Meet the Dietitian: Community service series

“DIETITIANS ARE ADAPTABLE!”

 

By Yuri Bhaga

 

I am a community service dietitian currently working at a hospital in Witbank, which places me very far from where I got my dietetics training at UCT . But a lot closer to home in Pretoria where I completed my BSc degree 3 years ago.

When I got accepted to study dietetics I had no idea what I was getting myself into. Much like everyone else who hasn’t gotten the formal training, I had a very narrow understanding of what the title “Dietitian” stood for. Now 3 years later it has become a great passion of mine and I make sure to promote the profession and spread awareness of the role that nutrition has in all areas of our health.

Being familiar with the Western Cape health system, Mpumalanga was new to me.  The province had its own set of unique challenges and demands that I had to learn to adapt to. The system is under immense pressure with far less than adequate resources and it would be a lie to say it doesn’t get frustrating at times. Some days will go smoothly and you will be able to implement a plan within the hour, thanks to a great multidisciplinary effort. Other days you will receive the wrong referrals and it will take up to 2-3 days just to start a feeding plan. It’s not always easy but it does provide hands on experience and a great opportunity for learning – and the feeling when you see an improvement in a patient’s condition or receive sincere thanks from a patient post counselling can really put things into perspective. Sometimes it’s not even about the clinical work or education you give but simply chatting to the patients and seeing how they feel that can make a world of difference to their stay.

I have been very fortunate to have arrived to an established and supportive department with members of staff who have years of experience and are always open to lending input and giving help should I need it. The hospital offers the majority of the services of a tertiary hospital which means I will have been exposed to a diverse patient population by year-end which is both a wonderful thing and a little daunting. That said, not everyone will have the same experience of community service, but if you are willing to work with what you have and find opportunity to improve and make good of what’s at your disposal you will come out having grown as both a person and as a professional.

Community service year is a great opportunity to gain independence and to be a fresh pair of eyes to fill gaps that are missing. Personally, it has put meaning to a phrase that I heard from an educator in my internship year: “Dietitians are adaptable!”. This year is all about what you are willing to put into it and the attitude you have going into the year will determine what you get out– as cliché as it sounds.

That’s not to say you MUST be busy day in and day out with no chance to breathe. Rest is equally important. I have found it has been of great benefit to find a support group. I am lucky to have been warmly adopted into the Speech and Audiology department where I go to spend most of my lunch breaks, or to vent about something that’s on my mind and have made new friends with their comm-serves. Working in a hospital is different for everyone and can be very taxing so it’s always good to have something other than work to help destress. If time allows it, find a new hobby or continue engaging in activities you enjoy –  I have decided to try my hand at sign language classes.

To conclude :

  • You won’t know everything (and that’s fine, you have plenty of time to learn and read-up)
  • Ask as many questions as you need (granted you have tried to come up with the answers yourself first)
  • Speak up and be firm – but polite.
  • Get to know your surroundings and the people you work with.
  • Have confidence, you likely know much more than you think! 😊
  • And lastly , enjoy it and take it all in!!

 


Meet the Dietitian: Community service series

Read more about her love-at-first-sight story with Dietetics.

By Rhodene Oberholzer

A little over seven months ago I moved into a tiny apartment in Johannesburg, nervous about starting my community service year at Charlotte Maxeke Johannesburg Academic Hospital. Suddenly, I felt as if I forgot everything I learned in my four years studying at the North-West University of Potchefstroom. I could feel my heart making 20 000 jumping jacks per minute as I walked through the hallway on my way to the dietetics department, my very first day as a dietitian. I honestly did not think I would be able to do this, but fast-forward seven months later and I cannot believe how much I have learned and grown as a person so far.
The reason why I decided to become a dietitian is quite simple, it is like a love-at-first-sight kind of story. I always knew I wanted to work with people, but being a dietitian never really crossed my mind as something I wanted to pursue. It was only in my matric year that I decided to shadow a clinical dietitian. The profession fascinated me, and I soon realised that my idea of what I thought a dietitian did was only a drop in the ocean. So, I instantly knew I found my calling.
Now this year has probably been the most challenging, but rewarding time of my life. I feel so blessed to be able to work in a place where I get to see and learn so much.

Working in a clinical environment, we as dietitians are responsible for all the dietary needs of patients, whether it is total parenteral nutrition (TPN), enteral nutrition, dietary education, supplementing a patient’s diet or prescribing a special diet meeting the requirements for their specific disease condition. At first, this was very intimidating for me, but after a while, you can see how your interventions pay off, and it gets so much easier. Nothing is more rewarding than seeing the premature baby gain weight, the severe acute malnourished child gaining his appetite again, to hear the patient with muscle wasting say that she feels much stronger after drinking the supplements you provided, or even just getting a smile from a patient because you ordered him some extra jelly and custard.

I also have the opportunity to work in various clinics this year (such as Paediatric Diabetics; Orthopaedic Slimming; Neonatal; as well as a General clinic) where we assess and counsel out-patients with a specific nutrition related health problems.
For any future community service dietitian that feels nervous about starting this next chapter: I understand how you feel. I don’t think starting your first job is supposed to be a walk in the park, so be kind to yourself if you feel anxious and unsure. I did not believe it at first, but I promise you it will get better. Take your December holiday to rest, and have peace about where you are placed as it is only for 12 months and time goes by so fast. I think the biggest mistake you can make as a community service dietitian is to finish your 12 months, feeling like you did not learn much and made no difference where you were placed. Enjoy being a dietitian, fall in love with your work, as it really is such a fun and exciting profession to be in!

 


Meet the Dietitian: Raeesa Seedat

We spoke to Registered Dietitian, Raeesa Seedat, creative and passionate about the field of nutrition.

 

Why did you become a Registered Dietitian?

Being a Dietitian is like being the Terminator, except that you’re analysing food instead of potential threats (even though some may be treated as such). So you get to see each food with special vision and all the constituents are flagged.

 

What do you enjoy most about the work you do? What are the most satisfying moments?

I enjoy being involved in nutrition education and promotion. I am passionate about writing and communicating science and evidence into nutrition advice with tangible benefits to an audience. I also enjoy working with paediatric patients and mums who are very appreciative for managing various conditions in infancy and childhood.

 

What has been your career highlight?

I think I still have a long way to go to achieve all my career goals. For now the highlight would be graduating with my Masters of Science degree in Dietetics.

 

What are the most challenging aspects of your career?

It is sometimes a challenge to convince patients that even though they have been eating a certain way for a number of years the effect on one’s health is cumulative. The value of one’s health cannot be taken for granted and preventing disease is easier than treating it.

 

How do you cope after a day of nutrition disaster and bad eating choices?

Dietitians are mere mortals and we all enjoy a treat every now and again. However, I try not to let it get to a point where I am wallowing in guilt over what I have eaten. I try to balance the energy I have taken in with energy expended through physical activity.

 

What are the three things that you think people should stop saying when they meet a dietitian?

  • I need a diet a plan
  • Will eating this make me gain weight?
  • How do I get shredded?

 

What should clients look out for when deciding which dietitian to work with?

It often narrows down to who you feel comfortable opening up to. Also, some Dietitians may have a special interest in specific areas such as food allergy or sports nutrition and if you require such expertise you can contact one of these Dietitians.

 

What is your favourite dish and your favourite treat food?

My favourite dish at present is homemade nachos (you can play around with healthier variations) and my favourite treat food is chocolate ice cream (yum!)

 


EMPOWERING PARENTS TO ENABLE BREASTFEEDING: COMMUNITY

 

Breastfeeding is one of the most crucial strategies to boost mother and child health. While South Africa has made some gains over the years, we still have one of the world’s lowest rates of exclusive breastfeeding for the first six months of life. Instead of being revered as the ‘superfood’ that it is for babies, a mother’s breastmilk is still often doubted as enough nutrition for her growing infant.  Often, close family members and friends are the ones who undermine exclusive breastfeeding by suggesting to the vulnerable mother that her breastmilk is ‘not enough’ and wrongly pressure her to introduce solid foods.

 

Another major barrier to exclusive breastfeeding for the first six months of life, and ongoing breastfeeding for two years, is society’s attitude towards this most natural nurturing of babies, especially in public.  Breastfeeding in public is protected by law; yet so often women are shamed and humiliated if they dare feed their babies, when and where they are hungry.

 

With its 2019 theme for World Breastfeeding Week, from 1 to 7 August, ‘Empower Parents, Enable Breastfeeding’ the World Alliance for Breastfeeding Action (WABA) is resolutely focusing on how we shift public and private attitudes to be appropriately supportive of the optimal nutrition for babies.  This is a theme that cuts across all sectors of society and applies to breastfeeding moms across the board.

 

In celebration of World Breastfeeding Week 2019, we asked ADSA (The Association for Dietetics in South Africa) spokesperson and lecturer in the Division of Human Nutrition at Stellenbosch University, Thembekile Dhlamini, who also happens to have breastfed her child, to answer two burning questions about how we can empower parents to best enable breastfeeding.

 

#BurningquestionbreastfeedingNo1 – Empowering Parents – What do you wish you had known before you started breastfeeding?

  • Due to my work, I was involved in breastfeeding training and advice for many years before I gave birth to my first son. Little did I know that the theoretical experience doesn’t equate to the actual experience. I wish I had known that.
  • I wish I had known more about Lactorrhea, the continued discharge of milk between nursing, as one of the challenges that I could face. As dietitians our experience is often about dealing with the perceptions of ‘Not Enough Milk’, so as a mother, I was caught off guard by ‘too much milk’. Lactorrhea means you need to know about breast shells versus breast pads, because you need different solutions, especially when you are going back to work.
  • I also wish I had known that hand expression of breastmilk is a hassle. I quickly understood why mothers struggle to do it at the beginning.
  • I wish someone had told me that I would not want to go back to work at the end of my maternity leave because I wanted to breastfeed all the time. I thought I would be ready when time came, but the pain of separation cannot be forgotten. My little one is now 20-months old and I still struggle with separation.
  • I wish I had known that breastfeeding goes deeper than most human bonds. It’s true love at its best.  Breastfeeding moments are like meditation; nothing exists except you and the little one.

 

#BurningquestionbreastfeedingNo2 – Enabling Breastfeeding – How do you think family, friends, businesses, shops, corporates, public spaces can enable mothers to breastfeed?          

  • Family: I want my family to support exclusive breastfeeding without their interference. My baby does not need gripe water, Phipps, etc. They should allow me to experience breastfeeding the best way I know how and understand that my baby does not cry because he’s hungry. Families should understand that breastmilk is food like any other; it does not make anyone sick.  I would like my family members to be there to feed my baby when I’m separated from him.
  • Friends: I need my friends to respect my space and choice to breastfeed. They should not bring dummies, bottles and formulas to my baby shower. My friends should respect that my baby’s container is my breast. Also, they should not come along with teething biscuits, or anything else that contributes to mixed feeding.
  • Workplaces: Businesses and big corporates need to adhere to the laws that ensure time and space for breastfeeding moms. They should take pride in promoting and enabling breastfeeding.  Facilities for breastfeeding moms to feed or express should be enabling, safe and comfortable. 
  • Shops: We need to get breastfeeding out of the shopping centre toilets and parking lots. Why should bottle-feeding babies be allowed anywhere, anytime but breastfeeding is an issue? Shops and restaurants can really be a part of the solution by putting up signs that communicate their support that breastfeeding is the best and is welcomed in their establishments. 
  • Public spaces: There should be an emphasis on safe public spaces where mothers and babies will be comfortable and free from harm, such as tobacco. Mothers should not be expected to hide the natural beauty of breastfeeding. Our South African public needs to learn to appreciate breastfeeding.

 

Essentially, while breastfeeding is a deeply intimate time-bound bond shared between mom and baby, it remains a team-supported effort.  As the WABA states: “Breastfeeding is in the mother’s domain and when fathers, partners, families, workplaces, and communities support her, breastfeeding improves.”

 

We can all play our part in enabling breastfeeding for the greater good by protecting, promoting and supporting it.

 

For information on World Breastfeeding Week 2019 visit www.worldbreastfeedingweek.org


EMPOWERING PARENTS TO ENABLE BREASTFEEDING

 

Snickering, disparaging, denigrating and casting aspersions on breastfeeding; shaming moms who breastfeed; who breastfeed in public or who excuse themselves to express breastmilk at work; raising doubts that a breastfeeding mom is producing enough milk to meet her baby’s needs; expecting a breastfeeding mom to place other priorities above her baby’s hunger – these are some of the insidious ways that we, as society, routinely disempower parents and ultimately discourage the very best way to feed a baby for the first six months of its life, and beyond.

 

You may think: ‘It’s not my baby, it’s not my problem’; or ‘I am so uncomfortable, I have a right not to have a breastfeeding mom near me!’  You would be wrong on both accounts.  As part of society, we all have a moral obligation as to how we collectively foster the care for our most vulnerable children; as well as a vested interest in them turning  into healthy, well-adjusted, contributing citizens.   Also, breastfeeding wherever, whenever a baby gets hungry is perfectly legal, and deserves to be fully supported.  Shaming moms into desperately breastfeeding their babies, or expressing breastmilk, in cold toilet cubicles and cramped cars in parking lots is the real problem.

 

With its 2019 theme for World Breastfeeding Week, from 1 to 7 August, ‘Empower Parents, Enable Breastfeeding’ the World Alliance for Breastfeeding Action (WABA) is resolutely focusing how we shift public and private attitudes to be appropriately supportive of the optimal nutrition for babies.  This is a theme that cuts across all sectors of society and applies to breastfeeding moms across the board.  In celebration of World Breastfeeding Week 2019, ADSA (The Association for Dietetics in South Africa) has brought together a panel of Registered Dietitians, who also happen to be past and current breastfeeding moms, to answer two burning questions about how we can empower parents to best enable breastfeeding.

 

#BurningquestionbreastfeedingNo1 – Empowering Parents – What do you wish you had known before you started breastfeeding?

NASREEN JAFFER:  “I wish I knew that breastfeeding is a learned skill for mom and baby.  As first-time moms, we are expected to know exactly what to do.  No matter how much you read, the practical experience of breastfeeding is learned, so expect it to be something new and not something you have to master from Day 1.”

VANESSA CLARKE: “As with everything in life, everyone’s story is different. From my university days I was very aware of the theory regarding breastfeeding.  However, I didn’t have any idea of the variables that existed. I really struggled to breastfeed my children and what made it even harder was seeing other mothers whose children latched beautifully, or they didn’t struggle with pain. I wish I had known that sometimes breastfeeding doesn’t come naturally and that everyone’s story is different – and that is okay to struggle.”

MARYKE GALLAGHER:  “I never knew how much I would enjoy it and how much I would miss it once I stopped!  Being able to breastfeed your baby is such a great privilege and the wonderful quality time you have with your baby is priceless.  I also learnt that just because it was easy first time around, doesn’t mean it is going to be easy the second or third time. Feeding my first and second child was relatively easy as they both loved breastfeeding. When my third child arrived I just assumed she would latch easily and feed easily like the other two did. But this wasn’t the case, although with perseverance I’m still breastfeeding 15 months later. My advice to new moms is to get help from a lactation consultant if you are struggling with breastfeeding. They are able to assess each situation individually and provide you with sound advice and support.”

LISANNE DU PLESSIS:  “Before I had my children, I had completed most training available on breastfeeding in the public sector at the time; so I had a good knowledge base. However, what training cannot instil is the VASBYT-factor; the perseverance required to make breastfeeding work for you and your baby. I believe that perseverance to breastfeed exclusively and to continue breastfeeding stems from the deep belief that it is the right thing to do and the very best nutrition and nurture I could provide my children. When times were tough, I reminded myself of this truth.”

THEMBEKILE DHLAMINI: “I wish someone had warned me that I would not want to go to work at the end of my maternity leave because I wanted to keep breastfeeding. The pain of separation that I thought I would be ready for; well, when the time comes, it cannot be forgotten. 20 months later with my little one, I still struggle to separate.”

CHANTELL WITTEN:  “I never knew how important my mind-set would have to be, to truly engage and enjoy my breastfeeding journey. I learnt as a mom that breastfeeding is not a job or a task to complete.  It is relationship you build and invest in; therefore it takes time.”

MONIQUE PIDERIT:  “Before I started breastfeeding, I wish I’d known just how much of a team effort this journey would be. I went in with the idea that breastfeeding was solely my responsibility and put a lot of pressure on myself. However, I, unknowingly, had a great support team, each contributing in their unique way. Friends and close colleagues shared their real-life mom stories and lactation consultants guided me on choosing the right pump as working mom. Within minutes of my baby being born I had the hands-on, practical support of great midwives in hospital, and by the time I got home, I underestimated the encouragement and support I would get from my husband.  He kept motivating me to keep positive and took care of things like stocking up the breastfeeding station with water, tea and healthy snacks, and bringing baby to me when I was utterly exhausted. As Helen Keller said: ‘Alone we can do so little. Together we can do so much.’”

 

#BurningquestionbreastfeedingNo2 – Enabling Breastfeeding – How do you think family, friends, businesses, shops, corporates, public spaces can enable mothers to breastfeed?          

 

We asked our ADSA Dietitian moms.  Here’s what they say:

NAZEEIA SAYED: “More shops, restaurants and other public spaces need to declare their support for breastfeeding mums to normalise breastfeeding.  All work places need to have a policy around support for breastfeeding mothers and take action to support breastfeeding mums returning to work.”

THEMBEKILE DHLAMINI: “My friends need to respect my space and choice of breastfeeding.  They should not bring baby dummies and formulas to my baby shower. I want my friends to respect that I choose to give my baby the breast, not milk from containers. Also, I do not want friends bringing teething biscuits as they contribute to mixed feeding.  Breast is best exclusively for six months, and that’s an important goal for breastfeeding moms.”

LISANNE DU PLESSIS: “Family is so important. My mother, sister, husband and extended family were all on my side. They fed me while I fed my babies! They also cuddled, winded, bathed and changed nappies so that I could shower, eat, sleep. There is power in the family circle!”

NATHALIE MAT:  “Breastfeeding takes a lot of time and energy; and only a mom can do it. Please support mothers by helping take other tasks off her plate that anyone can do. At home, this can mean tidying the kitchen or doing the laundry. At work, this can mean delegating tasks that are easily transferable so that the overall load on a new mom doesn’t become overbearing.”

NASREEN JAFFER: “Family members need to be careful about not telling a first-time Mom what to do, what to feel and what not to do.  Each person will find their way.  When it comes to public spaces, we definitely need to have many more public environments in which mom can breastfeed comfortably, and these need to be welcoming, clean and attractive spaces.”

CHANTELL WITTEN:  “Breastfeeding needs to be openly welcomed.  Salute to Spur Restaurants which has a public pro-breastfeeding policy.  We need many more corporates to normalize and encourage breastfeeding.”

MARYKE GALLAGHER:  “Business needs to look at longer maternity leave so that they give moms a bit more time for breastfeeding to be well established.  Providing breastfeeding mothers with flexi time that enable them to breastfeed when they need to can make a big difference. Having childcare facilities at businesses could benefit both the business and the mom as the mother can continue breastfeeding while at work.   Providing dedicated, private and relaxing areas for moms to feed and express breast milk is vital.”

Essentially, while breastfeeding is a deeply intimate time-bound bond shared between mom and baby, it remains a team-supported effort.  As the WABA states: “Breastfeeding is in the mother’s domain and when fathers, partners, families, workplaces, and communities support her, breastfeeding improves.”

 

We can all play our part in enabling breastfeeding for the greater good by protecting, promoting and supporting it.

 

For information on World Breastfeeding Week 2019 visit www.worldbreastfeedingweek.org