Parents have a lot to worry about when it comes to keeping their kids safe and healthy, and car seats are no exception. There is an abundance of information and it can be overwhelming, but choosing and installing a car seat may be one of the most important things you do to keep your child safe. Remember, safety is not negotiable with the child.

The right car seat is the one that fits your child, your vehicle and that you will use correctly every single time. Everyone who transports the child, including parents, grandparents, aunts, uncles or friends needs to be able to use the seat properly.

We know that car seats really matter. Motor vehicle crashes remain the number one cause of death for children. From 2003–2007, 115 child passengers have been killed in traffic crashes in Colorado. In more than half of these the child was either not in a child safety seat or seat belt, or was using one improperly. Car seats are 71% effective in reducing deaths for infants involved in a crash. In addition to having a car seat, making sure it is used correctly is equally important. Nationally, seven out of ten kids in child safety seats are not properly buckled in. Car seats prevent ejection, are designed to contact the strongest parts of the body and distribute the force over an extensive area. They are also designed to protect the head, neck and spinal cord when used properly.

Kids are different and therefore need to be restrained differently than adult passengers. Their heads are large relative to the rest of the body with big brains. They have a high center of gravity and weaker neck muscles. Their bones and ligaments are less developed and the naturally round shape of the hip bones prevents a lap belt from staying in place. Size, rather than age, is the most important factor when securing a child in a vehicle. There are also specific car seats for children with special needs.

Most parents know that from birth to 1 year and 20 pounds an infant needs to ride in a rear-facing car seat. However, research is now showing that kids are safer in the rear

facing position until 2 years of age. The American Academy of Pediatrics as well as other safety experts now recommend that children remain rear facing until their second birthday. During the second year of life, children are more than five times safer riding rear facing than forward facing. When your child out grows the infant car seat, there are convertible car seats that can face either forward or backward and can hold a child up to 30 or 40 pounds depending on the manufacturer’s limit.

Once a child has been turned to the forward facing position they should remain in a five-point harness until they reach the highest weight and height limit the manufacturer allows. In most cases this is at least 40 pounds and some may be as high as 65 pounds or more. When the child reaches at least 4 years and is more than 40 pounds, a booster seat should be used. Booster seats must always be used with both the lap and shoulder belts. Boosters reduce the risk of injury by 45% in kids 4–8 years of age. It is important to use the child’s size to guide your choice in safety seats even if their age meets the minimum requirements for the next safety system.

Children under 13 years of age should ride in the back seat and must be correctly restrained with the appropriate system. The risk of injury increases by 40% when a child rides in the front seat. One out of three children killed in traffic crashes in Colorado was riding in the front seat and of those, 67% were under age 13. While an airbag is a great safety device for an adult, it is not required to protect and actually may cause injury to someone under 61 inches and 105 pounds.

It is the responsibility of the driver to ensure that passengers under the age of 18 are properly buckled up in the appropriate restraint on every trip. Under Colorado’s

Child Passenger Safety law, infants and children must be properly buckled or the driver can be ticketed and fined a minimum of $82 for each unrestrained or improperly restrained child. If the driver is under the influence with a child in the car, he or she can be charged with child abuse in addition to the DUI charges. Keep in mind that the law is not as strict as the recommendations made by safety experts and should be considered only as a minimum requirement. The law currently requires infants to remain rear-facing until they are 1 year of age and at least 20 pounds. Children should be in a forward facing car seat up to 4 years and 40 pounds, a booster up to 8 years. For the best protection, safety experts recommend that kids continue to use a booster seat until they are at least 4'9" tall (57 inches), which half of children will not reach until they are 11 years old. For details of the law, please visit www.carseatscolorado.com.

A lap and shoulder belt may be used without a booster once the child is able to pass the 5-step seat belt fit test. This typically occurs when the child is 57 inches or taller, which is the average height of an 11 year old. The child can pass the 5-step test when:

• The child is able to sit against the back of the seat without slouching

• The child is able to sit with legs bent at the knees

• The lap belt stays low and snug across the lower hips or thighs

• The shoulder belt remains positioned across the shoulder and middle part of the chest

•  The child can stay comfortably in this

position for the entire trip

Each car seat should be installed properly according to the child restraint system manual and your vehicle’s owner’s manual. It is recommended that all car seats be checked by a certified passenger safety technician. For expectant parents it is recommended that this be done 6–8 weeks prior to the due date. To find a technician in your area visit www.seatcheck.org or call 866.SEATCHECK. The Longmont Fire Department will check and help parents properly install car seats. A technician is available on the second Wednesday of every month from 2 pm until 7 pm at Station #2 located at Mountain View and Hover. Call 303.651.8437 with questions. 

In Firestone and Frederick assistance is available from the Mountain View Fire Protection District. Call ahead for an appointment with a technician 303.833.2742. If you would like more information regarding car seat use, safety or recommendations please visit www.carseatscolorado.com or www.safekidsdenvermetro.org, call 877.LUV.TOTS, speak with a certified car seat technician or talk to your health care provider.

Dr. Katie Dueber is a board certified pediatrician practicing at Carbon Valley Medical Center. She joined the Medical Center in May of 2008. Dr. Dueber can be reached at 303.833.8880.