Karen J. Chorvat, M.D. Pediatrician at Dreyer Medical Clinic - Oswego

Every year, one of the leading causes of childhood deaths is motor vehicle collisions.  Even though all 50 states require the use of car safety seats, typically these deaths occur in children who are unrestrained or improperly restrained.

Keeping Your Baby Safe

Although it is not a law in Illinois, recent studies suggest that all infants should ride rear-facing until they are at least two years of age.  Children under 2 years of age are 75% less likely to be killed or severely injured if their car seat remains rear-facing.  This position decreases a child’s risk of a cervical spine injury in the event of a crash.  There are two types of rear-facing car seats.  The first type is an infant-only seat, often referred to as an infant carrier that sometimes comes as part of a stroller system.  These often have a base unit that the carrier clicks into and out of for easy removal of the carrier.  The second type is a convertible seat that can be used rear-facing for infants and then front-facing for toddlers.  These are bulkier seats that do not have separate bases.

It is not recommended that rear-facing seats be placed in the front seat of a vehicle, especially if the front passenger airbag is active.  It is important to ensure that the seat is at the correct angle, usually about 45 degrees, so the baby’s head does not flop forward.  Built-in features have been added to most seats to allow adjustments to be made to the angle.  Shoulder straps should be placed in the slots that are at or below the baby’s shoulders.  The harness should fit snugly.  If the weather is cold, the baby should be dressed in thin layers rather than a bulky snowsuit.  Consider covering the baby with blankets or a car seat cover rather than placing the harness over many layers of clothing.

If you have an infant-only seat, your baby may outgrow the seat before his first birthday, since each seat has its own weight and height limit.  If this is the case, you will need to change to a convertible seat in the rear-facing position.  Keeping your child in a rear-facing seat beyond 2 years of age is recommended for optimal protection.

Keeping Your Toddler/Preschooler Safe

Car safety seats with a full harness are the best option for children who weigh 40 pounds or less, or at least until 4 years of age.  Besides convertible seats, there are other seats available, including forward-facing toddler seats, combination forward-facing/booster seats, built-in seats (already in the vehicle), and travel vests.  Some children will outgrow their seats before reaching 4 years of age.  If this is the case, there are other approved seats with harnesses that are meant for larger children.  Remember, when children are riding in the forward-facing position, the shoulder straps should be placed in the slots that are at or above the child’s shoulders.

Keeping Your Older Child Safe

For older children, booster seats are available once they have outgrown forward-facing car seats.  Booster seats allow the lap and the shoulder belts, both which should always be used, to lie properly.  A child is recommended to stay in a booster seat until adults’ seat belts fit properly; the shoulder belt should rest over the center of the shoulder and across the chest and the lap belt low and tight across the upper thighs. Typically, children who are approximately 4 feet 9 inches tall and weigh around 80 pounds are the appropriate size to wear an adult safety belt.  Safety belts that do not fit properly increase your child’s risk for severe internal injuries or possible death if an accident occurs.  It is vital that your child never places the shoulder belt under their arm or behind their back.

Illinois Law Explained

Illinois law states that children under the age of 8 must always be properly restrained by a car safety seat.  Children who weigh more than 40 pounds may ride in the back seat with a lap belt, only if the vehicle does not have a lap and shoulder belt system.  Children between 8 and 18 years of age must always wear a safety belt in any position of the vehicle.  Currently, there are no Illinois laws that require a child to ride rear-facing to a set weight or age.

Safety Tips for All Kids

According to recommendations by the American Academy of Pediatrics, the rear vehicle seat is the safest place for a child of any age to ride, especially under age 13.  If a child must ride forward-facing in the front passenger seat with an air bag, the seat should be moved back as far as possible.  A child who rides in the center of a vehicle is the farthest away from frontal, side-impact, and rear-end collisions.

Additionally, car safety seats have an expiration date.  This is due to changes in technology and the plastic weakening over time.  Most car safety seats expire 5 to 8 years from their manufactured date.  The expiration date is usually found on a sticker on the seat or in the instruction manual.  If the expiration date is not posted on the car seat, it is recommended that it not be used after 6 years.  Alternatively, one could call that manufacturer of the seat for more information.

Lastly, always be a good role model for your children and wear your seat belt.  The state of Illinois requires drivers and all front passengers to be restrained.  Always read and follow the manufacturer’s instructions for your car safety seat, as well as the owner’s manual for your vehicle in regards to using car safety seats.  It is good practice to have your car seat installation checked by a Child Passenger Safety (CPS) technician.  This is often available at your local fire or police station.  They can check your installation and provide additional tips for keeping your kids safe while riding in the car.  To find a CPS technician near you, visit www.seatcheck.org.

For further information regarding child passenger safety, including a full list of available car seats with prices and specifications, please visit www.aap.org/family/carseatguide.htm.