Guest Blog Post By Alexandra Klein

Instagram Car Seat Techs, Local First Responders, or DIY – What is the Best Way to Install Your Child’s Car Seat? Authored by Alexandra Klein - CCCN Board Member, Founder of SMV Doula Collective, Doula, Soon-to-be Mother to 4, and Fire Wife

So often on local and international mom and parenting groups I will see these questions pop up; what is your favorite car seat? How did you get your car seat installed? Is it okay to turn my child around to forward face, they are really tall, heavy, etc.?

As I read the hundreds of responses I cringe as the reality sets in. So many of us are not informed on the best car seats for our family and our own children are put in great danger because of it. In April of 2016 a small study, including 291 families, was completed on the ‘Misuse of Car Safety Seats at Newborn Discharge’. That study determined nearly all (95%) car seats were misused, with 1 or more errors in positioning (86%) and/or installation (77%). Serious car seat safety misuse occurred for 91% of all infants. Frequent misuses included harness and chest clip errors, incorrect recline angle, seat belt and lower anchor use errors. (1)

Now with that information I take pause. When was the last time car seat safety was brought to your attention? Yet 95% of the people in the study were misusing car seats at the very beginning. So, what can be done about this? How do we better protect our children from unintentional injuries in accidents?

Car seat Basics

The first step is to understand the basics of car seat recommendations, as a general rule the CDC recommends the following (2):

  • Buckle children rear-facing as long as possible. This should include until they max out the car seat weight or height limit (per your car seat manual). Typically, this will be between the ages of 2-4 years old.

  • Forward-facing car seats should be used until the child maxes out the weight or height limit of the car seat. This is for a forward-facing 5-point harness system and should be used until at least 5 years old.

  • Booster seats can be used once a child has maxed out the forward-facing car seat height or weight. A booster seat should be used to help the vehicle seatbelt to proper lay on the child’s smaller frame. Generally, a child could be the appropriate size to use vehicular seat belts once they are 4’ 9” and at least 9 years old.

  • Vehicular seat belts can be used when the child is large enough for the seat belt to fit properly. A properly fitted vehicular seat belt is one that the lap belt lays across the upper and the shoulder belt lays across the chest. NOTE: If the seat belt lays on a child’s stomach or the child’s neck this is NOT a proper fit and could cause major traumas in a vehicular accident.

Additional key notes from the CDC include:

  • Children under 12 years old should always sit in the back seat.

  • Rear facing car seats should NEVER be used in front of a seat with an active air bag.

  • Car seats should only be used in accordance with your specific vehicle manual and your specific car seat manual.

  • All car seats are NOT compatible with seat protectors, check your specific car seat manual.

Why Does the Type of Car Seat We Use Really Matter?

So, we understand the general guidelines from the CDC, but WHY were these guidelines created? WHY should your family follow these guidelines? WHY is it important for those who care for your children to understand these guidelines? Well, lets dive a little deeper.

As a first-time mom in 2014, the car seat laws only required a child to be rear-facing until 1 year of age. By the time I was a mom to two children, in 2017, the laws had changed and required rear facing until 2 years of age unless the child reaches 40 lbs. or 40 inches in height before turning 2 years old. I remember being so irritated that my second born would have to be rear-facing for a whole year longer than her older sister. Then I started to research why.

Reason #1 – Motor vehicle crashes are the leading cause of death in children ages 4 and older. Motor vehicle crashes are the third leading cause of death for children from infancy through 4 years old. To help reduce the number of deaths due to vehicular accidents rules have changed (3).

Reason #2 – There is better understanding of how the infant, toddler, child, and adolescent body weight distribution and spinal fusion compares to that of an adult. With more data and information policy has been created to better serve the little ones in our vehicles (4).

Reason #3 – Age alone, is not an indicator that your child’s mind or body are ready to handle the responsibilities that come with ‘moving up’ in car seat safety configurations. It is important to note that every transition is associated with some decrease in protection; therefore, parents should be encouraged to delay these transitions for as long as possible (5,6).

The article ‘Why Rear Facing: The Science Junkie’s Guide’ by Car Seats for the Littles (last updated July 27, 2021) does a great job explaining the physical changes children go through and when their bodies should be more able to withstand more pressure. Below are a few of the main highlights from that article that helped me decide to rear-face my children as long as possible going forward.

Article Highlight #1 - A toddler’s vertebrae are connected via cartilage rather than ossified bone. Those connections are called synchondroses, which are slowly closing over time. There are three major points of ossification, each with two synchondroses. According to a study published in the Association for the Advancement of Automotive Medicine (7), the first station to close is the C3, second is the axis, and third is the atlas.

The results of the study show ossification patterns with a 75% probability that:

C3 Vertebrea - At 1 year and 5 months there are three synchondroses open and by the age of 3 years and 8 months the child has only one synchondroses remaining open.