Car seat safety
Car seat safety
How long should your child be in a car seat and what type of car seat is the best fit for your child?
By Kelly Kaiser Borning, MS, OTR/L
Almost all parents know about and use car seats for their infants, but as the infant becomes mobile and verbal, parents are less likely to continue to use a child-restraint while in a moving vehicle. Recently I gave a presentation on this subject, and I was surprised to find out the age and weight recommendations of the National Highway and Transportation Safety Administration (NHTSA). The NHTSA now recommends that children stay in appropriate car seats through 8 years, 80 pounds, or up to 4'9''. http://www.inventiveparent.com/rearfacingcarseat.htm. Knowing these recommendations is vital for responsible parents, but using them is even more important. Parents must be aware of what type of car seat is appropriate for their child, how to install it correctly and how it is properly used.
No one argues that infants need to be restrained in the car. However, as children age, they often don't want to be in a car seat or seat belt. Also, parents tend to be busy and taking the time to place your child in a car seat takes extra time. Many parents allow their children to ''hop in'' and go. Often these children are in the back seat unrestrained, but even more dangerous is when these children ride in the front seat (restrained or not). The safest place for a child under 12, often required by law, is in the back seat. Never place a rear-facing infant in the front seat of a vehicle with a passenger air bag.
Unintentional injury is the number one killer of children ages 14 and under. This includes all safety issues, such as helmet use, car seat safety, pedestrian safety, and life jackets http://www.safekids.org/tier3_cd.cfm?content_item_id=18010&folder_id=300. Four out of five car seats are installed incorrectly, which is one of the most preventable causes of malfunctions http://www.umcwy.org/MCS/Child%20Safety.htm. Of those car seats being used incorrectly, 63% of the seat belts do not hold the seat tightly and 33% of the straps are not snug http://www.inventiveparent.com/rearfacingcarseat.htm. Most local police departments and/or fire departments will check your car seat for free. Just call them to find out the details.
When you obtain a car seat, there are some general things to remember or know about it. Read and follow the instructions that came with your seat and with your car. Make sure the seat is firmly attached to your car. Send in the car seat registration card. This is important in case there are any recalls. Replace any car seat that has been involved in a crash. Even if there is no visible damage, the structure of the seat is compromised from pressure and impacts, and is not reliable if involved in another accident. This is a good reason to use new car seats rather than borrowed or bought second hand (the history of used car seats is not always known). Vehicles that are September 2002 and newer come equipped with the LATCH (Lower Anchors and Tethers for Children) system. The car seat must also be equipped for this system. Never place a car seat in front of an active air bag (forward or rear-facing).
Children 0-1 year old
Your child must be in a rear facing car seat until he/she is 1 year old AND 20 pounds. This is important due to the developing musculature of they infant's head and neck. In an accident, an infant is not able to hold his/her head up against force (and often not at all yet), so the damage to an infant's neck will be more severe than that of an older child or adult. Infants are born with their head disproportionately larger than that rest of their body, and they need time to develop the muscle and control before they can be forward-facing. As the infant approaches a year, it is tempting to turn him/her around earlier - DON'T! Often he/she will outgrow the infant seat, but a convertible seat can be used in the rear-facing position until he/she reaches that magic 1-year mark and 20 pounds.
Keep the straps snug. If you can pinch the edges of a strap together between your fingers, the straps are too loose. Make sure the straps are level, even and not twisted. Your baby could scoot around under the straps just like a hand inside a mitten--not very secure in case of an emergency. Place the chest clip level and in line with baby's armpits. Fit harness straps through the seat below baby's shoulders so that the straps run up and over the shoulders. http://www.inventiveparent.com/rearfacingcarseat.htm. Do not put heavy clothing, jackets, blankets or sweaters on your baby because this bulk keeps the straps from fitting snugly. Place blankets over the straps, not under them. Do not cover your baby's face.
There are two types of infant car seats for children under 1 year old. Infant Seat/Carriers are designed for Newborn babies through 20 or 22 pounds. They are designed to move in and out of the car. Some have bases that remain attached to the car's seat, others are buckled in and out. Some have padded, crooked handles, or a stroller base ... they are changing all the time. Convertible car seats let you use the same seat from the day your baby is born through forty pounds. They will have both a rear-facing and forward-facing weight limit. The rear-facing limit may be as high as 30-35 pounds. They may have removable inserts that effectively make the seat smaller to fit an infant. This car seat is installed once, and generally is not removed from the car on a regular basis http://www.inventiveparent.com/rearfacingcarseat.htm.
Children 20-40 pounds (over one-year old)
A convertible car seat is the most common seat to use for children in this age range. However, if your child is 20 pound or more, but is not yet one-year old, he/she should still remain in a rear-facing car seat. Some vehicles are equipped with built in car seats (such as mini-vans) and these are suitable for this age.
Children can use a convertible seat until they are tall enough for a booster seat. I have found that a 5-point harness for the infant seats and convertible seats are more secure and the child is less likely to get out of the seat. The belt should be tight enough to slide two fingers under the belt at the chest level. The chest piece should be horizontal with the child's armpits.
Children 40-80 pounds
This is the age range that many parents stop using proper child safety seats, placing their children at great risk for injury in the event of an accident. Ninty-five percent of children 4-8 years-of-age are riding at risk http://www.umcwy.org/MCS/Child%20Safety.htm. Children should be in car booster seats if they a) are too big for a car seat b) weigh about 40-80 pounds. Seat belt adjusters may be necessary for some booster seats.
When the child is old enough and tall enough for a booster seat, be sure you position the child well in the seat to ensure the comfort of the child (this will increase the child's proper use of the seat). There are two types of booster seats - High-Back and Platform booster seats. A general rule of thumb is that children should be in a booster until their knees bend over the edge of the seat when sitting properly. You may want to use a seat belt adjuster for some time thereafter http://www.inventiveparent.com/state-laws.htm.
Children over 80 pounds
Usually children over 80 pounds and 8 years old can fit correctly in lap/shoulder belts. http://www.umcwy.org/MCS/Child%20Safety.htm. Children should be 4'9'' to use an adult safety belt. Children under 12 should continue to ride in the back seat of a car, especially if a passenger airbag is in use.
''Parents need to provide consistency between their words and actions,'' says Martin Eichelberger, M.D., president and CEO of the National SAFE KIDS Campaign and director of Emergency Trauma Services at Children's National Medical Center in Washington , D.C. http://www.safekids.org/tier3_cd.cfm?content_item_id=18010&folder_id=300. Children learn best when messages are reinforced by role models. If parents aren't willing to follow their own rules, children are more likely to break the rules as well. You must be a role model. Talking about seat belt use is not enough. Wear your own seat belt!
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