Wednesday, March 19, 2014

Car Seat Safety


Tragically, thousands of young children are injured or killed in car crashes every year.  You already know that their best protection is a good car seat.  But did you know that you are likely using your car seat incorrectly? According to the National Highway Traffic Safety Administration, 3 out of 4 seats are used incorrectly.  Seatcheck.org claims that 7 out of 10 children are improperly secured in their car seats.  These numbers are shocking. 

Unfortunately, there is no session in your birth class on choosing a car seat and installing and using it properly.  When you leave the hospital or birth center, they make sure you have a car seat, but they do not verify that it’s the right seat, or that you are using it properly.  And your child’s provider may not address car seat safety.  So when and how are you supposed to learn the ways of the car seat?

There is an excellent article on HealthyChildren.org that outlines almost everything there is to know about car seats.  It is thorough and long.  Rather than reinvent the wheel, my goal in this post is only to point out some of the most common mistakes.

Photo by Bradley Gordon / bradleygee; uploaded from Flickr without amendments.

Choosing the Right Seat
·       Make sure your child is in the right car seat for her age, weight, and height.  As your child grows, keep checking the owner’s manual for height and weight limits.  Don’t try to push it past the limits just because the infant car seat is easier to use.
·       Be careful with used car seats.  Once a seat has been in a collision, it is worthless and should be discarded.
·       Do not use a seat that is more than 6 years old, has been in a collision, has signs of wear and tear, is structurally unsound, or is missing pieces.
·       Make sure your seat has not been recalled.  To do so, you’ll need to know the manufacture date and model number.  Check for recalls here.

Installing it Properly
This can get tricky:  LATCH versus seat belt; middle seat versus side seat; older cars that don’t have LATCH.  It’s not always obvious, and the owner’s manuals can be tricky to follow.  Do yourself a favor and have an expert do it for you (see resources).  Or, at least, stop by a free car seat inspection event and have an expert check your work (see resources).

Using it Properly
·       Ride rear facing until at least 2 years of age.  Don’t turn your child forward until he has exceeded the height and weight limits for his seat in the rear facing position (which usually means he can rear face long after 2 years of age). 
o   But what about his legs hitting the seat?  Injuries to legs are rare, and a child who is used to riding rear facing probably won’t be bothered since he doesn’t know the difference.
o   But I can’t interact and distract him as well if I can’t see him.  Consider this a small price to pay for a huge increase in safety. 
o   Is it really that much safer? Yes. A 2007 study in the journal Injury Prevention found that children under age 2 are 75 percent less likely to die or to be severely injured in a crash if they are rear-facing[1].  Alisa Baer, M.D., a pediatrician and nationally certified child passenger safety instructor quotes a different study showing that “rear-facing is 5 times safer for two-year-olds[2].”
·       Chest clip should be even with the bottom of the armpits.
·       The carrying handle should be placed in the retracted position.
·       Coats should not be worn.  In fact, your child can be in a onesie with an outfit over it, but nothing thicker than that.  Coats and other thick fabrics can compress in an accident, endangering your child.
·       Straps should be tight.  You should just be able to slip one finger between the strap and your child’s collarbone.
·       Do not set the car seat with baby in it
o   on top of a table, counter, etc – you would be surprised how far the car seat can fly when baby starts to wiggle
o   in the small part of grocery cart – again, the seat can fall from here, taking baby with it.  Only use the large part of the cart or your snap and go system.
o   down in the parking lot or street.  You never know when a car might lose control.  Always put the car seat directly in the car.
·       Keep your older child in her booster seat.  She must be 4’9” tall, which usually occurs around 10-12 years of age, before she can ditch the booster.  The lap belt must fit across the upper thighs, not the abdomen, and the shoulder best should fit across the shoulder and chest, not the neck and face.  She must also have the maturity to ride with her seat belt fastened correctly at all times.

Note in this picture that the chest clip is too low, the straps are loose, and the crotch strap may not be placed correctly.
Photo by Mark Evans / chimothy27; uploaded from Flickr without amendments.

Other tips:
o   Travel with a car seat.  Though it’s common to see children on airplanes riding in laps or squirming freely in a seat, it’s important to remember that they are safest when properly secured in their car seats. 
o   Use the car seat every time.  It may be tempting to forgo it, but remember that many accidents occur close to home, on familiar routes, and at low speeds.
o   Keep your child in the back seat until 13 years of age.
o   Everyone else in the car must buckle up too.  Having one person in the car not buckled up puts everyone else in the car at higher risk.

I know car seat logistics are not a fun thing to spend time and energy on, but I’m sure it’s worth the payoff in peace of mind and increased safety for your child.

Resources:
Find where to have your car seat checked by local experts:  NHTSA
More information on car seats: Parents Central 
More information on car seats and general vehicle safety: download the “Playing it Safe” Brochure here 
More information on car seats at Kids Health  
More details on common car seat mistakes  
More information on car seats at The Car Seat Lady

Car Seat Checks:
Car seat class at Seattle Children’s Hospital
Seattle area car seat expert, who will install your seat for you and review safety tips with you: Sue, (206) 619-2871
Safety Restraint Coalition events: (425) 828-8975
Seattle Children’s Hospital events




[1] http://www.cnn.com/2011/HEALTH/03/21/car.seat.guidelines.parenting/
[2] http://www.parenting.com/gallery/car-seat-laws-requirements-installation?pnid=318525

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