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Car Safety

How important are seat belts and car seats?

According to the CDC, motor vehicle accidents are the leading cause of death for children in the U.S. Thousands of children are at risk because they are not buckled up.

Car seats and seat belts must be used correctly to give the best protection. Children younger than 12 years old should sit in the back seat. The following are safety guidelines:

Infants (birth to age 1 year)

The infant car seat should:

  • Be placed in the back seat of the automobile

  • Face the rear of the vehicle

  • Be secured with a seat belt

  • Be placed directly on the seat of the car

Always read and understand the car seat mankerr's instructions. Never prop a child up with blankets or pillows. Never place a baby in a rear-facing child safety seat in the front seat with an air bag.

Toddlers and preschoolers

According to the American Academy of Pediatrics (AAP), toddlers should ride in a rear-facing car safety seat for as long as possible. That means until they reach the top weight or height allowed by their seat. Check your safety seat instructions. Most convertible safety seats have height and weight limits that will allow children to ride rear-facing for 2 years or more.

The car seat should:

  • Be placed in the back seat

  • Face the rear until the child has reached the top weight or height allowed by their seat

Once your child outgrows the rear-facing car seat, he or she is ready to travel in a forward-facing car seat with a harness and tether, up to the top weight or height allowed by the car seat.

School-aged children

All states have child safety seat laws. These laws require children to travel in approved child restraints or booster seats. Some allow older children to use adult safety belts. The age when seat belts can be used instead of child safety seats varies, so check your state's rules.

Belt-positioning booster seats should be used by all children whose weight or height is above the limit for forward-facing car seats. Once the car's seat belt fits the child correctly, it can be worn. This usually happens when a child is 8 to 12 years of age and at least 4 feet 9 inches tall. All children younger than 13 should ride in the back seat.

The booster seat

Children who are taller or weigh more than the limit for a forward-facing car seat should switch to a belt-positioning booster seat, according to the American Academy of Pediatrics. It's important to check your car seat owner’s manual for the seat's height or weight limit.

Booster seats are designed to raise children up on the car seat so that the lap and shoulder belts fit correctly. This happens when their ears are level with the top of the back of the safety seat, and their shoulders are above the top strap slots. Children should use a belt-positioning booster seat until the vehicle seat belt fits correctly. Typically this is when they have reached 4 feet 9 inches in height and are 8 through 12 years of age.

Booster seats should always be placed in the back seat of the vehicle. All children younger than 13 years ride in the back seat. 

What are tether anchors?

To ensure the safety of children in vehicles, manufacturers have a child safety seat system in new cars to make it easier to install seats. This is known as the LATCH system (Lower Anchors and Tethers for Children). Most new vehicles will have upper tether anchors for forward-facing child safety seats with top tether straps. By attaching the top of the child safety seat to the vehicle, it ensures that the seat more securely attached. This offers better protection for the child. New vehicles also have special child seat anchorage points between the vehicle's seat cushion and seat back. This lets you attach the child seat to the anchorage points instead of with the vehicle's seat belts. 

Replacing child safety seats and seat belts after a crash

Once a vehicle has been in a severe crash, replace child safety seats and seat belts. They may have become stretched or damaged. Always check with your child safety seat maker for any questions about the safety of your child's seat.

When car seats are recalled

Sometimes child safety seats are recalled for safety reasons. To check if your child safety seat has been recalled, call the seat's maker or the Auto Safety Hot Line at 888-327-4236. If the seat has been recalled, you will be told how to fix it, or how to get parts to fix it. 

The importance of shoulder belts

A lap and shoulder belt offers more protection than a lap belt alone. The shoulder belt keeps you from moving forward if you are in a head-on crash. It should lie across your shoulder, but it may touch the base of your neck. Never place the shoulder belt behind you or under your arm. If your car has only lap belts in the rear seat, consider installing lap and shoulder belts. Many cars with lap belts can be modified with shoulder belts for a small cost. Check with your car's manufacturer. 

Most experts believe that many injuries could be prevented if child safety seats and lap and shoulder belts are installed and used correctly. Remember to always buckle up when you are in the car, no matter how far you are traveling. 

Air bag safety

When used correctly, air bags save lives with little risk. Almost all people who have died from air bag-related injuries were either not restrained or not correctly restrained. 

But air bags do pose risks to children ages 12 and younger. For this reason, the AAP recommends that these children ride correctly restrained in the back seat at all times. They also recommend:

  • Never place a baby under age 1 or under 20 pounds in the front seat of a car with an air bag. Babies should always ride in a safety seat, facing rear, and in the back seat of the car.

  • Correctly restrain all children in the appropriate car safety seats, booster seats, or shoulder and lap belts, based on their height and weight.

  • Install an air bag on/off switch only if your child has a special healthcare need. This might mean they need to be watched constantly and no adult is available to ride in the back seat with the child.

  • When no other arrangement is possible and an older child must ride in the front seat, move the vehicle seat back as far away from the air bag as possible. Keep in mind that the child may still be at risk for injuries from the air bag.  

What is the correct use of air bags?

Always buckle your lap and shoulder safety belt. Air bags are designed to work with the safety belts:

  • Children under age 12 should be restrained in the back seat. Don't put a car safety seat with a baby in front of a passenger air bag. The baby's head is too close to the air bag when it opens.

  • Sit at least 10 inches from the steering wheel. This gives you the most protection and the least friction from contact with the back as the air bag opens.

  • Place your hands at the 10- and 2-o'clock positions on the steering wheel. This gives you the best protection by letting the air bag to open without anything in the way.  

What are the signs of a sleepy driver?

Drowsy driving is a major problem in the U.S., the CDC says. Signs that you, your driver, or other drivers on the road may be too sleepy to be safely driving a vehicle include:

  • Eyes closing or going out of focus

  • Trouble keeping head up

  • Continuous yawning

  • Wandering, disconnected thoughts

  • Not remembering driving during the past few minutes

  • Drifting between lanes, tailgating, or missing traffic signs

  • Jerking the car back into the lane

  • Drifting off the road and narrowly missing a crash  

Anyone who has any of these symptoms should pull off the road right away and find a safe place to nap. 

Driving while taking medicines

Drivers taking over-the-counter or prescription medicines should be very cautious. These medicines can often cause drowsiness right after taking them. A recent study found that people taking common antihistamines and allergy medicines were worse at driving than those who drank alcohol. Healthcare providers recommend not driving after taking these medicines. If you must drive, do so only when you have no other choice and be very careful. 

Distracted driving

The 3 main types of distraction are:

  • Eyes not on the road (visual)

  • Hands not on the wheel (manual)

  • Mind not on driving (cognitive)

 According to the CDC, distracted driving is blamed for reported car accidents each day in the U.S. that result in more than 9 deaths and more than 1,153 injuries. 

Online Medical Reviewer: Adler, Liora, C., MD
Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Date Last Reviewed: 5/1/2018
© 2000-2018 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.