Car Seat Safety Guide
Safety seats save lives
Whether you are a “veteran” or are dealing with the topic of child safety seats for the first time, it can be a challenge to know what is the right thing to do amid frequently changing and conflicting advice.
St. Louis Children’s Hospital understands that parents often have questions about the correct way to transport their child. This brochure contains some basic guidelines for keeping your children safe while they are riding in a vehicle. Also, it is important to read your safety seat instructions, as well as your vehicle owner’s manual for installation directions.
According to the National Highway Traffic Safety Administration (NHTSA), when used and installed correctly, child safety seats effectively reduce the risk of death by 71 percent for infants (under age 1) and by 54 percent for toddlers (age 1-3) and children in booster seats (age 4-8).
Types of safety seats and restraints
Infant safety seats
A rear-facing infant seat is designed to rear-face only. It is important for the safety seat to be placed in the back seat and for the seat to face the rear of the vehicle in order to support the infant’s head, neck and spine.
According to the American Academy of Pediatrics (AAP), infants and toddlers should ride in a rear-facing safety seat until they are age 2 or until they reach the highest weight or height allowed by their seat's manufacturer.
Most infant seats will accommodate weights up to 22-35 pounds. When your infant’s weight or height exceeds the seat’s limits, child passenger safety experts recommend the use of a convertible seat that rear-faces to a higher weight and height. In the rear-facing position, the harness straps should be through slots that are at or below your child's shoulders.
Convertible safety seats
A convertible safety seat is designed to rear-face and forward-face. When children reach the highest weight or height allowed by the manufacturer of their infant seat, they should continue to ride rear-facing in a convertible seat. Most convertible seats rear-face up to 35-40 pounds or 36 inches. The seat should be used rear-facing until your child reaches the weight or height limit of his seat.
Most child safety seats will hold your child in the harness until she reaches a weight of 40-50 pounds in the forward-facing position. It is recommended to keep her in the harness until she reaches the weight limit for the harness, unless her height exceeds the seat’s limit, then she must be moved to a booster seat or to a seat with a higher height limit. In the foward-facing position, the harness straps should be through slots that are at or above your child's shoulders. Developmentally, a child is not ready to move out of a harness until she is 4 years old and at least 40 pounds.
NHTSA and the AAP recommend children less than 4 feet 9 inches tall ride in a booster seat. Many states, including Missouri and Illinois, have booster seat laws. Regardless of the law in your state, using a booster seat is still the safest option for children in this weight and height category. Booster seats are designed to boost children so the vehicle’s seat belt system fits their body.
High back booster seats should be used to provide head restraint for vehicle seats without built in head restraints. Most high back booster seats provide a shoulder belt positioner to keep the belt snug across the chest.
Graduation from a booster seat
A child over 4 feet 9 inches tall, typically between ages 8 and 12, may be ready for the car’s seat belt system without a booster seat. A good way to check this is to place your child in the vehicle seat, sitting straight up, with his back flat against the car’s seat back. If he can bend his legs at a 90-degree angle at the edge of the seat, he is most likely tall enough to use the car’s seat belt system without a booster seat.
Guidelines to ensure your child’s seat belt fits properly
- Both a lap and a shoulder belt should be worn, when possible. The shoulder belt should never be worn under the arm or behind the back. Using a lap belt only increases the risk of internal injury in a crash.
- Lap belts should be worn low over a child’s hips, just touching the thighs. In a crash, the force of impact will be applied to the strong hipbones.
- Keep the lap belt snug so it does not ride up onto the stomach.
- Shoulder belts should be worn over the shoulder and across the body diagonally.
- The shoulder belt should not cross the face or neck.
As of September, 2002, all new passenger vehicles and child safety seats are equipped with Lower Anchors and Tethers for Children (LATCH). The LATCH system has three anchors in the vehicle for each child seat. The child safety seat has two attachments that snap onto the vehicle’s lower anchors located in the bight of the vehicle’s seat. There is also a tether strap near the top of the safety seat that attaches to the vehicle’s tether anchor.
If both the vehicle and the safety seat have the LATCH system, the safety seat can be installed without using a seat belt. If the vehicle or the safety seat is not LATCH ready, the child safety seat can be used with the vehicle’s seat belt system. It is not necessary to use both systems; choose the one you can use the most effectively. Some vehicles made prior to September, 2002 have a tether anchor, but do not have a complete LATCH system. The tether anchor should be used with the vehicle's seat belt system.
The purpose of a tether strap is to hold the top of a forward-facing seat in place during a crash. This helps to reduce serious head and neck injuries. Most vehicles made from 1990 on can have a tether anchor added; check your vehicle owner’s manual or your dealership. Tether straps can usually only be used on forward-facing seats. Read the owner's manual for your vehicle and the safety seat for complete LATCH information.
Children and air bags do not mix
While air bags and seat belts offer the best protection for adults and older children in a front-end collision, infants and children under age 13 should never be placed in the front seat of a vehicle with a passenger-side air bag.
Air bags inflate with great force, faster than the blink of an eye. Their impact can severely injure or kill infants and young children. For this reason, the safest seat is the back seat. If your vehicle does not have a rear seat, refer to the child passenger section of your vehicle owner's manual.
Loose items in car
Even a minor crash can turn loose items in your vehicle into deadly missiles. Many people store umbrellas, tools and sports equipment in their vehicle without realizing the consequences. To reduce risk to children and other passengers, loose items must be properly secured in the trunk or by a restraining device or removed from the car. Loose car seats can also be dangerous. Always buckle in seats that are not being used. Sunshades that cling to the vehicle's window are safer than those with a metal bar and suction cups that could come loose in a crash.
Keep your children safe
St. Louis Children’s Hospital hopes the information contained in this brochure helps you safeguard your child and minimize the risk of injury while traveling. Routine use of the safety seat can change its position, so it is important to check your child’s safety seat regularly even after a professional check. By staying current on the subject and paying attention to your child’s changing needs, you have the power to greatly reduce your child’s chances of serious or fatal injury in a car crash. The best seat is one that fits your child, fits your vehicle and is used properly and consistently.
St. Louis Children's Hospital performs free professional car seat inspections. Safety Stop is our car seat inspection station with four locations: St. Louis Children's Hospital, St. Louis Children's Specialty Care Center, Progress West Hospital and The Magic House. Call 314.454.KIDS (5437) or 800.678.KIDS (5437), then press 3 to make an appointment.