Car Seat Safety

Baby in car seat
Pediatric Trauma team member fastening car seat for child
Child helping another child with fastening their seatbelt

Buckle Up! Program

C.S. Mott Children’s Hospital Buckle Up! Program is here to make sure your child is in the right seat, that it is installed correctly, and your child is harnessed safely in the seat. Certified Child Passenger Safety Technicians and Instructors work one on one with families to show them how to properly install a car seat in their vehicle as well as how to buckle children in their seats. To better serve the community, most of our events require appointments. Appointments take approximately 30 minutes per seat. We encourage expectant parents to call at the beginning of the third trimester to schedule an appointment. For appointments or car seat questions, please call the Buckle Up! hotline at 734-763-2251 or 734-763-5063 (Español).

Child Passenger Safety Basics

Child safety seats provide the best protection for infants and young children. However, correctly installing a child safety seat can be challenging, especially with the wide variety of child safety seats, vehicles, and seat belt systems available today.

It's important to follow these guidelines:

  1. Select a child safety seat based on your child’s age and size and refer to the child safety seat instructions and vehicle manufacturer’s instructions for weight limits, proper use and installation.
  2. Register your child’s seat with the manufacturer. Send in the card that came with the seat, or register on the manufacturer’s website. This will make sure you are notified of any recalls.
  3. Car seats expire. Manufacturers are required to include the model number and manufacture date on each seat they produce. It can be found on a label attached to the restraint, usually on the bottom or the side of the seat. It can be helpful to take a picture of that label before you install the seat. Check with the manufacturer if you aren’t sure how long your seat is safe to use.
  4. Car seats are only tested for one crash. Avoid using seats from strangers, as you can’t confirm their history. Check out the National Highway Transportation Administration’s (NHTSA) recommendations on when to replace a car seat after a crash ▸

Child Restraint Recommendations

All children under 13 should be buckled in the backseat.

Rear-facing carseat

Newborns - 4 Years

Keep your child rear-facing as long as possible. It’s the best way to keep him or her safe. Your child should remain in a rear-facing car seat until they reach the top height or weight limit for that seat, or at least age two. Information about height and weight restrictions can be found on a label on the side of the car seat.

Forward-facing carseat

2 - 7 Years

Once your child outgrows the rear-facing car seat, they should travel in a forward-facing car seat with a harness. Five-point harnesses are best for toddlers and kids because they help distribute crash forces over a wider area, and keep children more consistently restrained as they mature. Keep your child in a forward-facing car seat with a harness until he or she reaches the top height or weight limit allowed by the seat manufacturer.

Booster seat

4 - 12 Years

Once your child outgrows the forward-facing car seat with a harness, it’s time to travel in a booster seat in the back seat. Booster seats are designed to make the adult seat belt fit a child properly. The lap belt must lie snugly across the upper thighs, not the stomach. The shoulder belt should lie snug across the shoulder and chest and not cross the neck or face. When considering if your child is ready for a booster seat or transition to the adult seat belt, make sure they can stay properly positioned for the entire ride. Typically, a child no longer needs a booster seat when they are 4 feet 9 inches tall.

Things to Remember

Inappropriately sized car seat

Always use a seat that is appropriate for your child’s weight and height. Every seat will have a sticker on the side with height and weight limits for that seat. Children grow fast, check for proper fit often.

Child with too much bulky clothing in carseat

Take off the wraps. Remove bulky clothing or blankets before placing the child in the car seat. Never place blankets underneath or behind the child or under the harness. Don’t use inserts that didn’t come with the car seat, as they aren’t crash-tested and safety can’t be guaranteed.

Rear-facing car seat at a 45 degree angle

Position rear-facing seats at the correct angle. Read the manufacturer’s instructions to determine the correct angle (normally 30 to 45 degrees), indicated by an arrow, level or other angle indicator on the car seat.

Aligned Forward-facing carseat

Aligning forward-facing seats. Most forward-facing seats should be flush with the back of the seat of the car. Always check the owner’s manual to find out if the manufacturer permit a semi-reclined position.

Harnessed child in carseat

Keep them harnessed. All infants and toddlers should ride in a rear-facing safety seat until they are 2 years old or until they reach the highest weight or height allowed by the car seat manufacturer. Once your child is forward-facing, they should stay in a 5-point harness as long as possible, until they outgrow the height and weight limits of that seat.

Unrestrained child

Never let children ride unrestrained. Keep your child in a harnessed car seat until they outgrow the height and weight limits of that seat. Make sure they are in a booster seat until the adult seat belt fits them properly. Seat belts for everyone else, even adults in the backseat!

Rear-Facing Seats

In a crash, a rear-facing car seat cradles and moves with the child to reduce stress on fragile necks and spinal cords. Remember that bones develop strength with age, not size, so even if your child is big for their age, their spine still needs to be protected.

Types of Rear-Facing Seats:

  1. Rear-facing only seats, often called infant car seats, can only be used rear-facing. This type of car seat isn’t safer than a convertible car seat, even for a newborn, but it can be more convenient as it can be removed from the car and carried.
  2. Convertible and 3-in-1 car seats switch from rear-facing to forward-facing. They typically have higher height and weight limits for the rear-facing position, allowing you to use them for a longer period of time.

Steps for Securing Your Child

  1. The straps should be positioned at or below the shoulders so the harness straps come up and over the baby’s shoulders. When the top of the baby’s head leaves less than an inch of hard plastic shell above it, the child has outgrown that rear-facing car seat.
  2. Always keep harness straps snug, straight and flat. The harness should be tight enough that your fingers slide off the webbing if you try to pinch the fabric up and down. The tightness should be similar that of suspenders. Before tightening the harness, make sure the baby is scooted all the way to the back of the seat. This will help them maintain an open airway.
  3. The harness chest clip keeps the shoulder straps in the correct position. The clip should be at the middle of the chest, level with the armpits.
  4. Make sure the vehicle seat belt is in the correct path through the seat. Convertible car seats will have two routing options. Always follow the manufacturer’s instructions to ensure you are using the correct belt path.
  5. Some manufacturers allow you to place tightly rolled receiving blankets on either side of the child for extra support. DO NOT put rolled blankets around the head or underneath the child’s head/neck.

If your child is in the car seat, but not in the car, keep them harnessed tightly as that will maintain good positioning for breathing and reduce the risk of strangulation by the harness retainer clip. As a general rule, baby should not be in their car seat for more than two hours at a time in or out of the car.

Rear-facing carseat


Carseats with proper and improper padding

Forward-Facing Seats

Types of Forward-Facing Seats:

  1. Convertible seats switch from rear-facing to forward-facing. A convertible car seat should not be used forward-facing until the child has outgrown the rear-facing height or weight limits.
  2. Combination seats come with a 5-point harness system. When the child outgrows the height or weight limit of the harness, you can remove the internal harness and use the seat as a high-back belt positioning booster (BPB) seat. Read the manufacturer’s instructions for more information. Combination seats cannot be used in a rear-facing position.

As babies grow into toddlers, they often want to adjust the harness straps and clips themselves, so it is more important than ever to ensure that they are properly harnessed and stay that way the whole ride.

To secure your child in a forward-facing car seat:

  1. Harness straps should be threaded through slots level to or just above your child’s shoulders.
  2. Harness clip should be fastened at the middle of child’s chest and level with armpits.
  3. The tops of the child’s ears should stay below the top of the seat’s plastic shell. Once their ears pass this point, or their shoulders pass the highest harness slot, the child has outgrown the harness of that seat and should move to a belt-positioning booster seat.
Forward-facing carseat

Belt-Positioning Booster Seats

All children whose weight or height is above the limit for their car seat’s harness should use a belt-positioning booster seat until the vehicle seatbelt fits properly, typically when they are 4 feet 9 inches tall.

Why use booster seats?

Booster seats are designed to better position a child to make the adult seatbelt fit them properly. There are two types of booster seats: high-back and backless. The high-back features built-in head and neck restraints. The backless booster relies on head and neck protection built into the vehicle’s seat (the seat’s headrest). As long as the seat has a headrest and the seat belt fits properly, either a high back or backless booster seat is appropriate.

Things to keep in mind when using a booster seat:

  1. The vehicle lap belt should fit snugly across the child’s upper thighs while the shoulder belt is snug across the chest, and rests on the collarbone.
  2. Always use vehicle’s combined lap/shoulder belts with boosters. Lap-only belts are not safe to use with booster seats, so always make sure your child is keeping the shoulder belt across their chest.
  3. Only use booster seats designed for use in cars.
Booster seat

Seat Belts

Once your child outgrows a booster seat (usually 4 feet 9 inches or taller) you still want to make sure that the vehicle’s safety belt is being worn the way it was designed and tested. Before moving them out of the booster seat, make sure the child passes the 5-step test:

  1. Children should sit up straight with their back and hips against the seat – no slouching.
  2. Knees should bend comfortably at the edge of the seat and feet should rest on the floor.
  3. Shoulder belt should be snug across the chest resting on the child’s collarbone. Putting the shoulder belt behind the back or under the arm won’t protect in a crash, and can even cause internal injuries.
  4. The vehicle lap belt fits snug and low over the upper thighs, never across the stomach.
  5. The child can stay this way for the entire car ride! No wiggling, slouching, or unbuckling.
Child with seatbelt

Installation Methods

Seat Belts

Seat belts are a tried and true way to install car seats. In order to get a good install, the seat belt must lock. Usually if you slowly pull the seat belt out all the way, and feed it back in, the seat belt will lock. This ensures when you tighten the seat belt around the car seat, it will stay tight. If your car was made before 1996, you may need to use a locking clip. Make an appointment with a child passenger safety technician to be sure.

Lock-Offs

Some child restraints come with a built-in locking mechanism, called a lock-off. This does the same job as the seat belt’s locking mechanism. Lock-offs can look very different from manufacturer to manufacturer, so look at the stickers on the side of the car seat or in the owner’s manual.

Lower Anchors and Tethers for Children (LATCH)

LATCH is an acronym for Lower Anchors and Tethers for Children. LATCH systems secure a child safety seat to the vehicle’s rear seats using straps from the child safety seat that connect to special metal anchors built into designated positions in the vehicle. However, unless both the vehicle and the child safety seat are designed to use the LATCH system, the vehicle’s seat belt will need to be used to secure the child safety seat instead. The LATCH system and the vehicle’s seat belt system should not be used together.

Tether Attachment

For forward-facing seats, you should use both the lower attachments or the seatbelt and the tether strap that comes out of the top of the car seat. The tether reduces the forward motion of the seat in a crash. Most seats do not use a tether when used rear-facing. Read your child safety seat instructions to be sure.

If you’re not sure where to find these hooks in your vehicle, read the manufacturer’s instructions to determine if it is equipped with the LATCH system, to locate the anchors, and look up the recommended weight restrictions.

Note: Installing child safety seats with either the vehicle’s seat belt or the LATCH system is equally safe as long as the child safety seat is installed correctly. The seat should move less than an inch at the side where it’s buckled in.

Special Needs

Premature infants and children with respiratory difficulties, orthopedic challenges, neurological and behavioral problems may require special child restraints. Learn more ▸

Avoid These Dangerous Mistakes

Unrestrained child with driver

Unrestrained: Never hold a child on your lap in a moving car, even if you are buckled in – especially in the front seat. No human is strong enough to hold a child in the event of a crash, and injury and death are much more common after an ejection. Even if they aren’t thrown from the car, an unrestrained child is placed at additional risk from the vehicle’s air bags. Children should always be properly restrained in the back seat.

Partially-restrained child

Partially Restrained: Never use seat belts other than as intended – with both the shoulder belt resting on the collarbone and lap belt across the tops of the thighs.

Toys

Projectiles: Hard toys and loose items can become dangerous projectiles during hard braking and crash situations. Keep an assortment of soft toys and plush animals ready for in-car entertainment. Don’t hang toys from infant seat handles. They can become loose in a crash.

Children and Air Bags

There’s a good reason that all car manufacturers are required to display warning labels regarding inflatable restraint systems, or air bags. They are designed to inflate with tremendous force and speed, and can cause serious injury or death to children, especially to infants in rear-facing child safety seats. Children under 13 should always be properly restrained in the back seat. This gives them time for their bones to fully develop.

Some cars have inflatable seat belts. If your car has these, check the owner’s manuals of the car seat and the vehicle to make sure it’s safe to use to install a car seat.

All inflatable restraint systems are required to have an air bag warning label. If you’re not sure about your vehicle, look for warning labels on seat belts, sun visors or the sides of the seat.

Need Help? Get a professional opinion.

A certified child passenger safety technician can check the installation of your child safety seat and answer questions.

Call 734-763-2252 or 734-763-5063 (Español) to schedule a car seat check appointment.