Infants & Rear-Facing Seats
Why is riding rear-facing the safest way for young children to ride?
At birth, a child's head is large for its body and the bones are not fully hardened. In a 30 mile-per-hour crash into an immovable object, a 10-pound baby presses against the shell and padding of the seat with 300 pounds of force. Their rear-facing seat moves with them to manage crash forces on the child's body.
If a child is placed forward-facing too soon, in a crash, the force of the baby's heavy head whipping forward can stretch the ligaments in the spinal column up to two inches, but the spinal cord can stretch only one-fourth of an inch. Severe head injury or paralysis may occur. As long as children do not exceed the height or weight limits of their rear-facing child restraint, they are five times safer riding rear-facing into their second year of life! Click here to read/print the one-page study.
Rear-facing car seats protect in two important ways.
- The seat keeps your child from being ejected from the car
- The seat spreads crash forces over a young child's back, the strongest part of their body.
Considering a convertible car seat for a newborn baby?
Rule number one: Not all seats fit properly into all cars.
- Most convertible seats (used rear-facing first then forward-facing for older children) are labeled for babies 5 pounds. If your baby might be low birth weight or premature (see premature and low birth weight below).
- Each rear-facing seat has a recline angle that must be followed when installing the seat into your vehicle. It is a requirement, not a suggestion.
- Choose a seat that does not press against either of your front vehicle seats backs and does not require you to move your driver and front passenger seats closer to the dashboard in order to achieve the proper recline angle. This is why trying before buying is important.
- In the lowest position, will the harness be at or below your baby's shoulders? Straps hold the baby down into the seat. An average newborn's torson is about eight and one-half inches. If the harness comes above a newborn's shoulders it should not be used.
- Consider grow room. Convertible seats protect rear-facing to 35, 40 or more pounds (read labels). Later the seat is converted to its forward-facing direction for older children.
The American Academy of Pediatrics recommends children ride rear-facing to AT LEAST two years of age or to the highest weight limit the seat permits (check the child restraint manual and labels on the seat). Choose a seat with a harness that is easy to loosen and tighten and to buckle/unbuckle.
What car seats fit a premature or low birth weight baby best?
Convertible Seats (rear-facing to forward-facing) are generally for full-term infants weighing 5 pounds or more. Check instruction books and labels for lowest weight limits. The Combi Coccoro Convertible seat is labeled for infants weighing 3 pounds or more while infant (rear-facing only) seats may begin at 4 pounds.
Select a seat with shoulder straps located 6 inches or less from the bottom of the seat. Use the harness in lowest set of slots. A crotch strap that is 5 ½ inches or less from the seat back will fit a small baby best. If needed, place a rolled washcloth between the baby's crotch and the crotch strap to keep baby from slouching. Two small rolled receiving blankets placed along the baby's body provide added support. Never place any extra padding behind or underneath the baby.
Many hospitals follow the American Academy of Pediatrics recommendation that babies born before 37 weeks should be tested in their car seat before going home. The test tells if heart rate, oxygen level or breathing problems will develop from car seat use. If they do, your baby may need to ride lying down in a crash-tested car bed.
When can my baby ride forward-facing?
Do not be in a hurry to move your child forward-facing. Research in Pediatrics, March 2008 shows children—up to 2 years of age—are 5 times safer riding rear-facing than forward-facing. NEVER turn a baby forward facing until AT LEAST one year of age AND at least 20 pounds. Move a baby who outgrows their infant seat into a rear-facing convertible seat. Most convertible models can be used rear-facing to 30 or more pounds. Read the instruction book and the seat labels. If you have questions about a certain model, contact the manufacturer or call the Safety Restraint Coalition at 425-828-8975 or 1-800-282-5587.Learn more…
How do I know when my child has outgrown his/her infant seat? What should I do next to have the best protection for my child?
An infant seat is outgrown when:
- the baby reaches either the height or weight limit listed on the seat's label or
- there is no longer one inch of padding and seat shell above the baby's head.
Move the baby into a convertible seat that allows him/her to remain rear-facing. Follow manufacturer’s instructions to determine when you may turn your child forward-facing. Remember that riding rear-facing offers the best protection for your baby's neck and spine. For optimal protection, the AAP recommends babies ride rear-facing in a convertible seat up to two years of age AND to the seat's highest rear-facing weight limit.
I have a child who is big enough now for a convertible seat. What do I need to know?
Convertible seats fit children 5 - 65 (or more) pounds depending on model. Read instructions and labels on the side of the seat. Choose a seat whose label specifies it has been tested for rear-facing use to a minimum of 30 or more pounds. For optimal protection, the AAP recommends babies ride rear-facing in a convertible seat up to 2 years of age and to the highest rear-facing weight limit of their seat.
- Height of the top harness strap slots varies. Forward-facing, harness straps need to be in reinforced slots at or above the child's shoulders. Is there enough grow room? In some seats, ONLY the top-most slots may be used when the seat is forward-facing. Read and follow the directions in manufacturer's instructions.
Preschoolers & Forward-Facing Seats
How do I know when my child has outgrown a convertible or forward-facing only car seat? What should I do next to provide the best protection for my child?
A forward-facing seat with a harness is outgrown when ONE of the following three things happens:
- The child exceeds the weight limit specified on the seat's label.
- The top of a child's ears are above the back of the child car seat. The seat shell and pad are needed behind the child's head to provide whiplash protection.
- On most seats when the harness straps ( in the top slots) are no longer at or above the child’s shoulders. Read and follow instructions.
- For best protection when a child outgrows a convertible seat but weighs less than 40 pounds, use a forward-facing only seat with a harness (sometimes called a combination or harness-to-booster seat seat).
- For tall/slim children, pay particular attention to the height of the highest set of harness slots. This "seated height" (fanny-to-top-of-shoulder) varies among car seat models. Choose one that will give the child enough room to grow.
- On many models of "forward-facing only" seats, the harness can be removed and the seat becomes a belt-positioning booster seat for use in vehicles with lap and shoulder belts. Weigh and measure your child to assure child is within the minimum height and weight on labels.
- Once a child exceeds the height or weight limits of their convertible or forward-facing harnessed seat, a belt-positioning booster seat should be used to properly position the adult lap and shoulder belt. A belt-positioning booster gives a child an artificial set of adult-size hip bones to position the lap part of the belt low on the hips/across the top of the thighs keeping it off the abdomen and routes the shoulder part of the belt properly across the center of the chest and shoulder.
Children & Belt-positioning Booster Seats
Are children 4 to 8 years of age big enough to use the adult seat belt?
No! In a crash, children this age can be seriously injured by an adult lap and shoulder belt because it does not fit properly. Children of this age do not have legs long enough to bend over the edge of the vehicle seat without slouching. When children slouch, the lap part of the seat belt slides up onto the soft part of their abdomen. In a crash, a seat belt that is not worn across the hip bones causes serious injuries such as a ruptured spleen, perforated intestine, or a fractured spine. These injuries are so common that Emergency Department doctors call them "seat belt syndrome".
Did you know? If the shoulder part of the belt is placed behind the child's back or under the arm, head injuries can result or the shoulder part of the belt can break ribs, puncturing internal organs. Children who are too small for the adult seat belt can, and have, slipped out from the lap/shoulder belt, been ejected from the vehicle killed in a crash.
Children need the protection of a belt-positioning booster seat until they are at least out 8 years old or 4 feet nine inches tall or can pass the 5-Step Test.
How does a booster seat provide protection?
- A belt-positioning booster seat lifts the child up and into the adult seat belt to properly position it on the child's smaller body. It gives your child a set of adult-sized "artificial hips" that keep the lap part of the seat belt off the soft tissue of the abdomen. The “best” booster seat for your child and vehicle places the lap belt low on the hips touching the tops of the thighs and positions the shoulder belt across the center of the chest and shoulder.
- A booster gives the child a seat that allows the child's legs to bend comfortably so the child doesn't need to slouch for comfort.
- A strap, belt guide, or clip allows the shoulder part of the belt to be adjusted properly at shoulder level as the child grows.
- High back booster seats offer support so a sleeping child is less likely to slip out from underneath the shoulder belt.
- The added height allows the child to see out the window like an adult can.
- Remember that the booster just sits on the vehicle seat and is not fastened down when the child climbs out. Teach your child to re-buckle the seat belt around the booster so it does not strike other passengers in a crash or sudden stop.
Can my child use a booster if our car has only lap belts?
No! A booster seat requires both the shoulder AND the lap belt. Even though the child will not have upper body protection, a properly worn lap belt is still better than being unrestrained. Teach your child to wear the lap part of the belt down low on the hips, not up on the tummy.
- Many car seat manufacturers now make products for children weighing more than 40 pounds that can be installed in vehicles with only lap belts. If your vehicle was made before 1999 adding a tether anchor will provide an additional point of security for the car seat.
- Purchase and install a shoulder belt retrofit kit if one is available from the manufacturer of your vehicle. Retrofitting a shoulder belt will offer the best protection not just to booster seat age children, but also to anyone who might ride in that seating position. Not all vehicles can be retrofitted and the parts and service departments of many dealerships may not be aware that the manufacturer at one time made a kit specifically for a given year and model of vehicle. In Washington State call the Safety Restraint Coalition at (425) 828-8975 or 1-800-282-5587 to learn more. If you live outside Washington State, you can call the National Highway Traffic Safety Administration’s Hotline at 1-800-DASH-2-DOT to learn more.
- EZ-On manufactures the Y-Harness and EZ-On Vest. Children weighing more than 40 pounds can use them in vehicles with a lap-only belt. Crash tested, each meets federal motor vehicle safety standards and offers upper body protection. Visit their Web site at www.ezonpro.com
I've heard small-shield booster seats are no longer recommended. Why?
These boosters are no longer being made and are too old for use.
Small shield boosters were originally designed for children 30-60 pounds, and were tested using a lap only belt and a dummy the size of a three-year old.
In 1996, the government's standards changed to require booster seats to be tested with a 47 pound crash test dummy the size of a six-year old child. Manufacturers revised instructions for shield boosters to allow use of the shield only until the child weighed 40 pounds. On some small shield booster seats, the shield could be removed and the base used as a backless belt positioning booster..
Children weighing less than 40 pounds should use a forward-facing car seat with a harness until they physically outgrow it.
Older Kids & Seat Belts
When is my child big enough to use the adult seat belt?
Keep using a booster seat until your child is about four feet nine inches tall. To see if the seat belt will fit your child, answer the following questions: *
- Does the child sit all the way back against the vehicle seat?
- Do the child's knees bend comfortably at the edge of the vehicle seat without slouching?
- Does the lap belt fit snugly across the top of the thighs?
- Does the shoulder part of the belt come across the center of the shoulder and chest?
- Can the child sit like this for the whole trip?
If you answered "no" to any question, then the child should continue to ride in a belt-positioning booster seat.
Remember, check for good belt fit in all the cars your child rides in. Just because the seat belt system fits your child in one vehicle does not mean that the seat belt will fit correctly in all vehicles. You must perform this test in each vehicle your child rides in to assure proper belt fit.
Can I buckle two children into one seat belt?
No, two people should never use one vehicle seat belt! In a crash, two people sharing one seat belt will collide violently. Buckling two people into one seat belt could cause serious injury or death.
Is it OK for my child to put the shoulder belt behind his back or under his arm?
No, the shoulder belt restrains the upper body. Placing the shoulder part of the belt under the arm can break ribs causing them to injure internal organs. Putting the shoulder part of the belt behind the back not only takes away upper body protection; it keeps the seat belt system from working properly. In a crash, the lap part of the belt is tightened as the upper body moves forward pressing against (loads) the shoulder belt. Placing the shoulder portion of the seat belt behind one’s back results in a loose lap belt increasing the risk of serious injury.
Check the vehicle owner's manual to see if the shoulder belt in your vehicle has an adjustable anchorage. If not, for older child passengers, choose a booster seat that will properly adjust the belt fit.
Your child restraint may be incompatible with your vehicle or improperly installed if:
- The child car seat moves more than one inch from side-to-side on your the vehicle seat cushion when pushed and pulled near where the seat belt goes through the child car seat.
- The vehicle seat belt stays loose, doesn't lock or loosens after it's been tightened.
- More than 20 percent of the seat hangs over the edge of the vehicle seat.
- Your vehicle seat does not face forward (faces the side or rear of the car).
- A newborn's head tips forward, with baby's chin on its chest.
My car seat moves more than one inch side-to-side even after I've tightened the seat belt. Should I buy and use one of those seat belt tightening devices?
Vehicle manufacturers explain how to properly tighten their seat belts around a child car seat. You will find this information in your vehicle instructions. No vehicle manufacturer advocates the use of belt tightening devices. Car seat manufacturers also provide instructions on how to properly secure their car seat. No child restraint manufacturer advocates the use of belt tightening devices. Here is what two manufacturers have to say:
“While Evenflo does not have a specific note in the product instruction manual about belt tightening devices, we do state in our warnings section in every book DO NOT attach additional padding, toys or other devices not made by Evenflo or described in these instructions to the child restraint. Items not tested with the child restraint could injure the child. Evenflo does not sanction the use of the Mighty Tite or any other similar device with our products.”
By Randy Kiser Director, Product Safety, Research & Development Evenflo Company, Inc.
Another car seat manufacturer, Britax, says this about tightening devices: "The use of non-Britax Child Safety, Inc. covers, inserts, toys, accessories, or tightening devices is not approved by Britax. Their use could cause this restraint to fail Federal Safety Standards or perform worse in a crash. Their use automatically voids the Britax warranty".
I've heard that most car seats are not used correctly. Where can I get my child's car seat checked?
Washington has many people who are trained as Certified Child Passenger Safety Technicians to check a child car seat’s fit and installation. If you live in Washington State, click on Car Seat Checks then on your county to find your local Child Passenger Safety Team or Safe Kids Coalition.
Children with Special Needs
I have a child with special medical needs. Where can I learn more about securing my child in the car?
Parents, health care providers and others can learn more about protecting children with special needs on the American Academy of Pediatrics Web site aap.org where you will find a list of medical conditions that affect how children fit into car seats, information about child restraint options and frequently asked questions about transporting children with special medial needs. In Washington State, contact the Safety Restraint Coalition at (425) 828-8975 or 1-800-BUCK-L-UP for more information.
Other: Vehicles, Air bags...
What about air bags?
NEVER place a rear-facing infant in front of an active airbag. An unrestrained child, an infant riding rear facing or a child who is out of position (for example sitting forward on the edge of the vehicle seat) can be seriously injured or killed by an inflating air bag. Whether or not the car has air bags, the safest place for all children who are not yet 13 years old is in the rear seat.
The driver air bag is stored in the center part of the steering wheel and the passenger air bag is stored in the dashboard. It may be in the flat area just below the windshield or in the area facing the passenger. All cars since model year 1998 must have driver and passenger air bags. Both air bags were required in pickup trucks, SUV's, and vans starting in the 1999 model year. Many vehicles made in the 1990's also have air bags. Newer cars may have lower-speed air bags or "dual stage" air bags. These may reduce injuries but still can be deadly for rear-facing infants and unbuckled or improperly positioned children. To locate the air bags in your car read your vehicle owner's manual. Inside the vehicle, look for a warning label on the sun visor, or for word "Air bag" or the letters "SRS", or "SIR" embossed on the dashboard.
In a crash, air bags inflate very quickly and can hit a rear-facing safety seat hard enough to kill a baby. Infants must ride in the back seat, facing the rear of the car. Even in the back seat, never turn your baby to face forward until he or she is at least one year of age AND weighs at least 20 pounds.
If there is no room in the back seat and you have no alternative, a child over age one who rides in a forward-facing car seat may occupy the front seat. Move the vehicle seat as far back as possible and make sure the child is correctly restrained for his age and size. Fasten the child restraint harness snugly, or if the child uses a booster seat, make sure the child does not lean toward the dashboard.
Many sports cars and pickup trucks have no back seat or seats are too small to install a rear-facing car seat correctly. Many recent models come have a switch that allows the driver to turn the air bag off when transporting a baby or child in the front seat. However, manufacturers are not required to install them as standard equipment. Older trucks or sports cars with passenger air bags may not have on/off switches. In this case you may be able to get a switch installed. Click here for a “Request for Air Bag On-Off Switch” form.
Excerpted with permission from "Kids and Air Bags" a publication of Safe Ride News. Visit them online at saferidenews.com.
I can't afford a child car seat or booster. Is there somewhere I can get help?
Your doctor's office, police department, hospital, or health department may be able to direct you to a local program that can assist you in acquiring a child car seat or booster seat for your child. If you live in Washington, and are pregnant and your medical coverage is through Molina or Community Health Plan of Washington, talk with your provider about obtaining a car seat. Or, click on Car Seat Checks then on your County to find your local Child Passenger Safety Team or Safe Kids Coalition.
Where can I get car seat information in different languages?
The Safety Restraint Coalition can provide most information in English and Spanish. Contact us at (425) 828-8975 or 1-800-282-5587. Outside Washington call the Auto Safety Hotline at 1-888-DASH-2-DOT
I've lost the locking clip that came with my car seat. Where can I get another one?
Are you Pregnant?
Now is a great time to learn how to keep you and your new baby safe in the car. Go to a car seat safety class if one is given by your hospital, health plan or clinic. This will help you learn about using car seats correctly from the start. Pregnant mothers should always use a lap/shoulder belt. Right now you are your baby's car seat. Avoid using a lap-only belt. Push the lap part of the belt down as far as possible below your belly. Check to make sure it stays low and snug. If you wear a heavy coat, open it and pull it away from your belly. This helps the lap part of the seat belt fit low and snugly. Never put the shoulder portion of the seat belt behind your back or under your arm. It should rest across your shoulder.
- Sit as far back from the steering wheel as you can. Let others do as much of the driving as possible during the last few months of pregnancy. Avoid unnecessary trips. When you ride in the car, sit in the back seat using the lap/shoulder belt.
- If you are in a crash, even a minor one, get checked at a hospital emergency room. Your unborn baby could be injured even if you do not seem to be hurt
I have a question about car seats that is not answered here. Is there someone I can call to get more information?
Look up your local Child Passenger Safety Team or Safe Kids Coalition resources here. The Safety Restraint Coalition in Kirkland conducts Washington State's Child Passenger Safety Program. The Coalition answers questions about choosing and using child car seats, Washington’s child restraint and seat belt laws, has information about booster seats, a list of car seat recalls, and information about protecting children of all ages in the car. In the Seattle area, call 425-828-8975 or from other areas of Washington call toll-free at 1-800-BUCK-L-UP (1-800-282-5587). Outside Washington State, call the Auto Safety Hotline at 1-800-DASH-2-DOT.