Ever wonder if lugging that car seat from vehicle to daycare to grandma’s house is worth it? Significant reductions in injury and death have occurred since the use of car safety seats and seat belts. A study published in 2009 showed that child safety seats reduce the risk of death in a car accident by 71% for infants and 54% for children between 1-4 years of age.
Of the 40,000 Americans that die in motor vehicle crashes each year, more than 5,000 are children and adolescents under the age of 21 years. In Missouri, 70% of car crash fatalities were not properly restrained. Car seats and safety belts are not just excellent protectors, using them is the law. Currently all 50 states require that infants and children ride in car safety seats. Despite this, one study by the CDC showed that each year, over 600,000 children under the age of 13 ride unrestrained in cars at least some of the time.
So, how do car seats help? Car seats are age-appropriately designed to help in several ways. They:
- Reduce the risk of ejection during a crash
- Help to distribute the energy or force of the crash to structurally stronger bones (rather than soft tissue)
- Limit the crash force by decreasing impact and limiting contact within the vehicle.
The safest car seat for your child is one that fits his or her size, fits your car and is easy for you to use correctly every time. Begin use of a car seat for your newborn infant on his or her first ride home from the hospital. After that, it might help to re-evaluate your child’s “car safety” each time he or she graduates to a new age group. Think of the age groups as “Birth through age 2”, “Between the ages of 2-4 and until 40 pounds”, “Between the ages of 4-8 or until 4 feet 9 inches tall”, and “After age 8 and 4 feet 9 inches tall”. Save the manual to your car seat as you will need to refer to it as your child’s age, height and weight change.
Birth through age 2
- Rear-facing only seats
- Rear-facing convertible seats
Children under age two require “rear-facing only” seats and/or “rear-facing convertible” seats. Rear-facing infant seats (up to 22-35 lbs) are small and easy to carry. Convertible car seats are also rear facing, (up to 30-45 lbs,) are larger and stay in the car, but have the advantage of being used forward facing when baby is older and bigger. All infants and toddlers should ride rear facing until they are 2 years of age. Use the center, back seat if available. Adjust straps to be snug as directed by the owners manual.
Between the ages of 2-4 and until 40 pounds
1. Convertible seats
2. Forward-facing seats with harness
All children 2 years or older, should use a forward-facing car seat with a harness for as long as possible, up to the highest weight or height allowed by their car seat manufacturer. Some convertible seats can be used forward facing up to 40 lbs, but other models go to 60-80 lbs. Check your manual to know the recommended weight and height allowances for the car seat you have. Adjust the harness straps to be snug and “sit tight.” Stop often to stretch on long trips.
Between the ages of 4-8 or until 4 feet 9 inches tall
1. Booster Seat
Booster seats help to position the seat belt in the right place on your child. Children whose weight and height are above the forward-facing limit for their car safety seat should use a booster. Use a “booster only seat” with lap-shoulder belt. Some boosters fit a child up to 120 lbs, so check the label. Use this until the lap-shoulder belt fits well. Typically at 4 feet 9 inches in height and between the ages of 8-12 years, children
can use the seat belt without booster.
After age 8 and 4 feet 9 inches tall
1. Seat Belt
When children are old enough and large enough to use the vehicle seat belt alone, always include both the lap and shoulder seat belt. If younger than 13 years, ride in the rear seat for optimal protection. Use the 5-Step Seat Belt Fit Test at http://www.carseat.org/Boosters/630.htm by SafetyBeltSafe U.S.A. to evaluate the fit.
Several other considerations are important to optimize the power of your car seat to protect your child. Review strategies of positive rewards to survive car seat struggles with young children. Never place a rear-facing car seat or small children in the front seat with a passenger air bag. Model safe behavior by always wearing your seat belt. Insist that everyone who transports your child uses the correct car seat or belt every trip, every time. Always read and follow the manufactures’ instructions for your equipment. Reevaluate when your child moves to different age groups or has significant height and weight changes. Remember, using a car seat consistently and correctly makes a big difference in your ability to protect your child. Be safe, and sit tight!
Esse Health Pediatric & Adolescent Medicine at Watson Road
9930 Watson Road, Suite 100
St. Louis, MO 63126
-NHTSA Auto Safety Hotline, 888.327.4236, 800.424.9153, www.safercar.gov
-SafteyBeltSafe U.S.A., 800.745.7233, www.carseat.org
-Find a Child Passenger Safety Inspection Location;866.732.8243, www.seatcheck.org
-St Louis Children’s Hospital, Safety Stop, 800.454.KIDS (press #3 to schedule appointment)
-Cardinal Glennon, Safe Kids Program, 866.776.3627, www.safekidsstl.com
-HealthyChildren.org from the American Academy of Pediatrics