Car Seat Safety
by Holly Owens, M.D.
Most parents wouldn’t send their children to school in shoes that don’t quite fit, so why should a car seat that doesn’t fit be any different?
A blister from an ill-fitting shoe is one thing—when it comes to car seats, the fit needs to be perfect, or the consequences can be deadly.
According to the National Highway Traffic Safety Administration, child safety seats can reduce fatal injuries by more than 70 percent in infants and nearly 55 percent in toddlers.
Yet seven out of 10 kids are not properly buckled in. In the majority of cases, nearly 90 percent, the seats are not even properly installed – even though more than 95 percent of parents and caregivers think they are.
It can be confusing trying to keep the rules, regulations, and recommendations for car seats straight, not to mention making sure everything is in its proper place once you’ve gotten the right model. Let’s break everything down.
Car Seat Code 101
According to the Governors Highway Safety Association, all 50 states have laws regarding child safety seats. 47 states, including Texas, have booster seat laws. But knowing when to transition from rear-facing infant seats to front-facing toddler seats—and from booster seats to big-people, regular seatbelts—isn’t always clear.
The Texas Department of Public Safety requires infants to be in rear-facing seats until age 1, but in April 2011, the American Academy of Pediatrics recommended parents leave their babies facing backwards until age 2. Children under age 2 are 75 percent less likely to be injured in a crash if they are facing the rear of the vehicle.
The next stage is a forward-facing seat, which should continue until the child is 40-80 pounds, usually around 4 years of age. Even though the child is facing front, the seat must remain in the back.
From there, children can progress to booster seats. As the name indicates, a booster seat lifts children high enough to ensure the vehicle’s lap/shoulder belt fits properly. The shoulder belt should lie across the middle of the chest, not near the neck or face. The lap belt should lie across the hips and upper thighs, not across the belly. In an accident, ill-fitting seatbelts can result in “seatbelt syndrome,” which is characterized by abdominal and spinal cord injuries.
The AAP says to keep kiddos in booster seats until they are 4’9” tall, which is usually somewhere between 8-12 years of age.
Even after graduating from the booster seat, children under the age of 13 years should never sit in the front seat, where airbag deployment can be fatal to smaller bodies.
On the right road
The fatality rate from car wrecks in children under the age of 16 has dropped significantly since car seats and booster seats became law – by nearly 45 percent between 1997 and 2009 alone. Yet motor vehicle accidents are the leading cause of death in children 4 years of age and older. And for every fatality, hundreds of kids require medical attention; nearly 20 end up in the hospital for every one child car accident fatality.
The most common motor-vehicle injuries I see in kids in the emergency room are facial contusions, head injuries, and the occasional broken nose. Often, the child was properly buckled into the car seat, but the car seat itself was not properly installed. There should be no more than one inch of “play” from side to side or back to front once the seat is installed.
There are several local organizations with NHTSA-approved inspectors who will check your family’s car seat for free. Find the nearest location by visiting www.seatcheck.org or by calling 1-866-SEAT-CHECK. The website also provides up-to-date safety-seat recall information, hotlines that connect directly to various car-seat manufacturers, and state-by-state child-seat laws.
That being said, there is another factor to consider when it comes to injuries related to car seats. In these cases, the seat isn’t even in the car.
We see a couple of cases a week where a child strapped into the car seat has taken a tumble—seat and all—from things like shopping carts. Other times, the child has been left unrestrained in the seat, perched atop a table.
Mistakes happen, we know that, and any parent taking the time to purchase a car seat certainly has the right intentions. But going that extra step to make sure it’s the right fit—and put in the right place; i.e., in a car—can make the difference between life and death.
Fast Facts
- A booster seat is 60 percent safer than being restrained by a seat belt alone
- 7 out of 10 kids in child safety seats are not properly buckled in
- Child safety seats can reduce fatal injury by 71 percent for infants and 54 percent for toddlers
- Source: SeatCheck/National Highway Traffic Safety Administration
Child-Seat Safety Resources:
Governors Highway Safety Association, www.ghsa.org
Texas Department of Public Safety, www.txdps.state.tx.us
American Academy of Pediatrics, www.aap.org
Seat Check, www.seatcheck.org or 1-866-SEAT-CHECK
