Pediatrics Common Questions, Quick Answers

Car Seats/ Child Safety Seats

Donna D'Alessandro, M.D.
Lindsay Huth, B.A.
Peer Review Status: Internally Reviewed
Creation Date: October 2001
Last Revision Date: April 2002

Common Questions, Quick Answers

• Why should my child ride in a child safety seat?
• How do child safety seats work?
• When should I use a child safety seat?
• Which child safety seat is right for my child?
• What is the correct way to use a child safety seat?

Why should my child ride in a child safety seat?

• The number 1 preventable cause of death for young children is injuries suffered while riding in a car.
• It is not safe to hold your child in your arms in a car. Your child can be ripped from your arms in a crash and crushed between your body and the windshield or dash. This is called the "child-crusher position." It happens at speeds as low as 30 miles per hour.
• Each year, hundreds of lives could be saved if children were protected in cars by using child safety seats.
• Infants and toddlers ages 0-4 years should always ride in child safety seats. It's the law in all 50 states.

How do child safety seats work?

• A child safety seat helps absorb the force of a crash.
• The seat holds your child in place so he is not tossed around inside the car.

When should I use a child safety seat?

• You should begin using a child safety seat the day you take your newborn home from the hospital.
• Children ages 0-4 years should be placed in a child safety seat every time they ride in a car.
• Older children often still need child safety seats, too.

Which child safety seat is right for my child?

• There are lots of different kinds of child safety seats. Use the information below to help you choose one.
• Keep your child in a child safety seat for as long as possible. When he outgrows the seat, use a booster seat.
• Booster seats are made for children who weigh 40-80 pounds.
• Booster seats lift up the child so the car's safety belt stretches across his hips rather than his stomach.
• If a shoulder belt crosses over your child's face or neck, put the child in a properly fitted booster seat. Do not simply tuck the shoulder belt behind the child's back.
• Safety belts should be worn over the hips, not over the belly. Use a booster seat if a safety belt crosses your child's belly.
• Convertible seats can be changed from rear-facing to forward facing for infants and toddlers.
• Household infant carriers should not be used as child safety seats.

What is the correct way to use a child safety seat?
Child safety seats should be positioned according to how much your child weighs. You should always follow the manufacturer's directions for installing the seat in the car. If you have questions about child safety seats, contact your pediatrician, a local safety group, or the National Highway Safety Administration's toll-free safety hotline at 1-800-424-9393.

Positioning

• Infants should be placed in semi-reclined, rear-facing child safety seats until they are one year old AND over 20 pounds.
• All children who weigh 20-80 pounds or who can sit up alone should ride in a forward-facing child safety seat.
• The safest place in the car is the middle of the back seat. Put the child safety seat there if possible.
• Never put a rear-facing child safety seat in the front seat of a vehicle with a passenger-side airbag. The airbag could hit the back of the child safety seat and cause serious injuries.

Installation

• Automatic safety belts should not be used to install child safety seats.
• Fasten the child safety seat inside the car using the car's safety belt. The seat should move only 1 inch side-to-side and front-to-back.
• If your child safety seat has a tether, be sure to follow the instructions for fastening the seat to the car.
• Fasten the child safety seat's harness. Leave only an inch of room for the child to move.

Quick Answers

• Infants and toddlers should always ride in car safety seats. It's the law.
• A child safety seat helps absorb the force of a crash and holds your child in place.
• Your child should be placed in a child safety seat every time he rides in a car.
• Keep your child in a child safety seat for as long as possible. When he outgrows the seat, use a booster seat.
• Child safety seats should be positioned in the car according to how much your child weighs.

References

• American Academy of Pediatrics, "Protect Your Child With A Child Safety Seat." URL: http://www.vh.org/Patients/IHB/Peds/Safety/ChildSafetySeat2.html
• Children's Health, "Car Seats often used incorrectly," 1997. URL: http://wellness.ucdavis.edu/child_health/child_safety/carseat/car_seat.html
• Department of Nursing: Children's and Women's Services/OB-GYN patient Education Committee, "Choosing Your Baby's Car Seat," 1997. URL: http://www.vh.org/Patients/IHB/ObGyn/Carseat.html
• National Highway Traffic Safety Administration: U.S. Department of Transportation, "Child Safety in Your Automobile." URL: http://www.vh.org/Patients/IHB/Peds/Safety/ChildAutoSafety.html
• SafetyBeltSafe USA, "Safe Ride," 1999-2001.URL: http://www.nhtsa.dot.gov

See related Patient Topics Motor Vehicle Safety, Preventing Disease and Staying Healthy, Safety or Wellness and Lifestyle.

See related Provider Topics Preventing Disease and Staying Healthy, Safety or Wellness and Lifestyle.

All contents copyright © 1992-2004 the Author(s) and The University of Iowa. All rights reserved.

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