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Confused about car seat safety? It’s time for a refresher.

October 22, 2020

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By Tiffany Vitt, P.N.P. for Community Choice Pediatrics

Car Seat SafetyAs parents, we’ve all been there before: your eight year old is begging to come out of their booster seat because several of his or her friends are no longer sitting in them. Or, you’re contemplating if you should switch your 5 year old out of his or her 5 point harness to the high back booster with the seat belt because the drop off line at school would be SO much easier to handle if you did. And I know I’ve personally experienced buckling my 2 year old in his rear-facing convertible car seat, eyeing his feet that are now touching the back of the vehicle seat, and wondering if I should turn him forward-facing? It’s the parental struggle of balancing what’s convenient and most comfortable with what is also most safe.

Motor Vehicle Accidents Leading Cause of Childhood Death

Per the CDC, motor vehicle accidents are one of the leading causes of childhood death. That said, correct car seat use can reduce that risk by nearly 70%. The simple act of making sure your child is safely buckled into their car seat or booster seat every single day is truly one of the best ways parents can help prevent unnecessary injury or even death of their child. Sounds easy peasy right? Sure, except parents today are faced with having to navigate safety recommendations that seem to change every couple of years. Add the pressure of trying to purchase the right child safety seat from an overwhelming number of brands and styles and it’s no wonder parents feel like they don’t know what the heck they’re doing.

As with all things in my practice, I look to the American Academy of Pediatrics (AAP) for the best and most up to date recommendations regarding the health and safety of children. In 2018, the AAP released child safety seat recommendations that were revised to no longer focus solely on age parameters, but rather on a child’s height and weight.

Below is a quick overview of AAP child safety seat recommendations.

1) Make sure the car seat you have purchased is correctly installed in your vehicle. Unfortunately, almost half of car seats are NOT installed or used correctly. Each car seat’s owner’s manual should detail proper installation in addition to seat height and weight limits. For example, rear facing child safety seats will use a seat belt or lower anchors to secure it to the seat. Both can be safe options, but you should never use both at the same time.

Car Seat Safety2) Infants and toddlers (birth until age 2-4) should ride rear-facing in their car seat for as long as feasibly possible. And they are safest if they don’t turn forward-facing until they reach the weight or height limit detailed per the seat’s manufacturer.

3) Once a child has outgrown a rear-facing car seat, they should then move to a forward-facing car seat that utilizes a five-point harness for as long as feasibly possible also. Again, children are safest if they remain in this type of car seat till they have reached the highest manufacturer allowed height or weight.

4) After a child has outgrown their forward-facing child safety seat’s weight or height limit, they should be buckled into the car using a belt positioning booster seat.

5) In most vehicles, 4 foot 9 inches tall is the height a child will need to reach before they can come out of their booster seat and be properly secured in a seat with the seat belt alone. A properly secured seat belt is a lap belt that goes across the upper thighs (not over the abdomen) and a shoulder belt that crosses the chest (not the neck).

6) Lastly, it is recommended to hold off on allowing your child to ride in the front seat of the car until they are at least 13 years of age. If a child riding in the front seat is not heavy enough, the air bags may not deploy in an accident. And if they do deploy, the airbag can injure a child vs. save their life because of the force in which it deploys.


When in doubt, or just looking for information in general regarding car seat safety, I highly recommend going to healthychildren.org. This website is a parent friendly site that gives recommendations from the American Academy of Pediatrics and offers information on everything child safety seat related including car seat types, general safety guidelines, handy car seat installation tips, answers to common questions, things to consider when car seat shopping, airbag safety, and airplane safety.


American Academy of Pediatrics. (2020, June 17). Car Seats: Information for Families. Retrieved September 4, 2020, from https://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families.aspx

Car Seat Safety Tips. (n.d.). Retrieved September 4, 2020, from https://www.safekids.org/car-seat

Centers for Disease Control and Prevention. (2019, September 13). Child Passenger Safety: Get the Facts. Retrieved September 4, 2020, from https://www.cdc.gov/motorvehiclesafety/child_passenger_safety/cps-factsheet.html

Centers for Disease Control and Prevention. (2020, September 22). Child Passenger Safety. Retrieved October 13, 2020, from https://www.cdc.gov/injury/features/child-passenger-safety/index.html

Devitt, M. (2018, September 21). AAP Updates Car Safety Seat Recommendations for Children. Retrieved September 4, 2020, from https://www.aafp.org/news/health-of-the-public/20180921kidscarsafety.html

US Department of Transportation: National Highway Traffic Safety Administration. (n.d.). Keeping Kids Safe: A parent’s guide to protecting children in and around cars. Retrieved October 13, 2020, from https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/13237-parents_guide_playing_it_safe_tagged.pdf