The Unexpected Danger in Leaving Infants in Car Seats Too Long

See why researchers suggest that a long road trip could be hazardous for your baby.

car seat buckle
Photo: Odua Images/Shutterstock

Are you planning a long car ride—perhaps a road trip when you travel over the holidays? If so, you might want to consider a 2016 pilot study published in the Archives of Disease in Childhood - Fetal and Neonatal Edition that found dangers associated with keeping an infant in a car seat for too long.

According to the study's authors, having your infant in the upright position created in a car seat for an extended period of time could increase the risk of suffocation.

Read on to learn about the risks of extended car seat use and how you can lower the risk when you travel.

The Risks of Extended Car Seat Use

Car seats are an advancement that, overall, keep infants safer while riding in cars. However, when used excessively or outside of use in a car, they can pose risks.

"In very young infants who have underlying cardio-respiratory problems, gastro-esophageal reflux, or who were born very prematurely, the car seat position may not be ideal—but you have to balance this with a mechanism to keep your child safe in a car, which is a potentially dangerous mode of transport that has its own risks. For these infants, a conversation with a physician is advised before planning a long car trip," says David Mathison, M.D., a pediatrician and pediatric emergency physician.


In the pilot study, the researchers used a simulator to mimic the position a child assumes in a rear-facing car seat. They tested 19 healthy newborns who were born at term and 21 newborns who were born preterm. The babies studied had a median age of 13 days and weighed about 2.5 kilograms.

The study's authors reproduced the vibration an infant might face when riding in a car driving at 30 miles per hour. Researchers monitored infants in various positions for 30 minutes in each position.

Researchers found that when infants were placed at 40-degree angles and experienced the vibration caused by a moving car, their respiratory and heart rates increased and oxygen saturation decreased.

The study's findings are worth taking into account—especially for parents of premature infants or babies with underlying health issues, says Dr. Mathison. That's because premature infants' low muscle tone and prominent back of head may make them more prone to neck flexion and airway obstruction, and this may be exacerbated by motion, according to the study's authors.

RELATED: The Best Car Seats for Babies and Toddlers

Sleep-related death

Further studies have found risks with car seats when they are used as devices for sleep. A 2019 study published in Pediatrics evaluated infant deaths in sitting devices. They found that of 11,779 sleep-related deaths, 348 (3%) occurred in sitting devices. Of these, 62.9% were in car seats, the majority of which occurred in non-traveling situations.

The American Academy of Pediatrics (AAP) recommends against placing infants in sitting devices, like car seats, for sleep. However, they say car seats should always be used for travel and infants should be placed in them whether sleeping or awake for traveling only. When you arrive at your destination, if your baby is still asleep, remove them from the car seat and place them in a safe sleep location, like a crib or bassinet.

How to Lower Car Seat Risks

If you do need to travel long distances, take frequent breaks to give your baby time out of the car seat—or consider having family travel to you during the holidays. The American Academy of Pediatrics (AAP) recommends the following for extended car trips with infants:

  • Ensure the car seat is properly installed.
  • Have an adult ride in the back seat to monitor the baby.
  • Take a break every couple of hours to remove your baby from the car seat.
  • Do not use the car seat for use outside of the car.

The Bottom Line

Car seats are a safety device that have saved countless lives when used properly during travel, and you should always use them when your baby rides in a car. But, be aware that car seats can pose risks when used for extended periods. So, keep rides short if possible, and take frequent breaks when you travel.

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