Safety Precautions for Kids in Cars

Motor-vehicle crashes are the leading cause of childhood death in the United States. In 2009, 1,314 children ages 14 and younger died as occupants in motor vehicle crashes, and approximately 179,000 were injured.

When properly installed and used, child safety seats reduce the risk of death by 70 percent for infants and 55 percent for toddlers. Adults can protect children by wearing seat belts. When a driver buckles up, children in the vehicle are buckled 94 percent of the time, studies have found. When a driver is unbuckled, children are buckled only 40 percent of the time.

When children outgrow their infant seats, some parents mistakenly place them in booster seats or adult seat belts. Because young children are not adequately restrained by booster seats or adult seat belts, they are at risk for head and abdominal injuries in a crash.

Although all current cars are equipped with air bags, parents still need to restrain their children properly in the vehicle.

Follow these precautions:

• Infants should never ride in the front seat of a vehicle that has a passenger air bag.

• Children under 12 shouldn't ride in the front seat of a car with a passenger-side air bag. If a child must ride in the front seat, slide the seat back as far as it will go.

• Anyone riding in a vehicle with air bags should buckle the lap and shoulder seat belt. Not doing so may result in serious injury if the air bag inflates.

Safety seats and belts

Follow these 2011 seat-belt guidelines from the CDC and the American Academy of Pediatrics:

• Children 12 and under should ride in the back seat, and they should be properly restrained in an infant seat, child safety seat, or seat belt. The safest place is in the center of the back seat.

• A car safety seat should fit the child, fit the vehicle, and be installed correctly in the back seat every time it's used. One common problem is not fastening the seat tightly to the vehicle; another problem is not fastening the harness tightly to the child.

• A car safety seat must be installed correctly to perform correctly in a crash. One study cited by the CDC found that 72 percent of child safety seats were not used correctly. Most of these are too loose. What's tight enough? The seat belt should feel stiff and the car seat should not move more than an inch, either from side to side or from front to back.

Some vehicles made before 1997 may need a locking clip to lock the seat belt; newer vehicles have built-in locks. Your vehicle owner's manual should explain how to use your seat belts with a child safety seat.

All vehicles, as well as all child safety seats made after September 2002, have Lower Anchors and Tethers for Children (LATCH). This type of system allows you to install a child safety seat without using the vehicle's seat belt. Even if you have a vehicle or seat made before 2002, it may have LATCH.

There are several types of car safety seats:

• Rear-facing infant seats. These are for infants up to age 2, or until they reach the highest weight or height allowed by their car safety seat's manufacturer, usually 22 to 35 pounds. Rear-facing seats are critical for infants to ensure that they have proper head and neck support.

• Convertible safety seats. These face either backward or forward and are for toddlers between ages 2 and 4, and for those who weigh between 30 and 40 pounds and who have outgrown the rear-facing weight or height limit for their car safety seat.

• Booster seats. These are used as a transition to seat belts by older children who have outgrown their convertible seats but aren't tall enough to use the belts. They are for children usually between 8 and 12 years old who are shorter than 4 feet, 9 inches. Many children ages 4 to 8 are restrained by adult seat belts instead of booster seats. Because adult seat belts aren't designed for children, youngsters risk injury to the intestines, spleen, liver, and spinal cord in a crash.

• Combination child seat/booster seats (three-in-one). These can be used with an internal harness until your child weighs 40 pounds (some seats allow harness use to 50 pounds) and then made into a belt-positioning booster seat by removing the internal harness.

• Lap and shoulder belts. Children ages 8 and older or who weigh more than 80 pounds and are about 4 feet, 9 inches tall should use lap and shoulder belts. The lap belt should stay low and snug across the hips without riding up over the stomach, and the shoulder belt shouldn't cross at the neck.