Whether it is a trip to the grocery store or to Grandma’s house, safely securing children--and car seats--into the automobile can significantly decrease chances of injury if an accident occurs. Motor vehicle crashes are the leading cause of unintentional injury-related death among children. Nearly 1,600 children ages 14 and under die in motor vehicle crashes each year; and nearly 228,000 children are injured, many the result of improper restraints. Nearly 73 percent of all restraints are used improperly, and nearly 12 percent of children ride completely unrestrained.

Children ages 4-8 years who are not using car seats are most likely to be unrestrained because many parents are unaware that children up to age 8 should continue to ride in booster seats. Adult safety belts do not fit properly until children are 8-11 years old; internal organ and spinal column injuries can result from an improper belt fit.

LATCH

“Buckling up” now has a new meaning. Beginning in 2002, retailers began stocking shelves with child safety seats equipped with LATCH. Lower Anchors and Tethers for Children (LATCH) is a new safety system mandated by the federal government to simplify and standardize installation of child car seats without use of the vehicle’s own seat belt system. New cars, minivans, and light trucks manufactured on or after September 2002 are equipped with the new LATCH system, including “anchor points” between the vehicle’s seat cushion and the seat back in at least two rear seating positions, as well as a top tether anchor.

Likewise, after September 2002, all newly manufactured child safety seats must have both seat belt and LATCH options. LATCH child safety seats are equipped with a lower set of attachments that fasten to the vehicle’s anchors. Forward-facing child safety seats also have a top tether strap that attaches to the top anchor in the vehicle, while rear-facing infant-only child safety seats have lower LATCH attachment only.

Childcare Activities

Childcare providers are important role models in the life of young children and can make learning to “buckle up” fun. For example, use a doll and doll stroller to demonstrate the importance of buckling up. Leave the doll unbuckled, push the stroller very fast, then have it come to a sudden stop. The doll should fall out of the stroller. Repeat the demonstration, except this time have the doll securely buckled.

Working With Parents

Caregivers can also encourage parents to buckle-up their children. Develop a written child transportation policy that requires proper child restraint while being transported to and from the center. Childcare providers and parents often use different approaches to adhere to each program’s transportation policies. Some parents leave their booster seats with the childcare provider when they drop their child off. Some childcare providers supply booster seats, while others choose not to transport children at all.

Sometimes it may be necessary for childcare providers to approach individual parents about their lack of, or improper use of, child safety restraints. Before speaking to a parent about specific concerns, have solutions available. Recommend a local child safety seat checkup event where trained child passenger safety technicians can inspect child safety seats and educate them about proper installation. Talk to the parent about the new LATCH system and have literature on hand. If cost is an issue, many communities now have car seat loaner/donor programs available.

Recommendations

Keep children safe, whether installing a car seat using LATCH or a seat belt system. The National Highway Transportation Safety Administration (NHTSA), the American Academy of Pediatrics, and the National SAFE KIDS campaign recommend the following when transporting children of all ages:

• Always read and follow vehicle owner manual and child safety seat instructions.
• Choose a child safety seat that is appropriate for the infant or child’s height and weight.
• Only use a borrowed car seat if it has been properly inspected. Check the NHTSA web site list of recalled car seats.
• A properly installed child safety seat should not move more than 1 inch from side-to-side or toward the front of the vehicle.
• Choose a five-point harness system. Keep harness straps snug and flat. Fasten the harness clip at armpit level.
• The back seat is the safest for children, especially if the front seat has air bags.
• Infants should ride facing the rear, correctly restrained, in the back seat until they are at least one year of age and weigh at least 20-22 pounds.
• Children who are at least one year old, weigh 20-40 pounds, and can no longer ride rear-facing should ride in forward-facing child safety seats.
• Once the child faces forward, he should remain in a car safety seat until weighing more than 40 pounds or reaches the maximum allowed height for the specific seat (check instruction book).
• Children more than 40 pounds should be correctly secured in belt-positioning booster seats or other appropriate child restraints until the adult lap and shoulder belts fit correctly (around age eight).
• Restrain children ages 12 and under in the back in a forward-facing restraint. If there is no back seat available, forward-facing children (over one year of age and at least 20 pounds) should be placed in their appropriate child safety seat with the vehicle seat pushed as far back as possible.
• Child safety seats should never be used on vehicle side or rear facing “jump” seats.
• Never allow passengers to ride in the bed of a pickup truck. Twenty-five states, the District of Columbia and Puerto Rico have laws that restrict certain passengers from riding in pickup truck beds.
• Never put a rear-facing child in a front seat with an active passenger airbag. During a forward impact, the rapidly inflating air bag could strike the safety seat with enough force to seriously injure or kill the infant.

Elaine Abrams, RN
Certified Health Education Specialist and Public Health Professional

RESOURCES

American Academy of Pediatrics, 141 Northwest Point Blvd., Elk Grove Village, IL 60007-1098; 847-434-4000; www.aap.org/family/cps.htm

National Safe Kids Campaign, 1301 Pennsylvania Ave., NW, Suite 1000, Washington, DC 20004; 202-662-0600; www.safekids.org

INTERNET RESOURCES

National Highway Traffic Safety Administration LATCH, www.nhtsa.dot.gov/CPS/LATCH