Since 2020, Magical Mila’s BP Under 3 initiative at Children’s Hospital of Philadelphia has worked to change how blood pressure is measured in the youngest patients. Our team led a study evaluating the Welch Allyn blood pressure machine for children under age three — a device that measures blood pressure on the way up rather than the way down, making the process faster, more comfortable, and more accurate for small children. After presenting our findings to the CHOP Medical Device Committee, the machine was approved and is now used in nephrology, neurofibromatosis and subspecialty clinics, as well as all 31 CHOP primary care centers. Our advocacy also helped lead to important system changes within Epic Systems, including a new alert that identifies children at high risk for hypertension and updated blood pressure thresholds for infants under one year old — a population that previously had no defined thresholds in the system.

Education has also been central to our work. Magical Mila funds training and resources across CHOP’s primary care network, including toolkits with instructional posters, badge cards for medical staff, reminders placed on Welch Allyn machines, and distraction toys that help young children stay calm during readings. Our team has also hosted “lunch and learn” trainings at every primary care site to reinforce best practices. These efforts are making a measurable impact: when BP Under 3 launched in 2020, CHOP’s system-wide blood pressure measurement rate for children under three was just 1.7%; today it has risen to 78%. Since the program began, 183 children have been referred to nephrology for further evaluation of high blood pressure, and many practices are now achieving 75–100% blood pressure attempt rates — turning what was once the ceiling into the new baseline.