Focus on Pediatrics: Safety seat inspection best way to save lives

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Most parents put small children in a safety seat while driving in a car thinking that their child is protected in case of an accident. However, if children are not properly fitted for the seat, parents are using the wrong type of seat for the child’s age, or the seat is positioned incorrectly, injury can result during a crash, says Elly Martin, MIA, MSJ, a spokeswoman for the National Highway Traffic Safety Administration (NHTSA) in Washington, DC.

The NHTSA estimates that more than 80% of child passengers under the age of 8 are not properly restrained in child safety seats, yet motor vehicle crashes are the leading cause of death for children ages 4 to 14.

While information about child passenger safety can save lives, the best education for parents is a visit to a fitting station, says Martin. "We can offer broad guidelines and general instructions, but to get the specifics to suit a child, there is nothing that beats going to a fitting station," she says. As the child grows and graduates to another seat, the process of visiting a fitting station must be repeated.

No seatbelt use for kids younger than 8

Children should not prematurely graduate to seatbelts, warns Martin. "A child should be in a safety seat until 8 years old unless they are unusually tall. Otherwise, the seatbelt will hit them improperly and there is potential for abdominal injuries and other problems if there is a crash," she explains.

Young children ages 4 to 8 who weigh more than 40 pounds and are shorter than than 4 feet 9 inches tall should ride in a belt-positioning booster seat. Toddlers older than 1 year who weigh between 20 and 40 pounds should ride in a convertible forward-facing seat. Parents who have infants from birth to 1 year should use an infant only or rear-facing convertible safety seat.

All children age 12 and younger should ride in the back seat of the car. "The back seat is the safest position for all occupants, but particularly for children who are fragile and vulnerable behind airbags," says Martin. Frontal collisions are twice as common as side or other collisions, she says.

The NHTSA trains and certifies technicians to work at child-passenger-safety inspection sites. This February, the federal agency awarded grants for the establishment or expansion of these inspection sites to 10 hospitals and health systems in conjunction with National Child Passenger Safety Week.

However, inspection sites are not always located at health care facilities. Law enforcement facilities frequently set up inspection stations either on a regular or intermittent basis, and car dealerships often have stations, says Martin. To create a list of local child-passenger-safety inspection sites, Martin advises patient education managers to contact the NHTSA office in their region. A list of these offices is available on the NHTSA web site at

The web site also has lots of educational information. A dictionary of child safety seat terms helps parents understand such terms as five-point child restraint harness, retractor, and tray shield. A one-minute safety seat checklist provides illustrations and instruction on age-appropriate safety seats. The various types of seats on the market are described in detail on another web page, including convertible seats and high-back booster seats. There also is a child safety seat recall list, a use chart, and child-passenger-safety laws.

For more information about child passenger safety seat education and inspection, contact:

Elly Martin, MIA, MSJ, Spokeswoman, National Highway Traffic Safety Administration, 400 7th St., S.W., Washington, DC 20950. Telephone: (202) 266-0651. Web site: