1. Overview

   • Use a child restraint to greatly reduce the risk of injury and death to your child. Use a harnessed seat from birth at least up to 40 lbs. and 4 years old. Then use a belt-positioning booster, along with the car's lap-shoulder belt, until your child fits well into the adult seat belt, usually around age 8-11 years.
   • Never place a rear-facing child in front of an airbag. The airbag can kill your child. Children 12 and under are safest riding in the back seat.
   • Always read and follow your vehicle owner's manual and your car seat's instructions. Car seats are more complicated than you might think. Errors in installation and usage are very common. Help is available if you have problems or questions.
   • Take the time to select an appropriate car seat, install it correctly, and use it correctly every ride. The stakes are high. Your child's safety deserves the time and attention it takes to get it right.
   • Drive safely. Do your part to help avoid a collision in the first place. Some crashes are not survivable, even for properly restrained persons.

     "NHTSA estimates that, when installed correctly in a vehicle with compatible seating and seat belt systems, child restraints are 71 percent effective in reducing the likelihood of death in motor vehicle crashes."
     --National Highway Traffic Safety Administration, quote from FMVSS 225

2. Select an appropriate seat for your child and for your car

   • Not all car seats are created equal. Five-point harnesses are safer than overhead shields and T-shields. Infant seats with three-point harnesses are also quite safe when properly used. Some seats are easier to install and to adjust than others. Not all seats are compatible with all cars. Research and try before you buy.
   • Children are safest when riding rear facing. Rear-face your child at least until one year old and 20 lbs., whichever is later. For premature babies, the earliest face-forward time is one year after due date and 20 lbs, whichever is later. Many convertible car seats are certified for rear-facing up to 30 or 35 pounds. These seats allow you to keep your child rear facing well past one year.
   • Use these guides to help select the seat that fits your child, fits your car, fits your budget, and that you can use correctly every ride:
     • Family Guide to Car Seats (AAP). Explains the types of car seats and how to use them. Comparison charts for current models.
     • Child Seat Safety Information (NHTSA). Usage information. Safety feature comparison charts for current models.
     • Buying Guide (Car-Safety.Org). Discussion of safety seat features and their benefits.
     • Car Seat Compatibility Database (T. McAdams). See which seats tend to fit well in your car.
     • Rear-Face Until at Least One Year (K. Weber). An expert explains why babies should ride rear-facing for a minimum of one year.
     • Recycled Car Seats (SafetyBeltSafe USA). Why you should not buy a used car seat with an unknown history (PDF format).
   • Special needs children. Work with your health care provider to select the restraint appropriate for your child. More details:
     • Choosing Car Seats for Children with Special Needs (AAP). Discusses premature, low birth weight, casts, and more.
     • Transporting Children With Special Health Care Needs (AAP Policy Statement, October 1999). Detailed statement with illustrations.
     • Special Needs Product Chart (AAP). List of special needs car seats with usage notes (PDF format).
     • Adaptivemall.com. Distributes special needs seats.

3. Install your seat: Take the time to do it right

   General

   • Select the appropriate position in your car. The back seat is safest for children under 12. Never put a rear-facing child in front of an airbag! The airbag can kill your baby.
   • Select the correct harness slots. Rear facing, use the slots at or below your child's shoulders. Forward facing, use the slots at or above your child's shoulders. Also, it is very important that you use only the top (reinforced) slots when forward-facing most convertible seats. Double-check the guidance in your seat's instruction manual. Review harness height as your child grows.
   • Read your vehicle owner's manual to learn how your seat belts lock. Some seat belts lock only in emergencies and require either a locking clip or a car seat with built-in lockoffs to keep the seat secure.
   • Harnessed car seats must be tightly installed according to the manufacturer's instructions. Put your weight into the seat and tighten the seat belt. Then unbuckle the belt, tighten it a little more, and re-buckle. Repeat until you have a secure installation. It should be difficult to buckle the seat belt the final time.
   • Newborns and young babies must face the rear and must ride semi-reclined (45 degrees relative to horizontal). Too upright and baby's head can fall forward and block the airway. Too much recline makes the seat less safe. If your baby has a breathing problem or other medical condition, your pediatrician may talk to you about using a car bed so that the baby can lie flat.
   • The links below give more details:
     • Selecting, Installing, and Using Child Safety Seats (NHTSA).  Detailed installation tips for each kind of car seat.
     • Vehicle Seat Belts and Child Seat Installation (NHTSA).  Explains the different kind of seat belt mechanisms.
     • How to Lock in a Child Restraint (J. Matlock). Includes a chart that explains how to lock a child seat in various situations.
     • Do You Need a Locking Clip? (Carseatsite.com).  Detailed explanation of locking clip usage, with photographs.
     • Photograph of a Broken Seat (SafetyBeltSafe USA).  The tragic outcome of a forward-facing convertible seat that had the wrong harness slots in use.

   Top tethers: Make your installation even more secure

   • Most convertible and forward-facing seats are equipped with top tethers for added stability. Older car seats can often have a tether strap retrofitted. Contact the seat manufacturer. A few seats can be tethered rear-facing as well. Read and follow the instructions that come with your seat.
   • Most new cars now have top tether anchors standard. Older cars can often have tether anchors retrofitted. Contact your car dealer's parts or service department. If your dealer is ignorant on the subject, contact the national customer service numbers for your car manufacturer. Child passenger safety technicians with access to a published tether manual can also look up tether anchor information for your car.
     • Top Anchorage System (NHTSA).  Description of tether system including diagrams. Vehicle and child seat requirements.
     • Tether Anchors in Older Vehicles (NHTSA).  Help for getting your car retrofitted with tether anchors.

   LATCH system

   • LATCH is a new way to secure child seats in a vehicle, independent of the vehicle seat belt system. The acronym stands for "Lower Anchors and Tethers for Children".
   • LATCH compatibility is now required on all new car seats and all new passenger vehicles. LATCH seats are compatible with non-LATCH cars and with aircraft seat belts. Non-LATCH seats are compatible with LATCH-equipped cars.
   • Non-LATCH seats and non-LATCH cars are still safe to use.
   • For details:
     • LATCH Information (NHTSA). Includes installation tips and photographs.
     • LATCH and Tether Information (Car-Safety.Org). Thorough discussion of these related subjects.
     • LATCH Requirements (SafetyBeltSafe USA). Summary of changes to Federal regulations (PDF format).

4. Use your seat day-to-day: Don't take shortcuts

   • Motivate yourself to properly secure your child every ride. Think about the fact that today could be the day that something unexpected happens on the road.
   • The harness must be flat and snug on your child. You should not be able to pinch a fold in the harness after it is properly adjusted. The combination of a tightly installed seat and a snugly harnessed child helps to reduce the risk of injury in the event of a crash or sudden stop.
   • Don't dress your child in bulky clothes or blankets before securing the harness. Dress your child in regular clothes. Put blankets on top after the harness is snug.
   • The chest clip must be threaded correctly and worn at armpit level.
   • Infant seats must have their carry handle positioned in accordance with the manufacturer's instructions.
   • Don't modify your child's car seat. Even changes that seem innocuous can have unintended effects in a crash.
   • Don't use after-market products such as harness strap covers, mirrors, etc. All of these can be dangerous in a crash environment. No federal standards exist in this area. Any "crash testing" that a manufacturer may claim for their product has no known level of quality control.
   • Replace your car seats after a significant collision. There may be unseen damage. Refer to your car seat's instructions. Ask your insurance company to pay for replacement car seats.

5. Booster seats

   General

   • Belt-positioning booster seats are for older children who are too big for a harnessed seat and too small to fit an adult seat belt. A booster seat raises a child so that the adult lap/shoulder belt fits well.
   • Backless boosters can be used when the vehicle seat or head restraint provides whiplash protection. Otherwise, you must use a high-backed booster.
   • Shield boosters are no longer recommended as safe under any circumstances. A child under 40 lbs. is better protected in a harnessed seat. A child over 40 lbs. is better protected in a belt-positioning booster without a shield. Some shield boosters convert to backless boosters via removal of the shield.
   • A shoulder belt positioning device is not a good substitute for a booster seat. Many of these devices pull the lap belt up too high.
     • A Parent's Guide to Booster Seats (NHTSA). Online brochure with photographs.
     • Boosters are for Big Kids! (SafetyBeltSafe USA). Includes the "five-step test" to see whether a child is ready for an adult seat belt alone.
     • Boost America!. (Ford Motor Co.) Booster seat education campaign. One million free boosters for low-income families and for Ford customers.
     • The Shield Booster Page (J. Matlock). Documents the problems with shield booster seats.
     • Shoulder Belt Positioning Devices (J. Matlock). Documents why these after-market products are not considered safe.

   Lap belt dilemma

   • Many older cars do not have three point lap-shoulder belts in the back seat. In this case, you have a dilemma once a child reaches 40 pounds or otherwise exceeds the limits of a harnessed seat. The child cannot graduate into a belt-positioning booster because of the lack of a shoulder belt.
   • Here are some solutions to this issue:
     • Shoulder belt retrofit. Contact your car dealer to see whether they can retrofit shoulder belts into your car.
     • Britax Marathon. Convertible seat with a 5-point harness. Rear-facing from 5 to 33 pounds, forward facing from 20 to 65 pounds. Certified for aircraft use.
     • Britax Husky. Harnessed forward facing seat 22-80 pounds. Child must be at least one year old. Tether required over 50 pounds. Too wide to fit in aircraft.
     • EZ-On 86-Y harness. An upper body harness that attaches to both the lap belt and to a vehicle tether anchor. Age 4 to adult. May require a booster to properly position the lap belt.
     • Britax Laptop. A unique restraint 30-65 pounds. Can be used with either a lap-only belt or a lap-shoulder belt. Not certified for aircraft use. Discontinued September 2002 but may still be found at some retailers.
     • Fisher-Price Futura 20/60. Harnessed forward facing seat 20-60 pounds. Optional tether. Certified for aircraft use. Discontinued summer of 2001 when F-P announced it would no longer manufacture car seats. May still be found at some retailers.

6. Get help with your questions and problems

   • Read your vehicle owner's manual and your car seat's instructions.
   • Contact the manufacturer of your seat. The manufacturer is the authority in the proper use of its products.
   • Attend a car seat "check up" event in your community. Trained child passenger safety technicians will give you hands-on help. Your goal is to learn how to properly install and use your car seat, in your car, for your child. Don't simply let the technician do all the work, because then you won't be able to do it yourself the next time you need to install the seat. Find a check up event by calling your local police department, fire department, or department of public health. If no luck there, try a neighboring community or contact your state department of public health, or your state police.
   • Find a certified CPS technician in your area. The NHTSA maintains a list of technicians.
   • Ask a certified CPS technician at an online discussion board. Describe your situation in detail: model of car, model of car seat, age/weight of child, etc. Before posting a question, check the board archives and browse their FAQ section.
     • List of Child Safety Seat Manufacturers (NHTSA). Includes phone numbers and links to manufacturers' web sites.
     • List of Certified Child Passenger Safety Technicians (NHTSA). Search by state or by zip code.
     • List of Child Seat Inspection Station Locations (NHTSA). Search by state or by zip code.
     • Seatcheck.org (DaimlerChrysler). Search for inspection stations by state or by zip code.
     • Car Seats Discussion Board (iVillage.com). Active discussion forum. Free registration required to ask a question.
     • Child Carseat Safety Forum (Car-Safety.Org). No registration required to ask a question.

7. Recalls

   • Recalls are sometimes necessary to correct a car seat defect discovered after the seat is in production.
   • When you buy a new seat, fill in the registration card and mail it back. This is the only way that the manufacturer can alert you in the event of a recall.
   • If you buy a used seat (not recommended), check it for past recalls. Tell the manufacturer your name and address so you can be notified in the event of a future recall.
     • Child Seat Recalls Since 1990 (NHTSA). List of official recalls.
     • Recalls--Is Your Car Seat Safe? (SafetyBeltSafe USA). List of official recalls. Also includes known problems that may not be classified as recalls.
     • Car Seat Recalls and Safety Notifications (UNC HSRC). Recall list in HTML and PDF formats.
     • Identify a Car Seat by Photograph (SafetyBeltSafe USA). Useful if the seat is not properly labeled.
     • Consumer Product Safety Commission. Includes e-mail alerts for consumer product recalls.

8. Air travel with children

   • There are many safety and convenience benefits to purchasing a seat on the airplane for your child and bringing your car seat on board.
   • Most harnessed car seats are certified for use on aircraft. Read the labels on the seat.
   • Many airlines offer discount fares to children under 2 years of age. These fares may not be available on travel web sites. You may need to call the airline.
   • Travel vests (such as the "Baby B'Air") are prohibited during taxi, takeoff, and landing. An aircraft-approved car seat is the safest way for babies and small children to fly.
   • Belt-positioning boosters require a lap-shoulder belt, and therefore are not permitted to be used on aircraft.
     • Tips for Parents Using Child Restraints on Aircraft (FAA). How to prepare for a trip with your child.
     • Airline Travel and Child Safety (J. Matlock). Answers to questions regarding air travel with children. Links to other information sources.

9. San Francisco Bay Area car seat resources

   • Call your local police department, fire department, public health department, or CHP office to inquire about car seat checkups in your area.
   • County-specific information:
     • Alameda County
       • Alameda County Seat Check Schedule
       • Berkeley Police Department (510) 644-6045
       • Livermore Police Department. Traffic Education Officer Traci Rebiejo (925) 371-4858
       • Oakland Children's Hospital (510) 428-3045
     • Contra Costa County
       • Nurses and Cops Caring for Contra Costa Children (925) 941-7989
     • Marin County
       • Marin County Car Seat Coalition (415) 507-2564
       • Marin County CHP (415) 924-1100
     • Napa County
     • San Francisco City and County
       • SFPD car seat check (415) 575-6363
     • San Mateo County
       • San Mateo County Sheriff's Office (650) 599-1693
       • Daly City Police Department (650) 991-8119 extension 8860
       • San Mateo/Santa Clara County Safe Kids (650) 724-3783
     • Santa Clara County
       • San Mateo/Santa Clara County Safe Kids (650) 724-3783
     • Solano County
     • Sonoma County
       • Sonoma County Safe Kids Coalition (707) 588-6078

10. Acronyms and abbreviations

    AAP	American Academy of Pediatrics
    CHP	California Highway Patrol
    CPS	Child Passenger Safety
    CRS	Child Restraint System
    FAA	Federal Aviation Administration
    FMVSS	Federal Motor Vehicle Safety Standard
    LATCH	Lower Anchors and Tethers for Children
    NHTSA	National Highway Traffic Safety Administration

11. Links

    • CPS References
      • American Academy of Pediatrics. Main CPS page.
      • Car-Safety.org. Information on vehicle and car seat safety.
      • CPSafety.com (J. Matlock)
      • Crash Protection for Child Passengers: A Review of Best Practice. Journal article by Kathleen Weber. University of Michigan Transportation Research Institute. (PDF format)
      • Federal Motor Vehicle Safety Standards (NHTSA). Brief description of each standard.
      • National Child Passenger Safety Board. Helps organizations implement child passenger safety training programs.
      • National Highway Transportation Safety Agency. NHTSA's main CPS page.
      • Safe Ride News. Bi-monthly child passenger safety newsletter. Articles, fact sheets, tether manual, back issues.
      • SafetyBeltSafe USA. Child passenger safety advocacy organization.
      • Traumalink - Child passenger safety interactive web site. Safety information and videos from the Children's Hospital of Philadelphia.
      • University of North Carolina Highway Safety Research Center. Research and CPS information.
    • Seat Belts and Pregnancy
      • Should Pregnant Women Wear Seat Belts?. NHTSA brochure in PDF format.
    • Choosing a Safer Automobile
      • Buying a Safer Car for Child Passengers 2002 (NHTSA). Includes safety features comparison charts for current vehicle models.
      • Buying a Safer Car for Child Passengers 2001 (NHTSA). Prior year's version.
      • Buying a Safer Car 2002 (NHTSA). Information on crash tests, safety features, and buying tips.
      • Buying a Safer Car: New Car Assessment Program (NHTSA). Look up crash test data for your vehicle by year and model.
      • New Vehicle Buying Guide (Car-Safety.Org). Discusses the benefits of various safety features and recommends vehicles based on safety.
    • School Bus Safety
      • Guideline for the Safe Transportation of Pre-School Age Children in School Buses (NHTSA).
      • How to Properly Transport Pre-Schoolers on Buses (T. McAdams). Outline covers practical aspects of transporting small children on school buses.
      • School Bus Safety (NHTSA). General information and equipment standards.
      • School Transportation News. A monthly news and feature magazine.

12. U.S. Equipment standards relevant to child passenger safety

Notes:

[1]. A future safety standard is in the works to require lap-shoulder belts in all rear seating positions of passenger cars. President George W. Bush signed H.R. 5504 ("Anton's Law") on 4 December 2002, which requires study and rulemaking on this issue.

[2]. Pre-drilled holes for upper tether anchors are included in many vehicles manufactured since January 1, 1989.  Tether anchor retrofit kits are often available.  Contact your car dealer for more information.

[3]. Indicates a standard that is related to the phase-in of the LATCH system.