Is Everyone Buckled?
Navigating Car Seat Safety For The Most Precious Of Cargo
By Dr. Sarah Pilarowski
Special to the GPHN
As the kids climb into the car, I ask my usual question: “Is everyone buckled?” And then it starts from my younger daughter, “Mom, can I stop using my booster seat?’ Ever since her brother was able to quit using his booster seat, she has been anxious for her turn.
“How tall are you, Lydia?” I ask.
“I’m 52 inches now, Mom!” she answers.
“And how tall do you need to be to stop using your booster seat?” I ask.
“57 inches, Mom,” is Lydia’s dejected response.
As a pediatrician, I have drilled car seat safety into my kids. As much as they may badger me, they know that I won’t bend on the rules. They know that their friends can’t ride in my car unless they follow the same rules. And they know that I will ensure that they also are following those rules in anyone else’s car.
Unfortunately, car seat safety rules can be a bit confusing as well as overwhelming for parents. To complicate matters, Colorado laws do not necessarily reflect recommendations from safety experts. I always try to review these recommendations with my patients’ families to ensure that their children are properly restrained from birth through the teen years.
Most parents have heard that toddlers should remain backwards facing until at least age 2. Statistics show that toddlers are five times safer in this position. Toddlers still have a relatively large head compared to the rest of their body, and their neck muscles are still relatively weak. As a result, they are at higher risk for head and neck injuries from the forces in an accident when riding forwards facing.
While toddlers should remain backwards facing until at least age 2, they will need to be transitioned from the infant bucket seat to a convertible car seat at some point. Convertible seats remain fixed in the car and are designed to be installed both backwards and forwards facing. The good news is that these seats will last a child for years until they are ready to move to a booster seat.
How do you know when your child is ready to move from the infant bucket seat to a convertible car seat? You will need to check both the weight and the height limit on your seat. I find that most infants reach their car seat’s height limit long before they reach the weight limit.
The American Academy of Pediatrics recommends that children remain backwards facing until at least age 2 or they reach the height or weight limit of their car seat. Many car seats will now allow children to ride backwards facing until 40 pounds. In fact, children routinely ride backwards facing until at least age 4 in many parts of the world.
Generally, a child is ready to move to a booster seat when she has reached the height and weight limits on her forwards facing car seat; when her shoulders are above the top harness slot; and when her ears are at the top of the seat.
Children are anxious to stop using their booster seat—especially as they watch their friends riding with just the seat belt. Unfortunately, seat belts generally do not fit children properly until kids are 57 inches tall (4 feet, 9 inches). And most kids will not be 57 inches until somewhere between 10 to 12 years of age.
In addition to the seat belt fitting properly, the child needs to be able to sit in the car with knees bent and feet on the ground—no slouching allowed. Remember that the seat belt can cause serious injuries if it slips up to your child’s neck or across his abdomen. Even when a child is safe using a seat belt without a booster seat, the safest place for a child under 13 years of age is the backseat.
With winter rapidly approaching, also remember that any child using a car seat with a five-point harness (whether forwards or backwards facing) should be dressed in the thinnest layers. Thick winter coats will make the five-point harness fit improperly and can result in injury. Instead of a coat, tuck a warm blanket or two around your child after he has been buckled into his seat.
Finally, statistics show that up to 70 percent of car seats are improperly installed, leading to a false sense of security for parents and an increased risk of injury for children. I highly recommend having your car seat checked by a certified technician. My husband and I did when our children were born—and we found that our seats were not properly installed.
It may sound cliché, but our children truly are our most precious cargo. Make sure you protect them in the car.
Dr. Pilarowski is a Denver native who lives in Park Hill with her husband and two children. She is a pediatrician at Sapphire Pediatrics.