NHTSA - People Saving People - www.nhtsa.dot.gov
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United States Department of Transportation - www.dot.gov
Contents

Introduction

Promoting Booster Seat Use

Know the Facts About Booster Seats
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  • What Is an Age/Size Appropriate Belt-Positioning Booster Seat?
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  • What If a Vehicle Has Lap-Only Safety Belts in the Rear Seating Positions?
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  • How Do Parents Know When a Child Is Ready To Use an Adult Safety Belt?
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  • Facts About Child Safety Seats

    Learn From Others — Challenges and Lessons Learned

    Reach Out to All Populations

    State and National Resources

    Additional Reading

    Appendix A

    Appendix B

    Exhibits (Booster Seat Demonstration Projects)
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  • Booster Seat Promotion Program, Nassau County, New York
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  • "Give Kids a Boost" Campaign, Phoenix, Arizona
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  • Booster Seat Education Program—"Alex Gets a Boost Before Blast Off," Houston, Texas
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  • Protecting Older Child Passengers—Rural, Bismarck, North Dakota
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  • Promoting the Use of Booster Seats Among Young Families in King County, Washington


    Know the Facts About Booster Seats

    NHTSA recommends that children ride in a child safety seat with a harness until their shoulders are above the top set of strap slots (usually until they are 4 years old). The harness provides upper torso, head, and neck protection. When children have outgrown their safety seat, they should ride in an age/size appropriate restraint, such as a belt-positioning booster seat.

    "Adult seat belts do not properly fit young children. The lap belt rides up around the child's waist and the shoulder belt crosses the face or neck, often causing the child to place the belt behind his/her back or under his/her arm. This reduces the effectiveness of the belt and compromises the torso restraint. As a result, the "premature graduation" from a child safety seat to adult seat belts can cause significant injury in the event of a motor vehicle crash."

    (Winston et al. (2000). The danger of premature graduation to seat belts for young children. Pediatrics, 105(6):1179-83)


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    What Is an Age/Size Appropriate Belt-Positioning Booster Seat?

    A belt-positioning booster seat (BPB) is a type of child safety seat that elevates and positions children so that the vehicle lap and shoulder belt fit them properly. Children who have outgrown their convertible (converts from rear-facing infant to forward facing) or forward-facing-only child safety seats but are too small to ride safely in adult safety belts should be properly restrained in these seats.

    A BPB is typically recommended for children who are 4 to 8 years old or who weigh at least 40 pounds and are up to 4 feet 9 inches tall.* BPBs must never be used with a lap belt only. A proper fit is obtained when the lap belt fits across the hips and the shoulder belt fits across the child's shoulder and chest. There are two major types of BPBs:

    • Booster seats without a back (backless or low-back) are used in vehicles with a high seat back in which the child's head can be supported (up to the top of the ears) by the vehicle seat back or head restraint.
    • High-back booster seats are used in vehicles with a low seat back in which the child's head cannot be supported by the vehicle seat back or head restraint; some models have a removable back (to allow usage in vehicles that can support the child's head and neck). Appendix A contains pictures of the major types of booster seats.
    To find out more about booster seats, you can download A Parent's Guide to Buying and Using Booster Seats from the NHTSA web siteTo find out more about booster seats, you can download A Parent's Guide to Buying and Using Booster Seats from the NHTSA web site.

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    What If a Vehicle Has Lap-Only Safety Belts in the Rear Seating Positions?

    Booster seats must be used with a shoulder and lap belt, never with a lap belt only. Although shoulder belts cannot be added to the middle seating position of the back seat of older vehicles, many automakers offer "retrofit" kits for installing shoulder belts in the outboard (next to the window) seating positions.

    Fortunately, there are alternatives for those who are unable to obtain and/or install retrofit shoulder belts in their vehicles. Some child safety seat manufacturers make child safety seats that accommodate children weighing up to 80 pounds. These seats can be properly installed using the lap belt only.

    Another alternative is the harness/vest, which includes a tether strap that must be attached to the top tether anchor on the shelf behind the back seat. These vests have two rings at the bottom to allow for use with the lap belt.

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    How Do Parents Know When a Child Is Ready To Use an Adult Safety Belt?

    Children who reach a height of 4 feet 9 inches before their eighth birthday may be ready for adult safety belts. They can move to a safety belt when they can place their back firmly against the vehicle seat back cushion with their knees bent over the vehicle seat cushion. The lap belt must fit low and tight across the child's upper thighs. The shoulder belt should rest over the shoulder and across the chest. Never put the shoulder belt under the arm or behind the child's back.

    Cover of Are You Using It Right? A NHTSA brochure, titled Are You Using It Right? is another source to help the parent/caregiver understand the correct child restraint for his/her child.

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    Facts About Child Safety Seats

    Infants, from birth to age 1 weighing up to 20 pounds should ride rear facing in the back seat in either an infant only, rear-facing safety seat or a convertible safety seat.

    • Harness straps should be at or below the infant's shoulders.
    • Harness straps should fit snugly. The straps should lie in a relatively straight line without sagging.
    • The harness chest clip should be placed at the infant's armpit level. This keeps the harness straps positioned properly.
    • Infants weighing 20 pounds or more before age 1 should ride rear facing in a convertible child safety seat rated for heavier infants. (Some convertible seats are rated up to 35 pounds rear facing.)

    Children older than 1 year who weigh at least 20 pounds may ride in a forward-facing child safety seat in the back seat. Children should ride in a safety seat with a harness until they weigh at least 40 pounds.

    • Harness straps should be at or above the child's shoulders.
    • Harness straps should be threaded through the top slots, in most cases.
    • Harnesses should be snug. Straps should lie in a relatively straight line without sagging.
    • Harness chest clips should be at the child's armpit level, which helps keep the harness straps positioned properly on the child's shoulders.

    Along with these recommendations, parents and other caregivers should always be told to read and follow the child safety seat and booster seat manufacturer's instructions, as well as those in the vehicle owner's manual.


    *NHTSA recognizes that proper fit does not depend solely on age. In general, children who have outgrown child safety seats should be properly restrained in booster seats until they are at least 8 years old. However, children who reach a height of 4 feet 9 inches before their eighth birthday may be ready for adult safety belts.

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