Car Seats

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Car Seats

Guiding Your Child Through The Early Years
Injury and Illness Prevention
Car Seats
Car Seats
Find out about the different types of seats and how to use them.
InteliHealth Medical Content
Reviewed by the Faculty of Harvard Medical School
Car Seats


Every state requires that infants and small children ride in car seats because car seats do save lives! Yet, car crashes are still the most common cause of death and injury in children. Although car seats are often used, some studies show that 80% of child safety seats are used the wrong way. To make sure your child has the safest ride, follow these rules of car seat safety:

  1. Buckle yourself and your child up for EVERY ride, no matter how short.
  2. Purchase the CORRECT seat for your child, which depends on his age and weight.
  3. Check the list of recalled car seats before buying a used car seat or before borrowing someone else's.
  4. Carefully read all car seat instructions and keep them for future reference.
  5. NEVER put a child in a rear-facing car seat in the front seat if there is a passenger-side air bag. Serious injury or death can occur from the impact of the air bag against the back of the car seat. In fact, the back seat is the safest place for all children, because it is the seat farthest away in a front-end collision, the most common type of accident. The back middle seat is preferable since a child in this seat is also protected from potential side impact.
  6. Always put a child who is younger than 2 years in a rear-facing car seat. A child who weighs at least 20 pounds and is at least 2 years old can be moved into a forward-facing car seat.
  7. Use a forward-facing car seat for as long as the child fits well (for example, shoulders below the seat strap slots and ears below the top of the back of the seat).
  8. Use a booster seat for a child who is over age 4 and weighs 40 pounds or more, but is still too small to fit properly in a seat belt.
  9. Never put a blanket around (over) a child BEFORE fastening the straps of the car seat.
  10. Never drive with any small children who are not sitting in a properly installed car seat. Every child in your car should be secured in a car seat or vehicle seat belt, no matter how short a ride.
  11. Never put your child in his car seat in a shopping-cart basket. The seat could slip out of the basket, injuring your child.

Types of car safety seats

Convertible seats. Bigger and heavier than infant-only seats, these seats should be used in the rear-facing position until the baby is 2 years and until the child reaches the maximum height or weight allowed by the manufacturer. The seats can be used in the front-facing position for toddlers who are at least 2 years of age and a minimum of 20 pounds.

Although these seats may be used for newborns, some don't fit newborns as well as infant-only seats do. So make sure your baby can recline comfortably in the seat.

Make sure your car seat uses a five-point harness. A five-point harness has five straps: two at the shoulders, two at the hips and one at the crotch. Be sure the harness is tight, so you cannot pinch extra webbing at the shoulder.

When your child is old enough and weighs enough to sit facing forward, move the shoulder straps to the slots above your child's shoulders (usually the top slots, but check your instructions to make sure). Also place the seat into the upright position and move the seat belt through the forward-facing belt path.

Forward-facing seats. These are designed to be used in the forward-facing position only. These seats are certified for use for babies weighing 20 pounds or more; the child also must be at least 2 years old. The harness straps should be at or above your child's shoulders. Forward-facing seats have several slots into which shoulder straps can be inserted, so choose the slots above and as close as possible to your child's shoulders. The chest clip should be positioned across the chest at armpit level to keep the harness straps in place. Use a forward-facing seat until the harness no longer fits.

Integrated (built-in) seats. These days, many vehicles, particularly station wagons, sports utility vehicles and minivans, have integrated forward-facing child safety seats that can be used for children older than 2 years who also weigh at least 20 pounds. These built-in seats eliminate the installation challenges associated with separate car seats. However, weight and height limits vary. Check with your vehicle's manufacturer for details about the built-in seats currently available with your car.

Booster seats. Once your child is over age 4, weighs at least 40 pounds and his ears have reached the top of his car seat, he is ready for a belt-positioning booster seat. Make sure to use the car's lap and shoulder belts to help protect your child's upper body and head. Both high-back and backless models of booster seats are available.

Your child should use a booster seat until the car’s seat belt fits properly, which is usually not until he or she is at least 4 feet 9 inches tall and 80 to 100 pounds. Your child will be between the ages of 8 and 12 when he is ready to move out of a booster seat.

When your child reaches 4 feet 9 inches and between 80 to 100 pounds, use the Safety Belt Fit Test to determine if she is big enough to use the adult seat belt without a booster.

The Safety Belt Fit Test includes meeting the following criteria:

  • With your child sitting in a back seat with her back against the vehicle's seat back, your child's knees must bend at the seat's edge.
  • The lap belt strap must stay low on the hips or high on the thigh. It should not rest on your child's stomach.
  • The shoulder belt should rest on your child's collarbone and shoulder. It should not rest on the face or neck.

Combination seats. Forward-facing combination seats can be used after your child is 2 years old and 20 pounds until he outgrows a booster seat. So, like the convertible seats, they can be used for several years. You should remove the harness when your child weighs 40 pounds and is at least 4 years old, according to the manufacturer's instructions, and instead use the seat as a belt-positioning booster seat with the vehicle's lap and shoulder belt.

When used as a forward-facing seat, the harness straps should be at or above your child's shoulders. Forward-facing seats have several shoulder strap slots, so choose the slots closest to (but always above) your child's shoulders. The chest clip should be positioned across your child's chest at armpit level to keep harness straps in place and snug.

Your child's safety is most important

More safety guidelines from the American Academy of Pediatrics and the National Highway Transportation Safety Administration when buying a car seat include:

  • Higher prices don't necessarily mean better quality.
  • Test the seat out in the store. Put your child in it and try out all the belts and buckles. Make sure it's easy to use and fits in your car.
  • Remember that the seats displayed in the stores may not be positioned correctly.
  • Some seats come with a tether strap that is attached to the car seat and bolted to the window ledge or floor of the car. If your seat requires or recommends a tether strap, be sure to install it according to the manufacturer's instructions.
  • Use either the car's seat belt or LATCH system to secure the car seat into the car. Never use both systems at the same time.
  • Once you have selected the appropriate car seat for your child, it must be properly installed. Watch our short video about car seat installation and then carefully follow the manufacturer's instructions for installing your specific car seat. If you are not sure that you have done this correctly, you can get a free car seat inspection and receive training in proper car seat installation by visiting the National Highway and Traffic Safety Administration to find a certified child-safety seat inspection station near you.


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shoulder,car seats
Last updated May 29, 2011

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