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Health blog

Child Car Seats

All parents want to do what’s best for their children, and that includes selecting the correct child car seat. Even though motor vehicle accident deaths have declined in recent years, 148,000 children between birth and thirteen years old were injured in car accidents in 2011. Another 650 died. Using the correct child car seat in the correct manner greatly reduces the risk of injury and death in young children. Even so, half a million children ride in vehicles without seat belts or safety seats at least part of the time.

Child car seats depend on a child’s height and weight. Convertible and three-in-one car seats can be used for several years as the child grows. Car seats reduce the risk of death for infants by 71% and for toddlers by 54%. Booster seats for older children reduce the risk for serious injury by 45% when compared with seat belt use alone.

Rear-facing car seat: Rear-facing seats belong in the vehicle’s back seat. Use this seat from birth until at least one year old. Some seats fit a child up to 40 pounds. As this is the safest position for small children, use the rear-facing seat until child reaches the weight or height limit of that seat. In a crash, rear-facing car seats protect the head, neck, and spine.

Forward-facing car seat: When your child outgrows the rear-facing seat (typically between two and three years old), move child into the forward-facing seat positioned in the vehicle’s back seat. Leave child in this seat until at least age five, or until child reaches weight or height limit of seat. The seat may fit until age seven. A forward-facing car seat has a harness and top tether to limit forward movement during a crash.

Booster seat: When the child reaches 57 inches tall, move to the booster seat, positioned in the vehicle’s back seat. Booster seats may fit children between seven and twelve years old, and up to 100 pounds. It raises and positions children so vehicle's lap and shoulder belts fit properly. A booster seat keeps the lap belt from injuring the child's abdomen and keeps the shoulder belt in place to protect the upper body.

Seat belts: For a seat belt to properly fit, the child must be: tall enough to sit without slouching; able to keep back against vehicle seat; able to keep knees naturally bent at edge of vehicle seat; and able to keep feet flat on the floor. Children should not sit in front seats until they are at least thirteen years old, because airbags can kill young children.

In 2012 the National Highway Traffic Safety Administration reported a study of child car seats of more than four thousand children from birth to age eight. Child passenger safety technicians observed the children in their seats and interviewed adult drivers. Using child seats incorrectly increases the risk of injury to head, neck and body. The five most common mistakes were:

1. The wrong harness slot was used. Use the slots located at or below child’s shoulders for rear-facing seats. Use the slots located at or above child’s shoulders for forward-facing seats.

2. The harness retainer or chest clip was improperly positioned. Position it over the child’s chest at armpit level, not over the abdomen.

3. The car seat was too loose. The seat should not move more than one inch from side to side, or front to back across the vehicle seat.

4. The harness strap was too loose. The strap should be tight enough so there’s no slack when you pinch the strap at the child’s shoulder.

5. The lap belt was improperly placed on child in a booster seat, or one old enough to use the adult belt. The lap belt should lie snugly across the upper thighs, not the abdomen. The shoulder belt should lie snugly across the shoulder and chest, not the neck.

Studies find that seven out of ten car seats are incorrectly positioned. Yet nine out of ten adults are confident they've installed the seat properly. Take the time to carefully read the instructions that come with each car seat you place into your vehicle. Your child’s life may depend on it.

(Resources: CDC Child Passenger Safety fact sheet:; Parents Central provides safety tips on car seats:
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