Car Safety Seats for Children Can Save Lives

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Child Safety

All 50 states in the U.S. require child safety seats and with good reason. According to the National Highway Traffic Safety Administration, child safety seats can reduce the risk of potential injury as much as 69 percent in infants and 47 percent in children between the ages of one and four. In Iowa, child car seats and seat belt use are also the law.

Charles Jennissen, M.D., Children's Hospital of Iowa pediatric emergency medicine specialist in the Emergency Treatment Center at University of Iowa Hospitals and Clinics, says the use of child safety seats is our best defense against the number-one killer of children, which is motor vehicle crashes.

"Unfortunately, these child restraint devices are often misused or improperly installed. A recent study by the National Highway Traffic Safety Administration found that more than 80 percent of child safety seats with harness devices were critically misused in a way that might prevent the seat from properly reducing injury risk. Some car safety seat check-up events performed in Iowa have found misuse in up to 90 percent of those seats checked," he says.

Jennissen says the most common serious mistakes are loose harness straps inadequately securing the child in the child safety seat and the seat belt too loose to firmly secure the child safety seat to the vehicle. "A potentially fatal but less common mistake is placement of the child safety seat in the front seat especially behind a front air bag.

"Harness retainer (chest clip) placement other than at the armpits and moving a child to the forward-facing position before they are at least 20 pounds and a year of age are also prevalent problems.

"Another frequent mistake is improper placement of the harness straps through the exit slots of the car safety seat. These should be placed at or below the shoulders while the child is in the rear-facing position, and at or above the shoulders in the forward-facing position," he says.

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Jennissen says the most important thing is to read both the vehicle owner's manual and the child restraint instruction manual for proper placement. "Another important tip is to put your weight into it! You really want to get a tight fit between the child safety seat and the vehicle seat. Put your weight into the child safety seat to compress the vehicle seat while tightening the seat belt as much as possible."

Some vehicles may have no middle back seat, lack adequate back seat space or have contoured seats that make proper installation extremely difficult if not impossible. He says families should consider this when purchasing their next vehicle.

"I encourage families to attend a car safety seat check-up event to have their installation evaluated by a certified car safety seat technician. These events are held frequently through the Johnson County SAFE KIDS Coalition," he says.

The Linn County SAFE KIDS Coalition sponsors monthly car safety seat check-ups in Hiawatha on the second Thursday of each month. Appointments are needed and can be scheduled by calling 319-310-SEAT. Also, the National Highway Traffic Safety website has comprehensive information on proper child restraint seat use and is a great resource for families.

When a child graduates from a car seat, it is important to use a booster seat because seat belts are not designed for young children. According to the National Highway Traffic Safety Administration, 84 percent of children ages 4-8 killed in car crashes in the 1990s were either completely unrestrained or incorrectly restrained in an adult seat belt restraint.

"Although any restraint is better than none, using only a seat belt with smaller children puts them at increased risk for some critical injuries. In children under 4'9", the shoulder belt cuts across the neck and the lap belt rides up over the abdomen/stomach making them vulnerable in a crash to injuries to the liver, spleen, intestines and spine. The younger and smaller the child, the more likely this will occur.

"A booster seat raises the child up so that the seat belt fits right--low across the pelvis or hip area and the shoulder belt crossing the child's chest resting snugly on the shoulder. Children who have outgrown toddler safety seats (around 4 years of age or 40 pounds) should be restrained in booster seats until they are at least 8 years of age, unless they are 4'9" tall," he says.

It is important that child safety and booster seats be installed in the backseat of vehicles. "The backseat is by far safer than the front seat during a crash. All children 12 years of age and under should always ride in the back seat," Jennissen says. "Front seat air bags are an additional potentially fatal hazard to children in the front seat. Children in rear-facing car seats are particularly at risk, as well as older children who may increase their risk by sitting forward in the seat placing their head in the direct path of an instantaneous air bag deployment."

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