Car Seat Safety

It is extremely important for all infants and children to be restrained when riding in a motor vehicle. Volumes of research have been compiled which stress the decreased chance of serious injury occurring during a collision when passengers are restrained properly. Although the clinician should discuss car seat safety with the parents of all infants, it is even more important to discuss this issue with the parents of premature infants. Issues particular to premature infants, such as potential airway obstruction, poor posture, and small body size, make proper car seat selection and use imperative.

The following material was taken from Baby Awareness and Support through interactive Computer Systems (BASICS), a project supported by the U.S. Department of Education and the University of Kentucky.

Important Considerations When Choosing a Car Safety Seat for an Infant

Before buying a car seat for an infant, families should check their vehicle to determine what type of seat will work best. Some seats work better in certain cars depending upon the size of the car, the type of seat cushions (flat, humped, or contoured), the amount of head room, the type of seat belts, and the presence of air bags. Families should be told to consult their owner's manual for specific instructions.

For many premature infants, the car seat is too simply too big. In this event instruct the family to place rolled up washcloths or blankets on each side of the infant's body and head. If the infant starts to slouch down into the seat, instruct the family to place a rolled up wash cloth between the infant's legs and the crotch strap. Do not place any padding under or behind the infant because it may make the harness looser, causing the infant to fall out of the car seat in an accident.

All infants less than one year of age or weighing less than twenty pounds should be placed in a rear-facing car seat in the back of the vehicle. This is the safest position for the infant and should be used as long as is feasible - per car seat manufacturer's instructions.

The best car seat is one that fits the infant the most securely. Newborn babies should always be placed in a rear-facing car seat in the back seat or in a car bed for medical needs. Medically fragile babies require special consideration when buying a car seat. Because premature and medically fragile babies sometime weigh under the minimum requirement for rear-facing car seats (usually 5 pounds), it is important to make sure that the car seat has harness straps that are low enough to fit securely around the infant.

Additionally, infants should be maintained in a reclining position so that their heads do not fall forward, potentially occluding their airway. However, one should never tilt the car seat more than halfway back.

For more information concerning car seat safety consult the following links:

SafetyBeltSafe U.S.A.
Helpline is 1-800-745-SAFE
This website has excellent links to other good resources including a frequently asked questions page.

To contact a certified safety inspector, call your local fire department.

For Recalls on car safety seats, call AutoSafety Hotline 1-888-327-4236 www.nhtsa.dot.gov/cars/problems/recalls/index.cfm

For additional information visit the following websites:
safe ride news
This site has general information about car seat safety, and a page to order additional written information

The National Safety Council
This site offers general fact sheets and newsletters on car seat safety as well as other safety issues.

The American Association of Pediatrics
This website offers recent articles and recommendations from the AAP on car safety seats.

The Kentucky Injury Prevention and Research Center
This site provides information on safety issues and contains many related links and contact information.