Child Safety Seats (continued)

Forward-Facing Only Seats

A forward-facing only seat is one in which the child sits facing the front of the car. The seat should be installed in the back seat of your vehicle. Most forward-facing only seats are for children between 20 to 40 pounds.

A combination forward-facing booster seat may be used for children between 40 to 65 pounds, depending on the specific seat. You can remove the seat's safety straps (harness) and use the booster alone, so that the car's lap and seat belts correctly fit the child.

Booster Seat

A booster seat raises your child up so that the car's lap and shoulder belts fit correctly. The lap belt should fall across the upper thighs. The shoulder belt should go across the middle of the shoulder and chest.

A booster seat is used for older children up to about 80 pounds. Some states have passed laws requiring booster seats for children up to age 8 or 80 pounds. Check your state's law.

Car Beds

These seats, also called flat car seats, are for premature or other special-needs babies. The American Academy of Pediatrics recommends that a health care provider looks at how your preterm baby fits and breathes in a car seat before leaving the hospital.

Built-In Seats

Some cars and vans have built-in car seats. Weight and height limits vary. You can get more details of these seats by reading the vehicle's owner's guide or calling the specific car manufacturer.

Installing a Child Safety Seat

It is important to use child car seats properly. Studies show that most people do NOT properly install car seats. The seat must fit snugly and be positioned at the proper angle. Many people install a car seat far too loosely, even though they think the seat is tight. The seat should be snug and not move more than 1 inch forward or sideways.

Follow the manufacturer's instructions for the installation and use of your specific car seat. Also, read your car owner's manual to determine the safest place to install a car seat in your car. If the instructions are unclear, call the company that made the car seat.

Contact your local police or first station for help installing your specific seat. Many have free programs to show you how to do this. To find a certified child passenger safety technician in your area go to www.seatcheck.org.

Child safety seats come with safety straps, called harnesses, which secure the child into position. Your safety seat may have a 3-point or 5-point harness system.

• A 3-point harness system has two straps at the shoulder and one between the legs.
• A 5-point system has two straps at the shoulder, two at the hips, and one between the legs.

The seat is secured into your vehicle using either car's seat belts or the LATCH system.

LATCH stands for lower anchors and tethers for children -- it is designed to make car seat installation easier. A child safety seat that comes with LATCH attaches to anchors in the back seat where the cushions meet and a strap called a tether, which connects the top of the safety seat to the car's frame. The car's seat belts are not used. All child safety seats and vehicles made after September 1, 2002 come with LATCH.

For more information on how to install child safety seats, see the National Highway Traffic Safety Administration web site at www.nhtsa.dot.gov. The NHTSA website also provides a list of all child safety seats recalled since 1990.

References

Quintana EC. Belt-positioning booster seats and reduction in risk of injury among children in vehicle crashes. Ann Emerg Med. 2004; 43(4): 544.

Committee on Injury and Poison Prevention; American Academy of Pediatrics. Selecting and using the most appropriate car safety seats for growing children: guidelines for counseling parents. Pediatrics. 2002;109:550-3.

Biagioli F. Proper use of child safety seats. Am Fam Physician. 2002;65:2085-90.

US National Highway Traffic Safety Administration. Misuse of child restraints. Washington, DC. US Department of Transportation, National Highway Traffic Safety Administration; 2004. DOT HS 809 671.

Update Date: 5/3/2007. Updated by: Leisha M. Andersen, M.D., Private Practice specializing in Pediatrics, Denver, CO. Review provided by VeriMed Healthcare Network.