nutrition

My child needs glasses. Now what?

Jan 31, 2017 by Hélène Serfontein Leave a Comment

It is a shock to find out that one’s small child can’t see properly. I somehow thought because they are still small their eyes should be very good. Well, actually I didn’t give it much thought at all. Until it happened.

The trouble is, children don’t know what things should look like. Or, if their vision deteriorated gradually, they forget. So they DO NOT COMPLAIN of bad eyesight. They might blink a lot. (Which, incidentally, also might point to a vitamin A deficiency or uptake problem). They may sit too close to the TV. They may develop a squint. They may become less attentive of their environment. They may stop paying attention in school. Their art work may not be the best – which sometimes it isn’t in any case. They may seem bored or unmotivated. In children depression can look like boredom. And it surely is depressing when one can’t see. They may seem anxious and unsure. They may suddenly fall down a lot or become car sick. And parents may very well overlook all these subtleties. Teachers too.

So well done if you realized your child has a vision problem. That was some great parenting right there! And if you are looking around for more help, even better. This is the list I wish I had. If someone could sit me down in the very beginning and say, “Listen, here’s what you do:…,” we would have had a much easier time. But when everything turns out ok, luckily we tend to forget a lot of those pesky little details. Remember that the whole body is one unit. Vision is a function of every single part of a child. This will hopefully demonstrate that. So here is my two cents’ worth:

STEP 1: Have your child’s eyes tested. Find the best ophthalmologist or optometrist by reputation. It is very very difficult to get a child into their ideal glasses prescription. And they may refuse to wear it, because of the big change it creates. Work with the professionals to find the prescription that your child can tolerate initially. It can be adapted once they get used to it.

STEP 2: While you are waiting for your eye appointment, start looking at frames. The optometrist’s is a good place to go. They should be small enough so the lenses don’t have to be too thick. And very sturdy for playing and rough housing in. Get your kid excited about these glasses – even though you are still struggling with the idea.

STEP 3: Get support. Yes, it helps to see you are not alone. And to ask all those many many questions. Two wonderfully useful Facebook groups are: Little Four Eyes and: Vision Therapy Parents Unite. Vision therapy is an option in some countries.

STEP 4: Have a developmental occupational therapy assessment. If your child could not see properly for however long, they are sure to need a little bit of developmental input. The occupational therapist will look at things like vestibular and proprioception or tactile issues. They will also test for gross and fine motor delays. These skills are the foundation for school skills later on. Visual-motor perception and motor planning is greatly affected by faulty vision.

STEP 5: Young children with vision problems often have retained primitive reflexes. These reflexes create movement patterns in babies before they do conscious, controlled movements. When the higher postural reflexes start taking over as babies mature, the primitive reflexes disappear. They may reappear as a result of physical stress (like lack of vision). Or they may have been retained because of lack of tummy time and movement opportunities as a baby. To check, look at a photo of your smiling child. If they have wide, staring eyes even when smiling, they may have a raging retained Moro reflex. Some paediatric physiotherapists, occupational therapists and behavioural optometrists address these reflexes and help integrate them. It is a long term process that requires dedication and daily effort, but it pays off big time. Retained reflexes interfere with vision development, gross and fine motor skills, hand-eye coordination and general school performance.

STEP 6: Inform your child’s teacher. Getting glasses is a transition. This child might have a hard time adjusting and coping. Kindness and gentle encouragement is needed. Keep the expectations at a minimum for a while and everyone will be happy.

STEP 7: This one should actually be the cornerstone of every step. Lots of love for this brave child. Patience, love, acceptance. Your child is going to be facing hard changes. Lots of challenges. They need you on their team. Loving them, cheering for every little step forward, carrying them sometimes. Your job as a parent is to know when your child needs a break.

STEP 8: Limit screen time. Too much screen time interferes with developmental movement opportunities of body and eyes.

STEP 9: Get moving, get active, get outside. Studies have shown outdoor activity has a positive impact on vision development. Work those core muscles. Head control and core stability has an effect on eye convergence. Very important for children with amblyopia (lazy eye). Ball sports are lovely and fun for improving eye tracking.

STEP 10: Nutrition. Certain foods can boost vision development. Zinc and Vitamin A deficiencies especially impact vision development negatively.

“Sucking on Sour Candies, Pickles or Lemon Pieces. Sour tastes help bring facial muscles and eyes into a more focused (aimed inward) state, called convergence. Sucking helps to bring the facial muscles, including eye muscles, into a convergent posture…After sucking on a sour food or piece of candy, encourage the child to attempt a near-vision task that was difficult for him previously, and see what happens!” – Quote courtesy of the book Eyegames: Easy and fun visual exercises by Lois Hickman and Rebecca E. Hutchins.

STEP 11: Sagging arches in the feet may affect vision development. Arch support is directly linked to eye convergence. The lumbrical muscles in the feet are responsible for arch support. They work in synergy with all the postural muscles. For children older than five with flat feet orthotics can be investigated. The physiotherapist can recommend a good orthotist to custom make these. Lumbrical exercises for feet are easy. It has been suggested that toe walking may improve the arch support in flat feet. Invest in good shoes that keep little feet more optimally aligned.

STEP 12: Reawaken the senses. You know how some people feel like they don’t hear/connect well without their glasses on? Same goes double for children. Not being able to see well does not sharpen the other senses. Rather it dulls them. With muted senses a child’s world becomes small. And they do less of the very activities that would have helped them. Practicing mindfulness on nature walks is a lovely way to help a child with visual neglect to reconnect. This could be a walk around the garden. Smells in particular raise a child’s level of awareness. Probably because the olfactory and limbic system, where emotions are seated, are enmeshed. Vestibular input helps restore proper eye movements, so running, rolling, swinging.

Enjoy this special time of rediscovering sight with your child.

Let’s talk about teeth

Jun 11, 2016 by Hélène Serfontein Leave a Comment

Dr. Louisa Piek is a practicing dentist and mom of three children – ages 9, 7 and 5. She very kindly agreed to answer some questions about kids’ teeth and dental health for us all. The following very relevant information on tooth development and dental care for children was compiled and written by Dr. Piek.

At what age should my child visit the dentist for the first time?
The first dental visit is mostly about getting kids used to the dentist’s chair and educating parents about how to care for baby’s teeth. If your child has moved from the bottle to cup and doesn’t snack or drink in the middle of the night, you get a one-year pass, until age 2. When your child is between ages 4 and 6, expect your dentist to take a first set of X-rays to check for cavities lurking between the teeth.

At the age 1 dental visit the dentist will discuss the following with parents:
How to care for an infant’s or toddler’s mouth
Proper use of fluoride
Oral habits, including finger and thumb sucking
Ways to prevent accidents that could damage the face and teeth
Teething and milestones of development
The link between diet and oral health

After this first visit, the dentist will suggest a schedule of follow-up visits. In the past, dentists typically called for visits every six months. Now, the schedule may vary according to each child’s needs and risks.

What influence do dental cavities have on my child’s development?
Failure to identify and prevent dental disease has significant and costly long-term negative effects. Tooth decay in children is painful, just as it is in adults. Unless treated in its early stages, dental decay becomes irreversible. Tooth decay, untreated, will lead to infection of the teeth, gums and tooth loss. Tooth decay compromises the child’s ability to eat well and sleep well. The unaesthetic appearance could also compromise the child’s self-esteem and social development.

Further, many children miss school as a result of tooth decay. Children with poor oral health were more likely to perform poorly in school due to pain, lack of sleep and days absent from school.

Stages of tooth development
The following chart shows when your child’s primary teeth (also called baby teeth or deciduous teeth) should erupt and fall out. Eruption times vary from child to child. As seen from the chart, the first teeth begin to break through the gums at about 6 months of age.

Usually, the first two teeth to erupt are the two bottom central incisors (the two bottom front teeth). Next, the top four front teeth emerge. After that, other teeth slowly begin to fill in, usually in pairs — one each side of the upper or lower jaw — until all 20 teeth (10 in the upper jaw and 10 in the lower jaw) have come in by the time the child is 2 ½ to 3 years old. The complete set of primary teeth is in the mouth from the age of 2 ½ to 3 years of age to 6 to 7 years of age.

Upper teeth	When tooth emerges	When tooth falls out
Central incisor (front tooth)	8 to 12 months	6 to 7 years
Lateral incisor (next to front)	9 to 13 months	7 to 8 years
Canine (eye tooth)	16 to 22 months	10 to 12 years
First molar	13 to 19 months	9 to 11 years
Second molar	25 to 33 months	10 to 12 years

Lower teeth
Second molar	23 to 31 months	10 to 12 years
First molar	14 to 18 months	9 to 11 years
Canine (cuspid)	17 to 23 months	9 to 12 years
Lateral incisor	10 to 16 months	7 to 8 years
Central Incisor	6 to 10 months	6 to 7 years

Dietary advice for parents
Tooth decay happens when plaque comes into contact with sugar in the mouth, causing acid to attack the teeth.
Foods that contain sugars of any kind can contribute to tooth decay. To control the amount of sugar your child eats, read the nutrition facts and ingredient labels on foods and beverages and choose options that are lowest in sugar. Common sources of sugar in the diet include soft drinks, sweets, cookies and pastries.
Limit the number of snacks your child eats. If they do snack, choose something that is healthy like fruit or vegetables or a piece of cheese. Foods that are eaten as part of a meal cause less harm to teeth than eating lots of snacks throughout the day, because more saliva is released during a meal. Saliva helps wash foods from the mouth and lessens the effects of acids, which can harm teeth and cause cavities.

Preschool, school age children and teenagers
Practical tips:
Foods
~Suggested snacks for in between meals are fruit, crisp raw vegetables, sandwiches, variety of breads, yogurt, cheese, plain popcorn and scones.
~Cereals such as porridge and shredded wheat are excellent energy providers, but avoid the sugarcoated types. In general, the sugar and salt content of breakfast cereals should be checked as some breakfast cereals are high in one or the other or both.
Drinks
~Milk and water are suitable to drink between meals.
~Pure juices, fruit squashes and smoothies should be consumed only at meal times.
~Drinks containing added sugars, including probiotic and yogurt type drinks, should be consumed only at meal times.
~Regular intake of carbonated drinks, including sparkling water, can lead to enamel erosion of the teeth and should be avoided.

Tooth brushing advice
Toothpaste tips
~Start brushing your baby’s teeth with fluoride toothpaste as soon as the first baby tooth breaks through (usually at around six months, but it can be earlier or later). It’s important to use a fluoride paste, as this helps to prevent and control tooth decay.
~There’s no need to buy special “children’s toothpaste” brands. In fact, some of them don’t have enough fluoride in them to help prevent tooth decay.
~Children of all ages can use family toothpaste, as long as it contains 1,350-1,500 parts per million (ppm) fluoride. Check the toothpaste packet if you’re not sure, or ask your dentist.
~Children under the age of six who don’t have tooth decay can use a lower-strength toothpaste, but make sure it contains at least 1,000 ppm fluoride.
~Make sure children don’t eat or lick toothpaste from the tube.
~Below the age of three years, children should use just a smear of toothpaste.
~Children aged three to six should use a pea-sized blob of toothpaste.

Tooth brushing tips
~Brush your child’s teeth for about two minutes twice a day: Once just before bedtime and at least one other time during the day.
~Encourage them to spit out excess toothpaste, but not to rinse with lots of water. Rinsing with water after tooth brushing will wash away the fluoride and make it less effective.
~Supervise tooth brushing until your child is seven or eight years old, either by brushing their teeth yourself or, if they brush their own teeth, by watching how they do it. From the age of seven or eight, they should be able to brush their own teeth, but it’s still a good idea to watch them now and again to make sure they brush properly and for about two minutes.

How to help children brush their teeth properly
~Guide your child’s hand so they can feel the correct movement.
~Use a mirror to help your child see exactly where the brush is cleaning their teeth.
~Make tooth brushing as fun as possible by using an egg timer to time it for about two minutes.
~Don’t let children run around with a toothbrush in their mouth, as they may have an accident and hurt themselves.

Finally: It is a very good idea to discuss preventative dental treatment options with your dentist. Fissure sealants are often placed on the first adult molars at between ages 6-8. These sealants can prevent decay. Your own dentist can give you good advice here.

Sand & Glitter would like to thank Dr. Louisa Piek for taking time out of her busy schedule to provide this very helpful information. Knowledge empowers parents.

WITH SPECIAL THANKS FOR LINKS

www.colgate.com

http://www.webmd.com/oral-health/guide/dental-health-your-childs-teeth

http://www.dentalhealth.ie/

The princess and the pea

Mar 20, 2016 by Hélène Serfontein Leave a Comment

I grew up with a number of sensory quirks, which seemed to run in the extended family. These goings on were duly noted and mostly disregarded. I recognise similar traits in my little daughter. Quite the sensory circus over at our house sometimes.

These sensory traits meant that having my hair combed was screaming agony. It meant waiting outside the house when my brothers were eating stinky fish in the kitchen. It meant bearing the discomfort of scratchy seams of clothing that felt like it had a wooden sticks sewn into the sides. It meant gagging from smells and refusing to go into places because of it.

Some of you will understand. The people who have to smooth down the creases in the fitted sheet in order to sleep know what I’m talking about. The ones who wake up in the dead of night from clocks ticking or blinds rattling in the wind. I get how the princess could not sleep with a pea under the mattresses. Honestly. Who could sleep in those conditions?

Without the proper sensory filters too much input comes through. Or: The body and brain does not know how to tone down sensory input or integrate it properly. This has huge emotional impact. Imagine walking through a minefield of sensory input. Any step can create an explosion of overwhelming sensation. Emotional volatility is bound to ensue. Anxiety is a given. Irrational fears are not uncommon. Food of course, is a big issue. Smelly things? No way. Funny textures? Keep away.

Today these things are classified on the continuum of sensory processing. On the one end are the people who get freaked out by sensory input. Overstimulated and affected. Where everything is too much: Too loud, too smelly, too heavy a pressure, too bright. On the other end are the people craving sensory input. The sensory seekers who need more input than is the norm, to make sense of their environment. On this end of the continuum there are also the people who seem more oblivious to sensory input. Visual neglect and other sensory neglect sometimes go together (where one sense can be therapeutically used to wake up the others). These people are more shut off from their environment, and often become ‘locked in’ emotionally. In the middle of the continuum is the happy medium where sensory input is accurately perceived and properly interpreted. Here the sensory feedback correctly guides motor planning, movement and emotional responses.

Depending on a myriad of things, sensory processing issues can become less intense eventually. Sensory input can become better integrated. Sensory sensitivities and the need for more sensory input can become better modulated. How? What is helpful?

Vestibular input. The vestibular system provides sensory feedback about a child’s head in space. It is vital for postural control. Insecure postural control causes so much anxiety. When the body can’t orient itself properly with changes in position – chaos may ensue.

Core muscle control. A stable core provides a stable background for movement. A strong core ensures grounded, strong, purposeful movements. Read more here.

Proper proprioceptive feedback. This is the body’s sense of position and movement. Movements can be executed with the correct amount of force/effort when you have a good sense of where your joints are. These first three aspects are great confidence builders. When your body responds the way it should, or the way you want it to… just wow.

Primitive reflex inhibition. With a retained Fear Paralysis Reflex, children are overly sensitive to sensory stimuli. The Moro Reflex over-stimulates the sympathetic nervous system, causing continuous fight or flight response. Read more here.

Tactile stimulation helps infants to integrate sensory experiences. It stimulates healthy proprioceptive feedback. Read more here.

Down regulation of emotional states. Story time, calming music, sensory water or sand play, deep breathing, yoga and mindfulness helps to calm and soothe.

Magnesium supplementation. Magnesium deficiency causes hyperirritability. Deficiency can mimic stimming behaviours in children. Stimming is viewed as a protective response to sensory overload, or too much stimuli. Never supplement without consulting your healthcare practitioner.

Rhythmic Movement Therapy (RMT) for integrating the emotional brain (which is so connected with smells) and prefrontal cortex (conscious reasoning). RMT helps inhibit primitive reflexes and helps to establish conscious control over emotional reactions to stimuli, by establishing brain connections.

Massage over the vagus nerve. The vagus nerve is meant to bring balance between the sympathetic and parasympathetic nervous systems. To override anxiety so to speak. This nerve is connected with vision, speech, heart rate, stomach, bowel functioning and more.

Attachment parenting. Having a calm dependable primary carer to help make sense of sensory turmoil. Lots of loving support, hugs and touch. Hold your child’s hand every time they need it. They will decide when they are ready to let go.

Olfactory stimulation. Smells have powerful sensory and emotional connotations. Smells can reawaken the senses in children with sensory neglect. Essential oils are very useful.

Limit screen time. Enough said.

Sand & Glitter would like to thank Caitlin Truman-Baker from ctbdesign for this truly inspired blog post cover image.

WITH THANKS FOR INTERESTING LINKS

What does the Vagus Nerve do?

Massage technique for Vagus Nerve

The power of smell

How smells affect the senses and a host of other cognitive processes

10 Super eye foods for kids

Dec 23, 2015 by Hélène Serfontein Leave a Comment

We all know the saying: ‘You are what you eat.’ We now know that all sorts of physical, emotional and health problems could and should also be addressed nutritionally. Research has shown that the nutritional value of the following foods have certain benefits pertaining to vision.

1 – Salmon

Who ate the salmon? Salmon has an unusually high omega-3 fatty acid content. Omega-3 cannot be manufactured in the body. It has to be consumed in the form of fish, oils, nuts and other sources. Omega-3 has natural anti-inflammatory effects and may enhance mood and brain function (IQ). Omega-3, together with Vitamin A, has a positive effect on chronic dry eye. This study demonstrated that oral consumption of omega-3 fatty acids is associated with a decrease in the rate of tear evaporation, an improvement in dry eye symptoms, and an increase in tear secretion.

Salmon contaminants are being addressed worldwide to bring healthy fish straight to the table. The Norwegian government has gone to great lengths to seemingly successfully improve the health standards of their farmed salmon industry. Wild-caught Alaskan salmon seems to be a favoured choice, as it is naturally low in contaminants. South African non-purists mostly eat the salmon that we find in the shops – Woolies has some nice oak-smoked and honeyed versions.

2 – Eggs

Eggs are a wonderful source of very affordable protein as they contain mostly all of the essential amino acids that the body needs daily. Proteins are essential for vitamin A absorption in the body. See The importance of vitamin A for the links between vitamin A, iron and protein.

Eggs contain two significant nutrients, lutein and zeaxanthin. Lutein and zeaxanthin are two major carotenoids found as colour pigments in the human eye. Lutein is synthesized only by plants and zeaxanthin by plants and some micro-organisms. Both act to moderate light energy in plants during photosynthesis. Lutein is found in egg yolks and animal fats and gives it the yellow colour. The human retina accumulates lutein and zeaxanthin. Both lutein and zeaxanthin have light-absorbing properties and supposedly work to filter harmful blue light in the eye and prevent the production of free radicals.

Eggs contain vitamins B6 and B₁₂, folic acid and fat-soluble vitamins A, D, E and K. Egg yolks are one of the few foods naturally containing vitamin D. Eggs also contain calcium, copper, iron, manganese, phosphorus, selenium and zinc.

3 – Lamb or beef

Both these meats contain high concentrations of iron, zinc and vitamin B_12.Zinc appears to play an integral role in normal eye function (Zinc and the eye). Vitamin A needs iron and proteins to be properly utilized in the body.

Vitamin B₁₂is only found in animal foods, such as beef, lamb, chicken, fish and eggs. This vitamin is important for normal growth and development in children as well as healthy functioning of the immune and nervous systems in the body. A vitamin B₁₂deficiency has been shown to cause optic neuropathy in selective eaters with autism.

4 – Bell peppers

Red sweet peppers or bell peppers have a very high Vitamin A content; in excess of 3000 IU per 100 gram serving. They contain lutein and zeaxanthin in good quantities.

5 – Blueberries

Blueberries have relatively high concentrations of vitamin K and choline. Choline is interrelated with vitamin B₁₂. A B₁₂deficiency would likely increase the demand for choline as well. Choline is an essential nutrient for humans and is necessary for the normal function of all cells. It is important for the brain development of a fetus.

Blueberries are rich in anthocyanins. These have a free radical scavenging ability in the body. Anthocyanins may improve eyesight in various ways: They have been shown to act as a ‘sunscreen’, protecting cells from light damage. They temporarily affect the eye’s ability to adapt from light to dark. During World War II, apparently Royal Air Force pilots were encouraged to eat bilberries (the wild European form of blueberries) to improve their night vision. Studies exist to show improvement in retinopathy and weak eyesight (eye fatigue) after administration of some form of anthocyanins.

6 – Apricots

Apricots are rich in anti-oxidants, carotenoids and choline. They have a fairly high vitamin A content. Carotenoids may absorb blue and near-ultraviolet light to protect the macula of the retina. Apricots also contain catechins – very potent anti-inflammatory nutrients, as well as iron, magnesium and zinc.
It has been said that apricots may help strengthen the optic nerve.

7 – Dark chocolate

This sweet treat is chock-full of vital nutrients and has some amazing benefits. Good dark chocolate contains zinc, iron, magnesium, copper and vitamins A and K, as well as vitamin B₁₂. Vitamins A and K are fat-soluble. This means that suspended in dark chocolate, they are already in a form that is easily absorbed in the body. Dark chocolate also contains phosphorus for strong bone and teeth formation and selenium, which is helpful for cognitive function.

8 – Melons

Also known as cantaloupe, melons have an interesting nutrient diversity. Melons contain a high concentration of beta-carotene. Beta-carotene is a precursor to vitamin A. They have anti-oxidant and anti-inflammatory properties and the seeds contain omega-3 fatty acids. Melons may improve insulin and blood sugar metabolism. 100 Grams of melon has an excess of 3000 IU of vitamin A. They contain a fair amount of vitamin C, lutein and zeaxanthin, copper, iron, zinc, and folates.

9 – Plums

Plums are a good source of vitamin K, choline, anthocyanins, lutein, zeaxanthin, and minerals like potassium, fluoride and iron. Yellow plums contain Vitamin A and beta-carotene.

10 – Pumpkin

Pumpkins contain zinc, iron, folates, magnesium, calcium and Vitamin A, among other nutrients. Pumpkin boasts these health benefits. It is one of the veggies that children eat more readily. I want to include a pumpkin recipe that is a big hit with most kids. This is a South African classic. Many people here know some version thereof:

Pumpkin Flapjack Recipe
Ingredients:
1 Cup of cooked pumpkin
1 Cup of flour
½ Teaspoon of baking powder
1 Egg
1 Tablespoon of butter
¼ Teaspoon of salt
1 Teaspoon of sugar
Cinnamon and sugar to sprinkle flavour on top

Method:
Mix the dry ingredients together.
Add pumpkin and stir well.
Beat the egg into the mixture.
Melt the butter and add. Mix well.
If the batter is not soft enough, add a splash of milk.
Bake in a pan over medium heat until golden.
Sprinkle with cinnamon and sugar.
Enjoy!

USEFUL LINKS

The influence of dietary lutein and zeaxanthin on visual performance

What is choline?

Vitamin A and Retinitis pigmentosa