Child Car Seats

Topic Overview

Infant and child car seats save lives. The laws in each state are different. Most states require them for all children under age 4 and those weighing less than 40 lb (18 kg). But some states require car seats to be used for children up to age 6 or 60 lb (27 kg).

A child who is not in a car seat can be seriously injured or killed during a crash or an abrupt stop, even at low speeds. A parent's arms are not strong enough to hold and protect a baby during a car accident. Many unrestrained children die because they are torn from an adult's arms during an accident.

Set a good example for your children by always wearing your own seat belt, and always insist that they buckle up.

Requirements for car seats

Buy a car seat appropriate for your child's current weight and age:1

  • Use an infant car seat that reclines and faces the rear until your baby is at least 1 year of age and weighs at least 20 lb (9.1 kg). See a picture of a rear-facing car seat.
  • Use a toddler seat that faces the front and has a shield or harness for babies and children who are at least 1 year of age and weigh at least 20 lb (9.1 kg). Stay with this type of seat until your child outgrows it [usually about age 4 and about 40 lb (18.1 kg)]. Some infant seats can be converted into toddler seats. See a picture of a front-facing car seat.
  • Use a booster seat for children who are at least age 4 and weigh at least 40 lb (18.1 kg). Booster seats raise the child and allow him or her to see out of the window. See a picture of a booster seat. Use regular lap and shoulder belts. Adjust the shoulder belt to fit across the shoulder, not the neck. Stay with this type of seat until at least age 8 or when your child is 4 ft (1.2 m)9 in. (22.9 cm) tall.

Never buy a used car seat. If a car seat has been recalled or has been in an accident or misused, it may not fully protect your baby.

Proper positioning

The safest position for your baby or child is in the back, middle seat of the car.2

  • Do not place your child's car seat in the front seat of any vehicle with a passenger side air bag that cannot be turned off.
  • Do not allow anyone younger than age 13 to sit in the front seat of any vehicle with a passenger side air bag that cannot be turned off.
  • Make sure a rear-facing seat is at an angle where your infant's head does not flop forward.
  • Take extra care if you have a premature infant. Slouching may affect his or her breathing and oxygen supply.

For maximum safety, follow the manufacturer's recommendations for car seat use, which should include weight guidelines, installation procedures, and how to position and secure your child. Cars manufactured since September 2002 are equipped with a standardized car safety seat attachment system. This feature allows parents to secure the car seat onto a permanently installed hook. Also, some newer cars are available with built-in car seats to accommodate children between 20 lb (9.1 kg) and 40 lb (18.1 kg).

Certified Child Passenger Safety Technicians can help you position your child safely. To see if one is in your area, go to www.nhtsa.dot.gov/cps/cpsfitting/index.cfm or www.seatcheck.org. You can also call the National Highway Traffic Safety Administration at 1-888-327-4236.

Do not let your child get out of his or her seat while the car is moving. If your child needs attention, stop the car, take the child out of the seat, take care of his or her needs, and put him or her back into the seat before the car starts moving again. If your child is fussy again soon after, stop and check your child again.

References

Citations

  1. National Highway Traffic Safety Administration (accessed November 2008). Child passenger safety. Traffic Safety. Available online: http://www.nhtsa.gov/portal/site/nhtsa/template.MAXIMIZE/menuitem.9f8c7d6359e0e9bbbf30811060008a0c/?javax.portlet.tpst=4427b997caacf504a8bdba101891ef9a_ws_MX&javax.portlet.prp_4427b997caacf504a8bdba101891ef9a_viewID=detail_view&itemID=ce45e2542a964110VgnVCM1000002fd17898RCRD&viewType=standard.
  2. American Academy of Pediatrics (accessed November 2008). Car safety seats: A guide for families 2008. Available online: http://www.aap.org/family/carseatguide.htm.

Credits

Author Debby Golonka, MPH
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
Last Updated February 26, 2009

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