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There are many costs to using the emergency department for non-urgent care.


There’s the literal cost of care, given that emergency room visits generally have higher co-pays than clinic visits.

There are also plenty of figurative costs. Bringing your child to the emergency department when she does not have a serious illness or injury is likely to lead to a long wait, because she will be triaged behind the actual emergencies. After that long wait, you’re likely to receive an unsatisfying diagnosis and/or treatment: a Band-Aid for a cut, a directive to drink fluids for a run-of-the-mill cold, etc.

These experiences may erode your trust in the emergency department, especially when you receive the bill. It’s hard not to feel snubbed, like your child’s pain doesn’t matter, even when you are being told that your child is medically fine.

If you and your not-so-sick child are in the emergency department all night, both of you might miss out on a good night’s sleep, and, as a result, school and work tomorrow. While logging all that time in the waiting room, you and your child are also susceptible to hospital-acquired infections from all of the other sick patients.

Visiting an emergency department for a non-emergency can also have longer-range consequences. Taking a child to the emergency room for common ailments like ear infections can harm continuity of care, argues a recent review article in the The Journal of Pediatric Health Care.

When parents seek treatment for such issues at the ED, their children’s primary care providers (PCPs) might not receive valuable information about different illnesses. Without knowing how many ear infections or cases of strep throat a child has had, a PCP will not know whether or not to recommend interventions, like tympanostomy tubes or tonsillectomies.

All of these consequences focus on your child, but there are consequences for other people, too – including the truly sick children whose care may be delayed by overcrowded emergency departments or by overstretched hospital staff.

Given all of the negative consequences of bringing children to the emergency department for non-urgent conditions, it’s surprising that so many parents are doing it. A study of 31,076 emergency department visits from 33 different pediatric practices found that nearly half of those visits (47 percent) were classified as non-urgent by hospital staff. In other words, roughly half of children being seen in the emergency department did not need to be there.

Why are so many parents bringing their children with non-urgent conditions to the emergency department? How can you avoid being one of those parents?

It’s rarely a matter of life and death

The ED is for acute medical problems that may kill or maim if left untreated, which is why many hospitals around the country use the Emergency Severity Index to triage patients. The ESI’s triage algorithm is easy to read and worth parents’ time, because it shows exactly what a triage nurse or other healthcare professional will be asking when evaluating your child’s case.

The ESI flow chart begins with one easy question: “requires immediate life-saving intervention?” A “yes” answer leads to an ESI score of 1, and hasty attention in the ED.

A “no” answer leads to another set of questions. If the situation is not high-risk, the triage score will be somewhere between 3 and 5, depending on how many resources will be required to help a patient. If a patient does not require any resources (say, for a cold or flu), then the patient will be scored a 5. Many parents who bring their children to the ER for non-urgent categories will get a 4 or 5.

Why parents head to the ED

If their children are not at serious risk, why are so many parents heading to the ED?

One recent study found that parents’ tended to rate their children’s conditions more severely than medical professionals did. The hospital staff determined that of 381 visits, 298 (78.2 percent) were non-urgent cases.

In other words, just over two in 10 patients actually needed emergency care. However, almost 40 percent of parents asked to rate their children’s conditions reported that their children needed emergency care.

One explanation for overuse of pediatric emergency services is that parents, who are, on the whole, less experienced medical providers than doctors and nurses, are simply not good at evaluating whether or not a medical condition constitutes an emergency.

That explanation, however, fails to account for the nearly 40 percent of parents in the study who brought their children into the ED knowing that they had a non-urgent condition.

One way to better understand why parents bring their children to the emergency room is to simply ask them. Two different interview studies have done just that, questioning parents who took their children to the ED for non-urgent conditions. Both studies took place on weekdays during normal work hours, in order to determine why parents chose the emergency room over a PCP.

In the first study, researchers identified three main reasons for choosing the ED over the PCP. Some parents indicated that they chose the ED because their PCP recommended it, either after an in-person visit or after a phone call.

Another group of parents chose the ED because of problems with their PCPs, including impolite staff, confusing directions from the PCP, or even a PCP whose accent was confusing to parents. Parents also saw advantages to the ED, which was available for walk-ins and might be closer to home.

The second study found similar reasons for ED use, but went a step further in matching those reasons to parents’ health literacy. Researchers found that parents with lower health literacy tended to seek care for a diagnosis and treatment, while parents with average health literacy usually came to the ED with a diagnosis in mind but seeking reassurance from a trusted source.

Both groups feared “getting it right” when it came to their children’s diagnoses. In that sense, the ED operated as a space to reassure parents that they were providing good care to their children.

The most interesting finding of this second study was that all parents heard alarm bells over some symptoms. No matter how much health literacy they had, nearly all parents in the study panicked about fever. Parents feared ear damage, brain damage, and other consequences frequently misattributed to fever, and took their children to the ED even when it was not recommended by their children’s PCPs.

What’s the best way to keep your kids out of the ED?

Boost your own health literacy.

What’s clear from the interview studies is that parents with stronger health literacy are better assessors of risk, better able to distinguish between non-urgent, urgent, and life-threatening situations.

1 | Learn to identify true emergencies

You’ll probably know a true emergency in the unlucky case you see it, but if you need reminders, the American Academy of Pediatrics’ Healthy Children site for parents offers a useful list of situations that count as emergencies.

Although medical emergencies come from the whole alphabet, remembering just the Bs is a good start: behavior changes (like disorientation), bleeding, breathing problems, broken bones, burns, and button batteries (only if swallowed). All of those things will be considered high priority in an emergency department, because they are either life-threatening, high-risk, or causing severe pain.

When you’re on the fence about whether or not emergency care is right for the situation, your child might be better served by urgent care. Many lacerations, for example, are urgent but not life threatening, and therefore do not require a trip to the ER. In fact, they may be more quickly resolved at an urgent care center.

Some hospitals, like the Mayo Clinic, operate both emergency departments and urgent care centers, which makes it possible for parents who are unsure about the severity of a condition to be redirected by the hospital staff.

If you don’t have a combination ED and urgent care center near you, and aren’t sure which of the two to go to, check out Colorado Children’s Hospital’s helpful quiz to train you to distinguish between urgent and emergency situations. Actually, if you have time to take the quiz, you probably have an urgent care need and not an emergency.

Many other terrifying-looking medical issues, like a high fever in a child over three months old or even febrile seizure, do not require urgent care and can be handled through follow-up with your child’s PCP, which is why the next step is so crucial.

2 | Develop trust in your child’s primary care provider

Try to see the same PCP for all of your child’s well visits. Doing so can help you build trust in that person’s judgment, which you can lean on when making middle-of-the-night healthcare decisions.

Your child’s PCP is there to monitor your child’s health, but also to educate you about how best to care for him. Make sure you are receiving the resources you need, including, for example, information on urgent versus non-urgent situations.

Many PCPs operate phone services for health questions. These hotlines are different from the insurer hotlines you might call to find out about health coverage. Instead, these hotlines put you in touch with a healthcare professional, often a nurse, who will help you determine how serious your child’s health issue is. That person can also contact your PCP to get further advice about how to proceed.

If your pediatrician does not have a triage after-hours phone service, ask why not. If you don’t trust your primary care provider, get a new one.

3 | Ask what you’re buying with an emergency department visit…and where else you can buy that

The hardest part of deciding not to go to the emergency department with a sick or injured child is probably not a medical issue. It’s a philosophical one.

One possible explanation for the overuse of emergency departments for common childhood illnesses is that parents are seeking reassurance more than they are seeking medical care. Although training yourself to identify true emergencies, developing trust with your child’s PCP, and cultivating a list of after-hours resources will all help you make better decisions, what you need most is to develop trust in yourself as a parent.

If you review the above studies about the ages of children brought to the ED, you would notice a distinct drop-off after the first few years of life. That’s not because young children are necessarily any more vulnerable than preschoolers or kindergarteners. It’s because parents of one-year-olds don’t trust themselves to identify and resolve their children’s health problems.

For the first three months or so, no new parents know what they’re doing. This is also the time period when some issues, like fever, are considered emergencies. So you might choose to follow an informal three-month rule, erring on the side of caution and making frequent calls to your child’s PCP until you can start to separate urgent from non-urgent.

As you begin to learn these distinctions, and develop your health literacy, start to trust as much in yourself as in your child’s medical staff.

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Whether you're filling out your own registry or shopping for a soon-to-be-mama in your life, it can be hard to narrow down what exactly new moms need (versus what will just end up cluttering the nursery). That's why we paired up with the baby gear experts at Pottery Barn Kids to create a registry guide featuring everything from the gear you'll use over and over to the perfect gifts under $50.

Check out the picks below, and happy shopping (and registering)!

MUST-HAVE BABY GEAR

These five gift ideas are designed to make #momlife easier while solving some of the most common parenting dilemmas.

1. Doona All-In-One Infant Car Seat/Stroller

One of the first things you learn when you become a mom? Those infant car seats are heavy. Which is what makes the Doona All-In-One Infant Car Seat/Stroller so genius. It's the world's first completely integrated mobility solution, quickly transforming from safe car seat to functional stroller without any extra parts. Simply pop out the wheels, pull up the handle bar, and you're ready to roll.

Doona All-in-one Infant Car Seat / Stroller, $499

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GIFTS THAT CAN BE PERSONALIZED

Even the most utilitarian gift feels a little more special with some personalization. Here are some of our favorite options that can be customized with baby's name or monogram.

1. Nursery Blankets

You'll never forget the blanket you bring your newborn home in. And with Pottery Barn Kids' assortment of blankets, there's a wrap to suit every new mama's style. Choose from fuzzy neutral patterns or stylish printed options, and add baby's name for an extra personal touch.

Nursery Blankets, Starting at $39.50

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GIFTS THAT GROW WITH THEM

Save money and space by gifting items that will last long after baby's first year. These clever gift items will have mama saying "thank you!" for years to come.

1. west elm x pbk Mid-Century Convertible Crib

A convertible crib is an investment in years of sweet dreams. We love this mid-century-style option made from sustainably sourced wood with child-safe, water-based finishes. When your baby outgrows their crib (sniff!), it easily converts into a toddler bed with the matching conversion kit.

west elm x pbk Mid-Century Convertible Crib, $399

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GIFTS UNDER $50

Sometimes the littlest gifts mean the most. Here are our favorite gifts under $50 they'll be sure to cherish.

1. west elm x pbk Dot Muslin Swaddle Set

When you're raising a newborn, you can never have too many swaddles. Perfect for naptime, burp cloths, stroller covers, and spontaneous play mats, a muslin swaddle will always come in handy. And we especially love this neutral patterned collection in platinum, nightshade, and peacock.

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Learn more and explore all Pottery Barn Kids' registry must-haves here.

In the moments after we give birth, we desperately want to hear our baby cry. In the middle of the night a few months later it's no longer exactly music to our ears, but those cries aren't just telling us that baby needs a night feeding: They're also giving us a hint at what our children may sound like as kindergarteners, and adults.

New research published in the journal Biology Letters suggests the pitch of a 4-month-old's cry predicts the pitch they'll use to ask for more cookies at age five and maybe even later on as adults.

The study saw 2 to 5-month olds recorded while crying. Five years later, the researchers hit record again and chatted with the now speaking children. Their findings, combined with previous work on the subject, suggest it's possible to figure out what a baby's voice will sound like later in life, and that the pitch of our adult voices may be traceable back to the time we spend in utero. Further studies are needed, but scientists are very interested in how factors before birth can impact decades later.

"In utero, you have a lot of different things that can alter and impact your life — not only as a baby, but also at an adult stage," one of the authors of the study, Nicolas Mathevon, told the New York Times.

The New York Times also spoke with Carolyn Hodges, an assistant professor of anthropology at Boston University who was not involved in the study. According to Hodges, while voice pitch may not seem like a big deal, it impacts how we perceive people in very real ways.

Voice pitch is a factor in how attractive we think people are, how trustworthy. But why we find certain pitches more or less appealing isn't known. "There aren't many studies that address these questions, so that makes this research especially intriguing," Hodges said, adding that it "suggests that individual differences in voice pitch may have their origins very, very early in development."

So the pitch of that midnight cry may have been determined months ago, and it may determine part of your child's future, too. There are still so many things we don't know, but as parents we do know one thing: Our babies cries (as much as we don't want to hear them all the time) really are something special.

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They say there's no use in crying over it, but for pumping mamas, spilled milk is a major upset.

When you're working so hard to make sure your baby has breast milk, you don't want to lose a drop, and Chrissy Teigen knows this all too well.

The mom of two posted a video to social media Wednesday showing her efforts to rescue breastmilk from a tabletop. She used various utensils and a syringe to try to get the milk back in the bottle.

"I spilled my breastmilk and this is how important it is in this house," she says while suctioning up milk with what appears to be a baster.

In a follow-up video Teigen continues to try to rescue the spilled milk.

"We're trying," she says as she suctions up a drop or two. "I got some."

Teigen is currently breastfeeding baby Miles, her son with husband John Legend, and has been very public about the fact that she pumps a lot as a working mom.

She's also been open about the fact that milk supply has always been an issue for her, not just with Miles but with Luna, too.

"I actually loved [pumping] because I'm a collector of things, and so when I found out I could pump I [did it] so much because I knew the more you pumped, the more milk you'd make," she told POPSUGAR back in March. "So I loved collecting my breast milk and seeing how much I could get, even if it was very, very little."

Like a lot of moms, Teigen did struggle emotionally when a pump session wouldn't get her the ounces she wanted.

"I wasn't producing a lot of milk, and it was frustrating. When you're frustrated, [it can also make you] not produce that much."

Research backs her up. Stress has been linked to lower milk production. Because of that, she's trying to stay positive this time around, but captioned her video post "EVERY DROP COUNTS IN THIS HOUSE" because, well, they do.


So many mothers can relate. Have you ever tried to save your breastmilk?

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What is it about networking that's just kind of...awful? Typically inconvenient and often awkward, formal networking events rarely yield the results most women (and especially mamas) are looking for.

Whether you're reentering the workforce post-baby leave or simply looking to make a complicated career switch as a busy mom (or just struggling to juggle play dates and professional meetings), making the right connections is often a hurdle that's difficult to surmount. And more and more often, networking comes up short in providing what moms really need.

When time is truly at a premium—a session swapping business cards can be hard to prioritize. Shapr wants to change all that.

Designed with busy people in mind, Shapr is an app with an algorithm that uses tagged interests, location, and professional experience to match you with 10-15 inspiring professional connections a day. You swipe to indicate interest in networking with any of them, and if the interest is mutual, you're connected. (But don't worry, that's where the similarities to that dating app end.)

It makes it easier to connect with the right people.

From there, you can chat, video conference, and even meet in person with potential mentors, partners, and investors while growing your real-life network. No more wasting hours trying to pick someone's brain only to discover they don't have the right experience you need. And no more awkward, stilted small talk—even suggests a few preset icebreakers to help get the conversation rolling more quickly.

The best part? You could do virtually all your connecting from your couch post-bedtime.

It simplifies switching careers or industries.

Sysamone Phaphone is a real mom who was fed up with traditional networking options. When she quit her full-time job in healthcare to pursue founding a startup, she quickly realized that in-person networking events weren't only failing to connect her to the right people, they were also difficult for a single mom of two to even attend. "I was complaining to a friend that I was so tired and didn't know how I was going to keep doing it this way when she recommended the Shapr app," Phaphone says. "I tried it right there at dinner and started swiping. [Later], in my pajamas, I got my first connection."

From there, Phaphone was hooked. Her network suddenly exploded with developers, potential partners she could work with, and even people to hire for the roles she needed. She was also able to connect with and empower other women in tech. Now, checking in with Shapr connections is just part of her routine. "I look for connections after drop-off at school and on my commute into the city," she says. "Then after bedtime is done, I go on to check if there is anyone I've connected with."

It helps you find a mentor—no matter where they live.

Another common roadblock Shapr removes? Location. While you probably wouldn't fly to LA from New York for a networking event, the Shapr app lets you connect and chat with the person who best meets your needs—regardless of where they're based. Even better for parents, the "mom penalty" many women contend with when trying to get back into the workforce doesn't exist on Shapr—if you have the right experience, the connections will still come.

To connect, simply create your account, enter up to ten hashtags you want to follow (either industry related like #film or #tech or by person you're seeking, such as #developer or #uxui), preset what you're looking for (investors, collaborators, etc.), and indicate how you prefer to meet. To connect with more people at once, Shapr also has community groups within the app around interest topics that you can join. And even though the connection begins in the digital space, it often results in the in-person experiences mamas crave.

"I wish I could encourage more moms and dads to use it because it has been a lifesaver for me," Phaphone says. "It empowered my career and career choices, and it provides so much convenience. I can put my kids to bed and not go to an event, but still meet 20 people in a night."

For women looking to grow their business, position, or simply achieve a little self-growth, Shapr is changing the way we connect. This powerful new app could change everything, mama. Download it today to get started.

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