How to outsmart a squirmy worm in a booster - Use the AUTOMATIC LOCKING RETRACTOR. Learn how below...

PROBLEM:

Do you have a squirmy worm riding in a booster seat?  Is your 6 year old half way across the back seat, but still buckled into their booster?  Do you tell your child in a seat belt to "sit still" a dozen times a car ride and it doesn't seem to work?  

SOLUTION:

For many kids, the solution is as simple as putting the seat belt into a special locking mode (in technical terms, engaging the automatic locking retractor).   

**Please note: If your child is 4 or younger and/or locking the seat belt does not keep them sitting still, then we would strongly recommend the child ride in a 5 point harness that is certified for bigger kids (i.e. the harness goes to at least 60 pounds).

Almost all shoulder belts have a retractor. The retractor is the device that not only spools the excess belt, but also locks the belt so that it holds you tight in a crash.

All shoulder belts typically have an emergency locking retractor.  This means that during normal driving the belt is loose - it slides freely in and out - but locks tight in an emergency, like when you slam on the brakes.  During normal driving, with the shoulder belt in the emergency locking mode, you can lean forward and back - an amount of freedom of movement that is just too much for many children in booster seats and seat belts as they can't resist the urge to wiggle and squirm.

If your car is a 1996 or newer, the retractor is usually a switchable retractor - meaning that it can switch from the usual mode of locking only in an emergency, to a mode where it locks at all times - called the automatic locking mode.  Changing the belt from the emergency to automatic locking modes is easy - simply pull the shoulder belt out all the way (do it slowly) - when you get to the very end, let the belt go back in.  As it goes back in you will likely hear a ratcheting sound - and if you give a gentle pull you will notice that the belt is locked.

In the automatic locking mode, the shoulder belt only gets shorter - it does not get longer.  Meaning, you can not lean forward to pick up your toy or fight with your sibling on the other side of the car.  With the belt in the automatic locking mode, the seat belt holds tight at all times just like the child was used to when they were riding in a 5 point harness car seat. 

Some cars do not have a switchable retractor.  Most Jeep, Chrysler, and Dodge vehicles do not have switchable retractors - they only have the emergency locking retractor.  Other vehicles that may not have a switchable retractor are some vehicles made by GM, Ford, Saab, and Volvo. 

Answers to "Mistake Monday" 3/8/10

ANSWERS: 
(please see bottom of page for teaching points & printable tip sheets for parents)

MISUSE
- Girl in front: Shoulder belt under her arm
- Girl in back: Lap belt high on her belly (note: the shoulder belt rubbing her neck is not likely to cause injury in a crash)

INJURY PATTERNS ASSOCIATED WITH THE MISUSE

HEAD AND NECK INJURIES
The head is the most important part of the body to protect.  In a crash, the head can potentially hit hard structures in the vehicle - like the seatback of the front seat, the window, the door frame, etc - all of which can cause significant injuries to the brain and upper spinal cord.  The best way to protect the head is to try and prevent it from hitting anything during the crash.  

Placing the shoulder belt under the arm leads to an increased risk of head and neck injuries as the head travels farther forward than it would with the shoulder belt properly positioned across the collar bone.  

These three pictures, taken from a 30mph crash test, show how far forward the head of this 6 year old crash test dummy moves.  The green line marks the farthest the head moved forward when the dummy was properly restrained in a high back booster.  The yellow line marks the farthest the head moved forward when the dummy placed the shoulder belt under its arm (and was not in a booster).  The red line marks the farthest the head moved forward when the dummy placed the shoulder belt behind its back (and was not in a booster).  Notice how the dummy's head strikes the seatback in the third photo - and in a smaller vehicle (or a large vehicle where the driver moves his seat back all the way) the dummy with the shoulder belt under the arm would also hit its head on the seatback.

 Photo: 6 y/o dummy properly restrained in high back booster - Copyright UVA 

 Photo: 6y/o dummy with shoulder belt under its arm -  Copyright UVA

Photo: 6y/o dummy with shoulder belt behind its back - head strikes the seatback - Copyright UVA

SEAT BELT SYNDROME
The lap belt is designed to rest on the strong hip bones.  The soft belly is not strong enough to withstand the forces of a crash.  Should the lap belt slide up over the hip bones and into the soft belly, the lap belt can cut through the belly all the way to the spinal cord causing injuries to the spinal cord and the soft organs in the belly.  This pattern of injuries is known as "seat belt syndrome" and is seen most often in 4-10 year olds who are not riding in booster seats - although it can be seen in anyone when the lap belt rests on the belly.

TEACHING POINTS
A shoulder belt that rubs the neck will not injure a child in a crash - but since it is uncomfortable for the child, kids often place the belt under the arm or behind the back.  Never allow a child to place the shoulder belt behind the back or under the arm - this only increases the child's risk of severe head and abdominal injury.

A lap belt that rides up into the belly can cause significant injuries to the soft organs in the belly (liver, spleen, bladder, intestines, kidneys) in addition to breaking the lower spinal cord causing paralysis.  Placing the shoulder belt behind the back or under the arm increases the risk for these belly and spinal cord injuries as without the shoulder belt to properly hold the upper body back, the body naturally folds at the waist (close to the belly button) which allows the lap belt to ride up over the strong hip bones and onto the waist, thus causing injury.

Does your child's booster make the belts fit well?

• The lap belt should rest low and flat on the tops of the child's thighs (nowhere near the belly button).  
• The shoulder belt should rest between the neck and the shoulder.

RESOURCES FOR PARENTS 
Are you a pediatrician or CPS Tech who wants to give a parents some more information on booster seats?  Here are several fantastic tip sheets that are free to reproduce.  Links will open as a PDF document.

• “Boosters Are For Big Kids” - This covers the 5-Step Test with pictures showing belt fit with and without booster.  Also available in Spanish.  
• Booster Seats and Other Products for Children Over 40 Pounds - Guidelines for size, fit, and usage; list of belt-positioning boosters with weight ranges and features.  Also available in Spanish.
• For Your Family: Belt Positioning Booster Seats.  Also available in Spanish. 
• Fotonovella (in Spanish) - designed as an educational tool to promote booster seats among Latino communities.

Monday's Mistake - can you spot the mistake/s in the picture?

To continue on our booster theme from last week, I thought I'd show two more common mistakes seen with booster seats.  Many parents think that because boosters are so easy to use (no installation required) that there couldn't possibly be a way to use them wrong.  Unfortunately, many booster seats are used improperly (like the ones below).

This picture shows two girls riding in high-back belt-positioning boosters.
The mistake on the girl in the front is much more obvious than the one for the girl in the back.
Can you identify both mistakes?
For bonus points, what type of injury pattern might you see in the girl in the front - how about for the girl in the back?
Post your answers below - and I will post the correct answer on Tuesday.

(Note: The child in the front is not riding in the front seat - this is a vehicle with 3 rows of seats)

Please note: These photos were not staged.  These photos were taken by real parents just like you who didn't know that they were using the boosters improperly.  9 out of 10 car seats are used incorrectly - don't let your child ride at risk.   If you are in the NYC or Baltimore areas, email us at info@thecarseatlady.com to schedule a private car seat installation lesson - otherwise, visit www.seatcheck.org to find someone in your area to teach you how to install your seats properly.

Monday's Mistake - can you spot the mistake/s in the picture?

These pictures show two kids riding in their Graco Turbo Booster.
Can you identify the TWO mistakes in the girl's picture and the TWO mistakes in the boy's picture?
Post your answers below - can you spot all three mistakes?

I will post the answers on Tuesday.

Please note: These photos were not staged.  These photos were originally posted by real parents just like you who didn't know that they were using the booster improperly.  9 out of 10 car seats are used incorrectly - don't let your child ride at risk.   If you are in the NYC or Baltimore areas, email us at info@thecarseatlady.com to schedule a private car seat installation lesson - otherwise, visit www.seatcheck.org to find someone in your area to teach you how to install your seats properly.