Car seat safety isn’t child’s play. Motor vehicle crashes are a leading cause of death among children in the United States. According to the CDC, more than 600 children under the age of 12 died from a car accident in 2014, and more than 121,350 were injured. Knowing how to use your car seat is imperative to protect your child during travels – whether it’s a road trip or a quick commute across town. But installing a car seat isn’t as easy as it seems. According to a study in the Journal of Pediatrics, 95 percent of parents make at least one mistake while installing a car seat.
So to mark Child Passenger Safety Week, pediatrician and certified child passenger safety instructor Alisa Baer M.D. goes over what we are doing wrong and how we can make it right. Here are 6 common car seat mistakes and how to avoid them.
1. The harness straps are too loose. Most parents worry about making the car seat straps too tight on their baby. Surprisingly, it’s quite difficult to make the straps “too tight” - and most parents swing to the other extreme and leave the straps way too loose. Your baby relies on you to ensure his car seat straps are properly snug to protect him in a crash.
Tightening the harness straps is like a 2-step dance - where one must pull firmly upwards on the shoulder straps to remove hip/belly slack AND then pull up on the tail to tighten the straps, and then repeat the steps a few times over. This 1-minute video shows how to tighten the straps on a child - whether they are 3 days old or 3 years old, the technique is the same on almost every car seat in the US.
2. The car seat isn’t installed tightly enough. 95% of all car seats are not used properly and are too loosely installed, which is detrimental to the child’s safety. In a loose car seat, the child’s body is more likely to hit hard structures in the car like the window, door, or the seat in front of them. There are two different kinds of installations:
Seat Belt Installations can be tricky because many people forget to lock the seat belt when installing the car seat. When we ride around, our seat belt is loose while driving and then locks when someone slams on the brakes. A seat belt holding a car seat can NOT be loose while driving - and must be held tight around the car seat using at least one of the following 3 locking methods:
- Seat belt locking device built INTO the child’s car seat. If you’ll be installing with a seat belt - like is necessary in the center of 95% of cars - splurge and get a seat with a built-in seat belt locking device to make installation much easier.
- Seat belt locking mode built INTO the vehicle’s seat belt. Since 1996, seat belts in the US have a special locking mode to hold a car seat tight - and most have the locking mode shown in this video. If this locking mode tilts your baby’s car seat (commonly happens on bases and rear-facing convertible seats), use one of the other locking methods to keep your baby’s car seat tight.
- Seat belt locking device added ONTO the vehicle’s seat belt. A locking clip - a metal H-shaped clip - can be added onto a shoulder/lap belt to keep it tight around the car seat. Locking clips are challenging and require two people for the installation - so be sure to visit someone trained for help.
LATCH Installations use lower anchor straps (often called LATCH straps). Unlike seat belts, LATCH straps have a locking mechanism built right in to hold themselves tight. But you still have to pull them tight. Watch this video to learn the inside/outside trick - as where and how you pull the LATCH strap can mean the difference between getting the strap tight or not.
Whether you use LATCH or a seat belt, the safest way to install your car seat is to get help. So take an hour and visit someone trained in your area to get one-on-one help with the installation of your child's car seat.
3. Switching to forward-facing too soon. Rear-facing is the safest way to ride. Period. Astronauts ride rear-facing for blast-off and re-entry as it’s is the only way the body can tolerate the G-forces involved. Rear-facing spreads the forces along the entire back, cradling the head and neck, unlike forward-facing where the head and neck are violently thrust forward. The large heads and stretchy neck bones in young children are exactly the features you do NOT want when forward-facing.
Many parents turn toddlers forward-facing because the legs looked scrunched. Not only are there many MORE leg injuries to forward-facing kids than rear-facing kids, there are also more injuries to all parts of the body when kids are forward-facing. Just like your toddler doesn’t wake up with a crick in their neck after a nap in the umbrella stroller with their head all the way down on their chest - so too your toddler won’t be uncomfortable sitting frog-legged or cross-legged in their rear-facing convertible seat. See here to learn when you should turn your child forward-facing.
4. Not buckling baby snug even out of the car. Every year, nearly 10,000 infants visit the emergency room with head injuries due to drops and falls from their car seat when they are used OUT of the car. Several babies every year die from strangulation or asphyxiation in their car seat. These injuries and deaths are nearly 100% preventable. Anytime baby is in the car seat (even if it is in the house or on the stroller), keep the straps fully buckled AND fully snug and keep the car seat either strapped into the car, locked onto a stroller, or placed on the floor. See here for more information on this important topic.
5. Baby’s head is not in a safe position for breathing. Every new parent worries about the position of their newborn's head. Most parents are surprised to learn that what they thought was the best position may actually not be the best one! So before you rush and buy an extra head/body support for your newborn, know that these can actually be dangerous. As they typically worsen the head position and add slack in the straps, they can ultimately increase the risk of injury in a crash. See here for more information on proper position for your newborn’s head.
6. Babies have too much puff in the car seat. Puffy coats keep us warm by trapping a layer of air as insulation. This layer of air is what makes puffy coats unsafe in the car seat. While you typically can’t push much of the air out when tightening the harness, the extreme forces in a crash do, leaving the baby buckled in straps that are now way too loose to protect optimally. In winter it is best to add thinner, tighter layers under the car seat straps - and save the puffy layers for over the car seat straps. We’ve got lots of suggestions on ways to keep kids warm AND safe in winter right here.
Alisa Baer is a pediatrician and co-founder of The Car Seat Lady - an advocacy organization dedicated to keeping kids safe in cars. She's an expert in her field with 18 years and more than 10,000 car seats installations of experience.
Photography by Alisa Baer.