Think you know the proper car-seat safety rules because you’ve transported your kids or grandkids, who are now grown?
For this month’s Healthy Actions column, which is a monthly look at a medical topic of interest with a local expert, we’re going to talk about car seat safety.
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This is an important topic not just for new parents, but also grandparents and other family members and loved ones who may be helping to transport little ones around.
Car-seat rules and recommendations change – so even if you think you know how to properly install a car seat or how long a child should be rear-facing from when your kids were little, chances are the rules have changed.
When I first was chatting with Heather Trnka, injury prevention supervisor at Akron Children’s Hospital, last month about a potential Healthy Actions topic, I told her that I used to write car-seat safety stories when my kids, now 22 and 19, were young.
But my kids were infants right around the time when the LATCH system (short for Lower Anchors and Tethers for Children) and tether anchors were getting introduced.
Nearly all cars after 2002 are required to have them. Many of our older cars didn’t have the new systems yet.
Trnka, who is also state director of Safe Kids Ohio, a community collaborative of individuals who are supportive of injury prevention throughout the community, told me that even with the new systems, 70% of all car seats today are still installed incorrectly.
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This is an edited version of my interview. There is also a Beacon Journal podcast of the interview and an instructional video of Trnka installing car seats available.
I was surprised at how many things have changed just in the time since my kids were little. Can you talk about that?
A lot has changed. Car seats have gotten fancier and they’ve made some really great innovations when it comes to installing them from our lower anchors – those little connectors in vehicles – to just the car seats themselves.
Can old car seats be reused?
Car seats expire anywhere, on average, from seven years to 10 years from the date of manufacture. There is a label or a stamp on each car seat. We also want to make sure a seat hasn’t been recalled. We also want no cracks and to make sure the Styrofoam is still put together.
We can’t tell you 100% that your car seat is safe if it’s not brand new and straight out of the box.
Car seats that have been in a crash or even a fender bender aren’t safe to use anymore and need to be replaced.
What types of car seats are there?
Let’s start with the infant carrier, which is a car seat that has the handle and it only faces the back of the car. They’re nice because you can take them in and out of the car without uninstalling the car seat and typically are used from birth to 10 to 12 months.
A convertible car seat is the only car seat you need. From birth to a booster seat, it faces the back of the car, then can be forward-facing and can be used as a booster seat.
There are two types of booster seats. There’s a high back booster that comes up behind the back of the child. And then there’s a no-back booster that just positions them so they can wear the adult seat belt properly. And then in between those two we have a combination car seat, which is a car seat with a harness and then it transforms into a belt positioning booster seat.
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When using an infant carrier, can you leave a sleeping child in the carrier after it’s removed from the vehicle?
No. That’s one of the biggest changes that we’ve seen since the ’90s. We used to leave the baby in the car seat on the floor once you get home. But the car seat rocks to an incorrect angle that would push the baby’s head forward and make it difficult to breathe. There have been deaths.
Either keep the child sleeping in the car seat while driving (since the car seat is at the right angle), bring the child inside to a flat surface or transfer the baby into a wearable carrier.
What is the danger of wearing bulky coats with car seats?
We do not want to put kids in heavy snow suits or puffy winter jackets in a car seat. In a crash, the harness needs to be nice and tight. If the child is in a puffy jacket, the harness is not holding the child in properly and the child could sustain an injury.
Use layers instead. A nice thin fleece works. Buckle the harness and tighten it. Make sure you can’t pinch any of the fabric of the harness and then put a blanket around the child, but not near the face.
You can also warm up your car before you put the child in. There’s also products called shower cap covers, which basically snap over an infant carrier. Those are fine.
Similarly, puffy jackets should not be used on toddlers or older children with a harness or seat belt. There’s even some strong research that shows adults wearing puffy coats could affect the performance of the seatbelt.
Rules have changed for how long a child should be rear-facing in a car seat. Can you explain?
It depends on each car seat. We have good, better and best practices when it comes to child-passenger safety. We want to make sure that we are doing the minimum that the car seat manufacturer requires because we are a proper-use state here in Ohio. We are required to follow manufacturers’ guidelines.
There’s a label on every car seat, which is in English and Spanish. It tells you the minimum height and weight that a child must be before they are forward facing and also gives you the height and weight for rear facing.
Most car seat manufacturers want a child to be at least 2 before facing the front in a car seat. We want to make sure their muscles and structurally within their skeletal system are able to withstand a vehicle crash in a forward-facing car seat. Rear-facing is safer in how the baby moves in the event of a crash to protect the baby’s head, neck and spine.
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Can I use a mirror in the back seat to see the rear-facing infant?
Yes, but make sure it is not a distraction to you as a driver. Also, make sure anything near an infant is soft. There are hard plastic mirrors and video cameras. Don’t hang hard toys on the infant carrier handle. Anything in a vehicle in a crash is going to fly.
Driving while your infant or child is crying in the backseat is very distracting and unnerving. What are some tips?
We as the child’s parents have got to protect them. I had a baby who hated being in the car and car seat. On some drives, I’d have to pull over three times to calm him down. But I was making sure I wasn’t turning around, fussing with the blanket or fussing with the pacifier. We want to be safe when we’re driving.
Where is the safest place to put a car seat in the car?
It really comes down to each individual car. Look at your vehicle owner’s manual and the car seat manufacturer’s manual and go see a certified technician.
Let’s talk about booster seats. What are the rules?
Most booster seats require you to be at least 4 years old and 40 pounds and – here’s the big kicker – be able to sit still. I don’t know about you, but I don’t know many 4 year olds who are able to sit still and maintain the position with the seat belt.
In Ohio, to graduate from the booster seat, you have to be at least 8 years old, or 4-foot, 9-inches. We see kids who are graduated to the adult seatbelt with no booster seat way too early.
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There’s also something called the five-step test that kids need to pass before they graduate out of the booster seat. Some kids don’t pass until they’re 10 years old.
It’s easy to remember by “Back to Back, Crack to Crack.” The child’s back is against the back of the vehicle seat. Their bottom is against the crack in the car seat, their knees bend at the vehicle seat, feet flat on the floor and seatbelt hitting them midway between their neck and their shoulder.
When is it safe for a child to ride in the front seat?
The recommendation for the American Academy of Pediatrics as well Safe Kids and the National Child Passenger Safety Board is that kids not ride in the front seat until they are 13 years old.
So it does not have to do with height or weight?
It really comes down to once they’ve entered puberty, their bone fusion has happened and their skeletal system could withstand the impact of a front airbag.
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What about a petite 13-year-old or even a petite adult?
Many cars have an adjuster on the side to adjust the seat belt so it’s hitting you midway between the neck and the shoulder. Don’t put the seatbelt underneath the arm or behind your back.
Can you use a booster seat in the front seat?
No. If you’re in a booster, you should be in the back. Sometimes there are instances where kids have to be in the front seat, but it’s not ideal.
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Is the LATCH and tether system or a seat belt better to use?
Both are equally safe. One is not better than the other. Using them properly is what’s important. One of the most common car seat mistakes that we see is that parents install the car seat using the seatbelt, but forget to lock the seatbelt. There’s also a mechanism that we’ll show in the video of how to lock a seatbelt to ensure that when Mom and Dad take a right turn and the car seat doesn’t tip over.
What kind of help can people get with car-seat installation or a safety check?
At Akron Children’s Hospital, we have nationally certified child passenger safety technicians who have gone through a 32-hour course to learn everything about car seats and can assist parents with making sure their car seat is installed properly.
We’re here Monday through Friday and offer free appointments to the public to ensure car seats installed properly.
Call our car seat hotline at 330-543-8942 or go to www.akronchildrens.org/carseats
There are also many local fire departments and a few police departments that have certified technicians. Akron Children’s can help you find the closest technician.
If a relative lives in another part of the country, you can also find a certified technician at www.safekids.org/inspection-stations
Are there any programs to help with the purchase of a car seat?
If you are income-eligible or you receive or are eligible for government assistance, you are eligible for the hospital’s discount car seat program. We also have some grant funding that if you’re unable to afford, we can cover the cost of your car seat. Call our hotline at 330-543-8942.
To read previous Healthy Actions topics, go towww.tinyurl.com/BettyHealthyActions Beacon Journal staff reporter Betty Lin-Fisher can be reached at 330-996-3724 or email@example.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ. To see her most recent articles and columns, go to www.tinyurl.com/bettylinfisher