Monday, 30 November 2015

10 Favourite Winter Illness Products

We talk lots on the Facebook group about making remedies and more natural alternatives, but sometimes you just want to buy something.  I thought I would share my favourite winter just in case products.

In no particular order:

Comvita Propolis Herbal Elixir: 


A natural all-in-one herbal formula designed to help maintain winter wellness. Which basically means a cold, sore throat, cough etc. A blend of UMF10+ Manuka honey, Propolis and carefully selected herbal ingredients. It does have a few bits like Xanthan gum and dextrose, so worth avoiding if you're super sensitive.

Pukka Herbs Elderberry Syrup

Elderberry juice, manuka honey 14+, trikatu and thyme, along with the other herbs in this syrup, have long been used to help support seasonal health.

This concentrated broad-spectrum syrup contains the highest organic grade, sustainably cultivated herbs, carefully selected to bring you the full potential of nature’s goodness.  Suitable for all of the family.

A Vogel Echinaforce Echinacea Drops


Produced using extracts of freshly harvested, organically grown Echinacea purpurea herb and root, picked fresh and used within 24 hours of harvest. Recommended for colds and flu. According to manufacturers it helps the body fight the symptoms of these infections by supporting the immune system, helping to maintain the body's resistance.

A. Vogel Echinaforce Sore Throat Spray


A tincture of Echinacea herb, root and fresh sage - we find this works well for sore throats.

Comvita 20ml Extra Strength Propolis Oral Spray

This is listed as an oral spray, designed to improve oral health - however we also find it helpful for sore throats, and as another reviewer says - to help with soreness from coughing.  Ingredients are Propolis, Manuka honey, peppermint, clove and myrrh oil.

Propolia® Nasal Spray - Propolis, Thyme and Eucalyptus


Containing 100% organic plant extracts (Thyme, Eucalyptus) and French Propolis, can help for blocked noses rather than the old Vicks style "sniffers".

Manuka Honey IAA10+ Sinus Spray


100% natural organic Spray that purifies, cleans and protects the nasal passage and sinus. An alcohol-free formulation to protect the sensitive sinus cavity enriched in Himalayan pink salt to facilitate easy nasal flow and organic eucalyptus essential oil to gently decongest. In other words recommended for blocked sinuses/sinusitis


Manuka Honey Comvita Umf 10


Good old Manuka honey, swallow for sore throats, mix with lemon and warm water at a soothing drink, can even be good for irritated patches of skin.

OptiBac Probiotics Saccharomyces boulardii


If you do find yourself winding up having to take antibiotics, Sacch boulardii can help prevent side effects according to the NHS

Kneipp Eucalyptus Cold and Flu Herbal Bath


According to the manufacturers this is a highly concentrated bath treatment with aroma-intensive, essential eucalyptus oil.  It stimulates and helps relieve sinuses especially during cold and flu season.  All products are made in Germany and contain no paraffin, silicone or mineral oils.

Related Posts: Naturally Healing Ear Infections

Tuesday, 20 January 2015

7 Things That Pro Vaccine Campaigners Need To Understand

I read a lot of really aggressive pro vaccination pieces via my Facebook contacts, and I can't help but cringe. Most seem to have no clue who the "anti vaccination" bunch are they're addressing, beyond some media caricature of the dirty unvaccinated spreading disease; as such most written is really quite pointless.

So I thought pointing out some basics might help.

1.  There is no "anti vax campaign"
I know, weird right given what the media tell us - but this article explains quite clearly why it's simply not true. What's more, this piece in which author Rachel Hills realises this made me chuckle:
"Not all of the parents Reich spoke with were “anti-vaxxers” in the sense that we typically think of the term; only a small minority identified as activists in the Jenny McCarthy mold, campaigning other parents not to vaccinate or advocating for policy change. Nor did they necessarily abstain from vaccination completely."
Guess what Rachel, not all gay men are into fashion, have uber trendy apartments and adore Madonna either.  That's the problem with stereotypes, they often don't reflect reality.

The further problem with the belief in an "anti vaccine movement" is that often people without a particular stance are lumped into "pro" or "against", potentially forcing their hand.

For example, someone shares a scientific study showing a measles outbreak came from a fully vaccinated person.  In response people quickly state whoever posted it clearly has an "anti vaccination agenda".  They claim it's irresponsible to share it at all, as it doesn't help the pro vaccination cause any" (which apparently all responsible people should do).

Whereas the poster may previously have felt aligned with vaccination and merely found the study interesting, now they might wonder why they aren't allowed to talk about it and whether that's because there's something to hide.  They might feel offended by those who have attacked them, and instead the responses that resonate are from those who also want to explore vaccine failure rates or wonder how long they actually last.  This leads them to do more questioning.

The problem is any questioning or initiation of discussion exploring vaccines, is similarly considered "anti vaccine" (and yes I speak from experience) - it seems one has to be wholly 100% behind each and every vaccine, without question, and trying to convince others of this to qualify as "pro" - otherwise you are "anti", and someone can quickly find themselves in this position in just a few mouse clicks.

Seems to me incorrect stereotypes and belief in an anti-vaccine agenda don't do either side any favours.

Let's then explore who actually make up these "anti vaxers"?

In my experience they include people who:
  • Selectively vaccinate based on disease - for example they may give meningitis but not tetanus.
  • Believe in selective vaccination based on age/demographic/availability of healthcare - for example they may be pro giving a Malaria vaccine in the slums of India, but not the Varicella (chicken pox) vaccine in the UK.
  • Really aren't sure and so are delaying whilst they decide
  • Have some concerns over certain aspects of vaccines ie perhaps they believe in the concept, but have safety concerns over how or where they are produced.  For example they may be concerned about contamination issues at foreign manufacturing plants.
  • Have had an experience following vaccination that has worried them or has led them to believe their child was injured by it.  Or have friends/relatives that have had a negative vaccination experience.
  • Recognise vaccination is absolutely cost effective from the perspective of a healthcare system focussing on £/$/€, but don't feel this is the same as stating there are of benefit of to each and every individual.
  • Believe vaccines may indeed prevent the disease, but this may carry other unforeseen consequences like virus mutation, increase in other illnesses or changing the target age range of the condition ie making the very young or elderly at risk.  For example they may believe the suggestion vaccinating everyone against flu, results in an increase in respiratory infections needs to be considered, or that maintaining acceptable vaccine compliance for an "eradicated disease" is notoriously difficult, leaving room for a more virulent strain to be re-introduced intead.
  • Have spend months or years gathering and debating evidence from journals and feel they have made an informed choice; or they feel the right studies have not been done, or that funding influences research, or that data presented is inaccurate.  For example it's standard to combine figures for both pneumonia and influenza to establish the death rate from flu.  This is done because flu can lead to pneumonia, and if this results in death, it's pneumonia that's recorded on the death certificate.  This quite rightly presents an artificially low picture of deaths from flu.  However similarly, adding all pneumonia deaths and calling them flu is likely to give an artificially high picture, because there are many causes of pneumonia.  What's more because many people never visit the doctor with mild to moderate flu, national figures are "estimates" that some feel are inaccurate.
  • Believe scientists don't fully understand the immune system, which is why auto-immune conditions prove so challenging to the medical world today.  They argue if it's not fully understood, how can anyone be confident vaccines don't impact?
  • Don't believe the diseases warrant vaccination and that a healthy immune system is key.
  • Don't believe vaccination prevents disease.
  • Believe vaccinations are linked to autism/ADHD/encephalitis because of what they have heard or read.
This list obviously isn't exhaustive, it's based on my experience of discussing vaccination - and I've listed those I hear most often near the top.  If we then consider most pro vaccination material typically focusses on the last three points and that in reality this isn't really why most people aren't vaccinating - you kinda have to wonder why waste the keyboard clicks?  Sure you might get lots of hits from others already on the same team, but this surely defeats the object somewhat.

2.  Forget Andrew Wakefield, forget autism.
Really it's a teeny, tiny, make that microscopic, number of people who choose not to vaccinate based on one study by Andrew Wakefield.  In fact I've never met a single person who has stated this as their reason for not vaccinating, yet every last blooming article bangs on about it.  People who aren't vaccinating tend to find it quite insulting, the assumption they make big decisions like vaccinations based on one man. Really, let it go..

3.  Vaccine debate has always existed
I know it's nice to pretend there used to be a time people were so ill and without hope they gratefully all lined up for vaccinations, but it's not true.  As another example when discussing introduction of the measles vaccine to the UK, it wasn't considered a "no-brainer", in fact there was a lot of disagreement between experts.

To be fair even now the CDC and the NHS can't seem to agree on the severity of Varicella and thus the need for a vaccination.  As a result one country routinely offers it, the other doesn't.  Ditto giving Hepatitis B vaccination at birth, the US/CDC recommends all children receive it, whilst the UK/NHS recommends it only for those at risk.

If health authorities can't agree, why expect anyone else to?  Writing articles that state or imply people are stupid for daring to engage in discussion or holding a different point of view, rather than "leaving it to the experts" are unlikely to provoke a change of heart.

4.  Herd Immunity
Another massive feature of pro vaccination articles is protecting others.  Selfish non vaccinators don't care about immune compromised children or newborns who can't protect themselves, not like those vaccinating who are carrying around their giant shields of protection, carrying the burden for society #romantic view.

Think this through for a minute though.  If you plan on giving a vaccine anyway because you believe they are the bees knees, the additional selfless act of "protecting others" is a by-product.

However if someone believes a vaccine is harmful and could injure their child, how likely are they to give one on the theoretical basis of protecting a stranger?  What are the ethics of asking someone to, even if they don't believe it works?  Put it this way I've never met a single person ever, who said they believed vaccinations were a bad idea, but gave them anyway to protect someone else who was vulnerable.

What's more, whether herd immunity is a feasible concept when vaccine driven (rather than via wild disease, which is where the concept of herd immunity is derived from), seems to also still be hotly debated. Recent events with pertussis certainly raise a brow; either way hinging an argument on herd immunity and emotional blackmail is unlikely to win over your target audience.

5.  Accuracy.
This is my pet hate, an example from late last year:
"Pertussis (whooping cough) cases are on the rise due to an increasing number of parents choosing not to vaccinate.  This means a disease that was virtually wiped out is now BACK and babies are dying as a result!"
Whilst this might trigger a good reaction and read rate (that's the job of the media done then), it's wrong, wrong, wrong, wrong wrong.

Pertussis levels have increased despite ever increasing vaccination rates.  Researchers have established its entirely possible to catch and pass on pertussis when fully vaccinated, all without showing any symptoms.

The CDC have updated their page stating that "vaccinated children and adults can become infected with and transmit pertussis; however, disease is less likely to be severe" (no research reference is given for claims regarding severity."

In addition to this they're currently exploring mutation and how this may be part of the picture.

The reality as things stand is that even 100% vaccination rate could not establish herd immunity against pertussis, because we know vaccines can fail. According to the CDC:
"Pertussis vaccines are effective, but not perfect. They typically offer high levels of protection within the first 2 years of getting vaccinated, but then protection decreases over time. This is known as waning immunity. Similarly, natural infection may also only protect you for a few years. 
In general, DTaP (Kerfuffle note - this is the initial vaccine) vaccines are 80-90% effective. Among kids who get all 5 doses of DTaP on schedule, effectiveness is very high within the year following the 5th dose – at least 9 out of 10 kids are fully protected. There is a modest decrease in effectiveness in each following year.
Our current estimate is that Tdap (Kerfuffle note - this is the booster) vaccination protects 7 out of 10 people who receive it. Since Tdap vaccines were only licensed in 2005, we don't yet have results on long-term vaccine protection. We're still working to understand how that protection declines over time or might differ based on which vaccine was received during early childhood (i.e., DTaP or DTP). CDC will be conducting an evaluation in collaboration with health departments in Washington and California to better understand how long Tdap vaccines protect from pertussis. The data from these evaluations will help guide discussions on how best to use vaccines to control pertussis.
Add to this that the entire population would need boosters, and that we don't yet know how long they last - and herd immunity against pertussis seems more fantasy than reality at the moment.  People often seem to conveniently forget that adults are perfectly capable of catching pertussis and passing it around too.  Adults can also not be aware they have pertussis, but put it down to a cough - because the symptoms are often milder than in children, reducing likelihood they will isolate themselves.

The US seems to highlight this more often, stating that if you have a baby - ask all your relatives to get a pertussis vaccine. However if we are really concerned about the vulnerable and immune compromised as per herd immunity claims, surely vaccination should not only occur when your own baby is born but at regular intervals regardless?  Otherwise how do we know who is passing it round the supermarket?

Of course with travel this means anyone entering the country (legally or otherwise) also needs vaccinating - and none of this considers that the vaccine is only against the current most significant strain....

Which rather begs the question as to why so many articles exist claiming it's the fault of those who don't vaccinate?  To induce hate towards another group?  To improve compliance for vaccinations via whatever means necessary?

6.  Discrediting due to vaccine stance.
Take one highly respected doctor with a glorious academic history, top of all his studies, referenced by many - and watch what happens if he questions or utters a single negative thing about vaccines.  Suddenly the label firmly shifts to "quack" in pro vaccine material, and he is accused of having an "anti vaccine agenda".

Now I get that in the academic world, the key is to go with the general body of research.  If scientists accept something as true, stating you disagree with this is likely to get you discredited with your peers PDQ.

However this doesn't mean that parents do or should feel the same - because rightly or wrongly as the old adage goes:
"First they ignore you. Then they ridicule you. And then they attack you and want to burn you. And then they build monuments to you." (Nicholas Klein 1918).
It's pretty well recognised that when we have our "belief system" challenged, the knee jerk reaction is denial - whether this particular person is correct or not.

Parents discuss what motive a reputed doctor would have for risking his career, being mocked by his peers and discredited - if he didn't really believe what he was saying.   What's more, because someone has  "pro vaccine" or "anti vaccine" stance, does this make what they have to say any less important? Simply stating an article is worthless because the author is a known "anti vaxer" doesn't make much sense to many - particularly when they themselves are now considered "anti vaccine".

7.  A duty to society.
Apparently due to costs of treating illnesses, protecting the vulnerable etc we often hear that parents should vaccinate for the greater good of society.  I have to be honest this annoys me because it seems to only apply to vaccines, yet it's in some ways it's rather comparable to breastfeeding.

There are recognised risks to not breastfeeding.  We know modest interests in breastfeeding would prevent so many hospital admissions in the UK it would save the NHS around £40 million.   Research suggests increasing breastfeeding rates in neonatal units from 35% to 75% could save £6 million per year by reducing the incidence of necrotising enterocolitis (NEC), according to the study.

Forget the money, what about the lives of those who die from NEC, who suffer long lasting complications as a result?  If we are really all about protecting the vulnerable, why aren't the papers highlighting the "selfish formula feeding mothers who don't attempt breastfeeding and as a result their babies die!".

Ouch harsh isn't it, and certainly not something I would like to read - so why do people feel it's OK to make similar comments to those who don't vaccinate, and then feel they might be receptive to considering another perspective?

People often respond that not breastfeeding only affects your own child and not other peoples - which I find confusing.  Does that mean it's OK for your own vulnerable young to suffer as long as this doesn't impact on anyone else?  Or that it doesn't matter to the economy if someone is off sick more caring for their child as the NHS state?

In an age where people can globally discuss issues, I suggest that instead of insulting those who don't agree - we try listening and perhaps re-examining our own beliefs.  In her piece above, Rachel sums it up well if we continue and read the rest of her quote:
"Rather, what united them was a sense that vaccines were up for negotiation: to be administered or rejected depending on the convictions of the parent and the needs of the child. Reich’s interviewees saw themselves as critical consumers of information. They engaged with doctors not as authorities to be obeyed, but as another data point to be evaluated, embraced, or discarded. They continually assessed risk: How likely was it that their child would be exposed to Disease A? What would be the consequences if they contracted Disease B?
This is absolutely the reality of today, whether the CDC et al like it or not.  Gone are the days when people did things simply because their doctor told them to.  And like a dominant parent, angry their child does not blindly comply without question - more aggression and force is unlikely to be the answer.

Wednesday, 12 November 2014

Homemade Stock Cubes - AKA The Easy, Space Saving Way to Store Bone and Meat Broth


Many people are now re-discovering the benefits of
homemade stocks and broths, rather than reaching for supermarket granules.

They're easy to make, and if using leftover bones from meals - cheap.  But perhaps the biggest draw for many, are the purported gut healing benefits and as a valuable mineral source.  You can buy tubs of good quality gelatin such as this, however it's even easier to create a rich stock from a cheap meat cut.

There are a lot of claims made about gelatine, how many are true I have no idea - but here is an interesting summary of proposed benefits.  Either way homemade stock is still an undoubtedly healthier option than shop bought.  Here is what's in a "knorr stock pot":
Concentrated Beef Stock (Water, Beef Extract) (39%), Glucose Syrup, Salt, Beef Fat (5%), Flavourings, Yeast Extract, Carrots (1.8%), Potassium Chloride, Palm Oil, Caramel Syrup, Gelling Agents (Xanthan Gum, Locust Bean Gum), Sugar, Leek, Parsley, Maltodextrin, Lovage Root.
Glucose syrup is right on up there....nom.

There is often confusion over broth and stock, with some using the terms interchangeably.  General consensus seems to be that broth is typically a meat plus some bones affair, cooked for a relatively short period of time, ie up to a couple of hours.  This is what you want to be making if you're doing say GAPS intro diet.

A stock on the other hand is mainly bones, although it can contain some meat; it's simmered for up to 4 hours and should be gelatinous. Bone broth is as per stock, but cooked for a  much longer period of time ie 24-48 hours (until the bones crumble).

It's important to start slowly with bone broth, as it can cause headaches for some people when large volumes are consumed straight off the bat.  Some claim it's a detox effect, others that it's the result of increased histamine levels, which those with a sensitive gut may be intolerant to.  Chicken or fish is thought to be the easiest to start with, even as little as one tablespoon if you suspect sensitivity.

I tend to cook mine for varying amounts of  time, depending on what I want to use it for (and how much other stuff I have going on).  This time I used organic, grass fed "stock bones", which have a little meat, but I didn't add extra.

The first batch I cooked for 6 hours after roasting the bones, which is the darker one in the image above. I then strained, and put the bones back in the pan with fresh water - cooking for a further 12 hours.  I sometimes return them again for 48 for true "bone broth", or pull the first batch earlier and the second batch later; sometimes I add meat and remove that after a few hours, but let the whole stock go 12/24/48 hours (really there's no exact science involved), but I wanted my stove for other things this week.

So normally I chill the liquid, skim and retain a lot of the fat, before reducing the volume by half - ready to portion up and store.

Which is what got me thinking about stock cubes.

Firstly from a storage perspective they're a massive bonus.  But also sometimes I want to add flavour, without loads of water.  Could I turn my stock into stock cubes?  I decided to have a try.

The first batch was the 6hr simmer.  After cooling this was gelatinous, but not solid - more like a wobbly jelly.  I returned it to the pan to reduce as normal, and then carried on reducing.
Ham Hock Stock Reduced

I carried on (turning the heat down as the heat as the amount reduced), until I was left with a thick dark paste resembling caramel.  I stirred constantly for the last few minutes so it didn't stick (see the picture on the right to give an idea of how thick we're talking).  A couple of minutes later it came together so I was pushing around one large "gloop" of meaty goo, and it stopped producing steam (showing all the water had evaporated). I then quickly tipped into a small Tupperware tub and popped in the freezer for half an hour.

Finished "stock strip" is pliable
After that I let it sit at room temp for a few minutes, before flicking it out of the tub.

It's a rubbery, pliable texture whether frozen or at room temp, so you can easily score and cut into portions.  I based how many pieces on how much stock I had initially, and how I would normally have it split for freezing.

In my case the tub I used was quite shallow, and so I have stock "strips" - which actually are probably handier in terms of storage.  They melt quickly when added to hot liquid, yet don't melt if left on the worktop.  They should be stable enough to take camping etc if you have access to water.

There are of course loads of possible variations too, in that you could add onion, celery or garlic powder; or any other herbs usually found in your favourite stock cube or granules.

The reason for this long blog, and why I didn't just say "reduce it down", was the second batch.

This was my 12 hr stock and was completely solid with gelatine when initially cooled ready for the fat removing.  I could have tipped it out and cut into cubes as was. Anyway, I did as before and returned it to the pan to reduce.  This time I found when I got to the point the steam had stopped, what was left was far too solid and sticky to move.  It would have been fine if I hadn't had to move it, however it stuck to the spoon, the side of the pan, the tub and was a solid ball within seconds of leaving the heat.  I think the concentration of gelatine was so much at that stage, it basically made glue!  I have got a plan to try to get around this, but for now plan b.

I chucked it back it the pan with more water for take 2.  This time I reduced it to a thick goo, but removed it before it stopped steaming.  After 10 mins in the freezer I scored and broke into cubes.  It felt more jelly like, and after another hour in the freezer they were completely frozen solid, returning to jelly after 5 mins at room temp.  I would guess these would store for less time in the freezer than the first batch, because of increased moisture content - however the same goes for the huge bags of stock I was storing, plus we use ours well before expiry so not a biggie.

I've also found it much easier to portion.  If I decide I want a small amount of stock for something, previously
Ham Hock Stock
I had to either freeze some smaller portions too (more bagging etc), or defrost a big one.  Then it was a case of prising the whole chunk out of the bag before it defrosted, or letting it do so and then squidging everything off the insides of the bag.

Now I can just cut a small piece off.  They've also worked well for drinks, as a small piece dissolves quickly with boiling water added.

Anyway, I now have two beef variations, ham hock, and chicken stock, all in one tiny Tupperware tub - and I can fit other food in my freezer again.  That alone is priceless.

Wednesday, 8 October 2014

Children's fire cider/ master tonic

Original "fire cider"
Fire cider, or master tonic as others like to call it, featured in a Facebook discussion a few weeks ago. For those not familiar, it's a traditional folk recipe based around raw, unfiltered apple cider vinegar. 
To this herbs, onions, roots and various other bits and bobs are added. To clarify there is no alcohol!  It should really be called fire vinegar, but that sounds somewhat less appealing.
"Hot, pungent, sour, and sweet, fire cider is certainly not for the faint of heart. Yet this fiery concoction has been revered for generations as a simple and effective remedy to relieve sinus congestion, ward off colds and flu, aid digestion, and increase circulation."
You can find the above quote and the recipe I used here. 

I didn't need to wait the two weeks plus for it to "mature", to know this was going to be way too strong for the smalls.  Super hot chillies, heaps of horseradish and garlic - I did at one point joke perhaps it keeps you healthy as the odour emanating from your pores following consumption, means most give you a wide berth!

Anyway, I digress.

"Fire-ish cider"
I had some bits and bobs left over, so decided to throw together a children's version.  I used a 300ml jar and kept the "fiery ingredients",  but in much smaller quantities.  It's still pretty interesting, but my two had some the other night and said it was doable.

Horseradish isn't recommended for consumption by children under 4.  I'm not entirely sure whether this applies to fire cider as the solids are strained and only 1/2 - 1 tsp of the retained liquid is consumed each time.  However use your own judgement and leave it out if you're concerned.

That's the fun thing about fire cider, you can switch and change ingredients and amounts, depending on what you prefer and what you have locally available.

However I know some people like a "recipe", so here's my version of fire-ish cider :)

Ingredients:
  • 3cm piece of horseradish root
  • 2 x shallots
  • 1/4 of fresh hot red chilli (I used cayenne)
  • 3cm fresh ginger root
  • 1 x "finger sized" of fresh turmeric root.  Mine left over were smaller and about widgety grub size, so I used a couple.   If you can't get fresh, you could substitute 1- 1 1/2 tsp of dried.
  • 2 x garlic cloves
  • 2 x small handful of roughly chopped blackberries, elderberries, haws, rowan berries. and/or rosehips.
  • 1 TBSP fresh parsley
  • 2 x sprigs fresh rosemary
  • 2  x springs fresh thyme
(you could substitute 1/2 amounts of dried herbs I'm sure!)
  • Quarter of lemon sliced thinly
  • 4 slices of orange (peel on if organic)
  • 2 x star anise
  • Small piece of cinnamon stick, I just snapped a bit off
  • 3 cloves
  • 3 black peppercorns
  • 2 dates roughly chopped
  • Raw (unpasteurised) apple cider vinegar.  Ideally use one "with the mother" like Braggs or Ostlers.  If you're super lucky and spot this one by West Lake when out and about, it's extra delish!
You can either slice everything finely (with the exception of the hard spices and peppercorns obviously) and layer into jar as I did; or you can just peel and in a food processor for an even easier option.  This doesn't look as pretty, but would be faster if you're pushed for time.
  
After 2 weeks 
Add all the solid ingredients, pressing down slightly as you go.

Pour in apple cider vinegar until the jar is full, and continue to push down ingredients gently to release any air bubbles.  If you're using a jar with an unlined metal lid, add a piece of baking paper between the jar and lid to prevent the vinegar touching.  

Shake/turn the jar once or twice per day for 2+ weeks.  There doesn't seem to be any sort of time frame people agree on for this stage, some leave two weeks, some two months, some leave everything in and just strain a small amount as needed.  I left mine 3 weeks.

If you use any dried herbs or berries which will absorb liquid, check it frequently and add more apple cider vinegar as required to keep it topped up.

Strain through a fine mesh sieve, pressing all the liquid from the ingredients.   If you used rosehips with seeds, pass a second time through a muslin or jam bag, to ensure any tiny hairs are removed (do not squeeze the bag on the second pass).

Traditional fire cider is often taken with honey, with some choosing to dilute 50/50 at the bottling stage.  I
Finished "fire-ish cider"
didn't do this, as I wasn't sure how my raw or manuka honey would stand up to a vinegar bath.

Instead I added 1 tbsp of hot water (boiled and left to stand) to 1 tsp of fire-ish cider, and added 1 tsp of manuka honey just before serving (don't add boiling water to raw honey or you risk destroying the live enzymes).   You could also add a teaspoon of any other syrups you make, such as elderberry or mixed berry if the taste is too strong :)

Some take one teaspoon daily, upping to several times per day when unwell.  So for younger children 1/2 tsp should suffice.

Other uses for fire-ish cider:
  • Soak a clean cloth in the cider and place on a congested chest
  • As a muscle rub
  • Added to vegetables juices
  • As a salad dressing, combined with a good olive oil
  • To make home-made mustard
  • Splashed into stir fries

Some people retain the solids and use in other food products such as spring rolls.  Can't say I'm entirely convinced what that would taste like, but hey ho let me know if you try it.

Share your finished product widely with friends and family, not least so they won't notice your garlic breath!

Saturday, 14 June 2014

Measles, Are We Being Lied To? Part 1

Part 1
I decided to start my reading around vaccines with measles.  The Scary Mary of illnesses, the one people rush en masse to vaccinate for should a local outbreak occur.  Canadian and American doctors have even discussed whether they should ban the unvaccinated from attending their surgeries when there is an outbreak.

I want to make it clear this post isn't an anti vaccine entry, and the information below does not mean people shouldn't vaccinate - far from it (as I will discuss more in part 2); but if we truly support informed choice, we surely need to separate fact from fiction when it comes to risks of a disease? Transparency is key, right? Furthermore I'm not a doctor, my blog is not medical advice and you are responsible for your own decisions.

I can still clearly remember a feeling of nauseating panic when my youngest got a suspicious rash at just over a year - pre even being offered the vaccine.   I had suffered fairly mild measles as a child, and my mother tells of how the doctors advised how much worse it would have been had I not been vaccinated.   

I ended up on Doctor Google and this was the sort of page I landed on.  This particular one belongs to the CDC
"Measles can be dangerous, especially for babies and young children. In the United States in 2011, 38% of children younger than 5 years old who had measles had to be treated in the hospital."
"For some children, measles can lead to pneumonia, a serious lung infection. It can also cause lifelong brain damage, deafness, and even death. One to three out of 1,000 children in the U.S. who get measles will die from the disease, even with the best care.
Remember this 1-3 per 1000 figure, we come back to it in a moment!

As luck would have it my son's rash subsided, and I didn't really think about the above again until recently, when I added this timeline of measles history in the UK to the blog.  The chart wasn't intended to prove or disprove anything, it was purely a sharing of historical interest.

But here's what I noticed.

1-3 per 1000 as quoted by the CDC is a mortality rate of 0.1 - 0.3%.  For ease let's average it out at 0.2%

In the UK pre vaccine in 1967, 460,407 cases of measles were reported - and of these 99 died. This is a mortality rate of 0.02%

Hmmmm, so mortality was 10 times higher in 2011 USA  than it was in 1967 UK? Really?

Using their figures, 460k cases would have resulted in between 460 and 1380 deaths, rather than the 99 recorded in the UK? For the record 1967 wasn't a fluke year, the mortality rate had consistently been at 0.02% since 1956.

In fact to get figures even close to those quoted by the CDC, we have to go back to 1940, pre NHS, pre the affluence of the 1950's and pre wider antibiotic use. Even then it was 0.2% i.e. 2 per 1000, not the potential "up to 3 per 1000" quoted.

To me it seems there are three possible reasons for this:
1.  The CDC have grossly exaggerated figures.
2.  Measles is up to 14 times more deadly in the US than the UK.
3.  The death rate from measles is now up to 14 times higher than it was in 1967.

The death rates may actually be a far lower percentage than either source state - because until more recently many may not have sought medical assistance for measles, and thus a significant number of milder cases are likely to have gone unreported. People may have been more likely to call the doctor should the illness progress differently or with more severity than expected. This makes sense as I know a lot of parents didn't see the doctor when their child got chickenpox for example (and thus it would never be recorded anywhere).  Even today people with mild measles symptoms who have received the MMR, may not be tested and thus this figure would not be recorded.

I also recently wrote about how different health authorities described chicken pox, ie if there was a vaccine on offer, it sounded scary and serious - where there isn't it's typically described as a mild self-limiting condition.

In this case, although both countries offer the MMR, the NHS data still isn't comparable to that provided by the CDC.  Instead they say:
"It's estimated that around 1 in every 5,000 people with measles will die as a result of a serious complication. (rather different from the 1-3 per 1,000 recorded by the CDC)
Complications of measles are more likely to develop in certain groups of people, including:
  • babies younger than one year old 
  • children with a poor diet
  • children with a weakened immune system, such as those with AIDS or those having chemotherapy for leukaemia, teenagers and adults
Children who are older than one year and otherwise healthy have the lowest risk of developing serious complications."
So using the CDC figures we would have 10-30 deaths from 10,000 people.  Using NHS figures we would have 2 deaths from 10,000 people.  Hmmm extrapolate that to a wider scale and I'm glad I didn't live in the US when I caught measles!

It gets even more interesting.

In 1967 (several years after the introduction of the first measles vaccine), D.J Spencer co-authored a paper that stated the following:
For centuries the measles virus has maintained a remarkably stable ecological relationship with man. The clinical disease is a characteristic syndrome of notable constancy and only moderate severity. Complications are infrequent, and, with adequate medical care, fatality is rare. Susceptibility to the disease after the waning of maternal immunity is universal; immunity following recovery is solid and lifelong in duration.”(2)
Why is that particularly noteworthy?

Dr David J Spencer was the longest serving director of CDC, a highly qualified and respected professional. So much so the CDC now have a museum dedicated to him.

Why has the CDC information about measles changed so dramatically?

I then remembered a book my children used to enjoy reading...

Mr Mischief wakes up feeling pretty pants:


The book continues with a highly amused Mr Mischief, entertaining himself by thinking about how each will pass it to another and how it might affect them all differently. As it turns out Mr Happy had already had measles, and the book tells us you can't get it twice so he didn't pass it anywhere!

Clearly the Mr Men doc hadn't read the CDC page to warn Mr Mischief of the risks of pneumonia, brain damage or death.  And perhaps it's just me but I can't imagine a similar story playing out for say Smallpox or Meningitis?  It would be more Stephen King than toddler fun?

There is also a Tom and Jerry cartoon featuring measles: 

Polka Dot Puss
7.38 minutes | 26 Feb 1949
"Jerry paints Tom's face while he is sleeping. Jerry convinces the cat that he has measles. He puts himself in Jerry's hands for some rather creative nursing. In the end the hoax is discovered, but Jerry does get the measles and then gives it to Tom."

1949 was pre any sort of vaccine, so again I found it interesting it was treated as an apparently lighthearted subject if the disease were as deadly as the CDC now state.

I decided to dig around more to see how measles was perceived pre vaccine - were people sat in fear like they were of other diseases?  Did they experience complications or did they know of anyone that did?

I asked pensioners - most of whom were children of the 40's/50's and it provoked some really interesting discussion. 

There was reference to measles parties, everyone wanted their child to catch it as they knew it was much
more serious to have as an adult. One developed a chest infection as a complication, his mother hadn't sought antibiotics as his siblings had all been fine, and as a result he developed pneumonia (he made a full recovery).  Another said it was typically mild, but if it was more severe you were just more carefully monitored - but of course this was in the days of the doctor making house-calls.  It certainly wasn't feared in the way some diseases were and most considered it something most children got, typically mildly and got over - with the odd child having a more severe case.  Nobody I spoke to knew anyone who had suffered acute encephalitis or death. Rather like chicken pox then?  Another illness that can cause encephalitis.  They were also surprised at the CDC statistic that 38% of 0-5 year olds ended up hospitalised.

Of course (as one pointed out), there is presumably also potential for doctors who are not used to treating measles (and potentially subject to litigation) to admit a patient "to be on the safe side"?  Particularly if they've stumbled across the CDC page!

Measles though isn't all about mortality.
We also need to explore other potential significant or long lasting side effects.

Pneumonia
The CDC state "For some children, measles can lead to pneumonia, a serious lung infection."

We're often told that measles is a virus and thus antibiotics are useless - this is why it's so scary. So it's worth considering that the majority of complications are bacterial and could not only be treated by antibiotics should they occur, but prophylactic antibiotic use in the "at risk/vulnerable" groups could significantly reduce incidence.  A 2006 study confirmed what previous "less rigorous" research had already highlighted, that antibiotic use could result in "80% less pneumonia"(1).

Great Ormond Street say:
"In most cases, pneumonia can be treated with oral antibiotics given to the child at home. The type of antibiotic used depends on the type of pneumonia. Sometimes, if a child does not begin to get better after 48 hours of treatment at home, hospital treatment may be needed."
Of course it's significant to note at this point that given the mass overuse of antibiotics in both humans and animals, the crisis we now face is the number of bacteria becoming resistant to them.  This could mean that should we have outbreaks of measles, such complications could again become much more significant - and potentially at a higher rate than the 1950s.  What's perhaps more worrying though is that without antibiotics to fall back on, anything potentially can.   In the vulnerable a chest infection can quickly progress to pneumonia, a urinary tract infection to kidney failure.

Encephalitis
One thing antibiotics can't treat is encephalitis, a serious condition where brain tissue becomes inflamed; furthermore nobody seems very sure what the rates of this condition are and it seems hotly debated in many circles.

The CDC (who I think we've established are going to give us absolute worst case, and then a bit more) state 1 per 1000 children will develop encephalitis, and I found this  2004 study linked from a couple of pages.  The problem however is I can't establish whether this figure is just for US children or globally.  It reads:
"Encephalitis occurs in less than 1 of every 1000 children with measles. Concurrent vitamin A deficiency increases rates of complications. Children under 5 years of age, adults, and persons with malnutrition or immunodeficiency disorders are at increased risk of complications.
Others who cite this study refer to "1 of every 1000 patients with measles" ie including adults or those who are at increased risk as highlighted by the NHS.

A study examining data from 1962-1979 found that of the children who developed encephalitis, around 15% died.  A further 25% suffered long-term problems as a result.

It gets more controversial right about now as some are adamant vaccines themselves are linked with encephalitis, and here whilst others absolutely refute such a condition exists.  A figure generally accepted by official authorities is 1–2 per million develop encephalitis following measles vaccination.  Others claim this figure is not accurate as doctors are not adequately diagnosing mild to moderate encephalitis in post-vaccinated infants.  Going to move along otherwise this piece could run forever I fear - however you can read more about encephalitis here.  It's also interesting to note that the herpes virus (that causes coldsores) is currently the leading cause of encephalitis in the US/UK & Ireland.

Going back to the 2004 study above, they note another interesting point:
In developing countries, measles case-fatality rates are 10- to 100-fold higher than in developed countries; ∼770,000 children died of measles in 2000. Older age at infection, vitamin A supplementation, and antibiotic therapy for secondary bacterial infections have reduced measles-associated deaths in the developing world.
The CDC agree:
"About 150,000 to 175,000 people die from measles each year around the world—mostly in places where children do not get the measles vaccine."
Perhaps it's just me, but this statement appears to imply that lack of vaccine is why some areas have such high figures.  This could lead someone to believe without vaccination we would suffer the same fate.  As the previous paper highlights this is clearly not the case.

I decided to look into any papers published around the time of vaccine launch, and I turned up this - published in the British Medical Journal, London, 1963:
"Before large-scale vaccination against measles is undertaken certain problems must be considered. There can be no doubt that an effective vaccine is needed for children who are especially liable to develop severe measles-for example, mentally defective children in institutions or children in underdeveloped countries.  But the need or desire for a vaccine for the general population of Great Britain is much less certain
Measles is now a mild disease, and many parents and doctors may feel that no protection against it is required. However, it is necessary to consider the encephalitis which follows measles in about 0.1% of cases," for though the risk may be slight for an individual child there will be a significant number of cases of encephalitis in the country during the biennial measles epidemics.
Another problem to be considered is the long-term effect of mass vaccination and the possible eradication of measles in a country such as Britain. The disease has a world-wide distribution, but its effects vary in different populations. In Nigeria, India, and South America measles is endemic, but the disease is severe and an important cause of death in childhood. In Chile'" the annual death rate from the disease rose during the period 1950-60 to 27.7 per 100,000 of the population, and 6.5% of patients with measles died.
This is in sharp contrast to the picture in Britain, where the death rate from measles has been steadily declining.
When measles has been introduced to " virgin soil" in such isolated communities as Greenland, Tahiti, Tristan da Cunha, and Northern Australia devastating outbreaks have resulted in which the entire population has become infected. Like other infections which usually attack children measles tends to be more severe in adults. This has been observed in gold miners in South Africa. Many of the Africans contract the disease when they come to work in urban areas, and in them prolonged fever is common, with temperatures which often exceed 1040 F. (40° C.). No doubt better nutrition and living standards play a part in determining the mildness of measles in Britain to-day, but it is probable that, as Sir Graham Wilson has suggested, there is some natural immunity to the disease in this country. This has little effect in preventing attack but appears to protect against death. If herd immunity were not preserved by clinical attack or by vaccination, the population would be subject to epidemics. Thus if measles was eradicated by vaccination a high rate of vaccination in future generations would be essential to maintain herd immunity. If herd immunity were allowed to wane at a later date-and it is notoriously difficult to maintain a high rate of vaccination against a non-existent disease -then the reintroduction of measles from another country might result in epidemics in both children and adults much more severe than are seen in Britain to-day. These are problems which need further thought." (3)
So, basically measles was typically mild with roughly 0.1% developing encephalitis. What's more, in addition to the risk factors previously identified, socio-economic status also appears influential.  A study entitlted "Measles mortality in the United States 1971-1975" noted:
"Mortality rates were higher in non-metropolitan than in metropolitan counties. Measles mortality rates were inversely related to median family income."
Again, this doesn't mean vaccination isn't a good idea, but I can't help but feel that the methods used to try and increase vaccine uptake by some are worthy of further examination. It's well recognised in several areas of maternity care that health care providers may at times try and obtain control via fear - by the implication of, or direct statement that, one or both parties may die or suffer significant consequences if one does not do as advised.

The shifting language and portrayal of measles has successfully moved it in the minds of most people, from typically mild with complications mostly occurring in the vulnerable, to parents peeing themselves at every blemish their child develops.  

Whilst this is clearly likely to improve uptake rates, it feels deceptive - as though someone somewhere thought had I been in possession of the facts without added drama I might have been less likely to comply.


1.  Prophylactic antibiotics to prevent pneumonia and other complications after measles: community based randomised double blind placebo controlled trial in Guinea-Bissau. BMJ 2006; 333 doi: http://dx.doi.org/10.1136/bmj.38989.684178.AE (Published 14 December 2006)
2. D. J. Sencer, H. B. Dull, and A. D. Langmuir. Epidemiologic basis for eradication of measles in 1967. Public Health Rep. 1967 March; 82(3): 253–256.
3.  Br Med J. Sep 28, 1963; 2(5360): 759–760.
4. Herpes simplex encephalitis treated with acyclovir: diagnosis and long term outcome, J Neurol Neurosurg Psychiatry 2002;73:237-238 doi:10.1136/jnnp.73.3.237

Monday, 19 May 2014

Which Side of the Vaccine Debate am I?

“Your assumptions are your windows on the world. Scrub them off every once in a while, or the light won't come in.”― Isaac Asimov

I avoided discussing vaccinations for years, as any attempt to read more left me more confused than a chameleon in a bumper bag of skittles.  Life was hectic and so I mentally shelved vaccines until such a time as more brain space was available.

This probably turned out to be a good thing, as boy do people get prickly when the topic hits the table.  It seems to turn a board of calm, rationale, adults into venom-spitting balls of fury faster than any breastfeeding or birth debate.

Like the above topics, vaccines are something all parents have to consider at one time or another - the first red flag that a discussion may get emotive. Regardless of which side of the fence they are on, nobody likes to consider they may not be doing the "right" thing for their child - it provokes a defensive response.
As a result you are given an "in or out" label, grey does not exist in the vaccine world - you're either "pro" or "anti" - period.
This makes little sense to me when vaccines cover such a vast array of illnesses - because when it comes to medicine, risk/benefit is key?

Let's consider birth.  C-sections for a baby carry an increased risk of breathing difficulties immediately postpartum, particularly pre 30 weeks. Yet if baby or mum are in significant distress, the benefit of the procedure outweighs the risk.

Similarly guidance of if, when and how to use a drug, and any risks of doing so, are weighed up against the benefits.  So a drug may be not recommended for one condition, yet prescribed for another - even when the same risks exist (although in reality there will always  be variation as different users will have different risk factors).

The same surely applies with vaccines?

Nobody, not even the staunchest vaccine supporter can claim vaccines are risk free.  Taking a paracetamol is not risk free - yet millions do that daily.  Nor does something need to be risk free to be the best choice - as discussed above, the benefits may outweigh the risks, or the risks may be so statistically insignificant that it's a no brainer.

The point is risks exist to taking a medication, and risks may exist from not taking it too.   
Furthermore, just like with medicines the risk/benefit is also variable depending upon what disease we are discussing and who we are talking about.  So the risks to an 8 day old baby, compared to an 8 month old, 8 year old or 80 year old - all located in different parts of the world will be completely different.  Whether we are talking chicken pox or smallpox also matters.

Even two different health authorities can arrive at different conclusions about the same disease:

The Centers for Disease Control and Prevention (CDC) have a page about chickenpox:
"Once it gets going, chickenpox is very contagious and can catch up with anyone in its path who’s not received chickenpox vaccine. Before the vaccine was available, about 100 people in the U.S. died each year from chickenpox. Fortunately, you can make yourself nearly invincible against chickenpox if you get the vaccine."
Compared to the UK NHS:
"Chickenpox is a mild and common childhood illness that most children catch at some point. Chickenpox in children is considered a mild illness, but expect your child to feel pretty miserable and irritable while they have it. Complications of chickenpox are rare in healthy children. "
Let's hope they don't meet on Facebook.

Because here is what happens to me:

Whenever I have reposted anything vaccine related, or posed a vaccine question/topic - it's amazing how offended people become.  Not about anything said - but that it has been posted at all.

"There is no debate to be had" (I'm often told), "It's irresponsible to post articles without hard evidence to support the content", "You should stick to breastfeeding I follow your page for that", "Stick to what you know, you're not an immunologist", "It's clear you're anti-vaccines, it's clear you're pro-vaccines" (depending upon the content shared, sometimes I get both for the same piece!).

I'm glad they know what stance I have as I don't - not if we are bringing it down to for and against ALL vaccines for ALL people....

I'm absolutely not an immunologist or any other sort of doctor, neither my blog nor my Facebook page is intended as medical advice.  However I am a parent - one that is faced with choices regarding vaccination and one that sees lots of grey (on both sides), where people are trying to pretend it doesn't exist.  Perhaps we humans just prefer definitive?  Maybe we feel safer that way?

Recently I posted an article from a highly respected journal suggesting immunity from the measles vaccine may not last as long as previously thought in some people.  Lordy were some irked I had shared that, I had several messages that people were unliking the page as a result.

Yet I (naively) thought it would be something of interest to those on team pro vax too; knowing how long it lasts is probably pretty key in knowing when to get another if you want continued protection?  If this is shorter than previously thought do we need to re-vaccinate if the plan is to generate "herd immunity"?

A lot of people it seems can't discuss the flaws and merits of a single piece of writing - not without the entire topic of vaccinations as a whole exploding,    It goes like this:

"A person already vaccinated against measles was at the centre of an outbreak xxx reports"
"Yes I read something recently that some suggest it may not last as long as previously thought"
" My sister's, friend's daughter is BLIND from measles, I will take my chance with the vaccine thanks"
" Me too, an autistic child is better than a dead one"
" We didn't vaccinate, filling a child's body full of toxic chemicals - no way!"
" MILLIONS of people die worldwide from measles, mothers in India would be grateful for the chance to vaccinate, I'm unliking this page!"
" Measles wasn't a serious disease pre vaccine anyway, do your research!!!"
"Oh here we go more "woo woo" - let me find my tinfoil hat.
"Not vaccinated?  Keep your measles incubator away from my child, and be grateful we vaccinate to keep your child covered with herd immunity.
"Herd immunity is a myth"
"We live in an age now nobody has seen the impact of these DEADLY diseases - here look at this picture of an iron lung!".
"Smallpox hasn't even been eradicated, diagnostic criteria has just changed".
"I believe my doctor knows best after all his training, I'm just a parent and if he recommends it I will do it!"
" Then you're stupid and small minded!"

I usually have to start getting heavy with delete round about now.

Consider that parents will see much popular material shared via one group or another, I frequently see things shared on numerous groups I follow.  I like to see the discussion surrounding it, as it raises things I hadn't considered or confirms what I already suspected.  I also think that if you're "right" you don't need to insult, mock or turn the discussion completely off topic - just tackle the material in hand and educate people as to why it is incorrect.

I truly believe the concept of "blind faith" has gone from medicine - so you can either engage, or someone else will...

So, all that said - where do I stand?  I started from the default point many do ie I hadn't given it much thought but presumed it must be a good idea because otherwise why would the government do it?  I started questioning really because I realised other things I had blindly accepted were wrong.  It reminds me a little of  something I once read highlighting that a child realising Santa isn't real is far more likely to question their belief in the existence of God. We realise blindly believing can at times be wrong - so we question other things we also took on "faith".

That doesn't mean we wont arrive back at the same viewpoint held originally, just like someone who questions their faith may indeed return, often stronger for their journey of exploration.

From there, some things have become apparent, some are still just as confusing as ever - and some are ever evolving "what if"; so these are my thoughts as a parent - I have no agenda.  If you work out which camp I am, do let me know.

Thursday, 17 April 2014

Grain Free Lazy Lunch Box Ideas - Mini Sausage & Egg Balls.

Whilst my blogging friends turn out perfectly pristine sourdough or schiatta (my attempts at the first not a million miles away from my pronunciation of the latter), I'm blogging about sausage balls.  Something which qualifies as a recipe about as much as "mash a banana with baby's usual milk" does, although hey many years ago I bought a book full of such gems.

This is definitely more a chucking together of a few items, but since I keep getting stuck in a lunchbox rut, I thought I would pin some things that go down well.

These are a mini scotch egg without the breadcrumbs.  If you prefer them coated, or have mastered that perfect loaf and have some left - dip the balls in seasoned flour, egg and then crumbs.  Redunk in egg and crumbs again (to prevent splitting whilst baking).

The size of these makes them ideal for smaller hands and with summer on the way, picnic food!  Stick on a cocktail stick for extra glam.

What you need:
Quail eggs
Good quality sausages
Seasoning if sausages are plain
Egg (optional.)

To go a step further in the "how quickly can we pack tomorrow's lunchbox" stakes, some supermarkets sell quail eggs pre cooked and peeled...

Otherwise cook your eggs as per guidelines here, plunge into cold water when cooked.  Then unless you want to spend the rest of eternity trying to pick of minuscule bits of shell from a rather fragile egg, let them cool before peeling.

Whilst waiting, snip the end off your sausage skins and squeeze out the meat into a bowl.  How many you need depends on the size of your sausages; if they're a chunky cumberland number one per egg would suffice I'm sure.  If they're skinny you might need one and a half.

If you're not using seasoned sausages add that now - if you want them to taste more like traditional scotch eggs, 200g sausage needs approx 1 heaped tsp sage/thyme/parsley, a pinch of ground mace and a heaped tsp english mustard.  If you want a kick add some paprika, cayenne and black pepper.

Sneak in healthy extras like spring onion finely diced, garlic, fresh herbs etc now if desired.

Add a small amount of egg if using, a tsp is usually enough for 6 quail eggs to make it slightly looser and easier to wrap around the egg.

Take a small meatball sized amount of meat, and squash flat to a depth of approx 0.25cm.  Place the egg on top and bring the edges together, smooth out any seams and roll them about until you have neat ball shapes - or until you get bored and figure one flat side isn't the end of the world.

Sit them on a baking tray (or in a muffin pan if you have rolling issues), and bake at 180 for 20-30 minutes as you would sausages.  Turn them regularly to cook all sides evenly.

I should really have cut one in half to attempt a suitably arty shot, however then the kids wouldn't consider it lunch boxable and this was around 11pm - so strategically placed chives were never going to happen.

If you have other quick, grain free lunch box ideas - please share and I will repost :)