Motor vehicle accidents are the second leading cause of child death in the United States. Proper use of the proper car seat can hugely reduce the risks. There are four stages of car safety restraints. To maximize safety, keep your child in each level of seat as long as possible, until they reach the maximum height and weight for that seat. Each stage provides less protection. Don’t move your child to the next stage until you have to. This is NOT one of the places where we want to rush our kids along to the next developmental milestone!

Note: To choose the right level seat for your child, it is more important to consider their height and weight than their age. (So, if your child is small for their age, they may be in a seat longer than age recommendations say.)

Rear-Facing. (Birth to age 2 or beyond)
Infant Seat. Weight from 4 pounds to 22 – 35 pounds and height up to 29 – 32 inches, depending on the seat. Convertible Seat. Weight from 5 or 20 pounds minimum to 45 pounds maximum rear-facing, maximum height 40 inches.

The American Academy of Pediatrics says “All infants and toddlers should ride in a rear-facing car safety seat (CSS) until they are 2 years of age or until they reach the highest weight or height allowed by the manufacturer of their CSS.” Riding rear-facing helps to protect a child’s fragile neck and spinal cord, and reduces the risk of severe injury by 75%.

Many parents notice that as their toddler grows, there is less room for their legs, and they have to bend their legs or sit cross-legged in order to fit. They wonder if they should turn the child forward. As a car seat technician told me: “yes, there’s a minor risk of broken legs in an accident. But, broken legs are much easier to heal from then a broken neck, which is more likely if they’re forward facing.”

Forward-Facing Car Seat with a 5-point Harness. (Age 2 to 7)
Should never be used for a child less than 20 pounds or less than one year old.
Maximum weight 35 – 70 pounds. Max height up to 50 inches.

These seats are equipped with a 5 point harness. In a crash, that harness keeps the child in the seat and helps distribute the force of the crash to the strongest parts of the child’s body. Use for as long as possible, as they provide more support and protection than a booster seat. Your child is ready for a booster when he reaches the top weight and height allowed for his car seat (shoulders are above the top harness slots and his ears have reached the top of the seat.)

You may find as your child gets older that they are riding in other people’s cars more often (for field trips, playdates, and so on). Make sure the person who is transporting your child knows how to install the seat or booster properly.  Some parents choose to use an easy-to-install booster for these occasional trips once their child hits the minimum size, while continuing to use a forward-facing car seat with a 5-point harness in their own car for the majority of car rides.

Booster Seat. (Age 4 – 8 or beyond)
Up to 100 – 120 pounds. Maximum heights from 34 – 63”.

Washington requires that children use a safety seat until they’re at least 8 years old or taller than 4’9” (57”) whichever comes first. (Note: Less than 5% of kids are taller than 4’9” at 8 years old. 25% don’t reach 4’9” until they are almost 12 years old.)

Boosters properly position the adult lap and shoulder belt for a child, so it provides proper restraint in case of an accident.

Your car must have a lap and shoulder belt to use a booster. If your car only has lap belts, you can use a forward-facing car seat with a harness or see if shoulder belts can be installed in your car. There are backless booster seats, which are generally less expensive and easier to carry. There are high-back boosters, which should be used in cars without head rests or with low seat backs.

Seat Belt. (Age 8 or older)
If your child is 8 – 12 years old or at least 4 feet 9 inches tall, AND you can answer yes to these questions, then they’re ready to move out of a booster seat.

• When the child is sitting all the way back against the vehicle seat, do the child’s knees bend comfortably at the edge of the vehicle seat?
• Does the lap belt stay on the top of the child’s thighs, not on their belly?
• Is the shoulder belt centered on the child’s chest and shoulder (and not on the neck or throat)?

Can the child stay seated this way for the whole trip? Without putting the shoulder part of their seat belt under their arm or behind their back?

Front Seat. By Washington law, all children should ride in the back seat until age 13.
(Exceptions for: pickup trucks or sports cars with no back seat, or if the back seat is filled with younger children)

Air bags are very dangerous to children riding in rear-facing car seats. If your vehicle has a front passenger air bag, infants in rear-facing seats must ride in the back. If a young child must ride in the front seat of the car, check your vehicle owner’s manual to learn how to turn off the air bag.

Choosing a Car Seat: Choose a car seat that is easy for you to use, so that you will use it right every time. NHTSA offers ease of use ratings for all the car seats on the market: http://www.nhtsa.gov/nhtsa_eou/

If your child is likely to be tall or heavy for their age, choose a seat with higher maximum weight and height to allow your child to use that car seat as long as possible.

Install the Car Seat Properly. For a car seat to work correctly, it must be installed correctly. Check the web resources below for information on car seat installation, and read your car seat manual and your vehicle manual for tips. Once you’ve installed a seat, you can have it checked for free. See www.800bucklup.org/carseat/inspections.asp for a list of inspectors.

Clothing. If a child is dressed in bulky clothing, the car seat may not properly restrain them in case of a crash. In the winter time, buckle your child into the seat without a coat on, and then place the coat or a blanket over the harness for warmth.

Other Objects. In case of an accident, loose objects in the car can fly around and strike passengers, and if your child is holding a hard object, it could hit them, causing injury. Keep this in mind as you do your best to keep your car tidy and consider what your child has access to in the car.

Be a Good Role Model. Always buckle up yourself. Always encourage all the other adults in the car to buckle up. Practice safe driving practices with minimal distractions. Your children will be driving themselves in just a few years, and they will have learned a lot about driving by watching you from the back seat. Make sure you are showing the behavior you want them to learn.

I think of motor vehicle safety as what I call a “red light” issue. When I teach safety skills to children, or talk to parents about safety skills, I think about “green light” situations with no risk of harm, “yellow lights” where we just let them know to be careful, “orange lights” where we only allow them to do something with very close adult supervision, and “red lights” which are absolute rules, set by the parents, and followed all the time in order to keep the child safe. Riding in the proper seat, properly buckled is mandatory. (To learn more about my thoughts on teaching safety skills, click here. And to learn about letting a child take reasonable risks as a learning experience, click here.)

More info: www.800bucklup.org; www.safercar.gov/parents; www.healthychildren.org

In this post, I reference Washington State laws. To learn the laws in your state, visit: http://www.ghsa.org/html/stateinfo/laws/childsafety_laws.html

For a printable handout of this information, click here.

Illustrations from healthychildren.org