Car crashes are one of the most common causes of death in children. In 2019, 38% of children who died in this way were unrestrained, according to the National Highway Traffic Safety Administration.
But it doesn’t have to be this way. Using an age- and size-appropriate car seat can reduce the risk of serious injury by more than 70%, compared to riding buckled in a seat belt, the CDC said. For children who are ready for booster seats, this figure stands at 45%.
This National Child Passenger Safety Week, which runs Sept. 18-24, experts are sharing information caretakers need to know about how to ensure children ride safely.
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Jim Savage, who manages the state’s child passenger safety program in the Safety Center at Children’s Wisconsin, said his team sees misuse rates as high as 75% during car seat inspections. In a severe crash, some of the errors could be life-threatening.
Many car seat experts say there’s an easy way to prevent this: Read the car seat’s manual, as well as that of your car to ensure the seat is placed correctly.
“Every piece of information they need to know is in their car seat’s manual: strap height, how to install the car seat (and more),” said Jessi Henkle, an Oshkosh-based child passenger safety technician who runs The Car Seat Files Facebook group and In the Know Car Seat Pro page. “If they actually read the manual, we wouldn’t see so much misuse.”
If the user manual is not with the seat, Savage suggested checking the manufacturer’s website or contacting them directly for a replacement. He added that many manufacturers post how-to videos online.
Car seat experts divide children’s car seat safety into four stages: a rear-facing five-point harness, a forward-facing five-point harness, a booster seat that correctly positions the seat belt on a child’s body and vehicle seat belt.
Each car seat comes with its own height and weight stipulations. Once a child reaches the maximum height or weight for their seat, it's time to move onto the next seat. When a child can sit without a booster seat properly and the seat belt lies in the correct position, they are ready to forego the booster, said Cassy Stefl, Outagamie County Public Health community health educator and child passenger safety technician senior checker with Safe Kids Fox Valley.
Some caretakers may opt for an infant car seat that doubles as a carrier. Stefl said the weight limit on these rear-facing seats is usually between 30 and 35 pounds. Convertible car seats can be used in both rear-facing and forward-facing positions, meaning that when a child outgrows the rear-facing height or weight limits, the caregiver does not need to purchase a new seat. All-in-one, also known as three-in-one seats, can be adapted to serve rear-facing, forward-facing and booster seat needs.
Henkle, Stefl and Savage said one of the most common mistakes is moving children to the next car seat safety stage too quickly.
“The reason we like to max out all of those stages is because you’re actually decreasing their safety as you go from rear to forward, and then from forward to booster,” said Jane Howard, Safety Center manager at Children’s Wisconsin. “So, we like to max those out to keep them as safe as possible for as long as possible.”
Child passenger safety experts said Wisconsin law does not reflect best, or safest, practices.
For example, Stefl explained, under state law a child can move out of a rear-facing car seat provided they are 1 year old and weigh 20 pounds. But children are safest rear-facing because in a crash there is less forward movement and therefore less pressure on a child’s neck and spine, Howard explained. Experts recommend children be kept rear-facing as long as they’re within the height and weight requirements for their rear-facing seat.
The same goes for the forward-facing five-point harness stage, Stefl said: Children should continue to ride in a forward-facing five-point harness until they exceed the height or weight limit as dictated by the car seat. Yet, Wisconsin law allows children to move out of a car seat and into a booster seat provided they are at least 4 years old and weigh 40 pounds.
After a child reaches age 8, weighs more than 80 pounds or is taller than 4 feet, 8 inches, state law permits them to ride without a booster seat and with only the vehicle seat belt.
“Because that’s so broad, our safest practice is children should ride in a booster seat until they’re tall enough to sit in the vehicle seat without any slouching and then the seat belt fits snugly across the top of their thighs and their shoulders," Stefl said.
Car Seats for the Littles, an organization staffed by child passenger safety technicians, said children should not sit in the front passenger seat until they reach age 13.
Because no two children are the same, each child’s passenger safety needs differ. It’s important for caregivers to remember their child can be ready to transition to the next child passenger safety stage earlier or later than their peers.
Savage and Howard noted that children with disabilities’ progression through the child passenger safety stages may come with additional considerations.
“It’s really about working with not just the child, but also with the family and the caregiver to determine what the child’s need might be,” Savage said. “For example, we might have some children with behavioral concerns who might be better off riding in a car seat with a harness longer rather than a booster. Oftentimes, we’ll also have children with low muscle tone who might need a little bit more support to keep their head in place and upper body in place, (so) it (might) be beneficial for children to ride rear-facing longer because they can gain that extra support.”
There are adaptive restraints that address these needs too, Savage and Howard said. If one of these seats would be best for a child, Children’s will work to help secure such seats, Howard said.
For more on the four stages of car seat safety, visit Car Seats for the Littles’ website, csftl.org. Car Seats for the Littles also has a post specifically on how to determine whether a child is ready to transition to a booster.
In the event of a serious crash, a car seat should be disposed of, and caregivers should purchase a new seat, Howard said. She added that no matter how small a car accident may be, caregivers should consult with their manufacturer about whether it is still safe to use.
Even if a car seat appears fine after a car crash, it could be problematic.
“Essentially, car seats are single-use products, much like a bike helmet. Crashed seats can appear to be intact when they may or may not have structural damage,” said Liz Tan, editorial director for Car Seats for the Littles. “Always follow the crash replacement guidelines in your car seat manual.”
Typically, car seats expire four to 12 years after their manufacture date. Car seats’ lifespans are typically included in their manual. Sometimes, a car seat’s expiration date will be printed directly on the seat, while others will require its owner to calculate it based on its manufacture date (typically found on the seat and registration card) and lifespan.
Savage explained there are two reasons why car seats expire. First, its materials may wear down — plastic can become brittle and break, metal can rust — making the seat less effective in a crash. Second, similar to cars, manufacturers are continuously learning new ways to maximize safety.
"So, a car seat that you purchase today might have some design features that might provide some additional protection than a car seat that’s 15 years old,” Savage said.
When accidents and expirations render car seats unsafe, it’s important to dispose of them properly. The best way to do this is to make it clear the car seat is unusable: Remove the cover and harness straps, cut them up, mark it as "unusable" and why on the plastic in permanent marker, whatever it takes to make it so the seat could not possibly be used.
As part of their commitment to sustainability, Targets nationwide are hosting their Car Seat Trade-in Event until Saturday, Sept. 24, where guests can bring in old, expired or damaged seats to be recycled. In exchange, guests will be given a 20% off coupon for select young children's items.
With frigid Wisconsin winters, it can be hard to resist the temptation to bundle your little ones to the fullest extent possible. However, this can pose a safety risk. Howard said that to ensure the car seat fits snuggly, there should be no extra padding between the child and their harness straps and seat.
“When you put a really puffy coat or snowsuit on them, oftentimes you have to move the straps up to even fit them in the coat, and then you pull the straps to what seems like snug,” Howard said. “However, in a crash, that puffy down coat will compress from the force, and then the straps will be very loose … and in the force of the crash, the child could eject from the seat.”
Instead, Howard recommends putting a thin jacket on the child, adjusting the car seat’s fit as needed and then laying a blanket over the top of the straps.
Putting other objects in the seat with the child can also be hazardous. This includes backpacks, which Henkle said she often sees when taking her daughter to and from school.
Sometimes caretakers are tempted to put objects under rear-facing car seats to achieve the desired angle. But Savage urged caretakers to refer to the car seat's instructions before taking that step.
“Car seats haven’t been crash tested with those objects in there,” said Ashley Tracy, who manages the Safe Kids Southeast Wisconsin Coalition in the Safety Center at Children’s Wisconsin.
Sometimes, children will slip foreign objects into their siblings’ seats, or even mess with the seat in other ways, such as unbuckling it. It’s important to check the seat’s installation and that the child is properly secured in it each time the seat is used, Savage said.
Accidents are bound to happen, so knowing how to properly clean your car seat is a must.
The first — and most important thing — is to always follow the manufacturer’s instructions. If you cannot find them, call the seat’s manufacturer, Car Seats for the Littles advises.
In general, Car Seats for the Littles warns against putting the harness in the washing machine (it takes out the stretch in the webbing, which is essential in an accident) and using hard soaps and other abrasives.
Howard said car seats must meet specific flammability standards, and washing them incorrectly could compromise this.
If it seems a mess is beyond cleanup, some manufacturers will sell specific car seat parts for purchase. Tan said most manufacturers send specific instructions on how to replace these parts, but if it’s unclear, consult a child passenger safety technician.
Foreign-made counterfeit car seats pose a serious threat to children, as they are not tested, according to the Federal Motor Vehicle Safety Standards. But they can be hard to spot.
Because they are often sold online, Howard recommended shopping in person at a trusted retailer. For more tips on how to avoid counterfeit seats, and what to do when they're spotted, visit bit.ly/CounterfeitCarSeats.
Children learn a lot from the adults in their lives, including proper car seat safety.
It’s important to model appropriate vehicle safety, from being properly fastened when riding in a car yourself to not driving while distracted.
“Children are more likely to buckle up if they see a parent or caregiver buckled up because they learn by association,” Stefl said.
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Child passenger safety technicians can be found at a variety of public safety entities, including police and fire departments and hospitals, as well as elsewhere in your community. Many, like Henkle, work in other fields but became CPSTs after becoming parents themselves.
To find a CPST in your county, visit bit.ly/wisconsinCPST. To find CPSTs anywhere in the U.S., visit /bit.ly/findacpstUS.
Here are some other helpful resources:
Madison Lammert is a Report for America corps member who covers child care and early education in Wisconsin at The Post-Crescent. Contact her at mlammert@gannett.com or 920-993-7108. Follow on Twitter @MadisonLammert0.
You can directly support her work with a tax-deductible donation online at http://bit.ly/Appleton_RFA or by check made out to The GroundTruth Project with subject line Report for America Post Crescent Campaign. Address: The GroundTruth Project, Lockbox Services, 9450 SW Gemini Dr, PMB 46837, Beaverton, Oregon 97008-7105.