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Carseat Safety by Christine Lee-McNaughton

5 May 2011 56 Comments

Car seats stress me out. When we were in the NICU with Little One, she had to pass a “car seat test” in order for her to be discharged from the hospital. Basically, the babies have to be able to sit in the car seat for thirty minutes without “de-satting” (when their oxygen saturation levels drop or swing). Little One was always good with sending off all her alarms in the NICU, so having all the bells and whistles go off all the time stressed me out. I just wanted her to pass that test so we could take her home. Home for us was a six hour drive from Toronto’s Mount Sinai Hospital, and therefore, her car seat test had to be longer.

A friend of ours had a baby the year before Little One was born and had given us her car seat/infant carrier and stroller attachment. I loved it! Then, a few months later, a friend of mine commented on how Little One’s car seat was dangerous because it was made before a certain date and was on the recall list.

Thus began my introduction to product recall lists.

Car seats terrified me because I was always worried that my car seat wasn’t good enough or Little One wasn’t positioned properly. Some sources said that there should not be any “rolls” or anything in the car seat except for the baby, lest the baby get smothered. Other sources said because she was a preemie and less than 5 lbs, it was okay to stick rolled up towels or rolled up blankets on either side of her. So many conflicting rules! Some said not to use the head support inserts that come with the car seat. Others said to use it. How confusing for a parent who just wants to do what is best and what is safe for her newborn.

Another reason car seats seemed daunting to me was because they look like Chinese torture devices when taken apart. I wash the car seat fabric and belts every now and then (just because I like washing them. Ha!). I get Hubby to take the washable pieces apart and put them back together again for me. I am really that scared of messing things up.

When Little One finally graduated from the infant car seat to the toddler car seat, my anxiety got even worse. One day, my friend looked at Little One’s car seat and said, “This isn’t in properly!”. I gasped. We had the car seat checked for safety, we still had Little One rear-facing, etc. Still, my friend said the problem was that it was not level to the ground. *sigh*

Car seat safety is extremely important to me. Our children are so precious to us. Of course their safety is paramount. For this reason, even though Little One is almost two years old, she is still rear-facing. Hubby and I are adamant about keeping her rear-facing for as long as we can. If you think of injuries sustained from the impact during rear end collisions, having your child rear facing is pretty smart. It’s a lot safer when it comes to neck injuries.

We get a lot of flack from people telling us we should put Little One frontward facing already. What do I do when I’ve got questions about products and safety? I do research, call the appropriate companies, check out company websites, talk to other moms, and…I go to my “Go To” person. Jill Winer is a car seat technician and a car seat safety advocate. I interviewed her for some car seat safety questions:

CM: What made you decide to become a car seat technician and what does being a car seat technician entail?

JW: When my almost 7 year old was a baby and I started doing some reading about car-seats and how to use them safely, I was amazed by how little I knew. I quickly started to recognize that all around me, car-seats were being used in unsafe ways. I tried to educate people about how to use car-seats properly, but didn’t really have any credibility. When I got pregnant with my now toddler, I knew that I would once again be around a lot of new moms and babies, and wanted to be able to help ensure all these babies were as safe as possible in their car-seats. So I got certified. Unfortunately, a lot of my friends and family still ignore my advice…but when I do see it taken and especially when I am am able to actively help ensure a baby is safer in the car, I am thrilled. I also love volunteering at car-seat clinics. It is fun, meaningful…and a great work-out!

For my training, I did a 2 day course (over the weekend) with St. John’s Ambulance. Contact them or check out their local web-site for more information. I also need to do 10 installs a year to keep up my certification. I easily do this at one clinic. Technicians need to be certified every 3 years.

CM: What are five of the most important things you would like to tell parents regarding car seat safety?

JW: 1. Cars accidents are the leading cause of death in babies and young children. Taking our kids and babies out in the car is the most dangerous thing most of use do with them, and many of us do it multiple times a day. Car-seats, used properly, are their best protection. So please use them properly.

2. The chest-clip goes at the chest, not the belly. Armpit level, at the chest. If it is too low, in the force of a collision the straps can come off your babies shoulders, and your baby could be thrown out of the seat.

3. Your baby will not freeze to death if you don’t use a snow-suit, or bundle me, in the car. I had a baby in December, in Toronto, and she made it! Warm winter clothes and a warm blanket (or a car-seat cover that goes over the seat and does not interfere with the straps) are sufficient, and the car-seat straps fit much better this way. Save the buntings and snowsuits for outside excursions.

4. The straps should be tight enough that you cannot pinch them at the collar-bone.

5. The car-seat should not move more than an inch, side to side, at the base (where the seat-belt or latch strap goes through the seat) when properly installed.

CM: My two year old is still rear-facing. She’s still pretty light and she’s very petite. We plan on keeping her rear-facing for as long as we can. In our opinion, it’s safer. We have been getting a lot of flack from others, telling us we should make her car seat forward facing already. Do you recommend keeping her rear-facing for longer?

JW: My almost 2 year old is also still rear-facing, and will be for some time, since she is 24lbs and her seat has a rear-facing limit of 35lbs. It is absolutely safer. The American Academy of Pediatrics recommends rear-facing for as long as possible. Babies and toddler should rear-face to the maximum limits of a convertible (rear and forward-facing) car-seat which (depending on the seat) OR when his/her head is 1-inch from the top of the car-seat shell (feel for it, it is hard, not the cushioning). The rule that most parents know is that children must rear-face to at least 1 year AND 20 lbs. What is not well known is that 1 year AND 20 lbs. is the bare minimum and it is strongly recommended that they be kept rear-facing for much longer.

When a child is forward-facing, there is a lot of stress put on the neck in a collision. The weight of a child’s head in a crash causes the spinal column to stretch, which is it not supposed to do. The spinal column can stretch up to 2 inches but the spinal cord can only stretch up to 1/4 inch before it snaps. This is referred to as “internal decapitation”. Scary, huh? Research shows that a forward-facing child is 4 times more likely to be seriously injured or killed than a rear-facing child of the same age. How big the child is or how well they can hold their head up has nothing to do with how well their spinal cord can absorb the force of a collision. That strength only comes from time and age. A 29lbs 16 month old is no safer in a collision if the car-seat is forward-facing than a 19lb 16 month old would be. Rear-facing seats absorb the forces in a collision, protecting the neck and spine.

By the way, it is fine for a babies feet to touch the back of the car-seat in a rear-facing seat. There has never been an incident of a broken leg due to this, and even if it did happen, I’d far prefer a broken leg to a broken neck or spine, wouldn’t you?

CM: In your opinion, are there any car seats that are better than others? Which ones would you recommend and why?

JW: The best car-seat is one that is properly used (and not expired or broken in any way, obviosly). One that fits the car, and child, well. More expensive seats have some perks (easier to adjust, etc..) but they are not proven to be safer. All seats sold have to meet the same requirements. That said, I do like seats that have higher rear-facing (at least 30lbs) and harnessing (at least 50lbs) limits, so that the little ones don’t have to be turned forward, or out of the seat and into a booster, for a long, long time. It used to be that only very expensive seats had higher limits, but this is no longer the case. These days many more affordable seats have excellent rear-facing and harnessing limits. Many parents know that their babies can go to forward facing at 1 year AND 20lbs, and can move from a car-seat to a booster at 4 years AND 40lbs, but they don’t know that it is safer to postpone both these moves as long as possible, and seats with higher limits allow that. Remember, every step up in the car-seat proegression is a step down in safety.

CM: What is the best advice you would give parents about proper car seat installation?

JW: Read the instructions cover to cover before, and while, installing. Use two people to install…when you are pulling the belt tight, it helps to have one person put their weight on the seat (and bounce) and another to pull the belt. If you are not sweating or out of breath after installing a seat, it probably is not in tight enough. I like mine tight enough to shake the car when I try to move the seat.

Most importantly, if you cannot get it in tight enough or it feels or looks wrong, please, please find a technician to double-check it. We know lots of tricks for getting a stubborn seat in correctly and securely! Many baby-shops have car-seat technicians on staff (for a fee). You can also attend a car-seat clinic. Click here for more information on where to find a clinic.


  • Michelle said:

    Excellent article! Thank you for posting this and also helping me realize I’m not the only one stressed out about car seats!!
    One thing I was told too is that those car seat blankets that the straps feed through are very dangerous. I had one for my daughter to bring her home in and was told not to by the nurse. The cushioning of the fabric can compress on impact making the seat belts too loose. I ended up getting one that fits over the top of the seat and elastics around the seat (like a fitted bed sheet)

  • Christine said:

    Thanks for mentioning that! :) That is so true. I have heard the same thing about those car seat blankets. We had one for Little One as well (a baby shower present), but I got her one that fits over the top of the seat. Sounds like the same kind you got. I remember being so paranoid about everything when I was bringing our tiny preemie home in her car seat! She looked so small! I worried that she’d stop breathing or something! Now, I’m much better and trust that I know what I’m doing with her car seat. It also helps that she’s now 2.5 years old! LOL!

  • Jill W. said:

    Thanx for posting this Christine…I am so glad I was able to help.
    Michelle, right you are. I referred to those covers in the interview, and am so glad you listened to the nurse. It is amazing to me how many people continue to use the covers (and do other car-seat non-nos) even after they are told it is not the safest choice!!!

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