I picked up the phone expecting to hear my father’s cheery voice. Instead, I felt the wind being knocked out of my chest with each word he spoke. There had been a car accident. He hadn’t made it. He had suffered severe head trauma; and even with the best neurosurgeons fighting for his life, they had been unable to perform the miraculous. Who else was in the car? Who else was hurt? My mind was racing. Her tiny toddler frame had suffered several fractures, but she was going to be fine. My mind buzzed. He wasn’t even 10 years old. How could life be so fragile?
Some moms have called me crazy for my car seat paranoia. “What are the odds of getting in a severe car accident in the first place? What are the odds of something bad actually happening to your child?” Unfortunately, the odds are greater than you might think. In fact, motor vehicle injuries are the leading cause of death for children living in the United States according to the CDC. I know first hand what it is like to lose someone you love in a car accident. In fact, three funerals for three different children from three different families have solidified my paranoia that car accidents CAN hit close to home. Standing over countless bodies in the trauma bay, bloodied and disfigured from motor vehicle accidents has only further cemented this scary and gruesome fact in my mind.
Car accidents DO HAPPEN. And, while preventing all of them in the first place would be ideal, the reality is that even with concerted efforts to eliminate texting, drunk driving, distracted driving, reckless driving, and poor judgement calls (all of which are paramount efforts); 100% prevention is impossible. So if we can’t prevent all motor vehicle accidents, apart from doing our best to drive safely, what can we do?
We can do our best to protect the little ones that we love by making sure that their car seats, booster seats, and seat belts are doing their jobs. Again, 100% protection is not a guarantee, but by paying attention to the safety resources and recommendations that we do have, we can significantly decrease the risk of injury and even death. According to the CDC, properly using a car seat reduces the risk of infant death by 71% and toddler death by 54%; and, the appropriate use of booster seats reduces the risk of serious injury for children aged 4-8 by 45% compared to just using a seatbelt. These numbers alone prove the importance of child passenger safety efforts.
Here are 7 Tips You NEED TO KNOW to make sure that your child has the maximum protection while in the car:
1. Choose a Safe Car Seat
-Make sure that your car seat has a label that says that it has been rated by the NHTSA. These all meet federal safety standards and strict crash test ratings.
-Make sure that it has the label with the Model number and the Manufacturer date
-Make sure that you register your car seat in case of recalls (which do happen!). Simply click on the highlighted link to register.
-If Choosing a USED Car Seat:
If you are choosing a used car seat you MUST know the HISTORY of that seat. Do not use a car seat that has been in a previous moderate to severe crash. If it doesn’t come with instructions, do not use it. If it lacks a safety label, model number, or manufacture date, do not use it. Contact the manufacturer and check to make sure that its specific make and model have not had any recalls issued before you use. Make sure that there is not obvious damage or missing parts-this could make it structurally unsound. Make sure that it is not more than 6 years old or expired. If you are missing even one piece of the history…move on and find another car seat.
2. Choose Your Car Seat Based on Age, Height and Weight:
Make sure that your child is buckled in an age and size appropriate car seat or booster. You can double-check the age, weight, and height restrictions of your seat in the owner’s manual and sometimes it is even labeled on the seat itself. You can find a more detailed chart from the CDC and from Healthy Children detailing appropriate seats based on age, height, and weight at the highlighted links here. Or, use this helpful calculator to determine the appropriate seat for your child. The general rules are as follows:
Infant to 2 years: Rear Facing Car Seat (this recommendation has recently changed. Previously parents were advised that if their child met the weight and height regulations they could be turned around after only a year of age. The recommendation now is to keep your child rear facing until at least 2 years or until they meet the maximum height and weight restrictions for their rear facing seat. This is the safest position to prevent and limit severe injury.
2 Years to At Least 5 Years of age (or they outgrow the weight and height restrictions)-Forward Facing Car Seat
Age 5 Up Until a Seat Belt Fits Properly: Booster Seat
3. Use Your Manual to Install Your Seat and Get Your Install Double Checked
Make sure that you take the time to review your car seat owner’s manual and even your car owner’s manual. Car seats are not all the same, and all cars are not the same. Simply clicking and tightening doesn’t ensure a safe installation. The location, the angle, and the latches are just a few things to consider. Click HERE for some helpful install tips and then follow your owner’s manual installation instructions step by step. When you have finished installing, make sure to have someone double-check your work. You may consider yourself an expert, but studies show that 90% of car seats are not used correctly! Yes, that was 90% according to Johns Hopkins. Many hospitals have staff that will double-check your car seat before you head home with your newborn, but it is always best to get your install double checked by a certified Child Passenger Safety Technician several months before your baby is expected to be born just in case your little one decides to come early and your hospital doesn’t offer this inspection service. If you are able to get it checked in advance or if you are simply changing car seats, most fire stations or public health departments will also offer install inspections free of charge or at a minimal cost. To locate a certified Child Passenger Safety Technician in your area, click HERE.
4. Choose the Safest Spot in the Car!
Car Seats should ALWAYS be placed in the back seat of the vehicle. If for some reason this is not possible (your car consists of only one front row of seats), and you do not have another transportation option, then you must make sure that the air bags are turned OFF in the front seat especially if you are using a rear facing car seat. If your child is in a car seat in the front and an airbag deploys, it could cause severe brain damage or even kill your child. So in general, the rule stands…PUT YOUR CHILD IN THE BACK SEAT OF THE CAR. Again, all vehicles are not set up with safety latches in the same locations, nor do all cars have the option for a middle seat (in the case of vans with bucket seats), and if you’re installing more than one car seat then the middle will not be an option either. But, if you are able to safely install your seat in the rear MIDDLE or CENTER SEAT, it is the safest spot in the car for your child according to current research. While placement of a car seat in any rear seat position does provide excellent protection if installed correctly (decreasing the risk of injury by 62% compared to front seats), the center rear position has been shown to reduce the risk of injury for children an additional 43% compared to the rear side seats, according to evidence published in the Journal of Pediatrics.
5. Rear Face Your Car Seat As Long As Safely Possible.
As I mentioned above, the safety recommendations on how long to rear face a car seat has changed. The longer that you are safely able to keep your child rear facing the better! Previously the recommendations had allowed for turning the car seat around (for convertible seats) or switching to a forward facing car seat at 1 year of age as long as the minimum weight and height requirements were met. Today, the American Academy of Pediatrics urges parents to keep their child rear facing until they are AT LEAST two years of age unless they have outgrown the height and weight recommendations for their rear facing seat (some small children can stay in a rear facing seat well past the age of 2 years). We now know that the rear facing position is the safest for protecting the head, neck and spine in infants and toddlers.
6. Secure the straps properly
Double check your car seat straps each time that you put your infant or child into the seat. Often times they will have loosened when you take your child out of the seat. The straps should be snug and leave no room for slack! If you can pinch the strap, then it is too loose. Grab the strap at shoulder level. Try to pinch the harness from top to bottom. If you can pinch a fold then the harness is too loose. It should fit snuggly like a hug. You want it snug not overly tight…you do want your child to be able to breathe! The shoulder straps and the lap belt should all be securely fastened. All 5 points of the restraint system should be used every time! The chest clip should be secured at the mid-chest level. Double check that it has not slid down lower (which often happens when previously removing your child from the seat). If your child is old enough to buckle himself in, make sure that YOU still double-check the security of the latches and the tightness. For more on safely securing boosters and seat belts check out this link.
7. Avoid Puffy Coats, Snow Suits, or Extra Padding or Positioners
Winter is a tricky time for car seats. As parents we often bundle our little ones up before we trek through the cold out to the car. The problem with this scenario is that bulky coats, snow suits and layered or bulky clothing could actually be putting our children in danger and limiting the protection of our car seats and safety restraints. Bulky clothing does not allow for safety restraints to be tightened appropriately. As parents we may have a false sense of security that they straps are tight enough, when in fact they may not be secure. In the case of a motor vehicle collision, bulky clothing often compresses leaving extra slack in the harness which could allow an infant or child to be ejected from the car seat, or it could allow for more severe neck or head injury. Instead of using bulky winter wear, simply put your child in a thin winter coat and hat, warm up the car ahead of time, or drape your child with a winter coat or a small blanket over their lap.
Additionally, extra positioners for the head and neck (or any extra positioners that do not come with the car seat) are not recommended. These positioners have not been safety tested with all car seats and could interfere with the safety features of your car seat.
This list is not meant to be an all-inclusive safety lesson on car seats, nor is it meant to substitute for following your owner’s manual or your pediatrician or family physician’s recommendations. For more resources check out the highlighted links throughout the article. As parents we want to protect our children. Knowing that motor vehicle accidents are the leading cause of death from injury for young children should motivate all of us to take extra precautions each time we put our child in the car. We can never be too safe or double-check too many times!
As always, I love to hear from YOU! Please leave a comment with your questions, experiences, or concerns.