Health Central Future Focus Issue 1 2019 by NZME. Educational Media

Issue 1 | Monday, 27 May 2019

An NZME custom publication

Health Future Central Focus

Family health Staying healthy in pregnancy

Battling the preschool bugs

Navigating the adolescent years

Informs. Inspires. Educates. | healthcentral.nz/category/futurefocus

2 | Monday, 27 May 2019

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ADVERTORIAL FROM HEALTH EVOLUTION

Contents

Ages and stages

NURSE’S LOVE AFFAIR WITH MAT Twenty-five years of nursing had wrecked Caroline’s back. Chronic pain had forced her to stop working for the past two years. “I just hated having to accept this was as good as things were going to get for the rest of my life,” says Caroline. “I’m an outdoor person and I still had things that I wanted to do! “Being a nurse, I was aware the longterm side-effects of pain killers and anti-inflammatory were not good and create their own problems with the stomach and liver. I was desperate to get some relief and looking for some other way.” Clinic owner Hayley Brown still remembers the first phone call she got from Caroline in Christchurch. “She was a bit scary – skeptical and very grumpy from being in pain for such a long time. Like many people she was worn down to a nub just dealing with day to day life while living in a world of pain. When she purchased her QRS mat, she ended our phone call with a threat... ‘This better work!’ “We sent her the QRS home unit and two months went by without a word. Until one day I got a phone call and it was Caroline. She sounded a tad worked up and I immediately began preparing for the worst...” ‘Hayley’, she said, ‘That mat you sold me...!’ ‘Yes?’ ‘It’s bloody AMAZING!’ she said. ‘I was hoping f or a reduction in pain but...I have NO pain, I just can’t believe it!’ Caroline had begun a long-lasting love affair with her QRS mat. Now wildly enthusiastic about the technology, she set about contacting other people involved in medicine to introduce them to this proven, effective and noninvasive treatment.

mat, select the appropriate frequency and you treat yourself – it’s as easy as boiling the kettle” Hayley explains. “And remember, vets use them too – and there’s no placebo effect on a dog or horse!” “With sixty years of clinical evidence, there’s no argument, PEMF’s work! Yes, it is complicated – subatomic particles, pulsating electrons and protons, ionic transfers, you may not understand it, but that doesn’t mean it’s not effective” says Hayley. “Perhaps the best description for PEMF technology and its effects on the human body is to think in terms of a battery. A battery is designed to hold an electrical charge, when used, it discharges to the point of requiring recharging.” “Our body works in an identical fashion. We are electrical beings; every activity from opening your eyes in the morning to closing them at night is driven by electricity. Your cells, like batteries, have positive and negative polarity, they are bio-batteries!

Jude Barback, Editor

The next issue of HealthCentral FutureFocus will be published on 25 July 2019.

3: More than just a ‘pill for every ill': a new approach to patient care

4: “The highest highs and the lowest lows”: navigating adolescence

5: It’s time to stamp out bullying in the workplace

6: MitoQ: The not-sosecret weapon for busy women

7: Baby on board: staying healthy in pregnancy

10: Newborn screening: helping babies have the best start in life

11: Coping with colic: new book for stressed parents out now

12: Battling the bugs: how to cope with sick preschoolers

13: Allergies and intolerances: what’s the difference?

14: Finding your voice: 15: A healthier New when is the right time Zealand starts in its for speech therapy? communities

“When you injure yourself, your body must develop additional energy or voltage to drive the immune and repair processes. The older you get the slower and the longer it takes for the battery to recharge. When your ‘battery’ remains ﬂat you may experience that as a nonhealing ulcer, a wound which won’t resolve, or no energy.” “PEMFs allow you to ‘plug yourself in’ to a proven, reliable and constant source of positive electromagnetic energy which recharges you cells, allowing you to heal faster.”

“If you are a doubter, simply do some research, type into your computer ‘PubMed’, then in the search box add “Coming from a hospital background, ‘PEMF’ in upper case and you’ll see I could see applications for this an extensive list of clinical trials for technology throughout mainstream depression, ﬁbromyalgia, arthritis, back medicine. I wish rehab units and orthopedic surgeons would adopt QRS. pain to name a few. Remember it’s not the PEMFs that ﬁxes these conditions... Pulsed Electromagnetic Field therapy you do! You just need enough cellular (PEMF) is long recognised to do charge to heal yourself – and that wonders for bone,” Caroline says. is what QRS has proven itself to do “QRS is a mainstream treatment in many fantastically well. countries. France, Germany, Austria, We rent QRS home systems all over Canada, Israel; in those nations doctors New Zealand – or purchase your own. will write you a PEMF prescription for back pain, arthritis, depressions, anxiety, Find us at www.healthevolution.co.nz or phone our clinic in Kapiti, Wellington high blood pressure,” says Hayley. “Our on 04 298 6158. success rate is about 80% with chronic pain.” “QRS mats are designed to go in your bed - you sleep on them! You can travel with them too as they are easily transportable. You lie down on your

s a busy mum of two, I can relate to much of the content in this issue of Health Central Future Focus, which focuses on family health: keeping healthy during pregnancy, juggling sick preschoolers while attempting to get back into the workforce, managing food intolerances and exploring speech therapy. With my eldest about to turn 11, I’m now staring down the gauntlet of the adolescent years. Rebekah Fraser’s article on this formative time is bound to speak to many as they encounter what school counsellor Jean Andrews describes as “the highest highs and the lowest lows”. Social media has a big part to play as it inevitably finds its way into young adults’ lives. While it has the ability to empower youth, Andrews says we need to be wary of the flip side, which can make youth very aware of their own limitations and lead to anxiety. One thing is for sure, with a fast-growing family every age and stage of every child’s development is filled with joys and challenges.

as seen at the recent Fielding Field Day 14- 16 March

Editor

Commercial Manager

Jude Barback judith.barback@nzme.co.nz

Nikki Verbeet nikki.verbeet@nzme.co.nz

Advertising enquiries

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027 712 1413

Aaron Morey aaron.morey@nzme.co.nz

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More than just a

‘pill for every ill’ Dr Tracy Chandler (a.k.a. Dr Wellness) says we need to move beyond the current ‘pill for every ill’ model of general practice to a more patient-centred integrative approach.

rosion. Not the usual topic for a GP to discuss, but when it comes to the conventional doctor-patient relationship, it is the best word to describe what’s happening. This erosion is not the fault of the doctors or the patients but is due to five main interrelated areas: The increasing epidemic of chronic disease.

1 The ‘ambulance at the bottom of the cliff’ of conventional medicine in 2 approach ‘managing’ this tide of chronic disease, which

stems back to archaic medical school training that has not significantly changed as human science has changed.

The lack of time doctors are able to spend with patients (mostly due to the first two factors). The ageing New Zealand population.

4 The overwhelmed, ageing and therefore 5 retiring GP population.

1 This element is multifactorial, but all are forms

of stress to the body, including nutritional stress from high-calorie, nutritionally poor processed food, for example, and environmental stressors such as pollution and medication over-prescribing. These stressors are creating more and more complex issues, meaning patients require multiple visits or longer consults. One environmental stressor that needs urgent review is the proposed new 5G cellular mobile network. More than 230 scientists from 41 countries have expressed their “serious concerns” about 5G, citing radical effects including increases in “cancer risk, cellular stress, harmful free radicals, genetic damage, structural and functional changes of the reproductive system, learning and memory deficits, and neurological disorders”.

2 In 2016 the government updated the New

Zealand Health Strategy and highlighted the need for “a shift from treatment to prevention”. There has been no significant progress, however, leading to

increased demand for ‘ambulance at the bottom of the cliff’-type medicine as conventional medicine fails to stop patients falling off the cliff in the first place. Whilst conventional medicine is generally able to assess and manage risk factors – for example, high blood pressure – as a risk factor for heart disease, it does not have the luxury of time or knowledge to look for and treat all the risks of the risk factors. This requires untangling patients’ biochemical pathways and searching for and managing all possible underlying causes as a whole, rather than treating patients as isolated body parts: an outdated reductionist style of medicine. Treatment protocols must be adapted to account for the new sciences of epigenetics and nutrigenomics (in simple terms, how our environment and nutrition “turns on or turns off” our disease genes). Potential solutions include government funding of clinics designated for investigating and managing all the root causes of chronic and complex medical cases. This would also require specialist training of doctors through bodies such as the Australasian College of Nutritional and Environmental Medicine. This would free up doctors in routine GP clinics to manage more straightforward cases, such as is often the case with young families. Wider measures, such as unravelling the privatisation of profits, e.g. in the food industry, and socialisation of costs, e.g.in the healthcare industry, would also help significantly.

3 As mentioned, the first two factors contribute

significantly to the lack of time doctors have with their patients. Added to this is the fact that over a third of GPs state they don’t have enough time to finish all their daily tasks, making it is easy to see why lack of time with patients is so prevalent. In addition, doctors are required to ensure they meet targets, e.g. for vaccinating patients. This compliance ‘war’ is time-consuming, with every doctor’s consulting hour requiring 20–30 minutes of administration and paperwork time. Doctors don’t go to medical school to learn paperwork; every minute of paperwork erodes the rapport between them and their patients. Again there are many possible solutions, but one is more realistic: funding compliance programmes and measures to improve doctors’ work-life balance.

The solutions here [are] to make the speciality more attractive, with better work life balance and reimbursement.

4 Back in 2009 the government was aware that

“ageing of the population alone, if nothing else changes, will require between 40 and 70 percent more health workers if current standards of care and of access to care are to be maintained over the next 10 or so years”. The solution here is a simple supply and demand formula. Reduce demand with the measures in areas 1 and 2 and increase supply by addressing the doctor and allied health practitioner shortage.

5 With more than 25 percent of GPs planning on

retiring in the next five years, about half of New Zealand doctors are experiencing burnout. With the government scrapping plans for a rural medical school in late 2018, the problem is going to get worse if nothing is done. The retiring GP population and co-existing lack of locum doctors results in more and more GPs feeling the need to retire or amalgamate into corporate health ‘supercentres’. These centres further exacerbate the problem of patients seeing a different doctor each time. The solutions here, again, would be to make the speciality more attractive with better work-life balance and reimbursement. Adopting allied healthcare practitioners, such as physician assistants, nurse practitioners and prescribing pharmacists, would also assist. These five elements affect young families the most because they are unlikely to all see the same doctor. The relevance of other family members’ health at the time a patient presents to their doctor is unfortunately underestimated. I can’t emphasise enough that adopting a preventative/integrative medicine model would save millions, if not billions, of dollars and increase the likelihood of patients seeing the same doctor for longer, leading to better health outcomes. It will take a mass movement to upend the archaic ‘old boys’ conventional medical training model and establishment. Thankfully, this movement is on the horizon, driven by patients’ desires for more than just a ‘pill for every ill’ and also by more enlightened health practitioners.

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“The highest highs and the lowest lows”:

navigating adolescence Navigating the teenage years can be hard work at the best of times. In today’s changing society, our teenagers are facing health issues that are vastly different from those faced by earlier generations. Rebekah Fraser speaks to youth health experts about how best to support them.

chool counsellor Jean Andrews sees “the highest highs and the lowest lows” of our youth. “There is incredible potential in our youth to change the world. Give them the right tools and they will fly.” However, she says the youth of today live in vastly different worlds from their parents, and have one vastly different tool at their fingertips.

The toll of social media Andrews, who holds the New Zealand Association of Counsellors guidance counsellor portfolio, says youth are now digital citizens. “Social media is an incredible tool that has made their world exponentially bigger. Everything is accessible at the push of a button.” She says adolescents now have far more knowledge and awareness of the world, for better and worse. “Young adult brains are still growing. They don’t have the capacity to deal with some of these things.” While social media provides wider experiences and makes some youth feel empowered, she says, there is a flip side.

“Social media has made youth very aware of their own limitations, which feeds into anxiety and low mood. There is an expectation that they have to be superhuman. It creates a deficit mentality in them.” Teens are constantly told they “aren’t brainy enough, aren’t beautiful enough, they don’t have enough friends on Facebook,” she says. “It affects them deeply.” Manaia Primary Health Organisation clinical director Dr Aniva Lawrence says social media is a big concern for youth health. “It’s changed the traditional face-to-face aspect and has really changed the way of relationships.” Bullying is now present at all times, in all spaces, 24-7, she says. “Online bullying is a real concern. It’s with youth all the time now. It’s not left at the school gate. Words hurts and having it there, in writing, you react much stronger to it.” She says the online world also leads to children being exposed to material earlier. “Accessibility to pornography is a big issues. We’re exposed to things at a much younger age now, all at the push of a button.” The online rise of pornography leads to youth facing sexual dysfunction and a misinterpretation of reality and fantasy. “The impact of social media is making it much more of a complex time for our young people.”

Drop in risky behaviours University of Auckland associate professor Dr Simon Denny says researchers have found a reduction in risky behaviours by youth over the past two decades. “So we’re seeing less binge drinking, motor vehicle incidents, less hard drugs being taken.” Coincidentally, this drop in risky behaviour occurred around the same time the iPhone was released in 2007. “So there is some discussion about maybe our youth are staying home on social media, rather than going out doing these things. Maybe they’re better informed because of what they’re finding on the internet.” He says social media does not mean “doom and gloom” for youth health “but it does need to be a balance”.

Vaping a growing concern Denny, an adolescent health research and paediatrician, says e-cigarettes, or vaping, is a growing concern within the medical fraternity in terms of youth health. He says there is a division in public health about vaping “but it is massively concerning to me”. He says when e-cigarettes first arrived in New Zealand, there were videos showing ‘smoke tricks’ that many believed to be harmless. “What we now know is those videos were a really sophisticated marketing campaign. Youth saw the videos, saw e-cigarettes being marketed as nicotinefree, and took up the habit. “We now know that they aren’t nicotine-free. So now we have a whole new generation hooked on them.” He says e-cigarettes are an accepted part of society now. “They are harder to police and we need better regulation. It’s a huge health problem that we are facing.” Denny says there is no research yet on the numbers of youth who have taken up vaping. A cross-sectional study of secondary school students, called Youth2000, will ask that question later this year. Lawrence agrees that vaping is an issue for today’s youth. She says there is no long-term, robust, reliable research about the impact of vaping or its effectiveness as a smoking cessation tool. “Emerging research has started to show it can be slightly better, but it’s not without its risks.” Accessibility to vaping equipment is also a concern, she says, with rising numbers of youth taking it up.

Transgender, family and health issues Denny says that transgender issues were also having a big impact on youth health. “This affects about one to two percent of youth, which doesn’t sound a lot, but it’s huge. If you put it across the country, it’s the same level as diabetes.” He says support services are desperately required. “These youth are really struggling. We’ve had a huge expansion of need in this area, but we don’t have the services.” He says transgender youth have much higher rates of suicide ideation and attempts than the general population.

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“Mental health services are struggling. There is a huge need for more people working in this area.” Andrews says today’s youth are also more aware of the economic disadvantages they face, which adds to their mental load. “I have children who come to school with no food and they’re anxious about where mum and dad are going to get the money to get food.” Divorce and changing family dynamics also weigh on adolescents’ minds, Andrews said. “When the family breaks down, those connections are lost and children have to adapt. They can often end up feeling like the spare wheel.” Denny also says that chronic pain and obesity are overlooked aspects of youth health. “Again, we don’t know the numbers of youth with chronic pain, but we know we need more specialists in this area.” Obesity continues to be an issue, with “no headway” being made in that area, he says. “Marketing to our children and youth is still prevalent. It’s still there and it needs to be banned in my opinion. We’ve seen no change in obesity rates.”

Parents: be present Andrews says parents and caregivers of adolescents should focus on being present. “It’s not about providing all the things, but it is about being there for the little things.”

Parents needed to reassure children and provide boundaries to protect them. “We live in a push-button society and really, as parents we need to be setting up some boundaries and limits around that.” She says providing unconditional love and a strong sense of security can help teens navigate adolescence. “You can’t problem-proof children, but you can role model the resilience that they will need.”

Three-pronged approach Denny says mental health is an important aspect of helping youth. “It’s really a three-pronged approach. The first is known as cognitive behaviour therapy, which is as cheesy as ‘change your thoughts, change your feelings’.” He says it is important to understand that 25 percent of youth are facing “significant trauma”, and those youth have five to six times the suicide rates of their peers. “Instead of labels and diagnoses, these kids need some compassion.” He says it is also important to teach youth about perceptual positioning. “This is about recognising your own perspective and other’s perspectives. Sometimes you do need to take a step out and look at it from another view.”

Denny says a cohesive approach to supporting youth is important. “We have lots of resources to help at the bottom of the cliff, what about the top?” He says health and education professionals need to work together. “It can be tricky to teach our youth these things. We all need to model them – educators, parents, communities. Everyone. We can all play our part.”

Vital message Andrews says making sure children also have realistic expectations is a vital message. “Best is good enough. Really. Do your best, live your own success. That’s the message we want to be hearing.” Andrews says youth of today are far more socially aware than ever before. “They want change and they aren’t afraid to make it happen.” She says the climate change protests and the vigils organised by youth in the wake of the Christchurch mosque shootings are proof of that. “They are incredible. I see so much hope and light in the youth of today.”

It’s time to stamp out

bullying in the workplace Revelations of bullying in Parliament drive home the need to have this conversation about bullying in the workplace now.

ollowing the release of the Francis Review on bullying and harassment in Parliament, a group of experts had much to say on the topic at Health Central’s recent ChalkTalks panel discussion on wellbeing in the workplace. Associate Professor Bevan Catley from Massey University said there is plenty of research, including the 2018 NZ Workplace Barometer survey, to show that workplace bullying is associated with psychosocial health problems. Targets of bullying are more likely to experience lower self-esteem, anxiety, stress, fatigue and depression, and witnesses report negative effects as well. The effects of bullying can spill over into organisational outcomes, including wasted time and resources, lost productivity, poor morale and motivation and high staff turnover. Fonterra’s Terry Buckingham said when there is bullying in the workplace we tend to operate defensively and stop taking risks. “We stop putting our hand up to do projects and go the extra mile, and performance and productivity suffer.” E tu-’s Alastair Duncan said bullying in the workplace can often be symptomatic of workplaces where there is understaffing or an overly directive approach to meeting financial or production targets. Victoria University researcher Alex Beattie said social media can create new channels for bullying to occur and can amplify its harms.

“While the memory of an in-person put-down or insult can pass, online comments are more permanent, crystallised in code.” WorkSafe’s Jude Urlich said it is crucial for a business to create a culture that values people speaking up by having a clear process for people to report concerns and speedy resolution options available. Businesses need to be flexible about how bullying concerns are reported, she said.

“While the memory of an in-person put-down or insult can pass, online comments are more permanent, crystallised in code.” Urlich pointed to WorkSafe’s bullying prevention toolbox as a good place to start. It has practical information for both businesses and workers about what bullying looks like and what to do about it. “Ultimately, the focus must be on a systems approach to improve the organisational environment, rather than on individual, isolated initiatives,” said Bevan Catley. See his tips for how businesses can prevent bullying in the workplace and improve the culture.

Six tips to prevent workplace bullying yy Implement a policy on workplace conduct that promotes diversity and inclusion. yy Provide clear pathways for reporting. yy Conduct climate surveys and risk audits with results fed back and acted upon. yy Training for managers in conflict management, interpersonal communication, negotiation, team building, stress management, and bullying awareness. yy Training for all employees in understanding workplace bullying dynamics. yy Introduce initiatives that focus on relieving unreasonable work pressures and other suboptimal work conditions.

Health Future Central Focus Informs. Inspires. Educates.

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The not-so-secret weapon for

busy women “Energy’s precious, so my advice is don’t just put up with hormones going haywire. Take things like MitoQ to keep your energy levels up – and be kind to yourself.”

Jude Barback asks New Zealand novelist and super-busy woman Catherine Robertson how she balances a hectic life with “hormonal shenanigans”.

atherine Robertson swears she can say ‘no’, but I’m not convinced. The Wellington-based novelist juggles writing with numerous other activities: running training and coaching activities for her husband’s business; helping lead many literary organisations; launching events; attending book events around the country, and volunteering for a penal reform programme that sees her helping inmates with their literacy and education. “I’m going to the prison today actually,” says Catherine, after telling me she’s just stepped off a flight from Queenstown. It’s 9.30am on a Monday. I feel tired just listening to her. And I sense I’m getting the watered down version; somewhere in that busy timetable, she also fits in time for exercise, walking her dogs and spending time with her friends and family.

The hormone battle I want to know Catherine’s secret. How do busy working women keep their energy levels up while fighting what can feel like a losing battle with hormones? Catherine is anything but secretive about her answer: it’s MitoQ, a supplement designed to increase energy levels and combat risk of disease as the cells in our bodies naturally start to wane. She first came across MitoQ when her husband started taking it. As a late-onset Type 1 diabetic, he was impressed when he started seeing results, particularly a reduction in his insulin use. As Catherine began to approach menopause she noticed it was becoming harder to balance her busy life with what she describes as “hormonal shenanigans”.

“I’m in my early fifties and in perimenopause at the moment. And one of the things that happens to you is your body loses the ability to use the insulin you naturally produce.” She started taking MitoQ on and off, but it wasn’t long before she started taking it full-time. She has been taking it consistently over the last six months and hasn’t looked back.

Heart benefits Catherine says it only took about a month to start to see an improvement with energy levels, iron deficiency as well as balancing out the hormonal ups and downs. She describes MitoQ as “a supercharged version of CoQ10”, which is recommended for women at her phase of life. She’s converted many of her friends – both women and men. “We had a couple of friends who are generally fit guys in their fifties, but both of them had heart attacks – so they’ve both gone on the heart formulation.” For her female friends, it’s all about having options, says Catherine. “At this time of your life there’s not much you can do. A medical hysterectomy or HRT [hormone replacement therapy] might really work for some women. But if you can manage it through smart use of supplements and diet and exercise, then I’m not keen on going under the knife or having more hormones through me.” “Energy’s precious, so my advice is don’t just put up with hormones going haywire. Take things like MitoQ to keep your energy levels up – and be kind to yourself.”

What are mitochondria? We’re all made up of trillions of cells, but the real power lies within our cells in the mitochondria, tiny power stations that produce the energy we need to live. Mitochondria wear down as we get older, producing less power – which causes all sorts of headaches for our health. When mitochondria produce energy they create a bi-product called free radicals – tiny rogue atoms that travel freely until they collide with something. As mitochondria weaken, they lose control of the free radicals and they escape into our cells, creating the potential for all sorts of damage and exposing us to innumerable health conditions, including those most costly to life. It’s a natural process and nothing could be done about it, until now.

What is MitoQ? MitoQ is a combination of molecules that enter mitochondria hundreds of times more effectively than any other CoQ10 supplement. They help restore mitochondria’s natural ability to contain rogue free radicals and support mitochondria to perform at optimal levels. Cells have more power, increased resilience and our risk of disease is lowered. Photo credit: Brent Backhouse

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Baby on board In the early stages of pregnancy it’s common to have many questions; suddenly it’s not just yourself that you have to look after. Rebekah Fraser speaks to midwives about how to stay healthy during pregnancy.

amilton midwife Christina Campbell says her best advice is to be “as healthy as possible”, both mentally and physically, every day. “It’s the basics, like having a healthy diet, cutting out sweet, fizzy or energy drinks, regular exercise, having a positive support network and adequate sleep.” Auckland midwife Sarai Tepou says prenatal health is “really, really” important. “It’s during this time that you set yourself up for a good labour, birth and postnatal recovery.” Preparing for a healthy baby needed to begin even before conception, Campbell says. Women need to avoid alcohol, all recreational drugs, and stop smoking or vaping if planning to get pregnant. “If you are smoking, this is the best time to quit through Quit Smoking agencies. This is a free service that you can self-refer online, or through your midwife or doctor’s practice.”

Folic acid and iron supplements Folic acid tablets were recommended for at least four weeks prior to getting pregnant to help reduce neural tube defects, including spina bifida. “If you are not already on folic acid then start taking this supplement, which is available on script from your midwife or doctor, and take up to the end of 12 weeks of pregnancy.” Iron supplements may also be needed as pregnancy progressed. “Having good iron levels helps to reduce the chance of illness and fatigue, reduces the risk of complications such as excessive bleeding during or after the birth, and also help you recover afterwards.” Iodine tablets are also recommended throughout pregnancy and breastfeeding, as iron is an essential nutrient for brain and cell development. Tepou says it is important for women to understand the purpose of the supplements. “If people don’t understand why they are taking these things, they just don’t take them.”

Healthy diet is key However, Tepou says women needed to remember medication is a supplement to healthy eating, not a replacement. “Fresh, healthy food is key. We need to return to this mentality of food as medicine.” Vaccines for flu and whooping cough are free to pregnant women and are recommended by the Ministry of Health. Campbell says the saying of ‘eating for two’ in pregnancy is not sound advice. “That can be an age-old excuse to overeat and to eat the wrong things. Moderation is key.” Pregnant women should avoid sugar, including sugary drinks. “Lots of water is best. Tea and coffee in moderation is okay. Some like to quit coffee but

keep it in perspective and try not to consume too much caffeine.” Women should also avoid eating precooked foods – the likes of ham, deli foods, soft cheese, and uncooked seafood – to reduce the chance of contracting listeria. Campbell says excessive weight could contribute to gestational diabetes, raised blood pressure, and large babies, all of which increase the chances of a caesarean birth. “Ideally it is good to be within a normal BMI range, which takes into account your weight in proportion to your height. For women with obese BMIs, this is a chance to look at making some simple changes to lifestyle influences, to either reduce weight or prevent excessive weight gain in pregnancy.”

The importance of exercise Regular exercise throughout pregnancy is important. “It’s much better to be active as opposed to inactive for good mental and physical health, which prepares you well for growing baby, birth, and recovery afterwards.” Campbell says women should aim to exercise for about 20 minutes a day minimum. Walking, pregnancy yoga, swimming, dancing, gym work or “whatever moves your body” is good, she says. “By regularly exercising, you get a good intake of oxygen, which is great for our own minds and feeds the unborn baby oxygen-rich blood – enhancing brain and cell development.” Tepou often advises her clients to walk for about 20 minutes a day, especially from 36 weeks pregnant. “Gravity and the weight of bub on the cervix makes an impact and helps prepare the cervix for birth.”

What to watch for Women should contact their doctors if they feel medically unwell, or contact their midwives if it is pregnancy related. Danger signs could be vaginal bleeding, unusually severe stomach pain, sudden severe swelling, severe headaches, reduced baby movements, trauma to the abdomen, and leaking waters. “All the risks may seem daunting, but looking after yourself well with the basics of a good lifestyle and regular check-ups with your midwife optimise best outcomes,” Campbell says.

“Fresh, healthy food is key. We need to return to this mentality of food as medicine.”

WE DISCOVERED A WE DISCOVERED A HEALTH PROBLEM HEALTH PROBLEM THAT NO ONE THAT NO ONE COULD SEE COULD SEE MitoQ. A Radical Breakthrough in Human Cellular Health. MitoQ. Anever Radical Health. You may have heard of Breakthrough in Human Cellular As we age, our mitochondria can mitochondria, free radicals or You may have never heard of cellular health. It’s time you learn. mitochondria, free radicals or It could change your life. cellular health. It’s time you learn. we move through life, we get ItAs could change your life. wiser and our ambitions grow. We As we move through life, we get step up to take on more – it’s the wiser and our ambitions grow. We power wetake all have. But –asit’s we age, step up to on more the the way bodyBut makes power power weour all have. as we age, begins to slow down, in a way the way our body makes power we all need to begins to understand. slow down, inThat’s a waywhere we all MitoQ comes in. need to understand. That’s where

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start to slow down in function As we age, our mitochondria can naturally – studies suggest that from start to slow down in function the age of 30, the rate of slowing is naturally – studies suggest that from as much as 10% per decade. the age of 30, the rate of slowing is When produce energy, as much asmitochondria 10% per decade. they create a by-product called free When mitochondria produce energy, tiny rogue atoms that theyradicals create a–by-product called free travel freely untilatoms they collide radicals – tiny rogue that with something. mitochondria travel freely untilAs they collide withweaken, they lose ability to neutralise something. Asthe mitochondria weaken, free radicals and they escape they lose the ability to neutralise into

As mitochondrial health declines so do our energy levels As mitochondrial health declines so do our energy levels

If our mitochondria are healthy andmitochondria functioning optimally, If our are healthyour will beoptimally, too. However, andbodies functioning our if our mitochondria are unhealthy, they bodies will be too. However, if our can’t supply our cells thethey energy mitochondria are unhealthy, can’t supply cells the energy they needour to do the jobs that they need towhole do thebody jobs that keep our running. keep our whole body running. When our mitochondria slow When ourso mitochondria slow supply; down, does our power down, doesour ourpower powersupply supply;slows andso when anddown, when so ourdo power supply slows we. down, so do we. That’s why the health of our That’s why the health of our mitochondria and our overall mitochondria and our overall health and wellbeing are one and health wellbeing are one and the and same. the same.

As we age, our mitochondria canage, start to mitochondria decline in function As we our – studies suggest that cannaturally start to decline in function from the age ofsuggest 30, thethat rate of naturally – studies from the age theas rate of per decline is of as 30, much 10% decline is as much as 10% per decade. decade. Nothing could be done about Nothing could be done about this natural decline until now. this natural decline until now. your cells. The longer free radicals yourgo cells. The longer free radicals unchallenged, the more they can go unchallenged, the more they can a harm your cells, which can pose harm your to cells, which canhealth. pose a threat your overall threat to your overall health. Nothing could be done about Nothing could be done about this natural slowing down, until this natural slowing down, until now. MitoQ has made a scientific now. MitoQ has made a scientific breakthrough that can help you and breakthrough that can help you and every human on Earth. every human on Earth.

Always read the label and use as directed. If symptoms persist see your healthcare professional. MitoQ Ltd, Auckland, NZ Always read the label and use as directed. If symptoms persist see your healthcare professional. MitoQ Ltd, Auckland, NZ

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have MitoQ the unique ability to enter is a game changing mitochondria hundreds of times combination of molecules that morehave effectively than any CoQ10 the unique ability to enter supplement has before. Once mitochondria hundreds ofinside, times MitoQ supports the mitochondria’s more effectively than any CoQ10 natural ability to neutralise supplement has before. Once inside, rogueMitoQ free radicals, supportssupporting the mitochondria’s mitochondrial performance, so natural ability to neutralise that optimum production rogue freepower radicals, supporting mitochondrial performance, so is supported and your body’s that optimumispower production natural resilience maintained. is supported and your body’s natural resilience is maintained.

It’s a numbers game. The longer free radicals go unchallenged, the more chance there is they’ll cause damage within your cells. It’s a numbers game. The longer free radicals go unchallenged, the more chance there is they’ll cause damage within your cells.

MitoQ helps power your cells, so you can power MitoQ helps through life power your cells, so you can power Once back to their best, through life

But what we now know is that when you take a But what we now know regular CoQ10 supplement, is that when you take a may not always get inside the regular CoQ10 supplement, mitochondria from the outside. may not always get inside the Some CoQ10 manufacturers have mitochondria from the outside. worked out ways to get better Some CoQ10 manufacturers have The CoQ10 Myth absorption intoways the bloodstream, worked out to get better but absorption once there,into thethe CoQ10 molecule CoQ10 is aCoQ10 special enzyme The Myth that is bloodstream, faces a once toughthere, challenge: first it must madeCoQ10 deep inside the mitochondria, but the CoQ10 molecule is a special enzyme that is cellchallenge: membrane and to support the energy faces athe tough first it if must made deep inside production the mitochondria, penetrate successful, it then needs to cross the process and to neutralise free penetrate the cell membrane and if to support the energy production mitochondrial before it the radicals. successful, membrane it then needs to cross process and to neutralise free can mitochondrial enter the mitochondria. membrane Many beforeofit radicals. As we get older, mitochondria make doenter not pass this test. can the mitochondria. Many of less CoQ10, so ifolder, you want to help make them As we get mitochondria themmitochondria do not pass this test. So your – the very your less mitochondria, taking CoQ10 CoQ10, so if you want to help Sothat yourneeds mitochondria – the very place CoQ10 support the your mitochondria, CoQ10 supplements seems like taking a smart place that needs CoQ10t.support the supplements seems like a smart most – receive little benefi strategy. most – receive little benefit. strategy.

mitochondria power our cells, which Once back to their best, power our organs, which power our mitochondria power our cells, which bodies, so we can power through power our organs, which power our life and do more of the things that bodies, so we can power through matter. life and do more of the things that matter.

More power toMore you.power to you.

10 | Monday, 27 May 2019

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Newborn screening:

helping babies have the best start in life The Paediatric Society of New Zealand strongly recommends metabolic screening for newborn babies.

ewborn metabolic screening is a simple and important check that is strongly recommended for all babies. It offers the best possible start to infants born with a number of rare, serious and treatable disorders. Since the New Zealand newborn metabolic screening programme began in 1969, over 1,800 babies have been given the best start in life by having their serious condition detected by newborn screening. Many of these babies are now parents and grandparents themselves. The screening involves a small blood sample collected from a baby’s heel onto a bloodspot card, which is then sent to the screening laboratory for testing. Early diagnosis through screening means that treatment can start quickly, before the baby becomes sick. Around 40–50 affected infants are picked up each year.

Screening identifies over 25 disorders There are over 25 individual disorders that can be identified through screening, including congenital hypothyroidism, congenital adrenal hyperplasia, cystic fibrosis, amino acid breakdown disorders (including phenylketonuria), fatty acid oxidation disorders, galactosaemia, biotinidase deficiency and severe combined immune deficiency (SCID). These disorders are hard to find without screening as there is usually no sign of disease before the screen result comes back. Although these disorders can’t be cured, early treatment such as medication or a special diet can help babies to stay well and prevent severe disability or even death.

The most common disorder Congenital hypothyroidism is the most common disorder detected, with about 30 affected babies picked up in New Zealand each year. The thyroid gland is critical for normal growth and brain development. Babies with untreated congenital hypothyroidism appear normal at birth but, untreated, would go on to develop intellectual impairment over the first years of life. Treatment with a daily replacement dose of thyroxine allows affected children to reach their full potential.

Helping babies with SCID Babies with SCID are born with little or no immune system. Although affected babies appear healthy at birth, they typically suffer from a series of life-threatening infections over the first few months of life. The screening programme started screening for SCID in December 2017 and expects to pick up one affected infant each year. Early detection through screening means that these babies can be treated with a stem cell transplant before they become unwell.

Recommended by health professionals The newborn metabolic screening test is strongly recommended by health professionals and the Ministry of Health. The screening test is discussed with pregnant women by their lead maternity carer (LMC) and babies screened with the consent of their parents. Cards are usually stored by the screening programme but can also be returned at the request of families. It is important to understand the limitations of newborn screening. If there are concerns about a baby’s health or development the family doctor should still be consulted for a comprehensive assessment, regardless of the newborn screen result. While screening identifies almost all babies with the disorder tested for, sometimes screening may not pick up a condition, or an infant could have a disorder that is not part of the routine screen. During pregnancy, parents should talk to their LMC about family members with inherited disease. This is because routine screening may not be the best way to look for these conditions. The programme is overseen by the National Screening Unit, Ministry of Health.

Early detection through screening means these babies can be treated before they become unwell.

Monday, 27 May 2019 | 11

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Coping with colic In her book Smart Mothering, clinical psychologist Natalie Flynn addresses a subject that strikes fear and trepidation in the hearts of new parents: colic.

want to pick out one parenting issue that, in extreme cases, can have serious consequences: colic. The current ‘rule’ for colic crying is: three hours a day for three days a week. Between 20 and 25 percent of babies will experience this, which means if you have a baby, you are very likely to experience it yourself. The reason I want to talk to parents about colic is because serious consequences do not arise from the condition itself, but from what happens when a few parents are so ground down by it that they lose control. In extreme cases parents end up shaking their baby, causing permanent damage or even death. Even if you are sure that would not happen to you, you still need to know the truth about colic in order to lighten your emotional burden during this trying time.

Trust your instincts Understanding the myths and the truths about the condition will help you behave in a calm way when your baby cries, even if you are feeling distressed. The stress caused by the bombardment of conflicting claims and advice – or as I call it, ‘bombardment stress’ (BS) – is becoming an increasingly emotional health issue. First, what research shows is that under normal circumstances, ordinary crying – including colic – has no short-term or long-term ill-effects. Much has been claimed about the link between crying and cortisol production, and then the link between cortisol production and later negative behaviour in children. However, what the studies really say is that with normal crying, including colic, you do not need to worry about that outcome. This is not the same as saying your crying baby does not need you for comfort. Trust your instincts. We know that babies respond to soothing and babies need to be with an adult when they are crying for any length of time – especially in the first months of life. No-one knows what causes colic, or what babies are feeling as they pull up their legs in what appears to be extreme pain. The dominant thought today is that the nervous system of new-born babies is incomplete,

and once they start crying, their ability to shut it off is limited. That is amongst the reasons the first three to four months of life are often referred to as the ‘fourth trimester’. Techniques we use to settle babies who do not have colic (such as feeding, nappy-changing, rocking, white noise and comforting) often have little impact on settling babies during bouts of colic; however, as a second point, research shows they have some effect. Each baby is unique, and you might get lucky and find something that helps. So, it is worth experimenting, while also knowing that your baby might remain inconsolable, no matter what you try. The most important part of being with a colicky baby is to manage your expectations. Because of the growing awareness of damage caused by parents who have crossed the line, increasingly the emphasis is shifting from strategies to stop bouts of crying to strategies that help parents cope with inconsolable crying.

if that is an easier way for you to provide comfort or if it simply feels right to you. But what it does mean is that you should not expect that practice to reduce crying. There are also a number of popular books that claim one magical sequence of manoeuvres or the other will flick off the colic switch and stop the bout of crying. If it doesn’t work, it is because you aren’t doing it right. Blame is placed on the parent.

Understanding the myths and the truths about the condition will help you behave in a calm way when your baby cries, even if you are feeling distressed.

Bogus promises High on professionals’ list of concerns are promises held out to parents about ways to ‘cure’ colic, promises which are largely bogus. The fear is that when these strategies fail to work, the additional frustration could push more parents over the edge. One example is the claim that carrying a baby in a sling, as some traditional tribes do, will eliminate crying. Actual research with tape recorders has demonstrated that babies in all cultures cry in much the same way – regardless of babywearing. One study in Botswana where babies remain in constant physical contact with mothers showed the same colic pattern as in the west. This study showed that colic happens everywhere on earth and follows the same pattern in terms of time of onset and duration. A later 1994 study showed babies in Manali (who were also constantly carried) not only cried more than London babies (who were not), but also cried six times more than the mothers had claimed! That is not to say that you should not use a sling with a colicky baby,

In actual fact there is no research to support any of the claims made in these books, and again the risk is that a sense of failure will only add to the frustration of parents. My personal feeling is that there may be some babies who might benefit a little from what is, after all, a sequence of calming activities. There is no reason not to try them if you manage your expectations. If you feel overwhelmed by your colicky baby, remember these things: it is not your fault; you have every right to call in the troops to help you; it will come to an end; normal crying will not damage your baby; inconsolable crying is normal; your job is to be with them in a calm way. If you have the urge to be rough with your baby, walk away. Your baby will survive a bout of crying but may not survive being shaken. Smart Mothering by Dr Natalie Flynn, RRP$39.99, published by Allen & Unwin, is out now.

12 | Monday, 27 May 2019

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Allergies

Battling the bugs

what’s the

Just as you’re returning to the workforce after having children, it feels like all your leave is poured into looking after a sick preschooler. Rebekah Fraser looks at why young children get sick so often and how to cope.

Living with food allergies can take its toll. Rebekah Fraser finds out more about a subject that affects many Kiwi families.

hen children get sick, all working parents face the same dilemma: send them to daycare or take the day off work? The balance between work commitments and caring for sick children is especially evident for preschoolers, who are more prone to illness. Plunket chief nurse Dr Jane O’Malley says it is common for children to have between five and seven colds a year. “Infants’ and young children’s immune systems learn by being exposed to infections and over time they develop greater immunity. Immunisations work much the same way.” She says when children spend time with other children at home, in playgroups, or in early childhood centres they came into contact with others and shared toys. Children also tend to place items in their mouths, thereby contaminating the objects and spreading disease. Retail manager Shari Adair’s son started daycare when he was four months old. “Pretty much within the first month he had his first cold, and it seemed like he would have one after another for the first year.” She used all her sick leave within the first few months of returning from maternity leave, then relied on annual leave entitlements. “I was breastfeeding at the time so it was important to me to give my son breast milk when he was sick.” Early childhood education supervisor Janet Oswald says it is very common for children to get sick when starting daycare. “When I went back to work after my son was born, he had a couple of days off due to a cold. At the time, he was only breastfed so I had to take time off too. It was really challenging because I had literally only just returned and it felt like I was letting my centre down.” She says employers need to be more realistic and provide more sick leave. “If your child gets chicken pox, they need to be off school or preschool for at least a week. That’s all your sick leave gone in one go.” Legal executive Helen Brasier has two daughters, with the eldest starting daycare at about 10 months old. “She definitely got sick more often that first year and we have suffered many more tummy bugs that we would have pre-kids.” She says she has a “very family-focused, supportive” workplace that allows her to work from home and be flexible with hours. “I know how fortunate I am and how rare it is to have such an understanding employer. All employers could be like mine. Brasier says it was also important to note that fathers were capable of taking time off work to be with children.

“It shouldn’t be that mothers are ‘expected’ to take time off. So employers and management could set an example in this regard.” In her spare time Brasier also runs Virtually You, a social media management business. “It definitely puts extra pressure on me when the kids are sick. I’m lucky I can work while they’re sleeping and my clients are very understanding if I need to switch off and be with my children.” Adair says her workplace was understanding at first, but the pressure to be at work weighed on her mind. “I went in to work, even when I was feeling really rubbish, if my son was feeling fine. I felt like I couldn’t take any time off to get myself better because I was already off so much with my son.” Adair says she feels working parents are in a “tricky situation” when it comes to juggling work with sick children. “You feel like you can’t give your work 100 percent of your attention because your child is sick. But I also feel guilty because I’ve sent my son into daycare when he’s not feeling 100 percent because of the pressure of work.” Dr O’Malley suggests parents clarify with their employers what their policy is for sick leave and taking time off when children are unwell. “Planning for these situations is also good. Depending on the illness, parents may be able to work with family members to help support them by looking after children for short periods if needed.” The Ministry of Education requires all early childhood education centres to have robust policies and procedures for health and safety, and hygiene. “It is really great to have a conversation with your childcare provider to understand what they are seeing, how they are talking to children about hygiene and what communication is going out to parents,” Dr O’Malley says. Brasier says although sickness is common in early childhood centres, they offer a great service for families who must return to work. “The teachers are great and are so dedicated. I’m hoping my girls’ years at daycare will have equipped them with great immunity when they go to primary school.”

ith allergies affecting about one in three New Zealanders at some point in their lives, it is likely we all know someone who suffers from them. Allergy New Zealand allergy advisor Penny Jorgensen says allergy symptoms ranged from “very mild” to potentially life threatening. An allergy is caused when a person’s immune system ‘overreacts’ to a substance, she says. “In an allergic reaction, the immune system is mistakenly trying to protect the body from an external threat.”

“I’m hoping my girls’ years at daycare will have equipped them with great immunity when they go to primary school.”

AUTION

CAUTIO N

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and intolerances:

CAUTIO N

CAUT

difference? The worst offenders

Intolerances not the same

"Just one bite"

Globally, eight foods are recognised as causing most food allergies, she says: milk (dairy), eggs, peanuts, tree-nuts, soy, wheat, fish, and shellfish. “There are regional variations and any food could cause an allergy. Kiwifruit and sesame are common in New Zealand.” Most allergies develop in early childhood. Children with a family history are at a higher risk of developing allergies themselves. “Commonly we see eczema as the first indication. It is not an allergy in itself, but increases the risk of developing allergies.” She says about 20 percent of young children have eczema at 12 months old, while 10 percent have food allergies “although many will eventually outgrow these.” Most, but not all, children will outgrow their milk and egg allergies by five years of age, as well as soy and wheat. “But in the main, peanut, tree-nut, fish and shellfish allergies last for life and are the main ones seen in adults.” Jorgensen says diagnosing food allergies is important, with a skin prick or blood test used to confirm the main trigger.

It is also important for parents to understand that an intolerance is not the same as a food allergy, she says. “An intolerance does not involve the immune system and does not run the risk of anaphylaxis. Most intolerances are dose-responsive. For example, a small amount won’t cause a response, and symptoms are delayed over a few days.” Parents should also not delay introducing a food to an infant’s diet, or cut a food out without seeking medical advice. “This can actually increase the risk of them developing allergy to it.” For children diagnosed with allergies, medical support is vital. “Because food allergic reactions can result in anaphylaxis, children should be assessed for their risk and given an anaphylaxis action plan, recommended to carry an EpiPen, and the family trained in recognising they symptoms and the emergency response.” Mother of three Malena Penney, who blogs about her family’s experiences at Fun With Allergy Kids, says living with food allergies has a huge emotional toll.

Penney says “nearly every single allergy family” have been told "just one bite won’t hurt". “Allergic reactions really do happen to very tiny doses of food. A crumb of gluten or chopped nut in the wrong hands can be deadly.” She says most allergy families have been in the “awkward situation” of being told something is fine for them, but not being sure themselves of how safe it actually is. “We have personally been caught out when people have made a cake without dairy and egg, but then icing has been made with dairy-containing margarine.” She says people catering for those with allergies need to be especially careful. “Although it is really nice to surprise those with allergies with what you think is an allergy-friendly cake, it’s way less stressful for everybody if you tell them you’d like to cater for them and ask if there is anything they need to know.” Penney suggests that families who have just been diagnosed with allergies spend time educating themselves on how to keep their children safe. “Then start looking for external support. There are lots of great support groups on social media and lots of bloggers publishing allergy-friendly recipes for free.”

HEALTHIER CHOICES MADE EASY.

Fuelled4life.org.nz

14 | Monday, 27 May 2019

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Finding your voice Speech-language therapist Briony McCormack discusses when the right time is to engage the services of a speech-language therapist for your family.

umans are born hard-wired to be able to communicate, be social and interact. Communication is hugely important in the workplace and at school, where inquiry and problem-solving skills play such a huge part. Consequently, when aspects of communication are disordered, it can have a big impact on those affected. Our ability to communicate is more than just words and can be impeded by a range of issues, from medical needs to developmental issues. Being able to communicate effectively can increase confidence and the ability to interact with others. A speech-language therapist can wear a number of different hats within the role. Our basic remit is to carry out full assessment and intervention in communication and swallowing disorders. We cover a variety of areas from children to adults, working with those with autism spectrum disorders and Down syndrome to those with voice disorders and swallowing difficulties. I work both with adults following a traumatic brain injury and stroke and with children, both preschoolers and schoolage. This leads to an variety of challenges and activities, which keeps the role hugely engaging.

Increasing family focus With children, therapy is becoming more and more family focused, often working on the parents’ interaction as their child’s ‘model’, encouraging more talk, more shared reading, following the child’s lead and focusing on adapting the environment to give maximum opportunities for engagement. With speech sound disorders, children can often struggle to produce certain sounds, be difficult to understand and become very frustrated.

With language, parents often ask, ‘Is it too early for therapy as my child cannot speak yet?’ In fact, the initial period before a child talks is hugely important and contains the building blocks for verbal language and interaction. Non-verbal communication, showing intent to want to communicate (even if it’s just a pointed finger or a child following your gaze to a toy) is a part of communication we can also work with. A speech-language therapist can also assist if a child or an adult may need an alternative means of communication. This can also be high-tech or low-tech and is part of augmentative and alternative communication. Therapists do lots of work around literacy for school-age children; at the pre-literacy stage we focus on oral language as this is the basis for literacy later on. This includes the skills that let kids recognise and work with language (phonological awareness). Parents often develop these skills instinctually by singing and rhyming together, clapping out the syllables of words and drawing attention to the sounds in a word.

Parents: “go with your gut” If a family is ever concerned about the way their child is communicating, whether they are unintelligible, stuttering, or they are frustrated over not having enough language, I would always say, “Go with your gut and seek help”. As parents or carers, we know our children best and know when something doesn’t feel right. The earlier the intervention, the better the chance of the child catching up to peers. Children will often be seen before they start school, when parents are aware of the big jump in demands that comes in a classroom. Also, parents should look for frustration, for a child being unable to communicate and negotiate with their peers or teacher, family and friends. Discussions with early childhood teachers can be great to get an idea of how the child is managing and communicating at kindergarten or daycare. If a child has the tools to allow them to communicate the way they want to, whether that is by being able to be intelligible, have

more language or be more specific in the way that they talk, it leads to better social communication, learning, listening skills and comprehension.

The earlier the intervention, the better the chance of the child catching up to peers.

Impacts for adults Changes in an adult’s ability to communicate can have enormous impacts on their career, their role in their family and their social inclusion. These changes may occur after a stroke or other brain injury or as a result of a degenerative disease such as Parkinson’s or Motor Neurone Disease. Speech-language therapists focus on what a client can achieve to try and increase their participation, increase their communication and assist to reclaim the activities they enjoyed before their stroke or head injury, for example. Many clients following stroke will have aphasia, a language disorder that can affect all modalities of language: understanding, talking, reading and writing. Aphasia can be chronic, but significant gains can be made after the initial hospital rehabilitation period. Similarly, adults may come to a therapist due to concerns about their swallow, such as an increase in choking or food going down into their lungs and causing an aspiration pneumonia. Anyone who feels they have had a change in their ability to communicate – whether that’s a change in their voice or language, finding words or understanding conversation, or their ability to swallow – should ask their GP about being referred to a speech-language therapist. As stated on the Universal Declaration of Human Rights, communication is a fundamental human right. As speech-language therapists, we can help our clients exercise that right.

Monday, 27 May 2019 | 15

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A healthier New Zealand

starts in its communities

Influencing change for healthier communities today and into the future is the key focus for Healthy Families New Zealand. The healthcare challenge of this century”. That’s how the World Health Organization has labelled chronic conditions such as diabetes, cardiovascular disease and obesity – and New Zealand is no exception. The rising tide of preventable chronic disease across the country has damaging effects not only on whānau and communities, but wields broader issues on social, economic and health systems – costs yet to be calculated nationally. The causes are complex and without a single solution, but a growing body of evidence indicates a comprehensive and coordinated approach is required over a sustained period of time.

"In healthier environments, children learn better, workplaces are more productive, whānau are healthier and happier, and communities thrive.” Healthy Families New Zealand is one such prevention approach being implemented across Aotearoa. Funded by the Ministry of Health, it was launched in 2014 to address the inequities faced by New Zealand communities with higher than average rates of preventable chronic disease and/or high levels of deprivation. The initiative operates in 10 sites across the country and each site has identified its priorities reflective of the unique needs and strengths of the community it serves. Key areas of focus include increased physical activity, improved nutrition and mental wellbeing, more people smoke-free and reducing the rate of alcoholrelated harm. The Healthy Families model empowers community leaders to think differently about the causes of poor health, and make changes to the systems which

influence the health and wellbeing of people, whānau and communities – put simply, the places where New Zealanders live, learn, work and play. Deborah Woodley, the Ministry of Health's Deputy Director-General Population Health and Prevention, explains a healthier Aotearoa starts in the places where we spend our time. "In healthier environments, children learn better, workplaces are more productive, whānau are healthier and happier, and communities thrive. Through the power of collaboration and co-design, Healthy Families NZ supports community leaders to identify, ideate and implement change to help make healthy choice, the easy choice in our communities." The Healthy Families NZ approach is underpinned by the concept that significant changes are needed within the current system, if issues such as obesity are to be improved long term. The initiative is underpinned by an explicit focus on improving Māori health and improving health equity for groups at greater risk of chronic diseases.

Unforeseen barriers The school system is one example where Healthy Families NZ is dedicating significant resource across the country. In 2016, the Ministry of Health set a challenge for schools to enact a ‘water only’ policy on school grounds. With only one in 10 schools currently having a water-only policy in place, schools were challenged to take the pledge. However, for some schools, there were unforeseen barriers to achieving this. In West Auckland, insights gathered by Healthy Families Waitākere clearly showed water infrastructure was lacking, requiring funding to resolve the issues and have new water fountains installed. Through this process, which included collaboration with community leaders and partners, Healthy Families Waitākere facilitated improved water infrastructure in more than 52 schools across the region. This included securing funding for new water fountains and developing water-only pledges.

Kerry Allan, Healthy Families Waitākere Manager, says schools are unique places which enable healthy habits to be learned at an early age, and in turn transcend to the wider whānau. “Through our work in schools, we have seen the message on water extend beyond school grounds, reaching the wider community and whānau. Parents have reported children asking for water at home instead of fizzy drink or juice, ultimately leading to a shift in behaviour and the adoption of additional healthy habits which last a lifetime.” With the support of their principals, teachers and board members, students in West Auckland have been key to driving the water-related changes in their schools. Installation of a new water fountain at Massey Primary School was the start of a much wider water-only policy that was embraced by the entire school community. “Initially 25 students took part in a pro-water project alongside Healthy Families Waitākere, looking at what a water policy would look like. The policy has since shaped a number of initiatives, including students identifying the best location for the new fountain,” says Massey Primary Principal Bruce Barnes.

Real changes achieved The water policy has brought about real changes in the school environment. “We’ve seen an associated improvement in learning. Teachers have also seen noticeable changes in lunch boxes since implementing the water-only policy. Students who used to bring sugary drinks to school are now reaching for their water bottle and refilling throughout the day.” Kerry Allan says schools are one of many environments the Healthy Families NZ initiative is working in. “Healthy Families NZ work across a variety of environments to improve health outcomes for our communities. Workplaces, marae, early childhood centres, sports clubs, parks and more all play important roles in our daily lives and working together we can create healthy communities now and into the future.”

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