All posts by CHOC Children's

Car Seat Safety Reminders Every Parent Should Know

By Michael Molina, community health educator at CHOC Children’s

Car seat safety: selection tips every parent should know

Car seats and booster seats are the basic protection systems for passengers who are too small to get the full safety benefits from adult seat belts. Choosing the right seat is an important part of keeping your child safe on the road.

The best seat is one that:

  • Fits your child: appropriate for the child’s age, height, weight and development level
  • Fits in your vehicle
  • Is in good condition: has not been in a crash, is not expired or recalled, and has no labels missing
  • You can afford: inexpensive seats may meet the same national safety standards as their more expensive counterparts, but may not have the same comfort features

Remember to register your car seat to ensure you receive any relevant recall information from the manufacturer.

Refer to The Ultimate Car Seat Guide produced by Safe Kids, a nonprofit organization working to help families and communities keep kids safe from injuries, for personalized car seat tips based on your child’s age and weight.

To speak to an experienced child passenger safety technician, please call CHOC Children’s community education department at 714-509-8887.

Car seat safety: direction is key

The direction your child faces in their seat matters. Many children move to the next seat stage before they are ready, potentially putting them at greater risk for injury in a crash.

Current California law requires children under age 2 to be rear-facing. This helps protect their developing fragile spinal cords during a collision by the seat absorbing the force of a crash, rather than the child taking the brunt of the impact. Keep your child rear facing as long as possible, until they reach the maximum weight or height limit of their seat. This could mean beyond two years old.

Car seat safety: location matters

The back seat is best for children under age 13. The back middle seat is the safest place for them because it will protect them from a crash and they won’t be injured by airbags. If you are unable to install a car seat in the middle seat, consider placing your child on the curb side, as opposed to the street side. Never place an infant carrier in the passenger seat, and always have children in booster seats use both the lap and shoulder belt.

Car seat safety: do’s and don’ts of installation

In the U.S., 59 percent of car seats are installed incorrectly. In Orange County, 98 percent of car seats inspected by Safe Kids’ Orange County chapter are misused. This may put your child at risk for injury in a crash.

Do’s Don’t’s
Do read and follow your car seat instructions and vehicle owner’s manual. Don’t use the seat belt and the lower anchors together to install car seats.
Do use tether anchor for forward-facing car seats. Don’t sacrifice the middle seat just because it doesn’t have a lower anchor system. Try using the seat belt for installation and make sure it doesn’t move more than 1 inch from the belt path.
Do lock the seat belt if you are installing your car seat with the seat belt and not the lower anchors. Don’t use a lap-only belts for children using booster seats. Use a 3-point lap-and-shoulder belt to have full upper body protection.
Do the 5 Step-Test for your booster seat child to know if he or she is ready to ride without a booster. Don’t ignore the labels on the car seats.
Do choose a car seat that you will correctly and consistently use Don’t install a car seat in the front passenger seat. The back seat is the safest location for your child to ride. If there is no back seat, make sure to turn off the front passenger air bags.


Car seat safety: harnessing 101

Proper use of the harness or seatbelt ensures your child is securely positioned in a car seat, booster seat, or vehicle seat, and provide optimal protection in the event of a crash. Here are some helpful tips for adjusting the harness and seatbelt securely for your child.

Rear facing:

Children in rear-facing car seats should have the harness straps at or below shoulder level. This ensures that your child doesn’t slide upwards in a crash.

Forward facing:

Children in forward-facing car seats with a harness must have the straps at or just above the shoulders.

Both forward facing and rear facing:

  • To ensure your harness is tightly adjusted, do the “pinch test” at shoulder level. If you can pinch any material of the harness at the child’s shoulder, it is still too loose.
  • Avoid wearing thick, padded clothing when your child is in their car seat. Wearing them will prevent the harness from being effective in a crash because the padding will compress in an event of an impact which will cause injuries.
  • The chest clip is at armpit level.
  • Always buckle both the harness straps and the crotch belt buckle.

Booster seats:

  • Always wear a lap AND shoulder seatbelt when your child is using a booster seat
  • Do not transition your child out of the booster just because he is 8 years old. Use the 5 Step Test to determine if your child is ready to ride without a booster.

Car seat safety: getting your car seat inspected

A list of car seat resources, including where to get a car seat inspection, is available in the OC Child Passenger Safety Resource Guide.

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Related posts:

  • New Car Seat Laws: What It Means for Your Family
    Echoing longtime recommendations from CHOC Children’s and the American Academy of Pediatrics, children in California are now required to ride in rear-facing car seats until age 2, under new state ...
  • Car Seat Safety for Children with Special Needs
    Choosing the right car seat and installing it correctly can be confusing enough, but imagine the challenges that mount for families of children with special needs. Traditional store-bought car seats may ...
  • The Right Car Seat for Your Little Passenger
    Just in time for Child Passenger Safety Week (Sept. 13-19), check out the following guidelines from OC Keep Kids Safe, an injury prevention program of the American Academy of Pediatrics, ...

Vote Yes on Proposition 4- Children’s Hospital Bond

Please join CHOC Children’s this November in voting YES on Proposition 4, the Children’s Hospital Bond.

Prop 4, The Children’s Hospital Bond, provides $1.5 billion over 15 years to support critical, life-saving care for California kids. California’s 13 regional children’s hospitals, including CHOC Children’s, provide specialized care to children and young adults who suffer from serious and life-threatening disease, regardless of the ability to pay. Our hospitals handle more than 2 million visits each year.

This November, vote YES on Prop 4 to support CHOC Children’s and California’s 12 additional children’s hospitals.

Learn more about Prop 4





Finding Humor in Cancer

Brianna Miller is a 22-year-old from Southern California who was diagnosed with Stage 2 Hodgkin’s lymphoma shortly before her 21st birthday. She is a patient at CHOC Children’s. In this five-part series, she takes readers along on her look back at her journey with cancer.

If there’s one thing I’ve come to know more intimately over the last year than I did before, is that cancer makes people uncomfortable. I completely understand. It can be hard to know the right things to say, the best way to react to bad news, and how best be supportive. Along with all the bad things that accompany cancer, however, there are a lot of things that happen and you can’t help but laugh. I want people to know that it’s completely okay to find humor in cancer!

When I was first coming to grips with the impending side effects of chemo, I found that an effective way to ease my anxiety was making jokes to help make light of my situation. I’ve always been easygoing, and this developed into a sense of humor during treatment. If we’re being honest, going from having long hair to being completely bald is shocking but also can be funny! I kept hair ties on my wrist even after I had no hair and would reach for the brush just out of habit. I would often make jokes about being bald, and my friends would always redirect and reassure me that my hair would grow back. Of course, I knew that my hair would grow back, but that didn’t mean that I couldn’t have a little joke at my own expense in the meantime! Now that my hair has started to grow back, it looks kind of funky- I like to call it my “baby Orangutan” look. I know it looks funny, so someone reassuring me that it doesn’t really just makes me internally cringe. I understand the impulse to make someone feel better, but if I’m lucky, I’ll only have to do this whole cancer thing once in my life- might as well make it interesting while I do!

Of course, it’s never okay to make fun of a cancer patient’s trials or downplay their experience, but to consistently only talk to a patient about their experience in a serious tone can be quite frankly boring and frustrating. I’ve found so many great, sarcastic memes and apparel from other members in a Hodgkin lymphoma support group on Facebook and through other groups like Stupid Cancer, and they never fail to bring a smile to my face. My personal favorite was my Halloween costume last year, Charlie Brown. I figured I might as well take advantage of the baldness while I had it!


I think it’s important for people to realize that if a cancer patient is making light of their situation or making jokes, it’s perfectly okay for them to join in too! Sometimes long hospital stays or hard chemo days can be bleak and tiring, and bringing humor into the situation can help immensely. You have to do what is best for you.

Learn more about the Hyundai Cancer Institute at CHOC Children's

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CHOC Teen Advisers Weigh in on NYT Article “Please Stop Merchandising Mental Illness”

In response to a recent New York Times article titled “Please Stop Merchandising Mental Illness,” the CHOC Children’s Teen Advisory Council weighed in on our culture’s tendency to romanticize mental illness. The CHOC Children’s Teen Advisory Council is made up of outstanding teens who are active in their community, committed to academic success, and support CHOC’s mission to nurture, advance and protect the health and well-being of children.

Armed with examples of what they see and hear in each of their schools, they discuss how each of us can do our part to put an end to the misconception that having a mental illness is trendy.

Do you have other ideas? Leave them in the comments below. We want to hear from you!

Layla, age 13

Slogans and quotes can be printed on a bag or shirt quicker than people can think about what it really means. Sometimes, people can say things before they have a chance to think about what they are saying. For example, a word we use commonly is crazy. It may seem innocent, but crazy can mean different things to different people. We have to be more aware when choosing our words. Instead of using words like crazy and insane, describe something unusual as strange or bizarre. If we make little changes, it can slowly make a difference.

Carina, age 15

Most people don’t fully understand anxiety, depression or other mental illnesses. On social media you find people talking about it all the time, which is great as it brings more awareness and allows people with actual mental illnesses to share their stories. However, it has become almost a cool thing to say on these platforms. Social media and TV shows have a part to play in the growth of mental illnesses being “trendy” and also bringing more awareness to it, but they could do more to provide real education. People don’t understand what mental illness is, and some just believe that anxiety and depression, for example, are just feelings.

I see some of this happening at my school. In most cases I hear the phrase, “Ugh, ______ gives me anxiety” when in reality, they mean stressed and it usually has to do with tests, quizzes or an upcoming presentation. I’m not sure if they do actually have anxiety. However, most people I hear use the term very loosely and should be more careful with their word choice.

Cameron, age 15

It doesn’t surprise me that people romanticize mental illness. There’s absolutely nothing wrong with wanting attention; humans are a social species and attention is essential for self-esteem and social skills. Many people who romanticize mental illness don’t have these illnesses; instead it is them asking for attention or validation. However, people are trying to normalize terms like depression or anxiety, almost in an effort for people to see an exaggerated version of their emotions. Something that comes to mind is a shirt that I’ve seen others wear that depicts an adorable coffee cup with the phrase, “No Coffee Makes Me Depresso” My friend pointed out to me how the shirt was problematic. Odds are that not having coffee doesn’t make this person depressed. I dismissed it as a poor excuse for a joke, but thinking about it, it was a call for attention. Not having coffee doesn’t make you depressed. It may make you upset or even feel a little off, but it doesn’t make you depressed, something experienced by millions of Americans. Depression is a widespread illness that shouldn’t be joked about in this way.

Celebrities are also extremely vocal about mental illness, which can be both good and bad. If many people speak out about mental illness, the suffering can start to seem normal. It then becomes this situation where when someone comes forth with their struggles and they are met with responses like, “So does everyone else” or “It’s not just you” which can invalidate their feelings. After all, it’s normal, right? If there’s nobody with social influence speaking out, who’s going to inspire those struggling by themselves to come forward? Society is complicated, but for now we just need to develop an understanding for each other and extend a helping hand to those who feel helpless.

As a society, we must grow to learn that mental illness is a serious issue, not something that we weave into our everyday lives for the sake of seeming trendy or getting attention. We’re only human and we make mistakes, but it’s time we fix our mistakes.

Alyssa, age 14

My first reaction to these claims is that we should be mindful that people express themselves different ways. We may not agree with how they do it, but it’s best to perceive their actions with some empathy and take the extra step to see if they are trying to reach out. Fashion has always been a form of expression so by people expressing their feelings with a necklace that says “anxiety” or an article of clothing that says “sad” that could be a way of expressing themselves or a cry for help. Mental illness should never be seen as a joke and should be taken seriously. Mental illness should never be trendy and should be talked about more, so if having an article of clothing or a piece of jewelry with the words “anxiety” or “depression” sparks up a conversation, then that’s a positive thing for people who care about helping people with these illnesses because it spreads awareness

Heather, age 14

I believe that having issues or being depressed has become a trend recently for adolescents. A while back, the TV show “13 Reasons Why” became popular with teenagers. The show depicts a girl named Hannah going through depression and eventually committing suicide. In my opinion, anyone watching the show who was going through similar stuff that Hannah was going through, would became sad along with her. I thought the show tossed around words like suicide, rape and depression very casually, making these words’ connotation less severe. When words like that are casually tossed around on popular TV shows and in songs we hear on the radio, people begin to use these words in their everyday conversations without really knowing the effect of their word choice. This trend in conversation leads companies to create backpacks, pins, t-shirts and other merchandise with these words in trendy font because it has become an ideal lifestyle for almost every teenager. Whenever people come across a difficult or stressful situation they often say ‘I’m gonna commit’ or “kms’’ which stands for kill myself. By casually using serious words in everyday conversation, some of these intense mental health situations have been stripped of their true meaning and are being tossed around like a joke. This is unfair to the people that actually struggle with mental health problems.

Learn more about mental health services at CHOC

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How a Bone Marrow Transplant Can Save Someone’s Life

Every three minutes, someone is diagnosed with a blood cancer, like leukemia or lymphoma. As many as seventy percent of these patients don’t have a compatible match in their family, and must hope to find an unrelated donor. You can help these patients increase their odds by joining the Be The Match Registry®, an international registry of potential matches for those seeking a bone marrow transplant. Today, meet two CHOC Children’s patients who have benefited from a bone marrow transplant.


Emma, age 23

In the summer of 2017, I went from being a healthy 21-year-old college athlete to an acute myeloid leukemia patient in less than a week’s time. To say it happened fast is an understatement. The doctors told me I needed a bone marrow transplant as soon as possible. Dozens of my family members got tested to be a donor, but because it needed to happen quickly, we used my dad. I received his stem cells on October 3, 2017. The procedure was difficult, but my medical team and the hospital staff were incredible. The oncology floor was like a huge family made up of patients, caretakers, survivors, supporters, and many others who had been touched by cancer. Thankfully, my husband was there every step of the way. By March 2018, I was able to move back to my hometown and resume college online. I was able to reclaim my life and feel hope for my future. Right now, I’m three weeks away from the one-year mark. I feel good, and I’m so grateful for my bone marrow transplant. It gave me back my life and the best gift of all: time.


Zaiden, age 3

I was diagnosed with B-cell acute lymphoblastic leukemia when I was 2 years old. Thankfully my parents took me to an amazing hospital, CHOC Children’s. Everyone is amazing there! I started heavy chemotherapy, and everything was going well. Unfortunately, I relapsed after nine months of treatment. It was after this I had my first bone marrow transplant, with my dad as my donor. Again, I was kind of back to my normal life when I relapsed again at the six-month mark. After this we tried Car T Cell therapy, but I again relapsed after nine months. So, in April 2018 I had my second bone marrow transplant and this time it was my sister who got to be my donor. These treatments were not easy, but I have been living my best life since then.

I am extremely lucky that I was able to be matched not once but twice with people in my family as my donors. A lot of kids are not as lucky and have to wait a long time to find a match. Because of my treatments it inspired my parents to register with Be the Match in hopes they could do the same thing for someone else that saved my life.