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 Car Seat SafetyUpdate on Car Seat Safety for Your NewbornMotor vehicle crashes cause more deaths and injuries than all childhood diseases combined. Each year some 600 children under the age of 5 are killed while riding in automobiles, tens of thousands are injured. As you are aware, there are state laws in place which require parents and care givers to provide safe transportation for infants and young children by using car seats and seat belts. Because there are so many different models of car seats, it is very important that you review the manufacturer's instructions and make sure that you have chosen a car seat that meets federal safety standards. It is also important to pay particular attention in those instructions, to the minimum weight at which a baby should be transported and how to safely secure him in the seat. Newer models of car seats are being stamped with an expiration date in order that older models, which might be unsafe, do not continue to be used. It is recommended that families avoid using car seats that are over 6 years old. You should always be aware of a car seat's history before using it. If you cannot be 100% certain that the car seat has NEVER been involved in a crash, DO NOT USE IT. Even though the seat may look perfectly fine, it may no longer be structurally sound enough to withstand the impact of a crash. In fact, second-hand seats should never be used. Make sure that your car seat has all of it's parts. It should have an intact outer shell, padding, a full harness system with no tears, or shredding of the straps. There should be a functioning buckle and a locking clip for the seat belt. Need and proper usage of the locking clip can be determined by reading your vehicle owner's manual. It is very important that the car seat still has its permanent labels, as well as the manufacturers' instruction booklet. If your seat is not brand new, it would be important to verify that it has not been included on any recall lists. To determine if your car seat might have been recalled you will need manufacturer's name, model number, date of manufacture. There are several web cites and 800 #'s that can provide recall information. Car Seat Recall Information
Additional Information
You should review your vehicle owner's manual to make sure that the car seat is installed correctly in your vehicle. There are Car Seat Safety Checks organized by the PA State Police and the Team Educators for Child Safety (TECHS), that can provide hands on instruction to assure that the car seat is appropriately installed in your vehicle. Your baby should ride rear facing until one year of age AND at least 20 pounds. The car seat should be in the back seat of your vehicle. A rear facing seat should NEVER be placed in the front seat of a car equipped with passenger side air bags.
When you come to the hospital you will be reminded about the Child Passenger Safety laws. Remember: the baby should sit firmly in the back of the seat with nothing between your baby and the padding of the car seat. Your baby should not be swaddled in a blanket. Commercially available head rolls or inserts should not be used. The baby should be centered in the seat and can be supported with rolled receiving blankets placed between him and the sides of the seat from the shoulders to the hips. Harness straps should be through the slots at or below the baby's shoulders and a rolled wash cloth can be placed between the baby's legs and the seat buckle to keep the him from sliding forward.
For the Baby Born Early or SmallIf your baby is born early or small, there are special considerations to keep in mind regarding safe transportation. When choosing a car seat for a premature or small baby there are several recommendations from the American Academy of Pediatrics to consider. The seat should be designated for infants from birth to 20 pounds. The seat should not have a shield, abdominal pads, or arm rest that could come in contact with the baby's face. A 3 or 5 point harness system with a distance of less than 5 1/2 inches from the crotch strap to the back of the seat and less than 10 inches from the lowest shoulder strap slot to the seat bottom provides the best fit.
All babies under 1 year and 20 pounds must travel rear facing in the car seat and never in a front passenger seat equipped with an air bag. The impact of the air bag could cause serious injury or death in a crash. When positioned in the car, the recline of the seat should be 45 degrees for newborns. There is an indicator on the side of many seats that tells you whether the seat is reclined properly or needs to be adjusted. This indicator may show that the angle of the car seat is not correct because of the slope of your vehicle's seat. A firm roll of cloth, newspaper, or a piece of pool noodle can be wedged under the car seat below the infant's feet to obtain the proper angle.
When positioning the baby in the car seat, there are things you can do to decrease the risk of breathing difficulty while still providing protection in the event of a crash or sudden stop. The baby's back and buttocks should be placed flat against the back of the car seat. Blankets or other items should not be placed behind or under the baby. Babies should never be swaddled in a blanket. Blanket rolls can be placed along both sides of the baby, from shoulders to hips to provide proper positioning. A small rolled wash cloth can be placed between the crotch strap and the baby to reduce slouching. The shoulder straps must be in the lowest slot at or below the babies shoulders and the harness must fit snugly. The retainer clip should be positioned in the middle or the chest at armpit level, not over the abdomen or neck.
If your baby is premature or small at birth, car seat monitoring will be done before your baby is discharged. You may hear this referred to as the Car Seat Test. You will be asked to bring your car seat to the hospital. You will position the baby in the car seat as described above. The nurse will be present to answer any questions you might have. The baby will be placed on monitoring equipment to assess heart rate, breathing, and blood oxygen level. The baby will be observed for 1 hour or the length of your drive home, whichever is longer. If your baby has no periods of breath-holding lasting longer than 20 seconds, no slowing of the heart rate, and no decreased levels of oxygen in the blood, the baby passes the car seat test. If the baby does not pass the car seat test the hospital staff will help you to identify different positioning or a different type of car seat or car bed.. If your baby did not pass the car seat test other devices that position the baby similarly, such as swings and infant seats, should not be used. A premature or small infant who does not pass the car seat test can frequently travel in a car bed. The baby is positioned in the car bed and monitored again. If the baby passes the test in the car bed, one can be loaned to you by the Intensive Care Nursery. Car beds can only be used until your baby weighs 9 pounds and is 20 inches long. It may be advisable to redo the Car Seat Test for your baby before discontinuing use of the car bed. Discuss this with your pediatrician. The retesting can be done at Allegheny General Hospital (call 412-359-6710 or 412-359-6612 to make arrangements) or at The Western Pennsylvania Hospital (412-578-5306). References: American Academy of Pediatrics. Safe Transportation of Premature and Low Birthweight Infants. Pediatrics, 1996; 97:758-760 American Academy of Pediatrics. Safe Transportation of Newborns at Hospital Discharge. Pediatrics. 1999; 104; 986-987 9-02 Last Updated: February 04, 2009 |
