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Column by Editor-in-Chief, Nancy W. Dickey, M.D.
One of the easiest ways to protect our children is to buckle them up every time they are in the car. While it may seem harmless to take them out of their car seats or let them loose from under their safety belts in response to the occasional tantrum or fit of tears, it could cost them their lives. The most common cause of injury and death from birth to age 14 is automobile accidents.
Just as important as using child safety seats and safety belts is the proper use of such devices. Installing a car seat or using it improperly can be as dangerous as not using one at all. According to statistics, four out of five child safety seats are used improperly.
Rather than a particular brand being the "best," the safest car seat for your child is the one that fits him or her properly and is installed correctly. Here are a few general guidelines:
- Birth to 20 pounds/ 1 year. Use a rear-facing infant safety seat. Some manufactures now offer seats that have a higher weight limit, making it easier for you to keep your child in a rear-facing seat for the full first year. The American Academy of Pediatrics (AAP) recommends that a rear-facing infant safety seat be used as long as possible. If your infant exceeds the weight limit before their first birthday, many convertible seats now go up to 30 pounds or higher.
- 20 to 40 pounds/ 1 to 4 years. Use a forward-facing child safety seat. A convertible seat can be changed from the rear-facing to the forward-facing position once your child has reached the rear-facing weight limit and is at least 1 year of age. Once your child has reached the weight limit on their forward-facing or convertible safety seat, or their ears line up with the top of the car seat, it is time to transition into a belt-positioning booster seat.
- 40 to 80 pounds/4 years of age and older. Use a belt-positioning booster child safety seat. A belt-positioning booster seat raises your child so that the lap and shoulder belt fit properly, while protecting the child's head and upper body. Be aware that a different type of booster seat called a "shield booster" is not approved for children more than 40 pounds. For children less than 40 pounds, shield boosters pose a risk of ejection in a rollover crash. Shield boosters should be ONLY used without their shields as a belt-positioning booster for children over 40 pounds.
- 80 pounds and over/4'9" and taller. When children are able to sit with their feet on the ground, back straight against the back seat cushion, and legs over knees over the edge of the seat cushion without slouching, it is time for them to use a seat belt. The lap belt should lie on their hips, rather than their stomach, and the shoulder belt should fit across the shoulder, not the neck or throat. Both the lap AND the shoulder belt should always be used.
Finally, a few tips to remember. It is always safest to have children ride in the back seat of the car. Never place a back-facing care seat in the front seat of a car that has airbags. Make sure to return the registration card when you purchase a child safety seat so the manufacturer can contact you if the product is recalled. Never have children share seat belts. Have a set of rules for riding in the car and enforce them. And, when your child is old enough, make sure to discuss the dangers of riding in the back of pickup trucks.
As Buckle Up America! Week comes to a close, it is important for us all to continue efforts to keep our children safe. By buckling yourself up for each ride, you will help teach your child the life-saving habit of using a seat belt. Even if it is only a quick jaunt to the grocery store, taking the few minutes to buckle up everyone in the family helps ensure a safe return home.
The American AAP has just issued a new "2001 Car Seat Guide." In it, you will find details on the various care seats I have outlined above. To read this important information, click here
To check on whether your child's car seat has been recalled, visit the National Highway Traffic Safety Administration's Child Seat Safety Recall Campaign listing at http://www-odi.nhtsa.dot.gov/cars/problems/recalls/childseat.cfm.
Nancy W. Dickey, M.D., is a recognized leader in medicine. She is a past president of the American Medical Association and served on the board of the Archives of Family Medicine, a medical journal published by the AMA. She is President and Vice Chancellor for Health Affairs at the Texas A&M University Medical School System Health Science Center in Bryan, Texas, where she maintains an active practice as a board certified family physician.
Copyright © December 2002 Medem Inc.
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