Has your child outgrown her booster seat?

New recommendations about booster seats for children state your child should remain in the back seat, in a five-point-harness car seat until the height and weight limits are out-grown. Then, your child should definitely be in the back seat, in a booster seat until age eight. In general, once your child is eight years old he should be 4 feet 9 inches tall before coming out of the booster seat. This will likely be until age 10 to 12! The front seat is for children who are ages 13 and up.

However, after age eight and before 4’9” tall there may be some car seat belts (in the back seat) that will properly fit your child without a booster seat. There are five steps to determine if the seat belt fits well without a booster:

1. Does the child sit all the way back against the seat of the car (their back and their bottom is up against the back of the seat)?
2. While they are sitting all the way back in the seat do the child’s knees bend comfortably at the edge of the car’s seat?
3. Does the shoulder belt come across the collarbone, between the neck and the arm?
4. Is the lap belt low in the lap, touching the thighs?
5. Is this a comfortable position that can last for the whole car ride?

This information originates from the American Academy of Pediatrics, and was printed in the spring 2011 newsletter (Volume XVI, No 1) of the Michigan Chapter of the AAP. Online sources of information can be found at www.facebook.com/childpassengersafety , http://twitter.com/childseatsafety, and www.healthychildren.org/carseatguide.

New Car Seat Recommendations

Wow! Nine years after the last policy guidelines were released the American Academy of Pediatrics has issued new guidelines for children and car seats: The big changes are to keep your child rear facing until possibly two years old, unless they outgrow the limits of the seat earlier, and to use a belt-positioning booster seat (not a bench style booster) until reaching 4 foot 9 inches tall (between ages 8-12). Here is the link. I'll add more to my blog later--this information just came out and I need some time to review it, as well.

http://www.healthychildren.org/English/news/pages/AAP-Updates-Recommendations-on-Car-Seats.aspx

http://pediatrics.aappublications.org/cgi/content/abstract/peds.2011-0213v1

Now back to my post. After reviewing the AAP guidelines (which you can see for yourself using the above links), as well as a helpful algorithm that accompanies the guidelines, I believe I can summarize them more effectively for you. The recommendations are evidence-based, meaning they have been shown in scientific studies to prevent injury and fatalities among children in motor vehicle accidents. The big changes are to stay rear-facing as long as the car seat accommodates until age two, to use a car seat with a built-in harness for as long as possible, and when that seat is outgrown to stay in a booster seat until 4'9" tall! This is a lot to absorb, and many older children will be quite vocal about their opinions of booster seats. However, their safety is at stake here so it is time for parents to take a stand.

INFANTS AND TODDLERS:
Infants under the age of two have relatively larger heads and weaker necks than older children and adults. In a crash this puts them at high risk for a head or spine injury. For this reason they should stay rear-facing in a car as long as possible up to the age of two years.

Many infants under the age of twelve months are in an infant-only rear-facing seat that can be attached or removed from a base that is left in the vehicle, and then carried by the attached handle. A convertible car safety seat is another option. It is a non-removable seat designed for infants that can be used both rear-facing and forward-facing. When an infant outgrows the infant-only seat they are best supported in a rear-facing child safety seat until they outgrow the rear-facing height or weight limits of a convertible car seat. Currently, most convertible car seats have a rear-facing limit of 35 pounds.

AGES TWO OR OLDER, OR HAS OUTGROWN LIMITS OF REAR-FACING CAR SEAT
A forward-facing car seat with built in harness should be used for children ages two and older, or children younger than two who have outgrown their rear-facing convertible seat. The built-in harness should be used as long as possible, until the child has exceeded the weight and height limits of the car seat. Different brands of car seats allow for different maximum weights, ranging from 40lbs. to 80lbs.

HAS OUTGROWN LIMITS OF FORWARD FACING CAR SEAT WITH HARNESS
Children who have outgrown the limits of their forward-facing, built-in harness car seat should use a belt positioning booster seat until they are 4 foot 9 inches tall (which is the average, or 50th percentile height for an eleven-year-old girl and boy), and at least eight years old, OR they can safely use their own vehicle's lap and shoulder restraint system. Most children in most cars will need to be 4'9" tall to safely fit into a vehicle's built-in seat belt without using a belt-positioning booster seat.

PROPERLY FITTING LAP AND SHOULDER BELT
A properly fitting seat belt will look like this: First the child should be sitting up nice and tall in the seat with their lower back against the back of the seat. While in this position the lap part of the belt will fit low across the hips and pelvis (across the upper thighs is the goal, not on the tummy), the child's knees will bend at the edge of the seat (not stick straight out), and the shoulder portion of the belt will cross the middle of the chest and shoulder (not coming across the neck or face).

FRONT SEAT?
Children under the age of thirteen should ride in the back seat.