Any parent with a newborn to preschooler knows about car seats—a necessary evil that comes with any automobile trip. Whether it’s a short jaunt to the grocery store or a three-hour drive to visit relatives, the child restraint system is required by law for your child’s safety.

But with 80 percent of car seats installed incorrectly, motor vehicle collisions are the leading cause of death in children ages 4 and older. Knowing the latest car seat guidelines, proper installation procedures and how to identify possible injuries is essential to minimizing harm.

Newest Guidelines

First, it is important to be aware of the latest National Highway Traffic Safety Administration car seat recommendations based on the most recent research from the American Academy of Pediatrics released in April 2011, as prevention is a vital part of maintaining health. The newest guidelines differ from  previous ones in that they recommend all children under the age of 2 be rear-facing, or until they reach the maximum recommendations made by the seat manufacturer. The previous recommendations set a minimum of 12 months of age and 20 pounds as a minimum. Additionally, children ages 4 to 8 should be in a forward facing car seat with harness, and children ages 8 to 12 who are not yet 4 feet 9 inches  tall are to ride in a belt-positioning booster seat. All children under the age of 13 are encouraged to ride as back seat passengers. Understandably, many parents are very frustrated by the newest guidelines, as they seem impractical and inconvenient. But it can be easy to forget that  these guidelines are imposed for the  safety of your children, not to make life more difficult.

Child Injury

Even with car seat laws in every state and additional safety measures, the best-positioned and properly installed car seat can only afford your child a certain amount of protection from injury. It’s important to realize that even children in safety seats can be injured. They’re not being thrown around the car or into the back of the seat in front of them, but they are still suffering from the impact. Their bodies are held to the car by the restraint but their heads and arms are thrown forward, which can cause mild to severe damage to their spine and nervous system. Most insurance companies and many parents mistakenly believe that a child in a car seat is immune from injury during a motor vehicle collision. In reality, the purpose of the car seat is only to lessen the degree of risk. The parent will rush to the chiropractor immediately after an automobile accident to get adjusted, not realizing that her child may be suffering to the same degree or more, but it is manifesting itself differently.

Why is this? Generally, if a child doesn’t complain of pain, it may not occur to a parent that any injury was sustained during the collision. Due to their inability to communicate their pain or discomfort, symptoms such as irritability, lethargy, restlessness, night terrors, poor focus and/or appetite, change in bowel movements and being very clingy, may be the only signs that an infant or child has suffered an injury. These symptoms are signs of nervous system irritation rather than the predominantly soft and hard tissue injuries that are so prevalent in the adult population. Since the injuries aren’t visible upon examination, the child is deemed harm-free and later suffers. After an accident, your child should see her pediatrician; then, consider taking her to the chiropractor to address the remaining issues and symptoms.

The Safer Car Seat

Despite the best intentions, there is no perfect car seat, safety seat or child restraint system because they all require proper installation.  When properly installed, they reduce the risk of childhood mortality by 54 percent compared to a child riding completely unrestrained. Call 866-SEAT-CHECK or visit seatcheck.org to find a seat-inspection facility near you.

Health Considerations

No one wants to spend more money  than they have to when a new child comes into the family. Consider the purchase of a convertible car seat that can be used rear facing and forward facing with weight ranges from 5 to 70 pounds, rather than an infant car seat.

The cost savings will be more than just those of buying one car seat rather than two. Yes, this will mean that you will have to take your child out of the seat when you arrive at your destination and transfer her to a stroller, or better yet, an infant carrier. You and she will survive. The perceived inconvenience now will be a tremendous health benefit to your child now and in the future. You’ll save yourself from injury, as carrying a car seat in addition to your child’s weight puts undue strain on your spine.

Moreover, the use of the car seat outside of the car is injurious to your child. For short periods of time, it can be helpful, but it would be far better to place your infant on her stomach for tummy time, or hold her/ wear her. Research from the International Chiropractic Pediatric Association shows that car seats are not the ideal mode of transport for your little one, “due to restricted postural options which can impact your baby’s developing cranium spine.” In essence, the child’s spine is forced to stay in the C-shape, which prevents the natural curves from forming enough muscle strength to hold up her head.

Better Safe Than Sorry

No car seat, no matter how well it is installed, will guarantee that your child will not suffer injury in an auto accident. If you and your child have recently been involved in a motor vehicle collision, it is better to have your child checked and find out that there is nothing wrong than assume she is fine and later find out there was severe damage  to her still developing spine.

Resources

• National Highway Traffic Safety Administration : nhtsa.gov/Safety/CPS
• American Academy of Pediatrics Car Seat Recommendations Report ap.org/advocacy/releases/carseat2011.htm
• Dynamic Chiropractic, Vol. 11, Issue 22, October 1993
• Pediatrics, Vol 117, No. 1, January 2006
• "Learn to Keep Kids Safe from Online Predators, Identify Unsafe Toys before They're Recalled and Make Sure Your Child Safety Seat is Installed Correctly at Baby Celebration LA. Business Wire.  2008. HighBeam Research. 14 Jan. 2011
• “The Benefits of Baby Carrying,” Pathways to Family Wellness, Issue 28, Winter 2010.

Katherine Kadin is a family wellness chiropractor who specializes in pediatric & prenatal chiropractic care. She and her husband have an 8-month-old son who is well-adjusted and lives the wellness lifestyle.