Introduction: It seems that buying a car seat or booster seat is getting more confusing by the day. There is a lot to sort through: 5-point, 3-point, T-systems, convertible seats, etc. And what about cost? Are more expensive seats better or are there cheaper ones that work just as well? So what is a parent to do? It is our hope that by defining some terms, giving guidelines, and making a few suggestions, this process will be easier for you. Please understand though, we will not tell you which seats to buy. This is an individual decision for each family.
Infant Seats. The American Academy of Pediatrics (AAP) recommends that infants should ride rear-facing starting with their first ride home from the hospital until they have reached at least a year of age and weigh at least 20 pounds. There are two types of rear facing seats: infant only and convertible seats.
- Infant only seats: Have carrying handles and come with a base that can remain attached to the car so that transporting the baby is fairly easy. There are also seats with a compatible stroller; the carrier snaps directly into the stroller. These systems both allow parents to move and transfer their baby with minimal disruption.
- Convertible seats: Start out rear facing and are then converted to forward-facing for older children. There are three types of harnesses.
- 5-point harness system: There are, literally, 5 points to be fastened with this system. Many child-care advocates recommend this type for the excellent fit it provides. Many parents are very happy with this system while many are frustrated the number of buckles necessary to restrain a very squirmy child.
- 3-point harness/overhead shield system: The significant feature here is the overhead shield (padded bar) that swings down over the child’s head and snaps into place. This system is easier to use for an active child but more difficult for a very big (and big headed) child.
- 3-point harness/T-shield system: This fairly convenient system has a soft “T” shaped shield that snaps into place between the child’s legs. This works great for most children but loses its efficacy when they get old enough to squirm out; that is when the overhead shield becomes more useful.
- Installation tips for infant seats
- Don’t place a rear facing seat in the front seat when there is an air bag. If the air bag deploys, the seat will jerk the baby back and possibly cause serious head trauma
- Some cars require a locking clip. Check the car safety manual for information about locking clips. They should be available from your car dealership.
- For vehicles made after 2002, there may be a LATCH system used to secure car safety seats. LATCH stands for Lower Anchors and Tethers for Children and is an attachment system that eliminates the need to use seat belts to secure the car seat. Instead, there is an anchor in the car that allows a hook on the car seat to attach to it. Remember, for LATCH to work, both the car seat and the car must be compatible with LATCH.
- Make sure the seat is attached firmly. You should not be able to move it more than an inch from side to side or from front to back
- Make sure the angle of the seat doesn’t allow the infant’s head to flop forward. Many new car seats have angle adjuster. If yours does not, you can put a roll of towels where the back and the bottom of the vehicle seat meet under the base of the car seat.
- When is it time to switch the seat to forward facing? The decision to turn forwards is not actually related to muscle strength; the bones and ligaments in the neck must be strong enough to prevent the spinal cord from snapping in an accident and so both age/development and bulk are necessary. Your infant’s head should not extend beyond the top of the seat’s backrest. This is generally around 26 inches. Large infants (>20 lbs, >26 inches) should be placed in a convertible child seat that has been approved for rear-facing use up to 30 lbs. Read the manufacturer’s directions and specifications for weight and height requirements. Not every seat is the same.
Convertible Seats. These seats are designed to comfortably seat toddlers up to 40 lbs. Although many convertible seats are approved for rear-facing use from 5- 20 lbs., parents tend to prefer the ease of the infant carrier for the first year (also, there is generally a better fit to the needs of an infant in the infant-only carriers). So most of the time, convertible seats are meant for forward-facing use from 20-40 lbs. Please note: not all convertible seats can be used rear-facing to 30 lbs., so for those big babies who need this feature, please read carefully! If the top of the restraint back is below your toddler’s ears, or if your toddler is more than 40 lbs., it is time to move to a booster seat. We are often asked about the types of harness systems available for these seats. All types are approved for safety; the key is deciding which system you want to use. You may want to take your child with you to look at seats. Try buckling him/her into each type. This may help you choose or rule-out an option.
- Types of seat for toddlers and preschoolers
- Convertible seats – see above
- Forward facing toddler seats – These are designed for children who weigh up to 40 (or 80 lbs depending on the model)
- Combination forward facing /booster seats- These are designed to be used with a harness for up to 40-65 pounds or without the harness for up to 100 pounds.
- Built in seats – These are built into many models of minivans and some SUVs. Check the manufacturers specifications carefully.
- Travel vests – Can be used from 20-168 pounds and are a good alternative if there are no shoulder harnesses in the back row.
- Installation tips for forward facing seats
- Move the shoulder straps to the slots that are just above the child’s shoulders
- Make sure the straps go through the forward facing path, not the rear facing path
- In vehicles built after 2002 with a LATCH system, check to see that your car seat is compatible.
Booster Seats. These seats are for forward-facing only. They are generally used when the child has outgrown a traditional car seat. This occurs when:
- The child has reached the top weight or height allowed for his seat
- The shoulders are above the top harness slots
- The ears have reached the top of the seat
Types of booster seats:
- High back boosters – These are often just convertible car seats without the harness. They are helpful in vehicles without head rests or with low back seats.
- Backless boosters – These are generally less expensive and can be more easily moved from car to car. These can be used in vehicles with head rests or high back seats.
- The lap belt should come across the thighs, not stomach. The shoulder belt must come across the shoulder and center of the chest. Additionally, the child must be mature enough to stay in this position while riding.
What else you should know about car seats:
- Installation - We cannot say this enough: Read the directions!! What your friend tells you about how she put her seat in does not necessarily apply to your seat in your car! You may also need to read the manual for your car to find out what type of seatbelts you have (i.e. Emergency Locking Retractors, Automatic Locking Retractors, passive or automatic restraints). It is recommended that in order to get a good tight fit, adults need to push the seat down and back with all of their weight while tightening the car seat belts. Read the directions to determine the need for locking clips or top tethers. There is only one correct way to route the seat belt, and that is the one in the manufacturer’s directions. Make no alterations!
- Positioning in the seat - Very small infants should have a foam insert, or blanket rolls on either side of them, for more support. Rear facing: the shoulder harness should come through the back of the seat at the same level as the shoulders, or lower. Forward facing: the shoulder harness should come through at or above the child’s shoulders; it is recommended in most brands to use the top slots. Harness straps should lay flat, with no twisting. Straps are tight enough if no more than 2 fingers fit between the strap and collarbone. The chest clip should be at armpit level.
- Car Accidents- For the most part, manufacturers recommend replacing a seat after a moderate to severe crash. Mild is defined as: no injuries, the car was drivable from the scene, the door nearest to the seat was not damaged and the airbags did not inflate. There is a good reason for this. In many high impact collisions, there are obvious cracks in the seat; but outward signs of damage may not necessarily be present. It is very possible that a seat has actually been weakened and damaged without any visible indicators. Some insurance policies pay for a new car seat, but you have to ask.
- 6 Nevers – According to the AAP, never use a car seat that is:
- Too old
- Has visible cracks
- Does not have a label with the model number and the date of manufacture
- Does not come with instructions
- Is missing parts
- Was recalled – check 888-327-4236 or the National Highway Traffic Safety Administration website
- For installation help – Check www.seatcheck.org or call 866-732-8243 for a list of CPS technicians who can help you insure that your seat is installed correctly. Check http://www.cruisinwithkids.com/OhioChildandInfantCarSeatSafetyInspectionStations.html for more information.
Rules and Problem-Solving Suggestions
- Front Seat: Unless there is an emergency, no one under 12 should be in the front seat if there is a passenger side airbag! This includes car seats, especially rear-facing! The impact of the inflating airbag is enough to kill small passengers. The safest seat is generally the center back seat. Please be sensible, a very small 12 year old should still be considered at risk, you wouldn’t let a 10 year old her size ride up front.
- Squirming and Unbuckling (Houdini Jr.): Adopt a simple rule-the car does not move unless everyone is buckled in. This must include adults, and there can be no exceptions. If your toddler unbuckles during a ride, pull over and be clear this is unacceptable. Anticipate these delays and allow extra time. Have the child teach others (including stuffed animals) to buckle-up. Take extra (short) rides, stopping for any unbuckling, to make your point. Encourage discussions of car safety in day care, preschool, and kindergarten.
- Lap belts: Cars pre-1989 my have lap-only belts in the back seat. There are many retrofitted shoulder belts available for these cars. If this is not an option, the E-Z-On Vest with a tether anchor is needed over 40 lbs.
- More kids than rear seat belts. Although it is not ideal, the only way out of this is to place one child in the front seat. This should be the child who will be most secure in a lap-shoulder belt. The seat should be placed as far back as possible. If there is an air bag, this can never be a rear-facing infant. Do not place more than one child in a seat belt.
- Air bags. If it is unavoidable to have a child in the front seat on a regular basis, or if there will ever be an infant in the front seat out of necessity, you need an air bag cut off switch. The air bag should be turned off for a child passenger and back on for adults.