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Diabetes is a condition that causes high levels of sugar in the blood. Insulin is a hormone produced by the pancreas. It helps your body change sugar to energy. Pregnancy hormones can change the way insulin works, so during pregnancy the pancreas needs to release more insulin than normal. If the pancreas cannot make enough insulin to control the sugar level, you become diabetic. Some women have diabetes before they become pregnant. Others develop it during pregnancy, a form called gestational diabetes. Gestational diabetes develops in 2 to 5% of pregnancies.

No one knows why some people develop diabetes and others do not. It may be a problem you can inherit from your parents. Women with the following histories or conditions are particularly at risk for developing diabetes during pregnancy:

• a family history of diabetes
• overweight, especially over 90.9 kg (200 pounds)
• a previous baby that weighed more than 4000 grams (9 pounds) at birth
• a previous pregnancy that resulted in a still born child
• a previous baby born with birth defects
• previous miscarriages
• age over 35 years

To help prevent gestational diabetes, stay at a healthy weight. Beginning a pregnancy at a healthy weight puts less strain on your body. This takes long-range planning. "Crash diets" are always unwise, and any weight loss can be dangerous during pregnancy.

Gestational diabetes usually goes away within a few weeks after birth. To make sure, your provider will test your blood sugar 1 to 2 months after the birth of your baby.

However, you have a good chance of becoming diabetic later in your life. 15% to 20% of women who were diabetic during pregnancy become diabetic again within the first year after delivery. To decrease this risk of becoming diabetic, you may need to lose weight after the pregnancy. Also make sure your diet is healthy and that you get enough exercise. Your health care provider will test your blood sugar level often.

If you have proper treatment before and during your pregnancy, there is a good chance you will deliver a healthy baby. If diabetes is not treated before and during pregnancy, there are a number of serious problems that could occur including the following:

• The high sugar levels in your blood might cause the baby to get too big before birth. Very large babies tend to have more problems before birth, during delivery, and after birth. Babies who are large or have other problems may need to be delivered by caesarean section (C-section).
• The baby might develop problems with the heart, kidney, spine, or brain. Some of these problems may be life threatening.
• You might have high blood pressure during the pregnancy (preeclampsia), which can cause problems for both you and the baby.
• You might go into preterm labour (before 36 weeks of pregnancy), or the baby might need to be delivered early.
• After delivery, the baby may have low blood sugar problems (hypoglycaemia).
• After delivery, the baby might have high levels of bilirubin in the body (jaundice).
• After delivery, the baby may have trouble breathing because the lungs are not fully developed.

Tests may be done during the later stages of your pregnancy to check the health of your baby. Examples of such tests are ultrasound scans, electronic fetal monitoring, and amniocentesis. With ultrasound, your health care provider can see if the baby is getting too big to deliver vaginally. He or she will also use ultrasound to check the amniotic sac and the development of the baby. Electronic fetal monitoring checks the heartbeat and activity of your baby and contractions of your uterus. Amniocentesis can be used to check the maturity of the baby's lungs if the baby needs to be delivered before the due date.

If you develop diabetes during pregnancy, you may be able to control your blood sugar level by:

• Checking your blood sugar level at home (your health care provider will tell you how often you need to check it).
• Following a special diet as recommended by your health care provider. It would be best to talk to your doctor or a dietitian about nutritional counseling.
• Getting regular, moderate exercise, as recommended by your health care provider.

If you have gestational diabetes, you may also need to take insulin shots or medicine by mouth to control your sugar level. If you need insulin, make sure you understand as much as possible about your insulin, including the right amount to use and the correct technique for giving yourself injections. It is also a good idea for another person, such as your partner, to learn how to give you insulin in case of emergencies. The timing of injections and the amount of insulin that you use should be determined by your healthcare provider.

For more information on nutrition or diet recommendations, contact Dial-a-Dietitian for a one-on-one consultation at 204-788-8248.

ManitobaParentZone.ca acknowledges the assistance of Health Links – Info Santé in responding to this question.

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Some interesting research suggests a link between organized music lessons and children's academic performance. One of the theories behind this positive association is that music lessons, like schoolwork, require a child to focus on a new task for a defined period of time, to apply new learning, and to practice. These are the same skills that help a child do better in school. As a result, learning to play a musical instrument has been shown to be good practice for learning other subjects like math and reading, and learning to play an instrument has been shown to have beneficial effects for brain development, which of course benefits all learning.

There is also solid research, which shows that many other extra-curricular activities also have positive effects on academic performance and overall well-being. Not only does physical activity increase fitness and self-esteem in children, but it also contributes to increased levels of attention and focus during school hours. Drama, chess, leisure reading, outdoor and family centered activities etc. all have similar benefits for children and families.

Encouraging children to engage in meaningful extra-curricular activities no matter what they are will have positive benefits, and providing opportunities for these activities doesn't have to cost a lot of money. While music lessons and organized sport can be expensive, most schools or community centers offer extra-curricular options for little to no cost. Getting involved in school or community activities also has the benefit of helping children feel more connected to their school and community which can boost self esteem and help them do better in school.

ManitobaParentZone acknowledges the assistance of Healthy Child Manitoba in responding to this question.

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The key thing to remember about bed bugs is that they are, as you stated in your question, a "nuisance" pest – but there is no evidence that they carry or spread disease.

Bed bugs cannot fly and they have no wings. The most common way for them to be transported from place to place is by "hitchhiking" on clothing, lunch-boxes, stuffed toys, backpacks, and other items. They are usually found in places where people sleep, or sit, for long periods of time. The Province has developed some very good resources for parents and families.

In 2012, all licensed child care facilities received a Bed Bug Guide describing the precautions and procedures to take when bed bugs are found on-site, and the importance of having an effective response plan in place.

In the spring of 2013, all school divisions received a Bed Bug Guide providing useful information about prevention, and how to minimize the spread of bed bugs when they are identified in the classroom or another common space.

Manitoba's provincial Bed Bug Strategy, launched in 2011, also includes useful tips and information about how to prevent, treat and monitor bed bugs in the home. Please click on this link to learn more about preventing the spread of bed bugs.

Early detection and treatment are the best ways to contain the spread of bed bugs. Please do NOT self-treat your home to eliminate suspected bed bugs. The chemicals in sprays and powders may harm your health and are best used by professionals. Store-bought or home-made products may not be effective against a bed bug problem–and while you wait for self-treatment to work, your bed bug problem can get much bigger.

For any further questions or concerns about bed bugs, please call the Manitoba Bed Bug Hotline at 1-855-3MB-BUGS (1-855-362-2847) or e-mail bedbugs@gov.mb.ca.

ManitobaParentZone.ca acknowledges the assistance of staff working with the Provincial Bed Bug Strategy in responding to this question.

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There is no research that indicates there is a concern having a healthy baby around a baby who has recently had their routine immunizations. The only time there would be a concern is if the other infant was immunocompromised, meaning they had a weakened immune system.

ManitobaParentZone.ca acknowledges the assistance of Health Links in responding to this question.

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If you are an insured resident of Manitoba, then prenatal care is insured through our medicare system and is provided by family physicians, obstetricians and midwives. In most cases, the choice of provider is yours. If you have a medical condition that places you or your developing baby at risk, you may be referred to a specialist.

Manitoba Health covers you and your registered dependents for medically required services. If you don't already have one, registering for a health card is your first step. You will need to present your Manitoba Health card each time you see a doctor, get a prescription, visit a hospital emergency room or access other insured health services. You are eligible for Manitoba Health coverage if you:

• are a Canadian citizen, or
• have Permanent Resident status, or
• have a Work Permit (valid for 12 consecutive months or longer) or are a spouse or dependant of a Work Permit holder with a Study/Visitor Permit (valid for 6 consecutive months or longer), and
• have a permanent residence in Manitoba, and
• live in Manitoba for at least six months in a calendar year.

You are not eligible if you:

• are a person who holds a temporary resident permit under the Immigration and Refugee Protection Act (Canada), or
• are a visitor, transient or tourist, or
• are a Canadian student from outside of Manitoba.

For more information on how to find out if you're covered by Manitoba Health, click on the link Manitoba InfoHealth Guide: Making Sure You're Covered by Manitoba Health or call one of numbers below.

786-7101 in Winnipeg
1-800-392-1207 toll-free in North America.

TTY/TDD:
774-8618
1-800-855-0511 Manitoba Relay Services toll-free

Or visit www.gov.mb.ca/health/guide/2.html.

Insured Benefits Branch, Manitoba Health

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As a patient in Manitoba, you have the right to ask questions of your health care providers, and you have the right to a second opinion if you wish to seek one. If you don't understand the treatment that your daughter's paediatrician has recommended, it's best to discuss it with the paediatrician as he/she is most familiar with the details and factors that were considered in developing the treatment plan for your child. You could also see an alternate health care provider for a second opinion or call Health Links-Info Santé, a non-emergency health care line in Manitoba, at 1 204 788-8200 in Winnipeg, or toll-free at 1-888-315-9257 to learn more about the treatment options that are available to persons with asthma. Patients and their families are encouraged to ask for the information they need to be active participants in their own health care.

ManitobaParentZone.ca acknowledges the assistance of Manitoba Health in responding to this question.

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As your question is urgent and pertains to health care, your best option is to contact Health Links – Info Santé. Health Links is a 24-hour, 7-days a week telephone information service. Staffed by registered nurses with the knowledge to provide answers over the phone to health care questions and guide you to the care you need.

Call anytime 1-204-788-8200 in Winnipeg or toll-free 1-888-315-9257. Alternatively, you can visit their website at www.rha-central.mb.ca/healthlinks.php for more information.

ManitobaParentZone.ca acknowledges the assistance of Manitoba Health in responding to this question

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Although sold at local grocery stores, many non-alcoholic beer and wines still contain a small amount of alcohol. "Non-alcoholic" or "de-alcoholized" means that the alcohol content has been reduced to less than 1.1 per cent.

However, there is no known safe amount of alcohol or safe time during pregnancy to drink alcohol. It is best that women do not drink any amount of alcohol while pregnant or if there is a chance of becoming pregnant.

The safest choice is no alcohol. Click on the link to Mocktails for Mom for delicious non alcoholic drink recipes.

ManitobaParentZone.ca thanks Dial-a-Dietitian in responding to this question. Dial-a-Dietitian can be reached at (204) 788-8248 in Winnipeg or Toll Free at 1-877-830-2892.

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People choose to become vegetarian for many different reasons. These can include personal, ethical, religious, cultural and health reasons. What are your child's reasons?

Following a vegetarian lifestyle can have benefits such as decreased saturated fat intake, increased fibre, increased intake of most vitamins and minerals and lower rates of chronic disease. However, like the general population, vegetarians can also make poor food choices. A poorly chosen vegetarian diet can be low or deficient in protein, iron, calcium, vitamin D and more. Therefore, it is important to plan for a healthy vegetarian diet by following Canada's Food Guide and including a wide variety of legumes such as beans, peas and lentils; nuts and seeds; whole grains; as well as fruit and vegetables. Legumes contain significant amounts of protein that all people – especially teens – require. Some vegetarians, called lacto-ovo vegetarians, choose to continue to eat low-fat dairy products and eggs, also good sources of protein.

Parents can support their young vegetarians by providing healthy food choices that replace any lost nutrients. Many alternative foods are available to replace meat and dairy products. Foods and meat substitutes made from soybeans, wheat proteins or other vegetable sources can be used in place of meat products and easily incorporated into a family meal. Tofu and tempeh are other good sources of protein and can be used in pasta, stir-fries, and even in smoothies and desserts. Some meat substitutes mimic luncheon meats, sausages, hot dogs, hamburgers or chicken patties. And textured vegetable protein (TVP) – often sold as "ground round" – resembles ground meat and can be used in sloppy joes, tacos or pasta sauces. Alternative milks such as soy, almond and rice milks as well as soy yogurts and soy cheeses can be used to replace dairy products.

It is important to involve your children in the planning, shopping and preparation of their meals and snacks. Beyond this, parents can also support their young vegetarians by including meatless meals for the entire family to enjoy together! If you would like to further discuss your or your families nutritional needs with a dietitian, please call Dial-a-Dietitian at 204-788-8248 in Winnipeg or toll-free 1-877-830-2892.

For more information on vegetarian diets, click on the links below:

• Dietitians of Canada: Vegetarian Diets
• Heart & Stroke Foundation of Canada – Vegetarian Diets
• Heart & Stroke Foundation of Canada – Vegetarian Recipes
• Vegetarian Diets for Children and Teens

ManitobaParentZone.ca thanks Dial-a-Dietitian in responding to this question. Dial-a-Dietitian can be reached at (204) 788-8248 in Winnipeg or Toll Free at 1-877-830-2892.

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There is no legislation that states how child car seats are to be used in relation to airbag switches. Having said that, research indicates that it is safer for your child to be positioned away from front seat air bags in case they inflate during a collision. The safest place for a child to be is in the middle back seat position. If there are no second row of seats (ie. some truck models), it is strongly recommended that the air bag switch be turned off. It is also recommended that the car seat be positioned in the seat as far back as possible before installation. You should check both your car owner's manual and the child seat user guide for more information. Please call Manitoba Public Insurance at 204-985-8737 should you require further information.

ManitobaParentZone.ca acknowledges the assistance of Manitoba Healthy Living, Seniors and Consumer Affairs in responding to this question.

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Thank you for your question.

There are many hazardous things that may pose a risk to a person.

In the environment, at home and at work, a person may be exposed to things that are in the air we breathe, in the products we consume and in the surroundings that we make contact with.

What is dangerous can be a personal judgement that can only be made once there is a clear understanding of what the hazardous agent is and what it can do to the body. Then you must consider "How am I exposed to it?" and "How can I prevent the exposure?"

For example, think about sun exposure which can burn you and may lead to skin cancer. Then consider the use of shade, hats and sunscreen to protect yourself.

In the northern Manitoba mining communities, valued minerals such as copper (Cu) and zinc (Zn) are extracted as ore and then concentrated or isolated from some of the other minerals that are present in the rock. The ore is crushed and treated with heat and/or substances that allow the processor to select the minerals to keep and those to release. The geology determines the mineral composition and Manitoba rocks often contain the hazardous heavy metal lead (Pb).

It is acknowledged that dust containing lead is an airborne pollutant often produced by the operations and many companies do strive to control the emission. Lead can enter the body by inhaling it and by swallowing it and it may cause a variety of health issues. It is especially harmful during early development when the body is forming and growing. There are limits established for lead in the air, in the water and in the blood.

The Manitoba Workplace Safety and Health Act states that the employer is responsible to ensure the safety and health of a worker at work. This means that you should have been informed about all of the hazards that may be at the workplace and what is being done to protect you. You are not obligated to disclose your future plans for pregnancy to your employer; however, if you are unsure about the effects of your exposure to chemicals at the workplace, you should ask your employer for this information.

Once you have information regarding the hazards that you may be exposed to at your workplace, you may pose your personal health questions including the risks of exposure to your unborn child, when you should leave your position, and what you should be doing before getting pregnant to a physician. The Occupational Health Centre of the Manitoba Federation of Labour (OHC-MFL) is a group that can assist you with finding a physician who understands workplace exposures that may impact your health and address your pregnancy concerns.

The OHC-MFL resource centre is open to all and their hours of operation are from Monday to Friday from 9 a.m. to 5 p.m. Here is their contact information:

The Occupational Health Centre of the Manitoba Federation of Labour
102-275 Broadway
Winnipeg, Manitoba
Canada, R3C 4M6
Email: mflohc@mflohc.mb.ca
Phone: 204-949-0811
Fax: 204-956-0848
Toll Free: 1-888-843-1229 (Manitoba only)

When you consult with an OHC-MFL recommended physician who understands workplace exposures, you will be able to receive specific information pertaining to your situation and learn more about the steps you can take to minimize exposure related risks during pregnancy.

For questions about requirements under The Workplace Safety and Health Act and regulations, for information on SAFE Work Manitoba training, prevention programs, services or events, to receive SAFE Work Manitoba resource materials, or to report serious workplace incidents, injuries or fatalities, you may contact them at:

Workplace Safety and Health
Winnipeg 204-957-SAFE (7233)
Outside Winnipeg 1-855-957-SAFE (7233)

Once again, we thank you for your question and we hope that the above information is helpful to you.

Manitoba Parent Zone acknowledges the assistance of the Workplace Safety and Health Branch of Manitoba Labour and Immigration in responding to this question.

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Thank you for your question.

Products combining skin moisturizer and insect repellent are not approved for use by Health Canada. Rather, Health Canada recommends the use of separate products simultaneously when needed.

Sunscreen and personal insect repellents can be used safely at the same time. To properly apply the product, follow the instructions on the package. Apply the sunscreen first and then the insect repellent.

Not recommended for personal protection

According to Health Canada, the following products are not recommended for a variety of reasons. They may not be very effective or long-lasting and they may have the potential to be harmful to human health.

• electronic or ultrasonic devices
• electrocuting devices, like bug zappers
• wristbands, neckbands and ankle bands that contain repellents
• odour-baited mosquito traps
• citrosa houseplants
• Vitamin B1 taken orally
• skin moisturizers and insect repellent-combination products

More information on the use of sunscreens, choosing a personal insect repellent for children, and on reducing health risks related to mosquito bites, can be found by visiting the Health Canada website or by clicking on the following link:

• It's Your Health: Insect Repellents

Manitoba Parent Zone acknowledges the assistance of Health Links – Info Santé in responding to your question.

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Helping your child and teenager to grow well is not always an easy task. These tips are some of the ways to guide their choices and pass on lessons they can use for life.

Healthy Eating Tips

Making breakfast a regular habit in your home.

• Breakfast helps children to participate and learn better at school.
• Great choices include: fruit, while grain cereals, bannock, pita, toast, milk, soy beverage, yogurt, tofu, eggs or peanut butter.
• Try to gather the family early to allow times for breakfast.

Drink water often – it's the best choice when thirsty.

• Limit the amount of sugary drinks such as pop, fruit drinks and sports drinks. They provide little or no nutrition and can cause dental cavities.
• Limit 100% fruit juice to 1/2 cup for younger children and 1 cup for teens per day.

Make mealtime a family time.

• Cook together. Eat together. Talk together.
• Family meals help promote healthy eating overall.

Share decisions about food.

• Parents and caregivers decide what kinds of food to offer and when.
• Let children decide whether and how much to eat. Trust their feelings of hunger and being full.
• Praise, hugs and just spending time together work well as rewards, rather than using food.

Meals and snacks.

• Meals and snacks.
• Serve a variety of foods from all four food groups in Canada's Food Guide.
• Offer foods that are generally high in fiber, low in sugar and fat.

Tips for Active Living

Build physical activity into the daily routine.

• Regular physical activity helps children develop strength and energy.
• Aim for 60 minutes of physical activity every day.
• Have fun together with activities suitable for your child's age.
• Plan walks or a bike ride after dinner.

Limit screen time to less than 2 hours a day.

• Screen time includes TV, computer or video games.
• The more time children spend at a screen, the less time they have for family chats or being active.

Get enough sleep.

• A child or teen is more ready for their daily activities if they have had a good night's sleep.
• Having enough sleep also promotes a healthy weight.

Model Healthy Habits

Build physical activity into the daily routine.

• Children learn from watching others. They are more likely to make healthy choices when that is a part of your family routine

Reference: Dietitians of Canada – Tips to help your child and teen grow well

For answers to your healthy eating questions contact Dial-a-Dietitian to speak to a Registered Dietitian in Manitoba. In Winnipeg call (204) 788-8248 or Toll Free at 1-877-830-2892.

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The Winnipeg Regional Health Authority "Family Lifestyles Program" is a free six-week program designed to support healthy eating and physical activity for the whole family. It includes a mix of individual counselling and group sessions hosted by a registered dietitian and a physiotherapist. Families will participate in lifestyle assessment, guided family physical activity sessions and group education discussions. For further information please contact Dawne Olafson, R.D. by phone at 204-654-6541 or by e-mail at dolafson@wrha.mb.ca.

For answers to your healthy eating questions contact Dial-a-Dietitian to speak to a Registered Dietitian in Manitoba. Dial-a-Dietitian can be reached at 204-788-8248 in Winnipeg or toll-free at 1-877-830-2892

ManitobaParentZone.ca acknowledges the assistance of Dial-a-Dietitian in responding to this question.

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Thank you for your question.

Babies can sweat, however, their sweat does not usually have that 'bad body odor' until they have hit puberty. Sweat itself does not have an odor; it only starts to smell when it combines with the bacteria that are normally found on your skin.

There are many reasons why babies smell and different babies will smell differently even when using the same soap or lotions. Here are some of the more common causes of baby smells.

Parents will describe a sour milk smell. This often comes from breast milk, formula or food that has gotten trapped in one of those of wonderful rolls of skin that babies can have. When washing your baby, make sure you are getting into all the nooks and crannies.

Where the smell is coming from on your baby is also important to know. If it's from around her head, it could be milk in the fold of her neck or cradle cap, or if it is coming from her ears, possibly an ear infection. If it's only after she pees, it could be from her diet or possibly a urine infection.

Also, if your baby is breastfed, some of the foods or medications that you ingest can create a smell in your baby.

Smells can also be transferred to a baby from another person or from clothes, smoke, cooking food etc. If you have a strong body odor and are cuddling your baby it could be passed on to the baby or her clothing.

Sometimes the way a baby smells can indicate a concerning health problem. Your health care provider would be able to help determine if there is a need for investigation.

If you cannot find an obvious cause- like sour milk in skin folds, then you should take your baby in to be seen by your health care provider.

Once again, we thank you for your question and we hope that the above information is helpful.

-- ManitobaParentZone.ca acknowledges the assistance of Health Links - Info Santé in responding to your question.