“Children don’t need to be in a car to be hurt by one” is a phrase that has percolated in my mind over the past week. Where we live in Virginia, I see at least one young child in a car not buckled in a seatbelt or safely protected by a booster seat, perhaps once a week. I rarely, if ever, see young children turned around facing backward in the backseat. Often I want to say something to the drivers–in a thoughtful way–but offering free advice about a hot-button issue like seatbelts or booster seats can elicit a hostile response. So we will continue to raise the issue in ChildSafetyBlog. Here, we are probably as sensitive to this issue as many people who see young adult drivers texting or adults simply using their phone, while driving. Yet, in our view, parents who transport children by car without at least fastening seatbelts or protecting them in a booster seat are clearly not using their best judgment.
To be protected very young children should remain in a rear-facing car seat until they are at least 20 pounds in weight and a year old. Babies can be vulnerable to head and spine injuries in the case of a car crash, if their car seats are not rear facing. Some parents are concerned that their children may sustain leg injuries if their seats face backward, but thus far, there is no evidence of kids receiving leg injuries because their car seats were facing the back.
We were surprised to learn recently that many parents have actually given up booster seats for children between the ages 4 and 8–even though children can sustain serious injuries without booster seats. Booster seats are especially helpful because the child is raised to a height where the seat belt fits properly across lap and chest. Strapping children snugly in their seats is also a key to safety. If parents loosen the straps for any reason, they need to remember before they go on their way, to tighten them again. One more caution to parents and caregivers is to make sure when you send your child in someone else’s car, that the driver has your child’s booster seat to use for your child. You might even think about purchasing an extra, basic booster seat to use for this purpose.
Back to the earlier statement, kids don’t need to be in cars to be hurt by them. Backing over children is still a terrible tragedy no parent or caregiver should ever experience. The statistics are shocking: Fatal backing accidents kill at least 228 people every year — 110 of them are children under age 10 — and injure 17,000. We have passed the end of 2012, and Transportation Secretary Ray LaHood, who pushed back the deadline to publish the new rules for car manufacturers, promised this would be done by the end of the year. The new rules would mandate new manufacturing requirements to improve the visibility behind passenger vehicles and help prevent fatal backing crashes. We want to know why this hasn’t happened? The response of “added costs to the auto industry”-in light of their current profits–is no longer a viable excuse!
Here are two good ideas parents like to put into practice: “Keeping children safe when they ride in the car by using the appropriate booster or safety car seats in the proper manner;” and “Car pooling in order to save gas, limit wear and tear on a vehicle, and rotate chauffeuring responsibilities of parents and caregivers.” Both of these sound like great ideas, don’t they? Is there any good reason these ideas should be mutually exclusive?
We don’t think so, but, according to a study performed by Michelle Macy, MD, of the University of Michigan-Ann Arbor, and her colleagues, “Parents who generally have their children use booster seats in the car are not consistent in their use of booster seats when carpooling.” Also, 79% of the group of carpooling parents in the study said they would always ask another driver to make sure to use a booster seat for their child and only 55% said they would have their child use a booster seat if their friends riding in the vehicle did not have booster seats. The data in the study were compiled from a survey of 681 parents of children, ranging in ages from 4 to 8. The article published in the February 2012 issue of Pediatrics, concluded that “social norms and self-efficacy for booster seat use may be influential in carpooling situations,” which is a lofty way of saying that peer pressure is at work and it limits children’s safe-riding behavior even in carpooling situations.
This means to me that as child safety communicators, we need to do a better and more thorough job in publishing the message long and loud that using restraints appropriate for a child’s size every time they are in the car is very important for the safety of your child! The American Academy of Pediatrics believes health care providers have an important role in the process of communicating this message as parents view health care providers as a major resource for information on how to keep their children safe. The American Academy of Pediatrics revised their policy statement on booster seat use last year to reflect an emphasis on the size of a child, rather than a child’s age, by “recommending the use of a booster seat from the time children outgrow their forward-facing car seat until they reach 4 feet, 9 inches tall, around ages 8 to 12.”  Safekids.org says “Use booster seats from 40 to 80 or 100 pounds.
The University of Michigan study reported that despite the type of restraint used for their children, most parents (64%) participated in carpooling and that booster seats were not uniformly used when the parents were driving other children. The good news is that 76% of the parents used a safety seat for their child (although they had difficulty distinguishing between a safety car seat and a booster seat so for the purposes of this study, safety and booster seats were combined into “safety seats”). The remaining 24% of parents in the study said they used restraints (safety belts), but not booster seats, for their children. Finally, children were more likely to be using safety seats if the children were younger or lived in states where safety/booster seats were mandated by law. Our conclusion: Parents and caregivers need to know the differences between booster and safety seats and always make sure to use the size-appropriate seat in the proper way for children… every time they ride in your car! Every state has a child passenger safety law and parents and caregivers need to know the law in their state. To find the child passenger safety and safety belt use laws in your state, go to www.usa.safekids.org  and, please, drive and ride safely!
One of the best ways to protect your young child is to CORRECTLY put them in an appropriate child safety seat. I emphasize correctly because the statistics show that only 72% of child restraints are properly used. Here are the most common ways that restraints are improperly used:
- Inappropriate age and weight for child restraints
- Wrong direction for the child restraint
- Child restraint improperly placed relative to vehicle’s airbags
- Improperly placed or secured child restraints (vehicle’s belt or straps not tight enough)
- Crotch strap or harness strap of child restraint secure or tight enough
- Use of a locking clip for certain safety belts
- Improper vehicle belt fit across child in a booster seat
- Child restraints with broken parts.
It’s amazing to me that these misuse statistics are so high when we know that proper use of child restraints is one of the most effective ways to protect children against serious injury. Personally, I personally believe this is a combined failure of government regulation/education and a failure to focus on or address the problem by our vehicle manufacturers.
So, this month will be dedicated to the proper use of child safety restraints. If there are any particular issues you want me to address, please let me know.