Make sure your child is in a booster seat if he or she is under 4 foot 9 but too big for a car seat, and pay attention to how the seat-belt straps touch the child’s body.

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RODALE NEWS, EMMAUS, PA— About two-thirds of parents who put their children in car booster seats—used when a child outgrows a forward-facing, harness-style car seat—aren’t using the seats properly, according to a recent study published in the journal Accident Analysis and Prevention. The improper placement increases the risk that the child’s internal organs could be damaged in the event of a crash, an injury known as “seat-belt syndrome.”

THE DETAILS: Booster seats are for older children who have outgrown their car seats. According to American Academy of Pediatrics (AAP) guidelines, children should stay in a booster seat until an adult seat belt fits properly, usually when a child is about 4 feet 9 inches tall. In the recent study, researched looked at 564 children using booster seats and found that the majority of the seats were installed incorrectly or misused. Often, the shoulder belts were too slack, or misplaced under a child’s arm, behind the child’s back, or over an armrest, any of which could cause serious injury in the event of a crash. “Our findings clearly show that booster seats are not protecting children, because of user error. Parents need to know how to safely place a child in a booster, supervise the buckling up of children who put themselves in the seat, and double-check that the shoulder and lap belts restraining the children remain properly positioned during the drive,” says study author Joseph O'Neil, MD, an associate professor of pediatrics at Indiana University School of Medicine.

WHAT IT MEANS: Booster seats protect kids who would otherwise be seriously injured in a car crash. But that protection is lost if the child isn’t properly fitted in the seat.

Here are some ways to make sure your little one gets maximum protection in the car: