Dr. Gollup's Pediatric Housecall
Dr. Howard Gollup is a board-certified pediatrician with Aurora Advanced Healthcare in Germantown. He cares for children from birth through adolescence. Though he cannot respond to individual medical questions, he welcomes your feedback and suggestions for future topics.
New Car Safety Recommendations for Children
One of the first safety measures parents will take--on the very first car ride home--and some of steps they should follow for years to come, involve car safety seats and seat belts.
In Wisconsin, we have laws requiring that infants and children are properly restrained in vehicles. Infants less than a year old and less than twenty pounds must ride in a rear-facing child safety seat in the back seat of a vehicle (unless there is no back seat). A child between one year and four years, and between 20 and 40 pounds, must be in a child safety seat in the back seat, but can be forward-facing.
A child four to eight years, who weighs between 40 and 80 pounds, but who is not yet 57” (4’ 9”), must be in a booster seat. Wisconsin law does not require children over four years to be in the back seat, even though most safety guidelines recommend it.
To be able to wear a conventional seat belt and sit directly on the seat of the vehicle, the law requires that a child must be at least eight years old, and either 80 pounds or 4’9” tall. This is the only “or” statement.
Recently, the American Academy of Pediatrics issued new recommendations regarding car safety restraint in children. Although they are recommendations, and not current law, they are worth consideration.
According to the new recommendations, infants and toddlers should ride in a rear-facing car safety seat until two years of age, or until they exceed the height or weight specifications of the particular car safety seat you are using. There is evidence to show that this is the safest position in a crash, and that children beyond a year of age will benefit. This makes sense, as it affords the neck and spine the most support during the sudden deceleration of most accidents. Actually, we’d all be a little safer riding that way.
Children over two, or those who have outgrown the rear-facing weight or height limit for their car seat, should use a forward-facing car safety seat with a harness for as long as possible.
Children whose weight or height limit is above the forward-facing limit for their car safety seat should use a booster seat until the seat belt of the vehicle fits properly, which is usually when they have reached 4’9”. The height requirement has always made sense to me, as it is designed to make sure the shoulder belt doesn’t pass right across a passenger’s throat.
Keep in mind, the State of Wisconsin still requires children under age four to be in a car safety seat, not a booster seat. And, of course, children who are large enough and old enough to sit directly on the vehicle seat should always wear a lap and shoulder belt.
Although the State of Wisconsin allows children four years and older to be in the front seat, there is no question that the rear seat is safer. For this reason, the American Academy of Pediatrics suggests all children under age 13 years ride in a rear seat. (It also decreases the arguments about which child is going to get dibs on riding “shotgun”).
I don’t know if there will be much going backwards if you’ve moved beyond some of these recommendations. It might be a challenge to get a toddler who has already been turned forward to accept the rear-facing position she was once in. It might be equally hard to get your twelve-year old back on a booster seat if he’s less than 4’9”. But, you can try.
Probably no one expects parents to run out and purchase new car safety seats just to be compliant with these newer recommendations. But, it may be something to keep in mind going forward. I’ve attached a link from an American Academy of Pediatrics web page which lists current manufacturers and the safety seat features that are worth your consideration.
Some of this might seem like worry-wart, hand-wringing overcaution, but when you consider that vehicular trauma is the leading cause of death in childhood is, anything that gives your child an edge is precaution worth considering.
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