Car Seat Safety By Age: Infants in Rear-facing Seats

Choosing and properly installing a child safety seat will help protect your baby from serious injuries. Remember, babies should remain rear-facing until they are 2 years of age.


Car Seat Safety By Age: Infants in Rear-facing Seats

Narrator: In the United States around 5,000 infants under the age of 1 are injured in auto crashes every year, some fatally. That's the bad news. Now here's the good news: research has shown that a properly installed rear-facing car seat can dramatically reduce the risk of serious injury for your baby in a crash.

Michael Nance is a doctor at The Children's Hospital of Philadelphia who is an expert at treating injured children.

Michael Nance, MD: Because infants' heads are the heaviest part of their body, young babies are not developmentally able or strong enough to withstand the shock of a crash when they are forward-facing. In a head-on collision, the rear-facing seat will support your child's head, protecting the brain, neck and spine and help to spread the crash forces across the back.

Narrator: Infants and children should always be secured in the back seat, especially if your vehicle has frontal airbags. These can injure or kill a child. The best seating position is always the one in which your safety seat can get the tightest fit. If possible, use the center position in the back seat.

During the first year, there are three car seat choices to secure babies; rear-facing infant-only seats, convertible car seats and in cases of low-birthweight or premature infants, a car bed. Rear-facing infant-only seats like these are made for smaller infants and should never be used in the forward-facing position. You can now find infant carriers with a higher weight harness just like this one. Some even hold children up to 35 pounds. Some families choose convertible seats like these to use rear-facing and then turn the seat forward-facing once the child reaches the maximum height or weight for the child seat. Safety experts recommend that infants and toddlers stay rear-facing until they are 2 years old or until they reach the highest weight or height allowed by the manufacturer of the child safety seat. Always check your car seat manual for maximum weight and height guidelines.

At times, car seats can be tricky to install and simple mistakes can have fatal consequences for kids. Be sure to always check your vehicle's owner's manual and your car seat instructions for specific information, but here are some general rules to follow:

For a good, snug fit, be sure your child is wearing light clothing when you adjust the harness. When tightened, the harness should lie in a straight line with no slack. The harness should be adjusted each time you place your baby in the seat to make sure the harness is tight. Harness straps should be threaded through slots at or below your baby's shoulders. If you can pinch a fold in the harness at the baby's shoulders, your straps should be tighter. Lastly, a harness retainer clip keeps the straps over the baby's shoulders. Buckle the harness and tighten the straps. Position the clip at armpit level.

Once the seat is in the car, it is important to make sure the seat is at the correct angle. You don't want the seat to be too upright or too flat. Some seats have angle indicators to show you when the seat is reclined correctly. Many infant seats have an adjustable base to help set the angle. If your seat doesn't have this feature, you may need to use a rolled towel, baby blanket or a swimming pool noodle under the foot of the safety seat to help set the angle.

Next, pull the seat belt out. Then, carefully thread it through the rear-facing belt path of your child's safety seat. Check your car seat manual to make sure you're using the correct belt path for the rear-facing position and check your car owner's manual to make sure you have locked the belt correctly. Some vehicles manufactured before 1997 may require the use of a locking clip to secure the seat belt. Your vehicle owner's manual will tell you if you need one. Read both the vehicle owner's manual and your child's seat manual to learn how to install the clip properly.

A loosely installed seat is one of the most common and dangerous mistakes parents make. To ensure a tight fit, use your upper body weight to press down on the seat, buckle and tighten and lock the seat belt. Now, hold the safety seat at the belt path and pull it firmly side to side and toward the front vehicle seat. A properly installed child safety seat will not move more than an inch in any direction.

As you put your child in the car seat, get in the habit of checking both the seat and the harness for a proper fit. As babies grow and clothes change with the season, it is important to adjust your harness every time you buckle your baby. After you are sure your car seat is tight in the car and baby is safely buckled into the harness, you're good to go.

Cars made since 2002 have an attachment system called LATCH which makes it possible to install safety seats without using the seat belt.

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