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Keeping your babies safe is everyone’s top priority. It might surprise you to learn that many parents are using and/or installing car seats incorrectly and making simple mistakes that can be extremely unsafe. Recently I felt like our car seat was feeling wobbly, but instead of MacGyvering the situation, we hired a dude named James DeCarli to install the seat correctly. He is the man. He was so good that you need his info. First time parents and seasoned parents, grandparents, caretakers and people thinking about having children need to read this post to learn about the newest and most current car seat safety information to date.

A little background on Jim before I get to the interview part: Jim runs a company called Pro Consumer Safety. He is the CEO. He is also this: Injury & Neuroepidemiologist, a Master Certified Health Education Specialist (MCHES) and Child Passenger Safety Technician (CPST). Above all, Jim (which I can call him now because we’re buds) is thorough. Any and all car seat related information should be included below.

Alright Folks, here we have my first Cool Mom Jamie interview!

  1. What is the most important thing a NEW parent – a new family leaving the hospital, should know when choosing a car seat and use it for the first time?

First, new parents must understand that by the time their baby is being discharged from the hospital they need to have already had a Certified Child Passenger Safety Technician (CPST) teach them how to install, test and use their car seat properly. Secondly, they need to understand not all car seats are always fully compatible to every vehicle. For example, there are over 684 models of motor vehicles and 238 models of car seats manufactured in the United States. And every year new models can change design ultimately affecting how compatible a car seat is to a vehicle. While both motor vehicle and car seat manufacturers are required to meet Federal standards, specific factors (design and position of car seat, location of vehicle seat belts and LATCH system, sporty vehicle seat contours, tall driver and passenger, size of vehicle, etc.) contributes to the 30-35% chance that a specific car seat might not be compatible to a specific vehicle.[i] Therefore it is highly recommended that parents not only test the car seat in the vehicle before purchase to make sure it is compatible but also have a certified technician teach them how to use it properly. In general, it is best to have this completed by 4-weeks of delivery. This allows time in case of early delivery so the parent already knows the car seat is compatible and they know how to test, reinstall and restrain the newborn baby properly.

  1. Is there a recurring error you have come across that parents are making when they’re installing and/or using car seats? Off that, is there a pattern or recurring issue you see with caretakers (secondary, not primary) with car seats?

There are several recurring errors that parents make then installing their car seats. Studies have shown that 96% of parents feel their child’s car seat is installed correctly and is being used properly, but research shows that 85-95% of car seats are not installed correctly and are not being used properly.[ii] So misuse of child car seats is very high. Some of the most common errors include:

  1. CAR SEAT LOCATION: Most errors and misunderstanding are placing the car seat on one of the side seats instead of in the center position, which is the safest when there is only one child in the vehicle. This generally happens because the sides are where the lower anchors of the LATCH system is usually located. While parents are correct about reading the owner’s manual of the motor vehicle and car seat instructions, they often are misled to place the car seat on one of the side positions where the LATCH system anchors are located. However, research has shown that when having one child in the back seat, the child is 43% safer in the center position compared to the two side seats (Behind driver 31% and 28% behind front passenger).[iii] This is because in the event of a collision and potential side impact side door intrusion, the car seat is further away from the side door. For most motor vehicles when installing a car seat in the center position will utilize the vehicle seat belt instead of the lower anchors of the LATCH system (the top tether portion when forward facing is also in the center positions to use when forward-facing even with the vehicle seat belt). Parents should always follow instructions of the motor vehicle and car seat. Keep in mind that the car seat must also be installed properly and securely in the center as well. Further, with a rear-facing car seat make sure the car seat is at the required angle (usually the back of the car seat is to be at 45-degrees) and distance between the back of the car seat and back of the front vehicle seat (generally 1-2 inches or three fingers width). This allows sufficient space for the driver and passenger knees. Whereas their knees are to be no closer than three-inches from the dash board and for the driver no close than 10-inches to the steering wheel and passenger no closer than 20-inches to the airbag.
  1. BORROWING THE LATCH ANCHORS: Another common mistake when placing the car seat in the center position is connecting the car seat by using the lower LATCH anchors by borrowing from the two side seats (which is NOT correct), instead of using the vehicle seat belt. The lower anchors of the LATCH system must be 11-inches apart, as seen on the two side vehicle seats. In the center position these lower anchors are generally more than 11-inches apart so it is not possible, nor safe, to borrow from each side. Most vehicles do not have the lower anchors of the LATCH system in the center position. But always check the owner’s manual of the motor vehicle to confirm. Some car seats will allow a further distance for the lower anchors, so always check with the car seat manufacturer. Keep in mind when using the lower anchors of the LATCH system these have a weight maximum of 65-pounds, combined weight of the car seat and child (when over this weight the vehicle seat belt must be used to connect the car seat). So when using heavier convertible car seats check in the instructions or contact the car seat manufacturer on the maximum weight and use of lower anchors of the LATCH system.
  2. USING BOTH THE LOWER ANCHORS OF THE LATCH SYSTEM AND THE VEHICLE SEAT BELT: Another common error parents make is installing the car seat using both the lower anchors of the LATCH system and the vehicle seat belt. Unless the car seat manufacturer specifically allows this, it is not safe to do so. To date, the only time this is possible is with the Nuna Pipa base and with the Clek Foonf (forward-facing only). When in doubt, call the manufacturer of the car seat and confirm with the vehicle owner’s manual.
  3. NOT BUCKLING THE CHILD’S HARNESS STRAPS PROPERLY: Another common error is parents leaving the child’s harness straps too loose, not in the proper location and the chest clip too low. This is dangerous and children have been partially ejected and severely injured from not being secured properly. Remember, while the car seat must be appropriate for the height and weight of the child, and the car seat properly installed, the child must also be buckled properly. Whereas, a) when REAR-facing the harness straps must be at-or-BELOW the child’s shoulders and when a FORWARD-facing the harness straps must be at-or-ABOVE the child’s shoulders; b) the harness strap must be snug enough on the child’s legs and shoulders so the parent is not able to pinch the straps with two-fingers and pull away from the child; c) the chest clip level with the child’s arm pits. This is highly necessary to keep the shoulder straps on the child’s shoulders to secure the child; and d) keep the center strap as close to the child as possible without them sitting on it (many car seats the center strap can be adjusted accordingly).
  4. TURNING THE CHILD FORWARD FACING TOO SOON: Another common mistake is changing a child to forward-facing too soon. Many parents, and even some pediatricians misunderstand the rear-facing recommendation. First, the new California rear-facing law that went into effect January 2017 (requiring children to be rear-facing up until at least 2-years of age or over 40-pounds or over 40-inches tall) can contribute to this confusion. Whereas some might feel that once the child is 2-years of age it must be safe to turn and place a child forward-facing, but this is not the safest. Secondly, some pediatricians have misunderstood the entire American Academy of Pediatrics (AAP) policy recommendation for rear-facing. Whereas the APP recommends “All Infants and Toddlers Should Ride in a Rear-Facing CSS [Child Safety Seat] Until They Are 2 Years of Age or Until They Reach the Highest Weight or Height Allowed by the Manufacturer of Their CSS”. Once a child outgrows their infant, rear-facing only car seat, they will transition into a convertible car seat, which is also rear-facing then converts to forward-facing. Most convertible car seats have been designed to keep children rear-facing up to at least 40-pounds and six manufacturers now have convertible seats keeping the child rear-facing to 50-pounds. Based upon clinical growth charts based on height and weight, a car seat keeping children rear-facing between 40-50 pounds means on average children can ride rear-facing between 3-5 years of age. It is important to follow both upper weight and height for each position of the car seat. Some parents become concerned the child’s knees are bent and feet up on the back of the vehicle seat when rear-facing. This is fine however. What is important is to keep the child rear-facing as long as possible to protect the child’s head and neck. Remember anytime a child is seated forward-facing, during a collision, that child is at an increased risk of neck injury from the child’s head projecting forward and traumatic brain injury from the child’s head slamming back into the vehicle seat, so keep them rear-facing up to the upper weight or height allowed for their car seat to help protect the child’s head and neck.
  1. What’s up with the coat wearing and car seats. I was just told that you have to take the kids out of their coats for safety? If this is a thing, until what age are you taking their coats off?

Bulkier clothing, such as a winter coat, heavier fleece, or even a snow suit can reduce the ability of a harness system in a child’s car seat or even a seat belt in a vehicle from doing its job of holding the child or passenger in place in the event of a collision. Therefore, when a parent is placing their child in a car seat they need to remove any bulky clothing, then buckle them up properly in their car seat. If it is cold, warm up the inside of the vehicle first, then remove their bulky clothing then buckle them up. For older children, they can slide their arms into their coat backwards after they are buckles up properly.

A parent can do a safe test to see what happens when a child is wearing too bulky of clothing. To test, 1) put a fluffy coat on the child, 2) seat the child in their car seat and fasten them in the harness strap properly, 3) then, do not loosen the harness straps but instead just unbuckle the chest clip and then the two center straps, 4) take the child out of the car seat and remove the child’s bulky clothing, 5) sit the child back into their car seat and buckle the two center straps and chest clip. You will notice the harness straps are likely too loose. Do the “pinch” test with two fingers and likely you can pull the strap away from the child. This looseness will occur because in the event of a collision the fluff will compress and thus the child’s body can move around, increasing the risk of injury.

Similarly, other fluffy items in car seats that have a similar risk are those items that did not come with the car seat. Such as, but not limited to, head and body support, padded shoulder strap covers, fashion covers, slip covers for the car seat, etc., all have a similar effect whereas during a collision these can reduce the effectiveness of the car seat harness straps. Even further such items have not been crash tested with the car seat so one does not know how it will perform in the event of a collision. Further, these can increase the risk of suffocation as well.

The American Academy of Pediatrics (AAP) has the following policy recommendation regarding bulky clothing, “Ideally, dress your baby in thinner layers instead of a bulky coat or snowsuit, and tuck a blanket around your baby over the buckled harness straps if needed.”. Further, the National Highway Traffic Safety Administration (NHTSA) provides a similar recommendation, “Bulky clothing or heavy coats can prevent a snug harness fit. Always buckle the child in the seat first, and then place coats or blankets over the harness.”.

So, every time a parent buckles their child into their car seat, booster seat or even older children or adults in a seat belt, if they are wearing bulky or fluffy clothing, remove it before buckling them up properly, so the harness strap or seat belt fits properly and snugly against their body.

  1. How do you know when your kid is ready to switch to forward facing?

It is time to move your child forward-facing when your child reaches the upper height or weight allowed for rear-facing of their car seat. Keep in mind that as babies outgrow their infant rear-facing only car seat (generally within 6-12 months) they will then graduate into a convertible car seat, which is again rear-facing then converts to forward-facing. Generally convertible car seats are rear-facing up to 40-50 pounds (3-5 years of age). Many parents become concerned that the child’s knees are bent and feet are up against the back of the vehicle seat but this is not a problem. Remember rear-facing position longer helps to protect the child’s head and neck.

  1. Can you describe what happens to the car seat in an accident? Once a car seat has been in an accident you need a new one, right?

Depending on the severity of car crash, the car seat structure can be damaged. Sometimes the plastic will have white stress marks but sometimes not. Further tears and ripples can occur on the harness strap, but sometimes they might not appear. The National Highway Traffic Safety Administration (NHTSA) recommends that car seats be replaced for moderate or severe crashes, but not for minor crashes. The NHTSA defines a minor crash as a) the vehicle was able to be driven from the crash site, b) the vehicle door nearest the car seat was not damaged, c) none of the passengers in the vehicle sustained injury, d) if the vehicle had air bags, they did not deploy, and e) there is no visible damage to the car seat. Now in California, when reporting a car crash to the auto insurance company they will ask if you had a car seat and if the child was in the car seat during the crash. Under California Insurance Code, Section 11580.011 of California law, required insurance companies to replace the car seat if the child was in the car seat during the time of the collision, regardless on the severity of car crash. If however, the child was not in the car seat at the time of the crash they insurance is not required to replace the car seat unless there is visible damage to the car seat. This is where a Certified Child Passenger Safety Technician (CPST) must inspect the car seat for damage. As a CPST myself, it is difficult to confirm “visible damage”, because there could be damage that we are not seeing and could put the child at risk during a potential future crash. In this case we check with the car seat manufacturer. Most car seat manufacturers will recommend replacing the car seat after “any” collision. This sometimes is written in the instruction manual of the car seat, or confirmed by calling the manufacturer. Even if the car seat manufacturer would not recommend replacing the seat, as a public health and safety professional I would recommend to the insurance company to replace it because as a CPST we cannot verify if possible unseen damage exists and could put the child at risk of injury or death in a future collision and increase risk of future liability to all parties. They generally accept this and replace the car seat. Replacing the car seat is always the safest option.

  1. Do you see any trends in car safety emerging? (different technology, different strategy, etc.).

Several trends have emerged which can affect the safety of their child.

  1. SMALLER SIZE & DESIGN OF VEHICLES: One trend that has been emerging more recently is how many SUV’s are becoming smaller in size, while car seats are being made larger to accommodate children to remain at each stage longer. This poses a problem that puts the child at an increased risk of injury from parents either changing the child to forward-facing too soon, having the car seat pressed up against the back of the front vehicle seats or the driver and front passenger putting themselves at risk from being too close to the dash board and front airbags. Even further are the design of rear vehicle seats and seat belts. Many 2017 and 2018 vehicles have seats with increased contours, fixed seat belts, and seat belts that are several inches away from the back of the vehicle seat. This causes a problem because when using the seat belt to install a car seat, these conditions makes it difficult for the seat belt to pull the car seat back into the vehicle seat for proper positioning and installation. Pro Consumer Safety has established shopping guidelines for parents when choosing a vehicle. This includes 12-factors for parents to consider before purchasing a new vehicle and helps to identify compatibility of proper car seat use and installation in a new vehicle.
  2. ACCESSORY CAR SEAT ITEMS: Another trend is the emerging non-regulated (after-market) car seat accessories, that indicate they are “crash tested”. Unfortunately there are no regulations for these types of accessories, so even though it might say it is crash tested we do not know what baseline or test they are using to assess how effective the accessory is. Some car seat manufacturers will make accessory items for their car seats, but only use these if the manufacturer specifically allows this for a particular seat and model. Always call the manufacturer to confirm before using. Some of these accessories such as head and neck support for examples are also so fluffy these can reduce the effectiveness of the harness strap holding the child appropriately. In addition to know knowing how these items would perform during a crash, it is equally unknown on the risk of suffocation from these fluffy accessories. A good rule for parents to practice is to use is using only what comes with their car seat, nothing else. Unless the manufacturer suggests otherwise.
  1. When parents are traveling out of town, what’s a resource they can use to find car seats? Last time we travelled that was an issue.

When traveling out of town, specifically with airline travel and renting a vehicle at your destination, several things to consider and best to plan ahead. Often parents might not want to travel with their own car seat. Sometimes it might be too heavy or expensive for travel and they do not want it to be damaged. There are several options, rent or purchase. First, there are companies that rent baby gear, such as strollers, cribs and even car seats. Secondly, many car rental companies have car seat available. Some states as in California require car rental companies to provide car seats for child passengers. Either way when renting a car seat the parent is responsible for ensuring the car seat is appropriate for their child, and for proper installation and use of the car seat.

Several downsides to this. The most important is safety. Among both baby gear rentals and car rental companies, neither have Certified Child Passenger Safety Technicians (CPST) to monitor recalls, assess damage, ensure all necessary parts are available such as head support, infant inserts, etc., and confirm it is safe for your child’s use. Additional concerns are cleanliness. Has it been sanitized and cleaned to your standards and would the company have an additional car seat immediately available if not. Another downside is the cost to rent, which can range between $6-10 per day and $35-55 per week depending on the type of car seat you need. So for example you might spend between $40-55 or more for a one week trip, and more for longer.

A more cost effective and much safer option is to purchase a less expensive car seat for travel. These prices can start at only $45 at department stores or online. Keep in mind that these less expensive car seats are just as safe as the most expensive car seats. They still meet federal standards in the United States. The difference is all adjustments are manual so no lock-off’s, levels or harness strap adjusters for example. The good news is that these car seats are much lighter to carry. They are new, clean and you do not have to worry if they have been damaged or are dirty when you arrive at your destination as with rented car seats. If you plan ahead you can purchase before or have them delivered at your destination as well. Once you are finished traveling, if visiting family or friends that you visit often just leave the car seat with them after you leave for future use or take it home with you for future travel. A final note for parents, it is recommended to plan ahead but also visit https://www.safercar.gov/ to find a CPST to assist them with proper installation and use, and even local car seat laws.

  1. Is there anything you want to raise awareness about or discuss or mention regarding auto safety?
  1. SEASONED PARENT: If you have already been a parent remember child passenger safety regulations, designs, requirements and recommendations changes rapidly, which is why it is always important to obtain an update by having a Certified Child Passenger Safety Technician consult you to ensure you obtain best car seat for yours needs and how to install, test and use your seat properly. And this includes buckling the child up properly.
  2. SUMMER HEAT: As warmer temperatures come closer, remember that motor vehicles become hot quickly. During the warmer spring and summer months, on average every two-weeks in the U.S. a child under the age of two dies from being left alone in a car. Most of these cases the child was left in the vehicle for a moment then was forgotten. Vehicles can become hot quickly. Even on a mild day of only 80 degrees it takes only about 10-minutes for the inside of a vehicle to rise to 99 degrees, and only 20-mninutes to rise to 109 degrees. The sun’s radiation heats objects inside the vehicle such as the dashboard, steering wheel, car seat, etc. These heated objects then radiate heat warming the air inside the vehicle. Similar to that of a convection oven. Remember the body of a baby heats up 3-5 times faster than that of an adult. So never leave a child, pet or even an older adult alone in a motor vehicle. Pro Consumer Safety has the following four helpful tips for keeping children safe in motor vehicles.
    1. Leave reminders! Especially when changing routines in driving a newborn. After you buckle the child up, leave reminders on the back floor by the car seat such as a briefcase, purse, mobile phone, anything that you will need when at your destination.
    2. Take your baby with you! Never leave them alone in a motor vehicle, not even for a moment. It is illegal in California and 18 other states to leave a child along in a motor vehicle.
    3. Lock your car! Keep your vehicle locked when you are not in it so children are not able to climb in to play.
    4. See a child alone – call 911! If you see a child along in a motor vehicle, call 911. Emergency personnel are trained in knowing how to respond in this situations. Your call could save a child’s life.
  1. SUMMER TRAVEL-RV: Remember that Class-A (those larger RV’s shaped like a bus) and Class-C (has overhead sleeper with a van shaped cab) recreational vehicles (RV’s) are not crash tested in the United States and their rear seating seat belts to not have to meet Federal seat belt standards as in U.S. passenger vehicles. This means that in the event of a collision, it is unclear how the car seat will stand a collision. This can include the seat bench breaking apart to projectiles and cabinets breaking apart. Pro Consumer Safety has established three recommended guidelines for parents or caregivers to consider when transporting children in recreational vehicles. For additional information visit Recreational Vehicles and Child Passengers:
    1. Best Alternative: Consider a non-motorized/towable RV such as a fifth wheel, trailer, tent trailer or truck camper. This ensures that children can ride properly restrained in a car seat in the passenger portion of the vehicle that meets Federal safety standards for passengers.
    2. Second Best Alternative: Drive the child in a passenger vehicle so they can be properly restrained and follow the RV.
    3. Least Best Alternative: For those who own an RV or for those considering in purchasing one, have custom seats built in the rear of the camper that meet Federal seat belt standards. However keep in mind the risk of cabinets and kitchen equipment breaking apart, as well as storage items becoming projectiles. This is the least safe alternative for any rear passenger and not idea not recommended for child passengers.

 

You made it!!!! That’s great! You’re smarter now.  I suggest printing for reference.

SO there you have it folks, arguably the most comprehensive guide to car seats available on the inter webs. While you might feel like omg TL;DR this information is crucial to safety in the car, and we spend so much time in our cars these days that this information may save a life!

James is available in the LA area for consultations.  Check out his website here.

Vital Car Seat Safety Interview with James DeCarli
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