Selecting and using a car seat is a normal practice for the average American parent and yet it is the deadliest. When quizzed, parents might list their fears over a variety of parenting and health topics –important in their own right — but fail to feel concern or fear about the risks of collisions.
Going to the numbers, though, shows that injuries from vehicle collisions are the leading cause of death for children (1). One study even found that almost two thirds of all car seats are installed incorrectly or buckled incorrectly (2). Just recently, a mother is facing charges due to using car seats incorrectly. One of her twin babies, a 6 week old, was killed in a collision.
To make matters worse, American culture has promoted the idea that turning a child forward facing is a celebratory milestone and that continuing to rear-face past the minimums is poor parenting or risky. yet this is the exact opposite of how physics works in collisions.
Rear-facing cradles the whole body, including the vulnerable spine and neck, distributing crash forces evenly and protecting the child from severe injuries. Forward facing restrains the child in the seat, but allows the head to move forward violently, potentially stretching or snapping the spinal cord and leading to severe injuries involving the spine and brain.
One study, for example, found that children in forward facing seats were “significantly more likely to be seriously injured than children in rear-facing car-seats in all crash types.” (3)
Despite a lengthy lapse in laws and recommendations, both are now catching up, with many states beginning to update their minimum rear-facing laws. Additionally, various children’s organizations have released updated recommendations, urging parents to continue rear-facing until the child is at least 2 years old or optimally until the child meets the height and weight limits on the seats. The car seat industry is trying to catch up to other countries, finally offering seats that rear face to 40lbs and even 50lbs.
What this means is that now more than ever, parents have knowledge, support and many car seat options to ensure their children are restrained in their vehicles as safely as possible. But where do you begin?
When choosing a seat to buy, it’s important to look at the child and the vehicle. The seat needs to fit the child and the vehicle it will be used in, as not all seats fit all children and vehicles the same way. Some car seats have shorter shells, meaning a tall or fast growing child will outgrow the seat sooner. Some seats are very large and bulky, meaning they won’t fit into a smaller vehicle or fit next to other passengers. Most seats are comparable in price and luxury options, and these options have nothing to do with safety, so it’s best to start with fit and installation when deciding on a car seat.
• Measure your child’s torso height. Sit your child against a wall and measure from the floor to the top of the shoulder. The torso height helps you to decide which seat will last the longest.
• Weigh your child and think about your child’s general weight gain pattern. The highest weight limit on a seat in America is currently 50 lbs, with most of the other available seats trailing behind at 40 lbs and the Diono seats coming in at 45 lbs.
• Research your vehicle’s rules and available options. Some cars do not have LATCH, and some cars do, but there is often a weight limit. Split seats, small seats and angled seats might mean wider car seats will tip over or install poorly. Visit www.car-seat.org to review vehicles and car seats and how they fit together from others who report their installation experiences.
Faced with a multitude of gadgets and nursery items to buy, many parents might bristle at the average cost of a mid-line car seat. But it’s important to prioritize and reserve money for the items that will directly protect children. With a little bit of preparation and research, it’s possible to shop frugally.
• Shop at the beginning of the year. Companies roll out new designs and new colors, so you’re most likely to find good deals around this time.
• Keep an eye on deal websites such as www.slickdeals.net to find out when a particular seat goes on steep discount or when a particular company has a good coupon.
• Combine deals to get the best price on in-store purchases. For example, Babies R Us often sends out flyers with 20% coupons, plus has a 25% discount during their “trade-in event.” Target coupons often include clearance and you can use their credit or debit card for an additional 5% discount. Whatever store you purchase from, scope out their sales and coupon schedules to prepare.
• It’s tempting to buy a used seat, especially to be earth friendly. But this is actually a hazard unless you’re buying from someone you absolutely trust. Do not purchase used car seats from strangers. They can pull a seat out of a wreck and resell it without you knowing, but the internal structure might be damaged and fail to protect your child in a future collision.
• The same goes for expired seats. It might look safe to you, but the expiration date is based on plastic degradation and weather exposure. Here is an expired seat in a low-speed test.
Installing a car seat can be one of the hardest parenting tasks you will ever do! It can seem very overwhelming at first, especially when trying to read the manual and trying to make sure you’ve done everything correctly. But it’s vital to install it exactly as the manual instructs. There is no loophole or room for preference when it comes to the intended function of a car seat.
Misuse, besides increasing your child’s risk of injury and death, can also void your warranty, allow the insurance company to deny a claim after a collision and even net you a fine and a visit from a CPs caseworker to investigate.
For example, a father was involved in a collision during a snow storm. Two of his children were ejected from the vehicle and one child suffered internal injuries. The father was cited for failing to install the seats correctly.
• About that manual: Read it! skim it briefly. Then read it again the next day to absorb more details. Also be sure to have it with you while you in-stall the seat. If you lose the manual, many are available for download online or free by calling the manufacturer.
• If you are stumped, don’t feel bad! some of the seats out there are re-ally tough to install. Find a certified carseat technician who can show you how to install your seat.
• Do not assume that a firefighter, police officer, nurse or other authority figure is capable of installing your seat. Most of them are not trained or certified. Always ask for proof of certification as a CPST (Child Pas-senger safety Technician). A CPsT will also encourage you to install it instead of doing it for you.
• No matter how much money you spend or how deluxe a seat is, if it isn’t installed correctly, it’s nothing more than a fancy death trap.
• Make sure it’s installed correctly every time, in every vehicle. If you suspect a friend or family member can’t or won’t install it correctly when watching your child, do it for them.
BUCKLING AND USAGE
So, once the seat has finally made it into the car, you’re really only halfway there. Now the child has to fit into the seat, and this is the part where many risky mistakes are made. Follow these guidelines and after you become familiar with them, it won’t feel inconvenient or overwhelming.•
If rear-facing, the straps must be at or BELOW the shoulders. If forward-facing, the straps must be at or ABOVE the shoulders.
• The straps should be tightened until you can’t pinch them and they shouldn’t be twisted.
• The chest clip must be at the chest, armpit level.
• The child should be sitting comfortably, legs in whichever position is desired, and the head should be be-low the shell if rear-facing. If forward-facing, consult the manual as it can vary.
• During cold weather, it is important to avoid loosening the straps to fit a thick coat, blanket or snowsuit. The thick material will easily compress in an accident and the child will be ejected. Use thin but warm materials such as a fleece jacket or purchase (or make) a car seat poncho. Store warm fleece blankets in the car. You can also place the coat on “backwards” after buckling. One of the best tools when it comes to relieving car seat anxiety and ensuring safe usage is to get a visual of these concepts.
MORE ON REAR-FACING
Turning a child forward is still considered a celebratory milestone and often parents have received many myths or urban legends about the debate between rear-facing and forward-facing. It’s important to filter out the popular sayings and look directly to the physics of how a car seat works and how a child moves in a collision.
• Many parents mistakenly fear their children will break their legs if they remain rear-facing. On the contrary, forward facing is associated with more injuries overall. It’s also notable that a broken leg is easy to cast. But a broken spine or damaged brain is very difficult to repair and has lifelong consequences. Rear-facing is the safest way to protect the fragile brain and head, even with a rare chance that the legs are injured.
• Another common fear is that children will feel uncomfortable or crowded if they remain rear-facing. Young children tend to be more comfortable in small spaces, curling themselves up into pretzels or hiding out in homemade forts. Most seats on the market today have a deep pan, allowing for more leg room. And children can choose their own leg positions for their comfort.
• Sometimes parents think that if they turn a crying child forward, it will end the tantrums or fights. It’s important to remember that children have struggled with restraints since before rear-facing car seats even existed. Toddlers don’t like to be held down in place no matter which direction they are facing. Distraction and flexibility is needed, not a reduction in safety.
• In cases of true hardship such as motion sickness, seizures or other medical conditions, find support and ideas by visiting www.car-seat.org and looking for parents who have similar experiences. There are tricks and tips to try before turning your child forward.
1 CDC. Web-based Injury statistics Query and Report-ing system [online]. National Center for Injury Preven-tion and Control, Centers for Disease Control and Prevention (producer).
2 Department of Transportation (Us), National High-way Traffic Safety Administration (NHTSA), Traffic safety Facts Research Note 2005: Misuse of Child Restraints: Results of a Workshop to Review Field Data Results . Washington (DC): NHTsA; 2006.
3 Henary B, sherwood C, Crandall J, et al. Car safety seats for children: rear facing for best protection. Inj Prev. 2007;13(6):398–402. [PMC free article] [PubMed]