Keeping Your Precious Cargo Safe on the Road

Wilmington, Delaware
Wednesday, September 23, 2009 @ 05:19 PM EDT
by: The News Journal; Kelly Bothum

Nytesha Hatley figured her son, Nyeem, was as safe as he could be buckled in his car seat. But after getting his seat checked by a child passenger safety technician earlier this month, she learned her 16-month-old could still be injured because the harness straps that go over his shoulders were too loose. She also learned that a car seat her grandmother had planned to install for Nyeem in her own car was too old to be safely used and was actually considered expired.

Mary Ann Crosley checks the seat of 1-week-old Evan Fortmann, of Wilmington, while his mother, Amy, watches during a recent Seat Check Saturday at Burlington Coat Factory at the Tri-State Mall in Claymont. The event offered free checks for proper installation and safety of car seats.

"I was glad I had I got get everything checked because I had no idea," said Hatley, who is due with her second son, Ny'seer, at the end of the month. Worried about the correct installation of Ny'seer's infant seat, she plans to have a technician do it instead of trying herself. "I didn't know there was even such a thing as expiration dates for car seats."

Most parents think they're pretty vigilant about their children's safety in the car, but loose straps and expired seats are two common mistakes child passenger safety technicians find when they check how a seat is being used, said Andrea Summers, community relations officer for the Delaware Office of Highway Safety. About 70 percent of the 1,561 seats that technicians in Delaware inspected last year had some form of misuse, Summers said, from seats that weren't installed tightly enough to parents who placed their children forward facing too early.

"Parents read the instruction manual and try and follow the directions. But it's really hard for the manufacturer to write directions that take into account all the different scenarios with the different vehicles," Summers said. "It takes a four-day, 32-hour course to learn how to be certified and know what to look for. How can we possibly expect parents to get [the seat] tight when they don't have all the training?"

Keep them restrained

Mary Ann Crosley looks through the manual of the car of Mike and Amy Fortmann to make sure their child's car seat is properly installed in the vehicle. The Safety Check Saturday event also helped parents make sure they were using the right car seats.

Nationwide, 87 percent of all children from birth to 7 years old used some kind of child restraint when riding in a vehicle last year, according to data from the National Highway Traffic Safety Administration. That's good news -- although down slightly from the 89 percent recorded in 2007 -- but the challenge is to make sure kids continue to ride in a child seat as they get older and use typically declines. From birth to 12 months, 99 percent of children ride in a car seat, according to NHTSA statistics. That drops to 92 percent for kids ages 1 to 3 and 89 percent when kids are aged 4 to 7. By the time they are 8 to 12 years old, only 85 percent ride in a restraint. Parents should try to keep their kids in five-point harness -- which has two shoulder straps, two hip straps and a crotch strap -- for as long as possible, said Sean Elwell, injury prevention coordinator at the Alfred I. duPont Hospital for Children.

Most infant and toddler seats have a five-point harness, and some high-backed booster seats also do as well. He said more parents than in the past are keeping their kids in the five-point harness rather than putting them in a seat-positioning booster.

"They're safer no matter what age you are," said Elwell, who is also a registered nurse. "If you're in a crash, a five-point harness has more contact for a proper hold."

Some parents think by the time their kids can unbuckle their car seat, they no longer need it. But Delaware law requires children up to age 8 or 65 pounds -- whichever comes first -- to be secured in a child safety seat, which includes a booster seat.

The requirement is with good reason -- safety seats reduce the risk of fatal injury by 71 percent for infants and by 54 percent for toddlers, according to the American Automobile Association. Using a booster seat reduces the risk of injury by 59 percent. In Delaware last year, 17 percent of the 151 children injured in motor vehicle crashes were not in a safety seat. One unrestrained child also died, according to data from the Delaware Office of Highway Safety.

Fit and installation are key

Parents researching child restraints want the same answer: which car seat is the best? Should they go with convertible seats, which can be used rear-facing for a newborn and also forward-facing for a toddler, a 3-in-1 combination system that can accommodate newborns to grade-schoolers or start with an infant carrier and move up to another seat as the infant grows?

"What I say is the best seat for a family is one that fits the child and the car and will be used," Elwell said.

One of the most important things parents should look at is the weight restrictions of a car seat, said NHTSA spokeswoman Pat Swift-Oladeinde. Infant-only car seats typically go up to 22 to 32 pounds, depending on the model, while most convertible and combination seats can accommodate children up to 65 pounds. Booster seats typically fit kids from 40 to 100 pounds. If your child falls on the smaller or heavier end of the weight range, be sure to make sure the car seat will fit them.

Once you've decided on a seat, installing it correctly is critical, Swift-Oladeinde said. According to AAA, eight out of 10 car seats are installed incorrectly. When properly installed and threaded through the vehicle's seat belt or LATCH system, car seats should not move more than one inch from side to side. Any more give than that and a child could be injured during a collision.

Newborn Evan Fortmann sits in his car seat after the safety check in Claymont.

Elwell said the addition of the LATCH system to vehicles made after 2002 has increased the number of correct installations by parents. LATCH -- which stands for lower anchors and tether for children -- is a way to secure a child restraint seat using straps from the seat that connect to metal anchors in the vehicle. They are required on vehicles made in 2003 and later. Lower anchors are usually found hidden in the seat crack while metal tether anchors are in the back of or behind the seat.

For infants, the car seat must be installed at a 45-degree angle, usually visible by an indicator on the side of the seat. If the seat is at an angle greater than that, Elwell said, their head could fall forward, potentially closing off their airway.

The internal harness that goes over a child's shoulders should also be free of slack, Elwell said. Parents shouldn't be able to pinch a fold of material in the strap. Summers likens the fit to a tight pair of suspenders -- tight, but not suffocating.

When it comes to adjusting her children's car seat straps, Phoebe Bosma of Brandywine Hundred makes sure she can't stick more than a fingertip between her sons and their harness. Bosma, who has a 2-year-old son, Danny, and an 8-month-old, Timmy, also checks their car seats weekly and makes adjustments as needed to accommodate bulkier clothing.

"Parents often think their children's straps are too tight, especially newborns. But they like that feeling of security," Summers said. "The forces in a crash are a lot greater so just a little bit of give in a seat is a lot."

Follow the rules

Sean M. Elwell, injury prevention coordinator of the Trauma Program at Alfred I. duPont Hospital for Children, installs two car seats in the vehicle of Brenda Rappa, of Pike Creek, for her 6-year-old son Joseph and a baby on the way.

During National Child Passenger Safety Week last week, Delaware technicians installed and inspected more than 60 child seats. Many were installed incorrectly, were past their expiration date for safety or weren't the right size for the child. In some cases, the seats were forward-facing when they still should have been rear-facing for an infant. Summers said a lot of parents aren't sure when to switch the seats.

At a minimum, children should be rear-facing in a car seat until they are a year old and weigh at least 20 pounds. But the American Academy of Pediatricians, which is expected to release its updated car seat recommendations next year, is strongly recommending parents keep their infants rear-facing until they are at least 2 years old. The AAP points to research that found children between ages 1 and 2 were five times safer in crashes when they faced back rather than the front.

While some parents are tempted to turn their baby's car seat early in order to get a better look at them while they're in the car, Summers said it's critical for children under the age of 1 to stay rear-facing. Developmentally, the muscles in their neck and spine aren't strong enough to withhold a sudden impact. If they were forward-facing in an accident, they could risk spinal cord injury, she said.

Expiration dates are another consideration, especially when choosing car seats that will only be used on certain occasions, like in a family member's car. Most car seats are good for six years, Elwell said, unless there is another date given by the manufacturer. More car seat manufacturers are stamping expiration dates on their seats so parents know how long they are good for.

Unlike spoiled milk in the fridge, it's not as obvious when a car seat has expired. Over time, the plastic used to make the seats can degrade, especially when exposed to extreme hot and cold, like is often the case in vehicles. Harness belts also can wear over time, making them less rigid than before.

As kids get older, parents may want them to ride in the front seat with them. But unless they are age 12 or 5-feet-5, it's against state law, Summers said. The reason for the back-seat rule is that most crashes occur in the front end, and keeping kids in the rear of a vehicle gets them from the farthest point of impact. Kids may balk at this rule or counter that their friends are riding shotgun, but unless you want to risk a $25 fine and serious injury in the event of an accident, it's best to keep them in the back.

When it comes to car seats, all the information and rules may seem overwhelming, but they don't have to be. "Mistakes are avoidable, with a little time and attention," said Catherine Rossi, spokeswoman for Mid-Atlantic AAA.

modified: Wednesday, September 23, 2009 @ 05:39 PM EDT
created: Wednesday, September 23, 2009 @ 05:19 PM EDT

About Nemours

Nemours, one of the nation’s largest pediatric health systems, is dedicated to achieving higher standards in children’s health. Nemours offers an integrated spectrum of clinical treatment coupled with research, advocacy, and educational health and prevention services extending to all families in the communities it serves. Starting with Alfred I. duPont’s bequest over seventy years ago, Nemours has grown into a multi-dimensional organization offering personalized clinical and preventive care focused on children.

Nemours owns and operates the Alfred I. duPont Hospital for Children in Wilmington, Delaware and major children’s specialty clinics in Delaware (Wilmington), Florida (Jacksonville, Orlando and Pensacola), Pennsylvania (Philadelphia and Bryn Mawr) and New Jersey (Atlantic City and Voorhees). Having recently received preliminary approval from the State of Florida, Nemours will establish a new full-service children’s hospital as part of an integrated pediatric health campus in Orlando. KidsHealth.org, the world’s most visited pediatric health care Web site for parents, kids and teens, is a project of Nemours.

Nemours employs over 4,400 individuals, including 430 pediatric physicians, specialists and surgeons who cared for approximately a quarter of a million children in 2007. The organization’s goal is to align with parents, physicians, community leaders, children’s advocates and elected officials to ensure optimal wellness for every child. Additional information about Nemours can be found at www.nemours.org.