Children in Pembrokeshire with respiratory problems and acute medical needs will need to attend a hospital in Carmarthenshire until autumn next year because the Pembrokeshire-based paediatrics unit remains closed.
Hywel Dda University Health Board members have agreed to extend the current arrangement - brought in on a temporary basis in March 2020 - but acknowledged the anxiety it was causing further west.
Clinicians joined the meeting to say the current arrangement was the safest option and had their collective backing.
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One frontline clinician at Withybush Hospital, Haverfordwest, said: "The problem we have had over the last 18 months is that children get stranded in the wrong hospital.
"It's absolutely vital that we minimise the chance of that happening."
He added: "Obviously if a sick child appears we will obviously do our very best. Children, with the best will in the world, should not come to Withybush for acute care."
Withybush's paediatric ambulatory care unit (PACU) was closed temporarily in March 2020 because the space it occupied was needed to separate Covid and non-Covid patients when the pandemic hit.
That space is said to still be required for this purpose, and the paediatric ambulatory care unit remains at Glangwili General Hospital, Carmarthen.
Paediatric provision remains unchanged at Bronglais General Hospital in Ceredigion.
After a long discussion about the increase in cases of a virus which causes bronchitis in children - predominantly the under fives - health board members decided to extend the current system.
This will include a review, starting next March, with the decision to be reconsidered by the board in autumn 2022.
Families which have been affected, along with patient watchdog the community health council, will be involved in the review.
In addition, support will given to parents who don't have a car or who have to travel a long way to get to Glangwili, and new signs could be installed at Withybush explaining that emergency care is for adults only, but that youngsters with minor injuries will be seen.
Planned care for children will continue as normal at Withybush.
Dr Phil Kloer, the health board's executive medical director, also said that children who were having trouble breathing could be anaesthetised at Withybush prior to being transported to Glangwili.
Mansell Bennett, chairman of the community health council, said it was good to see the existing arrangement had backing but said he was concerned about how long it would go on for.
He added that health council members had concerns about the effects on the Pembrokeshire population. He said a patient survey should be started now.
Dr Kloer acknowledged the proposal was a "significant" extension, but said the plan had been to start the review in March this year but that it hadn't been possible because of the ongoing pandemic.
Health board chairwoman Maria Battle said people wanted to know why there couldn't be a PACU or paediatric cover at Withybush.
Dr Kloer said the space the unit had occupied at Withybush was still needed to manage the Covid and non-Covid flow of patients.
"There really is no other appropriate PACU space," he said.
The virus, he said, spread easily between wards, and the third wave of the pandemic was in train.
Emergency and non-emergency transport for children and their families from Pembrokeshire to Glangwili was also discussed.
The report before the board said a new and faster way of assessing children who did arrive at Withybush - other than those with a minor injury - will be introduced in October.
Parents and carers in Pembrokeshire are asked not to delay seeking help if their child is unwell or injured.
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