Car Safety seats

Which car safety seat is the best?

• No one seat is the "best" or "safest." All car safety seats available for sale in the United States must meet government safety standards.

• Always use a car safety seat. 

• Read the instructions of your car safety seat carefully before use.

• Start with your baby's first ride home from the hospital.

Children younger than 13 years are safest in the back seat.

Booster seats

Booster seats are designed to raise your child so that the lap and shoulder seat belts fit properly. This means the lap belt lies low across your child's upper thighs and the shoulder belt crosses the middle of your child's chest and shoulder. Correct belt fit helps protect the stomach, spine, and head from injury in a crash. Both high-back and backless booster seats are available. They do not come with harness straps but are used with the lap and shoulder seat belts in your vehicle, the same way an adult rides. Booster seats should be used until your child can correctly fit in lap and shoulder seat belts (see "Seat belts" below).

Your child should stay in a car safety seat with a harness as long as possible before switching to a booster seat. You can tell when your child is ready for a booster seat when one of the following is true: Belt-positioning booster seat

She reaches the top weight or height allowed for her seat with a harness. (These limits are listed on the seat and are also included in the instruction booklet.) Her shoulders are above the harness slots. Her ears have reached the top of the seat. Seat belts

Remember, seat belts are made for adults. If the seat belt does not fit your child correctly, he should stay in a booster seat until the adult seat belts fit him correctly. This is usually when the child reaches about 4' 9" in height and is between 8 and 12 years of age.

Your child is ready to use a lap and shoulder seat belt when the belts fit properly. This means

The shoulder belt lies across the middle of the chest and shoulder, not the neck or throat. The lap belt is low and snug across the upper thighs, not the stomach. He is tall enough to sit against the vehicle seat back with his legs bent without slouching and can stay in this position comfortably throughout the trip. Other points to keep in mind when using seat belts

Make sure your child does not tuck the shoulder belt under her arm or behind her back. If there's only a lap belt, make sure it's snug and low on her thighs, not across the stomach. Try to get a lap and shoulder belt installed in your car by a dealer. Never allow anyone to "share" seat belts. All passengers must have their own car safety seats or seat belts. The safest place for all children younger than 13 years to ride is in the back seat. A warning about seat belt adjusters

There are products for sale that attach to the seat belt and claim to make it fit better. These products may actually interfere with proper lap and shoulder belt fit by causing the lap belt to ride too high on the stomach and making the shoulder belt too loose, and may even damage the seat belt itself. There is no federal standard for the performance of these products, and most vehicle and car safety seat manufacturers do not recommend their use. Until there are federal safety standards for these products, the American Academy of Pediatrics (AAP) recommends they not be used. As long as children are riding in the correct restraint for their size and age, they do not need to use any additional devices.

Installing a car safety seat

There are 2 main things to remember when installing a car safety seat.

The seat must be buckled tightly into your vehicle. Your child must be buckled snugly into the seat. Ask yourself the following questions to make sure both are done correctly. If you are not sure, check the instructions that came with your car safety seat, or contact a certified CPS Technician for help.

Is the car safety seat buckled into the vehicle correctly?

Is the car safety seat facing the right direction for your child's age and size? Is the seat belt routed through the correct belt path? If you are using the LATCH system (see "Installation made safer and easier" for more information) to attach the seat, have you attached the straps to the correct anchor points in the vehicle? Are the LATCH straps or seat belt buckled tightly? If you can move the seat more than an inch side to side or front to back, it's not tight enough. Is your rear-facing seat reclined enough? Your infant's head should not flop forward. If it does, tilt the car safety seat back a little. Your car safety seat may have a built-in recline adjuster for this purpose. If not, wedge firm padding, such as a rolled towel, under the base. Do you need a locking clip? They come with all new car safety seats, and some are even built into the seat. If the seat belts in your car move freely even when buckled and there is no way to lock them, you need a locking clip. If you're not sure, check the manual that came with your car. Locking clips are not needed in most newer vehicles and in vehicles with LATCH (see "Installation made safer and easier" for more information) Some lap belts (especially those found in older vehicles) need a special heavy-duty locking clip. These are only available from the vehicle manufacturer. Check the manual that came with your car for more information or visit a car safety seat inspection station. Is the child buckled into the car safety seat correctly?

Are you using the correct harness slots? Are the harnesses snug? Have you placed the plastic harness clip (if your seat comes with one) at armpit level to hold the shoulder straps in place? Do the harness straps lie flat? Is your baby dressed in clothes that allow the straps to go between the legs? It's OK to adjust the straps to allow for thicker clothes, but make sure the harness still holds the child snugly. Also, remember to tighten the straps again after the thicker clothes are no longer needed. Is anything under your baby? Tuck blankets around your baby after adjusting the harness straps snugly. Never place them under or behind your baby. Is your child slouching down or to the side? If so, pad the sides of the seat and between the crotch and the crotch strap with rolled up diapers or blankets.

Installation made safer and easier

There are several ways to make car safety seat installation safer and easier, including the following:

LATCH (Lower Anchors and Tethers for Children) is an attachment system that eliminates the need to use seat belts to secure the car safety seat. Vehicles have at least 2 sets of small bars, called anchors, located in the back seat where the cushions meet. Car safety seats that come with LATCH have a set of attachments that fasten to these anchors. Nearly all passenger vehicles and all car safety seats made on or after September 1, 2002, come with LATCH. However, unless both your vehicle and the car safety seat have this anchor system, you will still need to use seat belts to install the car safety seat. A tether is a strap that attaches to the top of a car safety seat and to an anchor located on the rear window ledge, on the back of the vehicle seat, or on the floor or ceiling of the vehicle. Tethers give extra protection by keeping the car safety seat and the child's head from moving too far forward in a crash or sudden stop. Tethers are part of the LATCH attachment system, though they should not be confused with lower LATCH attachments; the tether is a longer strap at the top of the seat and the lower LATCH attachments are located at or near the base of the seat. All new cars, minivans, and light trucks have been required to have tether anchors since September 2000. Most new forward-facing car safety seats and a few rear-facing car safety seats come with tethers. For older car safety seats, tether kits are available. Tethers are recommended because they greatly improve the protection of your child in a crash. Check with the car safety seat manufacturer to find out how you can get a tether for your seat if yours does not have one.

Child Passenger Safety (CPS) Technicians can help you. If you have more questions about installing your car safety seat, find a certified CPS Technician. A list of certified CPS Technicians is available by state or ZIP code on the National Highway Traffic Safety Administration (NHTSA) Web site at www.nhtsa.dot.gov/people/injury/childps/contacts. A list of inspection stations—where you can go to learn how to correctly install a car safety seat—is available in both English and Spanish at www.seatcheck.org or toll-free at 866/SEATCHECK. You can also get this information by calling the toll-free NHTSA Auto Safety Hotline at 888/DASH-2-DOT (888/327-4236), from 8:00 am to 10:00 pm ET, Monday through Friday. Car safety seats and shopping carts Many infant-only car safety seats lock into shopping carts and many stores have shopping carts with built-in infant seats. These may seem safe, but thousands of children are hurt every year from falling out of shopping carts or from the carts tipping over. Instead of placing your baby's car safety seat on the cart, consider using a stroller or frontpack while shopping with your baby.

Common questions about car safety seats

Q: What if my baby is born prematurely? A: Premature infants should be observed by a health care professional in their car safety seats while still in the hospital to make sure the reclined position does not cause low heart rate, low oxygen, or breathing problems. If your baby needs to lie flat during travel, use a crash-tested car bed.

Q: What if my baby weighs more than 20 pounds but is not 1 year old yet? A: Many babies reach 20 pounds well before their first birthday. However, just because your baby weighs more than 20 pounds does not make her ready to ride facing forward. Use a convertible or infant-only seat that can be used rear-facing by children who weigh more than 20 pounds and keep your baby rear-facing at least until she has reached her first birthday.

Q: What if my child has special health care needs? A: Children with special health needs may have to use special restraint systems. Talk about this with your pediatrician. Information about transporting your child with special needs is available from the National Center for the Safe Transportation of Children with Special Health Care Needs at 800/620-0143 or by visiting its Web site at www.preventinjury.org. For more information and a list of car safety seats available for children with special needs, visit www.aap.org/healthtopics/carseatsafety.cfm.

Q: What if my car has air bags? A: All new cars come with air bags. When used with seat belts, air bags work very well to protect teenagers and adults. However, air bags are very dangerous to children, particularly those riding in rear-facing car safety seats and to child passengers who are not properly positioned. If your car has a passenger air bag, infants in rear-facing seats must ride in the back seat. Even in a relatively low-speed crash, the air bag can inflate, strike the car safety seat, and cause serious brain and neck injury and death.

Toddlers who ride in forward-facing car safety seats also are at risk from air bag injuries. All children up to age 13 years are safest in the back seat. If you must put a child in the front seat, slide the vehicle seat back as far as it will go. Make sure your child is properly restrained for his age and size and stays in the proper position at all times. This will help prevent the air bag from striking your child.

Q: What if my car has side air bags? A: Side air bags improve safety for adults in side impact crashes. However, children who are seated near a side air bag may be at risk for serious injury. Read your vehicle owner's manual for recommendations that apply to your vehicle.

Q: Can I use a car safety seat on an airplane? A: The Federal Aviation Administration (FAA) and the AAP recommend that when flying, children should be securely fastened in car safety seats until 4 years of age, and then should be secured with the airplane seat belts. This will help keep them safe during takeoff and landing or in case of turbulence. Most infant, convertible, and forward-facing seats are certified to be used on airplanes. Booster seats and travel vests are not.

Never use a car seat that :

• Is too old. Look on the label for the date it was made. Many manufacturers recommend that car safety seats only be used for a certain number of years. Check with the manufacturer to find out how long the company recommends using their seat.

• Has any visible cracks in the frame of the seat.

• Does not have a label with the date of manufacture and model number. Without these, you cannot check to see if the seat has been recalled.

• Does not come with instructions. You need them to know how to use the seat. You can get a copy of the instruction manual by contacting the manufacturer or looking on the Internet.

• Is missing parts. Used car safety seats often come without important parts. Check with the manufacturer to make sure you can get the right parts.

• Is a shield booster. Although shield boosters are still around, the AAP ­recommends against their use. Major injuries have occurred to children in shield boosters. The only time shield boosters should be used is if the shield is removed and the seat is used with a lap and shoulder belt as described previously.

• Was recalled. You can find out by calling the manufacturer or by contacting the following: Auto Safety Hotline: Toll-free: 888/DASH-2-DOT (888/327-4236), from 8:00 am to 10:00 pm ET, Monday through Friday National Highway Traffic Safety Administration (NHTSA):

• www-odi.nhtsa.dot.gov/cars/problems/recalls/childseat.cfm

• If the seat has been recalled, be sure to follow the instructions to fix it or to get the parts you need. You also may get a registration card for future recall notices from the hotline.

Children should never be left alone in or around a car whether they are in their car safety seats or not.

Be a good role model—always wear your seat belt. This will help your child form a lifelong habit of buckling up.  

If you need help installing your car safety seat, contact a certified Child Passenger Safety (CPS) Technician. To locate a child safety seat inspection station and set up an appointment, call toll-free at 866/SEATCHECK (866/732-8243) or visit www.seatcheck.org.