May 19, 2014

Interview Transcript

Dr. Cindy Gellner: A lot of car seat regulations have changed in the past few years as to when your child should be in which car seat and when. I'm Dr. Cindy Gellner, and that's what we're going to talk about today on The Scope.

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Dr. Cindy Gellner: You probably remember when your child was a baby, they needed to be turned around at age 12 months and 20 pounds. Not anymore. A couple years ago, there was a study in 2007 in the journal, Injury Prevention, that found that children under the age of two are 75 percent less likely to die or be severely injured in a crash if they were rear-facing.

Another study found that rear-facing children were five times safer than forward-facing. What the article says is that a rear-facing child safety seat does a better job of supporting the head, neck, and spine of infants and toddlers in a crash because it distributes the force of the collision over the entire body. But when do you know? But when are you supposed to turn your child around?

The current guidelines and this goes for all the different car seats, the current guidelines are your child should be rear-facing as long as possible: infants until at least age 2 and 30 pounds. They can go into a forward-facing seat with a 5 point restraint when they are at least 2 years old and weigh 30 pounds. You can continue to use that seat until you get to the highest weight and height allowed by the seat.

Then when your child is ready for a booster seat, they should be at least age 4, about 40 pounds or more, and you need to continue to have your child in that booster seat until they're 4 foot 9. Why 4 foot 9? If your child is not 4 foot 9, the car seat belt will hit at their neck, not at their shoulder where it belongs. If your car is rear-ended and the child is in the seat belt at your child's neck, it's not going to be pretty. It can actually cut through the neck, and that's not what you want. You want your child to be safe.

So, until your child is 4 foot 9, they can't properly sit in a regular car seat without having a booster seat. What happens when they turn 4 foot 9? Then they can sit in the back seat in a seat belt until they're 13. Kids 12 and under need to be in the back seat. Once they're over 12, then you can have them sit in the front seat with you.

So isn't forward-facing easier for everyone, not just the big kids? Isn't it better for your toddler to not be rear-facing? They finally became 1 year old. You want them to see what's going on around them. Well, yeah, it's easier to interact with your child when they're facing forward, and it's less awkward to get a toddler into a rear-facing seat, but safety should be what you're concerned about most. Consider the protection of your child.

I get asked a lot, "My child's legs are all squished up. They don't look comfortable." Here's the thing. Kids who have only been rear-facing won't be bothered that much. They don't know anything else. They don't know what it's like to be forward-facing and have leg room, and it's completely fine for their feet to touch the back seat or even bend. Once you make the switch and have them forward-facing, it's really hard to go back and get them rear-facing again, so try not to even switch them before they're ready.

Another question I get asked is, "What if my child turns 2 before he reaches the height or weight limit for the seat? Should I keep him rear-facing?" We always say, "Yes." The safest decision is to keep your child rear-facing until they reach the height or weight limit of the seat.

Then there's the opposite side, "What if my child reaches the height or weight limit for the seat before they turn 2?" Once your child exceeds the height and weight limits of your infant car seat, I usually tell parents to purchase what's called a convertible car seat. It'll actually say the word "convertible" on it. It's a car seat that can go forward-facing or rear-facing, and it has a higher weight limit. Most go to 35 pounds rear facing, and some even go higher. Your child can continue to use that until they're 2.

The convertible car seats also have a deeper bucket, so they'll get a little bit more leg room just by switching to that car seat. Continue to use that one until your child hits the height or weight limit for the rear-facing use, and at that point, you can make your switch to the forward-facing or you can purchase an additional car seat that still goes rear-facing.

It's a personal decision, and it's got to be one that's influenced by the size of your car. I've heard a lot where the car seat just doesn't fit backwards. Again, do what you can to make sure your child is safe.

I also find that if there's a younger sibling coming along and they need that other car seat, then if your child is close to the height and weight limit, it's okay to go ahead and make the switch.

Once you get past the convertible car seats, your child's been turned around and they're now ready for a booster seat, what are booster seats? First off, they're designed for kids ages 4 to 8 and weigh 40 pounds to 100 pounds. They're designed to fit the child, again, so that the shoulder and the lap belt hit properly.

So which one of the booster seats is right for your child? There are several different kinds. There's the high back booster. That's the one where you actually have the head rest on it, and it goes all the way up. It also helps protect their head, and it's designed to protect whiplash in children who ride in the back seats, especially in minivans and some SUVs. They help with that.

For the high back booster, there's actually a slot for the seat belt to go through to make sure it fits properly on your child. For the base only booster seat, there isn't that. You need to make sure that the seat belt still fits properly on your child's upper shoulder where it's supposed to and not at the neck in order for your child to be in a base booster alone. Most kids that are older are the ones that like the base booster. The little kids are still good with the high back booster.

I get asked a lot, "Well, why do I have to have my child in a booster seat? I understand safety, but is there a law, really, that says I have to do this?" Yes. In Utah, children up to age 8 must be in an appropriate child safety seat or a booster when traveling in a passenger vehicle.

The only exception to that law is that children younger than 8 are not required to be in a booster seat if they are at least 57 inches tall. At that point, they can use the regular lap and shoulder belt without a booster. The primary enforcement for not being in a booster seat currently is a fine of $45. Unless you want to fork out money, make sure that your child's in an appropriate booster seat. Actually, some booster seats are cheaper than $45.

Again, the most important thing is to make sure you pick the right seat for your child. If you're not sure, you can ask your pediatrician. If you're not sure of how to put one in, there are fit stations, usually in several places. You can ask your local hospital. Primary Children's has one. Many fire stations do, too. You can ask them to check to see if your car seat is put in properly, and remember to where your seat belt, too. Seat belts really do save lives.

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