HEALTH INSIGHTS

Car Passenger Safety: Car Safety Seats

October 13, 2018

Car Passenger Safety: Car Safety Seats

Each year thousands of children are injured or killed in car crashes. Car safety seats can help keep your infant or toddler safe and secure in your vehicle. But they need to be used correctly. Five important things you can do to keep your child safe are:

  • Use a car seat every time your child rides in a vehicle. No exceptions.

  • Have your child ride rear-facing for as long as the car seat allows.

  • Use your car seat according to the manufacturer’s instructions. Also check your vehicle owner’s manual. Keep both manuals handy for reference.

  • Always use car seats in the back seat of your vehicle.

  • Switch to a booster seat when your child outgrows car seats. Children who are taller or weigh more than the limit for a forward-facing car seat should switch to a belt-positioning booster seat, according to the American Academy of Pediatrics. It's important to check your car seat owner’s manual for the seat's height or weight limit.

Car seat positions

Car seats are either rear-facing or forward-facing. As a rule, children should face the rear of the vehicle for as long as possible. This is the safest position for a child in a car crash. How long a child must face the rear depends on his or her age, size, and weight. Following is more information on car seat positions:

  • Rear-facing:

    • Babies and toddlers should ride in a rear-facing car safety seat for as long as possible. That means until they reach the top weight or height allowed by their seat. Check your safety seat instructions.

    • There are 2 types of rear-facing seats. They are infant-only and convertible. Infant-only seats must only be used rear-facing. A convertible seat can be used rear-facing then converted to forward-facing. Most convertible safety seats have height and weight limits that will allow children to ride rear-facing for 2 years or more.

    • When used with babies, these seats should be reclined according to the manufacturer’s instructions. This keeps your infant’s head from flopping forward.

    • The harness should come through the car seat slots located at or below the child’s shoulders. Always follow the car seat manufacturer’s instructions for correct harness placement.

  • Forward-facing:

    • These seats can be used for children who have outgrown the rear-facing weight or height set by the car seat's manufacturer.

    • Many types of seats can be used forward-facing. These include built-in seats, combination forward-facing/booster seats, and travel vests.

    • The harness should come through the car seat slots located at or above the child’s shoulders. Always follow the car seat manufacturer’s instructions for correct harness placement.

Using a car seat safely

  • Buy the right car seat for your child:

    • Be aware that the best seat for your child is one that fits your child’s weight and height. It should also fit properly in your car. Don’t go by price alone.

    • Try out the seat. Put your child in it and adjust the harnesses and buckles. Check that it fits your child and your car.

    • Whichever car seat you buy, check that it’s one that you will be able to use correctly every time.

  • Install the car seat correctly:

    • Check that the seat doesn’t move more than an inch from side to side where the seat belt goes through the car seat (the belt path).

    • Read and follow the advice in the car seat’s manual. Keep the manual handy at all times.

    • Check your vehicle owner’s manual for information about installing car seats.

    • Check that you’ve installed your car seat correctly. Contact a certified child passenger safety (CPS) technician. For information, visit www.seatcheck.org or www.safekids.org. Your local hospital, police, or fire department may also have CPS technicians.

  • Check that the child is secured in the car seat safely:

    • Check the car seat instructions to make sure you’re using the equipment correctly.

    • Check that harnesses are snug and lie flat against the child’s chest.

    • Keep the retainer clip at armpit level.

  • Always install the car seat in the back seat of the vehicle. Kids under 13 years old should always sit in the back seat in a booster seat until they are big enough to fit in the seat belt correctly. Once your child is big enough to not be in a booster seat, he or she should still sit in the back seat. This is safer in case of a car crash.

  • Don’t use a car seat after it has reached its expiration date. This is often when the seat is about 6 years old. Check the car seat manual for information.

  • Upgrade your child’s seat as he or she grows. Keep track of the child’s height and weight taken at healthcare provider visits so you know if your child has outgrown his or her car seat.

  • When your child has outgrown a car seat, switch to a booster seat.

Resources and tips for keeping kids safe in cars

Here are some suggestions for safety: 

  • Use car seats and seat belts on every single trip you take—even if it’s just down the street.

  • Model good behavior. If you buckle up, your child will be more likely to do so.

  • Check that your kids understand that unless everyone is buckled up, the car doesn’t move. No exceptions.

  • Never use a car seat that has been in a serious crash. A seat that has been in a minor crash might be OK to use. To find out more, visit www.nhtsa.gov.

  • Don’t use a used car seat if you don’t know its history.

  • Never use padding or other products that did not come with your car seat.

  • Never use a car seat that has been recalled. For information on recalls, contact the manufacturer or the Vehicle Safety Hotline toll-free at 888-327-4236. Also fill out the registration form when you buy your car seat. This will ensure that you are told of any recalls of that seat.

  • Find out about the child passenger safety laws in your state online at www.safekids.org.

The LATCH system

LATCH stands for Lower Anchors and Tethers for Children. This system allows you to secure a car seat without using a seat belt. LATCH uses 2 or more sets of small bars (anchors) located in the back seat of the vehicle. It can also use a top tether attachment. Most cars made since September 2002 have LATCH. Your vehicle and your car seat must both be designed to use the system. To find out if you have LATCH, check your vehicle owner’s manual and car seat instructions. Never use LATCH along with a seat belt. Use one or the other.

Updated:  

October 13, 2018

Sources:  

Durbin, DR. Child Passenger Safety. Pediatrics (2011); 127(4), pp. s1050-s1066

Reviewed By:  

Adler, Liora C., MD,Freeborn, Donna, PhD, CNM, FNP