Smoke Signals June 1990
Page 11
Health Information
COMMON QUESTIONS
ABOUT CHILD SAFETY
BELTS
Always encourage parents to read the instructions for
the safety seat they are thinking of purchasing as well as
any , they already own. There are questions that most
instruction booklets do not answer, however. Here are
the answers to the questions most often asked of the
Academy of Pediatrics' Safe Ride Program.
l. Wliich Seat is the safest or best for my child?
There is no one brand that everyone agrees is the
"safest" or the "best." All of the child safety seats
(CSS's) made after 1181 meet a strict federal safety
standard (look for the label). That means they all will
provide an adequate level of protection in most kinds of
crashes, when used according to the directions. If you're
getting a second-hand seat, see question 9.
The major questions for you to ask about any seat are:
1. ) Will it fit into my car, in rear and front seats?
2. ) How easy is it to:
a. ) put the automobile safety belt around or through the
device when putting the CSS into the car;
b. ) to buckle the harness or shield system to hold the
child in place;
c. ) to adjust the harness straps to fit snugly while the
seat is in the car?
3. ) Finally, does it require a top tether strap to be
installed in the car, as do many older models?
2. How can I get my child to stay in the car
seat?
Is any seat escape-proof? Not completely. Some
children seem to be able to get out of anything. This
usually occurs during the natural stage when they are
becoming more active and independent and learning to
stand and manipulate things with their hands.
What can you do? If you are buying a seat, look for
one with a buckle that is very hard for a child to reach.
Otherwise, keep the harness system adjusted for a snug
fit and use the shoulder strap retainer clip over the
child's chest.
You also need to be patient and firm, letting your child
know the car doesn't go unless he is in his CSS. Do not
start the car until he settles down, and stop at a safe spot
along the roadside if he gets out when the car is under
way. Positive reinforcement is also crucial, such as small
rewards for good behavior; short "training" trips to
favorite spots; and dramatic play in which he buckles up .
a favorite doll or stuffed animal for a real or "pretend"
car ride.
3. Should I put my child in the front or back
seat?
The rear seat is generally the safer position for anyone,
because the occupant is farther away from the point at
which a frontal crash (by far the most common type)
occurs.
For an infant, the ideal would be for a parent to ride in
the rear seat with the baby. However, if you are travel
ing alone with your baby, you may prefer to have her in
front to monitor her condition. A rear-facing CSS
provides good protection in the front seat, especially if it
rests against the dashboard. Infants (up to 18-20
pounds) should always ride facing rearward, whether in
the front or back seat.
Don't worry if the top of a rear-facing CSS rests
against the dashboard or the back of the front seat (
when placed in the rear seat). That is actually benefi
cial, because the dash or seat prevents the CSS from
tilting forward in a crash.
If your toddler must be placed in the front passenger
seat in a forward-facing CSS, adjust the auto seat to its
farthest back position, to keep her away from the
dashboard.
4. Wfien should I turn my child's seat to face
forward?
Convertible CSS's can be turned around; infant-only
seats should never be faced forward. Many children are
comfortable and happy riding rear-facing until they are
about a year old, but some parents want to change their
seat position sooner. A rear-facing seat is more protec
tive than a forward-facing one, because it spreads the
force of a crash over the baby's entire back, the strong
est part of his body, and cradles his head. Therefore,
keep your child facing the rear as long as possible, at
least to 17-18 pounds and preferably to 20 pounds, be
tween 9 and 12 months of age. Your child must be able
to sit up well alone before being turned to face forward.
What about the very large, young baby, such as a child
who weighs 17 pounds at three months of age? A child
of this age should be kept facing the rear, because his
body has not yet developed enough to withstand the
additional forces to which the shoulders, hips and neck
would be subjected in the forward-facing position.
5. Wliat do I need to know about harnesses and
shields?
They have some differences that parents should be
aware of. A 3-point harness attaches only at the shoul
ders and crotch. A 5-point harness has five attachment
points for the harness, two at the shoulders, two at the
hips and one at the crotch. A harnessshield system has
two shoulder straps attached to a small shield across the
lap, which takes the place of the hip straps, and fastens
at the crotch.
The three point harness is used only for rear-facing,
infant-only safety seats. This harness is intended to hold
the infant in place, but not to take the full force of a
head-on crash that a harness on a forward-facing seat
must withstand. Therefore, this type of seat and harness
should never be used facing forward.
Forward-facing seats, for children over 20 pounds,
have either 5-point harnesses or harnessshield systems.
Both types spread the force of a frontal crash over a
broad surface of the child's body and over the strongest
part of the skeleton, the hips and shoulders.
The 5-point harnessshield system each has one
disadvantage.
- The straps of a 5-point harness tend to become
twisted and tangled, while the harnessshield system
keeps the shoulder straps in place.
- For very small babies, such as premature infants, a
CSS with a harnessshield system should not be used.
This is because it will not allow for as snug a fit as a 5
point harness and the infant's face or chest could
possibly contact the shield.
Note that some seats with 5-point harnesses also have a
swing-up padded "armrest" that is held down by the
harnesses. Here the 5-point harness is the safety system
that protects the child, so the armrest should never be
used without it.
6. Are boosters really safe?
A booster seat provides less protection than a full-size
CSS, due to the lack of side wings and shoulder harness,
which protect the upper body and head. For the older
child (from approximately 40 to 60-70 pounds), if a lap
shoulder belt is available, it should be used with a
booster that is designed for use with a booster that is
designed for use with a shoulder belt, a "belt-positioning
booster" (see illustration). This provides better protec
tion than a booster with a small shield across the lap,
made for use with the lap belt. Either the belt-positioning
booster seat or a shield booster is generally prefer
able to the lap belt alone, due to the difficulty of keeping
the lap belt in the correct position on a small child (very
low on the hips) during travel.
7. Wlien should my child begin using a booster
seat?
You may be tempted to move your child into a booster
at 25 or 30 pounds, the minimum size specified by many
booster seat instructions. This often happens if a
younger child is born, or even when a toddler outgrows
an infant-only safety seat. However, for the best
protection, you should keep him in a full-size CSS (with
a high back and shoulder straps) for as long as he fits in
it, normally to 40-43 pounds and up to 40-43 inches in
height (or when the ears reach the top of the headrest).
8. Wliat if I can 't afford to buy a seat?
There are many low-cost rental or purchase programs
available. Check with your doctor's office, hospital or
public health clinic for ones nearby.
Remember, all the seats on the market today provide a
high level of protection. Purchasing a lower-cost,
"economy" model of infant or convertible CSS does not
mean sacrificing protection. Price differences reflect the
"extras, "like fancy upholstery or convenience features.
However, don't substitute a less expensive booster seat
for a more expensive convertible model for a child who
is under 40 pounds (see question 7).
9. Are used safety seats okay?
If you decide to get a used seat, shop very carefully. To
tell if a used seat is safe or unsafe, make sure that:
1. ) it was made after 1181 ( a label on the seat shows
the date of manufacture - if there's no label, beware);
2. ) it has the instruction booklet or that the manufac
turer can send it to you;
3. ) all the parts are included (check in the instruction
booklet) or can be obtained from the manufacturer;
4. ) it has never been used in a crash.
If you can't satisfy these requirements, you are taking a
big risk by using the seat.
10. Should I install retrofit shoulder belts in the
rear seat of my car?
If you intend to keep the car for some time, the
benefits for all rear seat passengers should outweigh the
cost of nstallation. The addition of shoulder belts would
allow you to use a belt-positioning booster for your 4-8
year old children, which is the best restraint method for
this age group. Lapshoulder belts also provide supe
rior protection for older passengers.