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Child Car Seat and Booster Safety
Recently I've noticed a trend among parents to get their kids out of car seats and boosters as soon as legally allowed, which is moving in completely the opposite direction of the recommendations by the American Academy of Pediatrics and many safety organizations. Parents feel that car seats are restrictive and inconvenient (the entryway of some daycares these days look like the car seat aisle at a baby store, since many families have one parent drop off and the other pick up), take up too much room in cars and are prohibitively expensive in sizes that accommodate larger children. So they stop using them as soon as possible – usually the second their child reaches the minimum age or weight limit. I get that…I do, but I have to say bluntly that I disagree with this course of action, and myself choose the opposite path.
Car seats are not an issue to be taken lightly. According to the National Highway Traffic Safety Administration (NHTSA), car accidents represent the "leading cause of death for ages 3-6 and 8-14." They also indicate that each day in 2007 an average of "5 children age 14 and younger were killed and 548 were injured," a total of 1,670 children. Honestly, this makes me tear up just writing it. If there is absolutely anything we can do as parents to reduce the chances that our children are represented in these numbers, we simply have to do it. On this issue, there are no second chances…only regrets.
[Note that the minimums listed in this article are referring to car seat requirements in the United States.]
It is important to note that the 1 year and 20 pound requirements to turn a child from rear-facing to front-facing are *minimums.* And it is not one or the other, but *both* that should be reached before making the change. Most children reach the 20 pound requirements well before a year, and many times reach the height limit of infant seats before the weight limit. They do make infant seats now that fit children up to 30 pounds and a few more inches than the traditional variety. I have one of these, the Graco SafeSeat Infant Seat, and *highly* recommend it.
If your child reaches 20 pounds before one year, you must use a convertible car seat, which is one that can be used rear-facing or forward-facing. Even when they reach 20 pounds, the AAP now recommends keeping children rear-facing for as long as the seat allows. This can differ from seat to seat, so check your car seat manual, but my understanding is that as a rule of thumb it is about when the top of their head reaches the top of the seat. My 22 month old is still rear-facing and will remain so until she outgrows the limit in her convertible seat, and she does ride next to a forward-facing big sister. This has not been an issue for us. As much as I believe in giving children control over many circumstances in their lives, car seats are not a negotiable issue in our household. It's that simple.
Once they are forward facing, children should remain in harnessed car seats until a *minimum* of 4 years or 40 pounds. Again, these are minimums. Car seats are available that harness children until 60 or even 80 pounds. For our older daughter, we used the Britax Advantage seat (a version of the Britax Roundabout that is no longer available) and then moved her to the Britax Marathon. We actually had little choice in this matter, as she is stick-thin and reached the height limit of the smaller seat before she weighed 30 pounds, which is the absolute minimum (but not recommended) for a booster seat. She is nearly 6 now and will be riding in the Marathon until she reaches the limit, even though she could have been in a booster for some time now and on her birthday could legally ride in the regular shoulder/lapbelt. Yes, it is sometimes inconvenient. We have to make special arrangements to get to friend's houses afterschool for playdates, because we do not allow her to ride without her car seat in others' cars. And she may start to complain soon when her whole Brownie troop piles into one minivan for an activity and we drive her separately. But I don't care… it's not worth it to me if she gets hurt, or killed. Other kids are different sizes and weights than her, and I simply won't compromise on this issue. I read recently that in Europe children ride in restraints (at least boosters) in many European countries until age 12. In the USA, we stop at half that age!
Once switching to boosters, children should remain in a booster seat until at least around 4' 9". Yes, this can be a long time… I am only 5 inches taller than this requirement *now* (and am fully aware that most car seat safety features are not made to keep as safe those of my size). But children smaller than this are not adequately protected from being thrown from lap/shoulder belts and restrained property in a crash situation. We actually purchased a low-back booster (VERY small and inexpensive) seat to keep in the back of our car to be able to transport my daughter's friends when that comes up.
And remember that even if you have the right seat and use it until the max requirements, it still needs to be installed correctly to work. The NHTSA estimates that as many as 50-90% of car seats are misused or installed incorrectly. NHTSA has a database of locations where you can have the installation of your car seat checked for free – there is sometimes a waiting period to get an appointment for this service, so plan for one in advance if you are going to be having a baby or installing a new type of seat. You should also plan to remove your car seat as few times as possible to ensure continued correct installation. So back to my example about car seats at daycares, ideally those parents should purchase additional seats and reduce the constant re-installation of these seats.
And yes, I know, car seats are expensive. But they represent some of the most important money you can spend. Buy less toys, or cut other places, but buy correct car seats. A common reason for moving a child to a less protective car seat sooner than the maximum fit (or sometimes even the minimum requirement) is a subsequent child coming along and needing that seat. So parents move along to the next seat type because they *can,* when the real question to ask is if they *should.* Some parents also choose to skip and infant seat (despite the convenience of the click-in base) and start with a convertible seat, even a Marathon-type or larger seat, most of which start at 5 pounds to save some money. This is a valid choice, but it is worth noting that I was told by a certified CPST (Child Passenger Safety Technician) that using the smallest seat appropriate for your child provides the safest fit until they are ready to go to the next size. For those who simply can not afford additional seats (or a proper seat at all) there are organizations that can help (see below).
For those looking for car seats, here are my top recommendations:
The Graco SnugRide is well-priced infant seat on Amazon.com, but be careful of which pattern. Only the Milan pattern meets all my recommendations (several other styles do not have a front strap adjust – when reading reviews note that they match up with all different varieties of the seat.. not a well-organized page):
For older children, I like the Britax Boulevard with adjustable height:
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