Copyright 2007 American Academy of Orthopaedic Surgeons
Child Safety Seats

Motor vehicle crashes are a leading cause of death for children between the ages of 4 and 14 years.

Incidence of Injury

In 2001, 649 children under age 5 were killed in motor vehicle accidents. An estimated 269 children of the same age were saved as a result of using child restraint seats. (Source: Highway Traffic Safety Administration, Traffic Safety Facts 2001.)

Research on child safety seats has found that they can reduce fatal injuries by 71 percent for infants who are younger than 1 year old. They can reduce fatal injuries by 54 percent for toddlers who are 1 year to 4 years old.

Most car crashes happen within 25 miles of home. That's why it is important to put your child in a safety seat every time you drive. Adults often think that holding a child on their lap is as safe as using a safety seat. It is not.

Experts refer to the "on-lap" position as the "child-crusher" position. In a crash at 30 miles per hour, a 10 pound child could be thrown from the adult's lap into the dashboard or windshield with a force of 200 pounds.

Installing a Safety Seat

It is important to purchase a safety seat immediately. Begin using it the day you bring your newborn home from the hospital. The type of safety seat you need depends on the age, size and weight of your child, and your vehicle's safety belt system.

Installing the safety seat correctly is as important as using it. Here are some basic tips:

  • Look for a label, usually on the back of the seat. It should state, "This child restraint system conforms to all applicable Federal Motor Vehicle Safety Standards" or "This restraint is certified for use in motor vehicles and aircraft."
  • Follow the manufacturer's instructions carefully. Keep them with your safety seat at all times.
  • Never use a rear-facing infant safety seat in the front seat if an auto is equipped with a front seat airbag. If a passenger side airbag is inflated, it could strike the back of the safety seat. This could seriously injure an infant. The back seat is the safest place for any child safety seat.
  • Your vehicle's safety belts should be long enough to secure the safety seat properly. Eighty percent of the base of the safety seat base should rest on the seat of the vehicle. Follow the manufacturer's instructions on how to fasten the safety seat.
  • Test the safety seat. Make sure it is secure by pushing the seat forward and backward. If it moves, tighten the belt while pressing the safety seat into the vehicle's seat cushion using your knee. If the lap portion of the safety belt does not hold your safety seat firmly in place, check the vehicle owner's manual and the car seat instructions about using a metal locking clip.

Complete and return the safety seat's registration card. It should be included with your safety seat. Send it in to the manufacturer so you will be notified of any recalls or other problems. The National Highway Traffic Safety Administration has a toll free Auto Safety Hotline. Call (800) 424-9393 to ask consumer questions concerning child safety seats. The hotline also supplies current information on car seats that have been recalled.

Infant-Only, Rear-Facing Seats

Infant-only, rear-facing seats offer maximum protection to an infant's large head and weak neck. They should be used until your baby weighs about 17 pounds to 20 pounds. For very small infants, soft blankets can be rolled and positioned for a more secure fit. Position them on either side of the child's head and between the child's legs. Never use an infant-only, rear-facing seat facing forward. Never use it in the front passenger side of a car equipped with a passenger airbag.

Forward-facing convertible seats

Convertible seats can be used from birth until the child weighs about 40 pounds. Use a convertible seat facing the rear until babies weigh at least 20 pounds. Then turn the convertible seat around to face forward. Follow the owner's manual to make the proper adjustments when converting the seat from backward- to forward-facing.

Belt-positioning booster seats

Belt-positioning booster seats are for children who have outgrown convertible seats and weigh more than 40 pounds. They use vehicle shoulder belts to protect upper body and head. These seats must be used with both lap and shoulder belts.

Infant car safety beds are especially suitable for premature babies or babies who must lie flat for medical reasons. Ask your doctor if this type of seat is appropriate for your child. Always have the doctor or hospital show you the proper way to use these seats, because children's medical needs vary.

Toddler-only seats/vests may take the place of forward-facing convertible seats and accommodate children weighing more than 20 pounds to 30 pounds. Follow instructions with these seats. Weight limits vary.

Japanese Translation

View Japanese translation of this article.View Japanese translation of this article. (http://www.naruoseikei.com/AAOS/injury_prevention/child_safety_seats/child_safety_seats.html)

AAOS wishes to thank Naruo Orthopaedic Hospital for translating this information into Japanese and for their support of educational programs for patients and the public.

Last reviewed: July 2007

Reviewed by members of POSNA (Pediatric Orthopaedic Society of North America)

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS "Find an Orthopaedist" program on this website.
Copyright 2007 American Academy of Orthopaedic Surgeons
Related Links
View Japanese translation of this article. (http://www.naruoseikei.com/AAOS/injury_prevention/child_safety_seats/child_safety_seats.html)
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