David M. Epstein, M.D.
Phone:
(302) 392-2077
Fax:
(302) 392 - 0020
www.DelawareModernPediatrics.com
Most parents are now aware of
the laws in each state mandating infant seats that are rear facing until the
child is one year old and at least 20 pounds. Most parents are also aware that their
children are safest if they continue to use a car seat during the toddler
years; this is also required in many states.
For older children,
However, most children are
removed from car seats and booster seats at too young an age, and are
restrained by adult seatbelts (“premature graduation”).
Here are some general recommendations for child auto
restraints beyond infancy, from the National Safe Kids Coalition:
ü For
children 20 - 40 pounds, and over 12 months, the child should be placed in a
forward facing car seat, and should continue to use the car seat until he is 40
pounds. (In fact, it’s safest to keep
the seat rear-facing as long as possible, even after 12 months, as long as the
child tolerates it.)
ü Until
the child is 80 pounds, and over 4’ 9” tall, a child should sit in a car
booster seat. (This is the Safe Kids
Coalitions’ recommendation, even though
ü Once the
child has grown past 4’ 9”, then a seat belt may be tried, if the belt position
is examined.
ü Avoid using a “Velcro” seat belt adjuster, or belt clip. If the seat belt does not fit properly
without one, then a booster seat should be used.
Position within the car is also important. At any age (and especially for children 12
and under), the rear seat is 2 to 3 times safer than the front seat. This is
because of the greater amount of structural steel around the rear wheels, which
protect the rear compartment. The middle
position of the rear seat is the safest of all.
Should school-age children use booster seats?
An average 11 year old child
weighs 80 pounds and is 4’ 9” tall. Many
parents are surprised to hear the recommendation that elementary school
children should continue to use a booster seat. However, the determining factor
for the safety of a seatbelt is not the child's height and weight as such.
Rather, the important factor lies in the way that the seatbelt restrains the
child.
How can I know if my car
seat, or seat belt, fits my child safely?
This can be determined by
inspecting the seatbelt when the child is strapped in and comfortable. The greatest safety is found when the lap belt restrains the child
across the bony projections of the lower hips, and the shoulder belt restrains the child across the collar bone,
shoulder, and ribs. If the lap belt restrains the child across the soft tissues
of the belly, or if the shoulder belt restrains the child across the soft
tissues of the neck, then an injury from the seatbelt itself is much more
likely. The knees should bend
comfortably at the edge of the seat., with the back against the seat back. If any of these conditions are not met, then
the child needs a car seat or a booster seat.
A car seat inspection can
determine whether the seat is installed correctly; ask us for a referral to a
Child Restraint Fitting Station, or check:
http://www.state.de.us/highway/information/cps.shtml
.
How can I convince my school-age child to use a booster seat?
Parents sometimes object that
peer pressure may make a school-age child unhappy about using a car seat. Our response, of course, is that a parent’s
role must be to enforce safety rules, and educate the child. When bike helmets were first introduced,
similar concerns about resistance from children were voiced; but bike helmet
use is now the norm.
In addition, it is important
that the adults always use seat belts on every trip. This is not only for their own safety, but
also because of the role modeling that parents can provide. Teenagers who have
not seen their parents wear seat belts are much less likely to wear them
themselves, during the "New Driver” period when they are at highest risk.
How important are seat belts and car seats for short errands?
Many adults make the mistake of
using seat belts for themselves and their children only for long trips.
Unfortunately, most accidents and injuries actually occur within a few minutes
of home, doing errands such as shopping. It should be a universal rule that the
children are properly restrained for any car ride, no matter how short the
trip.