Car Seats and Booster Seats And Your Precious Cargo While Carpooling

A friend pulled me aside last week urging me to write about car seat and seatbelt safety. His family had been involved in a rollover accident on the way home from school — literally, just turning in an intersection, as I understand it, they were plowed into by another car which caused their car to flip. No one was seriously injured, thank goodness, but the children were left dangling upside down, hanging by seat belts, until the medics arrived. Clearly they were shaken…and reminded how precious our time is on this planet — and how the most dangerous thing most of us do everyday is drive. All the children had seat belts on and all the children were in the back seat. Phew!
Thing is, just after this dad urged me to write this, I mean literally, just minutes later, we pulled away from a group of parents at pick-up and I watched an 11 year-old get into the front seat of her family’s car and drive away. My stomach dropped. Children under age 13 shouldn’t be in the front seat and goodness gracious, the irony of the timing just got me in the gut. Hard to message and write about something that I feel parents don’t want to know more about. Something about a laxity here for many people remains…seems this is advice many already feel they know (and don’t want to take).

3 reasons children shouldn’t sit it front seat until age 13 years: 1) It’s always safer to ride in the backseat (it’s also illegal to ride in front under age 13 years in WA state), 2) children under age 13 years are at increased risk for injury from airbags (designed for a 140 lb male), and 3) children’s bone development at the hips and breastbone is immature leading to increased risk of more serious injury in front seat

When it comes to infants and little children, maybe it’s different — I feel like parents are more interested in the data and reminders. Research out last week confirms what pediatricians have been recommending for years: rear-facing car seats to keep children safer in rear impact collisions. “We found that the rear-facing car seats protected the crash test dummy well when exposed to a typical rear impact,” said lead study author Julie Mansfield. If you’re hit from behind or the side or the front, we want children under 2 years of age rear-facing!

I talked to Dr. Beth Ebel, a Seattle Children’s pediatrician who also researches injury prevention and cares for children at Harborview Medical Center. Dr. Ebel is an expert on teen and child injuries and is especially knowledgeable about injuries related to vehicle crashes. Dr. Ebel came on my podcast to share how parents can help protect their children in their car and in the cars of others who drive their precious cargo around. Her points are emotional and inspiring to me.

5 Tips On Rear-Facing Until At Least 2 Years Old

• The American Academy of Pediatrics recommends children travel in a rear-facing car seat until they are at least 2 years of age. If the seat allows for longer (based on size), there is NO rush to turn your precious cargo forward.
• The worst crashes are when a car hits something from the front. Rear-facing seats protect the child’s head, spread out the force of a crash evenly across the seat, and significantly reduce the risk of injury.
• Consider buying a larger car seat which accommodates your child through the toddler period, and THEN can be turned front-facing when your child is at least 2 years old and has reached the weight limit recommended by the car seat manufacturer. You’ll save money in the long run since you won’t need to buy a new car seat for years.
• Use the easy “latch and tether” method to securely attach the car seat where possible. If you must attach the seat using a seat belt, make sure the seat belt is tight (i.e. the seat belt has no slack and won’t loosen).
• Some parents worry they can’t see the child. There are mirrors for rear-facing seats if you must briefly check at a stop light. But keep in mind that you AND your child are safest when you concentrate on driving with your eyes on the road.

Booster Seats Until 4 Feet 9 Inches Tall

• DO THIS NOW: put a mark on the wall at 4 foot nine inches from the ground. Tell your children to come and ask about getting out of a booster only when they are taller than the mark.
• Children should stay in harness-type (“5-point”)seats until they outgrow the manufacturer’s recommendations. Most kids outgrow their harness seats between 4 and 6 years of age, and are then ready for a booster seat.
• The booster seat is critically important because it helps the seat belt (and your child!) stay in position during a crash so that the car can do its job to protect the occupants. Seat belts are only designed for adults and don’t fit properly until a child is around 4 feet 9 inches tall – most kids will reach this height sometime between 9 and 11 years of age. I also like to remind kids that when in a booster they are up higher and can see better out the windows.
• Some parents mistakenly put kids into the seat belt when they aren’t big enough. Dr. Ebel sees these older kids admitted to Harborview or Seattle Children’s with serious abdominal injuries, spinal fractures and head injuries because the seat belt doesn’t hold their torso in a crash.
• Don’t negotiate on car safety. She and I both keep extra inexpensive booster seats and ask that every kid traveling in our car use one and provide it to others driving our children. (By the way, it is the law and the driver is liable).

Keep Your Children Safe In The Car

• The biggest tragedy is when a child isn’t buckled in the right seat, or worse, isn’t buckled at all. Even a very low-speed crash can cause life-threatening injury, ejection from the vehicle, or worse.
• Buckle up every trip. Every time. Even when you drive five blocks to grocery shop. Most crashes happen close to home. And children remember consistency – “we always buckle up in the car”.
• Install a car seat in every vehicle in which your child regularly travels. Buy an inexpensive seat for grandma, dad, or your regular child care provider and leave it with them. Make it easy for them and explicitly spell out your expectation that your child must ALWAYS be in the right car seat.
• Dr. Ebel’s trick for carpools: “Thanks so much for taking Elena; we really appreciate it. Do you have a booster seat for her or shall I leave one for you?”
• Keep your child in the back seat until they are at least 13 years old. Make it a clear rule and don’t cave. It’s harder to transition them back to the back seats than it is to never allow them the “treat” of sitting shotgun.
• There’s no reason to progress your child out of a booster seat before they are 4’9″. Every time you transition them you decrease their level of safety.

For a list of car seats and booster seats that meet Federal Motor Vehicle Safety Standard 213, view the American Academy of Pediatrics (AAP) Car Seat Product Listing. This list includes rear-facing car seats, convertible seats, 3-in-1 seats, combination seats, belt-positioning booster seats and travel vests.

Make the Most of Your Car Time

Remember that kids pay attention to what you do, not what you say. So set an example. Buckle up, put down your phone. Ask that kids also put down their electronics in the car. Driving time is a great chance to catch up in our busy lives; use it to listen, chat, sing or enjoy a shared sound track or radio station. Putting away your phone and redirecting attention to your child proclaims, “You are the most important person to me.”