Stillwater Healing Arts
By Janelle Boyington, RM, CPM
There are many families with broken hearts; they were close to home, perhaps on a country road, or with a “safe” driver in a car too full for a car seat, and then the worst occurred. When I was in midwifery school, I worked as an EMT in a busy Emergency Department. There we aided in the aftermath of countless motor vehicle accidents. Far too many included the tragedy of a small child riding in an improperly installed car seat, or no car seat at all. This is
preventable; CAR SEATS SAVE LIVES. All fifty states have laws that require infants and small children to ride in car seats. The American Academy of Pediatrics makes the following four recommendations: (1) rear-facing car safety seats for most infants up to two years of age; (2) forward-facing car safety seats for most children through four years of age; (3) belt-positioning booster seats for most children through eight years of age; and (4) lap-and-shoulder seatbelts for all who have outgrown booster seats.
Which car seat and when? (from Colorado’s Child Passenger Safety Law):
- Rear-facing car seat, correctly installed in the back seat: from birth to AT LEAST one year AND twenty pounds in weight (children who reach twenty pounds before their first birthday still need to be in a rear-facing seat); restrain your infant in a rear-facing seat as long as possible for the best protection in a crash (“convertible” car seats allow rear-facing until thirty to forty-five pounds)
- Rear or forward-facing car seat: from one to three years old (follow upper weight limit according to manufacturer’s instructions; restrain your child in a “five-point” harness system until they are AT LEAST forty pounds
- Forward-facing car seat or booster seat: from four to seven years old (follow upper weight limit according to manufacturer’s instructions; regardless of age, children should be in a booster seat until they are about 57” (4 ft. 9 in.); a child’s height is the best predictor of proper seat belt fit.
- Booster seat and/or the vehicle lap and shoulder safety belts: from nine to sixteen years old (forty to eighty or hundred pounds; to sit without a booster, a child should be able to sit back against the seat back with knees bent naturally at the edge of the seat, the shoulder belt comfortably crossing the shoulder between the neck and arm, and the lap belt low on the hips, touching the thighs. Children under thirteen should sit in the back seat only; use the booster until your child passes the “safety belt fit test” found at www.safekids.org
The next size child safety seat is appropriate when you can answer yes to ANY of the following questions:
- Does your child exceed the car seat’s height and weight limits?
- Are your child’s shoulders above the car seat’s top harness slots?
- Are the tops of your child’s ears above the car seat?
General car seat tips (adapted from the March of Dimes):
- Be wary of used car seats, they may have been damaged, the extent of which can be unseen
- Always put your baby in a rear-facing car seat in the back seat of the car, NEVER in the front with a passenger-side airbag
- Children under the age of twelve are 36% less likely to die in a crash if they are sitting in the back seat
- Use the car seat every time your baby (or small child) rides, never on your lap, always in a properly installed car seat, most accidents happen close to home on roads with low speed limits
- When installed with the car’s safety belt or LATCH (Lower Anchors and Tethers for Children) system, your car seat should not move more than one inch side-to-side or front-to-back. For more on installation, see your owner’s manual and go to the Safe Kids website at www.safekids.org.
If you’re not sure your car seat is installed correctly (and even if you think it is), get it checked out: The Lyons Fire Department has a certified car seat technician available by appointment; call recruitment officer Mike Marzano at (303) 823-6611, ext.103; The City of Longmont provides a car seat safety checkpoint on the second Wednesday of the month, from 2 to 7 p.m., at the Longmont Fire Department Station Two, located at Mountain View and Hover Street. No appointment is necessary.; Boulder Rural Fire Department provides this community service by appointment; call (303) 530-9575 and ask for the on duty car seat technician.
But by the way, “car seats are for CARS!” While it can seem convenient to tote a sleeping baby from car to store, back to car, and on into the house all while sleeping in the car seat; more and more families are keeping their baby in the car seat for hours on end. The American Academy of Pediatrics recommends that infants “spend minimal time in car seats (when not a passenger in a vehicle).” They make this recommendation for several reasons including a rise in plagiocephaly or “flat head syndrome” due to the pressure to one specific portion of the head for long periods of time. Head positioning inherent with infant seats can further lend to the infants head tilting which can prevent correct postural development (neck strength and cervical spine alignment to name a few). For the mother’s body, an infant car seat is heavy and cumbersome to carry (as one colleague says, “a chiropractic nightmare;” while carrying an infant in a sling or front pack is barely more that the weight of the baby. In addition to physical development, notes Catherine McKenzie, “spending excessive amounts of time in an infant seat deprives a baby of touch and stimulation.” In her article on this topic, she cites a Columbia University study where half of a group of new mothers were provided with a soft, wearable infant carrier. “After thirteen months, researchers found that the babies who had been transported in wearable carriers were significantly more likely to demonstrate a strong attachment to their mothers.” Babies need love and human contact. When they are carried from place to place, perhaps put down on a safe ground surface for play, then picked up and played with instead of jostled around in the car seat, they are receiving the attention and the varying positions that are imperative for their emotional and physical development.
A car seat is “extremely effective at protecting your baby or child when it is installed correctly and used correctly every time they are a passenger” (AAP); then keep your car seat in the car and support your baby’s enjoyment and development in this great big world.
Janelle Boyington is a midwife providing homebirths, midwifery, well-woman care, and lactation services, seeing patients at Stillwater Healing Arts Clinic here in Lyons.