Children who reach the highest weight or height of their forward-facing child safety seat should use a belt-positioning booster. There are four types of booster seats. In some cases, choosing a booster seat will depend on whether or not your vehicle has high seat backs, headrests or head restraints.
Booster Seats for Your 4- to 8-year-old Child
Narrator: In the United States around 300 children are killed in auto crashes every year. That's the bad news. Now here's the good news: research has proven that using belt-positioning booster seats with lap and shoulder seat belts instead of seat belts alone reduces the risk of serious injury by half for kids 4 to 7 years old.
Doctor Dennis Durbin is a physician in the Department of Emergency Medicine at Children's Hospital.
Dennis Durbin, MD: On young children, the shoulder portion of a vehicle seat belt often crosses the neck rather than the shoulders which is both uncomfortable and dangerous. To get comfortable, kids will often put the shoulder belt behind their back or under their arms making it useless. If the shoulder belt is not positioned properly and a crash occurs, your child's upper body and head can fly forward and hit the interior of the car causing neck, spine or brain injury.
Narrator: A belt-positioning booster seat raises your child so that the lap/shoulder belt is property positioned across the center of the chest and low on the hips, touching the thighs. In a crash, the belt will protect and restrain the child as it was designed to do.
When your child completely outgrows the internal harness of their forward-facing child safety seat, by reaching the maximum weight or height of the car seat, you can switch to a belt-positioning booster seat. Children should stay in a belt-positioning booster seat until the vehicle lap and shoulder seat belt fits properly, typically when they have reached 4' 9" tall and are between 8 and 12 years of age. Boosters need a vehicle seat with both a lap and shoulder seat belt to work correctly. There are four types of belt-positioning booster seats.
First is a booster seat that has an internal harness. These can be used with the harness until your child weighs between 40 and 65 pounds and without the harness, as a belt-positioning booster seat, up to 100 through 120 pounds. Check the manufacturer's instructions for the specific limits on your seat.
Second is the high-back, belt-positioning booster. These are for vehicles that don't have high seat backs, headrests or head restraints.
Third is the backless, booster seat and must be used in vehicles with head restraints, high seat backs or headrests.
Finally, your vehicle may have a built-in child restraint. Some of these are similar to child safety seats. Others are only booster seats used with a lap/shoulder belt. Again, check your vehicle owner's manual for weight and height information.
Belt-positioning booster seats are easy to install. Of course, you still need to read your vehicle Owner's Manual and booster seat instructions, but here's some general advice on installation.
The right place for a booster is anywhere in the rear seat that has a lap and shoulder belt. Backless models like this one should only be used in seating positions with a high seat back or headrest. Have your child sit in the booster seat, pull the lap/shoulder belt across his body, buckle it and make absolutely sure the shoulder strap stays in front of your child. Always use both lap belt and shoulder belt. If your vehicle doesn't have shoulder belts, consider using a child safety seat with a higher weight harness.
Lap belt guides are cut-out grooves on the sides of the booster that help make sure the lap portion of the seat belt lies below the hips and touches the thighs. Use shoulder belt guides only if needed. A shoulder belt positioner on the side of the high-back booster may be needed to guide the shoulder belt across the center of the chest. Check your booster seat manual to see how to thread the shoulder belt through the positioners taking care not to pull the belt off the shoulder.
Some backless seats come with a strap to help position the shoulder belt correctly. Depending upon your child's size, you may not need to use the positioners for a good fit. The shoulder belt should cross the center of the shoulder and chest and should not cross or touch your child's neck. The lap belt should fit snugly below the hip bones and against the upper thighs. It should never rest over a child's belly.
For more good advice on kids and cars, look for a certified car seat technician in your area. You may find a free child safety seat checkpoint or car seat check at a local hospital, police or fire department or state highway safety office. And remember, crashes happen, but with proper precautions, serious injuries don't have to.
This presentation was created by the Kohl's Injury Prevention Program and the Center for Injury Research and Prevention at The Children's Hospital of Philadelphia.
Related Centers and Programs: Car Seat Safety for Kids