Below are tips for keeping your children safe.  Read your car seat manual and vehicle owner’s manual for steps to install the car seat correctly.

Car Seat Facts

  • Car seats reduce the risk of injury in a crash by up to 82% for children. 
  • Booster seats reduce the risk for serious injury by 45% for children (ages 4 to 8).
  • Seat belt use reduces the risk for death and serious injury for older children and adults by almost 50%.

*Source: Centers for Disease Control and Prevention

Types of car seats and restraints

Infant car seats

Recommended for: infants, depending on the car seat weight and height limits.

Harness: Use slots at or below child’s shoulders. 

Important facts:

  • Designed to rear-face only.
  • Never place a rear-facing car seat in front seat of vehicle with an active air bag.
  • Make sure the car seat is installed at the correct angle. Check your car seat manual to learn how to tell if your car seat is at the correct angle.    

Convertible car seats

Recommended for:  children who have outgrown their infant seat.

Harness: In rear-facing position, use slots at or below child’s shoulders. In forward-facing position, use slots at or above child’s shoulders. 

Important facts:

  • Designed to rear-face and forward-face.
  • Keep your child rear-facing until the maximum height or weight for rear-facing mode is reached.
  • Use top tether strap when installing in forward-facing position.

Combination car seats

Recommended for: children who are ready to face the front of the car because they have outgrown the rear-facing height or weight limit of their convertible car seat.

Harness: Use slots at or above child’s shoulders.

Important facts:

  • Designed to be used with a 5-point harness up to a maximum height and weight specified by manufacturer.
  • Use top tether strap when using the 5-point harness.
  • Once child outgrows the harness, it can be removed and the seat can be used as a belt-positioning booster seat.

Booster seats

Recommended for: children who are at least 4 years old, 40 lbs. and are able to sit up straight and independently for entire car rides.  

Important facts:

  • The American Academy of Pediatrics recommends children less than 4 feet 9 inches (or 57 inches) tall ride in a booster seat.
  • Vehicle seat belts are designed for adults and can be dangerous for children if not fitted properly on their bodies.
  • Booster seats give children a boost so that the seat belt stays positioned over the stronger parts of their bodies (shoulders and hips).

3-in-1 Seats

Recommended for: infants through booster seat age.

Important facts:

  • Designed to change as the child grows from rear-facing to forward-facing with harness and tether, and finally to a booster seat.
  • Be sure to follow the manufacturer’s instructions for converting the seat through each stage.
  • Some younger children may outgrow the weight or height limit of the forward-facing harness but are not ready to sit properly in a booster seat using the vehicle seat belt. In this case, look for a harnessed car seat with a higher size limit.

Vehicle Seat Belts

Recommended for: children 4 feet 9 inches tall or taller, typically ages 9 years and up. 

Important facts:

  • Your child should pass the seat belt fit test in each vehicle before getting rid of his booster seat. Every vehicle is different. He may still need a booster seat in some vehicles.
  • The lap portion of the belt should lie low over child’s hips, just touching the thighs. It should not lie on the child’s stomach.
  • The shoulder portion of the belt should always lie snug across the shoulder and chest.  Never on the child’s neck or placed under her arm or behind her back.

Does your child pass the seat belt fit test?  

Your child must: 

  • Be tall enough to sit without slouching.
  • Be able to keep his or her back against the vehicle seat.
  • Be able to keep his or her knees naturally bent over the edge of the vehicle seat.
  • Be able to sit this way for the entire car ride, each time.

What is LATCH?

All new passenger vehicles made after September 2002, have Lower Anchors and Tethers for Children (LATCH).  All new car seats and some booster seats have lower anchor straps to connect to the vehicle’s lower anchors.  Convertible car seats, combination car seats and some booster seats have tether straps that have hooks to connect to the vehicle’s tether anchor. 

Lower Anchors

  • Located in vehicles’ back seats, where back of the seat meets the lower portion of the seat back.  
  • Can be used instead of the vehicle’s seat belt to secure the car seat inside the vehicle.
  • Do not use the lower anchors and the vehicle’s seat belt, unless approved by the car seat and vehicle manufacturers.  Choose the method that works best for you, your car seat and your vehicle.


  • Located behind the vehicle seat (exact locations vary depending on vehicle).
  • Using a tether strap reduces the movement of the top of a forward-facing car seat during a crash.  This provides extra protection from serious head and neck injuries.
  • A tether strap can be used with the lower anchors or the vehicle’s seat belt.  Some vehicles made prior to September 2002 have a tether anchor, but do not have lower anchors. 

IMPORTANT: Check your vehicle manufacturer’s instructions for LATCH availability and directions.  Check your car seat manual for LATCH instructions for your specific car seat.  

Children and air bags do not mix

Front air bags inflate with great force, faster than the blink of an eye.  Their impact can severely injure or kill infants and young children.  The back seat is the safest place for anyone under age 13.  If your vehicle does not have a back seat, refer to the child passenger safety section of your vehicle owner’s manual.  Never place a rear-facing car seat in front of an air bag.

Side air bags could be dangerous to children who are not properly restrained or are leaning against the door during a crash.  Although they are smaller than front air bags and inflate with much less force, injury could occur if your child is too close.  Check both your car seat and vehicle manual to determine if it is safe to place your child’s car seat next to a side air bag.  

Avoid loose items in the car 

Even a minor crash can send loose items flying around passengers in your vehicle.  Store loose items such as umbrellas, tools, and sports equipment in the trunk or closed console compartment inside the vehicle.  Always buckle-in unused car seats and booster seats.  Use sunshades that cling to your window rather than those with metal bars or suction cups that can come loose in a crash.

Kids in coats

Always remove bulky clothing and coats before putting your child in the car seat.  This will keep the harness straps as close to the body as possible.  In cold weather, place your child in the seat and secure the harness snugly.  Then, cover your child with a coat or blanket.  Instead of using a coat, you may also try dressing your child in 2-4 thin, tight-fitting layers.

Top tips

  1. “The longer the better.” Keep children rear-facing and in a 5-point harness for as long as possible.  
  2. Keep children less than 13 years old in the back seat.
  3. Read the car seat manufacturer’s instructions.  Each car seat is different. 
  4. Avoid using accessories and padding inserts that did not come with the car seat.  These items are not safety tested or proven to be safe with your car seat and could be dangerous in the event of a crash. 
  5. Know your vehicle.  Look for “Child Restraint” or “LATCH” instructions in your vehicle’s manual.
  6. Know your car seat’s history.  Buy a new car seat or a used car seat from someone you know and trust.
  7. Be sure to register the car seat with the manufacturer so you can be notified in the event of any recall. New car seats come with a registration card that you can complete and mail to the manufacturer.  You can also register the car seat on the manufacturer’s website.
  8. Car seats expire! Many car seats expire six years from the date of manufacture, however, some have longer expiration dates.  Check the manufacturer’s label on your car seat or check the car seat manual for this information.  
  9. Replace car seats that have been in a crash or are expired.
  10. The best seat is the one that fits your child, fits your vehicle, and is used correctly each time.

St. Louis Children’s Hospital Safety Stop provides free car seat safety checks at four locations:

St. Louis Children’s Hospital
St. Louis Children’s Specialty Care Center
Progress West Hospital 
The Magic House

Call 314.454.KIDS (5437) or 800.678.KIDS and press 3 to schedule a Safety Stop appointment.


Expert Advice