Car Seats, Boosters & Seat Belts — A Primer (by a Pediatrician) for the Outpatient Pediatrician Posted in: Tips & Tricks
To print this out as a PDF, see here.
Why is it important?
- Room for Improvement:
- Nearly half of the kids injured & killed were UNrestrained.
- Stress to parents to ALWAYS use SOMETHING (i.e. if in a taxi with a 3y/o without a car seat or booster… buckle child in his own seat belt & keep shoulder belt in FRONT of child)
- 90% of seats NOT used properly… average seat w/ 3 errors – #1 & #2 usually seat & child too loose
How will it help?
What is recommended?
- REAR-Facing (abbreviated as RF)
- Until AT LEAST age 2 (ideally longer… best way to prevent brain & spinal cord injuries)
- Kids <2y are 75% safer RF. Kids 12-24 months 5x less likely to die/be seriously injured RF than FF.
- Toddlers should be RF in a convertible seat – starts RF (up to 35-50lbs OR head 1 inch below top of seat), later goes FF
- Feet touching back of seat is FINE; approx 0.1% of kids rear-facing will suffer lower extremity injury – rate much higher forward-facing). Also, kids are flexible… it is not uncomfortable for them.
- FORWARD-Facing (using a 5 point harness as the restraint) (abbreviated as FF)
- Until AT LEAST 4y AND 40lbs AND mature enough to sit still in a booster
- Tether EVERY forward-facing seat! Tether is strap that secures top of car seat to anchor in back of vehicle – decreases brain & spinal cord injury by decreasing child’s head movement in crash.
- BOOSTER seat (using the vehicle’s shoulder & lap belt as the restraint)
- Booster positions seat belt properly on child’s body (poorly positioned lap belt is major source of injury to spinal cord & abdominal organs… shoulder belt rubbing neck is NOT a source of injury)
- NEVER put shoulder belt behind child’s back or under arm (this removes all head protection)
- Use booster until child passes 5-STEP TEST – must say YES to ALL 5 below… usually pass ~10-12y
- FRONT seat
- Not until at least 13 years of age – use as opportunity to model good driving behavior (scanning, lane changes, signaling) to prepare child to become a safe driver
2011 AAP Car Seat Safety: Policy Statement / Technical Report
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