Trying to figure out when children should move from a convertible or combination car seat to a belt-positioning booster is very confusing. Between the different car seats, vehicle seats and seat belt systems, it is estimated that there are more than 900 different configurations (and that is before you add the child in). Parents want a specific age, weight or height to know when their child is ready to move to the booster seat, but this is next to impossible because of all the variations that exist.
Child restraint and vehicle manufacturers continually work to improve the safety of their products. This is evident when you look at the number of safety seats that now have harness weight limits more than 40 pounds and many now have side impact protection. But it can also make parents confused and frustrated and often make them follow the “path of least resistance” – placing their child in a booster seat before they are ready.
Trauma Injury Prevention/Outreach Coordinator Sharon Evans, RN, BSN, CPN said for best protection, parents should try to keep their child in a five-point harness for as long as possible. This means keeping their child in the harness system until they outgrow the weight and/or height limits of their seat. Then if possible, they may want to look at some of the new seats where the harness can be used up to 65 or 80 pounds.
Many booster seats may be used starting at 30 to 40 pounds, but if the child still fits in a seat with a five-point harness, this will provide better protection. “Today we see 2 and 3 year olds that are 35 to 40 pounds, so parents transition the child over to a booster,” Evans said. “Yes, by weight they meet the requirement, but are they mature enough to set up straight and keep the lap/shoulder belt correctly positioned for the entire ride? Often these younger children will lean and wiggle around and then if they were in a crash, the seat belt may not be properly positioned to protect them.”
Evans wants to educate parents in basic crash dynamics and make them aware of the fact that motor vehicle crashes remain the number one cause of death for children 2 to14 years of age. She said most parents are unaware of the fact that there are three collisions in a crash.
• First collision is the car. If you are traveling at 60 mph and run into a concrete pillar, the car stops.
• Second is the human collision. Everybody and everything in the car continues moving at 60 mph until it hits something. Hopefully, this is your seat belt or the harness of the child restraint and not the windshield, dashboard or the pavement.
• Third is the internal collision. All the organs in your body are still moving at 60 mph until they hit something. Your brain is hitting inside your skull, your heart and lungs hit into your rib cage and so on. Consider this: A car traveling 40 mph and hitting a tree has the same force as hitting the ground after falling off a 50-foot cliff. The passengers in the car would hit the windshield with the same force as if they fell from a five-story building.
Another helpful tool to explain crash forces to parents is to show that the force needed to restrain a passenger roughly equals the weight of the passenger, times the pre-crash speed of the vehicle. Therefore, a 30-pound toddler in a car going 30 mph would require at least 900 pounds of force to keep them from moving forward. (Weight X speed=restraining force).
Booster seats fill a vital step in child passenger safety. Boosters are for children who have outgrown the child safety seats with a harness but are still too small to fit into the seat belt system. Boosters help “boost” the child up so that the seat belt system fits them correctly. Most boosters have a weight range of starting at 30 to 40 pounds up to 80 to 100 pounds. The National Highway Traffic Safety Administration (NHTSA), the American Academy of Pediatrics, and Safe Kids Worldwide all recommend that children be at least 4 feet, 9 inches (57 inches) before using the seat belt system. “The main point is that parents should follow the five-step test to make sure the seat belt system properly fits their child,” Evans said. “Because of all the different seat belt systems and vehicle seats, children may fit properly in one vehicle but still need a booster to properly fit in the seat belt system in another vehicle.”
Here is the five-step test to see if the seat belt system properly fits your child:
• Can they sit with their hips and back against the vehicle seat back without slouching?
• Do their knees bend comfortably at the front edge of the vehicle seat?
• Are their feet flat on the floorboard?
• Does the lap belt fit low and snug across the lower hips and the shoulder belt come across the middle of their chest and shoulder?
• Can they stay in this position for the ENTIRE ride?
If you can answer “no” to any of these questions, then your child still needs to use a booster seat.
“Parents want to protect their children and do the best they can with the information they are given,” Evans said. “Unfortunately, protecting your child in the vehicle can be frustrating due to all the variables you encounter.”
Evans reminds parents to always read both the vehicle owner’s manual and the child safety seat manual and follow the instructions. For more information, questions or concerns about your car seat, contact one of Cook Children’s certified child passenger safety technicians at 682-885-2634.
