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:
• See how it’s done. The lap belt should cross the child’s thighs, the shoulder belt should cross the collar bone and breastbone. Don’t let the belts get caught on the seat’s armrests. Make sure the belts don’t have any turns or twists in them.
• Get help from the experts. For hands-on advice on installing and using either booster seats or the harness-style seats that younger children use, check with a nearby state police barracks. If they don’t have a program that offers guidance, they can direct you to an organization that provides demonstrations, or will even check the seat you have in your car.
• Sort out guidelines. Know when your child should graduate from a rear-facing to a forward-facing harness-style car seat, or from a car seat to a booster seat. AAP suggests babies should be sitting in infant seats or rear-facing convertible seats until they weigh at least 20 pounds, preferably longer. Children at least 1 year old and 20 pounds or more can ride facing forward. But it may be wise to stick with a rear-facing seat as for long as you can: A recent study published in the British Journal of Medicine found that children 4 years old and younger riding in rear-facing car seats fared much better in crashes than those in forward-facing car seats. If you’re in the market for a car seat, look for a convertible model with a higher maximum weight and height limit, so your child can ride rear-facing for as long as possible, for optimal safety.
• Know when it’s booster time. When they exceed the weight limit of their harness seat, older children should graduate to a booster seat. They should keep using the booster seat until they can sit in the vehicle’s back seat, with their backs against the seat back, knees extended over the seat’s edge at a 90-degree angle, and feet touching the floor. Typically, this happens when a child reaches a height of 4 feet, 9 inches. Even when children are big enough to go sans booster seat, they should sit in the back seat until they’re at least 13.
• Don’t allow dissent. Sure, your 8-year-old may resist plopping into a booster seat after soccer practice, but your job as a parent is to protect him. Be consistent, making your child use the seat every time you go anywhere in the car. Even a short trip to the supermarket requires buckling in to the booster seat. (All adults in the car should set a good example by using their seat belts, too.) Don’t allow the child to move the shoulder belt behind his or her back or arm, or otherwise shift it out of place. If your child asks you why you make her ride this way, explain to her that children are often seriously hurt—or worse—in crashes when their seat belt doesn’t fit them properly. For more information about car and booster seats, visit AAP's Car Safety Seat Guide.