Infant and Car Seat Safety

How do I select a car seat?
Are there different types of car seats?
How can I check to see if the car seat is installed correctly?
When is my child ready for a booster seat?
Other tips to ensure safety while driving

Motor vehicle accidents are the number one cause of death for children in this country. Among children 5 years and younger, 451 lives were saved because of car seats and booster seats in 2004.

Infant seats and child car seats are designed to safely absorb and distribute crash impact over a child's body while holding a child in place. The restraint prevents the child from getting thrown out of the car or from being hurt by hitting the car's interior. Parents risk the lives of their children by not putting them in any type of car seat, putting them in incorrectly or putting them in an inappropriate safety seat.

Several myths surround infants and car safety.

• Myth: Holding an infant tightly will be better for the child in the event of an accident. Fact: During a 30-mile-per-hour crash, test studies have shown that a baby will be crushed between the parent's body and the dashboard or be ripped from the parent's arms with a force of almost 300 pounds.
• Myth: A child is safer NOT belted into the car because he or she will be thrown free of the crash and saved. Fact: A child not secured in a safety seat is 25 times more likely to die in a crash.
• Myth: If a child is in a rear-facing seat, then it's safe to have that child in the front seat. Fact: Infants should never sit in the front seat of a car with a passenger-side air bag. The impact of an air bag could injure your child. No matter what, the back seat is safer than the front for every car seat.

There are other advantages to securing kids in car seats. Parents whose children are buckled in are actually better drivers since they are less likely to be distracted by children moving around in the car. Some studies suggest children in the proper car seats tend to have less motion sickness.

• How do I select a car seat?

The National Highway Traffic Safety Administration offers the following guidelines. Child safety seat laws differ from state to state. To ensure you understand the specific laws regarding car seat safety in your area, contact your local officials.

Are there different types of car seats?

Besides the rear-facing infant seat, there is a convertible safety seat that can be used in rear- and forward-facing positions (a convertible seat faces backward for an infant and forward for a toddler). It has two different belt paths, one for each direction. There is also the booster seat, which always faces forward and has a removable shield.

How can I check to see if the car seat is installed correctly?

Besides selecting the right car seat for a child's age and weight, parents should make sure the car seat is installed correctly. Manufacturers give detailed instructions on installation and correct usage. Parents need to know the specifics of using shoulder straps, how to use a chest clip to keep harness straps on a child's shoulders and how the straps can be adjusted.

Always try out the seat in your car and make sure it's steady before driving with your child in it. Sometimes a locking clip or tethers are needed to keep the seat steady. Locking clips are usually necessary on older cars. Always fill out a car seat's registration card so you can be contacted if the car seat is recalled for a defect. You may also contact the American Academy of Pediatrics for its yearly updated list of infant/child safety seats.

As of 2002, all vehicles are required by law to have a "Lower Anchors and Tethers for Children" (LATCH) system, which is designed to make installation of child safety seats easier by requiring child safety seats to be installed without using the vehicle's seat belt system. For a car that does not have LATCH, you can buy LATCH kits to install yourself or you can have your car dealer put one in.

When is my child ready for a booster seat?

According to the American Academy of Pediatrics, your child should stay in a car safety seat with a harness as long as possible before switching to a booster seat. You can tell when your child is ready for a booster seat when one of the following is true:

• She reaches the top weight or height allowed for her seat with a harness. (These limits are listed on the seat and are also included in the instruction booklet.)
• Her shoulders are above the harness slots.
• Her ears have reached the top of the seat.

More information from the Centers for Disease Control and Prevention:

• The National Highway Traffic Safety Administration recommends booster seats for children until they are at least 8 years of age or 4'9" tall.
• For children 4 to 7 years, booster seats reduce injury risk by 59 percent compared to safety belts alone.
• All children ages 12 years and younger should ride in the back seat. This eliminates the injury risk of deployed front passenger-side airbags and places children in the safest part of the vehicle in the event of a crash.

Parents who are unsure about the proper safety seat for their child can contact a certified Child Passenger Safety Technician available from the National Highway Traffic Safety Administration. Many states and regions have "fitting stations" where a parent can get hands-on help.

Other tips to ensure safety while driving

• Set a good example. Make sure all adults in the car are buckled in. Insist that babysitters or grandparents always use the car seat or booster seat in their vehicles when transporting children.
• Never take the infant or the child out of the seat while the car is in motion, even for just a minute.
• Don't be influenced by crying or complaints while driving. Always pull over and stop the car to take care of the situation.
• For comfort in hot weather, place a towel over the car seat's vinyl covering.
• Break up a long car ride by stopping often and letting kids walk around for a while.

External Sources National Highway Traffic Safety Administration: State Legislative Fact Sheet on Child passenger safety laws National Highway Traffic Safety Administration Woolf AD, Shane HC, Kenna MA, eds. The Children's Hospital Guide to Your Child's Health and Development. Cambridge, MA. Perseus Publishing; 2000:369-371. The American Academy of Pediatrics Centers of Disease Control and Prevention. Child Passenger Safety: Fact sheet. Accessed May 21, 2007.

This article was reviewed and updated June 2007.

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