Post Road Pediatrics | Car Seat Safety

The proper use of car seats helps keep children safe. The type of seat your child needs depends on several things, including your child’s age, size, and developmental needs. Below is more information from the American Academy of Pediatrics (AAP) about choosing the most appropriate car seat for your child.

Types of Car Seats:

Installation Information:

Car safety seats may be installed with either the vehicle’s seat belt or its LATCH (lower anchors and tethers for children) system. Both options are equally safe, so use whichever one works best for your car seat and vehicle.

Vehicles with the LATCH system have lower anchors located in the back seat, where the seat cushions meet. Top anchors are located behind the seat, either on a panel, back of the seat, ceiling or floor. All forward-facing car seats have tethers that fasten to these anchors. Nearly all vehicles and car seats made on or after 9/1/2002 are equipped to use LATCH. Look at your vehicle’s owner’s manual for the highest weight allowed by the top anchor and bottom anchors.

If you install a car seat using the seat belt, make sure the seat belt locks to hold the car seat tightly. In most newer cars, you can lock the seat belt by pulling it all the way out and then allowing it to retract to keep the seat belt tight around the car seat. Additionally, many car safety seats have built in lock-offs so you can lock the belt without having to lock the seat belt separately as well. Refer to your vehicle’s owner’s manual for details about your vehicle’s seat belt locks.

Installation Help:

If you have questions or need help with installing your car safety seat, find a certified child passenger safety technician (CPST). Lists of certified CPSTs and child seat-fitting stations are available on the following websites:

• National Child Passenger Safety Certification (Click on “Find a Tech” or call (877)366-8154). Includes list of CPSTs fluent in Spanish and other languages or with extra training in transportation of children with special needs.
• NHTSA 87Parents & Caregivers
• Inspection Sites Near You

Shopping for Car Seats

When shopping for a car seat, keep the following tips in mind:

• No one seat is the “best” or “safest”. The best car seat is the one that fits your child’s size, is correctly installed, fits well in your vehicle, and is used properly every time you drive.
• Don’t decide by price alone. A higher price does not mean the seat is safer or easier to use.
• Avoid used car seats if you don’t know the seat’s history.

Never use a car seat that:

• Is too old. Look on the label for the date the seat was made. Check with the manufacturer to find out how long it recommends using the seat; a typical car seat lifespan is 6-10 years.
• Has any visible cracks on it.
• Does not have a label with the date of manufacture and model number. Without these, you cannot check to see if the seat has been recalled.
• Does not come with instructions. You need the instructions to know how to properly use the seat. Instructions can be found on manufacturer websites or by contacting the manufacturer.
• Is missing parts. Used car seats often come without important parts. Check with the manufacturer to make sure you can get the right parts.
• Was recalled. You can find out by calling the manufacturer or contacting the National Highway Traffic Safety Administration (NHTSA) Vehicle Safety Hotline at (888)327-4236.
• Has been in a moderate or severe crash. According to the NHTSA, car seats involved in a minor crash may still be safe to use. Some car seat manufacturers recommend replacing the seat after any crash, even a minor one.

Airbags:

Front airbags are installed in all new cars. When used with seat belts, airbags work well to protect teenagers and adults; however airbags can be very dangerous to children, particularly to those riding in rear-facing seats and young children who are not properly restrained. If your vehicle has a front passenger airbag, infants in rear-facing seats must ride in the back. Even in a relatively low-speed crash, the airbag can inflate, strike the car seat, and cause serious brain injury and death. Read your vehicle’s owner’s manual for more information regarding car seats and airbags.

Airplanes:

The Federal Aviation Administration (FAA) and the AAP recommend that children less than 40 pounds be securely fastened in certified child restraints when flying, which will help keep them safe during takeoff, landing, and with any turbulence you may experience while flying. Most car seats can be used on airplanes, but booster seats and travel vests cannot.

Read your car seat’s instruction manual and look for a label that says “This restraint is certified for use in motor vehicles and aircraft.” You can also use a restraint made only for use on airplanes and approved by the FAA. Remember - your child will also need an appropriate car seat once you reach your destination.

Using Seat Belts:

An adult seat belt fits correctly when

• The shoulder belt lies across the middle of the chest and shoulder, not the neck or throat.
• The lap belt is low and snug across the upper thighs, not the belly.
• Your child is tall enough to sit against the vehicle seat back with their knees bent over the edge of the seat without slouching and can comfortably stay in that position throughout the trip.

Other points to keep in mind...

• Make sure your child does not tuck the shoulder belt under their arm or behind their back. This leaves the upper body unprotected and adds extra slack to the seat belt system, putting your child at risk of severe injury in a crash or with sudden braking.
• Never allow anyone to “share” seat belts. All passengers must have their own car seats or seat belts.

Frequently Asked Questions (FAQs)

What if my child's feet touch the back of the vehicle seat?

No need to worry! Children are very flexible and can easily find a comfortable position in a rear-facing car seat. Injuries to the legs are very rare for children facing the rear, and there is risk of serious head/neck injuries from inappropriately facing a child forward.

What do I do if my child slouches down or to the side in the car seat?

You can try placing a tightly rolled receiving blanket on both sides of your child. Many manufacturers allow the use of a tightly rolled small diaper or cloth between the crotch strap and your child, if necessary, to prevent slouching. Do not place padding under or behind your child or use any sort of car safety seat insert unless it came with the seat or was made by the manufacturer for use with that specific seat.

Why should I dress my child in thinner layers of clothing before strapping them into a car safety seat?

Bulky clothing, including winter coats and snowsuits, can compress in a crash and leave the straps too loose to restrain your child, leading to increased risk of injury. Ideally, dress your baby in thinner layers and wrap a coat or blanket around your baby over the buckled harness straps if needed.

Do preemies need a special car seat?

Babies born preterm should be screened while still in the hospital to make sure they can sit safely in a semi-reclined position. Babies who need to lie flat during travel may need to ride in a car bed instead.

What if I drive more children than those who can be buckled safely in the back seat?

It's best to avoid this, especially if your vehicle has airbags in the front seat. All children younger than 13 years should ride in the back seat.

What if my car has only lap belts in the back seat?

Lap belts work fine with rear-facing–only, convertible, and forward-facing seats that have a harness but can never be used with a booster seat. If your car has only lap belts, use a forward-facing seat that has a harness and higher weight limits.

What is the difference between high-back boosters and backless boosters?

Both types of boosters are designed to raise your child so seat belts fit properly, and both will reduce your child's risk of injury in a crash. High-back boosters should be used in vehicles without headrests or with low seat backs, and for properly positioning a seat belt with smaller children. Many seats that look like high-back boosters are actually combination seats. They come with harnesses that can be used for smaller children and, later, removed for older children. Backless boosters are usually less expensive and are easier to move from one vehicle to another. Backless boosters can be used safely in vehicles with headrests and high seat backs as long as the seat belt fits properly. If it doesn’t, or you’re not sure, a high-back booster is a safer choice..

I've seen products that say they can help make the seat belt fit better. Should we get one of these?

No, these products are unapproved and should not be used. They may actually interfere with proper seat belt fit by causing the lap belt to ride too high on the stomach or making the shoulder belt too loose. They can even damage the seat belt. This rule applies to car safety seats too; do not use extra products unless they come with the seat or are specifically approved by the seat manufacturer. These products are not covered by any federal safety standards, and the AAP does not recommend they be used. As long as children are riding in the correct restraint for their size, they should not need to use additional devices.

Last Updated 3/28/2022

Source Adapted from Car Safety Seats Guide (Copyright © 2021 American Academy of Pediatrics). For more information visit healthychildren.org

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.