The 2013-2014 beijingkids Health Guide is the latest resource for Beijing families dedicated to providing information on family health care, maternity, eating and breathing safety, mental health, emergency care and traditional Chinese Medicine. Articles from the guide will be featured twice a week on our website. Find the full version here.

A recent study from The Chinese Society for Environmental Sciences revealed that the average incidence of asthma amongst children in China is a staggering 6.8% and rising. With asthma now being stated as the leading cause of hospitalization amongst infants in China, expats need to be well prepared for the pollution that they and their families are inevitably going to be exposed to in Beijing.

Dealing with Beijing’s pollution can be a big enough challenge for anyone. A dry cough, congested throat and feeling short of breath are common complaints for Beijing residents. But how does one cope when you add asthma to all of these problems? Dr. Pauline Tan, Chief of Pediatrics at Vista Medical Clinic, believes asthma is becoming increasingly common here in the capital. “It’s definitely gotten worse over time,” she announces. “Even in the seven years I’ve been at Vista, I can see a larger number of children coming to the clinic seeking treatment for asthma or related breathing issues.”

For families looking to protect their kid(s) from the Beijing smog she offers the following tips: “The first thing to be aware of is the triggers of asthma,” she advises. “Contrary to popular belief, exercising is not actually the biggest trigger for children. Nor are emotionally stressful situations,” she adds. “As they move into adulthood, exercise becomes more and more of a factor, but for very young children it has minimal impact,” she points out, adding that “Viral infections are what parents should watch out for the most as these can very often induce asthma in children. If your child is sick you should be keep him as far away as possible from places harboring a lot of bacteria, do not send him into school and most importantly, do not smoke in his presence. Studies have shown that children whose parents smoke are at a particularly heightened risk to developing asthma.”

Dean Phelan is 23 year old Irishman living in Beijing who suffers from asthma. He describes his asthma as quiet severe at home in Ireland but says that it has been a lot worse since coming to Beijing. “As an English teacher I have to avoid running around with the children during playtime completely if it’s a very polluted day. I can’t do it without gasping for breath,” he says. “Even running for a bus or climbing a flight of stairs was completely out of the question for me this winter when the pollution was at an all time high.” Phelan also stated that during the winter over 1/3 of his class was absent because of the pollution. “A lot of the parents actually took their children out of Beijing and back to their hometowns just to get them away from the pollution.” he says.

Dr. Tan explains that pollution levels are generally higher in the winter because there is more coal being burned, especially indoors. “People are actually exposed to the majority of pollutants indoors,” she explains. “If you think about it logically it’s where people spend most of their time.”

Dr. Tan advises Beijing resident to buy air purifiers and make sure their houses are properly ventilated. “Many homes in Beijing use gas cookers so this is particularly important. You should also avoid carpets, stuffed toys and any other items that can contain hypo allergens, and I would advise patients to shower in the evenings before they go to bed, especially girls with long hair,” she adds. “You collect so much debris and pollutants throughout the day and it can cling to your skin and hair. It’s better to wash it away before you go to bed so that you aren’t being exposed to it in your sleep.”

And although masks can help reduce pollution intake, they can be somewhat impractical because people just aren’t committed to wearing them. “Of the 24 children in my class, only one wears a mask on a daily basis and these will include many children that come in coughing and wheezing on a regular basis,” says Dean.

Wheezing is cited as one of the main symptoms of asthma and will often become more predominant during the onset of an asthma attack. Abdominal restriction (which can cause chest pain) is another telltale sign, as the abdomen contracts in an effort to draw in more oxygen. According to Dr. Tan, in these types of situations “everyone should have an asthma action plan.”

Asthma can be divided into either intermittent or persistent cases. “For the intermittent cases we provide patients with what we call inter-control medication,” she explains. “The most common thing prescribed for these patients is Salbutamol which taken by an inhaler.”

Persistent cases, the more serious of the two, are defined as a patient having two or more hospitalizations as a result of asthma in one month. “Maintenance meds are prescribed for these types of patients,” Tan elaborated. “A course of steroids is what is mostly used. The word “steroids” will often scare patients and parents,” she says, “but trust me they are necessary severe cases.”

In cases where the patients prescribed medication isn’t effective enough, patients should be brought to the hospital ASAP. “In some cases I’ve seen patients take two or three rounds of a nebulizer before being responsive,” Dr. Tan explains. “I know some parents who bring their child to a clinic everyday to get a dose of a nebulizer,” she adds. “If a child really needs it that much, you can rent the nebulizer from a hospital. Check with your local clinic.”

Dean says that aside from his doctor in Ireland telling him it was a bad idea to go to Beijing in the first place, he prescribed him with steroids before he left, in anticipation of the pollution affecting him badly. “It is actually worse than I was expecting” he confesses. “I take my reliever a lot more over here than I did at home and I have a supply of steroids at the ready just in case.” Phelan said that for him it’s about knowing what his own personal triggers were and what works best for him. “For me, Vicks Vaporub helps a lot,” he says. “It’s best to just stock up on what you need before you come over because you won’t always be able to find it over here. I’ve had friends bring over at least three tubs of Vicks for me since I got here.”

He also cites the lack of smoking ban in China as a problem for him. “Shisha pipes are definitely a personal trigger of mine. When I’m going out I would actually take the smoke levels of a bar into consideration, especially if they sell shisha pipes. Any incidents I have had over here have occurred after being exposed to smoke from shisha pipes. I just can’t be around them,” he says.

When asked if she had ever advised any patients to leave Beijing, Dr. Tan responds by saying that “she would give them the option. You can’t say it to a patient outright,” she said, “and it depends on their priorities because many parents have very high-paid jobs here. I would however, present the facts to them and tell them what it would mean for them and their family’s health if they were to stay in Beijing.”

Dean says that he “could never live in Beijing permanently. I can already see how badly it has affected my health,” he declares.

Every city has its ups and downs, but in Beijing’s case there is little one say to downplay the severity of its air pollution. It can be bad as people say it is and is a serious consideration for people who suffer from breathing problems. No matter how long you are committed staying in Beijing you should be proactive and practical about protecting your lungs while you’re here.

This article originally appeared on page 40-41 of the beijingkids Health Guide.

Click here to see the Health Guide in full.

Some of the articles covering the seven areas (family health care, maternity, eating and breathing safety, mental health, emergency care and traditional Chinese Medicine) within the guide will be featured twice a week on our website.

Can’t find the print edition? Send an email to distribution@beijing-kids.com
or call 5820 7700/7101. You can also browse the contents and comment on the beijingkids website.

Photos by Mitchell Pe Masilun and Sui

At first, having a natural birth in Beijing can seem like a daunting task. Living in a foreign country can be intimidating enough, but when you add potential language barriers and unfamiliarity with the Chinese healthcare system to the mix, fear and worry will inevitably emerge. Expectant mothers and their partners want nothing short of a “perfect” birth. For many, this means giving birth naturally. The good news is that this isn’t as difficult to accomplish in Beijing as one might think.

Jess Meider, a former healthcare professional, yoga instructor, and professional musician, gave birth naturally to her daughter in November 2012. “After doing my research, I decided to give birth at Beijing United Family Hospital,” she says. “I’d already worked there for five years and many of the staff still remembered me, which made me feel very comfortable.”
“They were very accommodating. My husband and doula were permitted in the room, something that I was very adamant about,” she says. “Once you know what your expectations are and you communicate them clearly with the hospital, a natural birth is very achievable.”
Communication with the hospital staff is paramount, whether it takes place between healthcare professionals, expectant moms, or doulas and midwives. In that sense, language barriers can potentially be a huge obstacle for moms-to-be. One way to overcome this is by finding a bilingual doula.

Doulas and Midwives – What’s the Difference?
Doulas support the mother throughout her pregnancy, labor, and post-delivery. They offer both physical and mental support and often live with the mother for the duration of her pregnancy. According to international doula association DONA International, doulas are professionals trained in childbirth and childcare. While this is certainly the case for many, formal training is not a strict prerequisite for all doulas in China. For example, doulas might simply be a family friend or relative.
Robyn Wexler, an American-born bilingual doula based in Beijing, completed her doula training ten years ago in San Francisco. She says that doulas play a vital role when it comes to those “awkward translation moments.” If you are at all anxious about language barriers, be sure to find a doula who can support you and ensure that none of your needs or requirements are lost in translation.
Ivy Makelin is the leader of the China branch of the La Leche League, an international non-profit organization dedicated to helping breastfeeding mothers by providing information and mother-to-mother support. Herself a mom, she also offers consultations and advice on a variety of topics. “When it comes to giving birth naturally, having a birth plan in place is very important,” says Makelin. “You need to be very clear about what you want and don’t want. When you’re researching hospitals, have your questions ready. If they don’t have everything you need, then move on to the next one.”

Going Native
The question of whether or not Chinese hospitals should be considered if you are planning a natural birth often comes up. Chinese hospitals have notoriously high C-section rates – the highest in the world at 46 percent, according to the World Health Organization. A staggering two thirds of urban Chinese women opt for a C-section and that figure is thought to be rising.
“If you are worried that your hospital is going to try and push you into having a C-section, the best thing to do is to ask your doctor lots of ‘what if’ questions,” says Makelin. “Ask them what they would do if something went wrong, at what point in a long labor would they opt for a C-section, and so on. This is a very easy way to gauge how inclined they are to perform C-sections without actually asking them directly.”
Jess Meider has hope for Chinese hospitals when it comes to natural birth, but says it depends a lot on your own attitude and mindset. “Chinese hospitals won’t offer the same kind of privacy that an international one would,” she says. “Bedside manner doesn’t exist. If you can get your head around that, then it might be OK.”
“It’s all about knowing what kind of environment you’re comfortable in and trusting your body to do the job it’s designed to do,” she says. “If you’re a bit anxious or unnerved by that sort of thing, then it probably is best to choose an international hospital. [However,] natural birth can be achieved in a Chinese hospital if you really want to.”

Testing the Waters
Water births are often sought out by those who want a natural birth. According to Water Birth International, the process can help reduce pain for the mother and ease a baby’s transition into the world. As it stands, there are two hospitals in Beijing that offer this service: Beijing Antai OB/GYN Hospital and Harmonicare Women and Children’s Hospital.
Water births are not very common in China. Officially, the first one on record occurred at Antai in 2004. It should also be noted that water birthing tubs are only available during the labor process; women must get out for the final stage of the birth. Makelin is one mother who has used Antai’s water birthing facilities. “I didn’t want to get out at the time,” she recalls of her son’s birth back in 2008. “I was so relaxed. But none of the hospitals here offer [a full warter birth.]If you want [one,] your only option is to do it at home.”
There have been many cases of women giving birth at home in Beijing, but there are no facilities in place for this in China. Women who take this course of action usually need to recruit internationally-trained midwives and bring them to China. Despite being technically illegal, many cases of home births are still believed to happen in Beijing. The only other alternative for foreign expectant mothers who want a home birth is to return to their home country.

Finding a Support Network
One of the most useful resources that mothers have is the Beijing Mamas Yahoo group. Here, women can seek advice and read first-hand accounts of women who have given birth in Beijing. In addition, there’s the baby and pregnancy section of the forum on beijingkids (www.beijing-kids.com/forum).
There are also pregnancy and breastfeeding support groups like the one hosted by Beijing Mamas founder Liora Pearlman every month at Beijing United Family Hospital or the new Bumps2Babes group that meets at SOHO Shangdu every Friday morning.
Whatever your birthing expectations are, it’s important to remember that things don’t always go according to plan; there are cases where a natural birth simply isn’t possible. Should that happen, there’s no need to be disappointed. As long as you bring a healthy child into the world and raise it in a caring and loving environment, you have already accomplished the greatest task any mother can.

Resources

Beijing Antai Maternity Hospital 北京安太妇产医院
Daily 8.30am-5pm. Bldg 18, Court 1, Xingheyuan, Jiayuan Lu, Fengtai District. (67735551, 67537768) www.antaihospital.com 丰台区北京丰台嘉园路星河城1号院18号楼

Beijing HarMoniCare Women and Children’s Hospital (HMC) 和美妇儿医院
Daily 8am-5pm. A2 Xiaoguan Beili, Beiyuan Lu, Chaoyang District (6499 0000, contact@hmcare.org) www.hmcare.net 朝阳区北苑路小关北里甲2

Beijing Mamas
This Yahoo group is a space for parents to share resources and ask questions about family life in Beijing. Membership is free, but must be approved. To join, visit groups.yahoo.com/group/Beijing_Mamas.

Bumps2Babes
This pregnancy and breastfeeding support group meets every Friday morning from 10-11.30am at SOHO Shangdu (beside The Place and Central Park). For more information, contact beijingbumps2babes@gmail.com.

English Breastfeeding and Pregnancy Support Group
Lay-led by Liora Pearlman, this group meets on the second Friday of every month at Beijing United Family Hospital in Lido. For more info, contact lioracc@yahoo.com.

La Leche League (LLL)
LLL is an international organization that specializes in breastfeeding advocacy and support for new and expecting mothers. The China branch is led by Ivy Makelin. To find out more about LLL, visit www.llli.org or muruhui.org.

photo by Mitchell Pe Masilun

This article originally appeared on p78-79 of the beijingkids October 2013 issue.

Check out the PDF version online at Issuu.com

The 2013-2014 beijingkids Health Guide is the latest resource for Beijing families dedicated to providing information on family health care, maternity, eating and breathing safety, mental health, emergency care and traditional Chinese Medicine. Articles from the guide will be featured twice a week on our website. Find the full version here.

It wasn’t so long ago when dental care was considered more of a luxury than a medical necessity in Beijing. Times have changed, of course, and now the capital has plenty of dental care experts and facilities, including a number catering to the international community. But for expats living in a place as dynamic and exciting and Beijing, it’s all too easy to forget those regular checkups they undergo back home. “Unfortunately we take in a lot of emergency cases, which we are always happy to do but it’s better for patients to take more care of their teeth on a regular basis,” explains Pat Christie, Marketing Manager and Patient Educator at the International Dental Clinic (IDC). “It’s very easy for your dental plan to fall by the wayside when you move to a foreign country.”

So what can you do to avoid neglecting your teeth while you’re living here in Beijing? Dr David Lee, OASIS International Hospital, advises that “the first thing people need to do is find themselves a regular and reputable dentist. At home people have the same dentist that they’ve been going to for years but when they move to Beijing they usually don’t have that consistency. My advice to expats is to find a dentist near you that has a high standard of care, especially if you’re planning on being here for the medium to long-term.”

He also points out the practicality of having the same regular dentist. “Medical records.” he exclaims. “How are you supposed to expect the best care for you and your family if you are moving from one dentist to the next? There’s no record of what kind of treatments you’ve had up until now so it slows down the process and very often leaves the job half-done. Continuity is vital when it comes to dental care.”

In addition to familiarizing yourself with a Beijing based dentist, both Christie and Dr. Lee offer some additional tips for families. “The water in China is not fluoridated,” Christie explains, “and fluoride is absolutely, 100% proven to help strengthen your teeth and cleanse them. I’m not encouraging people to overuse it but an occasional fluoride rinse can work wonders for your teeth and many patients will miss this, especially if they come from the US.” She too, is keen to stress the importance of continuity. “Coming in for cleaning every six months is highly recommended,” she says. “We are constantly trying to reach out and educate the community here at IDC. We do many talks in the international schools in an effort to get the children into good dental habits when they are young.” According to Dr. Lee, it goes back to the age old saying, prevention is better than cure. “Don’t wait until it hurts! That’s the number one thing I tell my patients.”

One of the things to avoid is places that offer mass discounts on treatments, warns Lee. “If you see a place offering a treatment for RMB 2,000 that other places are charging RMB 6,000 then the alarm bells should be ringing. You need to be asking yourself why they can afford to offer it this cheap. They need to be doing at least one of two things, either using poor quality materials or poorly trained staff. “This is your mouth you’re talking about,” declares Lee. “Do you really want to be putting something of low quality inside of it?”

He goes on to explain that in many cases it is fine to go to local dentists, but only for what he defined as “non-threatening procedures.” For any kind of surgery or complex procedure (these include crowns, implants, root canals and braces) you should only seek out an international clinic. “There is nothing worse than undergoing a poorly carried out procedure. If a patient comes to me after a root canal gone wrong and asks me to fix it, there’s very little I can do sometimes. It is ten times more difficult to fix an operation gone wrong than to do it right in the first place. If it is a case of doing it half right, it is better to simply do nothing at all.”

“IDC has internationally trained specialists to carry out surgeries and we bring in consultants regularly. That being said, if something is ever beyond or scope we will give a referral,” admitted Christie. “And that’s very important,” she elaborated. “You need to know your limits and what’s best for the patient. Some local clinics will operate beyond their scope at times which can have an adverse and in some cases, disastrous effect.”

It’s true that if you want good quality, then you have to pay for it. Both IDC and OASIS will charge the same and in some cases more than you would expect to pay at home. As far as Dr. Lee is concerned if he can offer you the same or even better service at OASIS than you would receive at home then he is “saving you the cost of a round trip.” He added that “when people leave and feel that they’ve gotten the same kind of service that they are used to in their home countries, that’s when I know I am winning.”

Christie also explains that internationally trained and accredited dental care professionals will inevitably charge international prices. “We offer price discrimination based on what particular professional you want to carry out your treatment but they will all invariably charge prices based on an international standard. If you want to receive an international standard of care then you can expect to pay an international price.”

Both parties cited sourcing materials as their biggest challenge whilst operating in China. Lee also pointed out the fact that there is a huge shortage of internationally trained dentists available. This of course, explains why prices are can vary so much from clinic to clinic and why some charge much more than others. You are paying for the scarce resources i.e. highly trained professionals and high standard materials. When it comes to your teeth however, that may well be a price worth paying.

This article originally appeared on page 16-17 of the beijingkids Health Guide.

Click here to see the Health Guide in full.

Some of the articles covering the seven areas (family health care, maternity, eating and breathing safety, mental health, emergency care and traditional Chinese Medicine) within the guide will be featured twice a week on our website.

Can’t find the print edition? Send an email to distribution@beijing-kids.com
or call 5820 7700/7101. You can also browse the contents and comment on the beijingkids website.

Photo by Lova Li