Dr. Karl Neumann’s Kids Travel Doc 10 Tips: New Recommendations for Infant Car Safety Seats

May 19, 2011

Posted in Outdoor Recreation, Prevention, Safe & Healthy Travel, Travel Comments Off
Tags: AAP, car accidents, car seats, children, front-facing car seats, infant car safety seats, kids car seats, kids travel doctor, nhtsa, parents, pediatrics, rear-facing safety seats, safe car seats

Just when you thought that you knew all you had to know about children’s car safety seats, the experts come up with a slew of new recommendations, forcing you to rethink what you were sure that you already knew.

1. The new recommendations:  Children should ride in rear-facing safety seats until they are two years of age or until they reach the maximum height and weight recommended by the manufacturer of that particular seat, says the American Academy of Pediatrics (AAP). The previous recommendations had children riding rear-facing only until one year of age or until they were 20 pounds. The changes are based on updated data on how children are affected by the forces involved in sudden stops and crashes.

2. Many reports regarding the new recommendations emphasized only the age changes.  In fact, car seat safety data is based almost entirely on height and weight, with weight more important than height for infants. Data shows that the severity of injuries from a crash of a given magnitude is related to the child’s size. Recommendations are age-based merely for clarity. While parents know how old their children are, few know their children’s precise heights and weights once they reach one year of age.

3. Children at any given age vary substantially in height and weight. The weight of “normal” two-year olds ranges from 23 to 32 pounds. But almost 50% of 18-month-olds have already reached 23 pounds.

The height of “normal” two-year olds is 32 inches to 36 inches but about 40% of 18-month-olds have reached that minimum height. And many “normal” children do not reach the minimal height and weight of a two-year-old until they are 2 ½ or even 3 years of age. And, as age increases, “normal” height and weight limits diverge even further.

4. All recently manufactured safety seats must (by law) state the maximum height and weight limits for which seats are designed. Maximum limits for popular model rear-facing seats vary from 22 pounds to 35 pounds. Height limits vary from 29 inches to 32 inches. Buying a seat with maximum height and weight limits allows you to use the seat for longer lengths of time.

5. Many parents prematurely switch children to front-facing seats.  One reason is that many older children and adults prefer facing forward; facing backwards makes them uneasy. This may be related to motion sickness. It is not known if this occurs with infants; they do not seem to be ill at ease facing backward.

Another reason for switching prematurely is that parents are eager (and proud) to advance their children as proof that they are growing. (With clothing, for example, manufacturers know to size clothing so that it fits children somewhat older than their chronological age.)

6. Keep children rear-facing as long as feasible.  You need not change out of rear-facing seats at two years of age unless your child has outgrown the seat. Riding rear-facing is considerably safer at all ages and in all kinds of vehicles.  (Safety-wise, all passengers in moving vehicles ideally would face backwards – as do passengers on most military transports.) 

Moreover, as children grow and advance through the various age-appropriate safety devices – forward-facing safety seats, booster seats, harnesses, and car seatbelts – each subsequent device is somewhat less safe. New recommendations allow you to keep children in each safety device until the child is larger than previously recommended. For more information, see the AAP website: www.healthychildren.org/carseatguide. 

7.  Safety considerations override a child’s apparent discomfort. Don’t assume that tall children are uncomfortable when they sit rear-facing and have their legs scrunched up between their bodies and the rear of the regular car seat. Few seem ill at ease. Children are far more flexible than adults. Nor will this position lead to leg injuries in case of an accident. Lower-extremity injuries are no more common for children rear-facing than forward-facing. But forward-facing increases risks of head and spinal injuries, which are far more serious than broken legs.

8. Safety considerations also override difficulties you may have in observing children when you are the lone adult in the car.  While it is easier to attend to forward-facing children, in fact, if children need attention you should stop the car, regardless of which way they face. Passing snacks, bottles or other objects to infants causes you to turn the steering wheel, says Consumer Union. Don’t allow infants to eat in a moving car. This increases the chances of you having to attend to them. Give them safe toys to keep them busy, toys they are unlikely to drop. 

9. Costlier seats are not safer seats. All seats must meet the safety requirements of the National Highway Traffic Safety Administration (NHTSA). (Hand-me-down seats are not recommended; many lack the latest safety updates.)  Convenience features and usable lifetime of seats generally determine seat costs. 

10.  Make sure that your child’s seat is properly installed. Studies show that up to 80% are not. Professional assistance is available in most communities, often at no cost. Check NHTSA Child Safety Seat Inspection Station Locator at www.nhtsa.gov/cps/cpsfitting/index.cfm for a facility near you.             

But even correctly installed, age-appropriate safety seats are not totally safe. A recent study at Yale University found that just over half of 378 parents interviewed reported that at least one of their children had managed to unbuckle a seatbelt.  Of these children, 75 percent were aged 3 or younger; some were as young as 12 months. More than 40 percent of these children did so while the car was moving.

There is no substitute for parental vigilance.

Posted in Outdoor Recreation, Prevention, Safe & Healthy Travel, Travel Comments Off
Tags: AAP, car accidents, car seats, children, front-facing car seats, infant car safety seats, kids car seats, kids travel doctor, nhtsa, parents, pediatrics, rear-facing safety seats, safe car seats