during the school day to avoid these later life problems, so good quality sunglasses for children are essential. www.avantgardeoptical.com
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hild eye care is a proactive rather than a reactive business—you need to be on top of it all the time, particularly in the summer. Making sure your child gets regular eye tests and health checks, controlling exposure to the sun, maintaining a balanced diet, limiting screen-time and getting enough rest all are important aspects of making sure their vision stays strong for years to come.
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Sleeping Soundly There’s lots of conflicting advice about safe sleeping practices, but follow our guide and your kids will snooze securely
here are a lot of old wives’ tales and urban myths surrounding how you should put a child down to sleep—but real experts stick to a few basic principles which will serve you well. As there’s still no complete explanation for the terrifying incidence of SIDS (Sudden Infant Death Syndrome, or cot death), these few basic rules can be the difference between happy night-times and tragedy.
SLEEPING ON THE SOFA Sleeping with your baby on a couch or an armchair is a temptation when you have had an exhausting day looking after them, but 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.
BACK OR TUMMY? Parenting blogs and books offer advice than runs from one extreme to the other—and then back again. But medical science has weighed in unequivocally on this question: infants should sleep on their
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backs. According to the NHS, this will reduce the risk of SIDS. There’s no need to worry about what to do once your baby is old enough to roll over, because at that point, they are big enough to no longer be at risk for cot death.
the risk of SIDS, as can bundling up your baby when the room is too cold. Ideally, 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.
SHARE A ROOM, NOT A BED
ASK A DOCTOR
The safest place for your baby to sleep for its first six months is in a cot in your bedroom. This doesn’t mean in your own bed, and it’s particularly important not to share a bed with your baby if you and your partner take sleeping medication, have recently drunk alcohol or are smokers—no matter where or when you smoke.
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
NO SMOKING On that note, babies exposed to cigarette smoke before and after birth are at an increased risk of SIDS. Don’t let anyone smoke in the house, and don’t take your baby into smokey places.
ROOM TEMPERATURE Overheating of the room can increase
TIPS FOR SAFE SLEEP ✤ Breastfeeding is best ✤ Give your baby a dummy to sleep with ✤ Keep your baby’s head uncovered ✤ Keep the cot free of clutter ✤ Choose a cot conforming to British Safety Standard BSEN716
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What’s the Story with
Coeliac Disease? Recent reports suggest that the immune system condition coeliac disease could be a reaction to eating gluten—so should we get our kids on a gluten-free diet? The truth is a bit more complicated
RISK FACTORS The Environmental Determinants of Diabetes in the Young (TEDDY) study was set up to look at the link between environmental and genetic risk factors for coeliac disease and type 1 diabetes. Both conditions are associated with genes which carry instructions for making immune cells. Researchers looked at children from 60 | Healthy Child with Dr Ranj Singh
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TEDDY trial The researchers in the TEDDY trial looked at the diets of 6,605 children from Sweden, Finland, Germany and the US, all of whom had genetic variants that put them at higher risk of developing autoimmune conditions like coeliac disease, where the immune system starts to attack the body’s own tissues.
birth to the age of five, as coeliac disease often starts in early childhood, and they did indeed find that children who ate more than the average amount of gluten were a little more likely to get the disease. But the form of the study means that we can’t definitely conclude that
the gluten led to the coeliac disease; the study involved children known to have a higher risk of developing an autoimmune condition, so they were not representative of children in general. For the study, more than 8,000 children with gene types linked to coeliac disease and type 1 diabetes were recruited at birth from six clinical centres in Finland, Germany, Sweden and the US. This sort of study, known as a cohort study because it studies a group of people sharing a particular characteristic, is a good way to spot patterns between risk factors (such as gluten in the diet) and outcomes (such as coeliac disease), but can’t tell us for sure that one causes the other—other factors may be involved and more research will be needed.
hen recent newspaper reports suggested that gluten in children’s diets can raise the risk of coeliac disease, they were basing their stories on a study carried out by researchers from 13 universities, hospitals and healthcare institutions in Sweden, the US, Germany and Finland. Funded by the US National Institutes of Health, the Centers for Disease Control and Prevention, and the USbased diabetes charity the Juvenile Diabetes Research Foundation, the study examined the theory that too much wheat and gluten in the early stages of infancy can raise the risk of coeliac disease in children. So was there any truth to the headlines? Well, up to a point. Coeliac disease is not a food intolerance—it’s a severe allergy, and the only treatment is a lifelong gluten-free diet. Between 1 in 5 and 1 in 10 of the higher risk subjects sampled in this study developed coeliac disease, a higher rate than the 1 in 100 population average.
HEALTHY So this study adds to our knowledge about how coeliac disease may develop in children with genetic variants linked to the disease, and how diet in early
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What is gluten? Gluten is a protein found in grains including wheat, rye and barley, and is an essential component of a healthy diet for most people. In people with coeliac disease, gluten triggers the immune system to produce antibodies that attack the lining of the gut wall, meaning they cannot absorb nutrients.
childhood appears to be linked—but it doesn’t tell us what young children should be eating, as most people do not have the genetic variants linked to coeliac disease, so the results do not affect them. As for the NHS’s attitude to the report, the conclusion is “There’s been a lot of media attention around people claiming to have a gluten intolerance and sensitivity, but this is not the same thing as an allergic reaction to gluten. Coeliac disease is actually fairly rare, affecting only around 1 in 100 people in the UK population, so gluten can form a normal part of a healthy diet for most people.” hc
DIETS The researchers asked parents to record their children’s diets over 3 days at intervals, when the children were aged 6, 9, 12, 18, 24, 30 and 36 months, and from the food records, researchers calculated the amount of gluten children ate per day. They also looked at how much gluten they ate as a proportion of their overall diet and compared with their body weight. The researchers looked for the development of coeliac disease through annual blood tests, and took account of varying factors including the child’s country of residence, sex, type of genetic variant, overall calorie intake and family history of coeliac disease. So what were the results? Indeed, children who ate more gluten than the average child in the study were shown to be more likely to develop coeliac autoimmunity or coeliac disease. The researchers said: “Higher gluten intake during the first five years of life was associated with increased risk of coeliac disease autoimmunity and coeliac disease among genetically predisposed children.” They added that a trial of different amounts of gluten in early childhood among genetically at-risk children “would be warranted to confirm our findings”.
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Is Choosing a Pram
Driving You Buggy? Call it a pram, a buggy or a pushchair, choosing a carriage for your kids isn’t a walk in the park. Read on for some straight-talking advice
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e first p around rams, designed 1650 of wicke , were built made to r and were be pull than pu ed rather shed.
kay, so you have a baby (or more than one), and you need to get from A to B with said baby in tow. Your little one is getting too heavy for their baby sling, and you want something that will take the weight off your feet—you want a pram. Or a buggy. Or a pushchair. What exactly DO you want? That rather depends on how many children you have, how big they are, and how long you want the baby carrier to last. The word perambulator dates from 1856 and is a sort of pig Latin for ‘baby walker’—from this of course we get the more familiar ‘pram’. But other phrases, such as pushchair, walker, buggy or the more American ‘stroller’ are equally common—so what’s the difference, what do you want, and how do you choose it? The right pushchair can carry your baby through from birth right into their toddling years, so let’s look at the variations.
Health Check The Traditional Pram If you like things to look traditional, you have plenty of storage space, and you have a newborn baby, you should opt for a pram. The pram allows the baby to lie flat, supporting their body and head, and keeps the baby facing the parent, so they can maintain eye contact. The deep, wide classic design can look a little old-fashioned and fussy, but prams often incorporate modern features such as detachable bodies and fold-down chassis. The sprung chassis gives a comfortable ride and a cotton liner and mattress are often included. You may get asked whether you’re the mother or the nanny, but a traditional pram will certainly get you noticed.
Pushchairs A pushchair is a more portable, manoeuvrable and compact alternative, which can usually be folded to go on a bus or in a car boot. Some can be folded with one hand, while others feature a carrying handle or fold strap. They’re suitable for babies under the age of two if they have a fully reclinable seat. Wheel types vary—they can be fixed, swivelling or lockable, depending on the sort of terrain you want to traverse. Often they can be set parent-facing or worldfacing, and fitted with shopping trays or baskets to make it easier if you’re running errands. Consider what type of ground you need to traverse, and the size of the boot of your car. Most brands offer a choice of models, some better suited to urban terrain, others to the countryside; if you’re a runner and want to combine pram-pushing with your usual exercise routine, you might want to opt for a jogging stroller, which alongside being suitable for your park circuit can also double up as an everyday option. You can also find pram/pushchair combinations with a carrycot and a seat unit, plus the necessary adaptors, which can be interchanged on the same chassis. Though this can be a more
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expensive option initially, it can pay off in the end as you should not have to upgrade in six months’ time. Another form of pushchair, the buggy, tends to be lighter in weight (perhaps 5kg rather than 10kg, collapsible, and for more everyday use. With some pushchairs, you do have the option to buy a second seat attachment for subsequent children, but of course if you have babies very close in age, or twins, you’ll need to opt for the double buggy option from the outset.
Travel systems The travel system is the ultimate in adaptability and versatility. For the first few months, your baby can sleep in a carrycot, which can be attached to a wheeled frame to go out. Travel systems are often compatible with carrycots and car seats, and usually feature shopping baskets. Add-ons can include rain covers and seat inserts.
Strollers Once your child is older than six months, you’ll probably want to graduate to a stroller. These are ideal for shopping, travelling and holidays, are easy to lift and carry, and can be taken as hand luggage on most aircraft. Twin (side by side) or tandem (one in front, one behind) strollers are available for twins, and also have features such as independent, multi-position reclining seats and foot rests, a bumper bar for older babies, removable washable covers, padded liners and a shopping basket.
Standards So you know what type of baby walker you’re looking for—now what features and functions do you need? First, bear in mind that all pushchairs, both new and used, must conform to the British Standard 7409:1996. They should also be marked as meeting the Furniture and Furnishings Regulations 1988, which set the bar for fire resistance of upholstered products designed for
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The clasp should be easy to operate and the straps should be adjustable. A five-point harness is the best type, as it provides the maximum security even with the most wriggly babies.
ACCESSORIZE Buying the pushchair or buggy can be just the start of your purchasing decisions, as you often need accessories which are not included with the basic design. Budget for a washable seat liner to stop crumbs getting into the lining, a rain cover or hood if not provided, and a sun parasol if there is no built-in shade. Some buggies come with an ultraviolet sunshade and insect net as part of the hood. For cold weather you might want to add a fleece lining and/or a footmuff, and to keep baby occupied, there’s always a
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e strolle did not r or pushchair b popular ecome really until the 1950s and 196 ownersh 0s when car ip becam common e more .
babies and young children. Don’t buy anything that does not feature both these standards labels. The second essential is to check the buggy’s weight limit. A larger child or the additional of some shopping bags could push the buggy over its safe limit and lead to dangerous instability. Another essential safety feature, the brakes, should also be tested, preferably with the buggy loaded—you need to be sure that they effective, particularly when the buggy is on an incline. Check the handles too, as if you are very tall, they may not extend enoughfor you to push the buggy comfortably. As it’s important that you are able to position your baby in a safe position lying flat, check that the buggy has a reclining function—not all do. The last safety check is the harness.
colourful choice of toys to hang on the bumper bar—which also makes your pram easier to identify when it’s parked in among many others. But make sure any toys you add are safely fastened to prevent accidents. Most changing bags for storing nappies and fresh clothes come with stroller straps so you can attach them to the pushchair handles, keeping everything in easy reach when you are out and about. A stroller organiser gives you somewhere to store your keys, mobile phone and purse in easy reach, while a stroller platform provides a standing space for an older brother or sister. A more heavy duty buggy board clips onto the back, so even older siblings can hop on and cruise along. Snack pots, cup holders and so on can also be handy little add-ons, and many come with a ‘universal connector’ so you can clip on what you need according to the weather and your outdoor plans. hc
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Safety On Four Wheels When you take you kids in your car, you take their lives in your hands. Find out all you need to know about the regulations covering car seats
riving with a child passenger in your car can be trying enough, what with the risk of distraction and the endless enquiries of ‘are we there yet?’ So the last thing you should do is to add safety worries to your burden by letting the kids ride unsecured. celebrityangels.co.uk
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Car seats come in all sorts of shapes and sizes, so it’s vital to know exactly what the law says about what you must provide and what is best for your differently aged children. First, safety belts. It’s wrong to assume that if you make your child fasten a safety belt, you have done all you need to do
for their security. In fact, you have done entirely the wrong thing, because car safety belts are designed for adults, don’t sit in the right position for children, and may actually harm them in case of an accident. Second, don’t assume that if you are a passenger, holding a child on your lap Healthy Child with Dr Ranj Singh | 65
Health Check ‘E’ in a circle and ‘R129’. Height-based seats are known as ‘i-Size’ seats. They must be rear-facing until your child is over 15 months old. Your child can use a forward-facing child car seat when they’re over 15 months old, but you must check the seat to make sure it’s suitable for the height of your child. For weight-based seats, the seat your child can use (and the way they must be restrained in it) depends on their weight. Only EU-approved weightbased child car seats can be used in the UK. These have a label showing a capital ‘E’ in a circle and ‘ECE R44’.
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must travel in the front seat with the correct child car seat. ✤ Children must normally use a child car seat until they’re 12 years old or 135cm tall, whichever comes first, and children over 12 or more than 135cm tall must wear a seat belt.
CHOOSING A SEAT You can choose a child car seat based on your child’s height or weight. Only EU-approved height-based child car seats can be used in the UK. These have a label showing a capital
is safe. The Child Accident Prevention trust says that trying to hold a baby in your arms in a 30mph crash would be like trying to lift eight bags of cement in one go. The law says that a child aged under 3 must not travel in a car without a child car seat, but there are some exceptions when a child can travel without a car seat: ✤ A child aged 3 or older can travel in a back seat without a child car seat and without a seat belt if the vehicle doesn’t have one. ✤ In a minibus, all children must travel in rear seats (any seats behind the driver) if a child car seat or an adult seat belt isn’t fitted. Minibus or coach drivers and companies don’t have to provide child car seats. You must provide your own if you want to make sure a child has one. ✤ On coaches, children can travel without a child car seat or seat belt, if they’re not available. ✤ If the correct child car seat isn’t available, a child aged three or older can use an adult seat belt if the journey is unexpected, necessary, and over a short distance ✤ In taxis and minicabs, If the driver doesn’t provide the correct child car seat, children can travel without one, but only on a rear seat. ✤If there’s no room for a third child car seat in a car or van, the child
The introduction in 2013 of the European i-Size (R129) standard means that eventually all car seats will fit in all cars. The car and seat must have Isofix, a fitting system that attaches car seats directly to the frame of your car using Isofix connectors. At the moment, even if your car has the anchor points, an Isofix car seat won’t necessarily fit: i-Size aims to change this. The i-Size standard introduces a side-impact crash test as part of the approval process, and classifies seats based on the child’s weight rather than height. The R129 standard also makes it mandatory to keep your baby rearward-facing until they are at least
You may be able to choose from more than one type of seat in the group for your child’s weight.
0kg to 10kg
Lie-flat or ‘lateral’ baby carrier, rear-facing baby carrier, or rear facing baby seat using a harness
0kg to 13kg
Rear-facing baby carrier or rear-facing baby seat using a harness
9kg to 18kg
Rear- or forward-facing baby seat using a harness or safety shield
15kg to 25kg
Rear- or forward-facing child car seat (high-backed booster seat or booster cushion) using a seat belt, harness or safety shield
22kg to 36kg
Rear- or forward-facing child car seat (high-backed booster seat or booster cushion) using a seat belt, harness or safety shield
Manufacturers can now only make booster cushions approved as group 3. This won’t affect any existing booster cushions in group 2 and you’ll still be able to use them. celebrityangels.co.uk
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FITTING You must only use a child car seat if your car’s seat belt has a diagonal strap, unless the seat is either specifically designed for use with a lap seat belt or fitted using ISOFIX anchor points. You must also deactivate any front airbags before fitting a rear-facing baby seat in a front seat, and not fit a child car seat in side-facing seats. The same rules apply for children with disabilities or medical conditions, but they can use a disabled person’s seat belt or a child restraint designed for their needs. A doctor can issue an exemption certificate if a child is unable to use a restraint or seat belt. Make sure the car seat you choose is easy to fit, or you might be tempted not
to bother with it on short journeys—and that’s when most accidents happen. Try your car seat before you buy it, fixing the restraint into the car as tightly as you can, and checking that it doesn’t move to the front or side. Make sure the seat buckle doesn’t rest on the frame of the child seat. Try a different position in the car if your initial attempts seem difficult. It can be tempting to save money by buying a second-hand car seat, but it’s not a good idea. It can be impossible to tell if a car seat has been damaged or dropped, so it could be a safety risk. If you lend a car seat to a relative or childminder, make sure they know how to fit it, and that it fits in their car. Seats with ISOFIX attachments are easier to install in cars than those that rely on the adult seat belt. Also, they are usually more secure. Check to see if you can fit an ISOFIX seat into your car.
FINAL TIPS Choosing and fitting a car seat is part of the process, but actually driving with children in the car is another thing altogether. Remember these safety tips: ✤ Avoid driving long distances with newborns.
The Lullaby Trust advises parents that they should avoid travelling in cars with pre-term and very young babies for long distances. The charitable organisation bases its advice on 2018 research in which babies showed signs of potentially adverse cardiorespiratory effects when seated in an upright position at 40°. ✤ Keep your eyes on the road. Obviously this advice applies to all drivers, but it’s particularly important to remember if you’re a new parent and tempted to take a quick look back at your baby. Apart from the risk of causing a crash,driving while distracted can carry a fine of £100 and three penalty points. You can buy special baby car mirrors which mount on the rear headrest and give you vision of the baby in a rearfacing seat. ✤ Bring your mobile phone for emergencies, and make sure it’s charged. ✤ Travel with first aid equipment, blankets and bottled water in case of accidents or delays. Drinks are particularly important in hot months, and consider fitting sun blinds on passenger seat windows to keep the heat off children. ✤ Never leave children unattended in a car, or leave your keys in the car. ✤ Never smoke with children in the car. It’s illegal to do this with children under 18 and can lead to a fine of £50. ✤ Don’t obscure your vision with Baby On Board stickers. They’re meant to alert emergency services and warn other drivers, so it’s counter-productive if they obscure your view and cause an accident. Finally, you’ll need to find a way to occupy little trouble-makers when they start wriggling around and trying to get out of their seats—a play-tray, tablet device or picture book should keep their minds on their toys so you can keep your mind safely on the road. hc
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15 months old, because of the relative size of babies’ heads compared with their bodies, and the weakness of their neck muscles. In a frontal impact, in a forward-facing seat, the forces placed on a baby’s neck by their head can be too great to withstand. But in a frontal impact in a rear-facing seat, the child is pushed further into the seat, supporting the head and back and limiting the movement of the head on the neck.
is No Accident The Child Accident Prevention Trust is starting its 2020 Child Safety Week campaign. What hazards are likely to be high on the agenda?
he Child Accident Prevention Trust is the leading charity working to reduce the number of children and young people killed, disabled or seriously injured in accidents. It exists because, sadly, accidents are now the leading cause of death, serious injury and acquired
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disability for children and young people. Many of these accidents can be prevented, and the Trust works to highlight different hazards each year as they arise. Events are held by a range of different organisations and individuals, including children’s centres,
childminders, fire and rescue teams, hospitals, schools and many more. This year’s theme, Family Life Today: Where’s the Risk? highlighted the potential hazards of everyday family life and the new dangers facing families today from our modern lifestyles.
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Health Check Among the points it raised were: ✤ Falls are one of the most common causes of childhood accidents ✤ Six toddlers are admitted to hospital every day because they’ve been so badly burned ✤ Many accidents can be prevented by moving dangerous objects ✤ Mobile phone use can be a dangerous distraction for children or for people minding them
BUTTON BATTERIES, particularly lithium coin cell batteries, can be deadly if they are swallowed and get stuck in the throat. The reaction in the child’s throat can kill in less than two hours. Button batteries power so many essential products in the home like watches, car key fobs, slim
The Trust says: “In fact accidents are the leading cause of death, serious injury and acquired disability for children and young people in the UK. They account for three deaths every week and over 2000 hospital admissions. Many of these accidents can be prevented. By their nature accidents often happen when they are least expected. Too often we hear from parents ‘why didn’t I know?’ "This year for Child Safety Week we aim to highlight the new dangers facing us from our modern lifestyles and offer
simple solutions to keep children safe.” So what are the latest dangers highlighted by the Trust’s campaign? Some of the hazards of modern family life seem unlikely, but experience has shown that often the very things that help make life more convenient bring new risks
remotes and kitchen scales. But spare and old batteries are often the culprits too. The simplest way to reduce the risk is to store them out of children’s reach. Check the compartment of appliances with lithium coin cell batteries to make sure they are secure and don’t let children play with them. Back in 2016, London’s Great Ormond Street Hospital reported a big increase in cases. Consultant neonatal and paediatric surgeon said Kate Cross said: “Button batteries should be treated like poison and kept out of reach of children.” Three-year-old Valeria, from Northern Ireland, was been left with permanent damage to her throat after she swallowed a watch battery in April 2015. The battery became stuck in her food pipe and she began being sick and refusing food. It was not until five days later that an X-ray showed she had swallowed a battery, by which time it had burned a hole through her oesophagus and windpipe. She needed nine months of specialist treatment at Great Ormond Street
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Health Check Hospital and still needs to visit regularly. Kate Cross continued: “If the battery gets enveloped in the mucosa of the oesophagus it creates an electrical circuit and the battery starts to function, releasing an alkali which is like caustic soda, which can erode through the wall to the windpipe. “If the battery is facing a different way it can burn into the aorta, a major blood vessel, and there have been cases in Britain where the child has bled to death. Katrina Phillips, Chief Executive of the Child Accident Prevention Trust, said: “Button batteries are everywhere in our homes, in many products that appeal to children. But very few parents know about the danger they pose, especially those containing lithium. We want to join forces with the battery industry to raise awareness and help keep children safe.” In 2014, engineers in the US produced button batteries with a special coating which conducts electricity only when squeezed, such as when it is in a spring-loaded compartment, but the technology has yet to be incorporated by manufacturers. The British and Irish Portable Battery Association (BIPBA) said it was investigating such designs. BIPBA said it “takes the safety of consumers very seriously”, adding that warning notices are placed on batteries, and packaging is child resistant.
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Hazards COT BUMPERS, which are supposed to prevent injury by covering hard surfaces in a cot or crib, are in fact a danger, as they can be the cause of suffocation or strangulation if a baby’s head gets trapped between them and the mattress. Francine Bates, Chief Executive of The Lullaby Trust says: “[There] is compelling new evidence that cot bumpers do pose a serious risk to babies. We do not recommend the use of any sort of cot bumpers and urge all parents to follow our safer sleep advice to use a flat firm mattress in a cot or Moses basket with no loose bedding, pillows or bumpers. “Cot bumpers pose a threat to babies once they begin to roll and move about the cot. We know that some infants have become entangled in the ties and material or fallen whilst pulling themselves up on the bumpers. “Baby retailers need to think twice before selling these products or at the very least we need to see
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,a a day a round 15 childr hospital re admitted int en they’ve because it’s thou o swall ght poisonou owed somethin g s. Swa medicin es such a llowing is the m s ost comm painkillers on children to be po way for isoned.
consistent safety standards for cot bumpers across Europe and clearer warning messages on all packaging. “New parents now have a massive range of baby products to choose from and it can be really confusing to know what is needed. Babies need just a few basic items for sleep: a firm flat surface and some bedding. "Our advice is simple: the safest cot is a clear cot.” NAPPY SACKS present another danger as their flimsy nature means they can easily cause suffocation. If a small baby gets one in their hand and puts their hand to their mouth, they are not able to pull it away. They should never be stored under the cot mattress. Healthy Child with Dr Ranj Singh | 71
measures, instead of bathing aids requiring constant adult supervision. “Babies and young children should never be left unattended in a bath, not even for a minute.” Katrina Phillips, of the Child Accident Prevention Trust, said babies could drown in just a few centimetres of water, very quickly and with no noise or struggle. “They can’t recognise danger, and don’t have the strength to try to reach the surface. This means you need to stay with your baby all the time near water.” David Walker, of the Royal Society for the Prevention of Accidents, said: “Bath seats are a really useful tool, as parents with babies and toddlers sometimes need all the help they can get, and that’s the intention of these products. However, they can lead to a false sense of security. “Distractions from the phone, other children or someone at the door are really quick events that have led to tragedies. What feels like a couple of seconds can be a minute or two, which is easily enough time for significant injuries or even death to occur.”
More Dangers BLIND CORDS which can act as a noose can cause strangulation in less than a minute. Blinds should be fitted with safety breakers, or a cleat hook fitted 72 | Healthy Child with Dr Ranj Singh
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so that the cord can be tied safely away every time. HAIR STRAIGHTENERS can cause severe burns, particularly if they are left on the floor where babies or toddlers can get at them. They get as hot as an iron and take time to cool down, so they also pose a fire risk. Hair straighteners should be stored in a heat-proof pouch out of reach of small children. WASHING CAPSULES are an invaluable aid in the laundry, but contain powerful chemicals which can cause damage to children’s eyes and throats. Washing capsules should be stored on a high shelf or in a cupboard with a safety lock and put away as soon as you’ve used them. Some are formulated with a bitter-tasting safety ingredient such as Bitrex (denatonium benzoate), which though completely harmless itself makes substances unpleasant to the taste. Bitrex is also found in detergents, fabric softeners, screenwash, anti-freeze, shampoo, bath gel, insect repellent and many other household items. If you want to know more about the Child Accident Prevention Trust’s Child Safety Week 2020, sign up at www.capt. org.uk to get an action pack, poster, competitions, quizzes and more, and do your bit to improve child safety. hc
BATH SEATS, which some parents assume are safety approved, are in fact not intended for babies to be left in, even for a moment, due to the risk of toppling forwards and causing drowning. In 2015 the Royal Society for the Prevention of Accidents said that one in three accidental drowning deaths in children aged two and below involved bath seats, and each year in the UK, about 13 children younger than five die from drowning. For each drowning fatality, there are eight non-fatal drowning events serious enough to require admission to hospital. Dr Yvonne Doyle, from Public Health England, said: “If unsupervised, young children can tip over in a bath seat and become trapped or climb out of it, with potentially fatal consequences. “These seats are used by parents when bathing babies and young children, but they can often be mistaken as safety
World Rugby recent ly recognised the risk of head injuries sustained th rough tackling and is lookin g at changing the height at which it’s allowed, and ba nning tacking above the waist
Playing for Kicks Children and teens made up almost half of of A&E patients with a sports injury last year. Is sport getting too dangerous for our kids?
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to get involved in different sports, the idea being that sports increase a child’s physical activity, but are sufficient safety precautions being put in place? Schools of course focus a lot of attention on protecting children from harm, but do they lack focus on the risky nature of some of the most popular sports among children, and the activities taught in P.E.?
Rugby Rugby is hugely popular among young boys but notorious for encouraging aggressive behaviour. The sport has become infamous for causing concussions and ‘scrum’-related injuries. Evidence presented by the American
NFL showed that 95 percent of children who played American football had been badly injured at least once during the time that they participated in the sport. In the UK, while it’s widely advised that young people do not engage in tackles and are encouraged to play non-collision or ‘tag’ rugby, there are still large amounts of injuries caused every year. Research published by the British Journal of Sports Medicine showed that tackles were responsible for 64 percent of all injuries and 87 percent of concussions.
Football Football is widely enjoyed by both boys and girls and isn’t usually considered dangerous. However, in recent years it
e all want to encourage kids to enjoy sports and exercise rather than sitting and watching the television— but has children’s sport become dangerously competitive? Childhood bumps and bruises are all part of the experience of growing up, but the risk of injuries far more serious than just a few scrapes and bruises is often overlooked. Children and teenagers made up almost half of those who came to A&E with a sport injury last year, many of them involving severe blows to the head and even broken bones, dislocations and fractures. The government’s Childhood Obesity Strategy hugely encourages children
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has been found to cause some of the severest concussions in children. The main reason for this is “heading” the ball. Children see players on their favourite teams do it, they see it in the World Cup, but don’t consider how risky it can be for younger players. A study in 2016 by the University of Stirling indicated memory impairment immediately after heading the ball, and campaigners draw attention to what they call “frightening” anecdotal evidence of former players suffering serious brain disease. The Stirling study reported a reduction in memory performance of 41-67 percent in the 24 hours after players headed a football 20 times that was delivered with the pace and power of a corner kick. Memory function did return to normal 24 hours later. Children aged 10 and under are already banned from heading the ball in the United States, and there is also a restriction on heading for those aged between 11 and 13. Heading has even been linked to increased risk of dementia in later life, raising even more questions about just how risky football for young people is.
HORSE RIDING Horse riding is popular among young girls; it’s good exercise, satisfying and good fun. It is however, considered one of the most dangerous sports in the world. A fall or a kick from a horse can be lethal, and many professional riders have died or been hospitalised in horse riding accidents. Strains, sprains, fractures and dislocations can be experienced due to horses falling, kicking their back legs, getting spooked, or disobeying the rider causing them to fall off. While most riding schools carefully follow safety procedures, there are always dangers from inconsiderate drivers when horses are ridden along roads, where horses can easily be spooked by oncoming traffic. 74 | Healthy Child with Dr Ranj Singh
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TRAMPOLINING The pet hate of the Royal Society for the Prevention of Accidents is probably trampolining, both a popular grass-roots activity and an elite, Olympic-level sport. ROSPA says: “Children of all ages love the feeling of flying through the air and mastering skills ranging from basic jumps and landing safely to advanced acrobatics including complicated somersaults. The downside is that hospital Emergency Departments are now having to deal with significant numbers of trampolining injuries.” While trampoline parks should be enforcing safety procedures and equipment maintenance, In fact research from Sheffield Children’s hospital found that out of 198 children with trampoline injuries, 130 used private equipment and 68 were from indoor parks. Out of all trampolining injuries, 63 percent were due to bad landings. This is why it is strongly encouraged for parents to surround their trampoline with safety netting, set it up at ground level and never allow children under the age of six to use a trampoline. hc
HEAD OFF INJURY Dr Bennet Omalu, one of the world's leading experts on brain injuries, strongly believes that heading the ball in football should be restricted for under 18’s. This is due to the evidence that repeated head trauma from heading the ball can cause brain damage.
Mental health provision for children in the UK is worryingly inadequate. What can be done to improve the situation?
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SUPPORT The Children’s Society report found that a third (32 percent) of parents of children between the ages of 4 and 17 said their child had been affected by a mental health issue in the last year, and 2 in 5 of those parents had sought help but not received any support. Many of these children, the report suggests, will likely have had problems with their emotional and mental health that were not diagnosable conditions or would not have met clinical thresholds, but parents were still concerned about these issues to report them in the survey or seek help. Two in three parents (64 percent) surveyed said that if they were concerned about their child’s mental health they would initially go to their GP to seek
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find support Specialist mental health services are known as CAMHS (Tier 3) services. They provide a range of support for young people with more severe, complex and persistent needs. Professionals who provide the services may include therapists, psychotherapists, psychologists, social workers and Youth Offending Teams, and referrals normally come from a GP, school or social worker.
help. However, due to high thresholds for Child and Adolescent Mental Health Services (CAMHS) they may not qualify for treatment. Just under a third of parents were unaware if counselling was available in their child’s school.
For those children with the most serious needs, NHS waiting times remain stubbornly high, with children waiting the equivalent of a school term, an average 12 weeks (or 83 days), from referral to treatment, when the current waiting time standard is four weeks. The report found in some areas children experiencing issues such as anxiety, depression and self-harm are having to wait much longer—up to 364 days from referral to first treatment. The Government is piloting more mental health support in schools, but as little as one fifth of the country will benefit from the planned pilot schemes, meaning the current “postcode lottery” will continue for the foreseeable future.
hildren and young people with mental health issues are being turned away from NHS services and up to 110,000 are missing out on treatment in a year, according to recent figures from The Children’s Society. The report, Finding Help—Children, Young People and Families Navigating the System, was based on Freedom of Information responses from 26 mental health trusts across England. Worryingly, it estimates that up to 110,000 10-17 year olds seeking help are being turned away because their problems were not deemed ‘serious’ enough. This means that due to high treatment thresholds many young people may never have their needs addressed and are more likely to reach crisis point. We all hear about the stresses of modern life and how they impact children—online bullying, exam stress, social pressures and fear of violence are in the news constantly. But it seems that there are rarely any solutions offered. Compound that with parents unsure how to help, schools unable to take responsibility and the NHS overburdened and under-resourced, and you it's clear how this is quickly becoming a crisis.
Health Check SCANDAL Sam Royston, Director of Policy and Research at The Children’s Society, said: “It’s a scandal that so many children and young people are suffering with their mental health are not getting the support they need, either by being deemed too well for treatment, having to wait many months, or having no early intervention alternatives available, meaning they are likely to become more unwell and hit crisis point. “The NHS estimates that one in eight children are experiencing mental ill health, but we see that as many as one in three parents have been worried about their child’s mental health over the last year. Families are reliant on their GP and schools for help but a third of parents don’t even know if their school can offer any mental health support so are often going to the wrong places, getting rejected because they aren’t meeting treatment thresholds and are receiving no further advice or guidance. “For those young people with the most serious need, NHS waiting times for CAMHS remain shockingly high and we urge the government to ensure all children and young people can get immediate help when they need it—at their school or at a local community drop-in centre—so they have an opportunity to talk about how they are feeling and not made to suffer in silence.”
will receive extra support to make sure people know how to promote good mental health in the same way that they look after physical wellbeing. These measures include: ✤ Training for all new teachers on how to spot the signs of mental health issues, backed up by updated statutory guidance to make clear schools’ responsibilities to protect children’s mental wellbeing ✤ All 1.2 million NHS staff encouraged to take suicide prevention training from the Zero Suicide Alliance, which we have already committed to support with £2m of government investment ✤ Support for school mental health leads so they can help children struggling with self-harm and risk of suicide ✤ Access to world-class teaching and training materials for all teachers to use in classrooms to meet the new requirements for mental health education for all primary and secondary pupils ✤ Extra funding to support local authorities to strengthen and deliver local suicide prevention plans so that they better meet the needs of the people they serve ✤ Updated professional standards for social workers across England to increase their knowledge and skills when helping those with mental health issues
In a statement, the Prime Minister said: “Too many of us have seen firsthand the devastating consequences of mental illness, which is why tackling this burning injustice has always been a personal priority for me. But we should never accept a rise in mental health problems as inevitable. “It’s time to rethink how we tackle this issue, which is why I believe the next great revolution in mental health should be in prevention. The measures we’ve launched today will make sure at every stage of life, for people of all backgrounds, preventing mental illness gets the urgent attention it deserves. “Further plans to drive a step-change
Based on a Freedom of Information request the Children’s Society estimates that as many as 185,000 young people aged 10-17 were referred to specialist mental health services in 2017 and only 79,000 received treatment in the same year. As a result, it’s concluded that around 60 percent of those referred, or almost 110,000 children, are not receiving care for their mental health problems.
TRAINING Earlier in the year, the government announced a package of support with the aim of overhauling approaches to preventing mental illness, “building on record investment in mental health services". According to the plan, teachers will be trained in how to spot the signs of mental health issues, and there will be better access to education, training and support across communities as part of an overhaul of society’s approach to mental illness. The announcement said:“Schools, social workers, local authorities and healthcare services
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The Children's Society
PROVISION As part of this prevention agenda, the Prime Minister also announced: ✤ £1 million to the Office of Students for a competition to find innovative new ways to support mental health at universities and colleges ✤ Research following the government’s Children in Need review to build new evidence on the best ways to support children who have faced adversity, abuse and neglect ✤ Greater transparency in how money is spent on mental health services, with a commitment to independent audits to ensure that the funding committed under the NHS Long-Term plan reaches the front line ✤ Support given to new parents from health visitors and other professionals 78 | Healthy Child with Dr Ranj Singh
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will be modernised to better support their babies’ behavioural and emotional development But Sam Royston, Director of Policy and Research at The Children’s Society, sounded a note of caution, saying: “The well-being of children in the UK has been in decline for almost a decade. We have found that 100,000 10-17 year olds get turned away from mental health services each year and early support is urgently needed to prevent issues escalating and forcing children into crisis. “This announcement, mostly a re-packaging of previously announced measures, does have some welcome additions. The training for new teachers is particularly welcome although it is a shame that the prime minister has not also included existing teachers. “The focus on social workers is a very positive addition, as children living with the consequences of abuse and neglect are especially at risk of mental ill health and in recent years very little has been done to address this. However, just because teachers and social workers will be able to “spot the signs”, it does not
mean they will have the resources and support to do anything about it, especially given the massive cuts to funding available for children’s services. “From our own research we have found that a third of parents think their child might have a mental health challenge, so the new prevention campaign is encouraging, but much more needs to be done to help parents know what is available in their local are as many parents don’t know if their child’s school has access to counselling. “Prevention of mental ill health should always be a priority given that mental ill health is often rooted in childhood. The Government must commit to properly measuring the well-being of our children, and ensure every child has easy access to early help services in their community, if we are truly to prevent today’s children from living with mental ill health in the future.” hc
in public awareness around looking after your mental health include a new national awareness campaign called Every Mind Matters, launching in October. From 2020 parents will also get access through the campaign to targeted advice on how to deal with issues like stress, online bullying and self-harm.
Find out more about the work of the Children’s Society towards ending child poverty and sexual exploitation, supporting young carers, and campaigning in areas including missing children and substance abuse support at www.childrenssociety.org.uk
BREATHE TO LIVE. INHALE TO DIE.
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Still-developing lungs and faster breathing rates means young children and babies are at high risk of complications from second-hand smoking. We look at how it affects your child
STOP According to the NHS, up to five million children in the UK are regularly exposed to second-hand smoke in their homes. In the UK, 9,500 hospital admissions for children are made per year, as a result of health complications stemming from second-hand smoke.
by 24 percent, by the inhalation of secondhand smoke. Perhaps surprisingly, the majority of exposure to second-hand smoke comes not from outside the school gates, park benches, or even outside the local shopping centre, but in your home. You may not be able to see it, but smoke lingers in the air even after you open the windows and finished smoking, and the confined space in rooms allows secondhand smoke levels to rise. Your home is where your child’s health is and therefore, if you choose to smoke, take a second to go outside.
econd-hand or ‘passive’ smoking refers to breathing in another individual’s tobacco smoke. Approximately 85 percent of the particles in second-hand smoke are invisible and odourless, so apart from the health risks to yourself, your smoking can also be exposing your child or someone else’s to hidden risk. In fact, Cancer Research reports children to be most at risk from the effects of second-hand smoking, due to their still-developing lungs and immune systems. Young children and infants who are exposed to second-hand smoke are at
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risk of bacterial meningitis, cot death, respiratory infections and asthma.
Healthy Homes The short-term effects of second-hand smoke exposure in children include sore throats, headaches, chest infections, coughing episodes and eye and nasal irritation and ear problems such as middle ear disease. Moreover, secondhand smoke can cause blood coagulation and increase the risk of heart attack, stroke, angina or heart failure. The risk of your child developing heart disease is increased by 25 percent, and lung cancer
Pregnant Puffing Kicking the habit is however a must, if you are pregnant. Each cigarette contains more than 4,000 chemicals and every puff you take exposes your baby to harmful toxins and limits their oxygen supply, meaning their hearts have to pump harder. These toxins can create a number of complications during pregnancy, for example a higher likelihood of stillbirth, premature birth, an underweight baby and, following birth, problems with nicotine withdrawal. So contact your local NHS 'stop smoking' service for help and advice on giving nicotine the boot, and shut down the impact of second-hand smoke on babies and children. hc
Why Are Our Kids Getting
With all the benefits of modern medicine and the NHS, you’d think our kids’ health would be improving. So why is the UK lagging behind other European countries?
e’re continually being bombarded with information about healthy lifestyles, the value of exercise, the health impact of smoking and the importance of a good diet—so you would think that our image-conscious kids would be top of the international ratings for health and well-being. But a recent report shows this isn’t necessarily the case. The Nuffield Trust, an independent health think-tank, produced a report earlier this year highlighting some shocking statistics. The UK has: ✤ The highest rates of obesity for 15to 19-year-olds among 14 European comparator countries. ✤ The highest inequalities in obesity prevalence between the richest and poorest, apart from Finland. ✤ The highest asthma death rate for those aged 10–24 among 19 countries apart from Australia, New Zealand and the United States. ✤ The highest rate of adolescent girls aged 15–19 giving birth among 19 countries apart from New Zealand and the US. So what’s going wrong? The report surveyed young people aged 10–24 in the UK compared with their counterparts in 18 other high-income countries, across 17 key indicators.
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ntries The cou e Nuffield d in th surveye eport for their Trust r ity to the UK , abil compar stralia, Austria k, u r a A m : e n wer a, De ny, , Canad Belgium , France, Germa an, Finland land, Italy, Jap nd, Ire Greece, nds, New Zeala n e r e Neth la l, Spain, Swed a g u t . r Po USA and the
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themselves than before, they are still more likely to die from asthma or have a poor quality of life from longterm conditions compared to their counterparts in other high-income countries. Apart from high rates for obesity, teenage pregnancy and asthma deaths, the UK also has the highest rate of young people aged 16–24 living with a longstanding condition among 14 European comparator countries, apart from Finland and Sweden; low rates of engagement in exercise by 11-year-olds in England and Wales; and a high percentage of young people aged 15-19 not in education, employment or training . Time trends within the UK suggest that some of these indicators are getting worse, including obesity, longstanding illness, severe material deprivation and exercise levels. Initial improvements in the number of asthma deaths have also stalled in the past few years.
MORTALITY The UK is performing in the middle of the group of similar high-income countries for several indicators, including cancer mortality, suicide death rates and health-related behaviours such as smoking, alcohol consumption and cannabis use. Trends in health-related behaviours have been going in a positive direction in the UK in recent years, with falls in smoking rates and rates for lifetime use of cannabis. There is some good news. Areas where the UK is performing well in this international comparison include low rates of road traffic injury deaths and low all-cause mortality. But even here, initial improvements may have stalled. For example, decreases in mortality rates levelled out around 2013, and there is a concern that they may be getting worse. In addition, stark inequalities exist in road traffic injury death between those from
OUTCOMES The report states: “Young people aged 10–24 make up approximately a fifth of the population of most high-income countries and there are strong health and economic arguments for improving their health outcomes. This report summarises how 17 key indicators of the health and wellbeing of young people aged 10–24 vary in a selection of 19 similar high-income countries both within and outside of Europe.” The report, published with the Association for Young People’s Health, provides an indication of where health outcomes for adolescents and young adults in the UK could be improved. Despite some successes, the UK’s performance on the 17 key health and wellbeing indicators highlighted in the report often lags behind that of the other 18 countries included in the analysis. Although young people in the UK are making healthier life choices for
Health Check the richest and those from the poorest backgrounds. The UK performs less well than the comparator countries particularly in terms of support given to young people with long-term health conditions. Adolescents and young adults in the UK are more likely to die from asthma and more likely to be obese and overweight, than their counterparts in the comparator countries. The burden of disability in adolescents, including from long-term conditions such as diabetes, is also greater in the UK. The report says “This is happening at a time when more and more adolescents and young adults are making better choices about their health than at almost any other time in living memory. By contrast, health services, professionals and policymakers are failing to live up to their part of the bargain, at best failing to keep pace with comparable countries, and at worst, falling behind. “There is an urgent need to prioritise and invest in the 10–24 age group to improve young people’s current health
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NUFFIELD TRUST Established in 1940 by William Morris, Viscount Nuffield, the founder of Morris Motors, the Nuffield Trust is a largely self-funded charity aimed at achieving a high quality health and social care system for people in the UK. It conducts and funds research and policy analysis, provides expert commentary and works closely with the NHS staff and policy-makers. Find out more at www.nuffieldtrust.org.uk.
outcomes and for a future healthy adult population. To improve the state of young people’s health in the UK, we must take an approach across three broad categories: policy initiatives focusing on young people; the improvement of everyday practice; and specific action to reduce health inequalities.” So is the solution entirely in the hands of the health authorities? That's
pretty much the opinion of the experts. Commenting on the Nuffield Trust report, Chief Executive Nigel Edwards, Chief Executive of the Association for Young People’s Health Emma Rigby, and Professor Russell Viner, President of the Royal College of Paediatrics and Child Health, said: “Adolescence is a time in which we take huge bounds, psychologically, biologically and socially. The forces shaping young people’s lives today continue into adulthood and have a huge impact on the society we all live in. “It is therefore worrying that young people aged between 10 and 24 in the UK now experience worse health and wellbeing outcomes than those in many other similar countries.
INEQUALITY “Too often, it is assumed that if we can just get provision during the vital early years of life right, health and healthy behaviours will simply flourish into adolescence, and on seamlessly into adulthood. “This seems dangerously complacent. Yet the muted response to reductions in the funding of local authority services over the past five years, disproportionately affecting young people, suggests it may be a widespread view.” By 2028, the NHS in England plans to move to a 0–25 years service, with adolescents receiving statutory health education from 2020, and measures to combat obesity being prioritised. “But inequality remains a stubborn impediment to progress on all these fronts” say the experts. “The UK has amongst the highest levels of income inequality in the developed world. Social and economic circumstances have a profound impact on health, and young people are bearing the brunt of this.” “This should sound the alarm for UK policy-makers. The renewed focus on young people signalled earlier this year in the Long Term Plan appears more necessary than ever: our collective futures may depend upon it.” hc Healthy Child with Dr Ranj Singh | 83
Protecting them. It’s what you do. It’s what we do too. Wellness Vaccination Specialists We understand just how important it is to know that you’ve done all you can to keep your family healthy. That’s why you can rely on MASTA to vaccinate your children against illnesses like chickenpox, meningitis B and HPV Chickenpox Chickenpox is a highly contagious, blistering virus which causes uncomfortable spots. Whilst it’s usually a mild illness, children must take time off nursery or school if they catch it. Plus, there’s the risk of missing special events or even pre-booked holidays if they have spots that are still in the infectious stage (the first 7 days).
All airlines have different rules regarding flying with chickenpox. Most will not allow you to fly until all the spots have crusted over.
Meningococcal infections can be very serious, causing meningitis and sepsis (blood poisoning) which can be fatal.
The Meningitis B vaccine protects against infection by the meningococcal group B bacteria, which are responsible for most infections in young children. The vaccination was introduced to the national immunisation schedule in May 2015. However, anyone born before this time would need to have the vaccination privately if they want it. Babies and young toddlers are at greatest risk, however there have been many cases of teens and young adults also contracting meningococcal infections.
HPV The HPV virus is passed on from a viral carrier when sexually active and can cause genital warts and cancer. In fact, HPV is responsible for 99.7% of cases of cervical cancer. From September 2019, all 12-13 year olds in Year 8 will be offered the HPV vaccine. Before this time, boys were not vaccinated and some girls out of the designated age range may have missed out. This group would need to have the vaccine privately if required.
According to Public Health England, since the introduction of the HPV vaccine, infections of HPV have reduced by 86%.
Visit masta-travel-health.com/Booking/Wellness to book your child’s appointment today.
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MASTA has been protecting people with travel and wellness vaccines since 1984.
Available from UK wide network of clinics including
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With the news that the UK has lost its measles-free status, it’s time we looked again at the essential nature of vaccination
n 2016, the UK reached the status of being free of measles, as confirmed by the World Health Organisation. It had been a difficult struggle with a 50-year history. But now, that status has been removed, and even the Prime Minister has recognised that our efforts against measles and other immunisable diseases have to be redoubled. Spread through moisture droplets, measles is regarded as one of the most highly infectious viral illnesses, and can be caught by anyone who has not been vaccinated or has not had it before, though it’s most common in young children. Symptoms include cold-like cough, sneezing and runny nose, high temperature, greyish-white spots inside the cheeks and a blotchy rash. The infection usually clears in 7-10 days, and
the body builds up an immunity to further infections, but in rare cases it can lead to life-threatening conditions such as pneumonia and encephalitis.
TRIALS By 2018, the 50th anniversary of the introduction of the first measles vaccine, into the UK childhood immunisation programme, it was estimated that 20 million measles cases and 4,500 deaths had been averted in the UK. Before this there were anywhere between 160,000 to 800,000 measles notifications and 100 deaths from acute measles in the UK each year. First large-scale trials of measles vaccines in the UK began in 1964 with a sample of 27,000 children under the guidance of the Medical Research
Council. By 1968 the measles vaccine was widely available, though coverage remained low until the late 1980s, and although the number of measles cases and deaths fell, measles transmission was not interrupted. In 1988 the measles, mumps and rubella (MMR) vaccine was introduced for children aged 13 to 15 months, with a catch up for children up to pre-school age, and high vaccine coverage, in excess of 90 percent, was achieved fairly quickly, with the number of cases falling to very low levels. Over the next 10 years measles control improved significantly but a pool of ‘susceptibles’ remained, so we continued to be vulnerable to outbreaks. Over the years, a number of catch-up campaigns have been rolled out to address gaps in population immunity. In 1996 a second dose of the MMR vaccine was introduced to the routine programme at pre-school age (3 years and 4 months) to protect those who hadn’t responded to the first dose.
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STUDY But in 1998, things went off the rails. A gastroenterologist, Andrew Wakefield, published a study linking the MMR vaccine to autism and bowel disease. Now thoroughly discredited, at the time the paper received intense media coverage in the UK and worldwide, and had a disastrous effect on immunisation rates; they dropped to about 80 percent celebrityangels.co.uk
Health Check nationally in the late 90s and early 00s, and took many years to recover. Even now there is a virulent ‘antivax’ movement, particularly in America, where according to the Centers for Disease Control and Prevention, more cases of measles were reported in 2008 than any year since 1997. More than 90 percent of those infected had not been vaccinated, or their vaccination status was not known. In the UK, by 2003 MMR vaccine coverage fell to 79 percent nationally, the lowest recorded since introduction of the programme, and by 2007 the annual number of confirmed measles cases exceeded 1,000 for the first time in a decade. After a large measles outbreak affecting mainly teenagers affected the UK in 2012, a national catch-up campaign was launched targeting children aged 10
to 16 years; first MMR dose coverage in children at the age of two years peaked at 93 percent, and by 2016 the UK achieved measles elimination. But in 2018 that status was lost with several measles outbreaks linked to importations from Europe, with the majority of cases in young people over the age of 15.
ELIMINATION Young people and adults aged 15 years and over who missed out on the MMR vaccine when they were younger have been particularly affected. There are also inequalities in vaccine uptake by ethnicity, deprivation and geography, and therefore the burden of measles falls disproportionately on some communities. Public Health England is developing a UK-wide Measles and Rubella Elimination Strategy, and the Prime
Minister has urged NHS England to write to all GPs to promote ‘catch-up’ vaccination programmes and will seek to strengthen the role of local immunisation co-ordinators in a bid to improve uptake. The Government has also said that it will seek to update the advice on the NHS’s website to address misleading information about the dangers of vaccines. Of course, while the MMR jab for children remains the most essential vaccination to consider, it’s also vital to remember flu and pneumonia vaccinations for vulnerable groups and the importance of travel vaccinations such as hepatitis, meningitis, diphtheria, polio and tetanus. For adults as well as kids, the minor discomfort of a vaccination could make all the difference between health and debility. hc
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laborato confirme the UK d measles cases ry in in outbreak 2018, with sev e s r al a c r oss mainly linked to the country importa from E tio confirme urope, and 231 ns d cases in the quarter of 2019. first
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Achieve A Lifelong Healthy Beautiful Smile For Your Child With orthodontic evaluations and treatment, Dr Kyi will be able to: Orthodontic treatment can be started on certain types of tooth problems even before all permanent teeth have erupted.
aking sure your children have healthy and strong teeth is a vital part of their development. Their teeth are for life and you must ensure that they’re looked aer and treated in safe hands. Coming to see our highly-trained, award-winning orthodontic specialist Dr Chaw-Su Kyi, your children’s teeth are in safe hands with her vast experience of successfully treating over a thousand children. Making sure you and your family are completely relaxed, our team are ready to look aer your family at our oﬀices in Harley Street and Hammersmith. Many of her patients choose Dr Kyi as her forward-thinking approach for early corrective treatment can prevent the need for more complex treatment later in their teens.
I have to say what a pleasure it has been visiting Dr Kyi and her colleagues for my daughter. Sophie was always made to feel at ease and we are of course thrilled with the exceptional result that been undertaken. Welcome Orthodontics have always gone beyond to help and ensure that we were looked aer with our irregular schedules and requirements. I highly recommend.
● Lower the risk of trauma to protruded front teeth ● Correct harmful oral habits e.g. thumb sucking ● Reduce the risk of plaque and food trap due to crowded teeth ● Guide jaw growth e.g. to correct overbites ● Correct cross-bites that can lead to facial symmetric growth ● Guide permanent teeth into a more favourable position ● Create a more pleasing arrangement of teeth, lips and face ● Possibly reduce the need for further treatment when patients are older
Come and schedule your orthodontic assessment with Dr Chaw-Su Kyi Call us on 020 8222 8760 Email us on firstname.lastname@example.org www.westlondonorthodontist.co.uk WeLCOMe Orthodontics, 23 Harley Street, London W1G 9QN 89 Hammersmith Grove, London W6 0NQ
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In the Teeth of Adversity Growing up
There’s more to tooth care than fillings— orthodontics provides a nicer smile and a healthier mouth too
✤ Lowering the risk of trauma to protruding front teeth ✤ Correcting harmful oral habits such as thumb sucking ✤ Reducing the risk of plaque and food trap due to crowded teeth ✤ Guiding jaw growth to correct overbites
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✤ Correcting cross-bites which can lead to asymmetric facial development ✤ Guiding permanent teeth into a more favourable position ✤ Creating a more pleasing arrangement of teeth, lips and face ✤ Reducing the need for further treatment when patients are older
✤ Removable braces: Most suitable for minor adjustments ✤ Fixed metal or ‘clear’ (toothcoloured) braces: Fitted to the outside of the teeth ✤ Lingual braces: Braces on the inner surfaces of the teeth, so truly invisible ✤ 'Invisible' braces: Clear plastic aligners customised so as to be almost undetectable ✤ Ceramic braces: With ceramic or porcelain brackets to blend better with the teeth ✤ Self-ligating braces: Allow some free movement of the teeth and can reduce the number of visits required ✤ Non-brace treatment: Using metal aligners to reduce treatment time
After an evaluation, which will take into account the general shape of the face and supporting soft tissue, treatment which usually takes 12 to 18 months can begin. There are a number of modern orthodontic options depending on the complexity of the condition, including:
See your regular dentist for a recommendation you to a trained orthodontist listed on the General Dental Council’s specialist register, and from there it should be a short step to a happier and healthier smile for your kids. hc
A recent NHS Children’s Dental Health Survey showed that 26 percent of five-year-olds in London suffer from tooth decay, even higher than the national average of 23 percent.
here’s a crisis in child tooth care in the UK, with cavities linked to more serious conditions such as cardiovascular disease, diabetes or dementia on the increase. This dental condition is considered entirely preventable, when issues such as sugar consumption, not brushing correctly or even smoking or alcohol consumption for some older children and teens are addressed. But it’s also clear that orthodontics, the speciality within dentistry which deals with correcting bites, occlusion and the straightness of teeth, can have a longterm impact on overall dental health. In the UK, awareness of the importance of a healthy smile has perhaps been driven by American culture—it’s a long-standing joke among Americans that the British have terrible teeth, but if that was ever the case, children influenced by US TV and pop stars now seem particularly aware of the importance of a perfect smile. And this is certainly in reach using modern orthodontics. Once all the permanent teeth have erupted at the age of about 10 to 12, and sometimes before then, orthodontic treatment can be started. Benefits of orthodontics include:
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Next-level clean. Next-level care. You would have to brush for a month using a manual toothbrush to do what Philips Sonicare can in just 2 minutes¹ ✔ ✔ ✔ ✔
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The most stylish electric toothbrush yet, from the brand recommended by dental professionals worldwide. ¹An electromagnetic drivetrain inside the Sonicare handle delivers more brush strokes in two minutes than an entire month of manual brushing ² Vs a manual toothbrush, with leading whitening toothpaste
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Love Your Teeth
Good toothcare in childhood will pay benefits in later life. So what do we need to do to keep our kids’ pearly whites in good order?
recent report shows that by the age of five, over a quarter of children in London are suffering from tooth decay. In fact, research shows that there is an association between oral health and overall health, and experts consider oral health problems to be a global health burden. So, what are the best practices for keeping your kids’ teeth and gums healthy? We’re taught from childhood that brushing twice a day and regular visits to the dentist are important—but what else do you need to know about your teeth and how they relate to your overall health?
benefits that can greatly improve the quality of their brushing, and one with a built-in timer will make sure they complete the brushing routine. The bristles of electric toothbrushes vibrate or rotate to help them remove plaque build-up, and is a more effective control against plaque and gingivitis. Older kids should be encouraged to floss using string floss, soft plastic picks or a water pick. And finally, but most importantly, get the kids in to the dentist for regular check-ups—apart from looking for cavities and tooth decay, they can also check for gum disease and other health issues. hc
London Assembly Health Committee plans include: ●
Making all schools in London sugar-free by 2022 Supervised brushing in schools Ensuring that every child in London sees a dentist by age one Appointing a specialist in children’s dental health to the Child Obesity Task Force
BRUSHING BASICS By far the best thing you can teach your kids do for their teeth is to brush them twice a day (or more) after meals. It is a good idea for parents to brush pre-schooler’s teeth and supervise the brushing and flossing skills of schoolage children until they are seven to eight years of age. Teach them the best technique, which is to use small circular motions, taking care to brush the front, back and top of every tooth. This process should take between two and three minutes. Make sure to teach them to avoid sawing, backand-forth motions. Brushing too hard or using a hardbristled toothbrush can damage tooth enamel and their gums, which can lead to tooth sensitivity, permanent damage to the protective enamel of your teeth and gum erosion. It’s best to give kids a toothbrush that has soft bristles and change it roughly every three months. An electric toothbrush has many celebrityangels.co.uk
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Symptoms of sensitive skin can be incredibly uncomfortable and can impede children’s learning in the classroom–our guide uncovers the most common skin conditions in kids
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he leading causes of sensitive skin are hormonal changes, stress, insufficient sleep, dehydration, air pollution and reaction following exposure to the sun, which in extreme cases is known as photosensitivity. Sensitive skin conditions in children can manifest as dry skin, eczema, dermatitis and hives or contact urticaria. Spotting the potential causes and acting accordingly can help alleviate discomfort.
BYE-BYE DRY SKIN Rough, flaky, peeling skin can be treated with a perfume-free emollient. More serious conditions such as atopic dermatitis or atopic eczema, which affects approximately one in five British children, can cause sections of the skin to become sore, inflamed and itchy—persistent scratching of an eczema-affected area can give way to an infection. Atopic eczema in the majority of cases typically affects the neck, hands, cheeks, scalp, knees and the elbows; certain triggers can exacerbate eczema, and these include allergens, stress and changes in the weather. Atopic eczema often develops before the age of one, and usually before a child’s fifth birthday, but nearly half of these cases improve once a child hits the age of 11. Avoiding irritants and applying an emollient to keep the skin moisturised, celebrityangels.co.uk
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alongside an over-the-counter corticosteroid cream to relieve itching is key to managing eczema.
REDNESS RELIEF There are two categories of contact dermatitis: irritant contact dermatitis, where an itchy, red rash develops following direct contact with an irritant, and allergic contact dermatitis, which occurs as part of an allergic reaction. You may also notice swelling, cracked skin and blisters.
Symptoms of contact dermatitis should clear up independently, once the irritant or allergen has been avoided. Continued itching of the irritated area can cause infection or lead to scarring of the skin and therefore, if you notice your child furiously itching an irritated area, apply an anti-itch cream to soothe the area. For allergic contact dermatitis, an oral antihistamine is a potential solution, as they can block the onset of an allergic reaction and its symptoms. hc Healthy Child with Dr Ranj Singh | 93
Life Changing Sensory Solutions For All Who are we?
Here at ROMPA® we provide sensory solutions to help improve the quality of life of people of all ages and abilities. Our extensive product range offers sensory tools for choice, empowerment, enjoyment, inclusion, meaningful occupation and comfort.
Our Range of Products
Not only do we provide our customers with multisensory environments and solutions we have hundreds of other products to support sensory requirements:
Every one of our customers has different needs, desires and outcomes, many of whom have sensory processing disorders which are commonly seen in developmental conditions like autism.
For a person with a sensory processing disorder interaction with others may be challenging and their sensory environment around them may feel overwhelming. As a result there can be an increase in behavioural problems.
We work with relevant parties in the Health, Education and Social care sectors, charities, professional advisors, universities and research institutes to place us as the forefront of innovation where we are now on the NHS Supply Chain Network for Multi-Sensory.
By modifying the sensory demand and focusing on abilities these abnormal behaviours may be reduced. This modification can also assist in sensory and information processing leading to fewer problems in adulthood.
What is Snoezelen®?
If the child has difficulty interpreting a sensory experience, it is easy to understand why they see the world differently to others. One such tool that may help with sensory processing is the Snoezelen® environment. This provides a range of sensory stimulation that may be tailored to meet the needs of people with sensory processing disorders in order to manage sensory processing and assist in the preparation for engagement in meaningful activity.
We are the owners of the Snoezelen trademark – a unique concept respected in the industry which includes the installation of bespoke equipment and high quality multi-sensory environments. Rompa are proud British manufacturers – many of our items are made on site at our Chesterfield HQ enabling us to deliver consistent high quality products. A Snoezelen® sensory room can transform from a calming and soothing place, to an exciting and engaging interactive space full of light and sound. ®
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Sleep and Relaxation Visual
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Sensory Integration & Movement
Look and Learn
For many children, a multisensory environment helps them to get to grips with learning better. So what’s the theory and how does it work?
cientist, politician and inventor Benjamin Franklin said: ”Tell me and I forget. Teach me and I remember. Involve me and I learn.” The principle he described (though he may have pinched it from Confucius) is what is known today as multi-sensory education, a way of teaching that engages more than one sense at a time. Multi-sensory education, using sight, hearing, movement and touch, can be of particular benefit to children who have trouble with reading. Experimental psychologist Paul Matusz of Lausanne University says: “Several decades of research have shown that we are able to recognize people, symbols and everyday objects faster and more accurately when available information stimulates multiple senses rather than just one, such as vision or hearing. “Studies that have recorded activity celebrityangels.co.uk
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from brain areas that process even the simplest bits of visual or auditory information (for example, the orientation of visual lines or frequency of sounds) have shown that these areas integrate the stimuli from different senses. “Our memories are stronger when the information is presented across multiple senses.”
BENEFITS And a multi-sensory approach might work better for a child otherwise regarded as having learning disabilities— Paul Matusz says “A person who benefits greatly from multisensory information might traditionally have been considered to have attention deficits.” But how does it work? The theory is that in order to learn, our attention must be activated, and that reading alone does not do that—we aren’t ‘hard-wired’ with the desire to read as a
The Senses in Learning The six senses as used in learning are defined as:
① Vision (sight) ② Auditory (hearing) ③ Gustatory (taste) ④ Olfaction (smell) ⑤ Vestibular
⑥ Somatic (touch) survival instinct. Multi-sensory learning activates something deeper in our brain, the so-called RAD (Reticular Activating System), or fight-or-flight mechanism. The physical or tactile element of multisensory learning activates the RAD and maintains the attention—or, to put it in a simpler way, multisensory learning is Healthy Child with Dr Ranj Singh | 95
Sand Writing This activity lets students use sight, touch and sound to connect letters and their sounds. Students start with a handful of sand on a sheet of paper or a dollop of shaving cream on a table. They use their finger to write a letter or word in it, and say the sound each letter makes.
Air Writing Otherwise known as ‘sky writing’, reinforces the sound each letter makes through “muscle memory.” It can also help reinforce letter forms that are commonly confused, like b and d. Students use two fingers as a pointer to write letters in the air. They say the sound each letter makes as they write it.
Word building Using tiles of magnetic letters, pupils connect sounds with letters. Magnetic
letters can have vowels in one colour and consonants in another. These basic techniques use the idea of engaging more than one sense in the learning process. We remember how to do things best when the directions we’re given engage multiple senses, so most educators add audio or visual multimedia into their assignments, but multisensory learning can also include tactile, smell, and taste-related materials. So long as the activity engages multiple areas of the brain, it can help students develop stronger memories around how to do it.
LITERACY Literacy in particular is an inherently multisensory skill that benefits from differentiated reading instruction. This is because reading involves both recognizing written words and translating them into their corresponding letter sounds. For struggling students or those with reading disabilities, particularly dyslexia, multisensory learning can help them use all of their senses while
reading a book and to rely on their strengths. Whether using it for classroom instruction or remedial assignments, multisensory learning can help all students develop or strengthen their literacy skills. Harvard educationalist Dr. Howard Gardner argues that the traditional notions of learning and intelligence are too limited. Gardner proposes that people can have proficiencies in different kinds of intelligences, and that teaching students in a way that matches their intellectual strengths can help them grasp tough subjects. According to Dr Gardner, children as young as four or five have already developed strengths and weaknesses in eight different categories, or intelligences: ✤ Linguistic intelligence: the ability to understand, read and write words ✤ Logical-mathematical intelligence: the ability to think conceptually and solve abstract problems ✤ Spatial intelligence: the ability to visualize in thought and analyse images ✤ Musical intelligence: the ability to understand and manipulate pitch, rhythm and timbre ✤ Bodily-kinaesthetic intelligence: the ability to control your body movements or objects in your grasp ✤ Naturalistic intelligence: the ability to recognize and care for plants and animals ✤ Interpersonal intelligence: the ability to understand and care for the needs of others ✤ Intrapersonal intelligence: the ability to analyse your own thoughts, feelings and beliefs Dr Gardner argues that general education and special education students can all benefit from multisensory learning. Individual students process information differently. Incorporating visual, auditory, tactile, kinaesthetic, taste
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more fun and so more engaging. So what sort of multisensory techniques could teachers be using to help struggling learners?
and smell in the instructional setting assist students in learning and retaining classroom material.
via sensory organs. For individuals with cognitive impairment, multisensory stimulation is often the only way to improve and increase synaptic connections and neuron-transmission.
For children with disabilities, multisensory learning can be a boon. In 1997, the Journal of Intellectual Disabilities Research published research showing that time spent in a room full of lights, textures, sounds and smells increases concentration, alertness, calmness and general awareness of the surrounding world. Individuals also appear happier while in the room, and tend to vocalize more and stay on task. For those with self-injurious or autistic behaviours, the gentle stimulation has a soothing effect and helps relieve agitation and promote relaxation. In addition to heightened sensory perception, the rooms also aid in cognition. The nervous system continues to develop during the first six years of life, and this maturation is dependent upon the stimulation of the nervous system
A huge range of specialist kit is available to create multi-sensory environments at home, in schools and in other institutions; for instance tactile play mats and materials, climbing and play frames, toys to develop fine motor skills, therapy balls, posture mats, tactile wall boards, mirrors, wall murals and outdoor games. Snoezelen, a controlled multisensory environment (MSE) developed in the Netherlands in the 1970s, is designed to soothe and stimulate people with autism and other developmental disabilities, dementia or brain injury. It uses hi-tech equipment such as bubble tubes, fibre-optic lights and wall light panels with multiple effects, to create the multisensory environmentâ€”and other specialist companies can be
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Learning to juggle In a 2004 study, Brain Friendly Strategies for the Inclusion Classroom, students were taught to juggle using multisensory learning practices. Brain scans of the subjects showed an increased number of synapses and dendrites in the regions stimulated during the juggling sessions, and the researcher concluded that multisensory learning can stimulate brain connections, leading to better retention and faster recall.
commissioned to design and build sensory gardens, incorporating musical devices, tactile furniture, wind chimes and so on. And itâ€™s never too early to start with sensory learningâ€”baby toys such as shaker cubes, coloured stackers, wooden puzzles, sound balls and musical sorters will get your child off to a flying start and get them used to the idea that learning can be fun. hc Healthy Child with Dr Ranj Singh | 97
Health and Wellbeing Information for Busy Parents and Curious Kids If you’re a busy parent, guardian or child and you need your health and wellbeing information in handy bite-sized pieces, Minute4Kids is for you
reated with the help of Dr Ranj Singh and leading health institutions and charities, Minute4Kids is the latest way to get your health and wellbeing information online. Minute4Kids brings top-tier children’s health and wellbeing information via one-minute podcasts tailored specifically for busy mums and dads on the go, and for kids who need help and advice in an easy-to-manage form. Take a look through the website to find
✔ Helping Children Cope with Divorce Divorce is a particularly emotional time for families—particularly for children
✔ Suicidal Thoughts Around 25 percent of young people feel suicidal at least once before they reach adulthood
✔ Coping with Exam Anxiety Most children experience stress during exam season. What are the best coping strategies?
✔ Explaining Sexuality to Children Development of sexuality is an integral aspect of a child’s growth and maturation
✔ Friendship and Child Development The importance of schoolyard friendships in a child’s development.
✔ Support for Self-Harm
According to youngminds.org, one in 12 children in the UK deliberately self-harm
key information surrounding today’s common health complaints including childhood diseases, growing-up problems and coping with the stresses of everyday life. For when your little ones start to get older, learn how to get the ball rolling with potty training, navigate the world of food with fussy eaters, prepare children for the arrival of a new sibling and deal with toddler tantrums quickly. A huge range of minute-long podcasts covers all these health subjects and more.
+ PLUS: ● Childhood obesity ● Common childhood diseases ● Food allergies and intolerances ● Meningitis ● Treatments for head lice ● Diabetes, causes and treatments ● Conjunctivitis, gastroenteritis
and rashes in babies ● Understanding asthma ● Friendship and child development
● Mental and emotional wellbeing ● Anger management ● Safeguarding online ● Night terrors and bedwetting ● Explaining sexuality ● Managing fussy eaters ● Potty training ● Dealing with ADHD ● All these and dozens more
subjects tackled in easy-to-digest podcast format
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Growing up CELEBRITY ANGELS Celebrity Angels publishes a wide array of medical health publications, including Dear Doctor with Dr Chris Steele, Live to 100 with Dr Hilary Jones and Healthy Child with Dr Ranj Singh. As a trusted and respected brand with years of experience in publishing health and well-being titles under its belt, Celebrity Angels drives the promotion of Minute4Kids to reach the widest audience possible. The Minute4Kids one-minute podcasts have been voiced some of the country’s favourite celebrities including Dr Ranj Singh, Zoe Salmon and Denise Welch.
It takes just a minute to listen to each fact-filled, bite-sized podcast!
Minute4Kids is brought to you with the help and advice of some of the country’s leading authorities and voices in the medical, publishing and entertainment arenas, and features links to helplines and sources of essential advice.
Dr Ranj Singh Dr Ranj Singh, resident paediatrician on ITV’s This Morning and the creator of the CBeebies Get Well Soon programme, is a leading figure in the medical media. Working closely with Minute4Kids, Dr Ranj is on a mission to educate parents about the key health concerns facing our children today.
Childline Founded in 1986, Childline has long been the leading authority in Children’s wellbeing in Britain, proving to be a trusted resource and shoulder to lean on for young people facing problems at home, school and more. Childline has provided Minute4Kids with information pertaining to the key topics surrounding children’s emotional and mental wellbeing today so that we can provide parents the knowledge they need to better understand their children and their needs.
The National Health Service has been providing the UK with healthcare services and key wellbeing information since 1948. The service has helped build the foundation of Minute4Kids by providing the top medical issues that are frequently searched on the web. This pivotal information has helped us to answer some of the most asked questions about children’s health today.
Education ● Development
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Eﬀective, pill-free supplementation for children Fast, effective immune support, delivered in a daily oral spray. For parents, when the back-to-school bugs raise their grisly heads, it’s a scramble to ﬁnd the best way to improve your child’s immunity (as well as your own) and you might sometimes feel like you need a little helping hand when it comes to nutrients. That’s because, due to their child’s ever-changing tastes, many parents ﬁnd it challenging to squeeze a variety of wholesome foods onto the plate. Meaning that your oﬀspring may miss out on the vitamins they need, so supplementing immune-boosting vitamins can help to provide some much-needed nutritional support.
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The government now recommends that we all supplement this vital vitamin, which also helps to prevent upper respiratory tract infections including; rhinitis, tonsillitis and laryngitis (otherwise known as the common cold), during the autumn and winter months. However, those under ﬁve-years-old are considered an at-risk group which means a year-round supplementation plan is advised.
“Due to the evolution of modern diets and lifestyles, it is increasingly important for us to monitor our children’s nutrient intake, to maintain a strong immune system and ensure they can lead an active and healthy lifestyle. Taking tablets and following a supplementation plan can be a constant battle with children, so a great-tasting vitamin oral spray may be the answer.”
A daily dose of vitamin D can help to protect all of us, especially children, against infection. Known as the ‘sunshine vitamin’, vitamin D is crucial for activating immune defences and without enough, the immune system is unable to react to ﬁght infections within the body.
Andrew Thomas, founder and managing director at award-winning natural health brand, BetterYou says; “As a father myself, I know that getting your child to eat a balanced diet can be challenging and ensuring they are getting all the nutrients they need can sometimes feel impossible. Variety and balance are key with children so building their meals around a rainbow of vegetables, a source of protein and healthy fats is a great start but if this is a struggle, supplements can help to plug any nutritional gaps.
A nutritional supplement, such as a multivitamin, which is designed to sustain health and wellbeing will also help to support growing bodies. Those supplements which are specially formulated for children are a great way to target a number of nutrients which may be lacking from your youngster’s diet. Helping to deliver an extra boost and fend oﬀ germs, BetterYou’s MultiVit Junior Oral Spray also supports bone and heart health whilst ﬁghting tiredness and fatigue.
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For more information about the BetterYou range and an exclusive 20% oﬀ your order, visit betteryou.com and use code CHILD at the checkout.
When Getting a ‘D’ is a Good Result As much as vitamin C is essential for immune support, vitamin D is another must-have vitamin for ensuring your child’s healthy growth and development
fat-soluble vitamin, vitamin D is imperative for regulating calcium and phosphorous to support both bone growth and the normal functioning of muscles. Vitamin D is typically manufactured by the skin through exposure to UVB rays in sunlight, but rainy days can cut off short your child’s ability to produce the recommended. Fortunately a number of foods naturally contain small quantities of vitamin D, and supplements can top up any shortfall.
Fishy Business The fatty flesh of salmon, herring, mackerel and tuna rank among the best sources of vitamin D. Alternative sources of this fatigue-fighting vitamin to add to your child’s dinner time menu are cheese, egg yolks and beef liver. Vitamin D gained via animal products or sun exposure is known as vitamin D3 or cholecalciferol, whereas vitamin D2,
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NICE National Institute for Health and Care Excellence reports that one in five adults and one in six children in the UK are suffering from a vitamin D deficiency, which accounts for an astounding 10 million Brits!
otherwise known as ergocalciferol, is a form of vitamin D derived from fortified breakfast cereals, certain mushrooms and supplements. According to the NHS, babies under the age of 12 months require 8.5 to 10 micrograms of vitamin D per day, while adults and children past the age of 12 months should be receiving a minimum of 10 micrograms of vitamin D every day.
Topping Up Babies on more than 500ml of infant formula will not need a supplement, as formulas come fortified with vitamin D. Vitamin D supplements can be purchased as tablets and capsules, though if you find your child struggles with swallowing capsules or simply isn’t at ease with taking them, an oral spray form of vitamin D can be used. Infants over the age of one should take no more than 10 micrograms of vitamin D as a daily supplement, whereas breastfeeding babies and infants under the age of one are advised to take between 8.5 to 10 micrograms. Staying topped up with a vitamin D supplement can help prevent tiredness, regulate insulin levels, lower risk of infection and encourage the growth of healthy bones and teeth. The Department of Health advises “at risk groups” to take a vitamin D supplement all year round— this includes pregnant and breast-feeding women, infants below the age of one, individuals aged over 65 years, people with darker skin and people who rarely experience exposure to the sun. hc
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Feet On The Ground
Finding shoes to suit uniform guidelines, look smart and withstand wear can be a shopping nightmare, but with our advice you won’t finish on your uppers
s with most children’s clothing, the art of buying shoes— particularly for school—is a fine balance cost and value. When children grow out of shoes so quickly, the temptation is just to buy whatever’s cheapest—but choosing shoes ‘solely’ because they’re cheap can be a false economy. So what features should you prioritise?
BREATHE FREELY Quality leather materials can help shoes last longer and fight odour by allowing air to pass through. The breathability factor keeps your child’s feet cool and provide with them that extra comfort throughout their school day. Its breathability also means that leather dries more easily, and treated leather shows excellent resistance to wet conditions. Picking leather
Did You Know? You shouldn’t re-use hand-medown shoes, which will have shaped themselves to the previous wearer’s feet, which may affect posture. And most school shoes are styled to allow for a season’s growth, so you don’t need to buy them a size larger.
means not having to worry about how inaccurate the weather forecast may be, though other waterproof materials are also an option in this regard.
FIT FOR PURPOSE Alongside durability and breathability, comfort is a key factor for healthy development and acceptance. Start with accurate measurement using the
foot gauge found in all shoe shops. Then check the style and colour laid out by school uniform rules, and within those guidelines, let the kids pick a shoe they’re happy with. So you’ve negotiated the tricky bit and avoided possible tantrums—but are there any extra features you could look for to add comfort or practicality? Playground footballers will want a sturdy shoe with a non-slip sole, while padding linings are helpful in supporting the heel area, particularly against hard concrete pavements. Ankle supports reduce wear and tear on the back of the shoe. Fasteners or buckles may be a more straightforward way of making sure your child’s shoes do in fact stay on, and can prevent trips and falls— though not all schools will accept them. hc
BACK TO SCHOOL STARTS IN KICKERS • Whether it’s your ﬁrst time dropping little ones off at the school gates, or your big kids are heading back after a summer of fun, Kickers has a range of durable and stylish shoes to tackle every ﬁrst day. • Kickers shoes are packed with technology designed to make them last longer, designed with the playground in mind. We listen to feedback and test on real feet to make sure parents can be conﬁdent when choosing us for school. • From the Playground Fun collection to the durable 360 and the bold Kick Luxx range, Kickers shoes are a celebration of both style and durability that offer adults and kids a shoe that they can trust and feel conﬁdent in.
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Wrap Up Warm The summer’s over and it’s time to think about kids’ clothes for autumn and winter. What’s the best buying advice for economy, safety and style?
t’s that time of year; it’s getting colder and you need to make sure your child is prepared for the winter months at school. It can be difficult to know how to get it just right, and avoid chilly fingers or sweaty bodies—our simple guide will help you ensure that your child will be cosy, healthy and stylish when heading back to school.
INSULATE Parents are beginning to appreciate the importance and effectiveness of a ‘base layer’. This can be anything from tights to ‘long johns’ that protect the skin and ensure that your child’s body keeps dry at all times, even when they get caught in the rain without their coat on. Don’t forget the value of thermal long-johns for when the weather turns bitterly cold; these basically insulate your child’s whole body, making a big difference if they get caught in the cold for a long period of time. Look for clothes made of wool or polyester for this layer.
LAYERS ARE BEST It can be tempting for parents, particularly of young children, to choose the heaviest coat they can find for their kids. However, this isn’t necessarily the way to go. Thin layers, instead of big restricting coats, will allow your child to shed off lightly, which means that they won’t be ever choosing between overheating and freezing. Try thin waterproof jackets and a thin fleece that can be removed easily. Cotton is very absorbent, and even if it isn’t raining or snowing, the cold weather can result in chilly kids as it absorbs sweat throughout the day. Even if your child’s school uniform is made of cotton, celebrityangels.co.uk
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providing your child with a fleece if the school allows it will make a difference.
EXTREMITIES While it’s important to cover your child’s body, according to KidsHealth, the head, ears, hands and feet are most prone to cold exposure–so make sure you send your child to school fully equipped with a hat, gloves and thick socks to ensure these bases are covered. Choose mittens rather than gloves for a young child, as getting every finger in the right place can be a challenge. Remember, as always, to let the kids have a say in what they wear, as if they like the style, it will make the early morning battle to get them dressed that much easier! hc Healthy Child with Dr Ranj Singh | 105
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Perfect Lunchbox Preparing a lunchbox before the school run can be a nightmare. We find out how adding fruit can simplify school meal preparation and help maintain a balanced diet
ussy eating habits? Traffic light rules? Primary school food regulations? It all adds up to making the preparation of a lunch box a demanding task. How do you make sure your child eats healthily without giving them food they’re more likely to pick at or play with? As part of a balanced diet, fruit could be the answer.
FANTASTIC FRUIT The good news is that fruit has no trouble getting past the lunchbox guidelines set by schools. Fruits have zero cholesterol, are naturally low in both fat and calories and contain vital vitamins. The best part Is you can mix and match, as different fruits contain varying levels of each nutrient—for example oranges are naturally higher in Vitamin C than apples, while apples contain pectin, a soluble dietary fibre. Not only is fruit visually appealing, with its range of colours adding interest to the diet, but it also contains the naturally occurring sugar fructose, which is the the perfect solution to reducing your child’s cravings for sweet treats such as muffins, doughnuts, cakes and chocolate bars. celebrityangels.co.uk
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What is a berry? According to strict botanical categorisation, strawberries are not berries but ‘aggregate accessory fruit’—though, amazingly, tomatoes, kiwis and even bananas are berries.
The processed and refined sugars found in these types of food can raise your child’s blood sugar and insulin levels, triggering insulin resistance— the key driving force behind Type 2 diabetes. In contrast to refined, added sugar, fructose is metabolised
differently in the liver and does not generate the same spike in blood sugar and insulin levels. The antioxidants in fruit can also aid with preventing inflammatory disorders. Berries rank particularly high for antioxidants and fibre, with 100g of raspberries containing nearly seven grams of fibre, an excellent aid to digestion.
FIBRE FABULOUS A report by the World Health Organisation on diet and nutrition recommends a minimum intake of 400 grams of fruit and vegetables per day to prevent the onset of diabetes, obesity and cardio-vascular diseases, while NHS guidelines on healthy digestion advise 30 grams of fibre per day for adults sixteen years and above, 25 grams for children between eleven to sixteen years old and 20 grams of fibre for children aged from five to eleven. For younger children and toddlers, aged between two to five years old, 15 grams of fibre a day is recommended. So next time you’re packing that lunchbox, make sure there’s space left for fruit! hc Healthy Child with Dr Ranj Singh | 107
Ultimately, it helps keep your child safe from potential online predators and cyberbullies. School Mode School Mode is activated from the AllMyTribe app and lets you decide which features are disabled or enabled during school. This way, you can still contact your child, but you can make sure they aren’t being distracted during lesson time. Reduces blue light absorption
Be With Your Child Even When You’re Not It is true what they say, parents worry constantly about their children from the very moment they are born. As each child starts to become more independent, the worry becomes more intense. Enter SPACETALK, an all-in-one smartwatch, phone and GPS location device for 5-12 year old’s. Recently launched in the UK, SPACETALK took four years of painstaking research to design and develop. Mark Fortunatow, CEO, said “we have worked with education systems globally for 17 years. We understood the need for parents to know their child was safe. We saw a gap in the market, and we seized the opportunity to fill it.” This colourful little companion might just solve all your worries, as you send your child oﬀ to school armed with the safest, most secure device of its kind on the market. SPACETALK boasts a range of features, such as calls and text and the AllMyTribe app, so you can pair your child’s device with your phone. Let’s take a closer look at some of the others:
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It is GDPR compliant We live in a digital world and the population is becoming increasingly concerned about data security. That’s why SPACETALK was made completely GDPR compliant; all data is encrypted and stored locally in the UK.
A study funded by the National Eye Institute (USA) shows that children absorb more blue light – a type of high energy visible light – than adults and increased exposure to this type of light can cause serious long-term damage to their eyesight. SPACETALK uses dark backgrounds and bold coloured icons to dramatically reduce the amount of blue light omitted from the device. SPACETALK is now available for £199 or through Clearpay, for 4 equal instalments of £49.75.
Location on Demand SPACETALK is automatically set to give you location updates at specific intervals, but the Location on Demand function, allows you to find the exact whereabouts of your child at any given moment. Safe Zones The trusty AllMyTribe app allows you to set Safe Zones and will even let you know when your child has left it, so you can make sure they don’t get into any Barney Rubble (trouble) on the walk home from nan and pop’s house. Safe from cyberbullying What we love most about SPACETALK is that there’s NO internet, meaning NO social media and NO access to dangerous video channels.
spacetalkwatch.co.uk Customer support: +44 (0) 208 017 5868
Keeping a Watch Kids and smartphones—you can’t separate them. But are there better ways to keep in touch and ensure your children’s safety?
lot has been said—much of it negative—about the relationship between children and their smart devices. Some say the more a child spends using a smartphone and surfing the web, the harder it is for them to make bonds with their parents and other people ‘IRL’—In Real Life. Smartphones, it’s said, also make children reliant on looking up information on the internet rather than celebrityangels.co.uk
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learning; disturb their sleep; damage their eyes and expose them to cyberbullying and online predators.
TRACKING The advantages of smartphones are that they allow your children to get in touch with you in an emergency, and by using GPS, they help you to montor their location. Maybe what’s needed is a device with some of the features
of a smartphone, without the disadvantages—which is what’s offered by a new generation of ‘smart watches’ for kids. Typically, a ‘kidsmart’ watch is aimed at children aged around five to 12 before they graduate to their first smartphone; it looks like a fitness tracker, with a wrist strap, active display and touch-screen controls, and has all the features of a basic phone, such as voice communication Healthy Child with Dr Ranj Singh | 109
The NSPC C’s T.E.A.M campaign . —Talk, Ex plore, Agre Manage— e, helps you to help yo child stay u r safe onlin e. Find ou t more at n spcc
and SMS messaging, at a fraction of the price of a smartphone. It normally takes a conventional pay-as-you-go or contract SIM. Unlike a smartphone, a ‘kidsmart’ watch is limited to communicating with certain phones, programmed from a master app running on the parent’s smartphone. It lacks a keyboard for composing complex messages, but basic messages such as ‘I’m on the way home’ or ‘Please come and pick me up’ can be preset. A ‘kidsmart’ watch can also make and receive voice calls, and of course has a mute function so it won’t cause disturbance by ringing in class. Other features can include an emergency call function, and a GPS locator so the smart watch can be tracked from the master app, showing when the child has moved in and out of preset ‘safe zones’, as well as other useful functions such as a pedometer.
BULLY-PROOF Just as important as what is included in the ‘kidsmart’ watch, is what is left out—there’s no internet access, no social media functions, and no camera. This means that without access to Facebook, Snapchat, Kik and so on, the option to access unsuitable websites or the ability to take or receive pictures, it’s pretty much proof against all forms of cyber-bullying. Just right for keeping the kids in touch without exposing them to harm. hc 110 | Healthy Child with Dr Ranj Singh
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V-KIDS WATCH When little adventurers want to go out exploring, it's a double-edged sword for most parents—on one hand, you want to instil them with a sense of independence and fun, but on the other, you’re fearful about not being close by in the event of anything untoward. The V-Kids Watch by Vodafone allows adults to keep aware of where their children are with GPS tracking, and also lets them communicate through voice messaging. It also gives kids access to an SOS button that sends for help and is controlled through a smartphone app. Being able to keep track of the device is made possible by the V-Sim: a sim card that powers the V-Kids Watch, expanding its tracking capabilities. The V-Kids Watch gives you the option of choosing up to four other app members who can also see where your child is on a map and get directions to their location. These trusted contacts will receive notifications from the watch should your child press the SOS button for 5 seconds. Then you can all figure out a plan of action between you. Whether they’re going around a new friend’s house for the first time or attending a classmate’s birthday party without you, V-Kids Watch’s voice messaging feature is great for checking in and keeping connected. The tool lets you record and send voice messages of up to 30 seconds to each other. And, if any of their friends also have a V-Kids Watch, they can send voice notes and emojis to each other—great if you want to delay that inevitable ‘first smartphone’ purchase by a year or two.
CONNECTED This isn’t the kind of watch kids get from a relative at Christmas and immediately cast aside, it’s designed
to be fun for wear and use. It’s waterproof and comes in a choice of colours, either pink or blue. There are three games available to keep them occupied, but they won’t distract them from their studies thanks to the ‘School Time’ feature, which allows you to disable games and messaging with their friends so they can stay focussed when they need to most. Whether or not you’re well-versed in the world of IoT (internet of things), keeping connected with your child even when you’re not together has never been easier than with V-Kids Watch.
v-kids watch V-Kids Watch is just one device in a whole range of smart products from V by Vodafone. Get V-Kids Watch for the discounted price of £99 (RRP £135) by going to https:// vodafone.uk/VKidsHC and using the code: HCKIDSP.
Terms and Conditions
For full functionality a 30-day V-SIM plan, Vodafone network coverage and GPS signal are required. Voucher includes money off the upfront cost only. Voucher code must be used by 1st April 2020. Cannot be used in conjunction with any other offer. See https://eshop.v.vodafone.com/uk
Keeping watch is child’s play V-Kids Watch by Vodafone lets children explore while giving parents reassurance that they’re safe. It’s inevitable - little adventurers are going to want to venture out and explore. And as a parent, you want to instil kids with a sense of independence and let them have fun, but also want to be able to check in for added reassurance. That is just one reason why V-Kids Watch feels like a device that parents have been waiting for. Not only does it allow them to see where their children are with GPS tracking, but it allows kids to communicate through voice messaging and send alerts via the SOS button. The V-Kids Watch is powered by the V-Sim, a sim card that connects to Vodafone’s fast and reliable network and lets parents check in even when they’re not nearby, straight from their smartphone. IT TAKES A VILLAGE Sometimes as a parent, you’re not always able to spring to action right away. That’s why V-Kids Watch gives you the option of choosing up to four other app members who can also see where your child is on a map and get directions to their location. This way, you can bring grandparents, aunts and uncles or family friends into the fold should your kid wander a little further afield. These trusted contacts will receive notifications from the watch should your child press the SOS button for 5 seconds, then you can figure out a plan between you.
THE IMPORTANCE OF CHECKING IN Whether they’re going around a new friend’s house for the first time or attending a classmate’s birthday party without you,
V-Kids Watch’s voice messaging feature is great for checking in and keeping connected. The tool lets you record and send voice messages of up to 30 seconds to each other. And, if any of their friends also have a V-Kids Watch, they can send voice notes and emojis to each other – great if you want to delay that inevitable ‘first smartphone’ purchase by a year or two.
THEY WON’T WANT TO TAKE IT OFF This isn’t a gimmicky toy they get for Christmas and immediately cast aside, it’s designed to be fun for kids. For starters, it’s waterproof and comes in either pink or blue. There are three games available to keep them occupied but they won’t distract them from their studies thanks to the ‘School Time’ feature. The function allows you to disable games and messaging with their friends so they can stay focussed when they need to most. Whether or not you’re well-versed in the world of IoT (internet of things), one thing’s for sure – keeping connected with your child even when you’re not together has never been easier than with V-Kids Watch.
V-Kids Watch is just one device in a whole range of smart products from V by Vodafone, visit vodafone.uk/VKidsHC
Get a V-Kids Watch for £99 (RRP £135) with voucher code HCKIDSP Terms and Conditions. For full functionality a 30-day V-SIM plan, Vodafone network coverage and GPS signal are required. Voucher includes money off the upfront cost only. Voucher code must be used by 1st April 2020. Cannot be used in conjunction with any other offer. See eshop.v.vodafone.com/uk
y k s e P s e t i s a Par I
f you live in a country like the UK, chances are you haven’t spent much time worrying about parasites. But throughout the world, parasites are a big factor when it comes to child illness and mortality rates—and children are more likely to pick up these parasites than their parents, since they spend more time barefoot outside and playing in dirt. By disrupting the internal workings of the bodies, parasites consistently waste nutrients and energy. This means essential fuel in a child’s body is diverted away from where it’s needed, such as in a their developing, energyhungry brain.
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The good news is that in the UK, if you practice good hygiene, you’re likely to avoid these parasitic diseases and their developmental consequences. Read on to learn about three of the most common parasites and what to do if your child picks one up.
WORMS Threadworms are one of the most common parasites with which children can get infected. The tiny organisms, which affect the large intestine, are passed through their eggs. Typically, children will touch a surface or object that has threadworm eggs and then touch their mouth or eyes.
The rate fo r deaths o f children under five from para si ti c diseases in First W orld countr ies is six in 1,000 d eaths. In th ird world countries, the figure ju m ps to 47 in 1,000 d eaths—nea rly eight times as h igh.
The good news is that by getting your little one into a strong habit of handwashing and encouraging them not to touch their mouth or eyes, their risk for threadworms goes way down. The bad news is that the eggs of the pesky parasite can survive for up to two weeks outside of the body, so they might still find their way into your child’s system. Once in the large intestine, the threadworm eggs hatch, and when the worm is ready to lay more, it travels outside of the intestine and lays eggs on the skin around the anus, causing itchiness. If your child has any of the following symptoms, they may have threadworms:
We don’t want to ruin the fun for all the kids enjoying their summer by running around outside barefoot, but their play can come with a risk. Here's everything you need to know about common parasites in children
Parenting ✤ Very itchy bottom
✤ Disturbed sleep because of itchiness ✤ Irritability due to disturbed sleep and discomfort ✤ White threadlike specks in faeces
Dr Ranj Singh's advice on protecting against Lyme Disease:
Use insect repellent, and in danger zones cover your skin and tuck your trousers into your socks ● Stick to paths whenever possible ● Remove tick heads only with special tweezers ● Check out the reporting app LymeApp which tracks outbreaks ●
If you think your child is infected, over the counter medications are available to treat threadworms. In fact, doctors recommend taking de-worming tablets annually, just to make sure your system is worm-free.
Head lice and nits Getting the news of an outbreak of lice at your child’s school and strike fear into the heart of any parent, but never fear, there are a number of ways to treat head lice. If your child complains their head is itchy or it feels like something is moving in their hair, it’s possible they have head lice. However, the only way to confirm is by finding live lice. This can be done by combing their hair with a special finetooth comb, which can be found at most pharmacies. The easiest way to treat head lice is by wet combing. Using the special finetooth comb, you:
Lyme disease Out final stop on this parade of parasites is the tick-borne illness Lyme disease. Ticks that may cause Lyme disease are
found all over the UK, but the high-risk areas include grassy and wooded areas in southern England and the Scottish Highlands. Many people with early symptoms of Lyme disease develop a circular red rash around a tick bite, although in others the rash can appear up to three months after the bite. Lyme disease is easier to treat the earlier it’s caught, so if your child develops a rash and fever after spending time in a grassy or wooded area, visit a GP. If your GP thinks you have Lyme disease, they’ll prescribe a three-week course of antibiotics. It’s important to finish the course, even if your child starts to feel better. Some people with severe symptoms will be referred to a specialist in hospital for injections of antibiotics. Most people with Lyme disease get better after antibiotic treatment. This can take months for some people, but the symptoms should improve over time. People with symptoms of Lyme disease that last a long time after treatment may be referred to a specialist in hospital for advice and more blood tests. hc
✤ Wash hair with ordinary shampoo ✤ Apply lots of conditioner (any is fine) ✤ Comb the whole head of hair from
roots to end This process usually takes about 10 minutes on short hair, and anywhere from 20-30 minutes for long, frizzy or curly hair. The NHS recommends wet combing on days 1, 5, 9 and 13 to catch any newly hatched head lice, and to check again on day 17 to make sure your child’s hair is still lice-free. If you’ve tried wet combing for 17 days, and your child still has lice, there are medicated lotions and sprays which will kill lice within a day. Ask a pharmacist for advice. celebrityangels.co.uk
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ove them as much as we do, our pets are not only prone to shedding their hair, but also bringing in dirt and debris from outside. Increasingly, young children are suffering from allergies, respiratory conditions like asthma or dry skin complaints and our beloved cats and dogs can exacerbate these problems. New born babies and toddlers are particularly susceptible as have no defence while they are still developing and so it is especially important to help improve the air quality and cleanliness in your home.
and ensures that more than 99.98% of fine dust is filtered so you can breathe with ease.
So what can you do if you have a pet? Regular grooming outside will help, as well as ensuring your pets have to walk over a washable microfibre mat when they enter the house to help absorb dirt and water from their paws. And of course, keeping on top of the housework is essential. Regular cleaning using microfibre cloths that attract dust like a magnet will help keep surfaces clear, while investing in a quality vacuum cleaner that is specifically designed for pet families will make all the difference. The Miele Complete C3 Cat & Dog Pro cylinder vacuum cleaner is one such model and will make light work of clearing up after your pet. Like all Miele vacuum cleaners, it features a PowerLine motor which creates incredible suction to deliver a deep clean every time across all surfaces, without pulling any carpet threads. But what really sets it apart is its innovative Miele TurboBrush specially designed to ensure that every hair, piece of fluff, dust or dirt particle lying in its path is picked up. In addition, its charcoal Active AirClean filter helps to neutralise any unpleasant odours
Heavy duty work requires heavy duty tools and German premium domestic appliance manufacturer, Miele is a market leader in cleaning performance. Before going into production, each model in its range is tested to the equivalent of 20 years use. For example, suction hoses are twisted, flexed and stretched with a 5kg weight 120,000 times. Floorheads are tested to cover a distance of 2,000km over various floor types – the equivalent of going from Berlin to Paris and back. And cables are unwound and rewound again more than 10,000 times.
On board cleaning tools include a crevice nozzle for cleaning in corners, a dusting brush with natural bristles for skirting boards, and an upholstery nozzle for mattresses, cushions, covers and curtains. Other features include a 12-metre operating radius, easy to use foot controls for adjusting suction across different surfaces such as rugs or fitted carpet and one touch cable rewind. It also comes with a standard, general purpose floor head.
Compact in design and easily stowed, the Miele Complete C3 Cat & Dog Pro not only delivers the ultimate deep clean but also peace of mind – knowing that you are doing all you can to give your family the cleanest environment and best quality air in their home.
For more information visit Miele.co.uk
Parenting for Pets You might feel your pets are part of the family, but you need to make sure everyone can live together safely and healthily. We look at some of the issues of sharing a house with animals There are many different types of pet vacuum including cylinder, upright and handheld, and also ‘robot’ vacuums, some of which claim to be able to handle animal hair. Your choice of model will depend on the size of the house, the size of your pet, how much hair is shed, and the amount of suction power you need. While nearly all dogs and cats shed, some breeds such as Labradors, German shepherds, golden retrievers and Siberian Huskies are particularly heavy shedders, while poodles and chihuahuas are amongst the least. There’s no real difference between cat and dog hairs so far as vacuum cleaners are concerned. So to our top tips for choosing a pet vacuum cleaner.
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Hair of the dog Possibly the biggest challenge is clearing up dog and cat hairs. Both can cause irritation and allergies, particularly in children, and are difficult to pick after becoming trapped in carpet fibres. Some vacuum cleaners actually make the situation worse by rolling the hairs into balls rather than sucking them up. Many vacuums also have poor filtering, so ‘dander’—discarded particles of pet skin—can be missed in the vacuuming process.
✔ Select a model with special tools for cleaning into upholstery, stairs and other awkward corners ✔ Look for a design with a powerful motor, perhaps 900w—more powerful designs are no longer manufactured, though you may find old stock available
e all love our dogs and cats (and hamsters and gerbils and rabbits…), and some of us even love snakes, lizards, birds and fish. But however much we care for them and regard them as part of the family, animals in the home can present unwanted health hazards, so we need to learn to keep our houses safe for both our pets and ourselves. So how do we go about cleaning up after these lovable bundles of dirt and potential infection?
✔ Look for a vacuum cleaner which collects dust into a disposable bag— though this will increase the running costs, it makes it easier to empty the cleaner without exposing yourself to allergenic dust
RUFF guide Don’t forget to vacuum the inside of your washing machine and clean its filter regularly to remove pet hairs. Once you have tackled the problems of pet hair, you can move on to other equally essential hygiene matters. ✤ Keep pets away from areas where you sleep, eat, and prepare food ✤ Wash your hands after touching your pet
✔ Check the cleaning radius—in other words the length of the mains lead and hose. Could you clean all the way up the stairs with the cleaner at the bottom?
✔ Bear in mind that a cordless model will not have the pickuppower of a mains model. Maybe budget for both if you can't manage the stairs otherwise.
✔ Check whether the cleaner has an odour removing function
✔ Check the model’s hard floor functions. Is it designed for wood, tile or polished floors? Does it have a special attachment?
✔ You might fancy a cordless rechargeable design, particularly for cleaning the stairs—but figure out whether the battery life is enough for you to get around your whole house without recharging, and check the charging time
25% 24% 2%
of UK adults own a pet
of UK adults have a cat with an estimated population of 11.1 million of the UK adult population have a dog with an estimated population of 8.9 million
of the UK adult population have a rabbit with an estimated population of 1.0 million
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✔ Check whether the design has a HEPA (High Efficiency Particulate Air) filter which will trap 99.97 percent of particulates 0.3 microns or larger. hc
✤ Take an animal that appears to be ill to the vet promptly. Regularly worm and protect your pets from fleas ✤ Clean cats’ litter boxes every day to avoid roundworm, hookworm and toxoplasmosis ✤ Wash pet bedding regularly to remove flea eggs and larvae ✤ Store pet food in sealed containers to avoid contamination ✤ Clean pet food bowls regularly in the dishwasher or by hand ✤ Keep pet toys clean and replace them regularly ✤ Use natural cleaning products to avoid irritating your pets’ respiratory systems Just follow our tips for a clean, healthy and happy household for you and your pets—your fluffy friends will thank you for it!
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Your furry friend is looking up at you from underneath the dining table, their eyes positively begging for you to give them a treat. So should you give in?
ust because your pet loves your table scraps doesn’t mean it’s good for them. In fact, passing on mum’s un-loved meatloaf to Spot could lead to him packing on unintended extra pounds, classing him with the half of all dogs and cats that are overweight. Caloric needs for pets will vary depending on size, but when trying to figure out how much to feed your cat or dog, go by this guide: ✤ A 10-pound cat needs only 200 calories a day. ✤ A 50-pound dog needs 700-900 calories. ✤ Larger dogs may eat up to 1,350 calories. In addition to total calories, your pet will need a balanced diet to keep them healthy and happy. Here’s what you should look for in your pet food.
Protein Protein is important for cell growth, muscle repair and general body maintenance. And cats and dogs—both descended from hunters—tend to prefer it as well. Look for a pet food option that uses animal-based proteins, which has all of celebrityangels.co.uk
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the essential amino acids that pets need. In particular, check to make sure that it includes taurine, which is important for cats’ vision, hearts and reproductive systems.
Fats and energy Dietary fats are the biggest source of energy in your pet’s diet. In fact, fats have more than twice as much energy per gram as protein or carbohydrates. Fats will: ✤ Keep your pets’ skin and fur healthy. ✤ Help absorb vitamins. ✤ Insulate the body. ✤ Protect organs. ✤ And make their food tastier!
Carbohydrates Don’t put your pet on a low-carb diet! Carbohydrates are essential for your furry friends—they deliver energy, help maintain digestive health and affect reproduction. In particular, try to get more fibre—yes, fibre is a carb—in your pet’s diet to influence the bacteria in their gut. For the biggest benefit, look for an option that includes fermented fibre, which can be found in wheat, rice or vegetables.
PUP ALERT High-fibre foods are good for young cats and dogs that are still growing. Puppies and kittens should eat a diet that has more fat and protein, to meet their high energy needs.
Vitamins and minerals Just like us, your pet needs a diet rich in vitamins and minerals. And again like us, if you’re feeding your pet a balanced diet of protein, fat and carbs, they’ll be getting everything they need and won’t need supplements. In general, stay away from vitamin supplements unless they’re prescribed by a vet, as it can be unclear what dose your pet actually needs and can cause more harm than good. For instance, feeding your cat or dog too much vitamin A can lead to brittle bones and joint pain. Too much vitamin D can cause overly dense bones and kidney problems.
Hydrate About 60 to 70 percent of your pet’s body is made of water, so keep the water bowl topped up. Remember: some cats don’t like standing water or the taste of tap water and prefer it filtered, distilled or from a running fountain. hc Healthy Child with Dr Ranj Singh | 119
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Holiday On Ice
The family Christmas holiday doesn’t have to be in the snow—there are lots of kid-friendly festive breaks in the sun and sea too.
hen you’re thinking of childfriendly Christmas holiday, chances are your thoughts will turn to Lapland and a visit to Santa, or for the older children maybe the snowy slopes of Val d’Isere— but those aren’t your only options. If you want a choice that doesn’t necessarily involve reindeer and elves, here are some of our favourite family options.
Beaches Negril, Jamaica The 12 Days of Christmas at this family resort on the island’s famous 7km-long beach include a beach carnival with a fire show, festive treasure hunts, parades, outdoor movies, and a Christmas Village with local crafts. On Christmas Day itself, Santa and Mrs Claus appear on the beach to hand out gifts, and there’s also a festive steel band performance and a Christmas party in the teens-only club.
Atlantis the Palm, Dubai Featuring a festive village with seasonal feasts in several restaurants, a chance to visit Santa in his grotto, a winter souk, and fun in the snow at Ski Dubai complete with penguins, Christmas in the UAE is different,
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but very entertaining. You may even catch a glimpse of Scuba Santa diving among 65,000 marine animals in the Ambassador Lagoon.
Costa Adeje, Tenerife If you really don’t like the cold, its proximity to Africa means that Tenerife, the largest of the Canaries, enjoys a warm climate all year around. The West Coast resorts are famous for their nightlife, while the luxury surroundings of Costa Adeje include holiday destinations to suit all budgets, and family fun including carol singing in Puerto de la Cruz, musical shows at the Tenerife Auditorium and loads of turrón, the traditional Spanish Christmas cake. And in Tenerife, the Christmas celebrations go on until January 5th and the arrival of Los Reyes Magos (the Three Wise Men).
Santa’s Magic, Lapland Okay, there has to be an option involving reindeer, and there’s none more authentic than the family breaks in Saariselkä, which include a 1.2km toboggan run, husky-driving, reindeer sleigh-rides, mini-snowmobiling, and of course a meeting with Santa himself.
La Plagne, French Alps Though New Year can be packed, a Christmas skiing break in La Plagne can be just right for the family, combining action on the slopes with fairylit markets, Santa’s grottos, spectacular skiing displays, fireworks, street parties, and a visit from Santa and seasonal kids’ activities in selected family-friendly chalets. hc
Top Tips for Christmas ❆ Travel ❆
Set the central heating to keep your house warm to avoid frozen pipes
Don’t gift-wrap presents you buy abroad, you may have to open them at Customs Remind the kids what to expect—in Australia it’s a barbie on the beach at Christmas, not a turkey in front of a fire Plan and book well in advance to get the best fares and avoid travel upsets
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development â€™s d il h c r u o y rt o p Sup
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Develop vocabulary and understanding ication Improve commun and self-expression n Increase motivatio Support behaviour and daily routines ence Promote independ
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Learning for Life Learning disabilities can present a challenge to children and parents, but with the right support many difficulties can be overcome
hile it’s concerning to realise that a child has learning disabilities, with the right support this should be no barrier to their achieving their best potential and having a happy and fulfilling life. A diagnosis of learning disability is just the start of the journey, and the intention is not to ‘cure’ the disability, but to give the child the social and emotional tools they need to cope with life’s challenges. The British Institute for Learning Disabilities estimates that two percent of the population in England (1.4m) have a learning disability—the term ‘learning difficulty’ is sometimes preferred, though this can also refer to specific difficulties such as dyslexia (difficulty in interpreting words and letters), dyspraxia (difficulty in coordinating movement), ADHD (Attention Deficit Hyperactivity Disorder) or dyscalculia (difficulty with numbers).
INCLUSION Getting a diagnosis can be a very difficult experience, but it is often the first step to accessing the care and support needed for the future. Fortunately, since the rights of learning disabled children were protected by law in 1970, there is now a presumption of their inclusion in mainstream education, and local authorities must provide for their special educational needs. Learning disability support website www.helpguide.org gives the following helpful tips for dealing with your child’s learning disability. celebrityangels.co.uk
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Mencap estimates that there are aroun d 19 children o 3,000 f age in the school UK have a lea who rning disability.
A learning disability isn’t insurmountable, and the important thing is to give your child plenty of emotional and moral support. ✤
Be an advocate for your child.
help build feelings of success and ability. Help your child develop their strengths and passions to inspire hard work in other areas too.
✤ Identify how your child learns best.
Be proactive, work on your own communication skills, and learn to speak up when it’s necessary to ask for special help for your child.
Is it by reading, seeing, listening, or doing? Identifying their primary learning style, and make sure that type of learning is reinforced in the classroom and at home.
You child’s life needn’t be defined by their learning disability. Encourage strengths and talents and nurture he activities where they excel.
Work with your child on activities that are within their capabilities to
Remember health awareness.
Exercise, sleep and a healthy diet are as important for a child with learning disabilities as for any other, so don’t forget to care for these aspects of their development as well as maintaining your own health. hc Healthy Child with Dr Ranj Singh | 123
Internet Safety is Just an App Away Keeping your kids safe online can be a challenge, but technology may be able to solve the problems it created
e all know that the internet is a vital resource for learning and education. But it can also be a dangerous playground for kids, with violent, sexually explicit or disturbing material, online predators and cyber-bullies apparently lurking around every corner. So how can you keep your kids safe without depriving them of important digital access? Other than ripping the smartphones from their hands, locking away their tablets and banning them from using computers, how can you protect children when they are texting, searching or surfing online? If technology is the problem, perhaps technology also holds the answers.
WORRIES Parents have to bear in mind many different dangers of internet use which might not immediately occur to their children; for instance exposure to cyberbullying, access to inappropriate web pages or mobile apps, giving away 126 | Healthy Child with Dr Ranj Singh
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financial or other data, exposure to risky online challenges, and the simple problem of spending too much time with digital devices. Are your children safe from all these digital dangers? The only realistic answer is that they’re not, because they’re all curious enough to explore unsafe places, and there are plenty of deliberately misleading sites and users out there ready to snare them. For instance, practically any smart device, be it a smartphone, tablet or laptop computer, now has a built-in webcapable camera. While this is a great resource for communicating instantly around the world, it does also open children to the threat of spying, and the sending and receiving of inappropriate images. Hackers can access a webcam, turning it on and off at will and accessing images, whether for their own gratification or in an attempt to extort money or images from victims.
For more advice on internet safety for children, check out www.saferinternet.o rg.uk, www. betterinternetforkid s.eu and the Internet Watch Foun dation at
DEFAULTS There are some basic ways to protect against this—making sure that the webcam is set to ‘off’ by default, or even taping over it—but it’s worth educating your kids not to locate webcams anywhere likely to give away any information inadvertently, or to use them for any purpose they wouldn’t want anyone else to see. You should set a good example by applying the same rule to any webcams in your devices. celebrityangels.co.uk
Parenting HERE ARE OUR TOP TEN TIPS FOR CHILD ONLINE SAFETY, AS SUGGESTED BY SECURITY EXPERTS:
Make sure you are there to help them when they take their first steps online
Set a good example by showing positive behaviour in your use of devices
Use parental control tools to block unsuitable sites and set time limits for use
Teach your children not to share identifying information or sensitive photos
5 6 7 8 9
Teach your kids password safety
Another good rule which applies as much to parents as to kids is not to give away any unnecessary information in online images—for instance if you must post a family portrait on Facebook, don’t include information on your whereabouts or images of precious belongings. You should also become a role model in the matter of selfies—never post anything which could lead to embarrassment or distress, and teach your kids to stick to this principle. Remember, anything posted online can spread quickly and irretrievably—there’s no magic ‘delete’ button. Teach your kids good password etiquette—don’t use easily guessed passwords, or the same password on every site. If you have difficulty remembering all your passwords, use a password manager app. It’s particularly important to check their use of chat rooms and make sure that they don’t spend long unsupervised periods talking online to anyone they don’t know in real life. celebrityangels.co.uk
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CONTROLS One of a parent’s most powerful allies in managing their kids’ digital world is the parental control settings feature. Offered by many broadband service providers, parental controls can set filtering levels for internet access and also block specific websites. They can also work away from home when connecting to a Wi-Fi hotspot using your ISP ID. Parental control apps can also be used to set specific times and hours for children to use the internet; limit the pages or types of pages they visit, adding new sites on request if they are suitable; restrict or allow the use of games; and locate the device, showing where the child is using it. It’s never too early to talk to kids about these issues, but equally, as a parent you should be responsible for taking control of your children’s internet use. Until they’re old enough to understand the risks, you are the guardian standing between them and what can be a dangerous online world. hc
Make sure they report any instance of cyberbullying
Keep control of online finances to yourself Teach them about spam, malware and viruses online
Talk to them about the dangers of sexting, grooming and stalking online
Teach them that not everything they see on the web is true
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NO FRAGRANCE NO WORRIES Fragrance is one of the key irritants for allergy sufferers, that’s why surcare doesn’t have any.
GREAT CLEANING RESULTS WITHOUT THE WORRY
Please note that no effective laundry product can be guaranteed suitable for everyone with serious skin conditions. Please consult your Doctor for advice. Always keep household cleaning products away from children.
surcare.co.uk McBride plc.indd 1
A Fresh Look at Laundry You might think you have your laundry routine down pat, but do you know the most magical cleaning tips, and are you aware of the environmental cost of your washday?
Clean without the worry
Eczema is one of the most common skin conditions in babies and children, affecting 1 in 5 children in the UK at some point in their lives. The condition can be extremely distressing for families. The NHS advises to try and identify anything that irritates the skin or make the problem worse—with washing detergent being one of the first considerations. Surcare has a complete range of non-biological products that have been developed with sensitive skin in mind and contain no unnecessary ingredients that could potentially trigger skin irritations.
veryone knows the importance of cleaning clothes and linen, but can you do a good job and still protect the environment? The average load of laundry releases 0.6 kg of CO2 emissions when washed at 30 degrees Celsius and dried on the line, but this figure rises to 3.3 kg, if the same load is washed at 60 degrees Celsius and dried in a washer-dryer. But there are steps you can take to set reduce the problem. Wash full rather than partial loads, and wash at lower temperatures. You might even be able to do a cold wash with special detergents. Consider switching to more concentrated cleaning products. When drying, consider a more efficient gas or heat pump dryer, and
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* 0% fragrance, 0% enzymes, 0% dyes, 0% acids * Dermatologically approved * Allergy UK Seal of Approval dry towels and heavy cottons separately from lighter clothes to reduce overall drying time. Energy.gov recommends using lower heat settings in the dryer—even if the drying cycle is longer, you’ll use less energy and be less likely to over-dry your clothes. Keep your dryer serviced to maintain efficiency—once a month, clean the lint filter, and if you use dryer sheets, scrub the filter once a month with a toothbrush to remove film build-up that can reduce air circulation.
For more information go to
✤Please note that no effective laundry product can be guaranteed suitable for everyone with serious skin conditions. Please consult your doctor for advice.
FABRIC FACT CHECK Make sure you understand washing labels and that you are treating your laundry properly. Healthy Child with Dr Ranj Singh | 129
STAINS, BE GONE! The battle with stains is a tough one, particularly with delicate clothing such as silk or cashmere. Cleaning gurus recommend a routine of “pre-treating.” Before chucking clothes into your machine, treat tough stains such as blood or dirt stains with detergent; allow
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the material to soak in the detergent solution for a short period and then place into the washing machine. Oil stains can be pre-treated with washing-up liquid to help remove the stain. After you’ve scrubbed some washing-up liquid into the folds of the oil stain, toss it into the machine.
FOR LAUNDRY HYGIENE The food poisoning bacteria salmonella and campylobacter can survive on fabrics for up to four hours, and other strains of bacteria can survive for up to five months, so certain “high-risk” items require extra precautions. Anything soiled with poo or vomit, sportswear, aprons, cooking gloves, shared towels, the uniforms of healthcare workers and clothing worn over an infection or wound must be washed at a temperature of 60 degrees Celsius and using a bleachbased product to prevent the spread of pathogens. And the final laundry hygiene rule to remember is to wash soiled items and clothes worn during cooking in two separate loads. hc
CLEANING WITH ACE Get rid of everyday stains, brighten up your wardrobe and protect your children from unwanted germs by applying a capful of ACE to each wash. ACE for Colours is best in every wash (or ACE for Whites for white washes) to prevent colour transfer or a build-up of dingy stains like discoloured underarms or collars. When you’re faced with stains like food, grass, makeup or unmentionable baby stains, it’s time to reach for the pre-treatment sprays—ACE Stain Remover Spray, and ACE Power Mousse for white items. To ﬁnd out where to purchase ACE around the UK and to discover more about the ACE product range which starts from as little as £2 each, visit
A tub with an “X” through it means that the item should not be washed in water, while the circles inside the tub show the appropriate washing temperature; one means to wash cold, two is wash warm at a maximum of 40 degrees Celsius, and three circles means this fabric can really take the heat and to wash at a maximum of 48 degrees Celsius. A circle on its own represents ‘dry clean only’, but an “X” through it means not suitable for dry cleaning.
CLEAN CLOTHES FOR A CLEAN BILL OF HEALTH. Kids don’t like clean. Whether they’re learning or playing, keeping their clothes clean is something they shouldn’t think about. Which means germs are constantly transferred onto whatever they’re wearing – from other kids, from animals and from anywhere they love to roll around. By using ACE in every wash, you can help protect your kids from germs and help them stay healthier for longer. Leaving them to explore and have more fun. You’ll also see brilliant results for both colours and whites.
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This issue of Healthy Child with Dr Ranj Singh looks at fertility problems, with the ultimate guide to pregnancy planning, then advises you...
Published on Sep 10, 2019
This issue of Healthy Child with Dr Ranj Singh looks at fertility problems, with the ultimate guide to pregnancy planning, then advises you...