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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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 legislation.

As of January 1, 2017, the law extends the former requirement that children face backward until age 1. The new law does not apply to children who weigh more than 40 pounds or are 40 inches or taller.

CHOC community educators, however, continue to recommend more stringent guidelines for children and rear-facing seats. They encourage parents to keep in mind the following tips:

  • Facing the rear is the safest way for a baby or toddler to ride.
  • Keep toddlers in a rear-facing convertible car seat at least until age 2 or until they reach the maximum weight and height for their seat.
  • The harness straps should be snug and placed at or below the shoulder level.
  • Children have outgrown their current car seat when there is less than one inch of space between the top of their head and the top of the car seat.

Motor vehicle crashes are the leading cause of death for children ages 1 to 14 in the United States. According to a 2007 study in Injury Prevention, children younger than 2 are 75 percent less likely to die or be severely injured in a crash when they’re riding in rear-facing car seats. They are also a major cause of permanent brain damage, epilepsy and spinal cord injuries. Many of the deaths and injuries can be prevented with the proper use of child restraints and seat belts.

CHOC child passenger safety technicians are available to answer car seat questions regarding current laws, how to select an appropriate seat for your child, and what you need to know to install and use the child restraint correctly.

For more information on child passenger safety, visit CHOC’s community education page.

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Car Seat Safety for Children with Special Needs

The AngelRide carries infants who must lie down.
The AngelRide carries infants who must lie down.
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 not work for children with certain conditions, and parents often must turn to specialty options that can be expensive with limited options.

“A lot of the families of patients with special needs will begin to see that and feel so overwhelmed,” says Elizabeth Perez, a CHOC Children’s community educator.

Parents and guardians should never attempt makeshift accommodation for children with special needs. Instead, Perez and her colleagues in CHOC’s Community Education department can help families in these unique circumstances navigate the process to select and acquire a car seat that fits their needs.

“Once we get that call, we meet with the family,” Perez says. “They will bring their seats and their vehicle, and we work to see what kind of seat they’ll need.”

Community educators can also help the family, as well as their clinicians and social workers, write letters to their health insurance provider to seek assistance for the family in purchasing the special car seats or accessories, which can be very expensive, Perez says.

Many conditions might make choosing a car seat more complicated, and require parents to find specially made seats, she says.

For example, children with cerebral palsy may have low muscle tone and trunk control and will have limited and less affordable options once they reach the upper weight limits of standard car seats.

Children with respiratory problems other conditions that prevent them from sitting up can face challenges as well, Perez says. In these cases, families might rely on “car beds,” which allow passengers to securely lie down on their backs, stomach or sides.

Children with behavioral challenges, autism, attention deficit hyperactivity disorder or cognitive impairment may also need special restraints in the car if they cannot stay secured in a car seat and risk distracting the driver. In these cases, harness system or travel vests might be helpful.

Also, children missing limbs or those wearing spica casts that immobilize the lower body can need special accommodations.

Contact CHOC’s Community Education department at 714-509-8887 for more information about car seat safety for children.

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 CHOC Community EducationAmerican Academy of Pediatrics, to make sure you are choosing the right car seat for your child.

Rear Facing Infant and Convertible Seats

  • Never in front of an airbag
  • Rear facing to upper weight or height limit
  • Harness snug at or below shoulders
  • Chest clip at armpit level
  • Attach to car with seat belt or lower anchors
  • Add nothing to or behind harness
  • Rear facing 5 times safer between ages 1 and 2 years

Forward Facing Seats

  • Up to 40-65 or 80 pounds
  • Lower anchors to 40-48 pounds
  • Harness snug at or above shoulders
  • Chest clip at armpit level
  • Attach to car with top tether strap and seat belt or lower anchors
  • Use a 5-point harness to upper weight or height limit of seat

Booster Seats

  • Until 4’ 9” and 8 -12 years
  • Always use lap/shoulder seat belt
  • Never put shoulder belt behind back or under arm
  • Use highback booster for vehicle seat without headrest

Adult-Size Seat Belts

  • Back straight against vehicle seat, and knees bent at seat edge
  • Shoulder belt across chest, not neck or throat
  • Lap belt low and snug across upper thighs, not stomach
  • Children younger than 13 should always ride in the back seat

As a reminder, rear facing is always safer and be sure to always read your car seat and vehicle manuals for specific directions.

For a downloadable pdf, click here.

Visit CHOC’s community education page for more on child passenger safety.

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New Car Seat Law Beginning Jan. 1st

Have you heard? Beginning January 1, 2012, a new law in California will require all children under 8 years old to ride in a car or booster seat in the back seat of a motor vehicle.

Children 8 years or older may use a vehicle seat belt if it fits properly with the lap belt low on the hips, touching the upper thighs, and the shoulder belt crossing the center of the chest. If children are not tall enough for proper belt fit, they must ride in a booster or car seat. The new law imposes fines and penalties for violations.

California joins more than 37 other states with strict booster seat laws. The law mirrors the recommendations of the American Academy of Pediatrics and the National Highway Traffic Safety Administration, among other agencies.  Car crashes are the leading cause of death for children ages 4-12 and one of the leading causes of injury and disability. For your and your family’s safety, please remember to have everyone buckle up!

Learn more about car seat guidelines from the American Academy of Pediatrics. 

For more information, please contact a certified child passenger safety technician in CHOC’s Community Education Department, by calling 714-509-8887. A free child passenger safety class and a low cost car seat program (in English and Spanish) is available.

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