“We're seeing a large amount of counterfeit or non-compliant car seats come on the market, and they are a real safety hazard because they don't meet the testing standards,” said Sharon Evans, trauma injury prevention manager at Cook Children's Health Care System.

Evans says the health care system has seen more than 15 counterfeit car seats since 2021.

The Hidden Cost of "Cheap" Seats

Experts from Cook Children's Health Care System, Viviana Esparza, program coordinator at the Center for Community Health, and Evans warn that while fake seats save money upfront, they fail when it matters most.

“The health and wellbeing of our children is of highest concern,” said Esparza. “The cost of a car seat doesn’t compare to the safety of a child.”

While counterfeit seats appear to be bargains, the price difference is often deceptive. Evans and Esparza recently encountered a knockoff Doona car seat at a safety event that cost $300, compared to the $650 retail price for a legitimate model.

“Often, parents are buying these from third-party sellers on TikTok Shop and Amazon,” Evans explained.

Red Flags: How to Identify a Fake

When shopping for car seats, Evans advises parents and caregivers to watch for counterfeits of popular brands. These knockoffs are often cheaper than their legitimate counterparts anddo not meet regulations to protect a child in the event of a car crash. 

Look for these warning signs:

• Materials: The plastic shell may feel thin, flexible, or even hollow.

• Harnesses: The chest clip may be missing, or the harness straps may not conform to U.S. width standards.

• Missing Documentation: Instructions may be missing or provided only in foreign languages.

• Lack of Labeling: Legitimate seats must have side labels with installation guides, weight limits, and manufacture dates. Fakes often have no labels or labels with poor grammar and typos.

Three Steps to Ensure Your Seat is Safe

• Buy Direct: Buy directly from the manufacturer or a reputable retail store.
• Call the seat manufacturer: They can help you determine if it’s a knockoff and will sometimes ask you to submit photos.
• Certified Child Passenger Safety Technician (CPST): Take your car seat to be checked by a certified child passenger safety technician. They are trained to help determine if it’s fake. 

Where to Get Help

Evans recommends parents and caregivers with a new car or booster seat, schedule a free inspection with a CPST.

• Visit freecarseatcheck.org and click “Book your appointment”
• Find a child passenger safety technician at safekids.org
• Find an inspection station through The National Highway Traffic Safety Administration

If you discover the seat is a fake, stop using it immediately. Report the seller to the retailer and file a report at StopFakes.gov or with NHTSA.

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Sharon Evans, trauma injury prevention manager for Cook Children's Health Care System, explains that, while these may seem like gifts without much concern, it is important to understand they are vehicles. She offers families tips on how to help their children safely enjoy e-bikes and e-scooters. 

“Always wear a helmet,” emphasizes Evans.

• Always wear a helmet: Make sure you have the right helmet. For e-bikes/e-scooters that go up to 20 mph, a bike helmet is sufficient, but parents may want to invest in a stronger helmet to better protect their children.
• Perform a safety check before each ride:
  • Check the tires. Ensure they are inflated to the recommended pressure on the sidewall.
  • Check brake levers. Squeeze them while rolling the bike forward and backward to ensure the brakes engage and stop the e-bike/e-scooter.
  • Inspect your e-bike/e-scooter for loose nuts or anything that looks abnormal.
• Follow the rules of the road:
  • Always ride on the right, in the same direction as traffic. Use the bike lane if available.
  • top and look both ways before entering a street or crossing an intersection.
  • Stop at all intersections.
  • Obey all traffic lights and traffic signs.
  • Be aware of your surroundings. Do not talk on the phone or text. Do not wear earbuds; you cannot hear what is happening around you.
• Night rides: Make sure you wear bright, reflective clothing. Ensure your e-bike/e-scooter has a light and reflectors.

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SUID can occur in infants younger than a year. It includes three causes of death: sudden infant death syndrome (SIDS), accidental suffocation and strangulation in bed (ASSB) and unknown/undetermined reasons. 

“SUID can happen in any sleep environment but is less likely to happen if the baby is in their own crib, bassinet, or portable crib,” explains Samantha St. John, program coordinator at Cook Children’s Center for Community Health.

St. John shares how families can prepare and keep their little one safe as they build their baby registry. The U.S. Consumer Product Safety Commission (CPSC) requires that products include clear labeling with information such as age recommendations, safety warnings, usage instructions, and manufacturer details to help ensure safe use and inform caregivers of potential hazards.  St. John adds that while some items may be marketed to help ease parenthood, they may not be safe.

Safe Sleep:

Weighted sleep sacks: Weighted sleep sacks are often advertised as providing extra comfort to a baby by imitating a parent’s hand resting on the infant’s chest.  However, according to the CPSC, the additional weight on the baby’s chest may hinder movement and breathing, which could increase the risk of SUID.

Alternative: Parents should use unweighted wearable blankets or sleep sacks to keep the baby warm and allow the baby to take full, deep breaths. 

Bumper pads: Crib bumper pads are a common piece of décor for the crib. Due to the significant risk associated with crib bumper pads, the Safe Baby Sleep Act bans the manufacture and sale of this product in the United States. Between 1990 and 2016, bumper pads were responsible for at least 107 infant deaths, according to the CPSC.  Even alternative products that claim to be breathable still pose a risk of suffocation and strangulation.

Lounger: A baby lounger is a portable, cushioned space for a baby, often called an infant lounger, a lounge pillow, or newborn lounger.  Though these products are made for the baby to use while awake and supervised, we often see infants sleeping in these loungers while in their crib, bassinet, or on the couch.  According to the American Academy of Pediatrics (AAP), infants are at risk of suffocation if they roll into the cushioned side of the lounger and their nose and mouth become blocked. 

When in use: Caregivers need to supervise while the baby is awake.  The lounger should be placed on the ground to avoid the risk of falling.  Manufacturer instructions and guidelines should be followed.   

Pillows: It is a common misconception that babies need a pillow in their beds for comfort.  Adding this soft product to their sleep space can increase the risk of suffocation and SIDS. 

Alternative: Save the pillows for when the child is over the age of one and it is developmentally safe.  This includes wedge pillows, regular pillows, anti-roll pillows and head shaping pillows.

Stuffed animals: Toys should never be placed in a baby’s sleep space, as they can increase the risk of suffocation.  Stuffed animals make great décor for the nursery but are not safe for the baby to snuggle with while sleeping until they are over the age of one.

Toys with button batteries: Infants learn by exploring and putting items in their mouths. If swallowed, toys with small button batteries can get stuck in the throat and be a choking hazard or can travel through the digestive tract, causing serious or life-threatening injuries within three hours.  Parents need to inspect toys to ensure the battery case is securely closed, there are no loose or broken parts, and the case is sturdy enough to withstand continued use without the batteries falling out.

Blankets: Blankets are a popular registry item because they are cozy, cute, and useful during cuddle time and for tummy time on the floor.  However, blankets can cover the baby’s face and increase the risk of suffocation while sleeping. 

Alternative: To keep the baby safe and warm, use a wearable blanket or sleep sack.

Swings/rockers/bouncers: Baby swings, rockers, and bouncers are great products on a registry because they can help soothe the baby and allow the baby to enjoy independent time in a different position or location.  For sleep, these products are not a safe place for infants because the incline of the product makes it easier for the baby’s head to fall forward, which can block their airway and increase the risk of suffocation. 

When in use: Swings, rockers, and bouncers are great for supervised awake time, but not for naps or overnight sleep. 

Safety over comfort

In 2024, the CPSC report on Injuries and Deaths Associated with Nursery Products among Children Younger than Age 5, stated more than 60,000 children visited the emergency department in 2023 due to injury related to a nursery product such as an infant carrier, bouncer, swing, or other items. St. John emphasizes that when caregivers are determining which products to purchase, safety should be top of mind.

When looking at items for vehicle safety with a baby, she suggests:

Mirrors/Cameras: Caregivers need to be mindful that these products can become detached in an accident and cause injury to anyone in the vehicle. Any loose and unstored items in the vehicle can become a projectile in a car crash. Mirrors and cameras are often added to registries because parents want to be able to see their baby while they are rear-facing in their car seat. 

Car Seat Accessories: Items such as car seat covers, head support inserts, and toys are not often approved products by car seat manufacturers because they can affect the safety of the child in the car seat. Parents should check their car seat owner’s manual before registering for these additional accessories.

Counterfeit car seats: Fake car seats may not have a manufacturer date, model number, warning label, or instruction manuals.  Caregivers can schedule an appointment to have their car seat checked by visiting www.freecarseatcheck.org.

Vehicle Seat protectors: Vehicle seat protectors are advertised as being able to help protect the fabric of the vehicle seat.  However, many child safety seat manufacturers do not allow the use of these seat protectors.  When registering for this product, parents need to be sure the car seat manufacturer approves the use of vehicle seat protectors.

Free car seat checks

Texas law requires kids to ride in a safety seat that fits by weight and height until age 8 or at least 57 inches tall.

The Injury Prevention Collaborative offers events where you can make an appointment with a certified technician. We offer FREE car seat checks and assistance to families who may need a car seat.

Click the link or call 682-885-2634 to book your appointment. Those without appointments will be seen on a first-come/first-serve basis. You MUST have your child with you, unless you are an expectant parent.

In 2023, 43% of children killed in car crashes were unrestrained, according to the National Highway Traffic Safety Administration (NHTSA). Texas law requires children under the age of 8 and those under 4 feet 9 inches to be in a child safety seat. Failure to properly restrain a child can result in a ticket of up to $250.  Despite these laws, NHTSA data shows that 46% of car seats are installed incorrectly.

 A Child Passenger Safety Technician (CPST) can help ensure a child is safely and correctly secured in their car seat. Cook Children’s Health Care System has 66 CPSTs across North Texas.  

CPSTs at Cook Children's work with patients and their families to ensure a safe discharge from the hospital. Nurses screen patients during admission to confirm they are in the correct car seat or booster. If a family needs a car seat, it is provided free of charge, and a CPST then educates them on its proper use and installation.

“We also provide special needs seats to patients who may have a spica cast and cannot sit up for their conventional car seat, or car beds for premature infants or those that need to lie flat at discharge,” said Sharon Evans, trauma injury prevention manager.

NHTSA data shows more than 300 children under the age of five have been saved due to their car seat.

Texas has only three special needs CPST instructors, and one of them is here at Cook Children's. The hospital also has 24 CPSTs with special needs training. These specialists assess children and families’ needs and order the correct special needs car seat for safe transport upon discharge.

In addition to those efforts, Cook Children’s Center for Community Health hosts events throughout the year. At these fitting stations, caregivers make an appointment to have their car seat checked, or if they need a car seat, it is provided free of charge. 

“The caregivers learn at these events how to correctly install and use their car seat to ensure the child’s safety,” explained Evans.

To become a nationally certified CPST, an individual must attend a four-day CPST course and pass both written exams and a hands-on skills assessment.

“These employees take on extra job responsibilities above and beyond their normal job description just to ensure the children are transported safely,” said Evans.

Know the Four Stages of Car Seats

Trauma Injury Prevention and the Center for Community Health share some tips on keeping your little one safe.

1. Rear-facing

Rear-facing car seats are the first stage of restraint for children ranging from newborns to preschoolers. This stage supports their head, neck, and back while riding in a vehicle until they meet the maximum weight OR height of their car seat. According to Evans, it is highly recommended by experts to keep your child in a rear-facing car seat for as long as possible, as it is the safest option available.

2. Forward-facing

Forward-facing is the second stage of car seats for preschoolers through school-age kids. Children should remain in a forward-facing car seat with a five-point harness until they meet the maximum weight OR height before moving to a booster seat.

3. Booster

Children must be at least four years old before transitioning into a booster seat. The booster seat stage is crucial for children who have outgrown a harnessed car seat, but do not yet fit safely behind a lap-shoulder belt. Still, booster seats are skipped over all too often. Evans said many kids between the ages of 4 and 8 get seriously injured due to being put in seat belts too soon.

4. Seat Belt

A seat belt is the final stage of restraint. The safest time to transition to a seat belt is when your child is at least 4’ 9”, or 57 inches tall. Though the law states children can transition to seatbelts at eight years old, Evans cautions that many children won’t reach 57 inches of height—and should therefore remain in a booster seat—until closer to 10 or 12.

Stay Vigilant for Counterfeits and Fakes

As you are shopping for car seats, keep in mind that many popular brands are being knocked off to create counterfeits. These knockoffs are often cheaper than their legitimate counterparts, but are significantly less likely to protect your child in the event of a car crash.

• Make sure you buy it directly from the manufacturer or a reputable retail store.
• Call the seat’s manufacturer. They can help you determine if it’s a knockoff and will sometimes ask you to submit photos.
• Take your car seat to be checked by a certified child passenger safety technician. They are trained to help determine if it’s fake. 

Over the course of a week, there were three different auto pedestrian injuries, where a child was hit by a car and ended up in Cook Children’s Pediatric Intensive Care Unit.

Once the school year ends, Sharon Evans, Trauma Injury Prevention coordinator, calls this time of year “the 100 deadly days of summer” because kids are so much at risk. They are spending more time on their own or with friends and often times without adult supervision.

"Kids are out because they are playing with their friends, going to the ice cream truck or riding their bike. In other words, it’s just kids being kids. But that’s also when children are getting hurt," Evans said. “We are asking parents to make sure their child knows how to cross the street, mainly that they wait until the driver actually motions to them to cross the road. Just because you think the driver is looking at you doesn’t actually mean they ‘see’ you.' These days everyone is so busy or distracted, even while behind the wheel, you can’t take anything for granted."

Studies show children don’t have the cognitive ability to safely cross the street until they are 10 years old.

So even though they can ride a bike and do multiplication tables doesn’t mean they can safely cross the street, Evans said. While they may ride or walk on the sidewalks, you still have the danger of cars backing out and/or turning into driveways. During the summer, Evans said the medical staff at Cook Children’s sees an increase in backovers. 

“With our larger cars and SUVs, you often can’t see the child and that’s where the backovers happen as you are leaving,” she said. “Of course this disaster is even worse because the injury is usually caused by a parent or family member.”

Evans asks parents to be extra aware that kids are out during this time of year and to be on the lookout for them. She adds distracted driving plays into this too.

“Drivers need to be extra aware that kids are out and about,” Evans said. “It’s up to us, as the adults, to be on the lookout for them. Of course, distracted driving plays into this too. We also need to make sure we are all driving the speed limit or below the limit in neighborhoods, around parks or just anywhere kids may be outside and playing. Really it’s up to all of us to be careful and watch out for kids."