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Car Seat Safety

By Vicki Herrman, M.D.

Car Seat image

Bringing home your baby from the hospital is a magical, unforgettable moment. It can also be extremely nerve-wracking. Now you are responsible for the precious cargo that is asleep in the back seat. Here are a few tips from the American Academy of Pediatrics (AAP) and Boys Town Pediatrics to make car travel safe and smooth at any age.

Car Safety Regulations

The AAP has five guidelines to follow when determining the safest way for your child to travel.

  • Rear-facing safety seats: Most infants up to 2 years of age should travel in a rear-facing child safety seat. Infants and toddlers tend to have relatively large heads with weak neck muscles, which puts them at a higher risk for head and spine injuries in the event of a crash. The rear-facing structure is most effective in guarding against this type of injury. However, if a child surpasses the height and weight limits of the safety seat before age 2, it is recommended to move on to a front-facing safety seat.
  • Front-facing safety seats: After their children have outgrown rear-facing seats, parents are encouraged to keep children in front-facing safety seats for as long as possible (until the child passes the manufacturer height and weight limits).
  • Belt-positioning booster seat: Children who have outgrown their front-facing safety seats can move on to booster seats. A booster seat will make it so that the seat belt fits your child for maximum safety: with the lap portion of the belt falling across the hips and pelvis and the shoulder portion hitting across the middle of the chest and shoulder. Children should remain in their booster seats until a seat belt fits them properly without the booster.
  • Lap-and-shoulder seat belt: When deciding if your child can move out of the booster seat, the AAP encourages parents to ask themselves three questions: 1) Can your child sit against the vehicle seat back with knees bent at the edge of the vehicle seat without slouching and stay in this position comfortably throughout the trip? 2) Does the shoulder belt lie across the middle of the chest and shoulder, not against your child's neck or face? 3) Is the lap belt low and snug across the upper thighs, not your child's abdomen? If the answer to any of these questions is no, your child is not ready to ride without a booster seat. Once the seat belt fits across the hips, pelvis, chest and shoulders properly without a booster, a child can use the seat belt built in to the vehicle on its own. Typically the child is between 8 and 12 years of age and at least 4 feet 9 inches tall.
  • Sitting in the front passenger seat: The AAP recommends that children under the age of 13 sit in the back seat only, regardless of if the vehicle seat belt fits them properly.

Car Seat Safety

  • The middle position in the back seat is considered safest place for a car seat because it is the farthest away from doors and windows that may be impacted in a crash. However, a tight-fitting car seat is essential. If you can't get a tight fit in the middle seat, move the car seat to one of the side positions.
  • Dress your child in clothing that will allow a tight fit in the car seat's harnesses. In cold weather, put your child in the seat without a heavy coat and put a coat or blanket over him or her once buckled snugly in the seat.
  • Children in rear-facing safety seats should never be placed in a passenger seat, especially if the seat has an active airbag.
  • Children under 13 years old are safest in the back seat, away from air bags.
  • If your child has physical or behavioral health complications, it may be necessary to take them into account when determining the safest way for him or her to travel.
  • To find a trained safety technician in your area who can help you with safety decisions, visit www.cert.safekids.org.

Remember to read the manual for both your infant seat and your car– each vehicle and safety seat is different – and if you have any questions about keeping your child safe on the road, ask your pediatrician.