Patient education: Car seat safety (The Basics)

Why does my child need a car seat? — A car seat is the best way to keep your baby or child safe in the car. If there is a car crash or accident, a seat belt is not enough protection for a baby or young child.

The main types of car seats are:

●Rear-facing car seats – These have a 5-point harness. They include infant seats that are rear-facing only. There are also "convertible" seats that can be used rear-facing then switched to forward-facing later.

●Forward-facing car seats – These have a 5-point harness. Some car seats are designed to be forward-facing only. Others are "convertible" seats that can be used rear-facing or forward-facing.

●Booster seats – These are used after a child has outgrown their forward-facing car seat. Some boosters have a high back to support the head and neck. Others are backless. Backless boosters are best for use in a car that has head rests.

Some car seats are "all in one." They can be used rear-facing at first, then forward-facing, then converted into a booster.

What kind of seat should my child use? — The right seat for your child depends on their age, their height and weight, and your car.

●All babies under 1 year should ride in a rear-facing car seat. Many people choose an infant "bucket" seat that clicks into a base that stays in the car. The other option is a "convertible" car seat. These can be installed rear-facing, then switched to forward-facing when the child is older.

●Keep your baby or toddler in a rear-facing car seat for as long as possible until they reach the height and weight limit for the seat. This is the safest position for them.

●Once your child reaches the rear-facing height or weight allowed by their seat, switch them to a forward-facing car seat with a harness.

●Your child should stay in a forward-facing car seat until they reach the seat's height or weight limit. Check your car seat's manual to make sure that you know what the limits are.

●When your child outgrows the forward-facing seat, use a booster seat with a lap and shoulder belt. This should be based on the child's height, not their age. They should be tall enough for the shoulder belt to lie across their shoulder and chest, not their face or neck.

●Keep using a booster until your child is at least 4 feet 9 inches (145 cm) tall. For most children, this is between about 9 and 12 years old. Make sure that the lap and shoulder belt fit properly.

●Children should not sit in the front seat of a car until they are at least 13 years old.

How do I choose a car seat? — Some things to think about when looking for a car seat:

●In the US, make sure that the car seat has a label saying that it meets or exceeds "US Federal Motor Vehicle Safety Standard 213."

●Consider your child's age and size, and how long they will fit in the seat.

●Make sure that the seat will fit in your car and can be installed properly.

●Register your car seat with the company that made it. You can do this by filling out the registration card that comes with the seat or by going online. This way, the company can contact you if there are any issues with the seat.

●Never use a car seat that has expired, is missing parts, or has been in an accident.

●Check the manufacture date and model number on your car seat. These can help in making sure that the seat does not have any safety recalls.

How do I correctly install a car seat? — This depends on the car seat and your car. In general:

●Read the instructions that come with your car seat.

●Check your car's manual. This will tell you where and how to install a car seat. Car seats should always go in the back seat.

●Many car seats can be installed with "lower anchors and tethers." This is called the "LATCH" system. You can also use the seat belt to install a car seat.

●Follow the car seat's instructions for securing it with the LATCH system or seat belt. Check your car manual to know where the anchors are.

●Push down on the seat while you tighten the straps or belt. Once installed, the car seat should not be able to move more than 1 inch (2.5 cm) side to side or front to back.

●If the car seat is rear-facing, make sure that it is reclined at the correct angle. The seat should have an indicator showing this.

●If the car seat is forward-facing and has a tether strap, make sure that it is connected to the anchor and pulled tight.

●After installing the car seat, consider getting it checked by a safety technician. Many police and fire stations can do this.

How do I make sure that my child is safe in the car seat? — First, make sure that you are using the right seat for your child's age and size. Be sure that it is installed properly in your car.

For a rear-facing seat:

●If you are using an infant seat with a handle for carrying, check the instructions to make sure that the handle is in the right position.

●The harness straps should be flat and not twisted.

●The straps should be threaded through the seat at or just below your child's shoulders.

●The chest clip should be even with their armpits.

●The harness should be snug against the child's body.

●Do not dress your child in bulky clothing or a coat while they are in their car seat. This can make it hard to buckle them in safely. If it is cold, tuck a blanket over the harness once it is buckled snugly.

For a forward-facing seat:

●The harness straps should be flat and not twisted.

●The straps should be threaded through the seat at or just above your child's shoulders.

●The chest clip should be even with their armpits.

●The harness should be snug against the child's body.

●Do not dress your child in bulky clothing or a coat while they are in their car seat. This can make it hard to buckle them in safely. If it is cold, tuck a blanket over the harness once it is buckled snugly.

For a booster seat:

●The shoulder belt should lie across the child's shoulder and chest, not their face or neck.

●The lap belt should lie across their upper thighs, not their belly.

Where can I go to learn more? — In the US, more information about car seat safety is available from the Department of Transportation on their website: www.nhtsa.gov/equipment/car-seats-and-booster-seats.