5 surprising things about big kids and car seats

Car seat safety not just a "baby" issue

is my child ready for a booster seatWhile most new parents are very focused on properly installing and using infant car seats, that same diligence tapers off as their children move on to forward-facing car seats and booster seats.

Here are five things about car seats and safety that may surprise you.

Size matters

While age can be a good basis for when kids move to new car-seat stages, it’s not always an absolute indicator. Some kids are smaller or larger than average age might suggest, so it’s a good idea to let their height and weight be your guide.

Most children can move from a forward-facing car seat to a booster seat after 4 years old, when they reach the top height and weight for the forward-facing car seat.

A child should continue to use a booster seat until he or she is 57 inches tall — about the average size of an 11 year old.

Michigan law requires the use of a booster seat only until age 8, but the size of the child is really more important than the age.

Patience prevents injuries

Compared with seat belts, booster seats reduce the risk of serious injury by 45 percent in children ages 4 to 8 years old.

The safety implications aren’t just about keeping the child secure in the seat. The seat belt itself can be dangerous if not used properly. Children ages 4 to 12 who switch from a booster seat to just a seatbelt before they are of the proper size are more likely to suffer “seat belt syndrome,” which includes abdominal, spinal cord and facial injuries.

Let their comfort be your guide

When children are shorter than 57 inches tall, the adult seat belt might not fit them properly and can be uncomfortable. This causes many children and adults to put the shoulder strap behind the child or under the arm. Not only can that be dangerous, but it’s a glaring signal that the child is NOT ready to be done using a booster seat.

When a child’s body is large enough to be safely secured by the seat belt alone, the shoulder belt should rest across the middle of their collar bone.  In that situation, it probably won’t be of such discomfort. In the meantime, booster seats help the shoulder belt to fit and work as intended.

Consistency is key

If your child should be in a booster seat, he or she should be in a booster seat in any car in which he or she is a a passenger. That means when they are with you, relatives, friends or a car pool. If you frequently drive many booster-seat aged children, plan ahead so they are all using a booster seat every time they are in your car. Some booster seats are narrower than others, making it possible to fit three across one row of seating.

Car seat inspections are not just for babies!

A recent study we conducted at the University of Michigan’s C.S. Mott Children’s Hospital and the Child Health Evaluation and Research Unit (CHEAR) showed that only 11 percent of car seat inspections conducted in Michigan were for booster-seat age children.

Many people don’t realize that car seat inspections are available to them well after they welcome a new baby into their family. Child passenger safety technicians (CPSTs) are experts in car seat safety across all ages. They can offer tips and tricks to ensure proper car seat and booster seat usage. For example, if you have a child who is uncooperative about properly using their seat, they can help offer tips and make adjustments to make the child more comfortable. They also can be a great resource for suggestions on fitting multiple car seats and boosters in your vehicle safely.

Take the next steps:

Michelle Macy MDMichelle Lea Macy, MD, is pediatric emergency medicine specialist. She graduated from the University of Michigan Medical School, where she also completed her residency in pediatrics and a fellowship in pediatric emergency medicine. She focuses her research on injury prevention through brief ED-based interventions to promote size-appropriate child passenger restraint use and increasing ED efficiency and decreasing hospital resource utilization by applying principles of observation medicine. Her research is conducted at the University of Michigan Child Health Evaluation and Research (CHEAR) Unit. Dr. Macy is also affiliated with the UM Injury Center and sees patients at the C.S Mott Children’s Hospital Emergency Department.

best children's hospitalUniversity of Michigan C.S. Mott Children’s Hospital is consistently ranked one of the best hospitals in the country. It was nationally ranked in all ten pediatric specialties in U.S. News Media Group’s “America’s Best Children’s Hospitals,” and among the 10 best children’s hospitals in the nation by Parents Magazine. In December 2011, the hospital opened our new 12-story, state-of-the-art facility offering cutting-edge specialty services for newborns, children and women.