Is your child's car seat safe?

As a mom and a pediatrician, I want what is best for my children and my patients. I want to keep my kids and my patients as safe as possible. One way to do this is to follow the recommendations and best practices regarding child passenger safety. Motor vehicle crashes are the leading cause of death for kids 14 and under. In the Tarrant County area, 92 percent of car seats/booster seats are not used or installed correctly. That means that only 8 out of 100 families in the area are properly using their car seats or booster seats. Let’s face it, car seats can be complicated! 

If you are having even the slightest trouble, questions or concerns regarding your child’s safety in the car, certified child passenger safety technicians are able to help or even double check your work.

For those of you in the Tarrant County area, you can call Safe Kids Tarrant County, led by Cook Children’s, at 682-885-2634.  Also visit this site for a quick car seat checklist with the top 5 things to do to check your seat. 

1. When can my child change from rear-facing to forward-facing?

The American Academy of Pediatrics (AAP) recommends children ride rear-facing until at least 2 years old or until they reach the maximum height and weight for their seat. Keeping children in a rear-facing position better protects their heads, necks, and backs. Seats will indicate on the side labels what the rear-facing weight/height limit is and you can also check the manual of the seat. Parents often worry about the safety of a child’s legs when the child is growing taller and is still rear-facing.  Studies show that a child’s legs are actually injured less often when a child is rear-facing.  Both of my children were in the 90+ percentiles for height at age 2 and both remained rear-facing past 2 years old.

2. When can my child use a booster seat instead of a harness forward-facing seat?

The AAP recommends children ride in car seats with a harness until at least 4 years old, however they should continue to use a 5-point harness up to the highest weight or height allowed by the manufacturer of the seat.  Moving from a 5-point harness to a booster seat is a step down in safety, so a child should remain in the harness seat as long as possible.

3. When does my child no longer need to use a booster seat?

Texas law requires children to remain in booster seats until at least age 8, unless the child reaches a height of 4 feet, 9 inches before age 8 (which is extremely uncommon). 

Recommendations state a child should remain in a booster seat until at least age 8 or until the seat belt fits correctly. Most children are 9 years or older before they reach 4 feet, 9 inches, which is when the seat belt will usually fit them correctly without the booster seat. You can use the “Safety Belt Fit Test” to help you determine if your child is ready to use the seat belt alone without a booster seat:

1. Have your child sit all the way back on the vehicle seat.  Do the knees bend at the front edge of the seat?  If no, then your child should stay in a booster seat.  If yes, then go to No. 2.
2. Buckle the seat belt.  Does the lap belt lie on the upper legs or hips (not the stomach)?  If no, then your child should stay in a booster seat. If yes, then go to No. 3.
3. Does the shoulder belt rest on the shoulder or outer collar bone (not the neck)?  [Note- Never put the shoulder belt under a child’s arm or behind a child’s back.]  If no, then your child should stay in a booster seat.  If yes, then go to No. 4.
4. Can your child maintain the correct seating position for as long as you are in the car without slouching or moving positions causing the belt to move improperly to the neck or stomach?  If no, then your child should stay in a booster seat.  If yes, and you answered yes to all 4 questions, then your child is ready to use a seat belt without a booster seat.

4. When can my child sit in the front seat?

Children should not ride in the front seat until age 13. The safest place for a child in the car (or any person for that matter) is the back seat, particularly since the most common crash is a frontal crash.  Air bags deploy with such force that they can cause severe head and neck injuries to a child.

5. Do car seats and booster seats expire?

Yes, all car seats and booster seats expire. Usually they last about six years, but be sure to check for an expiration date on the seat label.

For more information:

• Car safety
• Is your child's car seat safe?
• FREE car seat checks
• Never leave your child alone in a car
• Look and lock
• Spot the tot
• From the car seat to the driver's seat
• Resources

About the author

Nicole Wineriter, M.D., is a Cook Children's pediatrician at the Heritage Trace Clinic. She is a Fellow with the American Academy of Pediatrics and a member of Safe Kids Tarrant County, led by Cook Children's, and a certified child passenger safety technician.