Car Seats:

In brief: <1or20 infant seat face back, 1&20 convertible face forward , 4(when turn 5)&40 booster or when ears are above back of seat move to booster seat., 4'9"-80 reg seat belt

• <1 year old or < 20 lbs: infant seat, rear facing

• 1-4 y/o AND at least 20 lbs: convertible seat (may face forward), in 3 point  (2 straps form V) restraint or 5 point restraint (straps form H). Better guideline: when ears are above back of seat move to booster seat.

• >4 y/o (5 y/o) and at least 40 lbs and under 4 foot 9: belt positioning booster seats.

• When to d/c booster seat: 4 foot 9 AND 80 lbs AND can sit w/ lap belt low and flat across thighs and shoulder belt across chest (over mid clavicle and center of chest)

• Little preemies can have special lying down seats.

4 Types of Car Seats

• Infant- only

  • Rear-facing only

  • used from birth (about 5lbs) up to 20-22 lbs

  • 3-point or 5-point harness

  • some come with detachable base

  • adjustable harness slots, providing room for growing baby- shoulders should be AT or ABOVE strap slots
     

• Convertible seats

  • rear and forward-facing- can be used longer and for larger children

  • rear-facing until 1 year old AND 20 lbs- can then turn around to forward-facing\once turned to forward-facing: shoulders BELOW strap slots, ears below the top of the seat back, move seat into upright position (from reclined)

  • 4 types of harnesses:

    • 6-point (6 straps)

    • 5-point (5 straps): best if being used for a small infant

    • T-shield

    • overhead shield

  •  Forward-facing seat

    • only used forward-facing

    • used for children at least 1 year AND 20 lbs
       

• Combination seat

  • NOT used rear-facing

  • used only for children 1year and 20 lbs or greater

  • has internal harness system to be used in children who weigh up to 40-50 lbs

  • convert to belt-positioning booster seat (by removing the harnesses) for children who exceed the height or weight limits for use of the internal harness- use as a booster seat
     

• Booster seat should be used when the child has outgrown the car seat, but too small to fit in the vehicle safety belts- use of regular safety
  belt when 6 years or 60 lbs (actually when 4'9'')

• For more info, please refer to the AAP web site: http://www.aap.org/family/carseatguide.htm
   

Car safety: Take-home points for pediatricians
from Contemporary Peds 9/03

General guidance

• Every child must be properly restrained on every trip
• All children under 12 years of age should ride in the rear seat
• Children are more likely to be properly restrained if the driver is restrained

Infants under 12 months

• All infants under 12 months should ride in the rear seat in a rear-facing child safety seat; if a child has to ride in the front seat, the airbag must be turned off
• The safety seat should be firmly attached to the vehicle seat (no more than one inch of movement in any direction)
• The harness straps should come through the lower slots of the safety seat and should be snug with the chest clip connected at the level of the armpits

Children over 12 months, between 20 and 40 pounds

• Once children reach 12 months of age and weigh at least 20 pounds, they can face forward, but they should still ride in the rear seat. If a child has to ride in the front, the airbag must be turned off
• The safety seat should be firmly attached to the vehicle seat (no more than one inch of movement in any direction).
• Shoulder straps should come through the upper slots of the safety seat, just behind or over the shoulders, and should be snug with the chest clip at the armpit; there should be no more than two fingers of room between the strap and the child's body

Children between 40 and 80 pounds and under 4 feet 9 inches

• For maximum safety, these children should sit in a high-back booster and wear the regular vehicle lap and shoulder belt. They should ride in the rear seat

Children over 80 pounds and 4 feet 9 inches

• Children this size should always use the vehicle seat belt
• They should ride in the back seat until they reach 12 years of age

Children 12 years of age and older

• Children older than 12 years can ride in the front as long as they are wearing a seat belt
• Teenagers should be actively discouraged or prevented from riding with novice drivers

Teenage drivers

• Learners should have at least six months of supervised driving—including some driving at night and in bad weather—with a licensed driver over 21 years of age
• Once teenagers get a license and can drive without supervision, they should not carry passengers for at least six months, and they should be restricted from driving late at night