Pip and Josh share their New Zealand birth story and Pip shares how she overcame her extreme anxiety so that she could birth without fear – and birth without fear she did! “You couldn’t have come at a better time for me as the anxiety was getting the better of me as time progressed. I remember around 26 weeks in tears at my midwife appointment feeling completely overwhelmed and not knowing what to expect. I spoke to my dear friend Felicity Meek who put me in touch with you. As soon as I started listening to your affirmations and then doing your course from around 33 weeks my mind set started to change and I began to relax! Your course allowed me to understand the process but in a way that wasn’t scary but beautiful, something to look forward and that my body was going to do it. I had no idea how powerful hypnobirthing could be, but it was the best thing I could have done to prepare myself. I can not thank you enough Charlene – you are incredible and what an amazing birthing experience you and your course have given me.” Listen to her story in this episode…
DO THE COURSE IN YOUR OWN TIME, WHEN YOU WANT TO! Relax Into Birth is the most comprehensive online Hypnobirthing course available and features over 250 minutes of video course content, including a ‘doula in my pocket’ guide for dads / partners and mandy downloadable audio hypnobirthing tracks and downloadable e-Books. Visit www.relaxintobirth.com for more info. Check out the course by clicking here.
Dr Frances Straeuli and her husband, Dr Chris Straeuli share their birth story and the tools that helped them on their journey to meeting their baby girl Sienna Ruth. “It was a Saturday morning around 9.30 and I had just finished having some breakfast. As I got up to start my day I felt a small gush of water. Naturally, as every mom who’s ever had their waters break I thought to myself “this is it. I’ve now reached the part of pregnancy where I am incontinent” a few moments after that on my way to the loo, a bigger gush! That’s when I realised (initially feeling relieved that I hadn’t peed my pants, which was quickly taken over by fear) what was actually happening. I had ruptured membranes too early! I was only 34 weeks pregnant.” Keep listening for the rest of their birth story 🙂
DO THE COURSE IN YOUR OWN TIME, WHEN YOU WANT TO! Relax Into Birth is the most comprehensive online Hypnobirthing course available and features over 250 minutes of video course content, including a ‘doula in my pocket’ guide for dads / partners and thirteen (and counting!) downloadable audio hypnobirthing tracks and downloadable e-Books. Visit www.relaxintobirth.com for more info. Check out the course by clicking here.
Breath is your best and most accessible tool when it comes to mental preparation and relaxation for birth. Your breath is powerful and can get you out of a fear state (the sympathetic mode) into your birthing state (parasympathetic mode), which can make your labour feel instantaneously more manageable. You want to sink into your limbic centre, where the mind lets go and your body goes into a state of allowing your baby to come down and out. Breath helps to move you from survival mode into birthing mode, gently and effectively. These tracks have been created for your convenience and can be played in pregnancy, during birth and even as a calming visualisation after birth. They are included in the Relax Into Birth Hypnobirthing Online course of prerecorded packaged video, audio and e-book content.
DO THE COURSE IN YOUR OWN TIME, WHEN YOU WANT TO! Relax Into Birth is the most comprehensive online Hypnobirthing course available and features over 250 minutes of video course content, including a ‘doula in my pocket’ guide for dads / partners and thirteen (and counting!) downloadable audio hypnobirthing tracks and downloadable e-Books. Visit www.relaxintobirth.com for more info.
Tracy shares her birth story… Listen to the podcast above, or watch her tell it below.
Dr Tracy Flowers (of Médecins Sans Frontières) shares her birth story. Here’s an excerpt… “”As a doctor, I always imagined I would want a caesar, but then I fell pregnant and everything changed. There’s no doubt that the Relax Into Birth course and the preparation really made it such a wonderful event for us. We went into the birth feeling confident, calm and peaceful despite doing all this through Covid-19. Relax Into Birth helped me to normalise birth through daily listening to the hypnobirthing tracks. When I was in labour, I used the tools I had learnt about breathing, relaxation and visualisation, which all helped me keep calm. The surges felt so manageable and the techniques helped us both so much,” says Tracy.
Her husband Ryan Flowers, adds; “As a very inexperienced dad, the course gave me ultimate confidence and preparedness for the birth. I found the partner tracks handy, which helped me know what was to come and I enjoyed learning massage techniques too. I also used the course as a resource I could go back to anytime. Speaking to other dads who hadn’t done the Relax Into Birth course, I realised they had quite a different mindset on birth than me.”
Dr Tracy Flowers (of Médecins Sans Frontières) shares her birth story. Here’s an excerpt… “”As a doctor, I always imagined I would want a caesar, but then I fell pregnant and everything changed.There’s no doubt that the Relax Into Birth course and the preparation really made it such a wonderful event for us. We went into the birth feeling confident, calm and peaceful despite doing all this through Covid-19. Relax Into Birth helped me to normalise birth through daily listening to the hypnobirthing tracks. When I was in labour, I used the tools I had learnt about breathing, relaxation and visualisation, which all helped me keep calm. The surges felt so manageable and the techniques helped us both so much.”
Relax into Birth is the first proudly South African Online Birth Preparation School, of international standard, teaching women and their partners Hypnobirthing techniques and deep relaxation methods for a more comfortable and manageable birth experience at home or at hospital, for natural or caeasarean births.
DO THE COURSE IN YOUR OWN TIME, WHEN YOU WANT TO! Relax Into Birth is the most comprehensive online Hypnobirthing course available and features over 250 minutes of video course content, including a ‘doula in my pocket’ guide for dads / partners and thirteen (and counting!) downloadable audio hypnobirthing tracks and downloadable e-Books. Visit www.relaxintobirth.com for more info.
Caitlyn shares her birth story… Listen to the podcast above, or watch her tell it below.
Meet Cealyn Gary Goldring Poorter. Born 25 May at 9:59am at 3,13kg. Baby and mommy are doing well and hopefully going home today. Our birth was a whirlwind but what an adventure. I ended up with an unmedicated Natural Vaginal Delivery at 37weeks; what a wild ride!
My waters broke while I was asleep and at 1:15am I awoke to a popping sensation. We monitored the flow of fluids and there was no sign of contractions, so I decided I’d lie down in bed for a while. At around 4am I felt the first surge and from there on it was a crazy beautiful blurr, the storm outside was raging and we began timing the surges – and the next thing I knew it was 6am (I have no idea where time went) and we hopped in the car.
We arrived at emergencies and I was wheeled in. They monitored my contractions, which had advanced pretty intensely and the midwife thought I was already fully dilated. They rushed me up to the delivery rooms and the madness began 😋
We had been tested a week ago for COVID-19, in case baby came early and my tests were negative, but Corbs had somehow come back positive. He was entirely asymptomatic and it was quite a week for me – taking care of everything while he was locked up in isolation. It was not the nicest way to spend our last few days. There was no clear direction on what would happen and honestly we’d expected to let him remain in isolation and re-test in two weeks – and be all clear, but our baba had other plans!
We didn’t know what to do, but I couldn’t drive myself to hospital and my mum wasn’t able to drive in the storm and when the time came to leave, whether or not he had to be in isolation any longer was the last thing on our minds.
Corbs dropped me at emergencies and I didn’t see him again until he was kitted out with PPE, and I was in a lot of pain. I didn’t question if he should be there or not, I was just glad he was. Our doctor arrived and was very upset and immediately took Corbs aside as he should’ve been isolation (she was right I know, but when you’re in that situation and he’s just trying to be there for me – your brain isn’t focused on much! This was all new to us and being in labour is a whole new ball game. I know for one I lost my pants at some point – no idea where or when!)
The Dr rechecked and I’d only dilated to 3cm, but honestly it felt like 20cm and our boy was in a posterior position, which meant, his spine on mine, which meant it could be a longer labour.
The doctor came over and told me she was going to leave as I’d be in labour for about another seven hours. We discussed that I’d use Entonox (nitrous oxide) until the epidural arrived (“if” it arrived). I never imagined it wouldn’t!
And then Cealyn, our baby boy, decided he had other plans. The contractions came fast and hard and within three hours I was fully dilated and seeing the face of the doctor telling me there was no epidural coming, there was no pain relief coming – and that this was it, I had to push! And then the urge to push really kicked in.
Corbs was incredible and he held space for me in the most massive way. I know at the end of the day we could have caused a huge problem at the hospital (because he was COVID-19 positive), even though it was unintentional, but I honestly could not have done it without him. We also had the most incredible midwife who guided me and talked me through it all, telling me to let go now the baby can come (I realised that I could have been holding him back as I had been telling him to stay put for the two weeks of Corbin’s isolation), so hearing that from the midwife gave me permission to let go. The words sank in like hot butter on toast and the next thing I knew, the doctor looked at me sternly, held eye contact and told me to hold my own legs, deep breath in, no sounds, no breathing out put your all into it hold and push! And all I remember next was her saying “Caitlyn, Caitlyn give me your hands here he comes” and there he was, I caught my little bean! Everything and everyone left that room and I was on another planet entirely. My birthing experience was nothing like I’d imagined. There were no dim lights, candles, soft music, there was no gentle aromatherapy oil smells wafting around me while Corbs massaged my back gently and spoke mantras over me. My birth experience felt primal and it was fast! I could hear Charlene’s voice through Corbin, as he kept reminding me of my breath and speaking to me telling me I could let go.
I progressed very quickly, which is unusual for a first time mom, and I truly believe it’s because of the Relax Into Birth Hypobirthing course. I forgot most of everything I learned, but Corbs reminded me when I needed reminding). I guess when the baby’s ready he’s ready! There was this tiny bubble around me and Corbs and it was spectacular. I’d have loved the warm bath or the dim lights, but I wouldn’t change a single thing not for all the world. It was perfect and I’d do it all over again. Hypnobirthing helped me prepare from the inside out – so that the environment became secondary.
For precaution and safety even though I tested negative, I’d been told I was going to be treated as positive and re-tested. This meant we would not leave the birthing room, Corbs would not be allowed to stay and baby’s and my first night together would be without any help. However, I did have Liz, the expectional midwife until 7pm who never left my side. She’s heaven sent and made the entire experience so much more beautiful than it might have ended up. They tested us both, but the results only came back late evening. The good news was that Corbs was negative and so was I.
Just how easy is it to stimulate milk supply after stopping or induce lactation as an adoptive mother? Charlene Yared West explores the topic of relactation and induced lactation to find out more.
Firstly, what is relactation?
According to Leana Habeck, La Leche League Leader (llli.org/southafrica), there is a difference between relactation and induced lactation. “Relactation is about re-establishing of milk secretion after weaning baby from the breast,” says Leana. “Adoptive breastfeeding, also called induced lactation in a woman who was not pregnant with the current baby, may involve hormonal preparation (oestrogen and/or progesterone – simulating a pregnancy) followed by sudden cessation of the hormones (simulating a birth) and then the commencement of pumping or suckling and a galactagogue that increases prolactin secretion.” Internationally Board Certified Lactation Consultant, childbirth educator and midwife Emma Numanoglu explains the protocols for inducing lactation, developed by Dr. Jack Newman and Lenore Goldbarb, as involving a regime of taking the contraceptive pill together with domperidone. “A few weeks before the expected arrival of the baby the mother stops taking the pill, continues with domperidone and starts expressing milk (this mimics the process of pregnancy and lactogenesis after birth). This method has been used successfully and safely for three decades by many women who induced lactation,” she says. “A mother who is planning to apply one of the protocols will need to find a doctor who is supportive of breastfeeding, can explain risks and benefits of taking the medication, and is willing to take responsibility for prescribing domperidone in doses that exceed guidelines for licensed use.”
Commitment to breastfeeding is key to success
Relactation, explains Emma, is also an option for those mothers who have have decided to bottlefeed and have then changed their minds and wish to go back to breastfeeding, or even for those mothers whose babies are not tolerating formula well. “In my practise, this is the most common reason for relactation and the reasons are important as it requires quite a commitment from the mother. For example, if the baby is intolerant to the breast milk substitutes being given, the mother may be more committed to resuming breastfeeding,” she says. “It is important not to place emphasis only on her milk as evidence of success, as this can cause anxiety and thereby inhibit her milk production and ejection reflex. For these reasons it is important to discuss with the mother the benefits, the concerns and problematic elements of relactation.” Emma sees the most success in relactation with babies under three months, but older than that is not impossible, it may just take more effort. “Induced or adoptive lactation is becoming more popular. Mostly adopting couples and lesbian couples seek assistance in breastfeeding their adoptive baby.”
The aim is bonding and creating a milk supply
“For both adoptive breastfeeding and relactation, the aim is to bring about (or back) a milk supply and bring the baby back to the breast. These two are interconnected endeavours, as the best thing for a milk supply is to have a baby breastfeeding frequently and a baby is more likely to breastfeed or return to the breast if there is plenty of milk there,” says Leana. “The difference between the two is such that with a natural pregnancy the milk making tissues are built, whereas with adoptive breastfeeding (if a mother has never been pregnant) she may need hormonal preparation. For many adoptive mothers it may be more about connecting deeply with the new baby through breastfeeding, than producing large volumes of breastmilk.” Emma adds that relactation can fail if mothers are not given the correct support and professional advice preferably from an IBCLC or SACLC trained consultant and La Leche League leader. “Success also depends on quite a few other factors, such as the determination of the mother, no underlying medical conditions and the baby’s age.”
How the breasts work
Leana describes the anatomy of the breast as 10 to 20 branches (milk ducts), heavy with clusters of grapes all intimately bound together by interweaving vines and vegetation. Each single grape an alveoli or milk sack where milk is made and each alveoli is surrounded by a basket of muscle cells that squeezes the milk out into the ducts when it contracts. The 10 to 20 branches are all rooted in the nipple, though each nipple has only between four to nine openings through which the milk is excreted. “Baby’s suckling acts as a stimulus to mom’s body – sending a message to the brain to release the milk producing hormones, prolactin and oxytocin into bloodstream,” she says. “Prolactin, released with the Milk Ejection Reflex (MER), acts on the alveoli to produce milk and Oxytocin, released with the MER, acts on the muscle cells around the alveoli causing them to contract and squeeze out the milk towards the nipple.” It is important to note that large amounts of milk are not stored in the ducts before the MER and that the rapid sucking action of the baby stimulates the let down of milk. The most important thing is to ensure a good latch to help the MER during breastfeeding as well as a good breast pump to stimulate the production of milk too.
Methods of relactation
Emma recommends holding your baby skin to skin as often as you can, in a calm relaxed environment such as lying in your bed, in a comfy chair or even carrying them around in a sling at home. Directly feeding your baby from the breast is the most effective way to increase your supply or relactate. Offer your breast to your baby frequently when they are happy! Do not try breastfeeding when your baby is upset or irritated as it will be nearly impossible to latch them on. “This is an extremely important step. Although it sounds so simple, often this is how babies get interested in breastfeeding again.You can start pumping if you find your baby does not want to breastfeed for very long, or is not interested in taking the breast. Since you are trying to build your supply back up or induce lactation again, it is important to pump frequently,” she says. “If you can pump every two to three hours, that would be ideal. At night you can go for longer between pumping but try to get at least one pumping session in per night. When you start pumping you might not get any milk at all or just small amounts, just keep on going! Some women find it takes a couple of months to really get their supply going again, especially if their babies are not breastfeeding or are only occasionally breastfeeding.” She adds that women who have had an extended period of time since breastfeeding might find they do not build up enough of a supply to exclusively breastfeed, but most women will at least be able to partially breastfeed their babies and many women will eventually be able to exclusively breastfeed their babies.
What is a supplemental nursing system?
A nursing supplementer is a device that allows a baby to receive extra milk at the breast rather than by bottle and teat. It consists of a container that is worn on a cord around the mother’s neck. Fine tubing carries expressed breastmilk or artificial baby milk from the container to the nipple. When the baby sucks at the breast, milk is drawn through the tubing into his mouth, along with any milk from the breast. “Most mothers who have problems getting breastfeeding started will solve them without using a breastfeeding supplementer. Often all some mothers need is information and support. Talking the problem over with someone who understands and supports your wish to breastfeed and who knows a lot about breastfeeding can help you work through any problems. Often they will be able to suggest new ideas to try,” says Emma. “Sometimes, you can solve your own problems by learning more about how breastfeeding works. It is important that the baby is able to suck well at the breast, even if he tires easily, in order for the breastfeeding supplementer to work. A baby with a poor or abnormal suck may not be able to get the milk through the tubing any better than from the breast itself.”
I breastfed my adopted babyDanielle Bischoff is a photographer and storyteller and lives and works in Cape Town with her husband comedian, Rob van Vuuren and their six-year-old adopted daughter, Bijou. “Rob and I both have adoption in our families and when falling pregnant became increasingly difficult and a cause of huge distress for us, the doctors said the only option was to go the IVF route. We both felt like we needed to take a breather from the whole thing and put the baby plans aside for a few months. We didn’t want to rush into a whole IVF mission. We felt that we had been through enough of a wringer just trying to figure out what the problem was. So we left it for a while. After a couple of months we both felt that adoption was the best way forward. I can’t describe it in any other way than I just new our baby was coming to us through adoption. I felt a deep connection and I had even chosen her name before our first meeting with our social workers. There was just this indescribable knowing that baby was on the way and I had to get ready. I didn’t even know that inducing lactation was a thing, but I was so determined to make it happen. So you can imagine the relief I had when contacting Internationally Board Certified Lactation Consultant Jean Riddler, who immediately promised she could help me. It was important to me for two reasons, because I didn’t get to experience a pregnancy I felt like I didn’t want to miss out on the experience of breastfeeding. I had also done some reading on all the amazing benefits. Strengthening the bond was a huge reason and because Bijou was adopted I felt like I had some catching up to do as I hadn’t carried her.I started on the birth control pill to mimic a pregnancy. I wasn’t really happy about going on the pill but as I mentioned before I was pretty determined about it. Once we got the news that a birth mother had chosen us and we had Bijou’s due date, we sped up the process by taking the vomidom (domperidone) and using a double breast pump to stimulate the breasts. This was honestly the hardest part of the whole business. There were moments while sitting there with pumps on my breasts with nothing happening where I really questioned my sanity. Anyway just over a week later the milk started coming out! I was totally amazed and in awe of the human body. I wasn’t able to produce enough milk to purely breastfeed which I was initially quite sad about, but after sometime I was just grateful for the opportunity. I soon realized that being able share the feeding duties with my husband was beneficial for all of us. So in the end we mainly bottle fed her and did top ups with breast milk. I breastfed Bijou until she was about two-years-old. It was a bit of a roller coaster ride to be honest. I felt emotions that I didn’t know I would have. The feelings of inadequacy I felt when I realized that I wasn’t able to purely breastfeed did overwhelm me. I felt like I had let her down and how could I be a mother if I couldn’t feed her. Obviously in retrospect I realize how irrational all that thinking was. Luckily my husband was there to help me through all that. It was totally worth every second on my mothering journey with my precious daughter.”
<Sidebar> PATIENCE AND PERSEVERANCE!Many women who keep persevering and gently encourage their babies to breastfeed while doing heaps of skin to skin with their babies do get results, says Emma. “Don’t give up. It just takes a lot of patience, perseverance and time. It will not happen overnight. Support helps too and is very important. Ask for help with cleaning, laundry, cooking and other household chores, while you focus on just being with your baby. Rest and just “hang out” with your baby.”
<Sidebar>Amazing motherhood hormonesAt every stage of motherhood there are hormones present to facilitate the changes taking place. In addition to a very long list of natural ingredients, breastmilk also contains the following amazing hormones: Prolactin is the hormone of milk production. The suckling newborn increases prolactin levels which physically works in creating more milk, and emotionally, prolactin encourages the mothering instinct of nurturing and selfless devotion to the baby’s health and well being. Oxytocin is known as a shy hormone and is present in orgasm, labour, birth and breastfeeding and causes the Milk Ejection Reflex (MER). Emotionally it is a bonding hormone, also known as the love hormone because it occurs at intimate, private moments of family bonding and love. Physically it is a contracting hormone and as such contracts the uterus in orgasm, facilitates contractions in labour and birth and allows for the milk let down as the milk ducts are contracted and squeezed to allow for milk to flow. Endorphins are the body’s own natural painkiller and can create euphoria and are released during sex and breastfeeding.
<Sidebar> A word on galactagoguesGalactogogues are medications or other substances believed to assist initiation, maintenance, or augmentation of the rate of maternal milk production. Human milk production is a complex physiologic process involving physical and emotional factors and the interaction of multiple hormones, the most important of which is believed to be prolactin, explains Leana. “One should caution against inappropriately recommended galactogogues prior to emphasizing the primary means of increasing the overall rate of milk synthesis, such as frequent feeding and regular draining of the breasts.”A galactagogue may be helpful to speed up the process but are not magic bullets, she adds. They provide building blocks for milk production but effective removal of milk is essential since milk supply seem to be calibrated based on how well the breasts are drained. “If baby is not breastfeeding (well) yet, it is advisable to double pump with a good quality electric pump using the hands-on method.” According to Leana, the currently available pharmaceutical galactogogues are all dopamine antagonists and will increase prolactin levels. Herbal remedies have been used throughout history to enhance milk supply. Some herbs mentioned as galactogogues include fenugreek, goat’s rue, milk thistle (Silybum marianum), oats, dandelion, millet, seaweed, anise, basil, blessed thistle, fennel seeds, marshmallow, and many others. “Although beer is used in some cultures, alcohol may actually reduce milk production. A barley component of beer (even non-alcoholic beer) can increase prolactin secretion, but there is no hard evidence supporting this,” she says. “Mothers wanting to make use of a galactogogues should contact their doctor for a prescription since La Leche League Leaders or International Board Certified Lactation Consultants are not allowed to prescribe any medication be it natural or pharmacological.” Emma points out the most important thing to remember is that an herbal or prescribed galactogogue will only work if you take it while actively trying to build your supply at the same time. “You will not see an increase if you do nothing but take a galactogogue.You should only take a galactogogue if your doctor is in agreement and all side effects and contraindications have been discussed,” she says.
Osteoporosis and broken bones do not need to be a normal part of aging… you can take charge of your bone health and longevity.
Not many of us spare a thought for our hardworking skeletons, until of course, we experience a bone fracture. Only then do we realise how much we appreciate each and every one of the 206 bones of the skeletal system. Our bones provide protection just like body armour, keeping our essential organs safe, such as the skull for the brain and the spinal column and the rib cage. Our bones also allow the body movement, through the leverage of the muscles and are also magnificent storehouses of minerals, such as calcium and also work as factories to produce blood cells. As we age, our bones change, break down, repair and rebuild themselves throughout our lives, which makes it a necessity to understand the ins and outs of optimising our bone health. Charlene Yared-West speaks to Life Healthcare Orthopaedic Surgeons and brothers, Dr Duwayne Vermaak and Dr Slade Vermaak on the topic and finds out how to achieve this lifelong goal.
Your bones are alive and changing Skeletons conjure up images of Halloween, where bones are dry and stiff. However, this idea couldn’t be further from the truth of the bones which are in your body. In truth, your bones are made of tough, healthy, living tissue. “When bones crack or fracture, they are able to recover through rebuilding themselves and are usually restored to their original strength,” says Dr Duwayne Vermaak, Orthopaedic Surgeon at Life Healthcare Little Company of Mary. “However, the age and general health of the person must be taken into account – as this can affect the healing and regeneration process, which happens all the time – even when there is no injury.” Dr D Vermaak points out that there are often little or no warning signs that one can pick up on that could indicate a problem. “Bones don’t tell you much until it is too late – and then they break… Only then does the patient seek advice – and in most cases, some form of pain relief, as fractures can be very painful,” he says.
What is osteoporosis?
The body uses calcium to rebuild bones and 99% of the 1kg calcium in our bodies is located in the skeletal system. “If there is a shortage of calcium in the body, there is less building material available to the bones for rebuilding, repair and maintenance, which can mean more brittle, weaker and fragile bones; a condition known as osteoporosis. The word literally means ‘porous bone’,” explains Dr Slade Vermaak, Orthopaedic Surgeon at Life Healthcare Little Company of Mary. “Healthy bones can look like a honeycomb, but when you have osteoporosis, the holes in the spaces of the honeycomb comparison, are much bigger.The bigger holes indicate that your bones have lost density or mass, which means that your bones are weaker and more likely to break as you age.” Dr S Vermaak recommends going for a bone density test to assess your bone health.
Who is affected the most?
Worldwide, over 200 million people are affected and one in three women and one in five men over the age of 50 will suffer from a fracture due to osteoporosis. An osteoporotic fracture occurs every three seconds and by 2050, the worldwide incidence of hip fracture in men is projected to increase by 310% and by 240% in women. At the age of menopause, women experience a reduced level of oestrogen, which simultaneously causes a rapid reduction in their bone mass. In men, bone loss occurs at the age of 70 years old. Broken bones can occur anywhere in the body, but most commonly occur in the wrists, spine and hips.
When it comes to bone health… prevention is better than cure
Bone health begins in the womb, where good maternal nutrition ensures the healthy development of the baby’s skeleton in utero, which continues into later life, through living a healthy lifestyle and eating right, explains Dr S Vermaak. “The focus for children and adolescents is on building the maximum bone mass, which happens until the age of around 25, where about half of our bone mass is accumulated. Thereafter, as adults, the emphasis is on maintaining healthy bones and avoiding premature bone mass loss, which can occur through unhealthy lifestyles,” he says, adding that gastrointestinal disorders also affect the nutrient absorption – especially calcium, in people of all ages – and they can be at risk of bone disease, and therefore, may need to supplement with calcium and vitamin D. “When in doubt, consult your GP,” adds Dr D Vermaak.
How can you prevent osteoporosis?
There are certain risk factors which increase a person’s susceptibility to bone disease and these are a sedentary lifestyle and poor nutrition, smoking and alcohol use. In addition, the age is taken into account, previous injuries, the body mass index and existing metabolic and health conditions, such as arthritis. “Smoking and alcohol use should be avoided as much as possible and exercise, including weight bearing and muscle strengthening is important for building strong, healthy bones. This applies to both men and women,” says Dr S Vermaak. “A well-balanced diet cannot be emphasised enough – and one that is high in calcium-rich foods, vitamin D and proteins, as well as other micronutrients, including vitamin K, magnesium, zinc and carotenoids – can reduce the risk of osteoporosis.”
Six top tips to get bone healthy…
Soak up the sun! Get 600 IU of vitamin D per day. Sunlight has become the enemy in the last few years, as consensus tells us to cover up with sunscreen… Also, young people spend less time outdoors, as computers, mobile phones and television take centre stage. All that is required is 10 to 20 minutes of sun exposure on bare skin, outside of peak sunlight hours (before 10am and after 2pm), without sunscreen, while taking care not to burn.
Ensure sufficient calcium, vitamin D, protein and micronutrient intake daily.
Micronutrient-rich foods: green and leafy vegetables, cabbage, kale, liver, seeds, carrots, red peppers.
Avoid smoking and excessive alcohol and caffeine. If you love your coffee, or other caffeine-heavy beverages, drink less than four cups per day, as more than three cups could be associated with a 20% increase in the risk of osteoporotic fractures… and make sure you are getting enough calcium!
Include daily exercise and muscle strengthening into your regime.
Take the International Osteoporosis Foundation One-Minute Osteoporosis Risk Test to find out whether you may have specific factors which place you at higher risk of osteoporosis and fractures.
“One day, like any other day, I was making my bed and as I lifted the corner of mattress slightly, I heard something crack in my back. I lay down on the half-made bed and prayed that when I got up, I would be able to walk. Luckily I could walk after a rest and so I continued with my day, not giving the niggling sensation in my back a second thought. The sensation became painful as it became evening and in the morning, I visited my GP, who prescribed pain medication. No medication seemed to work; it only got worse. Two weeks later after seeing numerous doctors and having an XRAY, I was diagnosed with osteoporosis, a condition I had never heard of. I am a diabetic and have been living with the condition since 1957, so it was bad news that I now had to contend with another ailment. One thing I didn’t know was that as a diabetic, it is even more important to consume calcium-rich foods, which is now a priority in my diet. I have since been on medication to treat the osteoporosis and have made certain lifestyle adjustments and thankfully, I am pain-free and living a full and happy life.”
Polycystic Ovarian Syndrome (PCOS) is common in South African women and affects about one in 10 women globally. It is caused by a complex imbalance of hormones in the ovaries. Charlene Yared West spoke to Life Kingsbury endocrinologist, Dr Jocelyn Hellig and gynaecologist Dr Philip Zinn to find out more about this condition.
So what is PCOS?
In a woman’s body, the ovaries release eggs each month as part of a healthy menstrual cycle. However, with PCOS the egg is not released as easily, which leads to irregular ovulation and menstruation and can impact fertility. “The ovaries are described as polycystic because there is an excess of the fluid-filled, egg-containing sacs called follicles, all of a similar size, when seen on an ultrasound image,” says Dr Zinn. “This excess occurs due to disturbance of the growth of follicles – to the size required for ovulation.”
It’s all about the hormones… or is it?
Dr Hellig explains that the exact cause of PCOS is unknown. “There is no one singular factor which causes PCOS. It is considered to be a complex trait arising from the interaction of genetic and environmental factors, usually first presenting when mature gonadotropin levels (hormones essential for reproduction)are achieved at puberty. It occurs naturally in primates as well as humans,” she says. “The disorder arises clinically by the presence of two out of three criteria: irregular periods or the absence of ovulation, features of high androgen levels (acne or excess hair growth) and a certain appearance of polycystic ovaries on ultrasound,” she says.
You could be predisposed to PCOS if…
You have insulin resistance.
You have Type 2 diabetes.
You have unhealthy eating habits.
You do not exercise regularly.
You are overweight or obese.
Trying to fall pregnant?
If you are trying to fall pregnant, but it is proving difficult, PCOS might be the culprit, says Dr Zinn. “Many women are unaware that they even have PCOS until they start trying to have a baby. Once they start treatment and their symptoms are managed, then their chances of conceiving are increased.”
QUIZ: ✓Tick the boxes below to see if you might have symptoms of PCOS
Irregular menstrual cycle
Thinning hair or hair loss on the scalp (male-pattern baldness).
Acne on the face, back and chest.
Too much hair on the face or areas where men usually have hair (hirsutism affects up to 70% of women with PCOS).
Weight gain and difficulty losing weight.
Darkening of skin pigmentation, along the neck, groin and under the breasts.
Skin tags in the armpits or neck area.
How is PCOS diagnosed?
“If you think you have PCOS, make an appointment with your gynaecologist. There is no single test to diagnose PCOS, but we take your medical history and can conduct a physical exam with a pelvic ultrasound and do some blood tests,” says Dr Zinn. Dr Hellig adds: “Of utmost importance is that PCOS is a diagnosis of exclusion and it is important for your medical professional to look for other causes of your symptoms before ascribing it to PCOS.”
Physical exam: Checks your blood pressure, BMI and waist size. Also checking for extra hair on the body, skin discolouration, hair loss and any other signs of excess testosterone such as an enlarged clitoris. It is important to exclude other health conditions.
Pelvic ultrasound: A sonogram will examine the lining of the uterus and check the ovaries for the polycystic features.
Blood tests: To check your androgen hormone levels, as well as other hormone checks, including your thyroid.
Can I be cured from PCOS?
8Dr Hellig explains that there is no cure for PCOS, but symptoms can be effectively managed and therefore treated. “We take into account if you want to conceive, your risk of long-term health problems, especially diabetes and cardiovascular disease, and will help formulate an effective treatment plan through lifestyle changes and medication where necessary,” she says.
What can I do to alleviate my symptoms?
Dr Hellig and Dr Zinn agree on the following steps that women can take to treat PCOS:
Lose weight: This will help to stabilise your blood glucose levels and alleviate insulin resistance. Even a 5 – 10% loss in body weight can improve your chances of conceiving.
Remove hair: Using facial hair removal creams, laser hair removal or electrolysis. Medication is not very effective for permanent hair removal.
Hormonal birth control for women not wanting to conceive: Can help to regulate menstruation cycles, stabilise weight, improve acne and reduce new hair growth on face and body.
Anti-androgen medicines: Although not safe for pregnancy, can help reduce PCOS symptoms.
Metformin: A drug used to treat type 2 diabetes and may help some women with PCOS symptoms in certain circumstances.
Charlene Yared West 