A car seat is one of the most crucial pieces of safety equipment you'll ever use, so shouldn't it be simple for even a sleep-deprived parent to install? Unfortunately, many moms and dads don't realize they're making dangerous mistakes. "Despite design improvements, parents still find car seats very confusing," says pediatrician Benjamin Hoffman, MD, a certified child passenger safety technician. "I've done more than 4,000 seat checks and seen only 13 seats that were installed properly."
We at Parents realize it's no small task to get every detail correct. You have to know exactly when your child has outgrown his seat, buy a new one that fits him perfectly (and master a new set of installation guidelines), get the strap placement just right, and much more. It's enough to make you think you need a PhD in engineering to figure it all out. That's why we created this comprehensive -- yet easy to understand -- guide to help you navigate the complicated world of car seats. "The good news is that car seats are extraordinarily effective," says Parents advisor Dennis R. Durbin, MD, director of research for emergency medicine at The Children's Hospital of Philadelphia. "When you use one correctly, you can be confident that your child will be likely to survive a crash with little or no injury."
Baby on Board
Your child's first car seat is designed to face the rear of the vehicle, and for good reason. In a crash, the back of an infant seat absorbs most of the impact and evenly distributes the remaining force across a baby's back -- his strongest body part. It also cradles his heavy head and relatively weak neck, protecting him from neck and spinal-cord injuries.
Another key feature of an infant seat is the adjustable base. It lets you position your baby at a safe angle (about 45 degrees). "If the seat is too upright, your child's head could flop forward in a crash, potentially cutting off his airway," says Lorrie Walker, training manager and technical advisor at Safe Kids Worldwide, in Washington, D.C.
Although experts used to say that a baby was ready for a forward-facing seat after he'd turned 1 and weighed 20 pounds, research has found that children between ages 1 and 2 are five times less likely to be seriously injured in a crash if they're rear-facing. That's why the American Academy of Pediatrics now recommends that all kids ride in a rear-facing seat until they reach the maximum height or weight limit set by the manufacturer. This applies to babies in infant seats as well as to infants and toddlers in convertible seats, which can be used both rear-facing and forward-facing.
1. Placing your baby in the front seat.
The force generated by a deployed front airbag can severely injure or kill a child. Buckle her into the safest spot in your car: the center of the rear seat. A recent study conducted at The Children's Hospital of Philadelphia found that kids seated there were 43 percent less likely to be injured in a crash than those who rode in the side seats. However, any position in the rear is safer than in the front.
2. Using the wrong anchors.
The LATCH (Lower Anchors and Tethers for Children) system allows you to attach the seat to metal rings in some cars' rear seats without using the seat belt. But not all cars have anchors in the middle. To install your car seat in the center, make sure you're not using the anchors for a window seat by mistake. If yours doesn't have center anchors, use the seat belt instead.
3. Not getting a tight-enough fit.
The seat shouldn't be able to move more than an inch from side to side. When tightening the LATCH straps or seat belt, put your knee in the car seat and push down to help you pull them as tight as possible. You should adjust the harness straps so that you can't pinch a fold in the fabric. "If your child can move forward at all, there is a risk that he could whip forward during a crash and injure his head or spinal cord," says Dr. Durbin.
4. Positioning the harness straps too high.
When your baby is rear-facing, adjust the straps so they're threaded through the slots at or below his shoulder level, says Jennifer Stockburger, vehicle and child-safety program manager at Consumer Reports' Auto Test Center, in East Haddam, Connecticut. Otherwise, she could be injured or ejected in a crash.
5. Adding padding.
You can't tighten straps snugly if you cover them with cushy pads, wrap your baby in a blanket or a thick coat, or use seat pads that aren't designed for the seat.
Around age 2, your child has probably outgrown her infant seat, and she's ready for a forward-facing seat (or to turn her convertible seat around). One big difference you'll notice is that the forward-facing seat's LATCH attachments are toward the back of the seat instead of the front; there's also a top tether to hold the seat in place. (The anchor for the tether may be on the ceiling, floor, back dashboard, or seat back, depending on your car's design.) When your child faces forward, make sure the harness straps are at or above shoulder level to prevent her shoulders from jerking forward in a crash.
1. Turning the seat too early.
If you have a convertible seat, your child should ride rear facing until he's reached the maximum rear-facing limit of the seat (generally 30 to 35 pounds).
2. Not cinching the harness tightly.
The fit should be so snug that you can't slip a finger between your child's shoulder and the strap (or pinch the fabric of the straps).
3. Using the LATCH system and a seat belt.
You're not getting double the protection. "The two have never been tested together, and it's possible that using both could injure your child in an accident," says Walker.
4. Skipping the tether.
Fifty-five percent of parents make this dangerous mistake, according to the National Highway Traffic Safety Administration (NHTSA). The tether secures the top of the car seat so it's installed tightly enough.
5. Securing the chest clip in the wrong spot.
It should cross your child's chest at his armpit level. If it's too low, the straps might slip off; when it's too high, the clip could injure his neck.
Time for a Boost
Once your child outgrows his toddler seat (he's 40 pounds and his head reaches the top of the seat back), he's ready to just use a seat belt, right? Not so fast. Without the extra height and protection from a belt-positioning booster seat, the lap belt may rest across his stomach instead of his hips -- causing serious organ damage in an accident -- and the shoulder belt may be too close to his face or neck. That's why older kids need to ride in a booster until they fit a seat belt properly (usually when they're about 4'9" and weigh 80 to 100 pounds). Your child may not want to stay in a safety seat that long, but don't cave: Riding in a booster seat reduces his risk of injury in a crash by 59 percent compared with using a seat belt alone.
Boosters are available in two styles: highback and backless. If your car's seat back is lower than the middle of your child's ear, go with a high-back booster so she'll have adequate head support. Otherwise, using a backless booster is fine.
1. Giving up the booster too soon.
NHTSA surveys show that only 37 percent of children ages 4 to 7 were riding in a booster seat in 2007. Most states have booster-seat laws (which parents often ignore), but many only cover kids up to age 7.
2. Using the lap belt only.
If you skip the shoulder belt, your child's upper body could jerk forward so violently in a crash that her head may strike her knees or she may suffer severe internal injuries.
Like the convertible model, a combination seat grows with your child. It works as a forward-facing seat and a booster; simply remove the harness straps and use the seat belt instead when he's ready to make the switch. Kids can typically ride forward facing with a harness in a combination seat until they weigh 40 to 65 pounds (depending on the seat model) and without the harness as a booster up to 80 to 100 pounds.
1. Using the harness when your child's too heavy.
Check the manual for the harnessed weight limit. The maximum weight on the box applies to booster-mode.
2. Overlooking the height guidelines.
Your child may get taller before he gets heavier. When the harness straps are no longer above his shoulders or his ears have reached the top of the seat, use the seat as a booster. To see the proper way to install the different kinds of car seats, watch the expert videos at chop.edu/carseat.
Solve Your Seating Dilemmas
Make sure you know the safest ways to seat everyone in these situations.
You have more than one child.
Place the child who needs the most protection -- based on age, size, and health -- in the center, explains Laura Jana, MD, a certified passenger-safety technician in Omaha. "But if a car seat can't be safely secured in the middle seat of your vehicle, no one should sit there."
The kids outnumber your back seats.
In 13 states, it's illegal to put a child in the front seat (see the list at iihs.org/laws/childrestraint.aspx). If you have absolutely no choice, slide the passenger seat as far from the airbag as possible and buckle the forward-facing child whose seat has the most upper-body restraint in front. This may not be the oldest child: "A 3-year-old in a harnessed car seat will be farther from the airbag -- and safer -- than a 6-year-old in a booster, which allows more upper-body movement," says Walker. You should never put a child in a rear-facing seat in the front because the seat can't withstand the impact of an airbag.
Your kids fight when they're next to each other.
Put them in the window seats. They'll be safer than if they distract you while you're driving.
More About Car Seats
What About Side-Impact Protection?
Some car seats come equipped with a variety of features (retractable cup holders! ultra-plush padding!) that you -- and your wallet -- can do without. But should you choose a seat with side-impact protection? Unfortunately, there's no official recommendation, since the NHTSA has yet to develop a side-impact standard for car seats. (The premium side-impact seats are made in Europe, where the manufacturers conduct their own safety tests.)
The NHTSA has been working on guidelines that include side-impact protection since 2000. "This is a top priority at the agency, but the issue is deceptively complex and there are a number of challenges," says NHTSA spokesperson Rae Tyson. One reason for the holdup: Experts have to design a child-size dummy that can measure side-impact energy before they begin collision tests.
Until a standard is in place, many experts still say it's best to look for a car seat that offers side-impact protection. "The deep side wings, made of energy-absorbent foam, along the head and body of the seat, as well as the adjustable headrest could go a long way toward protecting your child," explains Dr. Jana.
Get a Second Opinion
Even if you think you've aced the installation of your child's car seat, let a certified child-passenger safety-seat inspector make sure you haven't made any errors. To find an inspection spot near you, go to seatcheck.org or call the Department of Transportation's hotline at 888-327-4236.
Originally published in the April 2009 issue of Parents magazine.