Choosing and Using Child Restraints
Choosing the "best" car seat for a child
 
updated 06-05-08

What is the best car seat for my child?

Rear-facing vs. front-facing... When should I turn my child's seat to face the front of the car?

How do you protect the larger child? Are booster seats really needed?

What are options for children over 40 pounds?

Is my child big enough for a seat belt?

What if I can't afford to buy a seat?

Are used child restraints okay?

What are recommendations for replacement of crash-involved safety belts and child restraints?

What is the best car seat for my child?
There is no brand that everyone agrees is the "safest" or the "best." The best car seat is one that:

• Provides the most protection for the size and age of your child, and
• Has a harness or harness/shield that can be adjusted to fit correctly and snugly on your child, and
• Fits into your vehicle(s) in the safest seating position(s) in the correct front or rear-facing orientation, and
• Is installed according to the manufacturer's instructions with a tight seat belt that locks and stays locked, and
• Is one that you like, feel comfortable with, and will install and use correctly every time you travel with your child in the car.

Price is not an indicator of safety. Price tends to be more of an indicator of comfort or convenience features. All of the child restraints sold in the United States must be designed and tested according to strict federal safety standards. This means that all models will provide a high level protection in most kinds of crashes when used according to the manufacturer's directions.

Parents need to cautious about using "hand-me-downs" or other older seats. There is no agreement on what is the useful and safe life of a child restraint. It is generally agreed that child restraints older than the "expiration" date set by the manufacturer or more than 10 years old should not be used. In addition, child restraints with missing or damaged parts may not be legal and are unsafe. For more information on using older seats, refer to: Are used child restraints okay?

» The restraint used must be the right type for the size and age of the child:
The major question to ask about any safety seat, new or used, is:  "Is the safety seat the right type and size for the child?" The basic recommendations for which type of restraints to use are as follow:

• Children should face the rear of the vehicle, in either an rear-facing-only (infant) seat or convertible seat, until they are, at a minimum, at least 1 year of age AND weigh AT LEAST 20 pounds. Keeping children rear facing until at least 18-24 months, if possible, is better. According to the American Academy of Pediatrics:
  • Children who weigh 20 lb. before 1 year of age should ride rear facing in a convertible seat or infant seat approved for higher weights until at least 1 year of age.
  • If a child restraint accommodates children rear facing to higher weights, for optimal protection, the child should remain rear facing until reaching the maximum weight for the car safety seat, as long as the top of the head is below the top of the seat back.
• After being turned around to fact the front of the vehicle (over a year in age and over 20 pounds in weight) children should ride in a front-facing restraint with harness until the harness is outgrown. The upper weight limit for most harnesses is 40 pounds, but a few models have harnesses that can be used over 40 pounds.
• Children should switch to a belt-positioning booster seat - used to raise a child up and make the lap and shoulder belts fit correctly - when the front-facing harness seat is outgrown (40 pounds for most models). The child should continue to use the belt-positioning booster until the vehicle's lap and shoulder belt fits correctly.
  • Add-on shoulder belt adjusters are not recommended since they are not covered by any Federal standards and may, in fact, do more harm than good.
  • Never tuck the shoulder belt under the arm or behind the back.
• Options are more limited for children over 40 pounds in vehicles with lap belts only in the rear seat. No booster seats are currently certified for use by children over 40 pounds in positions equipped with just the lap belt. Refer to What are options for children over 40 pounds? for additional information on these options. 
• Children should not be switched to a seat belt until the child is big enough for a correct fit of the belt and is mature enough to sit relatively still. Refer to Is my child big enough for a seat belt? for more information on the use of seat belts for children.

» The restraint used must fit into your vehicle(s) in the safest seating position(s) in the correct front or rear-facing orientation, and must be installed with a tight seat belt that locks and stays locked.
Try the child restraint out in your vehicle to check for the following:

• Will the seat fit into my car in the rear seat (or front seat if there is no rear seat)?
• Do my seat belts or LATCH anchors hold this particular seat tightly in place? Most seat belts will secure most seats, but you need to check to make sure. LATCH may or may not make for a simpler and more secure installation.
• How easy is it to put the automobile safety belt around or through the restraint when putting the seat into the car or installing it with the LATCH attachments?

» The restraint used must have a harness that can be adjusted to fit correctly and snugly on your child
The child must be buckled correctly into the restraint according to the manufacturer's instructions and must fit snugly on the child. Check to make sure that:

• The type of harness or shield is appropriate for the size of the child. Harnesses with shields do not fit small infants well.
• All parts of the harness are present and in good condition, and
• The harness is one that you like, feel comfortable with, and will use correctly every time you travel with your child in the car. Remember that you will need to adjust the harness from day to day when changes in weather lead to the need for heavy coats or jackets one day and lighter clothes the next.

back to questions

Rear-facing vs. front-facing... When should I turn my child's seat to face the front of the car?
Making the decision when to turn a child around from the rear-to the front-facing position can get quite complicated, especially when the instructions for child restraints conflict with advice that is given by child passenger safety advocates. It is important to note that the child restraint manufacturers have specific sizes of crash test dummies to use when testing and certifying their restraints.

The recommendation of the American Academy of Pediatrics is that:

1. Children should face the rear of the vehicle until they are at least 1 year of age and weigh at least 20 lb to decrease the risk of cervical spine injury in the event of a crash. Infants who weigh 20 lb before 1 year of age should ride rear facing in a convertible seat or infant seat approved for higher weights until at least 1 year of age. If a car safety seat accommodates children rear facing to higher weights, for optimal protection, the child should remain rear facing until reaching the maximum weight for the car safety seat, as long as the top of the head is below the top of the seat back.
2. Premature and small infants should not be placed in car safety seats with shields, abdominal pads, or arm rests that could directly contact an infant’s face or neck during an impact and injure the child.
3. For optimal protection, pediatricians should counsel parents of most children (those who weigh more than 12 lb at 4 months of age) to encourage use of a convertible car safety seat that will accommodate them rear facing at higher weights.

   American Academy of Pediatrics, Selecting and Using the Most Appropriate Car Safety Seats for Growing Children: Guidelines for Counseling Parents

The bones and ligaments of an infant's neck need at least until age one to fully develop and become strong enough to handle the forces placed on the neck in the front-facing position. The rear-facing position is the most protective way to ride down a crash because it spreads the forces over the baby's entire back, the strongest part of the body, and supports and cradles the head and neck. Switching an infant to the front-facing position before the neck is fully developed increases the risk of permanent neck and spinal cord injury. Understandably, many parents are anxious to turn the infant in the back seat (the recommended position) from the rear-facing to the front-facing position. It is very important, however, that parents resist the temptation to turn their child around to face the front too soon. 

Rear facing-only seats, those just for infants up to about 20 pounds, must NEVER be used facing the front of the vehicle. If using an rear facing-only infant seat, you will need to switch to a rear-facing convertible seat when the upper weight or height limit for the infant seat is reached and continue to use the rear-facing position of the convertible seat until the child reaches a year in age.

Depending on the specific model, convertible car seats can be turned around from the rear- to the front-facing position at weights ranging from 20 to 30 pounds. Older models of convertible seats had upper weight limits of 20 pounds for the rear-facing position. As of September 1996, new dummies available for testing and changes in federal standards allow seats to be certified for weights of 22 pounds or higher in the rear-facing position. Purchasing one of these "big baby" seats will assure that, at least in most cases, the infant will be within the rear-facing weight limit throughout their entire first year and somewhat beyond. Note that in most cases these seats can be used rear-facing beyond the first birthday. Keeping an infant rear-facing until forced to switch to the front-facing position will provide added protection as long as possible.

back to questions

How do you protect the larger child? Are booster seats really needed?
Many parents are tempted to move a child into a booster seat well before 40 pounds (the minimum size specified by booster seat instructions can be as low as 30 pounds). A restraint with a full harness provides the best protection for a child and most harnesses accommodate children up to 40 pounds. In addition to the protection provided by the harness, full harness restraints can be used in center-rear positions equipped only with lap belts.

Many parents also seem to be in a hurry to switch the child to the seat belt as soon as possible. Wanting to make a switch to a booster seat or a seat belt often happens when another baby is born and the parents want to use the older child's convertible seat for the new baby. Sometimes parents get tired of dealing with the hassles of car seats and sometimes parents give in to their children who want to sit in just the seat belt because "none of my friends have to sit in a baby seat!" Amazing how early peer pressure starts!

Effective as of January 1, 2005, NC law requires that children less than 8 years old and less than 80 pounds be restrained in belt-positioning boosters or some other type of child restraint. In addition to legal requirements, best practice recommendations relating to boosters are that:

• Once turned around facing to the front, children should ride in a front-facing seat with a full harness or harness-shield until it is outgrown, usually at about 40 pounds. Several models can be used with their harnesses over 40 pounds.
• Children should switch to a belt-positioning booster seat when the full harness seat is outgrown and continue riding in the booster seat until the child is older than 8 or weighs more than 80 pounds and both the lap and shoulder belts fit correctly without the booster seat. Refer to What are options for children over 40 pounds? for additional information on booster seats.
• Children should not be switched to seat belts until they are big enough for the belts to fit correctly and they are mature enough to sit reasonably still. Remember that NC law does not allow the use of a lap and shoulder belt until the child is older than 8 or weighs more than 80 pounds. Refer to When is my child big enough for a seat belt?

back to questions

What are options for children over 40 pounds?
Belt-positioning booster seats are the most readily available restraints for children over 40 pounds, especially for vehicles with rear-seat lap and shoulder combination seat belts.

Belt-positioning boosters are used with lap and shoulder combination seat belts to raise children up so that both the lap and shoulder belts fit properly. Belt-positioning boosters CANNOT be used in a position equipped with only a lap belt. Upper weight limits for belt-positioning boosters range from 60 to 100+ pounds. For the most part, the upper weight limits are based on how big of a child can actually fit into the booster base. There are two types of belt-positioning boosters:

• Backless belt-positioning boosters just have the booster base with no back to them. As long as the lap and shoulder belts fit well on the child, a backless booster will work just as well as a high-back booster in a frontal or side impact collision. Backless boosters may not provide the same degree of whiplash protection in a rear-end collision. If the child's head is higher than the vehicle seat back, a high-back booster may give better overall protection.
  
• High-back belt-positioning boosters, as the name implies, have a back to them as well as the booster base. Most models also have shoulder belt adjustment guides on the sides to help keep the shoulder belt off of the neck (but the shoulder belt should not be adjusted any closer to the shoulder than mid-collar bone). Note that some models of child restraints, called combination seats, are used with a full harness up to 40 pounds and then used as a high-back belt-positioning booster for a child over 40 pounds.

A belt-positioning booster provides very good crash protection as long as it makes both the lap and shoulder belts fit correctly on the child AND as long as the child is behaviorally mature enough to stay still and keep the belts properly positioned. Children who outgrow their full harness at a very young age may be better protected in a restraint that can be used with a harness over 40 pounds.

Many older booster seats were "small-shield boosters" that could be used in seating positions with just a lap belt. The small shield on one of these boosters fit over the child's abdomen to eliminate at least some of the problems of poorly fitting lap belts. Most older boosters were small shield boosters since most vehicles only had lap belts in all rear seating positions. Boosters with shields are no longer certified or recommended for children over 40 pounds. Most of the more recent models of shield boosters can be used without the shield for use as a belt-positioning booster with a lap and shoulder combination belt. Check the manufacturer's instructions to be sure this is allowed before doing so.

Seat belts are designed for adults and children should not be switched to seat belts until they are big enough for the belts to fit correctly and they are mature enough to sit reasonably still (but remember that NC law expected to go into effect January 1, 2005 will not allow the use of seat belts for most children until 8 years or 80 pounds). Switching a child to a seat belt that does not fit correctly is illegal in North Carolina and greatly increases the risk of injury.

Options other than the seat belt itself or older shield boosters (no longer certified or recommended for children over 40 pounds) for behaviorally immature children over 40 pounds or for any child over 40 pounds in a lap-belt-only position are very limited.

• There are several models of restraints with harnesses that can be used for children heavier than 40 pounds. For more information on available restraints, see Car Safety Seats: A Guide for Families produced by the American Academy of Pediatrics
  
• E-Z-On Products manufactures several types of harness restraints for children heavier than 40 pounds
  • E-Z-On offers vests that provide additional support by helping hold the wearer upright. This can be especially useful for the person who needs the additional restraint and support because of behavioral or physical disabilities. These vests require extra installation with top tethers or other mounting systems.
  • The Universal Harness is a restraint that supplements a vehicle's lap belt with two straps for upper body restraint. The Universal Harness has a weight range of 66-168 pounds when used without the Ride Ryte booster seat. The Universal Harness requires extra installation since it is anchored to car with a top tether.
    
• The Ride Ryte is a booster seat that can be used in combination with the Universal harness to raise the child up for a better fit of the lap belt and a better view out of the car.

back to questions

When is my child big enough for a seat belt?
Effective as of January 1, 2005, NC law does not allow the use of a lap and shoulder combination seat belt until a child is at least 8 years old or 80 pounds. In addition to the legal requirements, a properly fitted lap belt fits low and snug across the hips and should be at least touching the upper thighs. A properly fitted shoulder belt falls across the collar bone and chest. As a general rule, lap and shoulder belt combinations do not fit children well until they are over about 4' 9" tall. For most children, this will not be until they are about 8 years old and about 80 pounds.

An improperly fitted seat belt, with the shoulder belt placed under the arm or behind the back, is neither legal nor safe for children or adults. Improper use such as this can lead to serious injuries to the head, internal organs, or spine in a crash.

Add-on shoulder belt adjusters are not legal, nor are they recommended, since they are not covered by any Federal standards and may, in fact, do more harm than good.

SafetyBeltSafe U.S.A. has developed a simple "5-Step Test" to see if a child is big enough to ride in a lap and shoulder belt combination:

1. Does the child sit all the way back against the auto seat?
2. Do the child's knees bend comfortably at the edge of the auto seat?
3. Does the belt cross the shoulder between the neck and arm?
4. Is the lap belt as low as possible, touching the thighs?
5. Can the child stay seated like this for the whole trip?

If you answered "no" to any of these questions, your child needs a booster seat to ride safely in the car.

back to questions

What if I can't afford to buy a seat?
There are many low-cost rental or purchase programs available. Check with your doctor's office, hospital or public health clinic for ones nearby. 

Remember, all the seats on the market today provide a high level of protection. Purchasing a lower-cost, "economy" model of infant or convertible Seat does not mean sacrificing protection. Price differences reflect the "extras," like fancy upholstery or convenience features. However, don't substitute a less expensive booster seat for a more expensive convertible model for a child who is under 40 pounds. 

back to questions

Are used child restraints okay?

printable pdf

First, you must decide if the lower cost of a used safety seat is really worth it. Many of the newer child restraints are more convenient and easier to use correctly than older models. An inexpensive but hard-to-use seat may not be a bargain over time. 

If you decide to get a used seat, shop and make your decisions very carefully. In many cases, used seats can be a bargain as well as safe and easy to use. To tell if a used seat is safe or unsafe, make sure that:  It has a label that can be read and that clearly indicates the manufacturer, model number, date of manufacture, and that it met all applicable Federal motor vehicle safety standards in effect at the time of manufacture If there's no label at all or if the label cannot be read, do not use the seat!

• It is no more than ten years old at the oldest. Some advocates and manufacturers suggest not using seats older than 5 or 6 years old.
• It has the instruction booklet or that the manufacturer can send it to you;
• All the parts are included (check in the instruction booklet) or can be obtained from the manufacturer;
• It has never been used in a crash
• It is not under recall or that corrections have been made if it was recalled. Recall information can be obtained through the UNC Highway Safety Research Center (1-800-672-4527 in NC only) or through the National Highway Traffic Safety Administration (1-888-DASH-2-DOT).

If you can't satisfy these requirements, you are taking a big risk by using the seat and the best advice is to not use that seat.

back to questions

Recommendations for replacement of crash-involved safety belts and child restraints

printable pdf

Airbags, safety belts, and child restraints (CRs) are generally considered “one time use” products. After a crash they may need to be replaced. Without a doubt, airbags and pretensioners used with some belt systems must be replaced if they are activated during a crash.

Vehicle manufacturers also recommend that safety belts in use in a crash be replaced except in minor crashes. Some vehicle manufacturers suggest that the safety belts should be inspected by a service technician after any type or severity of collision. Contact your vehicle manufacturer’s Customer Service for their guidelines and recommendations.

Most child restraint manufacturers recommend replacement of their child restraints after any crash. Contact your child restraint manufacturer’s Customer Service for their guidelines and recommendations.

The National Highway Traffic Safety Administration (NHTSA) recommends that a child restraint always be replaced if it is involved in a moderate to severe crash. To determine whether a crash is severe enough to warrant child restraint (CR) replacement, NHTSA advises parents or caregivers to use the following criteria:

In general, automobile collision insurance should cover replacement of airbags, safety belts, and child restraints.

Additional information from NHTSA related to the replacement of child restraints after crashes can be found on the NHTSA web site.

back to questions

<< previous page    next page >>