“Tie your camel and put your trust in God.”
–Prophet Muhammad (peace be upon him), to a bedouin who was about to leave his camel untethered
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Child passenger safety–it is a subject that I am pretty passionate about, so let’s cut to the chase:
- Motor vehicle injuries are the number 1 cause of death among children in the US.
- In 2005, there were 1,451 car accident deaths in children under 14 and about 203,000 injuries. That’s about 4 deaths and 556 injuries a day (Source:CDC)
The tragedy is that many of these deaths are preventable. Ask any ER physician working in a busy hospital, or any policeman who deals with traffic deaths, and they will tell you how many of these dead and injured children were either not in car seats or were in improperly installed seats.
Do you use a car seat for your child? This article is for you. Don’t use a car seat or booster even though your child is young enough (under 8 years old or under 4’9″)? Perhaps you need to consider the above stats carefully and re-evaluate that choice. Think you can take your young baby/child out of the seat and into your lap because she’s screaming? In even a minor accident the laws of physics are not on your side. Take a quick look:
Ok, so for those of us who do use child seats: here’s the catch–unfortunately these seats are NOT idiot proof. In fact, they aren’t educated-mom-trying-her-best-proof. They are very tricky to install and use correctly, and minor mistakes can be fatal. I’ve seen more seats that I can count being used with fatally incorrect mistakes, heck I’ve made these mistakes myself sometimes when I have been less than careful.
What is the purpose of putting a child in a car seat if it is not used properly? Why risk the life or well being of your child when all it takes is a few minutes to read the manual and have an inspection to get a proper installation?
Here are some of the main issues that are important to pay attention to regarding car seats–this is by no means comprehensive, but some main things to look at:
- Rearfacing minimum guideline: A child absolutely, positively, must with no exception sit facing the rear of the vehicle until he is one year AND twenty pounds. So yes, my one year old 19 lb son must still face the rear. And so-and-so’s 20 pound 10 month old must still face the rear. There is no exception to this, period. It’s one of the more critical safety guidelines to remember, so important that it’s actually better to go beyond this minimum (see last bullet and section below for important details).
- Use it according to the instructions: Think it’s a no-brainer to buckle in your seat? I’ve done it wrong numerous times, even after attending a class and having an inspection done. I have seen many others do it wrong as well. Sometimes getting a proper fit is tricky and you may be overlooking a crucial step. The directions are there for a reason, read ’em!
- Use the correct sized seat for your child in the correct position: check the manual. No, that tall 14 month old does not belong in an infant carrier. No, that under 20 pounder does not belong in a forward facing position, and no, that 3 year old does not belong in a seatbelt, he needs some kind of booster or car seat.
- Make sure it’s in tight: The seat should not be able to move more than one inch from side to side along the belt path.
- Lock the seatbelt: if you can pull on the seatbelt to create slack, it is not a safe install. You need to pull the belt out all the way to lock it, or if it does not lock this way, read the manual with your seat to see how to lock the belt (you may need to use a locking clip).
- Make sure straps are at correct level: Rearfacing–straps should be at or below shoulders, forward-facing–straps should be at or above shoulders. NOTE: Some seats only allow the top one or two slots to be used for forward facing as they are reinforced, and use of the other, non-reinforced slots may cause your child to be ejected in a crash.
- Tighten the straps on the child: The belt on your child’s chest should have no more than a finger’s worth of slack. If the belt can slip off the child’s shoulders, the child can easily be ejected in a crash. Pinch the belt above the shoulders to see if you can grab any in your fingers: you shouldn’t be able to do so. This is especially important with tiny newborns, as many parents leave dangerously loose belts because they think the child will be uncomfortable.
- Chest clip: It goes on the chest! I have seen too many children with loose shoulder straps and chest clips down by their abdomen. It’s not going to do it’s job if it’s not in the right place.
- No thick coats: Thick winter jackets that require you to loosen the belt significantly more than normally are not safe to be used. Again, it’s physics: In a crash, that thick jacket will compress to virtually nothing and the belt will be slack, allowing the child to be ejected. Put your child in a thin jacket and then cover him up over the belt (something like this).
- No aftermarket products: Hold off on prodcuts like thick winter seat covers that come between your child and the belt, shoulder pads, or infant head supports unless they come from the seat’s manufacturer. These “aftermarket products” are not crash tested with the seat and often times cause the seat straps to be too loose or incorrectly placed.
- Don’t use an expired seat: Most seats expire about 6 years after they are manufactured. Safety standards change over time, and by the time you come to use an older seat, it may be that what was once considered safe is now not acceptable. Examples include the three point harnesses and shield boosters. Furthermore, some consider possible plastic degradation to be an issue after the seat’s expiry date. You cannot then guarantee that it will work safely in a crash.
- Tether the seat: Your forward facing seat likely has a tether to anchor the top of the seat to the back of your car. Check your manual for instructions and anchor it, because this will hold the seat more stable in a crash. A few seats have rear-facing anchors as well. In older cars you can have an anchor point installed in the car if one is not present.
- Keep your child rear facing and in a five point harness as long as possible: These two are so important I have separate sections for them below:
Rearfacing is Safest
Ever experienced whiplash when in a car accident? The neck pain can last for weeks. A child’s neck is much more flexible and weaker than an adult’s, plus they have a larger head to body ratio than adults. Autopsy reports reveal that children under two are at four times the risk of internal decapitation if they sit forward facing (source). The child’s heavy head whips forward when the car crashes, stretching the delicate neck.
Real-world experience has shown that a young child’s skull can be literally ripped from her spine by the force of a crash.
Seeing is believing. Take a look at what happens in a forward facing crash:
You are right if you guessed that that is enough force to break a child’s neck and cause paralysis or death. Forward facing crashes are more likely to lead to death, and it’s easy to see why when you take a look at a crash simulation with a rearfacing seat:
Keep in mind that these are 35 mph crash simulations, so multiply that force if you are in a high speed highway crash. You greatly increase your child’s chances of survival in a crash by keeping her rearfacing as long as possible. For many convertible seats, that usually 30 or 35 pounds (check your instruction manual). Turning the seat forward isn’t some kind of rite of passage into toddlerhood, it’s a step down in safety that ideally should be delayed as long as possible.
In Sweeden, children ride rearfacing until about 3 to 4 years of age, and this has led to a decrease in the number of accident fatalities. Read the Swedish data here.
Need more info? Read the MSNBC article here.
Here is the official statement from the American Academy of Pediatrics:
Children should face the rear of the vehicle until they are at least 1 year of age and weigh at least 20 lb to decrease the risk of cervical spine injury in the event of a crash. Infants who weigh 20 lb before 1 year of age should ride rear facing in a convertible seat or infant seat approved for higher weights until at least 1 year of age. If a car safety seat accommodates children rear facing to higher weights, for optimal protection, the child should remain rear facing until reaching the maximum weight for the car safety seat, as long as the top of the head is below the top of the seat back.
(emphasis added, source: AAP Policy Paper)
For more information on rearfacing, see this page, which also includes a list of links.
Rather watch than read? Watch this 3 minute video on the benefits of rear-facing.
Booster or Five Point Harness?
Your seat likely has a forward facing weight limit of about 40 pounds. So when your child gets over that limit, perhaps at age 3 or so, the logical next step is a booster, correct?
That’s what Kyle David Miller’s parents thought. He was riding in his parents’ car in his booster at the age of three. An elderly driver ran a red light and hit the car. His seatbelt failed in the crash and he was ejected and killed on the spot. Seatbelt failures do happen, but if your child is in a securely anchored seat with a five point harness, a seatbelt failure will not eject your child. Furthermore, seatbelts are not designed for small children (particularly under 5 year olds) and may crush their bodies in a crash. Ask the parents of Toni Perry, whose chest was crushed by her seat belt in a crash.
The Kyle David Miller Foundation is dedicated to raising awareness about the importance of five point harnesses. Read their informational page on why five point harnesses are safer than boosters. They offer this short video:
Take some time to read over the information and consider carefully the option of purchasing a seat that will allow your child to ride harnessed for a longer period of time. If you are not able to do this, a booster is the bare minimum until the child can pass the five step test. The general recommendation for boosters is up to age eight or 4’9″ but refer to the five step test as well.
Remember that some states have substandard laws when it comes to child passenger safety. The trend now has been for states to increase the age of booster/carseat use up to eight years, but some states are still lagging behind. I just moved from Florida where three year olds can legally ride in a car with only a seat belt. Seat belts are designed for adult bodies, they simply do not hold children that small safely. Once a child is large enough to outgrow a five point harness, a booster helps to position the belt to help protect the child in a crash.
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If you have made it this far, I hope you will take the next step to go over your carseat and its manual carefully, spend some time getting it installed correctly, and then have an inspection done to make sure it has been done right. Go to http://www.seatcheck.org to find a certified child passenger safety technician in your area. Do your homework, then do the legwork, and then remember: bismillah tawakkaltu ‘alallaah … “In the name of God, I put my trust in God.” Then if an accident and injury should occur, at the very least you may rest easy that you did your full best to ensure the safety of your child, and that you left the rest to Allah. Remember the Prophet’s words: “Tie your camel and put your trust in Allah.”
Related entry: Is this overprotective?
Fine print disclaimer: This article is not a substitute for an inspection by a qualified CPS technician, and the author is not responsible for anything that should happen as a result of applying the information in this article. For your child’s safety, please use this as an encouragement to go read your carseat’s manual and get an inspection done.