Motor vehicle crashes are the leading cause of death for children ages 2 to 14. Many child car restraints are still used incorrectly, or not at all, despite safety rules in every state that require children of certain ages to be restrained in approved seats. In recent years, safe driving campaigns and state safety laws have educated parents about the importance of using car seats for their small children.
While car accidents can be dangerous for all passengers, small children are especially at risk. The weight of the head of a child makes the neck much more vulnerable to injury. The infant has little control in the muscles of the neck, and the head can bounce from side to side and fall forward, which can cause serious spine and neck injuries. Children also have more flexible upper bodies and shoulders.
Car Seat Recommendations
- Use the car seat appropriate for the age and size of your child. A newborn infant and a 3-year-old toddler require different seat types.
- Car seats for infants should always face the rear of the car—to spread the impact of a possible crash more evenly along the back and shoulders, providing more neck protection.
- Always place car seats in the back seat of the car—ideally in the center. This is especially important in cars equipped with air bags. If an air bag deploys, the force could seriously injure or kill a child in the front seat.
- Properly secure the car seat to the seat of the vehicle. Place it at a 45-degree angle to support the head of the infant or child.
- Fasten the lap harness low and as close to the hips as possible—never around the waist. Also, fasten the shoulder harness securely, and make sure the straps lie flat against the body. Twisted straps can cause additional injury and may keep the seat from working properly.
- Use a retention or shoulder harness clip (if provided by the manufacturer) when securing a child safety seat with the shoulder harness. Fasten the clip close to the armpit of the infant or child and snugly between the legs.
- Don’t use a car seat that has been in a serious accident—it could be damaged and won’t protect your child.
- Be sure the seat meets federal motor vehicle safety seat standards. Consult the owner’s manual, or contact the manufacturer for that information. All car seats should have an owner’s manual and instruction booklet. To find a child safety seat inspection site near you, click here.
Car Seat Guidelines from NHTSA
The NHTSA’s “4 Steps for Kids” guidelines show which restraint should be used for each stage of a child’s development. The four steps are:
- Rear-facing infant seats in the back seat from birth to at least 1 year old (at least 20 lbs.)
- Forward-facing toddler seats in the back seat from age 1 to about age 4 (20 to 40 lbs.)
- Booster seats in the back seat from about age 4 (40 lbs.) to at least age 8, unless 4’ 9” tall.
- Safety belts at age 8 or older, or taller than 4’9”. All children 12 and under should ride in the back seat.
Reproduced with permission of the copyright owner, American Chiropractic Association. Further reproduction prohibited without permission.