Checkup Newsroom

Child Passenger Safety Week: Protect Your Kids On the Road

Thu, 19 Sep 2024 12:49:07 -0500

An average of three children are killed per day due to lack of car seat use or improper car seat use—and a staggering three out of four car seats are used incorrectly. Every year, children are rushed to the emergency room to be treated for car-related injuries, some of which occur without the car ever leaving the driveway.

In honor of Child Passenger Safety Week (Sept. 15-20), we asked Cook Children’s Trauma Injury Prevention Coordinator, Sharon Evans, for insights on how to keep your kids safe in the car.

Know the Four Stages of Car Seats

Knowing how to properly restrain your child in the car at every phase of their growth is crucial to their safety.

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.

Important Reminders for Car Seat Safety

These tips will help you do your due diligence for proper car seat and seatbelt usage before hitting the road.

When selecting a car seat for your child, ensure it fits in your vehicle properly before purchasing it.
Thoroughly read and closely follow all manufacturer instructions for your car seat to ensure it is installed correctly.
Infant car seats should always be rear-facing, and never used forward-facing.
Make sure the harness is tight enough using the pinch test—if you can pinch the harness between your thumb and forefinger, it is too loose.
Always lock the vehicle's seatbelt.
Regularly check the maximum height and weight limits of your car seat to ensure your children are transitioned to the next one in a timely manner.
For older children who are using booster seats or seat belts, ensure the belt is across the pelvic area and the shoulder belt strap is placed across the shoulder. It should never be placed along a child’s neck or abdomen, under the arm, or behind the back, as it could cause severe injury in a crash.
Always make sure you are wearing your own seatbelt to set an example for your kids.

Stay Vigilant for Counterfeits and Fakes

As you’re 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. Below are some red flags to watch out for when shopping, as well as ways to check the authenticity of your seat.

Red Flags:

A great deal on a car seat. If it’s “too good to be true,” it probably is.
Do not purchase from someone on social media or from a yard sale.
Do not purchase from e-commerce sites, which allow for third-party sellers and can lead to a counterfeit car seat.
A safety warning label with symbols and pictograms, but no detailed written information

Check for Authenticity

If you haven’t yet purchased your car seat, 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.

Evans strongly recommends anyone with a new car or booster seat does a car seat check with a child passenger safety technician. These professionals, many of whom are also nurses and physical therapists, educate caregivers/patients/families on car seat safety and know what is required for car seats to meet the Federal Motor Vehicle Safety Standard 213. Here are a few ways to schedule a free car seat check:

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

For additional information about car seat safety, visit the Texas Department of State Health Services.

About Cook Children's Health Care System

Cook Children’s is more than a health care system: we strive to be an extension of your family, growing with your child from their first steps to adulthood. By collaborating to deliver on our Promise—to improve the well-being of every child in our care and our communities, we connect the dots for our patients. Between primary and specialty. Between home and medical home. Between short-term care and long-term health.

Based in Fort Worth, Texas, we’re 9,700+ dedicated team members strong, passionately caring for over 2 million patient encounters each year. Our integrated, not-for-profit organization spans two medical centers (including our state-of-the-art location in Prosper), two surgery centers, a physician network, home health services and a health plan. It also includes Child Study Center at Cook Children's, Cook Children's Health Services Inc., and Cook Children's Health Foundation. In 2024, Forbes named Cook Children’s the top health care employer in the U.S., and third on the list of ‘America’s Best Large Employers.’

And our impact extends beyond the borders of Texas. We proudly treat children from virtually every state in the nation and 32 countries. By seeing the world through the eyes of children and their families from all backgrounds, we’re able to shape health care suited to them: connected by kindness, imagination and respect—with an extra dose of magical wonder.

Discover more at cookchildrens.org.

Counterfeit Car Seats: Parents May Be Using a Knockoff Without Knowing It

Thu, 22 Sep 2022 11:23:00 -0500

By Eline deBruijn Wiggins

Child Passenger Safety Week is Sept. 18 through Sept. 24. National Seat Check Saturday is Sept. 24, 2022.

Choosing a car seat for your baby can be overwhelming. There are so many different colors, styles and price points. But there’s one more thing to keep in mind – these popular brands are being knocked off to create counterfeit car seats.

These knockoffs may be cheaper, but are less likely to protect your child in a crash. Some parents don’t even know that their seat is a knockoff, due to ecommerce sites or purchasing car seats on social media. The dupes are eerily similar.

Last month, a Cook Children’s Child Passenger Safety Technician found a fake brand car seat, which was a dupe of a popular brand. There were a few differences that could be easily overlooked, unless you know what to look for.

Cook Children’s has Certified Child Passenger Safety technicians (CPST’s) who know how to properly use and install car seats within the Medical Center to ensure our patients ride safely. Under the Center for Children’s Health and Safe Kids North Texas there are also CPST’s who work in the community and have partnerships with fire departments, police departments and other community agencies to help educate the communities around us. “My fear is there is going to be more and more fakes out there and parents really need to be vigilant to make sure they have a true crash tested safety seat that will protect their child in the car at all times,” said Sharon Evans, RN, BSN, CPN, CPSTI, trauma injury prevention coordinator at Cook Children’s.

Cook Children’s Child Passenger Safety Technicians educate caregivers/patients/families on car seat safety and know what is required for car seats to meet the Federal Motor Vehicle Safety Standard 213. On the authentic seat, safety warning labels are much more informative with detailed, written information, which are required by law. The fake car seat had safety symbols and pictograms, but no wording.

Fake car seats may have incorrect features altogether, such as strap width, which when placed on authentic car seats will protect an infant or toddler’s fragile bodies in a crash.

The knockoffs do not meet federal safety standard guidelines set by the National Highway Traffic Safety Administration. Authentic car seats have passed rigorous safety standards and crash safety tests.

Parents and caregivers who shop online will want to stay extra vigilant for fake car seats. The best way to ensure your child’s car seat is authentic is to buy directly from the manufacturer or from a reputable retail store.

Red flags:

Great deal on a car seat. If it’s “too good to be true,” it probably is.
Do not purchase from someone on social media.
Do not purchase from ecommerce sites, which allow for third-party sellers and can lead to a counterfeit car seat.

What can I do? Is my child’s car seat authentic?

Call the manufacturer. They can help you determine if it’s a knockoff. Sometimes they will 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.
Find a Child Passenger Safety Technician: Welcome! | National CPS Certification (safekids.org)
The National Highway Traffic Safety Administration maintains a directory of many inspection stations.
Additional information about car seat safety from the Texas Department of State Health Services

Car Seat Check Saturday: Sept. 24, 2022. Events are scheduled across Fort Worth and Willow Park areas.

Register and view upcoming events at www.freecarseatcheck.org

Did you know?

Car crashes are a leading cause of death for children, according to the U.S. Department of Transportation. On average, two children under 13 were killed and an estimated 374 were injured every day in 2019 while riding in cars, SUVs, pickups, and vans.

608 child passenger vehicle occupants died in traffic crashes in 2019.
38% of children who died in 2019 while riding in passenger vehicles were unrestrained, compared to 33% in 2018.

There hasn't been a “death-free” day on Texas highways since 2000, that's more than 78,000 deaths. #EndTheStreakTX (txdot.gov)

This year so far 2,839 deaths, as of Sept. 14, 2022
2021 had 4492 deaths
2020 had 3897 deaths (10.5/day)
2019 had 3623 deaths (10/day)

Is your child's car seat safe?

Sun, 31 Aug 2014 15:51:02 -0500

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:

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.
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.
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.
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:

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.