Bumper Cars For Kids

This week’s guest columnist is Dr. Ben Fontenot, a Family Practice resident at the University Hospital and Clinics here in Lafayette.

Juice in one hand, 2 year-old in the other, 15 minutes late for work.  I buckle my girl into her car seat, off to daycare.  After the second curve, screaming came from the back.  In the rear view mirror I saw only feet, sticking up in the air!

I pulled over and found my daughter and her seat upside down, a confused look on her face.  What happened?  Someone had borrowed the car seat and forgot to re-buckle it when putting it back in my car.

Summer travel season is approaching, so everyone needs a reminder on car seat safety: road injuries are the leading cause of preventable deaths in children in the United States.  “Preventable” is an important word in that statistic, because 71% of those deaths would be avoided with proper child seat use.

And “proper” seat use is another important caveat, since 4 out of 5 car seats are used incorrectly, with an average of three mistakes for every seat!  Car seats are complicated things to buckle and position; ask anyone who has tried.  But it’s your kid’s best safety device, since car crashes are her most likely way to die.  Some important tips:

-Know your car seat!  Read the manual!

-Rear-facing seats: for newborns until age 2, or until the child reaches maximum height and weight for that seat (read that manual!).  Most bad crashes are head-on, and rear-facing supports baby’s heavy head.

-Forward-facing seats: when your child has outgrown the rear-facing seat.  Some seats are convertible, from rear to forward-facing.  Your child should stay in this seat until he maxes the seat’s height and weight (manual!)

-Booster seat: used with the car’s standard lap and shoulder harness, to position the child so that the adult seatbelts give maximum protection.  A child sitting in a regular seat would have the shoulder harness resting on his neck (very bad!), and the lap belt over his belly instead of his hip bones.  Boosters avoid this, and are for kids age 4 to 7 years.

Once we saw a case where a car had been hit by a truck.  The driver cried to the firefighters that her baby was in back, but they couldn’t see baby because the car was so crumpled.  They heard no noise from inside and feared the worst.  It took 45 minutes to cut away the roof and find baby in her car seat, sleeping quietly, clutching her stuffed rabbit.  When we examined baby in the ER, she was completely unscathed.  Hooray for car seats!

The backseat is actually the safest place in car crashes, and kids of all ages should be back there, not in front.  It’s not convenient, but it’s safer, and it’s the law.  Follow the rules every time, even for short drives.  Inconsistency with restraint use confuses children, again is illegal, and we see many injuries with unbelted kids when ”I was just going down the block!”  All kids under 13 should be in the back seat; airbags in front can kill younger children.

Shoulder and seat belt use: when kids are 80 lbs. and 4 feet 9 inchest tall, they can go in booster seats, at about 8-12 years old.  When using regular seat belts, the lap belt should fit snugly across the thighs, not on the groin or belly.  The shoulder belt should lie on the mid-shoulder, at least two inches from the neck.

Correct installation: to tell if you have strapped the car seat in properly, use the “tug test,” tugging the seat from side to side.  It shouldn’t move more than an inch.  The “pinch test” ensures that the seat’s shoulder straps are snug on the child; you shouldn’t be able to pinch a fold in those straps when she’s buckled.  Young infants should have their seats in a semi-reclining position; if baby is too upright, his heavy head could fall forward and pinch off his airway.  Most seats have a built-in level on the side to show the proper recline.

If you get a used car seat, be absolutely sure it hasn’t been in a crash.  Replace ones that have been in a crash, are broken, or expired.  Throw them away, don’t give them away!

Finally, always wear YOUR seat belt.  Be a good example, and stay alive for your children!

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