And Now For Something Completely Different...

I got to install a car seat today and teach someone how to use it properly! While not as exciting as, say, attending a birth, certainly, I do appreciate the opportunity to exercise another area of my growing expertise, despite no formal training, that of car seat safety. You see, along with VBAC and breastfeeding advocacy, my "... on Babies" interests also extend to car seat safety and using car seats correctly. I've written a few articles on my Facebook and LiveJournal about this very thing, as well as producing an article on proper car seat and booster seat use for my son's preschool, which was distributed by email to most of the parents in the school. But that's about as much car seat safety advocacy as I have had the chance to do.

I guess being specifically asked to help install a car seat and then asked to teach its user how to do it properly herself made me feel that people really do appreciate that I know what I'm doing and willingly come to me for help. They trust me. Which is kind of a neat feeling. Of course, there's always that insecurity that I won't live up to that trust. But once I took my car to a have my car seats checked, and I found out that I knew more than the guy doing the checking. So that was enlightening. And irritating. I guess maybe I do know what I'm talking about most of the time. I like knowing that I've made my friends' kids safer in the car by being available to help them when they have questions about their car seats.

I actually would like to take the car seat technician training at some point, along with wanting to be a fully licensed lactation consultant someday, and maybe a doula or something. I have ambitions, I suppose. I don't know how much of that is actually going to happen, at least not as long as I keep having babies of my own!

I am not the be-all and end-all of car seat knowledge, since I have not taken a certification course. I don't know all the brands and all the newest developments. But I know how to use a car seat correctly, and there are general rules that apply to all kids and all car seats, and I read articles that come out with new information or recommendations or guidelines whenever I see them.

So, here are some basics that I like to make sure everyone knows about using their car seats. These are based on the most recent safety recommendations from the NHTSA (National Highway Transportation Safety Administration), the AAP (American Academy of Pediatrics), and other sources of car seat research and information.

1. The safest car seat is one installed and used properly. The car seat with the highest safety ratings on the books is not safe if it is not installed properly or if the child is not buckled properly in it. Read your manual, know the weight and height limits of your seat, and consult with a certified car seat technician if you're not sure about something.
2. Your child is safest in the back seat of the car, rear-facing. This means they should be looking at the back of your car for as long as possible. From the time they are born until at least age two, children are safest in a rear-facing car seat, as long as they are within the height and weight limits of that seat.
3. For most car seats, your child is too tall for the seat, rear-facing, when the top of their head is within one inch (1", 2.5cm) of the top of the car seat. The weight limit of your seat will vary. Most seats now have this weight limit information printed on the seat itself. I highly recommend you take five minutes to read the information printed on the side of your car seat. Typical infant carrier "bucket"-style car seats are rated for infants 5 to 22 pounds. Newer ones may go as high as 30, 33, or 35 pounds. However, I have found that many babies outgrow these seats by height long before they reach the weight limit. Be sure to pay attention to both weight and height. Convertible car seats, which can be installed either rear- or front-facing, typically have rear-facing limits of 33, 35, or even 40 pounds in the newest seats, meaning you can keep your child rear-facing much longer even after she has outgrown the infant carrier.
4. When rear-facing, the harness straps should be adjusted at or below the child's shoulders. This prevents the child from riding up the back of the car seat in a collision and allows the head, neck, and spine to be properly cradled by the seat. 
5. You may decide to turn your child to face the front of the car (front-facing) sometime around the time he or she turns 2. If your child has not yet reached the weight and/or height limit of the rear-facing car seat by the time he reaches age 2, you may consider keeping him rear-facing longer. However, if you decide to have him face the front, make sure you are using a convertible car seat or a front-facing-only car seat with a 5-point harness. Small children should not be in booster seats that rely on the seat belt to keep them in place. In fact, many states' laws now require a child to be in a five-point harness until at least age four AND 40 pounds. Many, many car seats these days accommodate children up to 65 or 70 pounds in a front-facing 5-point harness. A 5-point harness is safer for everyone, not just children, and if the seat belt of the car does not fit the child properly, it can actually do more harm than good in a collision.
6. In the front-facing position, the harness should be adjusted so that the straps are located at or above the child's shoulders. Note that this is different from the rear-facing guideline!
7. Typically, a child has outgrown a front-facing car seat by height when the child's ears are in line with the top of the seat, or when the child's shoulders are higher than the highest harness-height setting. Check your particular car seat's information, usually printed on the side of the seat itself, for the upper weight limit for your particular seat.
8. Your child is buckled into the car seat properly when:
1. The harness is securely clipped into the crotch buckle AND
2. The chest clip is closed and aligned with the child's armpits AND
3. The straps are tightened so that there you cannot pinch the strap at the child's shoulder and maintain a fold in the strap. That is, the harness does need to be quite tight, but it should not cause the child to be pushed into an unnatural position or to be unduly uncomfortable.
9. A car seat is good only for six years after its manufacture date. After that expiration date, you should dispose of the car seat and replace it. 
10. You should immediately replace a car seat if it has been involved in a traffic accident even if your child was not in it and even if there is no visible damage. Your car insurance should cover the replacement of the car seat.

As for installation, every car sold in the United States after model year 2002 is required to be equipped with LATCH hooks in the back seats, and every car seat on the market is equipped with LATCH connectors. It is equally safe to install a car seat with either LATCH or the vehicle's seat belt (if done properly), but do not use both simultaneously. A car seat is installed snugly when you cannot shift it horizontally more than 1" in either direction while grasping the car seat at the belt path. There should be an illustration of this in your manual.

There's tons more to say, but this isn't meant to be comprehensive. If you had your car seat professionally installed and/or checked, then you just need to be sure you are buckling your child in correctly. If you didn't, you may want to find out where and when you can have your installation checked by a qualified person. Depending on where you live, this (free) service may be available at a local fire station, police station, Highway Patrol station, or hospital.

Please feel free to ask me questions about this one. As I mentioned, there's a lot more I could say, but I was hoping to keep this brief...ish.