MIRACLE PREMATURE BABY BABY HELMETS CRAFTS FOR
Transcription
MIRACLE PREMATURE BABY BABY HELMETS CRAFTS FOR
Autumn/Winter 2014 MIRACLE PREMATURE BABY DEFIES THE ODDS TO SURVIVE NELL McANDREW FAVOURITE BABY ITEMS CRAFTS FOR KIDS Treating Children with Botox BECOMING A DAD A DAD’S GUIDE TO PREGNANCY BABY HELMETS DO THEY REALLY WORK? Children’s Headaches REAL LIFE STORY USING STEM CELLS TO GROW YOUR OWN ORGANS D RE MM E N D E CO SINCE 2002 BY M U MS Leading & Boutique Brands | Exclusive Offers | Expert Advice Exclusive Advance Tickets Book Now & Save Up To 45%* - Quote ‘NMZ’ thebabyshow.co.uk Our Official Charity *Saving based on standard ticket price of £20. To book by phone call 0871 231 0844, calls cost 10p per minute from a BT landline, other networks may vary. Advance Booking Office closes 23/10/2014, £2 transaction fee applies per booking. For more information on the products featured visit www.thebabyshow.co.uk. E R P ER D R O We know that becoming a parent is complicated enough, without worrying about changing their stroller when they outgrow it. So the revolutionary Armadillo Flip is the only pushchair you’ll ever need. Ready to go from day one, it’s the most compact travel system-ready design on the market that still manages to give them loads of wriggle room. The small wheels are ideal for nipping around your favourite suburban and city destinations, and a reversible seat means you can easily flip baby’s view from you to the world. But best of all, it doesn’t matter which way the seat’s facing. The innovative patented design lets you fold it down with one hand – forwards or backwards – in seconds, into the most compact fold out there. armadillo ÅPW Call instore or go online for a demonstration at THTHZHUKWHWHZJVT HYTHKPSSVÅPW because we’re family theBabaSling® Classic Organic - Pebble theBabaSling Classic ® embrace life ® theBabaSling a multi functional single shoulder baby carrier. With five carrying ® positions, theBabaSling provides the baby with a secure environment, while giving the wearer the flexibility to carry on with their day. Available at most major retailers: www.facebook.com/babasling More information available online at: www.thebabasling.com @theBabaSling Exquisite casts of your children’s hands and feet in silver, bronze and glass. Available at the Portland Hospital. And now at 180 Walton Street, Knightsbridge London sw3 2jl. 020 7639 9085 www.wrightsonandplatt.com FEATURE AUTUMN 2014 FEATURES �� 18 Becoming a Dad COMIC STRIP COOL 20 Top Ten: Lip Balms 22 Health: Urinary Tract Infections 26 Health: Using Stem Cells to Grow your own Organs 28 Beauty: Add a touch of Sparkle 30 Fashion: The Maternity Blues 34 Health: Solving Teenagers’ Period Problems 38 Children’s Fashion: Comic Strip Cool 44 Children’s Clubs 48 Health: Baby Helmets 50 Charity: Wellbeing of Women �� 52 Health: Children’s Headaches 61 Crafts for Kids BABY HELMETS 64 Fashion: Get Shirty 67 How to access Private out-of-hours Care for your Child 68 Health: Treating Children with Botox 76 Toys: A Walk on the Wildside �� WEEKEND GETAWAYS 8 AUTUMN SPRING 2014 2014| | �� URINARY TRACT INFECTIONS AUTUMN 2014 �� TOP TEN LIP BALMS �� BECOMING A DAD �� SOLVING TEENAGERS PERIOD PROBLEMS REGULARS 11 News 13 Listings 14 Practical Parenting with Marina Fogle: Weekend Getaways 17 My Favourite Baby Things: Nell McAndrews 22 What is Happening at �� Weeks Pregnancy 37 Parent Talk 40 Real Life Story: Miracle Baby defies the odds to Survive 55 A Day in the Life of: Dr Adrian Lloyd Thomas, Consultant Paediatric Anaesthetist �� 71 Nurture Loves 77 Contributors TOYS: TAKE A WALK ON THE WILDSIDE | AUTUMN 2014 9 WELCOME There’s no getting around the fact that pregnancy, childbirth and breastfeeding are all about women and their newborns – it’s just the biological facts of life. However, there’s also no doubt that dads play a crucial role in the whole process from conception through childbirth to nurturing the new addition to the family. Many dads feel at a loss during pregnancy and childbirth: theirs is a supporting role and one that, unfortunately, sometimes gets lost with all the focus understandably on the mother and baby. Yet dads need help and support too so that they know what to expect and how they can best help their partner. So with that in mind, in this edition of Nurture magazine we asked Portland Hospital experts to come up with the ten questions and answers about pregnancy and childbirth every new dad needs to know. From antenatal classes and pain relief to how soon you can resume a sexual relationship with your partner after childbirth, we have everything covered. We also talk to one of the country’s leading dad bloggers about his tips for surviving fatherhood. The amazing work of the hospital’s Neonatal Intensive Care Unit (NICU) also comes under the spotlight. The dedication and expertise of its staff means hundreds of sick babies every year are nursed back to good health. We also focus on groundbreaking research using stem cells which means that one day we could be growing our own body parts for transplantation. Added into the mix are the cutest animal inspired toys, the coolest comic strip children’s fashion and the definitive guide to the best jeans and denim for mums-to be. Happy reading! Rachel Ellis, Editor [email protected] Follow us on Facebook or Twitter @ThePortlandHosp Published by The Portland Hospital for Women and Children 205-209 Great Portland Street London W1W 5AH United Kingdom Tel: 020 7580 4400 Email: [email protected] www.theportlandhospital.com 10 AUTUMN 2014 | Nurture™ is a trademark owned by HCA International Limited. Editorial: Claire Coleman, Tamara Abraham, Deborah Arthurs, Jo Waters, Sophie Goodchild, Nicole Mowbray Design and Production: Sam Mitchell-Innes, Cindy Cash, Parul Babbar, Vicky Bell, Naomi Cox www.phoebusassociates.com Advertising Sales Manager: Katie Amps Direct Line: 07818 056651 Images: Corbis and Veer This publication may not be reproduced in whole or part by any means without the prior consent of the publisher. Whilst every effort has been made to ensure accuracy of the content at the time of publication, the publishers shall not be held responsible in any way for any inaccuracies or omissions. © 2014 HCA International Limited. All Rights Reserved. NEWS LIFESTYLE REVERSED DAMAGE CAUSED BY AN UNHEALTHY LIFESTYLE can be reversed if you kick bad habits by the age of 50, research claims. The study of 5,000 people, published in the journal Circulation, found that giving up smoking, improving diet, maintaining a healthy weight and taking exercise in your 30s and 40s can control and potentially even reverse the natural progression of heart disease. However, scientists warned that picking up extra bad habits as you get older, will have a detrimental effect on the arteries. READING ALOUD DOCTORS ARE ADVISING PARENTS TO READ aloud to their children every day from birth to help with brain development. The new policy from the American Academy of Paediatrics is based on growing evidence that crucial brain development occurs during the first three years of life and that reading to children, as well as talking and singing, enhances vocabulary and other important communication skills. STRESS CAN BE ‘CAUGHT’ STRESS CAN BE PASSED FROM PERSON TO person just like a cold, claim researchers. A study by American psychologists found that stress can be ‘caught’ from strangers through their tone of voice, facial expressions, posture and even odour. 'To find that in some people, some of the time, you can elicit these responses just by sitting and watching someone else under stress was somewhat surprising to us,' said Tony Buchanan, Associate Professor from Saint Louis University. LACK OF SLEEP LACK OF SLEEP CAN CAUSE THE BRAIN TO shrink, according to new research. A Singapore study found the less older adults sleep, the faster their brain ages and declines. However, other research concluded that too much sleep in middle age can be just as bad for you as not having enough. A study of almost 9,000 people by the University of Warwick found those aged 50 to 64 who slept for less than six hours a night or more than eight had worse memories and decisionmaking abilities. Seven hours sleep is thought to be the optimum for adults. | AUTUMN 2014 11 THERE’S A SECRET IN THE FOREST this christmas advanced booking essential 0207 434 3111 [email protected] 20 shaftesbury avenue, london w1d 7eu www.therainforestcafe.co.uk www.facebook.com/rainforestcafelondon @rainforestcafe LISTINGS TOYS ARE WITHOUT DOUBT ONE OF CHILDREN’S MOST PRIZED possessions. A new exhibition of portraits by Italian photographer Gabriele Galimberti tells the story of 21 children and their toys from a wide range of countries and backgrounds. The exhibition at the V&A Museum of Childhood, Cambridge Heath Road, London, E2 9PA, runs until Sunday December 14 and is free. www.vam.ac.uk/moc THE ROYAL OPERA HOUSE, Covent Garden, opens its doors to families to explore the building, its artists and the world of opera and ballet. Sessions aimed at children aged six and over include live make-up and stage combat demonstrations, costume dressing up and creative activities led by set designers, and informal performances from Royal Ballet dancers. Tickets, costing £5 for adults, £3 for children, go on sale roughly three months in advance. www.roh.org.uk DELVE INTO THE MIND OF THE world’s most infamous detective Sherlock Holmes at a major new exhibition at the Museum of London. The Man Who Never Lived And Will Never Die asks searching questions about who Sherlock Holmes is and why he still conjures up such enduring fascination. The exhibition, the first on the detective since 1951, runs from October 17 to April 12 2015. Family tickets available. www.museumoflondon.org.uk TREAT YOUR CHILDREN TO A PERFORMANCE of Hansel and Gretel at the Lyric Hammersmith Theatre. With sumptuous music, film, puppets and masks, this is a treat of a show as delicious as a gingerbread house. The 75 minute performance by the Horse + Bamboo Theatre is aimed at children aged five to 11, with daytime shows on February 6 and 7 2015. Tickets £8. www.lyric.co.uk | AUTUMN 2014 13 WEEKEND FAMILY GETAWAYS AS EVERY PARENT WILL ATTEST to, travel with children often ends up being more stressful and tiring than a weekend at home. Packing can take a week of planning and still you manage to forget something crucial, the journey quickly turns into a cacophony of squabbling and, once you finally get there, the children are out of their comfort zone – the bed is too small, the room too dark, the food not right or the pool too cold. So for a hotel to get it right for children is extremely hard. Ben and I had planned an indulgent week without the children in South Africa, something we try to do every year. But, at the eleventh hour, this had to be cancelled; Ben was needed on a fishing trawler in the North Sea before a month in Sochi for the Winter Olympics. Before he went, he really wanted to spend some quality time with all of us so we decided to go away for the weekend. Chewton Glen lies at the edge of the New Forest. It’s a convenient ninety minute drive from London but actually feels like a destination. I had been obsessed with this folkloric forest where wild ponies roam when I was a child, and I knew it would appeal to my little ones. We had the added bonus of staying in a tree house and, within days of announcing this, our children had convinced themselves we would be surrounded by elves and pixies, and that baby wild ponies would be sleeping in their beds. Our treehouse was our little cocoon from which we could watch the rain drip off the trees, water trickle by in the brook and, as night fell, the owls hoot Using natural materials where possible and glass, the treehouse embraces its magnificent setting. Even on a wet spring weekend, our treehouse was our little cocoon from which we could watch the rain drip off the trees, water trickle by in the brook and, as night fell, the owls hoot. While our room was indulgent with 180 degree windows, heated floors and a huge bath, the children had a little attic room, accessed by a ladder built into a bookcase. Two little beds were tucked into the eaves, and boxes of toys awaited their arrival. That night bedtime was a dream; no coercion just two happy children, leaping into their beds, excited for the day ahead. The next morning was one of pure indulgence. The children joined us in bed for cuddles and very soon we heard the ‘elves’ delivering our breakfast. We opened a little hatch and there was a wicker hamper, full of delicious breakfast goodies. We set up a little picnic on our balcony and 14 AUTUMN 2014 | talked about the magical creatures that lived in the forest while devouring warm croissants. That day’s mission was to explore the forest. Your imagination can run wild with you here, so two hours passed quickly as the children searched for elves, pixies and baby ponies who needed rescuing. We then went on to the technicolour gardens at Exbury which never fail to astound. We returned just in time for a swim before tea. An hour splashing, jumping and swimming in the light and airy indoor pool finished the children off and they practically fell into bed, allowing me a rare, indulgent bath before dinner at Vetivier, the hotel’s renowned restaurant. On Sunday morning, we explored the grounds, the outdoor swimming pool, play area and tree house before the ‘elves’ delivered our picnic and we headed off to the beach. In spite of the winter storms, the beaches remained spectacular and provided plenty of flotsam and jetsam for hours of exploring. Salty, sandy, wind burnt and tired we returned to our tree house with heavy hearts for the children’s final bath. The only protestations we had that weekend came at the end when they realised we had to leave our forest utopia. But we promised we’d return and, within five minutes of leaving, they could no longer fight sleep and we drove home listening to the contented snores of two happy, exhausted children. Chewton Glen, New Milton, Hampshire, BH25 6QS www.chewtonglen.com Room from £325 a night. FEATURE Practical Parenting WITH MARINA FOGLE MARINA’S TIPS FOR PLANNING A WEEKEND BREAK WITH YOUR CHILDREN Be realistic about the journey. Around two hours is easy, any more has the potential to become a nightmare. Also think about the timing of your journey. Children sleep beautifully in the car so try to tie it in with a good sleep. You might even avoid rush hour this way. Speak to the hotel beforehand to ask them what equipment they can provide. If you can borrow a cot and high chair you’ll have to pack less. Otherwise, I love the Phil and Teds MeToo Clip on high chair that folds flat. philandteds.com Check with the hotel about curtains in the room. If light pours in through thin curtains at 5am waking your child, your weekend will not be particularly restful. If you want to play it safe, it’s worth investing in the Gro Anywhere Blackout blind that attaches to any window. gro.co.uk You never know when your child might develop a temperature. Get into the habit of taking a small medical kit with you when you travel including a thermometer, Calpol and Nurofen. With little children, ask the hotel about food. Some provide puree menus or equipment to puree. Failing that, pack plenty of pre-made pouches such as Ella’s Kitchen or Plum Baby. If you’re storing food in your mini bar, remember often those fridges are cool enough to cool drinks but not for storing food or milk. Depending on the age of your children, remember to pack some toys. Think about what can entertain them for a long time but isn’t too cumbersome. If you’re heading to the country and have a small child, consider leaving your buggy behind. Country walks tend to be difficult even with ‘off road’ buggies. Instead take a baby carrier – Baby Bjorn is great for small babies and the Ergo baby is great for when they get older. babybjorn.co.uk OTHER FUN WEEKENDS FOR CHILDREN Rent a house by a lake in the Cotswolds. The Lakes by Yoo offers 3-6 bedroom houses to rent with a concierge service so it’s not dissimilar to staying in a hotel. There are plenty of activities to keep energetic children entertained including fishing, canoeing, cycling and even zip wiring across one of the lakes. If the weather’s bad, there’s a great spa and indoor pool. www.thelakesbyyoo.com/rentals Head to the beach. The Pig on the Beach is the newest of the hugely popular and reasonably priced Pig hotels and its location on Studland Beach makes it a perfect family getaway. Overlooking Poole Harbour, the miles of sandy beach are the perfect exploration ground for adventurous families. www.thepighotel.com Immerse yourself in Nature. For animal or tractor-mad children, a stay on Kate Humble’s working farm in South Wales is an experience few will forget. Stay at the Piggery, a two bedroom cottage at the heart of the farm. Collect your vegetables and eggs from your own garden each morning and days are spent mucking around with Farmer Tim. Lambing season is particularly magical. www.humblebynature.com Further afield. If the British weather has taken a turn for the worse, there’s nothing like a quick hop over to the Algarve for some early spring or late autumn sunshine. The Martinhal is a family friendly resort which is chic and luxurious enough to give the most discerning of parents a well-earned break too. www.martinhal.com | AUTUMN 2014 15 LIFESTYLE MY FAVOURITE BABY THINGS Nell McAndrew Nell McAndrew, 40, is a model, author, television personality and accomplished athlete (she has a marathon personal best of 2:54:39). She is also a fulltime mother to son Devon, eight, and daughter Anya, one, her children with husband of 10 years, Paul Hardcastle. The family live in Surrey. 1. Oysterbaby sling, £75, oysterbaby.co.uk Made from bamboo which is gentle on baby's skin, this sling kept my baby close to me and I found that she slept more soundly. The sling position promotes correct hip joint development, prevents flat head syndrome and is great for breastfeeding discreetly. 3. Green People products, from £3.50, greenpeople.co.uk Again, I have tried out various products and like that both baby and I can share them. My favourite is the soothing baby oil (£10.95) which I have used for baby massage and even on my hair to tame my dry frizzy ends. 2. MAM products, various, mamonlineshop.com I have tried out various products from this brand and have been pleased with all of them, especially the curved cutlery (£5.99) and first drinking cup (£2.99). I am now using the toothbrushes (from £3.50). How time flies! 4. Familia organic baby muesli, £2.80, health food stores nationwide I can't stop eating this! I always carry a tub with some of this muesli in then just add either water or milk when needed. I add extra oats and chia seeds and add either oat, soya or rice milk to make it extra nutritious and delicious. 5. BOB running pushchair, around £400, bobgear.co.uk Without this I would not be able to get out for a run as often as I do. This pushchair has helped keep me fitter and happier as well as both baby and me getting lots of fresh air. | AUTUMN 2014 17 FEATURE Becoming a Dad A dad’s guide to pregnancy, childbirth and beyond By Sophie Goodchild A dad in the delivery room was once a taboo. However, today, the journey from the first scan to childbirth is a more inclusive experience for men. But many still end up daunted by the prospect of impending fatherhood. So what’s it really like having a baby if you’re the daddy? John Adams is a stay-at-home father to five-year-old Helen and Elizabeth, aged 19 months, while his wife works full time. He is also one of the UK’s ten most influential dad bloggers. His site Dadbloguk.com chronicles his experiences and is read by several thousand people a month. John says: ‘It makes sense for dad to attend ante-natal classes, read up on childbirth and visit the delivery suite prior to the birth (a visit is standard practice at most hospitals). birth plan then people will know your attitude towards pain relief, for example, and whether dad is to cut the umbilical cord.’ ‘In my opinion, dad needs to know about the experience and his partner’s wishes so he can act as an advocate for her. It is, after all, difficult to tell a midwife whether you are comfortable or not mid contraction while puffing on gas and air. John sees the greater involvement of dads in their children’s upbringing as wholly positive. ‘Many people will tell you a birth plan is pointless. I strongly disagree. You should write a birth plan with your partner and get to know it inside and out. ‘It’s true, things can move very quickly in the delivery room and the medical team might not be able to adhere to every single wish your partner has stated. If, however, you have a ‘If you hear men of older generations talking about their children, they often didn’t know them,’ he says. ‘Everything was left to the mum and womenfolk of the family, and society had very low expectations of fathers. Thankfully that has changed. ‘I was at home for several days while a builder was doing some construction work on our house. The man was in his sixties so I thought I’d better explain why I was always at home with my daughter. ‘Expecting to get a rough-ride, I was very surprised when he said, ‘I wish I could have done what you’re doing. I didn’t see my kids growing up, I was always working’. After the birth, John advises letting standards slip for a while. ‘Concentrate on your family and let the small things go. When my wife returned from hospital following the birth of our second baby, we went for nine days before putting a full set of sheets on the bed. John with Helen and Elizabeth 18 AUTUMN 2014 | ‘We were so tired and so wrapped up in our expanded family we just kept forgetting to do it. It sounds very slovenly but so what? Did anyone get hurt? No, we just spent those valuable few minutes with each other instead of doing mundane housework.’ FEATURE Here Mr Emeka Okaro, Consultant Obstetrician and Gynaecologist at The Portland Hospital, answers 10 questions every dad should ask about pregnancy and childbirth. 1. What can I do to help during pregnancy? This can be an exciting and confusing time for dads-to-be and some end up feeling like a bystander. Prepare yourself by talking to other dads or reading parenting guides. And if you smoke, this is a good time to quit: second-hand smoke is bad for pregnant women and babies. 6. How can I prepare for the birth itself? Make sure you’ve planned the route, know where her hospital bag is stored and have a relative/childminder on standby (if you’ve already got children). Discuss your partner’s birth plan so you both know what she wants - one of your key roles is to be her advocate during your child’s birth. 2. Can we continue to have sex? Your partner may want to have more or less sex than before - let her guide you on what she feels comfortable with. Try different positions that avoid deep penetration. Do remember that sex won’t hurt your baby. 7. Should I attend the birth especially if it’s a Caesarean? This is a matter for you and your partner to discuss. These days, most dads are there even with a C-section and you can help support her during labour which can last anything from two to 20 hours. 3. Should I go to all the antenatal checks and classes? These will help you and your partner share the experience. She’ll appreciate you being there and you’ll benefit from knowing what’s going on. Your job during labour is to provide a calm presence, so it’s essential to be informed about what to expect. 8. How can I be of assistance with breastfeeding? Your support and encouragement is vital. Patience with helping the baby to latch on to the breast is important. Encourage her to drink plenty of fluid as the true milk production starts after 48 hours. Help her persevere with feeding as the colostrum fizzles out. Her nipples may become cracked and sore so do take care. 4. Why are her moods so up and down? Mood swings are common during pregnancy. Your partner is facing all sorts of hormonal changes, may be anxious about the future and is carrying a growing life inside her, while also coping with work and domestic demands. So, if she’s tired a lot of the time, teary or irritable, don’t take this personally - she needs your support. 5. What do I need to know about pain relief? Your support is the foundation for effective pain relief. The options include use of the birthing pool, gas and air, medication or an epidural. Your midwife/obstetrician will guide and support you to make the right choices as labour progresses. 9. What happens if I don’t bond with my child? You may be more concerned about supporting your family rather than excited about the birth. This is perfectly normal. Don’t panic if you don’t feel an instant rush of love when baby arrives. Instead, find quality time to bond with your newborn. 10. How soon is it ok to begin having sex again after childbirth? Every woman is different - for some it may take weeks, others months. It’s best to wait until the post-birth bleeding has stopped and she’s had her six week postnatal check-up. If you have sex before this, there’s a risk of infection because her uterus is still healing. | |AUTUMN SPRING 2014 19 BEAUTY 10 LIP BALMS 1 2 3 4 6 5 7 8 9 10 1. Eos Smooth Sphere Lip Balm in Strawberry Sorbet, £5.99, victoriahealth.com 2. Lanolips 101 Ointment Strawberry, £7, waitrose.com 3. By Terry baume de Rose 10 Year Anniversary Edition, £38, spacenk.com 4. Dr Lipp, Original Nipple Balm for Lips, £11.50, cultbeauty.co.uk 5. Dr Hauschka Lip Balm, £10, selfridges.com 6. Eve Lom Kiss Mix, £18, evelom.com 7. Clinique Chubby Stick Moisturising Lip Colour Balm, £16, johnlewis.com 8. Rodin blush lip balm, £23, liberty.co.uk 9. Hourglass No. 28 Lip Treatment Oil, £32, net-a-porter.com 10. Aromatherapy Associates Moisturising Lip Balm, £15.50, aromatherapyassociates.com 20 AUTUMN 2014 | The Emilia www.icandyworld.com FEATURE F EA ATURE URINARY TRACT INFECTIONS By Sophie Goodchild A BURNING OR STINGING sensation when peeing is a common problem for mums and children. The most likely cause is an infection in the urinary tract, the system for making and getting rid of urine. This part of your body includes the bladder lining and kidneys, and you’re more likely to develop a bug or urinary tract infection (UTI) during and after pregnancy. There are three reasons for this, according to Professor Ellis Downes, a Consultant Obstetrician and Gynaecologist at The Portland Hospital. Firstly, it’s more common in pregnancy to have more glucose in the urine which can ‘act as a focus for infection.’ The bladder not emptying completely and hormone changes which continue during breastfeeding are other factors. ‘The bladder may not empty fully in pregnancy due to the weight WHAT IS 32 HAPPENING AT 32 WEEKS OF PREGNANCY? 22 AUTUMN SPRING 2014 2014| | of the baby and fluid in the uterus pressing on it, and also compressing the tubes (ureters) coming from the kidneys to the bladder. This may leave a pool of urine in the bladder, which can act as a focus of infection,’ explains Professor Downes. ‘Hormonal changes, chiefly progesterone from the placenta, cause the tubes going from the kidneys to the bladder to dilate, again making urine collect.’ Although UTIs are painful and uncomfortable, they are treated effectively with antibiotics which are completely safe for pregnant women to take. To prevent a recurrence, Professor Downes recommends drinking plenty of fluids to keep urine diluted so bacteria are flushed out. Cranberry juice is also a popular ‘cure’ for cystitis, the most common type of UTI. Studies have shown special compounds in the berries can reduce the likelihood of UTIs but the evidence is ‘less robust’ FEATURE in pregnant women, according to Professor Downes. In children, UTIs are more likely to affect girls than boys. It’s just the way girls’ bodies are designed - the tube (known as the urethra) that allows urine to pass out of the body is shorter. Feilim Murphy, a Consultant Paediatric Urologist at the Portland, says children in general are prone to these infections because they don’t realise the importance of emptying the bladder. ‘Having residual urine is like a stagnant pond. You’re increasingly likely to get infection unless you allow the bladder to fill and empty fully,’ he says. ‘Boys are just as likely to be dysfunctional (as girls). They’ll say: ‘I don’t need to go, I’m busy on the Xbox’. That maturity comes later on.’ Any child with a suspected UTI will need a thorough investigation, and antibiotics if they test positive, says Mr Murphy. His advice is to make sure your GP sends off the urine sample to be analysed by a laboratory. Some children may have an underlying issue such as their kidneys not functioning effectively. So an ultrasound scan is important in boys under a year and girls under six months even if they’ve had only one infection, says Mr Murphy. To prevent recurrent problems, parents may need to re-educate little ones on how to empty their bladder YOUR BABY IS ALMOST FULL TERM now and he or she will be a fullyformed little human being, weighing almost four pounds and measuring just about 19 inches. All the organs and body structures such as the ribs will be formed at this stage, and more and more fat is accumulating under your baby’s skin so they are becoming less transparent in appearance. Their fingerprints and nails will be forming along with the nervous system which allows humans to send and also ensure their child isn’t constipated as this can also prevent the bladder from emptying normally. Another tip from Mr Murphy is to make sure your daughter can sit on the toilet seat with her feet touching the ground. The urologist says: ‘If a child is trying to pee with her feet in the air, this contracts the pelvic floor muscles. So have toddler steps up to the toilet until her feet can reach the floor.’ Tips for Preventing UTIs Drink lots of fluids: women need the equivalent of around eight glasses of water (1.6 litres) and children six glasses (1.2 litres) a day. Make sure your daughter’s feet can reach the floor when she’s on the toilet. w Try cranberry juice or cranberry tablets to o fight bacteria. Ensure your child eats ea enough fibre to reduce risk of constipation. Probiotic yoghurts can increase levels of ‘good’ bacteria in the gut. messages back and forth from the brain. However, there is still progress to be made. In the last few weeks of pregnancy, development is really about fine tuning. The muscles and lenses of the eyes won’t be fully mature yet - that’s why babies take a few days to focus after they’re born. Also their lungs are still developing. Babies will be practising for life in the outside world by breathing, swallowing and using their own kidneys to urinate. As your baby is getting bigger, it’s harder for them to move around. However, this doesn’t necessarily mean a breech birth if they’re feet down. Around 60 to 70 per cent of babies at this stage will be in the head down position and the others will be feet down (in the breech position). But there’s still plenty of time for the baby to move into the head down position. Professor Ellis Downes Consultant Obstetrician and Gynaecologist at The Portland Hospital | |AUTUMN SPRING 2014 23 LA ANGELS MATERNITY SERVICES La Angels maternity services will provide you with the best maternity solutions LQWKHÀUVWIHZZHHNVRI\RXU QHZEDE\·VOLIH We give all our clients the confidence with their newborn and help to make them feel that they’re not alone. Our aim is to provide discreet professional guidance and make sure that all duties associated with mother and baby are fully supported and well balanced. We are happy to share experiences with parents and discuss what their real needs are. T: 020371801181 | M: 07867127148 E: [email protected] s p e t e a l se nev s T he CHECKS COMING SOON theart ADJUSTS MONITORS The KING II ATS actively watches over your child from the moment they sit down to the moment you arrive. It helps you check that your child starts off with the harness correctly tensioned. It adjusts as you drive, dynamically retracting the harness to keep the tension exactly as it should be. It constantly monitors the harness tension, alerting you if there’s any problem. Made in Germany for peace of mind, every minute of every journey. Find your freedom at britax.com be free FEATURE USING Stem Cells Organs TO GROW YOUR OWN By Jo Waters © PA IMAGES Pioneering research means we could be using ‘home grown’ organs for transplant ZLWKLQ¿YH years. 26 AUTUMN SPRING 2014 2014| | ELEVEN-YEAR-OLD CIARAN FINN-LYNCH made medical history in 2010 when he became the first child in the world to have a stem-cell supported trachea transplant. Stem cells are capable of developing into any type of cells and they were added to the donor organ in the hope that they would colonise the structure so his body would not reject it. Ciaran, from County Down, was born with a very narrow windpipe and his lungs collapsed on the day he was born. The operation, carried out by a team from Great Ormond Street Hospital and University College’s London’s Institute of Child Health, was a world breakthrough. Breathing problems meant he was in very poor health. Metal stents inserted to keep his airways open had eroded his trachea and caused bleeding, and a trachea transplant was his only remaining option. During the groundbreaking procedure, Ciaran’s own windpipe was removed and replaced by a donor windpipe laced with his own stem cells. Professor Paolo De Coppi, a Consultant Paediatric Surgeon at The Portland Hospital, led the Stem Cells and Regenerative Medicine team at the UCL Institute of Child Health. ‘We showed that we could use a donor organ as a “scaffold” to build a new trachea with the child’s own stem cells and grow it in the body,’ explains Professor De Coppi, who was recently FEATURE made Chair of Paediatric Surgery at the Institute of Child Health and Great Ormond Street Hospital. and the UK Stem Cell Foundation to oesoph develop an oesophagus (gullet) using stem cells. ‘We stripped off all the donor’s cells leaving only a three dimensional web of collagen and then used stem cells taken from Ciaran’s bone marrow to o grow a new trachea on the e structure. s rru st uctur ccttu urre e.. For developing this project for babies born without their oesophagus, oesophagu he has been awarded this year a prestig prestigious Institute for Health Research Resear National Institute (NIHR) (NIIH (N HR) R) professorship. pro roffe essorship. ‘I In the t e past, we w th ou uld ld h avve used ave ussed ed d onor on o ‘In would have donor ttransplant tr an a nsp splant tissu tissue sue su e but but this bu th his is would wou uld d have have avve brought br ro ou ugh ght with it it the tth he the t e risk th risk sk of of organ organ ga an rejection. ass ssynthetic re eje ject ctio ion. Alternatives Alt lte terna erna er ative tive ti v s su ssuch uch ha yntthe heti ticc scaffolds sc caff affolds dss are are e difficult diffi fficcu ffi cult to cult to integrate inte in tegr grat gr ate e with wiith w h native and grow th na the th n ati tiivve e ttissue issu is sue an a nd do do not ott g ro row ow with with tthe th he child.’ chil illd.’ e is is also allsso a o part pa arrt of of a consortium consortium awarded He £10 £10 million miillliio mill on of of funding fun undiin ng g ffrom r m the ro Wellcome Welll We llco come me Trust Tru r st to to develop devve de ello op stem cell therapies therap the th apie ies es in tthe h ffoetuses. he oe etu t se es. s. Two years ye ea arrs after aftte af ter the th he transplant, tran tr ran nsp spla spla lan ntt, rese earrcch hp ubllish ub shed d in in the th he medical medi me dicca al research published journal journa na n al The al Th he Lancet L nce La nccet et revealed rev eveal eale ea led the the th had graft ha h ad not no triggered trr ig gg ge ere red any any immune im mmu mun ne e rejectio on response resp resp re po on nsse e and and had had d formed for ormed med an me an rejection adequate adequa atte e llining. iin nin ng. g. However, r, most mosst importantly, im mpo ort rtan rtan antl ttlly ly, y, iit’s t ’s helping t’ h lp he lpin ng Ciaran, now w 16 1 o llive ive a no iv orm ma all llife ife if 16,, to normal years off h health problems. after so many ye ear a so e ltth prob ea p pr ro ob ble ems ms. ‘Although the trache he ea iss a simple sim mpl ple organ, orrga o gan, an, n trachea we will we hope that in the future futu fu tu ure re w ew wi illl be be complex organs able to engineer more co comple le ex or o rga g nss hearts, using stem cells including heart rtts, intestines, kidneys and livers,’ explains rofessor De Coppi. Professor e continuing to make advances ‘We are ur recent discovery that such as our und in amniotic fluid flui stem cells found surrounding the e foetus show good e engin potential for tissue engineering. The cells could one day be used to grow more complex organs which are made up of different types of tissue. ‘At the moment this work is being done on children partly because their organs are smaller but also because they can potentially benefit the most in terms of extra years of life – each stem cell transplant costs round £250,000. In the future, they will be done on adults too.’ Professor De Coppi has recently received over £3 million from the Oak Foundation, the Catapult Cell Therapy, ‘Congenital ‘C ‘Con Con on g e n itall organ o rg g a n defects de d effe e cctts are arre usually a detected de e te e c ted ted d in babies in ba ab biies es at at the th e 20 th 2 0 week wee eek de ve de ve lo l pm men enttta a l scan,’ scan scan sc an ,’ says s ay ayss Professor Prro P offfe es sor es developmental De D e Coppi. Cop oppi pi. Other organs being studied for stem cell transplant purposes include bladder and skeletal muscle to repair congenital defects of the bladder and diaphragm. ‘We are also investigating using 3D printers to help replicate an organ and then use stem cells, polymers and gels to grow to the scaffold structure,’ he adds. Professor De Coppi currently performs Pro general gener paediatric surgery at the Portland including hernia repairs, re appendix removal and treatments for gastroesophag gastroesophageal reflux disease and bowel problems, problems but says one day he hopes that ste stem cell organ transplants will be available at the Portland too. avail We W e are are ccontinuing ontinuin to make advances ssuch uch aass o ur rrecent ec our discovery that stem ccells ells ffound ound iin amniotic fluid surrounding tthe he foetus foetu show good potential for tissue eengineering. ngin ‘We hope eventually to be able to harvest stem cells from the amniotic fluid of an unborn baby and grow organs for them which will be ready by the time they are born to be transplanted into them. ‘We hope this will happen in clinical practice within the next five years. ‘The next stage will then be performing the transplant in utero before the baby is born so they are born with everything in place.’ His team have also made progress towards engineering donated intestines so they can be implanted without rejection, but this is a more complex and challenging organ to replicate. Professor Paolo De Coppi A Consultant Paediatric Surgeon at The Portland Hospital, led the Stem Cells and Regenerative Medicine team at the UCL Institute of Child Health. | AUTUMN 2014 27 BEAUTY e l k r a p S 1. of a h c u d o d t A 2. 3. 4. 6. 7. 5. 8. 1. NARS Eye Paint in Ubangi, £18.50, narscosmetics.co.uk 3. Omorovicza Gold Shimmer Oil, £52, net-a-porter.com 2. Christian Louboutin Beauté nail polish, £36, selfridges.com 4. Shu Uemura u Dazzling Diamante false eyelashes, £16, shuuemura.co.uk 5. Urban Decay Heavy Metal glitter eyeliner, £13, houseoffraser.co.uk k 7. Benefit Watt’s Up face highlighter, £24.50, benefitcosmetics.co.uk k 28 AUTUMN SPRING 2014 2014| | 6. 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Sorry! bedroomãstorageãplayroom ãhundreds of toys and accessories www.aspace.co.uk FEATURE HEALTH Solving teenagers’ period problems PERIODS ARE JUST ANOTHER PART OF PUBERTY FOR TEENAGE GIRLS. and some are too embarrassed to ask friends or family members.’ But some suffer more than others with pain and heavy bleeding or experience irregular cycles, particularly in the first three years of menstruation. Apart from painkillers to treat menstrual pain, there are also drugs available to make problem symptoms more bearable. Australian research, published in 2010, suggests as many as one in four adolescent girls suffer significant problems with their periods which affect life activities and result in time off school. ‘Around 95 per cent of problems in the first couple of years after a girl starts her period can be attributed to the body ‘settling down’ and developing a regular hormone cycle. Rarely will it be due to an underlying pathological problem,’ says Professor Sarah Creighton , a Consultant Gynaecologist at The Portland Hospital and Honorary Clinical Professor at University College London Hospitals. ‘But that’s not to say we can’t give treatments to ease their symptoms while we wait for nature to settle down. ‘If girls and young women are experiencing heavy bleeding, clotting and flooding, pain or their cycle isn’t improving and they are missing school for instance or, in rarer cases, developing anaemia and tiredness, then it is worth considering treatments that can help.’ Sometimes, all that’s needed is reassurance that what they are experiencing is normal and in most cases will settle down, she says. ‘I advise them not to wait for period pain to start but to take painkillers such as ibuprofen or paracetamol as soon as the period starts as a preventative treatment. ‘It’s also important they get enough sleep, avoid constipation, take enough exercise and eat healthily,’ explains Professor Creighton. ‘I find not all young girls have had access to this type of information – they may have touched on it in a biology lesson, but that will just be the biological facts and not the useful stuff about how to cope with period problems, 34 AUTUMN 2014 | ‘One of the commonest treatments for heavy periods is an oral progestogen pill such as norethisterone (NET). This has to be taken for 3 out of 4 weeks each cycle and can make periods regular, less painful and lighter. One study on NET showed it reduced blood loss by 83 per cent,’ explains Professor Creighton. ‘For older girls, the contraceptive pill can be a very effective treatment. Some studies have shown it reduces blood loss by 43 per cent and cramping by more than 50 per cent.’ Girls can also be prescribed iron tablets for anaemia, medication called tranexamic acid for very heavy bleeding and nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain. HEALTH Teenagers suffer gynaecological problems just like older women but they can get overlooked or not taken seriously. Jo Waters reports. OTHER CAUSES OF PERIOD PROBLEMS POLYCYSTIC OVARIES This term describes ovaries that contain many small cysts (about twice as many as in normal overies). The condition affects one in five adult women. Symptoms include irregular, less frequent periods or a complete lack of periods, oily skin and acne, weight problems, depression or mood changes and unwanted facial or body hair. ‘We don’t know how many teenage girls may have Polycystic ovary syndrome (PCOS) as there is very little research on this condition in teenagers,’ says Professor Creighton. ‘But it’s important to stress that acne, mood changes and irregular periods are common in the teenage years and that doesn’t always mean you have PCOS. ‘Blood tests and scans can confirm a diagnosis and then the condition can be managed – there is no cure. A combination of diet and lifestyle advice and sometimes prescription of the contraceptive pill can improve symptoms.’ BLEEDING DISORDERS Blood clotting disorders such as von Willebrand’s disorder, where individuals have either low levels or a complete absence of von Willebrand’s factor (a protein needed for healthy blood clotting), platelet disorders and haemophilia carriers, are rare, but can cause heavy periods. They may need treatment by a haematologist. When girls don’t respond to these treatments, there may be an underlying cause which requires specialist investigation. These conditions include: ENDOMETRIOSIS This is a condition where endometrial cells lining the womb migrate to other parts of the body, causing painful heavy periods. Each month these cells react to the menstrual cycle and also bleed. However, the blood cannot escape and causes inflammation, pain and the formation of adhesions (scar tissue). ‘We used to believe that teenage girls didn’t get endometriosis but now we know they can. At The Portland I would refer suspected cases for laparoscopic (keyhole) investigation and treatment to remove endometrosis,’ says Professor Creighton. CONGENITAL ABNORMALITIES ‘Very rarely girls can be born with gynaceological abnormalities such as a blocked or absent uterus or vagina. This may not become apparent until puberty and some of these conditions may require surgery,’ says Professor Creighton. | AUTUMN 2014 35 I LOVE YOU DADDY from %HVSRNHMHZHOOHU\ZLWK¿QJHUSULQWHQJUDYLQJ OO LK¿ L )LQHFDVWLQJRIEDE\KDQGVDQGIHHWLQJROGVLOYHUEURQ]HDQGJODVV Philippa Herbert Ltd 37 Riggindale Road, London SW16 1QH Telephone 020 8769 4757 Mobile 07977 477 518 [email protected] www.philippaherbert.co.uk Chelsea and Westminster Health Charity Borne is a collaboration between Chelsea and Westminster Health Charity and Chelsea and Westminster Hospital Registered Charity No. 1067412 CHELSEA, BELGRAVIA, GLOUCESTER ROAD T: 020 8767 9827 E: [email protected] PUTNEY, BARNES, FULHAM T: 020 8480 6064 E: [email protected] PRIMROSE HILL, HAMPSTEAD, KENSINGTON, NOTTING HILL d͗ϬϮϬϴϰϯϴϬϭϴϵ͗ŚĂŵƉƐƚĞĂĚ͘ŶŽƫŶŐŚŝůůΛŵŽŶŬĞLJŵƵƐŝĐ͘ĐŽ͘ƵŬ PARENT TALK PARENT TALK Q. My daughter has just started primary school and I’ve found nits in her hair. How do I get rid of them and prevent her from getting them again? A. Nits are the bane of most primary school parents’ lives. No matter how clean you keep your children’s hair, there seems to be no escaping an infestation of nits or headlice at some point. Headlice are extremely common: girls are more likely to be affected than boys, and children tend to get them between the ages of three and 11. The good news is that they don’t transmit any other diseases. They also like clean hair so, if your child does catch them, at least you have the consolation that their hair was clean! However, it is important to treat these annoying but essentially harmless creatures because they irritate the skin and spread very easily - crawling from one head to another (they are only rarely passed on through bedding and clothing). If you don’t treat them, your son or daughter will be passing them on to other children and maybe even to you too! The first sign of your child having nits is often when they start itching their head – but some children have no symptoms at all so it is worth checking their hair every now and again. ‘Diagnosis is by finding live lice or nymphs (early phase lice) or nits (eggs),’ explains Dr Gill MacLeod, a GP at Rood Lane Surgery. ‘Eggs persist after successful treatment as they stick to the hair shaft and if they are more than a quarter of an 37 SPRING 2014 | inch from the scalp they are unlikely to be active. ‘The eggs (or nits) may remain glued to the shaft even when dead but will grow out with the hair. chemical treatments for severe infestation. However, these are not 100 per cent effective and headlice do become resistant to them so could be used in conjunction with combing. ‘You may want to remove them for aesthetic reasons. Combing can help achieve this but they can be resistant as they are literally cemented to the hair shaft. Before using medicated head lice lotions on young babies (under six months old), pregnant women and people with asthma or allergies, always seek the advice of a healthcare professional and read the instructions carefully. ‘Rinsing the hair with vinegar will weaken the cement and loosen them making it easier to comb them out.’ A quick search on the Internet will throw up a wide range of nonechemical products too. If your child has nits, anyone who is in close contact with them including parents and nannies may be infected and can reinfect the child if they are not treated too. So it is very important to check everyone’s hair with fine tooth combing and then treat all infected household members at the same time. Meticulous wet combing using a special nit comb will inevitably be at least part of your treatment of an infestation. It’s a pretty miserable, time-consuming task but if you lather the hair in cheap conditioner and then go through it with a fine tooth comb, it really does work. ‘To be thorough, bedclothes should also be hot washed and hot air dried to ensure any lice are killed because lice and eggs are killed by exposure for five minutes to temperatures greater than 53.5°C (128.3°F). The same applies to scarves and hats,’ says Dr MacLeod. There are several different ways of treating nits – chemical treatments, wet combing and homeopathic remedies. Whilst careful combing can be very effective, Dr MacLeod recommends You need to repeat every couple of days until you are well and truly sure all the eggs and lice have gone. In short, it seems there is no avoiding getting nits among primary school children and there’s really very little you can do about it other than to be vigilant and regularly check your children’s hair. If your daughter has long hair it might also be worth tying it back. However, it’s not a reflection on you and your hygiene habits, and you are certainly not alone. Happy combing! | AUTUMN 2014 37 FASHION Batman booties, £16 fabricflavours.com Batman print onesie, £24, johnlewis.com j h l i Spider-Man er-Man a dressing gown, £14 mothercare.com ca are.com Marvel print belt £9, River Island riverisland.com Superman socks with cape £4, sockshop.co.uk Marvel Spider-Man pyjamas, £22 fabricflavours.com 38 AUTUMN 2014 | FASHION Star Wars toddler era shoes, £27 vans.co.uk Marvel Marv Spider-Man camo print T-shirt £17.99 , truffleshuffle.co.uk Superman baseball cap £16.99, dandyisland.com Silly Bandz Marvel Bandz £4.75, amazon.co.uk Monsters babygro by Aarrekid £27, thekidwho.eu Superman onesie £12, mothercare.com Marvel projection watch, £8.99 truffleshuffle.co.uk Comic print Dr Martens £101, luisaviaroma.com | AUTUMN 2014 39 REAL LIFE STORY MIRACLE BABY defies the odds to survive Special care from the Portland’s Neonatal Intensive Care Unit saves baby Grey born at 31 weeks. By Jo Waters When Laura Capstick-Dale and her husband Nick brought their tiny son Grey home for the first time this summer, the couple were in no doubt about one thing. ‘The staff at the Portland Hospital saved our son’s life – it was their attention to detail and caring attitude that means Grey is here with us today,’ says Laura, a jewellery designer, who lives with Nick, a property developer, and their son Nate, two, in London. ‘We had the best specialists on call to speak to any time, modern technology and the nurses were just amazingly kind and caring. They were our friends, our family, we cried with them, we laughed with them and they made a horrendous experience vaguely bearable.’ However, later that day, he was put on a ventilator after he started having breathing problems, and heart problems were also detected including a hole in the heart and valves that hadn’t closed. Worse was to follow when Grey developed sepsis and lost all the weight he had gained since birth. Doctors suspected he was developing a disease that affects premature babies called necrotising enterocolitis, where parts of the bowel start to die. Only one in five who have a confirmed diagnosis survive. Luckily, Grey’s infection was caught early and treated with antibiotics and intra-venous nutrition, avoiding surgery. Grey was born premature at just 31 weeks in March this year after Laura started bleeding and having contractions. However, he still ended up spending eight weeks in hospital – five and a half of them in the Portland’s Neonatal Intensive Care Unit (NICU). He was delivered by emergency Caesarean section weighing 4lbs and, initially, seemed healthy. ‘It was horrendous,’ recalls Laura.‘ I would sit by his cot for 10 to 12 hours a day, he had over 60 cannulas 40 AUTUMN 2014 | inserted in the first six weeks, and sometimes it would take five or six attempts to get them in as his tiny veins had collapsed and he would be crying and screaming. It was like a slice of heaven and hell – a beautiful new baby but one who was desperately ill and having to fight for his life.’ Grey was cared for by a team of top medical specialists including neonatologists and paediatricians. ‘I always felt we were in the best place and Grey would be safe at the Portland,’ says Laura. ‘There was one point where there was a possibility he might need a heart operation at Great Ormond Street. In the event, he didn’t need the operation but, if he had, he would have come back to the Portland within two days – that was very important to us.’ It was Laura’s second premature birth at the Portland - her elder son Nate was born at 34 weeks and spent one day in intensive care, five days in special care and a further eight days in transitional care in 2012. REAL LIFE STORY The Portland’s three-cot Neonatal Intensive Care Unit (NICU) and fourcot Special Care Baby Unit (SCBU) are both equipped with the latest equipment to monitor and care for babies with complex medical needs or post-surgical problems. This includes ventilators and brain function monitors. Dr Simon Bignall, a Consultant Paediatrician and Neonatologist and Director of the Unit, says: ‘We have a team of six neonatologists on a rota to give 24 hour care, all of whom have practised at a very high level in lleading NHS hospitals. ‘The team has a daily ward round and ‘T co conference at which we’ll decide if a baby needs input from a sub-specialist bab such as a cardiologists or a dietitian. is very sick, this happens If a baby b twice a day. Babies can become very ill extremely fast and also recover very quickly, so we are always on the lookout for signs of infection.’ ‘The environment of NICU is designed to reduce stress to babies – there is low level lighting and we try to reduce any sharp abrupt noises. We also involve patients in care as much as possible and encourage skin-to-skin contact. Parents get a very personalised service from the consultants and nursing staff.’ The staff at The Portland Hospital saved our son’s life – it was their attention to detail and caring attitude that means Grey is here with us today The unit has just taken delivery of a special brain function monitor which can measure brain activity. - as we know the 6 to 12 hours after the birth, the brain can produce toxic chemicals which can cause secondary damage to the brain,’ explains Dr Bignall. ‘Low levels or abnormal brain activity can be detected by the monitor and we can transfer the baby to a nearby centre for brain cooling treatment, which can help prevent secondary brain damage.’ For Laura, the level of care Grey received was something she’ll never forget. ‘Grey is really thriving now - he’s feeding well and is such a chilled baby, taking everything in his stride. He is seeing a developmental therapist to check he is meeting his developmental milestones, but all the signs are that he’s healthy. We are thankful everyday to have him home. He is a true miracle.’ ‘This is particularly useful where a baby has had a difficult birth - for instance, if they are born with no heart beat and have to be resuscitated | AUTUMN 2014 41 ADVERTISING FEATURE PREGNANCY STYLE INSIDER We caught up with Baukjen De Swaan Arons, founder of the leading maternity wear brand Isabella Oliver and mum of three, for a bump-friendly tips and style advice chat. Ruched Midi Maternity Dress Before the design process starts, what do you always keep in mind? It’s really important that every piece is effortless, comfortable, relevant and great quality – if any of these elements are missing, it doesn’t make the cut. Women buy fewer pieces and wear them more frequently during pregnancy so it’s important to get it right. Maternity wardrobes can be quite the investment. What advice can you give? Camrose Maternity Poncho We like to talk about the ‘bump-o-nomics’ of the collection at Isabella Oliver, highlighting the number of wears something is likely to get. We also design pieces with ‘forever’ appeal and mark them as such so you know they’ve been designed for postpregnancy too. And if you had to whittle it down to three key pieces? A great pair of jeans, a dress that will take you from day-tonight and a wear-with-everything tee. Tell us something that might surprise us. Never underestimate the styling power of great quality jersey. It’s fits and flatters a bump like no other fabric and has become the cornerstone of our collection making wrapping, ruching and other top design details a possibility. Hutton Maternity Top How would you style your favourite piece from the AW14 collection? Right now, I’m loving the boyfriend jean and with the weather feeling distinctly more wintery I’d definitely pair them with our maternity turtleneck. Libby Maternity Tunic The Relaxed Maternity Jean And finally, what celebrity pregnancies have you admired for their fashion choices? I really like it when mums manage to ‘keep-it-real’ while staying true to their style. With day-to-day dressing I think Gwyneth Paltrow, Jessica Alba and more recently, Rachel Bilson, have all achieved a good balance. I always love the way Gwen Stefani styles herself too. Ardley Tote FEATURE Children’s Clubs Increasing numbers of parents in London are turning to private members’ clubs to provide daycare for their children. So what can you expect? had in mind for your young son or daughter. By Rachel Ellis FINDING DYNAMIC AND stimulating childcare in pleasant surroundings can be a challenge for parents. However, a rapidly growing new breed of childcare in London is designed to plug these gaps. With enviable locations in Kensington, Chiswick and Parsons Green among others, smart interiors, cafes and a wide-range of classes, private members’ h clubs for toddlers are t i w e t hom can a the answer for many g n i ‘Be ll day a parents. n e r ld It sounds like it should be easy, but it can be surprisingly difficult to find classes or daycare that tick all the boxes. The location may not be ideal or the activities not quite what you lt chi difficu ou y r e v be es y metim else and so e omeon ing s d e e n nk he thi to do t ’ for you The first private members’ club to open its doors to children in London was Maggie & Rose. Its founder Maggie Bolger, 37, originally from New Zealand, decided to set up the business eight years ago after finding herself at home with three young children and nowhere to go. Maggie and Ros co-foun e de first fam rs of London’s ily mem bers clu b 44 AUTUMN 2014 | ‘Being at home with children all day can be very difficult and sometimes you need someone else to do the thinking for you,’ she says. ‘When I was at home with three young children, there was nowhere that offered relatively decent and stylish childcare and classes that weren’t plastic fantastic. So I decided to set somewhere up myself in Kensington.’ Today Maggie & Rose offers many different types of classes including dress up and dance, cooking, art and make believe. ‘The idea is that you come to the club and do activities with your children in a friendly environment. It might be the mum or dad, nanny or grandparents who come with the child,’ says Maggie, who is now a mother of four. ‘The club also allows you and your child to get messy but without it being in your living room. For example, we ran a Jackson Pollock workshop recently where children and parents had a great time throwing paint around. ‘Working parents can drop their children off for a couple of hours too. We try to cover every option.’ Over the last eight years, the club, which is open every day except Christmas Day and Boxing Day, has gone from strength to strength and a second branch in Chiswick opened in 2013 which includes a full nursery, roof terrace and a double decker bus which serves as a great class location. t en ay a ft Pl rson’s Gre o S g n a i y P , jo b En ly Clu mi ke Fa a Cupc Play Area Maggie & Rose, Chiswick The Kensington branch of Maggie & Rose has recently been refurbished and now includes a pre-nursery and fully licensed brasserie. Membership fees have also changed from yearly to monthly starting at £190 a month to give parents more flexibility. The clubs are aimed at children aged one to five but they also run holiday camps for older children (ages 5-10) at their Chiswick branch. ‘Many parents find there are not great options that are inspiring for their children. We try to plug that gap and offer spacious, inspiring and flexible surroundings with everything under one roof. You can do a class with your children in the morning and then meet up with friends for lunch. It’s a great place to get together with your baby network,’ says Maggie. ‘We also do birthday parties and courses for parents on things like First Aid and cookery. The great thing about it being a members’ club is that users have the ability to shape how they want to use the club. ‘We have had people from all over the world coming to look at what we are doing. My hope is that we have set a precedent and standard for childcare and family clubs for others to compete with. Raising the bar has got to be a good thing for parents and children.’ Cupcake Family Club is a newer addition to the children’s club market and is situated in Parson’s Green. Area Soft Play wick e os R , Chis Maggie & It is aimed at children aged 0 to 5 and runs over 90 age-appropriate classes a week which children attend with their adult carer. Family membership starts at £79 a month. ‘Our classes support every stage of baby’s development helping them to discover, imagine, explore and grow healthily,’ says Suzanne Warner, general manager at the club. ‘We offer a broad curriculum including classes in cookery, crafts, drama, music, dance, gymnastics, ballet, football and tennis. Once you are a member you are free to pick and choose your daily activities to suit your little ones changing developmental needs or the ‘mood’ of the day.’ ‘Our classes su pport every stage of baby’s development helping them to disco ver, imagine, explore and g row healthily,’ The club, which opened two years ago, has an on-site crèche, a café with children’s play areas and a soft play room. The crèche is also available to non-members and is a big draw for members of its sister club Slice Fitness. ‘The idea is that you can spend the whole day with us if you want,’ says Suzanne. ‘For parents who have nannies, it means you know exactly where your child is being taken and parents can ensure their children are gaining access to a safe, sociable, fun, learning environment. The club also offers after school activities for children aged 3 to 7 years. For more information go to: www.maggieandrose.com www.cupcakefamilyclub.com HEALTH BABY HELMETS They’re not available on the NHS, and can cost upwards of £2,000 a time, but infant helmets to correct misshapen heads are increasingly popular. So do they really work? And are there other alternatives? By Claire Coleman BABY HELMETS ARE DESIGNED to address something called plagiocephaly - more commonly known as flathead syndrome. ‘A child may have a flathead for various reasons,’ explains Mr Owase Jeelani, a Consultant Paediatric and Craniofacial Neurosurgeon at The Portland Hospital, Great Ormond Street Hospital and The London Craniofacial Unit. ‘Sometimes it may be because of the way it was lying in the uterus, or if it was delivered using forceps, but we also know that babies who are described as ‘good sleepers’ can be prone to it.’ Part of the reason for this is because, by necessity, a child’s skull is quite malleable or plastic when they’re born. ‘Plates of bone are connected by what are called sutures,’ explains Mr Jeelani. ‘Because a baby’s brain grows a lot in the first two years, these spaces allow the skull to expand. In general, they have closed by the time the child reaches two.’ Mr Jeelani believes the incidence of flathead syndrome has increased 48 AUTUMN 2014 | in recent decades, primarily due to the Back To Sleep campaign, which began in the mid 1990s and advocates putting babies to sleep on their backs to avoid Sudden Infant Death Syndrome. One in two babies are estimated to suffer from flathead syndrome ‘Before then, around one in twenty babies suffered from flathead syndrome, now estimates have it as closer to one in two,’ he says. But he is at pains to point out that flathead syndrome is primarily an aesthetic concern with no implications for brain function or brain growth. ‘There’s a very rare condition called cranial synostosis, which causes these growth lines to close early resulting in an abnormally shaped skull which can put pressure on the brain, but that’s not what we’re talking about in most cases,’ he says. Flatness that is the result of positioning in utero or at birth should have resolved itself on its own by about six weeks. But if it’s caused by the way the baby sleeps, parents tend to notice it around the threemonth mark. ‘Babies who sleep on their backs looking upwards may have a flatter skull at the back, whereas children who favour one side over the other can get flattening at the side,’ says Mr Jeelani. Sometimes this preference is down to the way a baby’s head has been positioned in the womb, which can result in a tightness in the neck, making it more comfortable to lie on one side. A doctor can easily identify this by checking the baby’s range of motion, and while this can improve with age, a referral to a physio might be appropriate. ‘Any flatness tends to get worse up to the six month point when babies start to sit up more, lie on their tummies and spend less time sleeping or on their backs,’ says Mr Jeelani. While he believes helmets - which have to be worn 23 hours a day and HEALTH HOW TO ENCOURAGE A FLATHEAD TO BECOME ROUNDER 1 Rotate the position of the cot and which end you lay the baby in when you put him/her down to sleep. This gives them different focal points which may encourage a different position for the head. 2 Similarly when changing your baby, lay them so that in order to see you they have to turn their head onto the non-flat side. 3 Don’t rely too heavily on devices that mean your baby’s head is resting against something for long periods of time. Ideally children shouldn’t be in car seats or baby rockers for more than a couple of hours at a time. 4 Make sure your child gets ‘tummy time’ - supervised periods of play where they’re on their stomach, which will strengthen their neck and shoulders. work by restricting growth in certain areas, but not the flat area - can be helpful in severe cases, for most mild to moderate cases, it’s simply not necessary. Indeed, a study in the Netherlands, published in the British Medical Journal earlier this year, which compared babies wearing helmets with those who hadn’t, saw no significant differences. Furthermore, parents of the babies wearing helmets reported downsides including skin irritation and sweating. ‘A helmet is a major commitment. You can’t take weeks off, or not do it for a few nights,’ says Mr Jeelani. ‘In the UK, where the weather is relatively mild, that’s not a problem, but I’m not sure you’d want to take a child on holiday to a warm climate and have them in a helmet.’ So how can parents know whether their child’s deformity is mild, moderate or severe? ‘I would always advise anyone who is worried to see a specialist who sees this sort of thing all the time. And, as helmets are most effective when used under a year, if someone is undecided at the six-month point, I think it’s worth waiting until the child is nine months as you can usually see then if the situation is starting to improve on its own.’ It’s worth bearing in mind that such deformities are more apparent in babies because they have so little hair. As their hair grows, any asymmetry will be far better camouflaged. There are an awful lot of adults walking around with less than perfect heads, but most of us will never even notice. Make sure your child gets ‘tummy time’ supervised periods of play where they’re on their stomach CHARITY WOMEN’S HEALTH PROBLEMS NEED MORE INVESTMENT NOT ENOUGH IS KNOWN ABOUT many of the health issues that affect women and babies. Millions of women across the UK suffer from health problems related to the menopause and urinary incontinence, for example, and 4,000 babies are stillborn each year. Yet, despite affecting large numbers of women and babies, medical research into these areas is chronically underfunded. treatment to help women with fertility issues was another. Researchers have discovered that women experiencing severe hot flushes during the menopause may have an abnormality in the function of blood vessels, and there has been a major breakthrough in understanding the irregular cell activity which causes endometriosis. As Professor Peter Brocklehurst, Director of the Institute for Women’s Health at University College London, explains: ‘Research is limited by funding, not by ideas and enthusiasm.’ More recently, research into the link between the Human Papilloma Virus (HPV) and cervical cancer has been instrumental in the creation and implementation of a vaccination programme across the UK and beyond. According to the charity Wellbeing of Women, there is an urgent need to fund more medical research into these problems. These results are vital in continuing to understand women’s health problems and have become a standard part of medicine today. Since 1964, the charity has funded ground-breaking medical research into a wide range of health issues that have an effect on all babies, and all women at every stage of life. Equally impressive have been the breakthroughs in infants’ health. The results of this research have led to significant steps forward in the medical treatment of women and babies. The first revolutionary result of their research was a significant contribution to the creation of ultrasound technology in the 1960s. The development of in vitro fertilisation (IVF) 50 AUTUMN SPRING 2014 2014| | For example, in recent years, researchers funded by Wellbeing of Women have discovered that brain damage in babies deprived of oxygen at birth can be reduced by more than half if they are given melatonin. However, we still do not know enough. While research is progressing, it is not progressing quickly enough, says Wellbeing of Women. In 2011, around 12 women died of ovarian cancer every day in the UK. Around 4,000 mothers had stillborn babies and countless women had miscarriages, suffered menopausal symptoms or faced dealing with incontinence. Liz Campbell, Director of Wellbeing of Women, says: ‘If the same money spent on heart disease or breast cancer was spent on women’s health, these numbers would simply be much smaller.’ ‘Greater investment into medical research would make a huge difference to the lives of women and babies. We do not know enough, but we will.’ reflex the most advanced pushchair in the world? Reflex is a unique combination of convenience, comfort and safety. It’s probably the most advanced stroller in the world right now. Reflex utilises breakthrough technology including LED safety lighting for low light conditions and an ergonomically designed seat for built in comfort. Plus it can be adapted to create a travel system or a rearward facing pram. Discover the Reflex for yourself, quite possibly the only stroller you will ever need. Available at John Lewis and leading Specialist Nursery stores. silvercrossbaby.com HEALTH What’s causing your child’s headache? Headache is a common complaint in children with up to 75 per cent reporting at least one notable headache by the age of 15. Here The Portland Hospital experts offer their tips for getting to the root cause of headaches. By Jo Waters ALTHOUGH MOST HEADACHES in children are not due to a serious underlying condition, they can affect their lives by interfering with school and other daily activities. ‘Common triggers for such headaches can include skipping meals, dehydration following sporting activities or not taking enough fluids, emotional stress and anxiety, allergy to certain foods or food additives and beverages and irregular sleep patterns,’ says Dr Dion Alexandrou, Consultant Paediatrician at The Portland Hospital. ‘Infections such as the common cold and flu, ear and throat infections are also possible causes. These can be treated by addressing simple lifestyle issues, using painkillers, tackling stress and treating infections accordingly.’ TYPES OF HEADACHE There are two broad categories of headache: primary headache - a headache without a significant underlying cause - and secondary headache, which is a symptom of an underlying serious problem. Migraine and tension headaches fall into the primary headache category. TENSION HEADACHES ‘Tension-type headaches tend to be featureless and milder, and the child can continue normal activities, in contrast to migraine,’ says Dr Alexandrou. ‘Tension headaches tend to occur during times of stress. They involve the neck and the back of the head, there is no sickness, vomiting or abdominal pain, and no family history of headaches. ‘Children are under a lot of pressure to succeed at school these days and 52 AUTUMN 2014 | HEALTH exam season can be particularly stressful. Bullying at school may be another cause. They also pick up on relationship problems within the family, loss of a loved one and financial worries.’ Different people have different triggers and some people have warning signs before they get a migraine. If the headaches are not severe enough to affect the child’s daily activities, Dr Alexandrou usually talks to the family about what is going on in their child’s life and suggests making adjustments if necessary. If the child’s headaches are more severe and stopping them from going to school or socialising, a referral to a psychologist may be advised. MIGRAINE ‘Migraine is a very bad headache. It is unpleasant but not dangerous and we don’t know why some people get them,’ says Dr Alexandrou. The main difference from an ordinary headache is that migraine can last a long time and it might only go when you sleep. You may also feel worse if you try to do anything, sick, light or sound may hurt your head and you may need to lie down in a dark room. ‘Triggers can include light, noise, sleep disruption, changes in routine and even some foods including cheese and chocolate. Addressing these triggers can help prevent or reduce frequency of attacks in many cases,’ explains Dr Alexandrou. If you get migraines as a child, there’s more than a ��% chance they will stop when you reach puberty. If you get migraines as a child, there’s more than a 50 per cent chance they will stop when you reach puberty. However, if you start getting migraines as a teenager, they will probably continue into adulthood (although migraines tend to be not as bad as people get older). EYESIGHT PROBLEMS Headaches can sometimes be related to eye strain from staring at a screen too long – and computer screens, tablets and phones can all have this effect. ‘This is caused by the eye blinking less so the muscle gets tired and the surface of the eye gets dry,’ says Consultant Ophthalmologist Jane Leitch, who practises at the Portland and the Epsom and St Helier NHS Trust. ‘Some children will also develop headaches when they try to see the blackboard – they may be short-sighted and need to wear glasses to correct their vision. ‘Most children are given a routine eye test between the ages of 4 and 5 and some of these problems can be picked up then. ‘Distorted vision can be associated with migraines. Sudden onset double vision is rare, it can be an indication of pressure in the brain causing changes at the back of the eye which need urgent investigation.’ Red Flag Symptoms If a child’s headache gets worse when they bend forward or when coughing and straining, or it wakes the child (as opposed to the headache being present on awakening) it could be a sign of a more serious underlying problem. Other red flag symptoms include morning or persistent sickness and vomiting, recent change in personality or behaviour, gait and balance problems and visual disturbances (double vision). ‘Acute onset of severe headache associated with high temperature and neck stiffness and fear of lights (photophobia), is particularly worrying and most likely due to severe infection, most notably meningitis, and the child should go to Accident and Emergency immediately,’ says Dr Alexandrou. ‘Most of the children I see as a paediatrician suffer from tension-type headaches, followed by occasional migraine headaches and extremely rarely headaches accompanied by neurological symptoms and signs due to brain tumours or bleeds.’ ‘All parents fear the worst when their child complains of a headache but thankfully serious conditions such as brain tumours and meningitis are rare.’ | AUTUMN 2014 53 “we call the Puckababy the miracle bag...” “couldn’t imagine living without this beautiful babywrapper...” with .. www.puckababy.co.uk aday DR ADRIAN LLOYD THOMAS is a Consultant Paediatric Anaesthetist at The Portland Hospital and Great Ormond Street Hospital. Here he tells Claire Coleman about his typical working day. A DAY IN FEATURE THE LIFE OF in the life of ‘I arrive at the hospital at 6.30am and take all the paperwork for that day’s theatre list down to the operating theatre so that when the staff arrive they’ll know what medications need to be prepared and any special requirements for specific patients. There are three theatre sessions morning, afternoon and evening - and, if they’re not already in one of the hospital wards, the patients for the first session start arriving from 7am, and I spend the next three quarters of an hour talking to them and their parents. My patients range from newborns to eighteen-year-olds and so you’re dealing with all sorts of different questions. With the very tiny babies, it’s about reassuring the parents that the approach and the medications we use are adapted to deal with their immature bodies. With the older children, it’s about talking through their fears that they might wake up in the middle of the operation or be in pain afterwards. These are quite normal concerns - after all you’re relinquishing control so you’re no longer a sentient being, you’re putting someone else in charge of your destiny. By 7.45am I’m down in theatre, checking the equipment. It’s like the pre-flight checks that a pilot will do to make sure everything works and the staff are clear with what’s going to happen. Then, at 8am, the first patient - and their parents too - are in the anaesthetic room. The parents are there to support and reassure the child while they go off to sleep. Sometimes we’ll play games with them, have them blow up balloons, or sing nursery rhymes. I’ve had to learn the Greek version of Old Macdonald Had A Farm as one little girl whose family is from Cyprus, comes in quite regularly for operations and likes to hear that as she goes to sleep. Handing over responsibility for your child to someone else at such a stressful time can be very upsetting; I hope that I manage to communicate to parents, at the pre-operative visit, my ability to manage the situation. There’s a bit of a misconception that anaesthetists just put you to sleep and that’s their job done. But we’re there throughout the operation constantly monitoring the patient, administering fluids and blood if necessary, as well as administering various types of pain relief, such as nerve blocks and epidurals, which will keep them comfortable after the operation. not much time to eat or drink, but the theatre staff are very kind and I’ll often find a cup of tea - or a banana - waiting in the anaesthetic room for me. When surgery has finished for the day, I’ll do a final ward round to check on the patients that I’ve seen that day, and have a look at the schedule for the following day, telephoning parents if we need to discuss anything before the operation. I never usually leave before 7, and I’m often there until 9, but it’s very rewarding work. The biggest compliment I’m paid is when a child comes back for further surgery, or I see a sibling, and the parents say, ‘oh I’m so glad it’s you, we were hoping it would be’. That’s very humbling.’ While they’re in the recovery room, coming round, the next patient is in the anaesthetic room. It really is non-stop. The numbers vary but I can see up to 20 patients in a single day and, when one session is done, I go to talk to the patients for the next session. There’s | AUTUMN 2014 55 ADVERTISING FEATURE Why be ordinary when you can be tarting a family is a magical time for any parent, the future is full of hope and mystery and, more than anything, you want to give your child the very best that you can, starting from the very moment you find out a little one is on the way. 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The family dynamic The special bond with Daddy For bookings and more information, please visit: www.thebabyacademy.co.uk or contact: 60 SPRING 2014 | T: 07811 218686 | E: [email protected] TOYS TO 1. crafts for kids As Perri explains: “Give a child a specific project - to create an origami plane, for example - and they’ll discover how THE WEATHER’S LOUSY, THEIR beloved toys have fallen out of favour and satisfying it can be to set goals, complete both the children – and you - are reaching something themselves and be proud of what they’ve done. the end of your proverbial tethers. by Nicole Mowbray If this scenario sounds as familiar to you, perhaps you should consider a good oldfashioned craft session. “And when they get stuck - they can’t work out why the glue isn’t sticking or the paper mache won’t dry - it gives them a chance to hone their problem-solving skills.” “Making stuff with kids is brilliant, especially when they don’t have to follow One of Perri’s favourite activities - for strict instructions,” says Perri Lewis, author boys or girls - is creating origami – the of Material World, the Modern Craft Bible. 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UK Birth Centres Ltd Ad Wherever you choose to have your baby, support from our experienced and dedicated midwives will ensure that you’re more likely to enjoy your pregnancy and have a positive birth experience. Call 0800 3800 579, email [email protected] or visit www.ukbirthcentres.com Independent dependent Day School for Girls from 4 to 18 years Queen's Gate School offers girls a warm, supportive environment, where individuality is nurtured, academic standards are high and a broad based curriculum ensures a well rounded education. A range of Scholarships and means-tested bursaries are available to assist girls to join us and parents are welcome to visit us throughout the year. See our website for details of Open Events for entry to the Senior and Junior Schools in 2015 For a prospectus, or to make a private visit to the School, please contact the Registrar, Miss Janette Micklewright on 020 7594 4982 or email, [email protected] Queen’s Gate Junior School 125-126 Queen’s Gate London SW7 5LJ Queen’s Gate Senior School 131-133 Queen’s Gate London SW7 5LE www.queensgate.org.uk How to access private out-of-hours care for your child Unwell children can go downhill suddenly at any time of the day or night. In many cases, seeing a doctor can wait until the morning but, when children become seriously ill, they need medical attention quickly. A medical emergency always requires calling an ambulance to take your child to Accident and Emergency. ‘It is very reassuring to know that this service exists, especially for those children who are unwell, not to the extent that they need an urgent ambulance transfer to A&E, but who require a full assessment, investigation, treatment and likely admission without having to wait for several hours to be seen.’ However, if your child’s condition is serious but not a medical emergency or does not require emergency surgery, The Portland Hospital offers private out-of-hours paediatric care around the clock. To access the Portland’s 24/7 Paediatric Medical Admissions Service you will need a referral from a GP to ensure your child is appropriately screened and directed to emergency services if required. A senior member of the hospital’s paediatric nursing team will talk to your GP on the telephone to gather as much information as possible about your child, their condition and medical history and arrange their admission. At the hospital, the child will be assessed by an experienced medical team including the oncall Consultant Paediatrician and Resident Medical Officer (RMOs). R TREAT O WE CAN ITH... HELP W Payment must be made on admission although some parents will be able to claim back on their medical insurance (policy dependent). Dr Shazia Ovaisi, a private GP at Thurleigh Road Practice, Clapham, was very impressed with the service when she used it to deal with a very sick child. ‘The process from initial referral to admission went smoothly,’ she says. ‘It can be very stressful dealing with a child who is acutely unwell; you have to deal with the clinical problems, manage parental anxiety and time is of the utmost importance. ‘I was able to contact the triage nurse very quickly and run the referral past her (she liaised with consultant) and arrange admission.’ Following a medical assessment, a child is taken to the day case unit or ward as appropriate. Dr Ovaisi adds: ‘It is very reassuring to know that this service exists, especially for those children who are unwell, not to the extent that they need an urgent ambulance transfer to A&E, but who require a full assessment, investigation, treatment and likely admission without having to wait for several hours to be seen. I would definitely use the service again and would recommend it to colleagues too.’ ing Wheez th ss of brea Shortne c) (not cardia in a p t s e Ch e Ear ach rexia) rature (Py e p m te h Hig tion tract infec Urinary reaction Allergic Rash Eczema s Celluliti l) urgica ain (not s p l a in m o Abd e ed jaundic Prolong loss/ te Weight ing neona poor feed ation ery) Constip uiring surg q re if t o (n nteritis Gastroe ild’s e your ch g n a r r a o k your T ission as m d A t c e 111 Dir 0 7390 8 2 0 ll a c GP to rvices urs GP se o h f o t u For o nd’s he Portla ck t t c a t n o c lo nd The C Doc Arou 2 390 802 on 020 7 HEALTH TREATING CHILDREN WITH BOTOX Botox is a popular cosmetic treatment for lines and wrinkles. But, increasingly, it’s being used to treat children’s medical problems too with some highly effective results. By Jo Waters BOTULINIUM TOXIN - COMMONLY known as Botox® or BoNT - has become a well-known quick fix to banish the signs of ageing. It is produced by the bacteria clostridium botulinum and, when used in tiny controlled doses, can be useful to relax excessive muscle contraction. Now doctors are using it on children to treat a whole host of medical conditions. Here are some of the most common uses in children. Cerebral palsy Botulinium is very useful for treating muscle stiffness in children with cerebral palsy, a neurological condition that affects movement and co-ordination. ‘Children with cerebral palsy can develop stiff muscles as they grow and this can lead to pain and severe restrictions in movement if left untreated,’ says Stacie Ahern, a Specialist Paediatric Physiotherapist at The Portland Hospital. ‘Botox helps by blocking messages from nerves to muscles telling them 68 AUTUMN 2014 | to contract and this enables the muscle to relax. ‘In the right children with cerebral palsy – usually those aged under eight - Botox can be a very effective way of reducing stiffness in specific muscles. It is more effective the younger you are, although we do also use it in older children too. In some patients Botox can be effective and less traumatic than surgery. ‘The selection of who is appropriate for Botox treatment, the muscles to be targeted, treatment goals and post injection goals are decisions made by a multi-dicilplinary team of experts and the child’s family. ‘It works better in some children than others - some will only need one injection a year but others may need follow-up treatment every three months.’ Botox injections are used in conjunction with splints and serial casting for celebral palsy. This involves the foot, for example, being moved into a straight position and kept in place with a splint or plaster cast which is taken off regularly so the position can be adjusted, as well as a course of intensive physiotherapy for six to eight weeks. Squints Squints are an extremely common condition affecting one in 20 children, and occur when the eyes are misaligned. According to Mr Saurabh Jain, Consultant Ophthalmologist at The Portland Hospital and London’s Royal Free Hospital, in some patients Botox can be effective and less traumatic than surgery. ‘Eye surgery to correct a squint involves moving muscles attached to the eye into an optimal position so that the brain can maintain what is known as the “fusion range”,’ he explains. ‘Unfortunately, it’s an invasive procedure and there is a risk of HEALTH scarring. Sometimes the operation has to be repeated and every time you do an operation, muscles lose elasticity. ‘Botox can move the muscles into the correct position without the need for surgery and the hope is that the brain will take up the fixation and the squint will be permanently corrected.’ The only disadvantage is that a child may need a course of injections – up to three – with four or five month gaps between each one. ‘The standard treatment is oral medication but it doesn’t work for all children and the side-effects can include blurred vision and dry mouth. ‘Botox can be a good treatment for those children who have tried oral medication without success – it has about a 50 per cent success rate and involves two or three injections over six months. It works by paralysing the bladder wall muscles so that they relax and pressure doesn’t build up.’ ‘Botox may be particularly suitable for patients who cannot tolerate, or are not compliant with, the daily intake of oral headache preventive drugs’ ‘Generally, there is a lot less scope for things going wrong so, for me, it’s a no-brainer as there is a really good chance of good outcomes,’ he says. ‘Although Botox is not suitable for every child with a squint. In some cases it can be a permanent solution.’ Bladder complaints Botox can be injected into the bladder wall as a last-resort treatment for an overactive bladder. ‘Normally, as the bladder fills, it relaxes and the pressure goes down. But in children with an overactive bladder, the pressure builds up as it fills and it becomes tight leading to wetting or frequency of passing urine,’ explains Mr Imran Mushtaq, Consultant Paediatric Urologist at The Portland Hospital and Great Ormond Street Hospital. Migraines Migraines are a severe type of headache, usually felt as a throbbing pain at the front or side of the head. Botox is thought to help relieve migraines by inhibiting the release of pain transmitters. Dr Maria Kinali, a Consultant Paediatric Neurologist at The Portland Hospital and the Chelsea and Westminster Hospital, says Botox is a potent muscle relaxant found to have pain relieving effects in patients with various pain syndromes. She has been using it to treat children’s migraines for two years. ‘Botox may be particularly suitable for patients who cannot tolerate, or are not compliant with, the daily intake of oral headache preventive drugs,’ she says. ‘Indications for use are chronic migraines, present for 15 or more days per month for three months or more, with each headache lasting four hours, where patients have tried and failed two previous anti-migraine medications in adequate doses.’ Advantages over other treatments include its long-lasting effects - usually three months - and its favourable sideeffect profile, she says. French Nanny, the best care for your children! The only nanny agency excusively dedicated to placing French nannies! www.french-nanny-london.co.uk +44 (0)203 445 0266 +33 (0)1 83 62 00 01 [email protected] !! " BOYS & GIRLS ffrom 3 months h to 4 years Come and browse our gorgeous Italian collections! #& !"!"% !"! $ " ! /! ).$ '+0.,+-.2-/1 *!!!" ( •• www.susieandtoto.com [email protected] - facebook.com/susieandtoto LIFESTYLE LOVES Silver Cross Surf 2 travel system, £700, www.silvercrossbaby.com The Surf 2 travel system is light yet strong with a magnesium alloy chasis, puncture free and large pneumatic tyres and designed to provide the same exceptional ride you would expect from a traditional Silver Cross pram. It comes with a suitable from birth carrycot which provides a safe, cosy, lie-flat environment, also suitable for overnight sleeping. Puckababy 4 seasons sleeping bag, £84.99, puckababy.co.uk This is an investment that will grow with your child and offer a sleep solution no matter what the weather. You no longer need to buy different sleeping bags as the 4 seasons has come up with the answer. The luxurious bag is from 7 months to 2½ years and has won several consumer awards. 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The hotel is offering a 7-night half board Family Package from a discounted rate of £1,950, representing savings of up to £375, based on a family (two adults and two children) sharing a Junior Suite. | AUTUMN 2014 71 MyGPPlus Your Trusted Advisor Affordable private GP care for you and your family – peace of mind for less than £1 a day We are used to being empowered in our modern lives. We aspire to live the way we want to and make choices about where to shop, what (and where) to eat, who to bank with, where we want to live; we can even choose which hospitals we want to use when we need care. In theory you can choose your NHS GP but in reality most people find it isn’t that easy. Wouldn’t it be good to have more power to choose who to trust as your personal health advisor, who you want to be that crucial first person you turn to when one of the family is ill? You may get great care from your NHS GP, but getting an appointment may not always be easy, if possible at all. A recent survey showed that 1 in 10 patients (34million appointments) can’t get an appointment with their GP when they need one, so being seen quickly when you need a doctor is of paramount importance to us. Health shouldn’t have to wait. A comprehensive private GP and wellbeing service with you and your family at its heart Annual health screen Unlimited Private GP appointments Nurse appointments Referrals to private consultants or advice on appropriate NHS care Private physiotherapy, chiropractic and osteopathy referrals Private psychiatry, psychotherapy and counselling referrals At Roodlane (part of HCA) we know about health. We have been looking after patients for 23 years and we have now created MyGPPlus offering a comprehensive private GP and wellbeing service with you and your family at its heart. Travel advice and vaccinations Cryotherapy and minor surgery Annual flu vaccination The service is open to individuals and families on a subscription basis, giving you the exceptional standards of care you deserve at an affordable price. MyGPPlus gives you access to our own private clinics across London and you can book online, over the phone or through the app to arrange an appointment which will be within two working days at most – sooner if it’s urgent. If getting to one of our clinics isn’t possible, you can also have a consultation by phone or telemedicine, making life even easier if you are on the move or at home looking after children as well as yourself. This service enables you to make a choice about your healthcare and your family’s healthcare. It’s convenient, thorough and gives you peace of mind that all of your medical needs are being met in a time and space that works for you. Your care with us starts with getting to know each other through a careful health check which will be repeated annually so that we are always up to date on how you are. *2012/2013 GP Patient Survey, NHS MyGPPlus is provided by Roodlane Medical, a long-established GP practice in the heart of London with a refreshingly old-fashioned approach to care where the focus is on you. For more information: E: [email protected] T: 0300 456 2215 W: mygpplus.co.uk Burlington B urlin ngton N Nannies annies Ad A d Burlington Nannies & Maternity Ltd 83 Victoria Street. London. 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TOYS A WALK ON THE WILDSIDE � � � � � � 1 Ingela P Arrhenius nesting animal dolls, £19, thekidwho.eu 2 Wooden bird whistle, £4.50, Djeco, crafts4kids.co.uk 3 Hand-knitted lion soft toy, £24, notonthehighstreet.com 4 Nuts Inflatable Ball £7, Djeco, alexandalexa.com 5 Baby paper mobiles, elephant or hippo £10, thekidwho.eu 6 Noah’s Ark in bamboo, by Everearth, 64cm, £199.53, woodentoysuk.com k.com m 7 Sophie The Pull Giraffe, £45, Studio Delle Alpi, alexandalexa.com 76 SPRING 2014 | � CONTRIBUTORS Stacie Ahern Senior Paediatric Physiotherapist [email protected] 020 7390 6551 Dr Maria Kinali Consultant Paediatric Neurologist [email protected] 020 7390 8020 Dr Dion Alexandrou Consultant Paediatrician [email protected] 0203 583 2828 Miss Jane Leitch Consultant Ophthalmologist [email protected] 020 7387 4072 Dr Simon Bignall Consultant Paediatrician and Neonatologist [email protected] 020 8941 8192 Dr Adrian Lloyd-Thomas Consultant Paediatric Anaesthetist [email protected] 0207 405 9200 Professor Sarah Creighton Consultant Gynaecologist [email protected] 020 7390 8201 Dr Gill MacLeod GP at Roodlane Medical [email protected] 0845 437 0691 Professor Paolo De Coppi Consultant Paediatric Surgeon [email protected] 020 7182 7709 Mr Feilim Murphy Consultant Paediatric Urologist [email protected] 020 7390 8323 Professor Ellis Downes Consultant Obstetrician and Gynaecologist [email protected] 020 7935 7341 Mr Imran Mushtaq Consultant Paediatric Urologist [email protected] 020 7390 8325 Mr Saurabh Jain Consultant Ophthalmologist [email protected] 0207 390 8020 Mr Emeka Okaro Consultant Obstetrician and Gynaecologist [email protected] 020 7078 3894 Mr Owase Jeelani Consultant Paediatric Neurosurgeon [email protected] 020 7467 3004 | AUTUMN 2014 77 MATERNITY SOLUTIONS A leading agency with over 30 years’ experience in the industry Fully Vetted Maternity Nurses Available SINGING FROM THE HEART Being a chorister at St Paul’s Cathedral is the experience of a lifetime Our first class maternity nurses: • Establish breastfeeding • Provide advice • Develop routines • Allow you plenty of rest to recover 7RƃQG\RXULGHDOPDWHUQLW\QXUVH St Paul’s choristers sing in one of the most famous and beautiful places of worship in the world, perform in concerts around the globe, and receive a first-class academic education at the Cathedral School. Boys are not expected to have fully-developed voices or much formal singing experience – enthusiasm, intelligence and musical potential are the keys. 0207 225 1556 — — — — — 5HJLVWHURQOLQH If your son is aged 6–8 and shows musical promise, do get in touch. He could become one of the next generation of choristers at St Paul’s. Call the team www.nannyworld.co.uk 3OHDVHTXRWHUHIHUHQFHPDWZKHQFRQWDFWLQJXV 100% tuition fees for all choristers Assistance with boarding fees available One of the top preparatory schools in the country The finest musical education An amazing start to life For more information please contact: Clare Morgan, Registrar, St Paul’s Cathedral School 020 7248 5156 · [email protected] Helen: +44 (0) 7815-770-557 | Lucy: +44 (0) 07881-658-340 [email protected] www.topbabyguru.com GreyCoat Lumleys Dedicated to finding the very best childcare solutions for you and your family. Greycoat Lumleys’ candidates are interviewed and thoroughly checked by expert consultants. 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