How long does child have to sit in car seat

Car Seats: Information for Families

One of the most important jobs you have as a parent is keeping your child safe when your child is riding in a vehicle.

Each year, thousands of young children are killed or injured in car crashes. Proper use of car safety seats helps keep children safe. But, because so many different seats are on the market, many parents find this overwhelming. If you are expectant parents, consider working with a certified passenger safety technician (CPST or CPS technician), before your baby is born, to ensure a safe ride home from the hospital.

The type of seat your child needs depends on several things, including your child's age, size, and developmental needs. Here is more information from the American Academy of Pediatrics (AAP) about choosing the most appropriate car safety seat for your child.

Visit here for a listing of car seats & car seat manufacturers.

Types of car seats at a glance:

This chart is a quick guide on where to start your search. It's important to continue your research to learn about each seat you use.

Age-group	Type of Seat	General Guidelines
Infants and toddlers		All infants and toddlers should ride in a rear-facing seat until they reach the highest weight or height allowed by their car safety seat manufacturer. Most convertible seats have limits that will allow children to ride rear facing for 2 years or more.
Toddlers and preschoolers		Children who have outgrown the rear-facing weight or height limit for their convertible seat should use a forward-facing seat with a harness for as long as possible, up to the highest weight or height allowed by their car safety seat manufacturer. Many seats can accommodate children up to 65 pounds or more.
School-aged children	Booster	All children whose weight or height exceeds the forward-facing limit for their car safety seat should use a belt-positioning booster seat until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches in height and are 8 to 12 years of age. All children younger than 13 years should ride in the back seat.
Older children	Seat belts	When children are old enough and large enough for the vehicle seat belt to fit them correctly, they should always use lap and shoulder seat belts for the best protection. All children younger than 13 years should ride in the back seat.

Car safety seats may be installed with either the vehicle's seat belt or its LATCH (lower anchors and tethers for children) system. LATCH is an attachment system for car safety seats. Lower anchors can be used instead of the seat belt to install the seat, and many parents find them easier to use in some cars. The top tether should always be used with a forward-facing seat, whether you use the seat belt or lower anchors to secure it. The seat belt and LATCH systems are equally safe, so caregivers should use one or the other, whichever works best for them, for their car safety seat, and their vehicle. In general, caregivers should only use 1 of the 2 options unless the car safety seat and vehicle manufacturers say it is OK to use 2 systems at the same time.

Vehicles with the LATCH system have lower anchors located in the back seat, where the seat cushions meet. Tether anchors are located behind the seat, either on the panel behind the seat (in sedans) or on the back of the seat, ceiling, or floor (in most minivans, SUVs, hatchbacks, and pickup trucks). All forward-facing car safety seats have tethers or tether connectors that fasten to these anchors. Nearly all passenger vehicles and all car safety seats made on or after September 1, 2002, are equipped to use LATCH. See vehicle owner's manual for highest weight of child allowed to use top tether.

All lower anchors are rated for a maximum weight of 65 pounds (total weight includes car safety seat and child). Parents should check the car safety seat manufacturer's recommendations for maximum weight a child can be to use lower anchors. New car safety seats have the maximum weight printed on their label.

NOTE: Seat belts—If you install a car safety seat by using your vehicle's seat belt, you must make sure the seat belt locks to hold the seat tightly. In most newer cars, you can lock the seat belt by pulling it all the way out and then allowing it to retract to keep the seat belt tight around the car safety seat. In addition, many car safety seats have built-in lock-offs so you can lock the belt without having to lock the seat belt separately as well. Refer to the vehicle owner's manual for details about how your seat belt locks.

Middle of the back seat—The safest place to ride for all children younger than 13 years is the back seat. If possible, it may be best for the child to ride in the middle of the back seat. However, it is sometimes difficult to install a car safety seat tightly in the middle if the vehicle seat is narrow or uneven. Also, many vehicles do not have lower anchors for the middle seating position. It is safest to put the car safety seat in a position where you can install it tightly with either the lower anchor system or the seat belt; in some cases, this position may be on either side of the back seat rather than in the middle. A child passenger safety technician (CPST or CPS technician) can help you decide which place is best to install your child's car safety seat in your vehicle.

The AAP recommends that all infants ride rear facing starting with their first ride home from the hospital. All infants and toddlers should ride in a rear-facing seat as long as possible until they reach the highest weight or height allowed by their car safety seat manufacturer. Most convertible seats have limits that will allow children to ride rear facing for 2 years or more. When infants outgrow their rear-facing–only seat, a convertible seat installed rear facing is needed. All parents can benefit from getting installation help from a CPST to ensure that their child's seat is properly installed.

Types of rear-facing seats

Three types of rear-facing seats are available: rear-facing–only, convertible, and all-in-one. When children reach the highest weight or length allowed by the manufacturer of their rear-facing–only seat, they should continue to ride rear facing in a convertible or all-in-one seat.

Rear-facing–only seats

Are used for infants up to 22 to 35 pounds and 26 to 35 inches, depending on the model.
Are small and have carrying handles.
Usually come with a base that can be left in the car. The seat clicks into and out of the base so you don't have to install the seat each time you use it. Parents can buy more than one base for additional vehicles.
Should be used only for a child's travel (not sleeping, feeding, or any other use outside the vehicle).

Convertible seats (used rear facing)

Can be used rear facing and, later, "converted" to forward facing for older children when they outgrow either the weight limit or the length limit for rear facing. This means the seat can be used longer by your child. Convertible seats are bulkier than infant seats, however, and they do not come with carrying handles or separate bases and are designed to stay in the car.
Many have higher limits in rear-facing weight (up to 40–50 pounds) and height than those of rear-facing– only seats, a feature that makes convertible seats ideal for bigger babies and toddlers.
Have a 5-point harness that attaches at the shoulders, at the hips, and between the legs.
Should be used only for a child's travel (not sleeping, feeding, or any other use outside the vehicle).

All-in-one seats (used rear facing)

Can be used rear facing, forward facing, or as a belt- positioning booster. This means the seat may be used longer by your child as your child grows.
Are often bigger in size, so it is important to check that they fit in the vehicle while they are rear facing.
Do not have the convenience of a carrying handle or separate base; however, they may have higher limits in rear-facing weight (up to 40–50 pounds) and height than those of rear-facing–only seats, a feature that makes all-in-one seats ideal for bigger babies and toddlers.

Installation tips for rear-facing seats

Always read the vehicle owner's manual and the car safety seat manual before installing the seat.

When using a rear-facing seat, keep the following tips in mind:

Place the harnesses in your rear-facing seat in slots that are at or below your child's shoulders.
Ensure that the harness is snug (you cannot pinch any slack between your fingers when testing the harness straps over the child's shoulders) and that the chest clip is placed at the center of the chest, even with your child's armpits.
Make sure the car safety seat is installed tightly in the vehicle with either lower anchors or a locked seat belt. Many car safety seats have an integrated lock-off system to keep the seat belt locked. If your seat has one, follow the manufacturer's recommendations on how to use it. If you can move the seat at the belt path more than an inch side to side or front to back, it's not tight enough.
Never place a rear-facing seat in the front seat of a vehicle that has an active front passenger airbag. If the airbag inflates, it will hit the back of the car safety seat, right against your child's head, and could cause serious injury or death.
If you are using a convertible or all-in-one seat in the rear-facing position, make sure the seat belt or lower anchor webbing is routed through the correct belt path. Check the instructions that came with the car safety seat to be sure.
Make sure the seat is at the correct angle so your child's head does not flop forward. Check the instructions to find out the correct angle for your seat and how to adjust the angle if needed. All rear-facing seats have built-in recline indicators.
Check the car safety seat instructions and vehicle owner's manual about whether the car safety seat may contact the back of the vehicle seat in front of it.
Still having trouble? Check with a certified CPST in your area who can help.

Common questions

What if my child's feet touch the back of the vehicle seat?

What do I do if my child slouches down or to the side in the car seat?

You can try placing a tightly rolled receiving blanket on both sides of your child. Many manufacturers allow the use of a tightly rolled small diaper or cloth between the crotch strap and your child, if necessary, to prevent slouching. Do not place padding under or behind your child or use any sort of car safety seat insert unless it came with the seat or was made by the manufacturer for use with that specific seat.

Why should I dress my child in thinner layers of clothing before strapping them into a car safety seat?

Bulky clothing, including winter coats and snowsuits, can compress in a crash and leave the straps too loose to restrain your child, leading to increased risk of injury. Ideally, dress your baby in thinner layers and wrap a coat or blanket around your baby over the buckled harness straps if needed. See Winter Car Seat Safety Tips from the AAP.

Do preemies need a special car seat?

A car safety seat should be approved for a baby's weight. Very small babies who can sit safely in a semi-reclined position usually fit better in rear-facing–only seats. Babies born preterm should be screened while still in the hospital to make sure they can sit safely in a semi-reclined position. Babies who need to lie flat during travel may be able to ride in a car bed that meets Federal Motor Vehicle Safety Standard 213. They should be screened again while in the hospital to make sure they can lie safely in the car bed.

Always read the vehicle owner's manual and the car safety seat manual before installing the seat.

Any child who has outgrown the rear-facing weight or height limit for her convertible seat should use a forward- facing seat with a harness for as long as possible, up to the highest weight or height allowed by her car safety seat manufacturer. It is best for children to ride in a seat with a harness as long as possible, at least to 4 years of age. If your child outgrows a seat before reaching 4 years of age, consider using a seat with a harness approved for higher weights and heights.

Types of Forward-Facing Car Seat Restraints

Four types of car safety restraints can be used forward facing:

Convertible seats: Seats can "convert" from rear facing to forward facing. These include all-in-one seats.
Combination seats with harness: Seats can be used forward facing with a harness for children who weigh up to 40 to 65 pounds (depending on the model) or without the harness as a booster (up to 100–120 pounds, depending on the model).
Integrated seats: Some vehicles come with built-in forward-facing seats. Weight and height limits vary. Do not use a built-in seat until your child has reached the highest weight or height allowed for your rear-facing convertible car safety seat. Read your vehicle owner's manual for details about how to use these seats.
Travel vests: Vests can be worn by children 22 to 168 pounds and can be an option to traditional forward- facing seats. They are useful for when a vehicle has lap-only seat belts in the rear, for children with certain special needs, or for children whose weight has exceeded that allowed by car safety seats. These vests usually require use of a top tether.

Installation tips for forward-facing seats

Always read the vehicle owner's manual and the car safety seat manual before installing the seat.

It is important that the car safety seat is installed tightly in the vehicle and that the harness fits your child snugly.

To switch a convertible or all-in-one seat from rear-facing to forward-facing:

Move the harness shoulder straps to the slots or position that is at or just above your child's shoulders. Check the instructions that came with the seat to be sure you are positioning the shoulder straps correctly.
You may have to adjust the recline angle of the seat so that it sits more upright in your vehicle. Check the instructions to be sure.
If using a seat belt, make sure it runs through the forward-facing belt path (be sure to follow car safety seat instructions) and that the seat belt is locked and tightened. Many car safety seats have an integrated lock-off to keep the seat belt locked. If your seat has one, follow the manufacturer's recommendations on how to use it.
If using the lower anchors, make sure that the weight of your child plus the weight of the seat does not exceed 65 pounds. Most seats now state in the manual and on the stickers on the side the maximum child weight to use the anchors. If the child weighs too much, caregivers must use the seat belt to install.
Always use the tether when you can. A tether is a strap that is attached to the top part of a car safety seat and holds the seat tightly by connecting to an anchor point in your vehicle (often on the seat back or rear shelf; see your vehicle owner's manual to find where tether anchors are in your vehicle). Tethers give important extra protection by keeping the car safety seat and your child's head from moving too far forward in a crash or sudden stop. All new cars, minivans, and light trucks are required to have tether anchors as of September 2000. Forward-facing seats come with tether straps. A tether should always be used as long as your child has not reached the top weight limit for the tether anchor. Check the car safety seat instructions and vehicle owner's manual for information about the top weight limit and locations of tether anchors.
Watch the Video: How to Install a Forward-Facing Car Seat

Common question

What if I drive more children than those who can be buckled safely in the back seat?

It's best to avoid this, especially if your vehicle has airbags in the front seat. All children younger than 13 years should ride in the back seat. If absolutely necessary, a child in a forward-facing seat with a harness may be the best choice to ride in front. Just be sure the vehicle seat is moved as far back away from the dashboard (and airbag) as possible.

Booster seats are for older children who have outgrown their forward-facing seats. All children whose weight or height exceeds the forward-facing limit for their car safety seat should use a belt-positioning booster seat until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches in height and are 8 to 12 years of age. Most children will not fit in most vehicle seat belts without a booster until 10 to 12 years of age. All children younger than 13 years should ride in the back seat. Instructions that come with your car safety seat will tell you the height and weight limits for the seat. As a general guideline, a child has outgrown a forward-facing seat when any of the following situations is true:

They reach the top weight or height allowed for his seat with a harness. (These limits are listed on the seat and in the instruction manual.)
Their shoulders are above the top harness slots.
The tops of their ears have reached the top of the seat.

Types of booster seats

High-back and backless are 2 standard types of booster seats. They do not come with a harness but are used with lap and shoulder seat belts in your vehicle, the same way an adult rides. They are designed to raise a child up so that lap and shoulder seat belts fit properly over the strongest parts of the child's body.

Most booster seats are not secured to the vehicle seat with the seat belt or lower anchors and tether but simply rest on the vehicle seat and are held in place once the seat belt is fastened over a child. However, some models of booster seats can be secured to the vehicle seat and kept in place by using the lower anchors and tether along with lap and shoulder belts. (Currently, only a few vehicle manufacturers offer integrated booster seats.)

Installation tips for booster seats

When using a booster seat, always read the vehicle owner's manual and the car safety seat manual before installing the seat. Booster seats often have a plastic clip or guide to correctly position vehicle lap and shoulder belts. See the booster seat instruction manual for directions on how to use the clip or guide. Booster seats must be used with lap and shoulder belts. When using a booster seat, make sure:

The lap belt lies low and snug across your child's upper thighs.
The shoulder belt crosses the middle of your child's chest and shoulder and is off the neck.
Watch the video: How to Use a Booster Seat

If your booster seat has lower anchors or tether attachments, check its manual for installation instructions.

Common questions about booster seats

What if my car has only lap belts in the back seat?

Lap belts work fine with rear-facing–only, convertible, and forward-facing seats that h av e a harness but can never be used with a booster seat. If your car has only lap belts, use a forward-facing seat that has a harness and higher weight limits. You could also

Check to see if shoulder belts can be installed in your vehicle.
Use a travel vest (check the manufacturer's instructions about the use of lap belts only and about the use of lap and shoulder belts).
Consider buying another car with lap and shoulder belts in the back seat.

What is the difference between high-back boosters and backless boosters?

Both types of boosters are designed to raise your child so seat belts fit properly, and both will reduce your child's risk of injury in a crash. High-back boosters should be used in vehicles without headrests or with low seat backs. Many seats that look like high-back boosters are actually combination seats. They come with harnesses that can be used for smaller children and, later, removed for older children. Backless boosters are usually less expensive and are easier to move from one vehicle to another. Backless boosters can be used safely in vehicles with headrests and high seat backs.

Seat belts are made for adults. Children should stay in a booster seat until adult seat belts fit correctly, typically when children reach about 4 feet 9 inches in height and are 8 to 12 years of age. Most children will not fit in a seat belt alone until 10 to 12 years of age. When children are old enough and large enough to use the vehicle seat belt alone, they should always use lap and shoulder seat belts for the best protection. All children younger than 13 years should ride in the back seat.

Using a seat belt:

An adult seat belt fits correctly when:

The shoulder belt lies across the middle of the chest and shoulder, not the neck or throat.
The lap belt is low and snug across the upper thighs, not the belly.
Your child is tall enough to sit against the vehicle seat back with her knees bent over the edge of the seat without slouching and can comfortably stay in this position throughout the trip.

Other points to keep in mind when using seat belts include:

Make sure your child does not tuck the shoulder belt under her arm or behind her back. This leaves the upper body unprotected and adds extra slack to the seat belt system, putting your child at risk of severe injury in a crash or with sudden braking.
Never allow anyone to "share" seat belts. All passengers must have their own car safety seats or seat belts.

Common question

I've seen products that say they can help make the seat belt fit better. Should we get one of these?

No, these products are unapproved and should not be used. They may actually interfere with proper seat belt fit by causing the lap belt to ride too high on the stomach or making the shoulder belt too loose. They can even damage the seat belt. This rule applies to car safety seats too; do not use extra products unless they came with the seat or are specifically approved by the seat manufacturer. These products are not covered by any federal safety standards, and the AAP does not recommend they be used. As long as children are riding in the correct restraint for their size, they should not need to use additional devices.

When shopping for a car seat, keep the following tips in mind:

No one seat is the "best" or "safest. " The best seat is the one that fits your child's size, is correctly installed, fits well in your vehicle, and is used properly every time you drive.
Don't decide by price alone. A higher price does not mean the seat is safer or easier to use.
Avoid used seats if you don't know the seat's history.
Watch the Video: What to Look For When Purchasing a Car Seat

Never use a car seat that:

Is too old. Look on the label for the date the seat was made. Check with the manufacturer to find out how long it recommends using the seat.
Has any visible cracks on it.
Does not have a label with the date of manufacture and model number. Without these, you cannot check to see if the seat has been recalled.
Does not come with instructions. You need them to know how to use the seat. Instructions can be found on manufacturer websites or by contacting the manufacturer.
Is missing parts. Used car safety seats often come without important parts. Check with the manufacturer to make sure you can get the right parts.
Was recalled. You can find out by calling the manufacturer or contacting the National Highway Traffic Safety Administration (NHTSA) Vehicle Safety Hotline at 888/327-4236. You can also visit the NHTSA Website.
Do not use seats that have been in a moderate or severe crash. Seats that were in a minor crash may still be safe to use, but some car safety seat manufacturers recommend replacing the seat after any crash, even a minor one. The NHTSA considers a crash minor if all the following situations are true:

The vehicle could be driven away from the crash.
The vehicle door closest to the car safety seat was not damaged.
No one in the vehicle was injured.
The airbags did not go off.
You can't see any damage to the car safety seat.

If you have specific questions about the car seat, contact the manufacturer.

Front airbags are installed in all new cars. When used with seat belts, airbags work well to protect teenagers and adults; however, airbags can be very dangerous to children, particularly to those riding in rear-facing seats and to preschoolers and young school-aged children who are not properly restrained. If your vehicle has a front passenger airbag, infants in rear-facing seats must ride in the back seat. Even in a relatively low-speed crash, the airbag can inflate, strike the car safety seat, and cause serious brain injury and death.

Vehicles with no back seat or a back seat that is not made for passengers are not the best choice for traveling with small children; however, the airbag can be turned off in some of these vehicles if the front seat is needed for a child passenger. See your vehicle owner's manual for more information.

Side airbags are available in most new cars. Side airbags improve safety for adults in side-impact crashes. Read your vehicle owner's manual for more information about the airbags in your vehicle. Read your car safety seat instructions and the vehicle owner's manual for guidance on placing the seat next to a side airbag.

About carpooling

If your child is being driven by someone else, make sure:

The car safety seat your child will be using fits properly in the vehicle used for transport.
The car safety seat being used is appropriate for the age and size of your child.
The person in charge of transporting your child knows how to install and use the car safety seat correctly.

Child care programs and schools should have written guidelines for transporting children, including

All drivers must have a valid driver's license. In some states, school bus drivers need to have a special type of license.
Staff to child ratios for transport should meet or exceed those required for the classroom.
Every child should be supervised during transport, either by school staff or a parent volunteer, so the driver can focus on driving.
School staff, teachers, and drivers should know what to do in an emergency, know how to properly use car safety seats and seat belts, and be aware of other safety requirements.

About car safety seats on airplanes

The Federal Aviation Administration (FAA) and the AAP recommend that children less than 40 pounds be securely fastened in certified child restraints when flying. This will help keep them safe during takeoff and landing or in case of turbulence. Most rear-facing, convertible, and forward-facing seats can be used on airplanes , but booster seats and travel vests cannot.

Read your seat's instruction manual and look for a label on the car safety seat that says, "This restraint is certified for use in motor vehicles and aircraft. " You can also consider using a restraint made only for use on airplanes and approved by the FAA. Larger children may use the airplane seat belt or continue to use their car safety seat on the airplane as long as it is labeled for use on aircraft and the child has not exceeded the seat's weight or height limit. Remember that your child will need an appropriate car safety seat to use at your destination. For more information, visit the FAA Website or the CARES (Airplane Safety Harness for Children) Website.

If you need installation help

If you have questions or need help with installing your car safety seat, find a certified child passenger safety technician (CPST or CPS technician). Lists of certified CPSTs and child seat–fitting stations are available on the following websites:

National Child Passenger Safety Certification (Click on "Find a Tech" or call 877-366-8154.) – Includes list of CPSTs fluent in Spanish and other languages or with extra training in transportation of children with special needs.
NHTSA Parents & Caregivers

Important reminders

Be a good role model. Make sure you always wear your seat belt. This will help your child form a lifelong habit of buckling up.

Make sure that everyone who transports your child uses the correct car safety seat or seat belt on every trip, every time. Being consistent with car safety seat use is good parenting, reduces fussing and complaints, and is safest for your child.

Never leave your child alone in or around cars, and lock your vehicle when it is not in use. Any of the following situations can happen when a child is left alone in or around a vehicle. A child can

Die of heatstroke because temperatures can reach deadly levels in minutes.
Be strangled by power windows, retracting seat belts, sunroofs, or accessories.
Knock the vehicle into gear, setting it into motion.
Be backed over when the vehicle backs up.
Become trapped in the trunk of the vehicle.

Always read and follow the manufacturer's instructions for your car safety seat. If you do not have those, write or call the company's customer service department. Staff will ask you for the model number, name of seat, and date of manufacture. The manufacturer's address and phone number are on a label on the seat. Also, be sure to follow the instructions in your vehicle owner's manual about using car safety seats. Some manufacturers' instructions may be available on their websites.

Remember to fill out and mail in the registration card that comes with the car safety seat. You can also register your seat on the manufacturer's website. It will be important in case the seat is recalled.

Follow manufacturer directions for cleaning car seats. Cleaning but not disinfecting is usually permitted. That's because disinfectant products may decrease the protection provided by the seat and harness.

More information

Ask the Pediatrician: Is it safe for my baby to travel in a car seat a few hours at a time?
Car Seats: Product Listing
Car Seat Checkup
Car Seats and Obese Children: Suggestions for Parents
Prevent Child Deaths in Hot Cars
Travel Safety During COVID-1 9

_{Although the AAP is not a testing or standard-setting organization, this article sets forth the AAP recommendations based on the peer-reviewed literature available at the time of its publication and sets forth some of the factors that parents should consider before selecting and using a car seat.}

_{Figure 1 adapted from US Department of Transportation, National Highway Traffic Safety Administration (NHTSA). LATCH Makes Child Safety Seat Installation as Easy as 1-2-3. Washington, DC: NHTSA; 2011. DOT HS publication 809 489.}

_{Figure 4 from Bull MJ, Engle WA; American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention and Committee on Fetus and Newborn. Safe transportation of preterm and low birth weight infants at hospital discharge.}_Pediatrics_{. 2009;123(5):1424–1429.}

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Child car seat sleeping - how to keep your baby safe

Car seats are, on the whole, very secure, essential pieces of baby gear, for keeping our children safe when travelling in a vehicle.

But only when they're used correctly. And sadly, car seats and, by extension travel systems, are sometimes used for too long or for general sleeping, leading to some devastating consequences.

Between 2004 and 2008, a total of 31 children under the age of 2 died due to suffocation or strangulation while sitting in a car seat for extended periods of time, according to a 2015 study published in the Journal of Pediatrics.

The Penn State Medical Centre report says children as young as 1 month had either suffocated or been strangled by the straps of their car seats. In the image above, you can see how a small baby can easily wriggle out of car seat straps if they're not tightened correctly.

What the research says:

A study (October 2016) funded by the Lullaby Trust and conducted by an NHS Foundation Trust and University of Southampton, has also recommended parents do not keep infants or babies in car seats for long periods of time.

That's because as well as being in a scrunched position, the movement of the car while travelling also has an impact on babies while in car seats. Previously, safety tests did not take into account the angle a seat will take while in a car or the vibrations of the seat while in motion.

More like this

Using a motion simulator (and 40 babies in the car seats) they replicated a 30mph car journey to reproduce vertical vibration - similar to that at the base of a car safety seat in a rear-facing position in the back of a small family car.

The study revealed that movement and an upright position of 40 degrees, significantly increased heart and respiratory rates, and decreased oxygen saturation, leading to an “increase in potentially clinically significant oxygen desaturations.”

Of course the experts aren’t saying we should ditch car seats, but they are once again warning against keeping babies in a car seat for too long, especially while sleeping.

“Parents should not stop using car safety seats to transport their infants. Infants must be protected in moving vehicles, and UK law requires car seats be used whenever infants travel in cars,” says consultant Paediatrician of the Great Western Hospitals NHS Foundation Trust, Dr Renu Arya.

“However, our findings support the AAP (American Academy of Paediatrics’) guideline that infant car seats should not be used as a routine infant sleep environment. ”

It's important not to get over-anxious about your baby sitting in a car seat. These are still small numbers. The key message is that car seats are for travelling, cribs and cots are for sleeping. It's really about knowing the safety advice.

Does it effects newborn infants differently?

Reports (some worrying) in the mainstream media questioned whether newborn babies are safe if they sit in a car seat for just 30 minutes.

The research (November 2016) carried out by researchers at Swindon's Great Western Hospital, the University of Southampton and the University of Bristol and commissioned by the Lullaby Trust found that when newborn or premature babies sat in a car seat for 30 minutes, their heart and breathing rate increased, and their blood oxygen levels were lower compared with lying flat in a cot.

This happened when the babies were both stationary in the car seat and 'moving' in the car simulator and these effects were more marked with premature babies but still seen with term babies.

Here's the full story

The two hour 'rule'

The '2 hour rule' is the established safety recommendation endorsed by safety experts and manufacturers, that suggests children shouldn't sit in a car seat for more than 2 hours at a time. That's not only when your baby's in a car but also when they're in a travel system (pictured above) - a buggy chassis with a car seat attached.

The reason, as we explained above, is that babies and very young children can experience breathing problems if placed in a seated or scrunched position for too long.

“Car seats are desperately important to save lives from car accidents. However, families should not leave babies in car seats for long periods or once they are removed from the car,” explains Justin Daniels from the Lullaby Trust.

“Small babies do not have the ability to support their heads and this study shows being upright in a seat is a risky position for a long period of time.”

The safest way for babies to sleep is on their backs - as recommended by the experts at the Lullaby Trust.

It's best if they are on a firm, flat, waterproof mattress in a separate cot or Moses basket for at least the first 6 months.This is because your baby’s ability to keep their head held up is not fully developed, meaning their head can flop down and restrict the airways.

Read: How to stop your child wriggling out of car seat straps

So to keep your baby safe:

Ensure your baby is not sitting for more than a couple of hours in the same upright position
Don't use a car seat as an alternative to a cot or crib - as a regular place to sleep (although obviously don't worry if your baby falls asleep in your car, as most babies do! You just don't want them sleeping for more than two hours in the same position)
If you're travelling on a long car journey, stop for a little bit and take your baby out of the car seat
If you're using a travel system, don't keep your baby in the car seat for more than the two hours. If you know your baby is going to be in the travel system for a longer period, use a carrycot or lie-flat seat rather than the car seat

Lie-flat car seats

There are two types of car seats that can help solve this issue:

A converting lie-flat car seat - such as the Jane Matrix 2 (pictured above) or the Kiddy Evo-Lunafix, is a car seat that will keep your baby upright in the car, but then can be converted to a lie-flat position on a travel system or at home.

A permanent lie-flat car seat/carrycot - such as the Britax Baby Safe Sleeper or the Jane Transporter 2, lets your baby lie flat in the car and is also a carrycot suitable for overnight sleeping

Read: Why your newborn needs a lie-flat buggy

Read: 6 of the best lie-flat car seats from birth

Beware with slings, bouncers, swings and buggies too

It isn’t only car seats posing a small risk to sleeping children, according to the report.

In total, 47 deaths were recorded, with 31 occurring in car seats, 5 in slings, 4 each in swings and bouncers, and 3 in buggies.

These findings mirror an older study published in the British Medical Journal back in 2006.

That report warned parents against keeping babies in car seats unchecked, particularly when not travelling, following the deaths of 9 children. But of these, 8 children died while sleeping in a car seat at home and only one baby died while in a seat as the car was being driven.

Both reports have warned parents against using car seats, travel systems and any kind of sitting device as a general place for your baby to sleep.

The Lullaby Trust is aiming to release new guidelines for parents on how to use car seats. However, you can follow these car seat and safe sleep tips from the Trust and Dr Erich K Batra who led the recent research:

Car seats

Car seats should not be used as sleeping areas outside of the vehicle
Do not leave children unsupervised (awake or asleep)
Never leave children in a car seat with unbuckled or partially buckled straps
Car seats should never be placed on a soft or unstable surface

Bouncers and swings

Infants in bouncers, strollers, and swings may be able to move themselves into positions that could restrict their airways
Restraints should be used according to manufacturer’s instructions but these may not prevent infants from getting into hazardous situations
Ensure that infants cannot twist their heads into soft bedding or slump forward in a seat
Do not place more than one infant together in a swing meant for one infant

Slings

If slings are not used correctly or safely there's a risk of your baby's airway becoming compromised
Your baby's face should be “visible and kissable” at all times
Always follow the 'TICKS' safety advice shown below when using a sling

General sleeping

Always place babies on their backs to sleep
Place your baby to sleep in a separate cot or Moses basket in the same room as you for the first 6 months
Use a firm, flat, waterproof mattress in good condition
Remove all pillows, soft bedding, cot bumpers and soft toys from the cot
Don’t let your baby get too hot
Don’t cover your baby’s face or head while sleeping or use loose bedding

We've got more on safety here…

5 baby safety rules that can genuinely save lives
Shocking footage shows main retailers not fitting child car seats safely
Safe sleep warning as cot deaths rise
Baby slings – how to wear one safely

How long can a child sit in a car seat

How to transport a newborn in a car seat? At what age can a baby be transported in a car? All these questions arise before every parent who is worried about the safety of their baby. Today we will try to dot the “i” in this matter!

The European Baby Products Association (BPA) has drawn attention to the increased interest in this topic. Recently, a growing number of publications have published information that infants may be at risk of suffocation during long trips.

In a recent study, Professor Peter Fleming, Professor of Pediatrics at the University of Bristol, found that newborns should not be in a Group 0+ car seat for more than 30 minutes.

It is too early to say with full certainty because very few clinical trials have been conducted. There is still no clear answer to how much the angle of inclination or vibration affects the baby's body.

By far the safest position for a baby is completely horizontal. But all car seats for newborns are designed in such a way that at the time of the accident the head and spine of the baby are minimally affected. That is why the position of the child's back is at a slight angle so that the shock load is evenly distributed. Many car seat manufacturers recommend that a child stay in a car seat for no more than two hours.

Separately, we would like to draw attention to the use of a car seat in combination with a stroller - a travel system. After all, the position of the back of the child in the car seat mounted on the chassis of the stroller is also not horizontal. It is worth considering this when planning your walking routes and trips.

In summary, BPA recommends:

• During the first month, the infant car seat should not be used for more than 30 minutes in a car or in combination with a travel system;

• For longer trips, an adult must be present next to the baby to monitor the child's condition. It is recommended to take breaks every 30 minutes to remove the baby from the car seat and change its position;

• As you get older, you can increase this time to two hours. Again, do not forget that the travel time in the car seat and on the stroller chassis as part of the travel system is summed up!

Family doctor and pediatrician Alexandra Khomenko answers:

Modern parents are very mobile - they travel a lot, walk.

But! I recommend using the car seat only when necessary, that is, you need to take the child somewhere, fine, but you don’t need to walk with him in the car seat around the store, park, seashore, etc. Up to a year, the child's spine is still fragile, so if you keep him in the car seat for too long, he may be deformed. Indeed, in this chair, the spine is arched, like a small kitten.

Therefore in the first six months it is advisable not to carry the baby in a car seat for more than 30-40 minutes .

If you still have to ride longer distances, then make stops, pull the child out of the chair, give his spine a break.

When a child starts to crawl, sit down (it happens for everyone at different ages, approximately at 6-8 months), then you can increase the time of continuous travel in the car seat to an hour or two , but no more.

If the child is already sitting well, if necessary, you can leave him in the car seat for 3-4 hours .

After a year, if the baby sits and walks, you can gradually increase the time that he sits in the car seat, however, you always need to have a sense of proportion.

Interests: proper and healthy nutrition, treatment and prevention of diseases in children from birth to 18 years.
He considers the upbringing of healthy children to be the most important point, therefore he pays great attention to hardening and preventive methods.

Author of books and articles on child health, parenting and development, and treatment and prevention of disease in adult patients. Author of the "Modern Collection of Medicines" and other books on medical and pharmaceutical subjects. Collaborates with medical journals and publishers.

car seat selection guide - magazine Behind the wheel

What is a combined group? What ratings should be trusted? Along the way or against? When to switch to a booster and how to understand that the child is already big enough to do without restraints, fastening with standard seat belts? “Behind the wheel” answered these and other questions.

To choose a car seat for your child, you need to know three parameters - age, height and weight. It's understandable with age. And parents of very young children know exactly the height and weight, as a rule. Parents of kindergarteners and younger schoolchildren know approximately. Exactly - only if the child has recently undergone medical examination.

0 and 0+

Newborns and infants under six months of age are transported in category 0 or 0+ seats, often referred to as "car seats" or "carriers". Children are in them in a lying position (they still do not know how to sit). And they put them against the direction of movement, since babies do not hold their heads, their neck muscles are not developed, which prevent serious injuries in the event of a sudden braking of the car or in an accident. So, against the move, it is recommended to carry children for at least a year. The Swedes, who have made a cult out of road safety, carry children backwards up to 3 years! Maybe right.

Children under the age of one year (and according to Swedish recommendations - up to 3 years) can only be transported backwards.

Children under the age of one year (and according to the Swedish recommendation - up to 3 years) can only be transported backwards.

Related materials

How to carry a child: forward or backward?

Installing the infant carrier in the direction of travel, across the car (in the back seat), loose fasteners - these are all serious, if not potentially fatal mistakes. It is clear that it may be more convenient for you. But imagine (even though it's hard) what will happen to the baby in an accident. Frivolity can kill.

It is believed that the safest place in the car to install a child seat is behind the driver's seat, as the driver instinctively protects himself and exposes the other side of the car to the impact. But there are no supporting statistics to be found. If you imagine all possible impacts, it turns out that the safest place is in the middle of the back seat. But when installing a child car seat (or car seat), you need to fix it as rigidly as possible so that the seat (and the child with it) do not fly off upon impact. Of course, the child must also be securely fastened in the seat. Teach him to use belts from day one - despite the tears.

You can use your favorite toy to teach your child how to buckle up without whims.

The most important point: if you decide to put a child seat in the front seat, turn off the passenger airbag - otherwise, in the event of an accident, it can shoot into the back of the seat, break it and injure the child. And try not to be distracted by the child while driving.

Combined groups 0+/1, 0+/1/2, 0/1/2/3

Category 0+ seats are designed for children weighing up to 13 kg. On sale there are also chairs of the combined group 0+/1, designed for weights up to 18 kg. But they tend to be very large for babies, and even padded inserts don't always make up for the extra space. In addition, the child is in such a chair in a semi-sitting position, which is bad for newborns. So if we use such devices, then only when the child learns to sit. At the same time, long trips should be avoided in order to reduce the load on the spine.

Universal seats (combined groups) are usually quite bulky, expensive and not always comfortable for the child.

Universal chairs (combined groups) are usually quite bulky, expensive and not always comfortable for the child.

This is especially true for the seats of combined groups 0+/1/2 and 0+/1/2/3. Yes, there are some. The former are designed for weights from 2.2 to 30 kg, the latter - from 2.2 to 55 kg. Wow ranger! Of course, it's tempting to buy one car seat for your entire childhood rather than changing it out every couple of years. But, firstly, such a chair will be very large for the child at first, despite all the inserts, and then it may turn out to be small (for short, for example, the legs will hang in the air). Both are bad, the chair should be "fit". Secondly, before buying, the model you like must be checked for compliance with safety standards. After all, the seat is bought specifically to ensure the safety of the child. Ratings you can trust - for example, the German ADAC Automobile Club. The Germans annually conduct crash tests of current models of child seats. Unfortunately, not all models presented on the Russian market are found in these ratings. And thirdly, universal chairs are very expensive - despite the nuances mentioned above.

Armchairs groups 1, 2, 3

Related materials

These are children! Main rules for choosing a car seat

Seats of the first group are designed for children weighing from 9 to 18 kg (conditionally from 9 months to 4 years). The second - from 15 to 25 kg (from 3 to 7 years), the third - from 22 to 36 kg (from 6 to 12 years). Recommendations for selection are given above. If your car is equipped with Isofix mounts (and most modern cars have them), it is better to choose the “isofix” model - these hold better than those that are fastened with standard belts. And therefore, safer.

Armchairs of the second group are quite rare. More often devices of group 2/3 are sold. Five-point belts in them, as a rule, are no longer there. These seats are secured with the car's seat belts. And they are often disassembled into two parts - a back and a booster (seat with armrest). Booster is already the third group.

Boosters

It is sometimes said that boosters can be used from the age of four. But in this case, it is better to focus not on age, but on height and use a booster when the child outgrows 130 cm. Then regular seat belts will be able to protect the child, and not threaten him with injuries in an accident.

According to WHO, for boys, normal height at four years is from 94.9 to 111.7 cm, for girls - from 94.1 to 111.3 cm. 130 cm is quite a lot even for seven-year-olds.

According to Russian traffic rules, a child can be transported without a special device in the back seat from the age of seven. But it's still better to use a booster.

What the SDA say

According to our Traffic Rules (in force since July 12, 2017), children under 12 years old can be transported in the front seat only when using a special restraint device (car seat or infant carrier). In the back seat, a car seat (or booster) is mandatory up to seven years. From 7 to 12 years old, parents can either use a restraint or fasten their child with standard seat belts.

From 7 to 12 years old, children in the front seat can only be transported in a car seat (or with a booster seat).

Our recommendations

Use car seats from reputable manufacturers, focusing not only on price and design, but also, first of all, on places in safety ratings.
Do not chase after universal models, but choose a chair according to the height and weight of the child so that it is comfortable.
Use booster from 7 to 12 years old. Earlier - only if the child is significantly ahead of peers in growth.

Baby in the car: car seat guide