Guest blogger – Arlene Greenspan, DrPH, MS, MPH
Senior Scientist, Motor Vehicle Injury Prevention Team, NCIPC
My sons, Jason and Kenny, are now 17 and 21 and when I think back about their infant and toddler car seat experience, I think about how far we have come in addressing traffic safety issues. By the time my sons were 2 or 3 years old, children were already in booster seats. And by 3 or 4 years of age, adult seat belt use was common. While children are now using car and booster seats longer, one thing hasn’t changed; children want to be “big kids”.
I remember fighting with each of my children about staying in a booster seat longer (at that time age 5 was considered old to be in a booster seat), and they would whine and say that none of their friends were in booster seats anymore. Does this sound familiar to you? Most of my friends with young children now tell me that their children want to sit in adult seat belts before the recommended age, height, and weight. Because I am a child traffic safety researcher, they ask me, “Is that okay? They are only a few inches shorter than the recommended height or they are almost 8 years old.” At this point, I remind my friends that keeping their children in car or booster seats is not only better for their children, but also better for them as drivers; reducing distractions that may occur with the greater movement allowed using an adult seat belt. In addition, making the seat your child’s “special place” may help gain his or her acceptance. Well, times may have changed, even if children’s mantras haven’t. The good news is that the age of these complaints has shifted from children ages 3 or 4 year to ages 5, 6 or even 7. While we are generally keeping kids in car safety seats longer, it is still not long enough. In fact, in one CDC study, we estimated that during a 30 day period an estimated 8 million children less than 8 years old used adult seat belts prematurely.
To add to the confusion about when to move to the next stage of car or booster seat, recommendations have shifted from definite age and weight guidelines to parameters based on a combination of age, weight, height, and the height and weight limits of the car seat your child uses. Child car and booster seat specialists no longer recommend that parents turn their car seats forward-facing when their baby turns one year and reaches 20 pounds. The recommendations now suggest that it is safest to leave babies rear-facing as long as possible after they turn one year and 20 pounds and wait until they reach the height and weight limits of the car seat for the rear-facing position. Once children are able to sit forward-facing in their car seat, that is what they should use until they reach the height and weight limits of their seat. Then they should use booster seats until they are about 4 feet 9 inches tall. While guidelines suggest that children usually reach 4 feet 9 inches at about 8 years of age, we know that most children are not yet 4 feet 9 inches when they first turn 8 years old.
When children are too small for adult seatbelts, the lap portion of the belt usually rides high over the child’s stomach instead of the top portion of their thighs and the shoulder portion often cuts across their neck. While a seatbelt is more protection than riding unrestrained, children who prematurely use adult seatbelts are at greater risk for abdominal, spinal cord, and brain injuries if they are in a traffic crash. Guidelines have been established to help parents decide which type of car or booster seat is most appropriate.
Another difference between now and when my boys were small is the abundance of choices for car and booster seats and the development of the LATCH system. While with more choices it may be easier for parents to buy a car or booster seat that fits their needs and budget, correctly installing car seats can be a challenge, varying by type of seat and method of installation. Does my car have a LATCH system or should I use the vehicle seat belt? Are the straps correctly set for my child? Is it time for my child to go to the next stage of car seat? Although installing and correctly using car and booster seats may seem simple enough, NHTSA estimates that close to 3 out of 4 parents do not restrain their children correctly. In honor of National Child Passenger Safety Week, September 19 – 25, NHTSA will be sponsoring National Seat Check Day on Saturday, September 25. Certified technicians will be available to inspect your child safety seat, free of charge. Find a location nearest to you.
So what do you do when your child complains about wanting to ride using an adult seatbelt, like his or her friends and previous explanations for staying in a car or booster seat no longer works? This is never easy, but what I did then—as well as today, when my teen wants to drive home late at night or carry several of his friends as passengers—is tell him that he can’t. And when he continues complaining, I tell him that the reason the answer is no is because I love him and want to keep him safe. The tears, tantrums, and anger may not stop that moment, but they do eventually subside and you know that you are doing everything you can to protect your child.
Dr. Arlene Greenspan, DrPH, MS, MPH, is a Senior Scientist on the Motor Vehicle Injury Prevention Team at the CDC National Center for Injury Prevention and Control (NCIPC).
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