Tips & Tricks - How to Prevent Someone from "accidentally" unbuckling your child's car seat

You know the sound - the double "click" - the first click is the "oops", and the second click is the person unbuckling their own seat belt.  Oops - I accidentally unbuckled Ella's car seat...

When two seat belts buckle right next to each other, it is very easy to accidentally unbuckle the wrong one first.  Here are a few easy solutions to try and prevent the "oops".

If your vehicle has the lower anchors (LATCH) in the seating position where your child is riding (remember, the center of MOST vehicles does NOT have the lower anchors) AND your child is not too heavy for the lower anchors (most have weight limits - which vary by vehicle & child restraint - but typically 40-48 pounds) - THEN install the car seat using LATCH and no one can accidentally unbuckle the child's car seat.

If you are using the vehicle's seat belt:

If your seat belt and buckle will allow for this (some won't), rotate the buckle (the female end) half a turn before buckling the seat belt.  This way the red release button will be facing in towards the child's car seat instead of tantalizingly sticking out near the other seat belt buckles.

Can't flip the buckle around?  Don't despair.  Here are a few other tricks:

If your child's infant or toddler car seat came with shoulder strap covers that velcro on/off, you may have already noticed that the shoulder strap covers were too long to allow you to keep the chest clip in the proper place - and most annoyingly of all, the shoulder strap covers tend to make the harness straps twist.  Here is a great way to REPURPOSE a seemingly useless item (as having them on actually makes things more UNcomfortable for the child as now there is more sticking into the side of their neck).  Once you are done installing the car seat, slip one shoulder strap cover behind the vehicle's seat buckle, and the other in front of the seat belt buckle - velcro them together and now you have "hidden" the red release button.

The RED button showing is the seat belt buckle for the person sitting NEXT TO the child's car seat.

Perhaps the person sitting next to the child's car seat is a 6 year old in a booster who just has really sticky fingers and the shoulder strap cover trick just isn't enough of a deterrent.  The solution is a disposable plastic or paper cup - or even a plastic yogurt container (6-8oz size).  Make a vertical slit in the cup going all the way from the top to the bottom.  Next, cut out the bottom of the cup.  Now your cup is like a tube with a slit - place the cup around the vehicle's seat belt buckle and secure the cup closed with a piece of tape.  Do NOT put tape on the vehicle's seat belt or the buckle itself.  Now Mr. Sticky Fingers can't push the wrong button (well, at least not the seat belt release button - I'm sure he's good at pushing other buttons...)

Bubble Bum - the most innovative backless booster you've ever seen

The Bubble Bum is an incredibly innovative new booster seat that will arrive in the US April 2011 - it is already wildly popular in Europe.  The Car Seat Lady is super excited about it as I think it will eliminate many of the barriers to booster seat use - in a way that no other booster seat does.

What makes it so GREAT?

• LIGHTWEIGHT
• Weighs just 1 pound!
• Great for playdates, travel, taxis & rental cars - anytime you need to take a booster
• COMPACT 
• INFLATES in seconds to its regular size, but quickly deflates to fit in a child's tiny backpack
• Unlike other boosters which are bulky pieces of plastic (even if they weigh only 5 pounds), this one is compact enough that you have no excuse to not bring the booster with your child for EVERY trip (even just a short taxi ride from the airport...)
• NARROW
• Until now, the Nania High Ride was the narrowest booster on the US market at 14.5 inches - but the Bubble Bum is just 12.5 inches wide!
• With smaller, more fuel efficient cars becoming the primary family vehicle, the need for a narrow booster has never been greater.
• LOW PROFILE
• Without "arm rests" like other booster seats, it will fit in smaller spaces where other boosters won't (think trying to fit 3 kids across the back seat)
• Many kids find it hard to buckle themselves into traditional boosters as the arm rests block their view of the seat belt buckle - this booster will give them more independence
• Note: the "arm rests" on other boosters are to prevent the lap belt from sliding up into the child's abdomen - the Bubble Bum uses innovative belt guides on the side of the booster to accomplish this same goal, but without bulky arm rests
• FUN
• A large focus group of school kids picked the fun purple color scheme
• Since it doesn't look like other boosters, your child may not fight as much about riding in it
• COMFORTABLE
• AFFORDABLE
• At $30, you can afford to have one for playdates, one for grandma's car, another for the babysitter's car...

Who can use it: It is appropriate for kids age 4 and up who weigh between 40 and 80 pounds.

The fine print:
The Car Seat Lady received this Bubble Bum booster for free - but is in no way affiliated with Bubble Bum and is not paid in anyway for this blog post. 
Why the glowing review?  We simply think this may be the best thing since sliced bread (well, for boosters at least).  There are many barriers to booster seat use - convenience, cost, portability, lack of space in the vehicle to name a few - and this booster addresses them all in a way no other seat does.  Therefore, we think this booster has the chance to keep many kids safer as we think kids will be more likely to have this booster with them when they need it (the ride to the airport, the taxi in NYC, the last minute playdate, etc). 

Introducing the new.... Graco Smart Seat

Graco Smart Seat

I had the privilege and pleasure to spend the past 2 days in Atlanta at the Graco headquarters for the Smart Seat Launch conference for car seat advocates.  I feel honored to be amongst the 13 car seat advocates invited - with "just" 13 years experience in the field I was the baby of the bunch and was humbled to be in the company of greatness - as the other 12 advocates have devoted many years of their lives helping to keep children across this country safe when riding in cars. 

In an effort to be as transparent as possible, Graco invited us to preview their new seat - but it was more than just a preview.  This was an opportunity for those of us with the highest level of expertise in the field to share our thoughts and feedback on this and other products with the engineers and product design teams so that we can work together to create the best seats possible - ones that not only offer the best crash protection, but also facilitate proper use and fit the widest range of children possible. 

So, without further adieu, let me introduce the Smart Seat (images provided by Graco)

 

The Basics:
- Rear-facing: 5-40 pounds
- Forward-facing with 5-point harness: up to 65 pounds (top shoulder strap slot 17.2 inches)

- High back booster seat: to 100 pounds

Smart Seat - Rear-facing recline

Smart Seat - Forward-facing

Graco Smart Seat - High Back Booster mode

Why is this seat a game changer?

Graco Smart Seat base

You know the old adage, "only infant seats have bases"... well, rules were meant to be broken and the Smart Seat has rewritten the rules.  This seat comes in 2 pieces - there is a "stay in car base" and the shell that the child rides in.  The base is not optional - i.e. unlike most infant seats that can be installed with or without the base, you MUST use the base on this seat.  The base is used when the seat is installed rear-facing & forward-facing - but is NOT used in the booster mode.

PROS:

• You know that fantastic built in lock-off that appears on the Snug Ride 35 base?  You guessed it - the Smart Seat has it too - which makes a tight installation as easy as pie.
• Narrowest belt path of any seat - which works GREAT for the narrow center in many vehicles (some centers are as narrow as 8 or 9 inches "wide") - and while the base itself is much wider than 8 inches, it is possible to access the side seat belt buckles due to the fact that the base is cut out and raised on the sides.  This is not the case with any other forward-facing car seat - none others have this narrow of a "footprint".
• No towels/noodles needed under the seat to make it reclined enough for a young infant - all recline adjustments are made on the shell once the base is installed.  
• 40 pound rear-facing weight limit with dimensions that should really accommodate many kids to this point
• This is the first, and currently only, Graco seat to allow the use of the lower anchors at any spacing so long as the vehicle manufacturer designates that seating position as a LATCH position.  For more info on center LATCH, visit this older post - please note that the table on this post will be updated to include this Graco seat once the seat becomes available on the market. 
• No re-thread harness adjustment - with 6 harness heights (from 8.2 to 17.2 inches)
• This seat would be great for parents who carpool - if you need to take 2 year olds in the morning and 5 year olds in the afternoon, you can change the seat from rear-facing to forward-facing very easily (just remember to use the tether for forward-facing!)
• Wide comfortable seat
• Lowest shoulder strap slot is 8 in (same as on the Graco Snug Ride 22, 32, and 35 infant seats) - but with the requirement to use the shoulder strap covers for rear-facing this will likely not fit infants until closer to 10 pounds as the shoulder strap covers are long and bulky
• You can store the 5 point harness in a handy hideaway when the seat is in booster mode - so you don't have to worry about taking the harness out and/or losing it.
• Color coding to try and reduce confusion/errors - Blue is for rear-facing, Orange is for forward-facing, and Green is for booster mode
• Easy to read "bubble" level indicator on the car seat
• Steel reinforced base and shell - with 4 metal to metal connections between the shell and the base
  

  

  6 position no-rethread harness/headrest

CONS:

• This is not a seat for travel.  Why - it weighs 35 pounds.  If that isn't enough, it is likely too wide to fit on most airplane seats - that is if you could haul it down the aisle anyway.
• Currently, when it is installed rear-facing it sits quite reclined, which for older toddlers who are eager to look out the back window might be problematic as they get more of a view of the roof than the back window. HOWEVER - GRACO HEARD THIS FEEDBACK AND WILL LOOK INTO WHETHER THERE IS A WAY TO ALLOW OLDER KIDS TO RIDE MORE UPRIGHT WHILE REAR-FACING.  IRONICALLY, SITTING THIS CAR SEAT MORE UPRIGHT ACTUALLY INCREASES THE CHILD'S LEG ROOM, AND INCREASES THE LEG ROOM FOR THE FRONT SEAT OCCUPANTS.
• This is a wide seat - great if you have a captain's chair in a minivan, but problematic if you are trying to fit 2 car seats in the back seat of a car or SUV while still allowing enough room for a person in the back.
• With the current recline position allowed for rear-facing it takes up a fair amount of room into the front seat - and will likely not fit rear-facing in the center of many vehicles unless the driver and front passenger don't need a lot of leg room.
• Shoulder strap covers are long and bulky (with a firm piece of foam in the layer that goes between the harness strap and the child's body) - this may be uncomfortable not to mention it will likely prevent a snug harness fit for smaller infants.  Many of us find that shoulder strap covers make the harness straps twist - this is the only seat that REQUIRES the strap covers to be used, so removing them is not an option (note however that after 40 pounds the harness strap covers must be removed)
• The crotch buckle distance is only 6.25in (the same as the Graco Nautilus) which by 3-4 years of age is coming from under the child's bottom, rather than in front.
• In the booster mode (as with the Graco Nautilus in the high back mode), the top head rest height is not nearly tall enough to accommodate a child who is approaching 4'9".

Good Morning Las Vegas!

The Car Seat Ladies (Alisa & Emily) along with Lulu, Emily's 10-month old daughter (the car seat baby????), are in Las Vegas for the ABC Kids Expo.  Over the next 3 days we will be meeting with all the major car seat manufacturers to learn what new products and features they'll be launching in the next year - and to share feedback with them on how (in our humble opinions) they can improve their products - because frankly, car seats are just too darn hard to install properly.

Lulu, Emily & Alisa

Lulu sleeping comfortably in her Combi Coccoro on the plane

Having just traveled with a 10 month old in tow, we can share a few travel tips.

1. Buy a seat for the baby on the airplane.  It is not just the safer way to travel, it is the saner way to travel - who wants a squirmy toddler on their lap for 5 hours?
2. Travel with your car seat.  We brought the Combi Coccoro (which we wheeled around the airport connected to the Combi Coccoro Flash stroller).  I am a small person (just 5'2") and found it very easy to carry the car seat with sleeping Lulu in it down the aisle of the plane.  It also fit nicely in the airplane seat and allowed the person in front to recline their seat just about all the way. 
3. Encourage the baby to suck during take off.  Nurse or bottle feed the baby until you hear "flight attendants prepare for take-off" - then strap the baby into the car seat and offer a bottle, pacifier, sippy cup, or food that you have to suck out of the packaging.
4. Fly at night - the baby is most likely to sleep through the majority of the plane ride (Lulu thankfully did).
5. Change your baby into their pajamas before the flight - this will keep them warm as the plane is often chilly.

CAR POOL TIPS - What is the NARROWEST BOOSTER available?

Nania High Ride

Are you driving carpool this year and wondering how you are going to fit 3 boosters across the back of your minivan?  Trying to fit multiple car seats & boosters can be a challenge - even in a big vehicle like a minivan.  Wondering which booster is the narrowest?

Harmony Juvenile Cruz

The Nania High Ride (backless booster) is the narrowest booster seat currently available - at just 14.5 inches wide.  The Harmony Juvenile Cruz is the next narrowest - at just 15.5 inches wide.  Both are available for less than $25 each.  The Bubble Bum, which will be out in April 2011, is the narrowest of all at just 12.5 inches - and also has no arm rests (which are the parts that tend to interfere most with placing a booster next to another car seat or booster).

Bubble Bum

Before you rush to buy a booster for carpool...

Kids, especially younger ones, are safer in a 5-point harness.  Don’t rush to “graduate” your child to a booster seat.   Kids who are AT LEAST 40 pounds AND AT LEAST 3-4 years old can start riding on boosters.  Kids should ride on a booster UNTIL they can pass the 5-step-test (usually age 8-10).

If you can check "Yes" to all the statements below, your child is okay to use a booster:

YES       NO
  [ ]          [ ]       There is a shoulder AND lap belt where the child sits (boosters need shoulder belts)
  [ ]          [ ]       The child is at least 40 pounds (kids under 40 pounds are safer in a 5-point harness)
  [ ]          [ ]       The child is at least 3-4 years old
  [ ]          [ ]       The child can sit still the entire trip without leaning forward or sitting on their knees

Do you need something EVEN NARROWER?
The Ride Safer Travel Vest is a great option as it is only as wide as the child's body (see below for more info).


Does a child need to ride in a position with just a lap belt?
One option would be to use a 5-point harness car seat with a high-weight-harness (a harness that accommodates kids who weigh more than 40 pounds).  A list of such car seats can be found here thanks to our fantastic friends at Safety Belt Safe USA.

Ride Safer Travel Vest using tether + lap belt

Ride Safer Travel Vest in center showing tether

Another option is the Ride Safer Travel Vest - which is a vest that functions like a booster by positioning the vehicle's seat belt properly on the child's body.  The Ride Safer Travel Vest can be used with just a lap belt so long as there is a tether anchor available.  For vehicles 2000 and newer, there are tether anchors in at least 3 seating locations in the vehicle - most older vehicles (as old as 1989) can have tether anchors retrofitted for free or at minimal cost.  The vest was redesigned about a year ago; please make sure to get the newer version. You can distinguish the new from the old as the old one was only available in silver and had 2 buckles in front whereas the new one is available in a rainbow variety of colors, but not silver, and the new one has only one buckle in front.

NOTES: 

• The boosters shown above are BACKLESS boosters.  In order to use a backless booster, or the Ride Safer Travel Vest, you need to make sure that the vehicle seat back comes up to at least the top of the child's ears in order to provide adequate head support.  If the vehicle seat back does NOT come up to at least the top of the ears, then you need to use a high back booster.  
• For wiggly, squirmy kids it is often helpful to "lock" the seat belt - click here for tips on how to "lock" the belt. 
• The Bubble Bum will be available in April 2011 - it meets all applicable Federal Motor Vehicle Safety Standards and crash testing like all other boosters.
• The Nania High Ride (which meets all applicable Federal Motor Vehicle Safety Standards like all other car seats and boosters sold in the US) is not sold in any retail stores.  It is available individually for $20 from the University of Iowa Children's Hospital Online Safety Store.  Otherwise it is sold in packs of 6-8 boosters (total cost comes to less than $20 per booster) and is available from the following websites:
• AllegroMedical
• Child Source
• OpenTip

For approximate dimensions of other boosters and car seats, click here. 

They said it was impossible... - fitting 3 car seats across the back seat - some tips, tricks & "go to" seats

Safety 1st Go, Chicco Key Fit 30, Britax Boulevard

3 car seats in 2008 Range Rover Sport

Fitting 3 car seats across the back seat is a challenge.  Truth be told, it is not possible in many vehicles.  In other vehicles, it requires just the right combination of seats - not only a specific car seat, but putting it in the best position in the vehicle to allow the other seats to "puzzle" next to it.

You might be thinking - this is a Range Rover Sport, of course you could get 3 car seats in a huge truck like this.  But there you would be wrong - as just having a large vehicle in no way guarantees that you will be able to fit 3 car seats, just as having a small vehicle in no way guarantees that you won't be able to fit 3 car seats.  Case in point - the Range Rover HSE, which has similar exterior dimensions to the Range Rover Sport, will not accommodate 3 car seats due to the awkward layout of its back seat and the narrow dimensions of the center seat.

Having installed thousands of car seats, The Car Seat Ladies have some "go to" seats when it comes to fitting lots of seats into not a lot of space.  In the vehicle shown in the pictures (the 2008 Range Rover Sport) I installed the Safety 1st Go behind the driver (using LATCH), the Chicco Key Fit 30 in the center (using the vehicle's shoulder/lap belt), and the Britax Boulevard behind the passenger (using LATCH).  Had there been two forward-facing kids and one rear-facing, I likely would have tried the Safety 1st Go behind the driver, the Britax Boulevard forward-facing in the center, and the Chicco Key Fit 30 behind the passenger - as putting the Boulevard and the Go next to each other would allow the Go to tuck itself underneath the Boulevard and use up a little bit less space in the back seat with this overlap (each seat would be installed and the belt marked to make sure that the car seat was installed tightly INDEPENDENT of the other seat - i.e. and not relying on its neighbor to feel snug).

"Go To" Seats

• Infant
• Chicco Key Fit
• with a starting weight of 4 pounds it is guaranteed to fit almost any infant
• very narrow where the handle attaches (the widest part of most infant seats) - which allows it to fit nicely next to other car seats
• built in locking clips - very important for an easier seat belt installation
• 30lb weight limit so you get more use out of it than the 22lb infant seats

• Convertible (Rear to Forward Facing)
• Britax Marathon / Boulevard / Decathlon
• extra tall seated height to accommodate older kids rear-facing
• narrow where it needs to be and wide where it needs to be - making it fit in spaces where seemingly smaller seats won't
• built in locking clips - very important for an easier seat belt installation
  
• high weight limit forward-facing
• Combi Coccoro
• at 15 inches it is the narrowest convertible car seat
• built in locking clips - very important for an easier seat belt installation
•  note: it is shorter in seated height than the Britax/Sunshine Kids so will last less time rear-facing & forward-facing
• Sunshine Kids Radian
• high weight limit rear-facing & forward-facing
• narrow profile
• Note - this is typically a difficult seat to install securely using the vehicle's shoulder/lap belt as it does not have built in locking clips for either rear-facing or forward-facing.  As such, it is often not our first choice.  Installing this seat rear-facing with a shoulder belt is typically a very challenging installation as since the seat has no built in locking clips (and using the switchable retractor - the locking mechanism built into most shoulder belts - will tilt the car seat on its side) - you must use a metal locking clip to keep the seat belt tight.  A metal locking clip is a 2 person, multi-step process that is hard to do properly (and easy to do wrong).  Another issue with this seat is that in many vehicles it sits quite reclined when rear-facing which may mean that the adult in front of the car seat does not have adequate space to drive/sit comfortably. 
• Combination Seat (5 point harness car seat to booster)
• Safety 1st Go Hybrid
• Narrow (17 inches) with an exceptionally narrow profile at the top due to its lack of sides (except at the child's head) - which allows it to fit very nicely next to other seats, including puzzling underneath seats with an overhang like the Britax Marathon/Boulevard/Decathlon
• Great seat for older kids as:
• it doesn't look as much like a "baby seat"
• provides a 5 point harness for longer
• allows older kids some independence as with another car seat next to them they often have difficulty buckling themselves into a booster - but with this seat they can use the 5 point harness and many kids by the age of 5 can buckle themselves in
• Note: When installed with the vehicle's seat belt the top shoulder strap height is just 14.5 inches - but when installed with the vehicle's lower anchors (LATCH system) the shoulder strap height is 17.5 inches.  Therefore this seat must be installed with the lower anchors for most kids over the age of 3-4 as they need the additional shoulder strap height.  Since most vehicles only have the lower anchors for the side seats, this seat will usually have to go on the side.
• Belt Positioning Booster
• Nania High Ride
• Narrowest backless booster - 14.5 inches wide (1 inch narrower than the next narrowest booster)
• Note: this booster is only available in packs of 6 (with shipping it is about $15/booster) - but since it is great for fitting 3 kids across the 3rd row of a Honda Odyssey I'm sure you can find a few neighbors who will buy a few from your 6-pack
• Ride Safer Travel Vest
• A vest that functions like a booster - but since there is no "seat" you only need to have enough room for the child's bottom to fit instead of the extra 6-8 inches that most boosters take up

FREAKONOMICS Fallacy: An Economist or a Pediatrician - Who Would You Trust To Keep Your Child Safe?

Economists vs Pediatricians

Who is really looking out for your child's safety?

Unfortunately, many parents have mistakenly put their trust in the economists Steven Levitt & Stephen Dubner, co-authors of the popular book Freakonomics, rather than following the advice of pediatricians and the medical community when it comes to protecting their children in the car.  In 2005 the Freakonomics authors wrote an article in the NYTimes Magazine entitled "The Seat-Belt Solution" which came to the sensational conclusion that "there is no evidence that car seats do a better job than seat belts in saving the lives of children older than 2." But fatalities are just the tip of the iceberg; for every death there are 19 injuries requiring hospitalization (some leading to permanent disability) and 300 requiring medical attention.


While Dubner & Levitt have "softened" their stance over the past 5 years to say that "car seats are a little better..." than seat belts and advised parents "don't throw out the car seats" The Car Seat Ladies feel like the damage has been done - and we want to try and undo it by providing you with the whole story. More people heard and remember the sensational message than Freakonomics' weak efforts to bring their message more in line with what we know to be best practice. Therefore, we at The Car Seat Lady want to provide you with the evidence so that you can come to your own conclusions and make the best decisions regarding your child's safety. As an interesting side note, both Dubner & Levitt admit to using car seats and boosters for their own children beyond the age of 2; they are willing to endanger the lives of other people's children to sell their books, but aren't willing to make their own children be the guinea pigs for their own misguided hypothesis.


Dr Dennis Durbin & Dr Flaura Winston are pediatricians at the Children's Hospital of Philadelphia and co-principal investigators for the Partners for Child Passenger Safety study, which is the largest study ever done of children in crashes. Data from this ongoing study has led to the publication of dozens of papers in some of the most highly regarded peer-reviewed medical journals including JAMA, Pediatrics, Archives of Pediatrics, Journal of Trauma, and Injury Prevention. 


Drs Durbin & Winston wrote a letter to the editor in response to the 2005 NYTimes article.   

• "As pediatricians, scientists and leaders of the world's largest study on children in crashes, we think that overinterpretation of findings from a single source of data led Stephen J. Dubner and Steven D. Levitt (July 10) to claim that child safety seats are no more effective than seat belts for 2- to 6-year-olds. They examined children in fatal crashes (about 1,200 per year) while ignoring the equally informative data on those in nonfatal crashes (450,000 per year). Our research, which includes over 25,000 in-depth interviews and over 800 crash investigations, consistently shows that child safety seats and booster seats significantly lower the risk of serious injury compared to seat belts alone. Their conclusions stand in stark contrast to the existing body of scientific data that support current child restraint recommendations, and are, in our opinion, irresponsible and dangerous.  Learn the facts at www.chop.edu/carseat. We hope that this misleading article does not cost a child his life."

Drs Durbin & Winston followed up this letter with an study published in the June 2006 issue of the Archives of Pediatrics & Adolescent Medicine. This study was designed in direct response to Freakonomics' conclusion that seat belts are equally effective as car seats/boosters at preventing death for kids 2-6 years of age.  Drs Durbin & Winston's study found that children who were using child restraints were 28 percent less likely to be killed in a crash than children who were wearing seat belts alone - or as Dr. Durbin explained "for every 100 children who were killed in a crash wearing only a seatbelt, 28 of them would have survived if they'd been in a car seat or booster seat."  

In August 2008 Dubner & Levitt published their study concluding that seat belts are equally effective as child restraints for kids 2-6 in the journal Economic Inquiry.  A quick survey of the archives of this journal uncovers such scientifically rigorous and groundbreaking studies as "Secret Santa Reveals the Secret Side of Giving" and "The Influence of Social Forces: Evidence from the Behavior of Football Referees".

The data refuting the Freakonomics conclusion keeps coming in.  A 2009 article from the Partners for Child Passenger Safety study published in Pediatrics showed that 4-8 year olds using boosters seats were 55% less likely to be injured in a crash than 4-8 year olds wearing seat belts alone - or said another way, for every 100 children injured in a crash wearing only a seat belt, 55 of them would have been injury-free if they'd been in a booster seat. 

The Car Seat Lady feels that car seats (with a 5 point harness) are the best protection for kids until they are at least 4 years old AND at least 40 pounds (but with many seats offering the option of using the 5-point harness beyond 40 pounds we are in full support of this) - and boosters are the best protection for school age children until the vehicle's seat belt fits them properly without the booster (i.e. when they can pass the 5-step test). 

1 Minute Tip: Learn WHY babies & toddlers ride rear-facing from this fantastic video.

Babies ride rear-facing. Everyone knows that. But do you know why (and not just because safety experts say so). This 1 minute video explains "why" more eloquently than any I've seen before. If everyone forwards this video to one parent of a toddler - think how many kids could get to ride 5 times safer!

Evidence-Based Medicine from this month's PEDIATRICS: Nearly 10,000 babies a year are injured in their car seats NOT DURING A CRASH

What the study found:

Parents use infant car seats as more than just car seats.  Babies are often carried in these seats, ride in them on stroller frames, and nap in them while in the house and on the go.  

Nearly 10,000 infants in the US are injured each year in their infant car seats NOT in crashes, but rather while using the seats outside of the car.  10% of the injuries are severe enough that the baby has to spend at least 1 night in the hospital.  

Of the injuries, 85% were related to falls - 65% of the infants fell out of the car seat, 15% fell from elevated surfaces (with shopping carts, tables, and counters being the most common surfaces).

What you NEED TO KNOW to keep YOUR CHILD SAFE: 
 

1.  Anytime your baby is in the car seat (be it in the car, on the stroller, in your house) the harness straps must be BUCKLED and SNUG.  (When unbuckled the baby can fall out of the seat.  When buckled loosely the baby can get tangled in the straps and strangle themselves.)  

 2.  Anytime your baby is in the car seat, the car seat should either be in the car, on the stroller - or ON THE FLOOR.  Never put the car seat on a counter top, bed, sofa, table, bench, shopping cart, restaurant high chair, etc - as the car seat can fall from these raised surfaces.

 

REFERENCE

Parikh S, Wilson L. Hazardous Use of Car Seats Outside the Car in the United States, 2003–2007 Pediatrics. 2010;126:352-357. 

Video Installation Tips & Tricks: How to PUSH & PULL most effectively to get a Rear-Facing Convertible Car Seat installed tightly using LATCH

This video highlights 2 important installation tips:

1. On a rear-facing convertible seat, use your stomach to 1. push the car seat into the back of the vehicle seat and 2. sway the car seat side to side - WHILE you pull the belt tight
2. Always pull the tail of the belt from "inside" the car seat - not from "outside" - see this earlier post for more on inside vs. outside

While the seat shown in this video is a Graco My Ride 65, the techniques apply to most rear-facing convertible seats (see the above blog post for a list of seats that are the exceptions to the "inside" rule)

TRIPLETS!!!! - Tips on fitting 3 infant seats across the back seat (or 2 side by side for twins)

3 Chicco KeyFit 30 infant car seats installed in a 2007 Volvo XC90

Please note that MANY (if not the majority of) vehicles can not accommodate 3 infant car seats across the back seat.  While it is possible to simply rest all three infant seats side by side, once you try to install one or two it becomes obvious that there is not enough room for the other/s due to the layout of the back seat.  Due to 60/40 splits and other divisions of the back seat in many vehicles, you are often not dealing with three equally proportioned seats - but rather one larger seat (the 40 side - which is 40% of the back seat) and two seats that are each only 30% of the back seat.  

Many people will assume that the width of the back seat is the amount of room they have to work with - when this is almost never the case.  Because the lower anchors (part of the LATCH system) and the vehicle's seat belt usually start several inches away from the door, it makes it impossible for the car seat on the side to sit next to the door - rather, it is forced to sit several inches into the car.  As you can see from the photos to the right - there is enough room to fit a large fist between the Chicco car seat and the Volvo door frame.  Short of installing the car seat loosely, there is no way to get the car seat to sit closer to the door.  In some vehicles, installing the car seat using the seat belt instead of the lower anchors allows you to install it an inch or two closer to the door - and that inch or two might make all the difference between fitting all the seats and not. 

Will the Driver Have Enough Room to Drive - Why the Carrier Handle Position Matters

Another issue with infant seats is that not only do they take up room in the back seat - but by virtue of the fact that they lay semi-reclined, they take up leg room for the person sitting in front of the car seat (i.e. the driver or front passenger).  When installing an infant seat behind the driver, it is not enough to make sure the car seat is installed securely in the back seat - but also that the driver has enough room to drive safely and ideally comfortably.  Many infant seats require the carry handle to be placed either in the "store" position (at the top of the carrier) - which often makes the car seat take up an additional several inches of space front to back.  Finding an infant carrier that allows the handle to be placed in the "carry" position while in the car will allow the person sitting in front of the car seat the most room.  Please see this blog post with tip sheet for further info on the carry handle position - including a chart of the permissible handle positions for current and recently discontinued infant seats.

For example, the Britax Chaperone is a fantastic seat for preemies - but because it is almost 1.5 inches wider (external dimensions) than the Chicco Key Fit and takes up more room in the car front to back (meaning the driver has less room to drive) it may not work well for families with multiples depending on the vehicle.

Infant Car Seats for Babies LESS THAN 5 Pounds
10% of all babies in the US leave the hospital weighing less than 5 pounds.  With multiples, there's an increased chance of taking home a baby weighing <5 lbs.  Did you know that most infant seats are certified for babies 5 pounds and up.  Therefore, finding a car seat that not only fits properly in your vehicle - but is also certified for the baby's weight - is of the utmost importance.  Please see our tip sheet on preemies & small newborns for info on the starting weight for all the infant seats currently sold in the US, along with other pertinent info.

Infant Carrier Handle Position: Where Should it Be in the Car?

*** For an easy-to-print version of this handout, please CLICK HERE***

A lot of parents think that the handle has to be down when the carrier is in the car.  This is not true!  Many carriers allow - and some even insist - that the handle be up when the seat is in the car.

What many people don't realize is that while the carrier is in the back seat, it also takes up room in the front seat too as it sits semi-reclined, often forcing the front seats to move up to accommodate it.  With the handle in the store position, the carrier often takes up another several inches side-side in addition to 2 inches or more front-back - extra room that typically prevents the carrier from fitting securely in the center without the driver being forced to sit too close to the steering wheel.  Therefore, the most versatile carrier allows the handle to be up (i.e. in the carry position).  With the handle up, the carrier is more likely to fit securely in the center of the back seat, nestled between the two front seats, while still allowing the driver and front passenger enough room.

If trying to fit two car seats side by side, the extra width of the handle when in the store position will often prevent the two seats from fitting securely side by side.

The table below lists the authorized handle positions for travel in the car for current and recently discontinued infant carriers.  Please always double check the manual to your child's seat.  If the box is colored, this means you may use the handle in that position. 

NOTES

• Evenflo: On the Embrace, ensure there is at least 1.5 inches of space between any part of the carrier and the vehicle seat in front.  Handle may need to be in stand position to provide enough room.
• Graco: There are often several locked positions between carry and store - these are not OK to use in the vehicle
• Orbit Baby: Soft handles are lowered to top edge of seat 
• The First Years: Anti-Rebound Position (all the way closest to the baby’s feet) is the PREFERRED position

Curious how the rumor "the handle always has to be down" got started?

The first infant carrier with a base ever sold in the United States hit the market in the mid 1980's.  On this particular seat - the Century 580 - you placed the infant carrier into the base with the handle up and then rotated the handle back to the store position to lock the carrier into the base.  Forgetting to move the handle back meant that the carrier was not locked into the base, and could come out of the base in a crash!  The Century 580, and its successor the 590, were the only infant carriers to feature this type of locking mechanism - all other seats lock automatically when you place the carrier in the base.  Other manufacturers were concerned that if they allowed their seats to use the carry position, parents might mistakenly think it was OK to use the carry position on a Century 580/590, which could be a deadly mistake.  With the last Century 590 made in 1997 (and too old to be used after 2003), manufacturers now feel comfortable recommending different handle positions.  In fact, most seats in Europe use the handle in the carry position.

CENTER LATCH (not always an oxymoron) - 2010 Vehicles that allow the use of the lower anchors in the center position

Why do I need a chart like this? 

• This chart will tell you all of the 2010 vehicles that allow, in some form or another, the installation of a car seat in the center seat using the lower anchors.
• Since the vehicle manufacturers were only required to place the lower anchors in 2 seating positions, most vehicles only have the lower anchors for the 2 side seating positions. In most vehicles it is not permissible to install a car seat in the center using the lower anchors. 
• However, there are some vehicles where you can secure a car seat in the center using the lower anchors – either borrowing the inner most lower anchors from the 2 side seats or using the center’s own set of lower anchors.

What do the car seat manufacturers think of a center installation with the lower anchors? 

• Oftentimes, the lower anchors used in these center installations are at non-standard spacing (i.e. anything wider than 11 inches).
• Therefore, you must know what the car seat manufacturer allows – as many only allow their car seats to be installed when the spacing is 11 inches.  
• The car seat manufacturers in the table below allow their car seats to be installed using non-standard lower anchor spacing if (and only if): 
• a) the vehicle manufacturer allows the use of LATCH in a middle seating position with non-standard anchor spacing AND
• b) you can achieve a tight car seat installation

• Note: Combi's policy allowing 11-20 inches is retroactive for ALL Combi seats
• The car seat manufacturers in the list below allow their car seats to be installed using lower anchors if (and only if): 
• a) the vehicle manufacturer designates that location as a LATCH position AND
• b) the lower anchors are spaced 11 inches apart (standard spacing) AND
• c) you can achieve a tight car seat installation
• Baby Trend, Bergeron, Chicco, Dorel (Cosco, Eddie Bauer, Maxi Cosi, Safety 1st), Evenflo, Graco, Jane, Learning Curve, Magna, Mercedes-Benz, Mia Moda, Peg Perego, Sammons Preston Roylan

The FINE Print

• Even though this chart might indicate that you can install a car seat in the center using the lower anchors, there are some obstacles you may encounter that might prevent you from 1. installing the seat in the center using the lower anchors (and instead having to use the vehicle's seat belt) or 2. installing the seat in the center period (typically due to the size and contour of the vehicle's center seat & the specific child car seat).  
• When installing a car seat anywhere, in any vehicle, make sure it is not sitting on or in any way obstructing the use of the seat belt or buckle for an adjacent seating position.  It is an absolute that EVERYONE in the vehicle wears their seat belt - so never allow someone to ride in a position where they can't use the seat belt.  
• In many cases listed below, the child car seat will often block the seat belt buckle of an adjacent seat - either by sitting on top of it, or the lower anchor strap will cross it in such a way that the adjacent seat belt becomes unusable.  DO NOT install the car seat in the center in these situations if anyone will need to ride in that adjacent seat.  
• NEVER attach 2 child car seats to one lower anchor

HOW TO USE THE TABLES

• The tables that follow are organized by the total number of lower anchors - with 4 being the most common amount (as the government standard only requires the lower anchors to be in 2 seating positions - so with 2 positions and 2 anchors per position you get 4 lower anchors).  
• Note: For vehicles that have a 3rd row of seats (minivans, some SUVs) this table is speaking of the 2nd row seat.  
• Of the vehicles with a 3rd row of seats, the following have lower anchors for the center position in the third row:
• Dodge Grand Caravan 2008-2010
• Honda Odyssey 2005-2010
• Toyota Sienna 2004-2011 
• (also had lower anchors for the 3rd row passenger side 2004-2010)
• Volkswagen Routan 2009-2010

4 LOWER ANCHORS

Center ones spaced more than 11 inches apart

• This situation is the most common
• In this situation you are "borrowing" the inner most lower anchors from the two side seating positions to attach the car seat in the center. 

 Equidistant - All spaced 11 inches apart

• This works great for installing a car seat in the center using the lower anchors - but when installing a car seat on the side using the lower anchors the car seat is half into the center position and half into the side position - thereby taking up 2 seating positions in the back seat
  

 5 LOWER ANCHORS

Inner passenger anchor shared between center & passenger seats 

• This works well when trying to install 2 car seats side by side (driver & center) - but you will find that the passenger side seat is in most cases not big enough for a car seat or a moderate sized adult when there is a car seat in the center seat.
  
• Honda CRV: When using center lower anchors, a child restraint on the driver's side seat can NOT be secured with the lower anchors - rather it must use the vehicle's seat belt - even though the center & driver positions do not share any lower anchors.
• Chrysler PT Cruiser: the spacing between the center lower anchors is 15.4 inches

Inner driver anchor shared between center & driver seats 

• This works well when trying to install 2 car seats side by side (passenger & center) - but you will find that the driver side seat is in most cases not big enough for a car seat or a moderate sized adult when there is a car seat in the center seat.
  
• Acura RDX: When using center lower anchors, a child restraint on the passenger's side seat can NOT be secured with the lower anchors - rather it must use the vehicle's seat belt - even though the center & passenger positions do not share any lower anchors. 

 6 LOWER ANCHORS

All 3 LATCH systems can (theoretically) be used at once

• There are NO car seats on the market that are 11 inches wide - the narrowest ones are 15 inches wide, with the average width being closer to 20 inches.  
• If you number the lower anchors 1-6, you need to have at least 4 inches between anchors 2&3 and 4&5 in order to be able to fit even the narrowest car seats side by side (as if the car seat is 15 inches wide and the lower anchors are 11 inches wide - you still need an extra 2 inches on either side for the 15 inch car seat to fit).  This is why I said that "theoretically" all can be used at once - as with many of these vehicles the spacing between adjacent lower anchors is too close to actually allow for 2 car seats to be installed side by side.  

6 Lower anchors - use either A. 2 sides or B. center

• In these vehicles, if a car seat is installed in the center using the lower anchors you can not use the lower anchors for either of the side seats to secure a car seat on the side.  

6 Lower anchors - driver & center anchors overlap

Use either A. 2 sides or B. Center or C. Center & Passenger

• Because of the overlapping anchors, you will likely find that with a car seat installed in the center it is impossible to use the seat belt on the driver's side - therefore if someone needs to sit on the driver's side you should NOT install the car seat in the center using the lower anchors.

LATCH 201: Which LATCH attachments come with which child safety seats (the standard & the optional)

WHICH LATCH ATTACHMENTS

COME WITH MY CHILD SAFETY SEAT?

Note: The following info pertains to car seats currently sold in the US.  Always refer to your child seat & vehicle owner's manuals. 

INFANT SEAT WITH BASE

Rear-facing infant seats usually come with a base.

LOWER ANCHOR STRAP: permanently attached to the base
TETHER STRAP: none currently sold in the US use a tether

NOTE: When using the infant seat without the base, you will need to use the vehicle's seat belt to secure the seat - as the lower anchor strap is permanently attached to the base (and should not be removed).  All infant seats EXCEPT the following allow you to use the carrier without the base: Evenflo Cozy Carry, Evenflo Embrace (those made before 10/08), The First Years Via (formerly the Compass I400), Peg Perego Primo Viaggio (non-SIP 30/30 versions). 

INFANT SEAT WITHOUT BASE

Sometimes rear-facing infant seats come by themselves (i.e. without a base).  The information below is for carriers that come without a base (for carriers that come with a base, see above info)

LOWER ANCHOR STRAP: permanently attached to the carrier
TETHER STRAP: no infant seats currently sold in the US use a tether

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CONVERTIBLE SEAT 

(CONVERTS FROM REAR-FACING to FORWARD-FACING)

LOWER ANCHOR STRAP: permanently attached to the seat.
Most convertible seats have one long lower anchor strap with a connector on either end - while others (some Britax & Recaro for example) have 2 separate lower anchor straps each with a connector on the end.  Some convertible seats have a separate lower anchor strap for rear-facing & forward facing (ex. Graco My Ride 65).
**Always make sure the lower anchor strap is routed/positioned in the proper place for the direction the seat is facing - nearly all seats require you to make some change in the lower anchor strap when the seat goes from rear-facing to forward-facing.

TETHER STRAP: Most convertible seats do not use the tether rear-facing.  ALL convertible seats use the tether forward-facing.  
***Remember: While the lower anchors are used INSTEAD of the vehicle's safety belt to secure the child safety seat to the vehicle, tethers are used IN ADDITION to the lower anchors OR the vehicle's safety belt to secure a forward-facing (and some rear-facing) child safety seat to the vehicle.
These convertible seats can use the tether rear-facing:
- Britax: all convertible car seats allow Swedish or Australian method
- Combi Coccoro: will retroactively allow tethering (further info to come)
- Snug Seat Hippo: changed 5/30/07 to retroactively allow Swedish or Australian method (this seat is for children in Spica casts)
- Sunshine Kids Radian (all models) - tether using Swedish method

Swedish method: down to an anchor/structural piece of metal on the floor of the vehicle. Check out this video from Britax (see step 9) which shows how to find an anchor location & how to use the tether connector strap
Australian method: to the forward-facing tether anchor

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COMBINATION SEAT 

(FORWARD-FACING 5-POINT HARNESS CAR SEAT 

THAT TURNS INTO A BELT POSITIONING BOOSTER)

5-POINT HARNESS CAR SEAT MODE

LOWER ANCHOR STRAP: permanently attached to the seat.
TETHER STRAP: All combination seats come with a tether.  While the tether is technically optional on most combination seats (but should always be used whenever possible as it decreases how far the child's head moves forward by up to 8 inches), there are a few that require the tether.  For example, the Safety 1st Go Hybrid requires the tether at all times, while the Britax Frontier 85 requires it for children weighing more than 65 pounds who are using the 5 point harness.
***Remember: While the lower anchors are used INSTEAD of the vehicle's safety belt to secure the child safety seat to the vehicle, tethers are used IN ADDITION to the lower anchors OR the vehicle's safety belt to secure a forward-facing (and some rear-facing) child safety seat to the vehicle.

BELT POSITIONING BOOSTER MODE

Most combination seats do NOT allow the use of the lower anchor OR tether strap to secure the seat to the vehicle while the seat is being used in the booster mode (i.e. the child is using the vehicle's shoulder/lap belt across them). 
Current exceptions:
- Britax Frontier & Frontier 85: allow use of lower anchors & tether
- Evenflo - all combo seats (retroactive) allow use of lower anchors & tether
- Recaro Young Sport - recommend use of tether (do not allow lower anchors)
- Safety 1st Go Hybrid (formerly Safeguard Go) - allow use of lower anchor
- Nania Airway & Nuevo/Solo - allow use of lower anchors & tether

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HIGH- BACK BELT POSITIONING BOOSTER

TETHER STRAP: None of the high-back boosters (that weren't part of a combination seat) currently come with a tether strap.

LOWER ANCHOR STRAP:  Most booster seats do not come with lower anchor connectors - however, the few that do most often have rigid lower anchor connectors (instead of a flexible lower anchor strap as is found on nearly every other type of car seat).  See close-up drawing at left of a rigid lower anchor connector. 

The following high-back boosters allow the use of the lower anchors:
- Cybex Solution X-fix - rigid lower anchor connectors
- Jane Indy Plus - rigid lower anchor connectors
- Magna Clek Oobr - rigid lower anchor connectors
- Sunshine Kids Monterey - (flexible) lower anchor connectors

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BACKLESS BELT POSITIONING BOOSTER

TETHER STRAP: No backless boosters use a tether strap.

LOWER ANCHOR STRAP: Most do not have a lower anchor strap/connector
The following backless boosters allow the use of the lower anchors:
- Magna Clek Olli & Ozzi - rigid lower anchor connectors
- Safety 1st Go Hybrid - flexible lower anchor connectors
- Sunshine Kids Monterey - (flexible) lower anchor connectors

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SAFE TRAFFIC SYSTEMS RIDE SAFER TRAVEL VEST 

(FUNCTIONS LIKE A BELT POSITIONING BOOSTER) 

LOWER ANCHOR STRAP:  Does not have a lower anchor strap

TETHER STRAP: tether must be used when using a lap-only belt, and may be used for extra support when using a shoulder belt.