Kids Health Watch is brought to you by our friends and Magnolia Springs Pediatrics
Baldwin County has seen an explosion in population, and with this comes more infants and toddlers. One of the frequent questions I get is regarding car seats. There have been updated recommendations for infants, toddlers, and older kids so 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. 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. Use all available attachment devices, including seat belts, lower anchors, and tethers. If possible, try to avoid installing a used car seat. Sometimes, if a seat has been recalled or been in a crash and cracked, it might not work properly. Also, avoid car seats that are missing parts.
Now, let’s talk about some specific ages and seats. Based on the new guidelines, infants should be in a rear-facing car seat until they are two years of age and/or 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 crucial to have the seat installed properly and have the straps fit correctly in the shoulder and around the trunk. Many car seats also have an angle indicator to show the proper seat placement for good head control.
For toddlers who meet the above criteria, it is okay to face forward and stay in either a converted infant seat or a forward-facing child safety seat. It is essential to read the manufacturer’s handbook for recommendations on the age and weight restrictions for the seat. 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). Be sure 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 should ride in the backseat if possible. Again, these are guidelines, not absolutes. A few big toddlers out there can move to a booster. 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, they can move up. For kids in booster seats, use a lap and shoulder seat belt that fits across the lap and chest. The shoulder belt should fit well across the chest, not the neck, and the lap belt 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 more specifics on car seat use.
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).