Car Seats

Is all this hullabaloo over car seats a symptom of an overly safety-conscious culture, or is there some genuine concern here?

Actually, this one is quite real. In fact, not only is it real, but I would go so far as to say it is even quite a bit understated. Car crashes have long been the leading cause of death for children in the United States. But this isn’t just a lack of using car safety seats — though that’s part of the problem. What a lot of even well-informed families are surprised to learn is that most of them are not using their car seats properly. In fact, as many as 73% of families have been found to have CRITICAL misuse of their car seats. So stay tuned, and I’ll let you know what you can do to correct common errors and make sure your little one is safe.

Some examples of this are the straps not being tight, the car seat not being snuggly fit to the car, or the lap or shoulder belts not being positioned appropriately. Why do these details matter? When you are applying hundreds of pounds of deceleration force to a tiny baby, every inch of slowing deceleration makes a huge difference. Contrary to some people’s beliefs, the safest thing is to be firmly attached to the vehicle: the risk of death is 4 times greater when flung from a vehicle vs. staying inside it. Loose straps also cause more injury than tight straps — if you were parachuting, would you rather be securely in the harness when the chute opens, or fall into the harness after the chute opens? Ouch. Indeed, people who go sky diving will typically have highly experienced certified professionals check and adjust their straps. How many parents bring their car to a certified car safety seat technician to check their straps? This is a bit shocking, considering that there are about 20-30 deaths total per year from sky diving (USPA data), and 10,000-20,000 deaths per year just in children alone from car crashes.

I’ll spare you the horribly sad and gruesome stories of children that I have lost due to car crashes. But please, if you take anything away from this page, please please please research your car seat and have your installation checked. It’s easy!  Here are a couple resources:

  • Safercar.gov — has great general information as well as this tool for finding places to get your installation checked. 
  • Oregon Impact — has a handy car seat check calendar.
  • Here are some videos posted by the Children’s Hospital of Philadelphia that give lots of tips on proper safety seat usage, as well as info on airbags and the LATCH system.

Lastly, here are my quick tips on car safety issues. (I’ll spare going into lots of detail on the car seats themselves, since that is well covered in the videos and seat checking stations.)

  1. Make each car seat transition as late as possible, not as early as possible. Wether it’s turning your seat around to forward-facing, transitioning to booster, transitioning to belt, etc., with each transition you lose safety. So don’t do it until you absolutely have to, such as when your child or baby exceed the manufacturer's limits for the seat. Also, get seats with high weight limits so you don’t have to transition early.
  2. Drive slower. Aggressive driving will save you at best a minute or two; less than it feels. But the force applied to your child during a crash is directly related to the speed you are going. Double your speed, double the force. Not to mention, if you’re going slower you are more likely to avoid a crash altogether or at least decelerate your car more prior to the crash. 
  3. Count to three. Leave 3 seconds of road between yourself and the car in front of you at all times (4 or more in slick conditions). A spot on the road should last 3-4 seconds after the car in front of you passes it before you reach it. You may arrive 3 seconds later to your destination (oh my!) but you have dramatically more time to get your foot on the break and decelerate the car should something suddenly change in front of you.
  4. Slow down through intersections. You may have the right of way, but most crashes my patients experience come from other drivers going through lights or stop signs. Slowing down and looking both ways at every intersection can help prevent or reduce the severity of these crashes.
  5. Never text and drive. Don’t do it. Pull over for a quick second if you absolutely need to read or send a text message.
  6. Drive a safe vehicle. Newer vehicles (in the past 10-15 years) are designed to absorb much of the energy in a collision, reducing the amount of energy that is passed to your body, and are thus quite a bit safer.
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Healthy Schedule

  • After birth (within 24 hours)
  • Newborn visit (day 3-5 of age, home visits encouraged)
  • 2 weeks
  • 2 months
  • 4 months
  • 6 months
  • 9 months
  • 12 months
  • 15 months
  • 18 months
  • 2 years
  • Yearly thereafter