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Scott Beck
/ Categories: Pediatrics

Keep Your Children Safe in Car Seats and Bicycle Helmets

Brittany Kaiser

Brittany Kaiser is the Community Education Instructor for Safety Stop at Progress West Hospital.  To schedule a free Safety Stop appointment, call 636.344.KIDS or toll-free 800.678.KIDS and press 3. 

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To schedule a free Safety Stop appointment, call 636.344.KIDS or toll-free 800.678.KIDS and press 3. 

How long should a child be rear-facing in their car seat?

A child should stay rear-facing in their car seat until they are two years old, ideally longer. Children are 5 times safer rear-facing rather than forward facing. What we look at is, in a rear-facing accident, the child’s body will go into a “cannonball position” and that crash will get dispersed throughout their whole body.  In forward-facing kids, it’s getting exerted on certain parts. Forward-facing children will have their head thrown forward – this is why we see 5 times more injuries in children who are forward facing.  Not only are the injuries more common for kids who are forward-facing, but the injuries are far more severe in those crashes. What we’re looking at are neck, spinal cord injuries and brain trauma.

What causes parents to turn their children around too soon is leg space.  Parents get worried about their kids’ legs being cramped and not having enough room. As long as your child is under the height requirement of their car seat, their legs aren’t a concern.  Toddlers joints are fully formed yet, so when they are sitting in positions that look uncomfortable or weird, that’s perfectly fine to them.  Their legs might fold or bend or criss-cross, that’s okay, as long as they are under the height requirement. 

All in all, keep them rear-facing as long as you can, but at a minimum until they’re two years old.

How long does a child need to be in a booster seat?

A child needs to be in a booster seat much longer than people think.  Typically, a child needs to be in a booster seat until they are 10-12 years old. Kids need to be at least 4’9” before they are out of the booster seat.  The reason is so that the seat belt can fit properly on them.  If they are 4’9” and you think they are ready to get out of the booster, there are some things you can look for.

First, you can have them sit in the vehicle without the booster and you want to see their knees bend right at the edge of the seat. Their seat belt shouldn’t be digging into their neck, but it should be setting nicely between the arm and the neck on the shoulder. When you look at their lap belt, it shouldn’t be touching their stomach, but should be setting nice and low on their thigh.

Seat belts aren’t made for kids – they’re made to restrain adults, which is why kids need booster seats for so long. The booster seat helps properly position the seat belt on the child’s body, so it protects them in a crash.  Kids without a booster are 60% more likely to have an injury in a crash.

Why shouldn’t a child wear a coat while riding in their car seat?

Coats and car seats just don’t mix.  What happens is that a child wearing a coat involved in an accident, all of the extra fluff that the child is wearing gets compressed down.  You think your child is nice and snug, but they really aren’t and can actually project out of their car seat during a crash.

If you’re worried about your child getting cold, infants can be dressed in thin layers, or wear a light, thin, fitted fleece jacket.  And once they’re harnessed in, you can always cover them with a blanket.  Just make sure to take things into account, like how hot or cold does your child normally run, how hot or cold is it outside and how warm is your car already?  For older children, after they are strapped in nice and snug, they can put their coats on backwards over their harness, or you can just keep blankets in the car to keep them warm.

How do I know my child is properly restrained in their seat?

It really doesn’t matter if you have the best car seat if you’re not using it right.  The first thing is to make sure you are harnessing your child correctly.  You want to make sure they’re sitting in the right seat.  You can do that by checking the sticker on the side of the car seat.  Check the maximum height and weight is for the child and make sure your child still fits.  You also want to make sure their harness fits nice and snug. If you can pinch any slack when they are sitting in their seat with the harness, it’s too loose.  You also want to make sure the harness is at the right height.  With rear-facing children, the harness should be touching or dipping below their shoulder. With forward-facing children, the harness should touch or be above the shoulder.  Another important thing is the chest clip placement.  It should always be right in between their armpit levels.  The car seat also has to be installed properly.  You can always make an appointment with us at Safety Stop – we’ll be more than happy to check your car seat, make sure you’re installing it correctly and make sure your child is sitting in it properly.  We have four locations – one in O’Fallon at Progress West Hospital, one at St. Louis Children’s Hospital, one at the Magic House and one in West County at St. Louis Children’s Specialty Care Center. They are free, but we do work by appointments.  Call 314-454-KIDS to set up an appointment with us.

Are infant carriers considered car seats?

Yes.  What’s really important with infant carriers is that you are fitting the child properly, but also level.  Babies need to sit at a 45 degree angle so that their airway will stay open while you’re driving.

What are some things to look for to make sure my child’s bike helmet fits?

Bike helmets have an average use of about 5 years.  Your child’s helmet should sit level on their head. You never want to see more than two finger-widths of their forehead exposed.  It’s important that the helmet sits level to properly protect their skull.  The side straps need to come to a Y-shape or a “V” right below their earlobe, and make sure it’s nice and snug.  You should only be able to sneak one finger right under their chin.  It needs to be snug so that if they do fall off their bike, the helmet stays in place and protects their head the way it’s supposed to.

To schedule a free Safety Stop appointment, call 636.344.KIDS or toll-free 800.678.KIDS and press 3. 

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