Focus On Pediatrics-Misuse renders child safety seats worthless

Lessons on selection and installation a must

Child seat safety laws were implemented to reduce injuries to children in automobile accidents. However, the laws have little impact if parents use car seats incorrectly. At present, about 80% of all adults misuse car seats in some way, according to the National Highway Traffic Safety Administration (NHTSA) in Washington, DC.

"There are all kinds of gross misuse," says Cathy Morris, program director for Buckle Up Baby in Roseville, CA. People don't put the seat belt around the car seat, they don't put the shoulder harness around the child, or they position the infant seat facing forward too soon, putting the baby at greater risk for spinal cord injuries, she explains.

"People don't understand crash dynamics or what happens in a car crash. Also, a lot of parents just don't read the instructions that come with the car seat," says Morris. Another big problem is that parents often purchase car seats that aren't compatible with the seat belt system of their car. Some seat belts are too narrow for certain safety seats. Therefore, parents must consider the make of their car when purchasing a car seat.

To combat this problem, Morris conducts four-day child passenger safety workshops for law enforcement, health care professionals, and firefighters. At the end of the workshop, participants are child safety seat technicians and are qualified to teach parents the proper use of car seats and to conduct safety seat checks.

During the class, participants learn about the various vehicle systems, including seatbelts and air bags. The lesson is hands-on, and the trainees actually identify the seat belt systems in an array of cars. They also learn about the different car seats and how to determine if one is appropriate for a child based on age, weight, and physical tolerance. For example, a 2-year-old who weighs 45 pounds has outgrown the standard 40-pound harness, but is not yet mature enough for the lap/shoulder belt system in the car. This child would need to graduate to a 60-pound harness instead.

Although the laws in most states require a child to remain in a car safety seat until the child reaches a certain age or weight, NHTSA wants children to graduate to a booster seat. "We are seeing lots of injuries because seat belts don't fit kids properly. Normally, a seat belt doesn't fit a child until they are 60 to 80 pounds, so the booster seat lifts them off the vehicle seat and helps position the lap and shoulder belt properly," explains Morris.

The workshop includes information on the misuse of car seats and ends with a live check, where parents are invited to have their car seats inspected for proper use. One of the key points the safety seat technicians learn is that they are not an installation service, says Morris. They don't install the car seats for parents, but teach them how to use them correctly. Many times, families just want the seat installed, but it is unrealistic for them to think they will never have to move the seat, she explains.

Health care facilities that train technicians will find many opportunities to teach parents about car seat safety. They can be included in parenting classes before the baby is born so parents-to-be can purchase the correct seat and install it before the baby arrives. "A lot of times, parents show up at the hospital with the car seat in the box. We like them to shop and make sure it is right for the vehicle before they have the baby," says Morris.

Day care centers present another good opportunity. Because a lot of the children are 2 and 3 years old, it is a good time to discuss moving the child up to a booster seat.

The safety seat technician program is a national program. Although the laws in each state may differ slightly, the information taught in the class is the same, says Morris. However, the requirements for each class may vary. Morris, who runs Buckle Up Baby with grant funding, does not charge for the workshop as long as the institution sponsoring the class provides lunch for the participants. The workshop materials are provided by NHTSA.

To find an instructor in your area, contact your state office of traffic safety or visit the NHTSA Web site at The site has a lot of safety materials that can be downloaded for health and safety fairs, says Morris.

For more information about child safety seat workshops, contact:

Cathy Morris, Program Director, Buckle Up Baby, 401 Oak St., Roseville, CA 95878. Telephone: (916) 772-6300. Fax: (916) 772-6353. E-mail: cathy@ Web site:

National Highway Traffic Safety Administration, 400 7th St. S.W., Washington, DC 20590. Telephone: (202) 366-9550. Web site: