The first step you can take in protecting your children in the car is to buckle them up. Riding unrestrained or improperly restrained in a car is the single greatest risk factor for death and injury for children.
All 50 states require child safety seats, but restraints may vary by age, weight, and height among states. You can find out what each state requires at the Governors Highway Safety Association website.
Here are some tips that will help you keep your tot safe in the car.
When a car seat is correctly installed and used, it can reduce the risk of death for infants by 71% and for toddlers by 54%.
Make sure you have the right car seat for your child's age and size. Each type of seat will have different height and weight recommendations, so it is important to carefully read the product information provided with your car seat. States may vary in their traffic safety regulations as well, so you may want to look up the laws in your state. A certified child passenger (CPS) technician can help with your selection. Visit the
National Highway Traffic Safety Administration
website to search for a technician in your area.
Another point to consider is your car. Most cars made after 2002 are equipped with the LATCH (lower anchors and tethers for children) attachment system, which offers additional protection. Check with your car dealer if you have questions.
Types of Car Seats
The following list of provides a general outline for their appropriate use by type of car seat. Keep in mind that the manufacturer's guidelines for each seat can differ even within a particular category of seats:
- Rear-facing seats (infant seats and rear-facing convertible seats)—The American Academy of Pediatrics (AAP) recommends rear-facing seats for all children until they reach age two or until they meet the highest height and weight limits for the seat.
- Front-facing convertible seats and other front-facing car seats—According to the AAP, these seats can be used once a child reaches age two or the height and weight limits for the rear-facing seats. There should be a harness used with the front-facing seat. Again, the child should use this seat until he reaches the recommended height and weight limits.
- Belt-positioning booster seats—These types of seats allow the child to sit higher up so that the adult seat belt can be used. The AAP recommends that the booster seat is used until the child can fit in a seatbelt without a booster (4 feet, 9 inches [1.45 meters]) and age (8-12 years old).
Once the child has reached the recommended height and age, the regular seat belt can be used. It is important that both the lap and the shoulder belts are properly positioned. In addition:
- The child should be sitting all the way back in the car's seat.
- The child’s knees should bend comfortably at the edge of the seat.
- The shoulder belt should cross at the center of the child's chest and shoulder.
- The lap belt should fit across the child's upper thigh, not stomach.
- The child should be able to remain seated comfortably like this for the entire trip.
Children under 13 years of age should still ride in the rear seats of the vehicle.
- Never Place Rear-Facing Infant Seats or Children Under 13 in the Front Seat—If it makes you nervous to not be able to see your baby's face, allow enough time so that you can pull off the road periodically to check on your baby, or consider purchasing a car seat mirror designed specifically to allow you to see the baby by looking in your rear-view mirror.
- Never Leave a Child Unattended in the Car—Even if you are running into the store for just a second, take your child with you.
- Do Not Use the Car Seat Outside of the Car—Car seats are designed to be securely positioned in a vehicle. Falls can happen when a baby is placed in a car seat outside of the car. For example, if the seat is placed on the ground or on a table, the baby could fall and be seriously injured.
- Always Use an Approved Car Seat—And make sure your car seat is compatible with your car.
- Periodically Check for Recall Notices on Car Seats—You can check the National Highway Traffic Safety Administration's website for recall notices.
- Know When to Replace Your Baby's Car Seat—Do not use a car seat that is too old. Contact the seat's manufacturer to learn how long it recommends using the seat. Do not use a seat that has been in a moderate or severe crash.
- Use Caution When Taking Your Child Out of the Car Seat—Do not take your child out of the car seat while the car’s engine is running or the car is parked where it could be stuck by another vehicle. This holds true even if your child is fussing or crying.
Remember to be a good role model for your children. Always wear your seat belt and make sure your children know that your attention must be on the road and not them. Consider bringing along some soft toys to keep them occupied. Not all accidents can be prevented but these safety steps will help create the best outcome possible.
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Car Seats and Booster Basics. National Highway Traffic Safety Administration Patents Central website. Available at: . Accessed December 6, 2012.
Child passenger safety. National Highway Traffic Safety Administration website. Available at:
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Child Passenger Safety Laws Governors Highway Safety Association website. Available at: . Updated January 2013. Accessed January 7, 2013.
Traffic Safety Facts 2008 Data: Children. National Highway Traffic Safety Administration website. Available at: . Accessed December 6, 2012.
10/5/2010 DynaMed's Systematic Literature Surveillance
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3/28/2011 DynaMed's Systematic Literature Surveillance. .Committee on Injury, Violence, and Poison Prevention, Durbin DR. Pediatrics. 2011;127(4):788-793.
Last reviewed January 2013 by Brian P. Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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