TIP #2: TRAVELING SAFELY WITH INFANTS, TODDLERS,
AND PRESCHOOLERS

INFANTS: BIRTH TO 1 YEAR OLD

The safest way for infants to ride is rear-facing in the back seat. Rear-facing child safety seats protect the infant's head, neck, and back in a crash. The infant should ride rear-facing until at least 1 year of age AND at least 20 pounds, longer if possible.

Two kinds of child safety seats for babies:

1. Small, lightweight "infant-only" child safety seats are designed for rear-facing only (A).

• Baby's head must be at least one inch below the top of the seat.
  
  
• The label on the seat gives the upper weight.

2. Larger "convertible" seats can be used rear-facing (B) from about 5 to 35 pounds.

• Some older models only go up to 20-22 pounds rear-facing. Always check the label and instructions for the rear-facing weight limit.
  
  
• If a baby under 1 year old grows too tall or too heavy for an infant-only seat, a convertible seat with a higher rear-facing weight limit (over 22 pounds) is recommended.
  
  
• Convertible safety seats may be turned around to face the front when the baby is over 1 year old AND at least 20 pounds (C). It is recommended that a child ride rear-facing as long as she/he fits. Follow the seat manufacturer's instructions.
  
  
• A convertible seat with a 5-point harness works best for a newborn baby. Seats with a padded overhead shield do not fit small babies properly. The shield comes up too high and may make proper adjustment of the harness difficult. (D).
  

BUCKLING BABY IN THE SAFETY SEAT

• Use the lowest harness slots (E) for a newborn infant. Keep the straps in the slots at or below the baby's shoulders for the rear-facing position.
  
  
• Harness straps must fit properly on the baby's shoulders and between the legs. Dress the baby in clothes that keep the legs free.
  
  
• Keep harness straps very snug and flat on baby's shoulders, not arms. If the harness is even slightly loose, the baby can be thrown out of the seat.
  
  
• Place the plastic harness retainer clip (F) near the child's armpits to hold the harness straps on the shoulders. Check instructions if the seat doesn't have a harness clip.
  
  
• Always buckle baby in the seat first, then place blankets OVER the harness.
  
  
• If baby needs support, fill empty spaces with small, rolled blankets on each side of the baby's shoulders and head (F). A rolled diaper or small towel can also be put between her/his legs behind the crotch strap.
  
  
• Thick padding should NOT be put under or behind the baby.
  
  
• Babies must ride sitting in a semi-reclined (halfway back or a 30-45 degree angle from vertical) to keep the airway open.
  
  
• If the safety seat is too upright for the baby, and the base is not adjustable, put a tightly rolled bath towel, or part of a foam pool noodle, under the front edge of the child safety seat to tilt it back a little (G). Do not tip it too far back or the child could be ejected.
  

WHAT ABOUT SEATS FOR PREEMIES?

• A baby born earlier than 37 weeks may need to use a car bed if he/she has any problems breathing or other medical problems when sitting semi-reclined.
  
  
• Ask the baby's doctor if the baby needs to be tested for breathing problems or other medical problems before he/she is discharged from the hospital.
  
  
• If the baby's doctor recommends it, a baby with medical problems may need to ride lying flat in a car bed (H).
  

TODDLERS AND PRESCHOOLERS: 1 TO 4 YEARS OLD

Children over 1 year old AND over 20 pounds may face forward in a convertible seat (I), forward-facing child vest (J), or a combination child seat/booster (K). Some child safety seats are built into the vehicle seat. A child should ride in a child safety seat with a harness until about 4 years old.

This convertible seat (a seat that can be used rear-facing or forward-facing) may face the front for a child OVER 1 year old AND OVER 20 pounds.

This vest requires use of a tether. The vehicle’s safety belt goes through loops near the hips.

This combination child seat/booster is used with the harness (left) for younger children and with the vehicle’s lap and shoulder belt (right) for older children. Remove the harness before using with the lap and shoulder belt. Check the manufacturer’s instructions for weight limits.

USING FORWARD-FACING CHILD SAFETY SEATS

• When a child rides in a safety seat that faces forward, harness straps (L) must be at or above the child's shoulders.
  
  
  Most convertible seats require use of the top-most slot for the forward-facing position. These slots are reinforced to prevent the seat from failing in a crash.
  
  
  Check the manufacturer's instructions for the best and safest placement of the harness straps.
  
  
• Place the harness retainer clip (L) at armpit level. Check the instructions if the seat doesn't have a harness clip.
  
  
• Use the correct belt path (L) for the direction the seat is facing. Check the instructions and look for labels on the safety seat.

For more information, contact the DOT Auto Safety Hotline at 1-888-DASH-2-DOT (1-888-327-4236) or www.nhtsa.dot.gov Illustrations from Indiana University School of Medicine