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Car Seats and You!

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Kids Health Watch is brought to you by our friends and Magnolia Springs Pediatrics

As Baldwin County continues to grow, we have seen an explosion in the population! With this comes more infants and toddlers, and one of the more frequent questions I get pertains to car seats. There have been updated recommendations for infants and toddlers as well as older kids so that your child can be as safe as possible in a car wreck.

First, never place a car seat in the front seat, especially if there are front airbags. If the airbag deploys, it will do so right at your child’s head and could have bad results. It is recommended that all infants and children ride in a back seat. If an older child must ride in the front, move the seat as far back as possible from the dash for safety. When installing your car seat, be sure to follow the instructions. Not all car seats fit in every car! Be sure to use all available attachment devices, including seat belts, lower anchors, and tethers. If possible, try to avoid using a used car seat. Sometimes, if a seat has been recalled or been in a crash and cracked, then it might not work properly for your child in the event of a crash. Also, be sure to avoid car seats that are missing parts or don’t have the owner’s manual.

Now, let’s talk about some specific ages and seats. For an infant, based on the new guidelines, it is recommended that they are in a rear-facing car seat until they are two years of age and/or they outgrow their current seat for height and weight restrictions. This is different from the current Alabama state law stating that toddlers may turn around after one year of age and twenty pounds. It’s important to know that this is not an absolute deadline but is to be used as a guide to help decide when it’s safe to turn them around.

Now, there are two main types of car seats for infants. First are the smaller infant-only seats that can be removed from a base and placed in a stroller. Second, are the convertible car seats that can be adjusted in shoulder belt placement and angle for an older toddler. For both, it is important to not only have the seat installed properly but to have the straps fit properly in the shoulder and around the trunk. A lot of car seats also have an angle indicator to show the proper placement of the seat for good head control.

For toddlers who meet the above criteria, it is OK to face forward and stay in either a converted infant seat or a forward-facing child safety seat. It is important to read the manufacturer’s handbook for recommendations on the age and weight restrictions for the seat. For installation, it is important to correctly install the seat using seat belts, base anchors and the head tether. This is the strap in your car that can attach to the head of the car seat and is critical for safety during a crash. It is also important to adjust the shoulder straps in the seat to ensure a snug fit.

Once a child reaches school age, they can sit in a booster seat. But here they have changed the recommendations as well. They suggest that kids stay in booster seats until they are 4’9” tall and between eight and twelve years old. Finally, all children up to thirteen years old should ride in the backseat if possible. Again, these are intended to be guidelines, not absolutes. Now there are a few big toddlers out there that can move to a booster. Basically, if your child exceeds the height and weight limits for your forward-facing seat and/or your child’s shoulders are above the highest harness slots, then they can move up. For kids in booster seats, be sure to use a lap and shoulder seat belt that fits across the lap and chest. The shoulder belt should fit well across the chest and not the neck, and the lap belt should fit across the waist and not the belly.

A list of certified technicians and car seat installation stations can be found at www.nhtsa.gov or www.seatcheck.org. Also, check www.aap.org and www.healthychildren.org for specifics on car seat use. Finally, ask your healthcare provider for any clarifications of the new changes for your child.
Be a good role model and buckle up!


Robert L. Rux, M.D. is a Board Certified Pediatrician at Magnolia Springs Pediatrics. Originally from Mobile, he attended medical school at The University of Alabama School of Medicine (UAB) and completed residency at The Children’s Hospital of Alabama (UAB). He is married to Jaime and has three children, Adler, Walker and Mary McAtee.

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