What Can I Do If I See Car Seat Misuse?

I'm nosy about car seats. I like to know what seats people have. I like to watch them buckle their kids, or unbuckle them, or watch the kids buckle themselves. I like to offer help when a friend is purchasing or installing a new seat.

But when I see misuse out on the street, or in a parking lot at a store, or at school, I'm at a loss. I know those kids aren't as safe as they could be, but they're not MY kids. They're not even my friends' kids, where I might be able to make a gentle suggestion in passing. I am not confrontational by nature, and I am sure that the words of a complete stranger in the Safeway parking lot would not convince someone to change their habits anyway.

There are venues where education and knowledge are possible, however.

Social Media

Share articles, videos, and images about proper car seat use and encourage friends to share them as well. If you do spot misuse in a friend's picture, send a friendly private message (no shaming, no public retribution).

Here's an idea for a gentle message you might send: "Hey, your baby is getting so big and is sooooo cute. I love the little hat he's wearing in the picture you posted! I have that exact car seat, and I had trouble figuring out how the straps should go. I went to a professional car seat installer and got the scoop. I'm not sure if you realize that the straps are supposed to be BELOW the baby's shoulders! My baby kept squirming and getting his arms out until I adjusted the straps. Also, if you tighten the straps until you can't pinch them, then it'll hold him in the seat better. They showed me that if you put the chest clip right up at his armpits, then the straps stay on his shoulders. I can't wait to see more pics of your sweet little one! Let me know if you have any other questions!"

This is likely to be fairly inoffensive, and if you "blame" your observations and information on a professional, then it's not you criticizing, it's you sharing information that you didn't have and that you found useful (even if that isn't precisely true). You may also want to include a link to a neutral third party's article or video (The Car Seat Lady is a great resource, or, of course, this very blog!). Again, the advice isn't coming from you! Just like you might say, "My doctor told us...", saying that a car seat expert told you something will probably have more power and feel less judgmental than if you jump in and say, "Hey, you're doing it wrong!"

Day Cares and Schools

My mom is a preschool teacher and often helps kids in and out of cars in the carpool line. She sees rampant misuse and isn't afraid to speak to parents about how they might improve their car seat use. As a fellow parent, you may not have that ability, but here are some ideas for ways to address misuse among other parents at your kids' schools.

Speak with the Teacher

In some schools, the teachers may not have any authority or may not be permitted to speak to parents about car seat safety. The school may not want to take on the liability for poor advice or risk angering parents with unsolicited information. However, it may be possible to share with the teacher an article or video or website that she or he can distribute to the other parents in your child's class universally, as a interesting bit of information or an issue of safety right alongside fire prevention, first aid, and stranger danger. This way, no parent is singled out, and all parents get good information. You can't control whether the parents read the articles and watch the videos, and you can't control whether they take any of it to heart and make changes, but at least you know you took some action.

Speak with the Administration

Taking things one step further up the line, you can speak to the school administration about school-wide car seat safety. If the administration is open to the idea, you might suggest having the school host a "Car Safety Day" where parents can have a CPST check their seats in the school parking lot. After all, schools often have police offers and fire fighters come to do presentations about safety. Isn't car safety equally important? (After all, car accidents are one of the leading causes of death and injury to young children!)

You may also be able to suggest that the administration to issue a newsletter or memo or include an article about car seat safety in their regular bulletin.

Direct Confrontation

If you have any rapport with the fellow parent you're concerned about, you may be able to confront them directly. As in the social media example above, though, try to be kind, nonjudgmental, and helpful. "Hey, can I show you something about your car seat?" will obviously go over much better than, "Your kid is buckled wrong." Whether you choose the direct confrontation method is dependent on your own personality, the relationship you have with the other parent, and the type of person that parent is. You may be pleasantly surprised to find that he or she is open to your information, or you may find that they shut down. If you truly don't trust this person's car seat safety commitment, then, at the least, don't let your child ride in their car.

Out in Public

I unfortunately see a lot of misuse in stores and parking lots where the fellow parent is a total stranger. I have never personally approached anyone to comment on their car seat use, but there have been times where I've been tempted. If you can establish some kind of friendly contact with the person before mentioning their car seat, your information is likely to go over better. If you feel obligated to convey the information regardless, be aware that the other parent may ignore you, become angry, or argue back.

I had an experience a few years ago with a woman when I stopped into the bank to make a deposit. This experience - as the one being "advised," not the one doling out tips - gave me a lot of insight into how it feels to be approached by a stranger out of the blue.

If I were the one making a safety mistake - willingly or not - how would I want to be approached? Probably in a similar way to methods I've listed above. I'd want the person to be friendly, "on my side," and nonjudgmental. I'd want to feel that that person genuinely had my kids' safety at heart and not merely a need to feel like a superior parent. I'd want a chance to respond, ask questions, and make my case. And I'd want to leave the encounter smiling, not fuming.

Start off with a simple greeting. A smile and a friendly "hello" are always a better opener than, "You shouldn't." Use "I" statements: "I noticed..." "I was concerned..." Most importantly, don't accuse or judge! Parenting is not a competition. You are not a better parent because you know something about car seats that someone else doesn't.

I think it's important to understand that a random encounter with a stranger is probably not going to change anyone's mind. But if you give them the information and they have it confirmed by other sources, at least you planted the seed.


Do you have suggestions for addressing car seat misuse in various venues? Have you successfully approached or been approached by someone about a safety issue? In what context? Please share your experiences and your tips here in the comments or on the Facebook page!

Vaccines Keep Our Kids Safe

The measles outbreak traced to Disneyland this winter has created a great resurgence in the "vaccinate or do not vaccinate" debates that surface relatively often in parenting discussions. The media has been covering different angles, from encouraging everyone to get their shots to heart-rending stories of children purportedly injured by a vaccine. It's a hot topic.

I did an Ask-Me Monday video on vaccines a couple of months ago, coincidentally just before the Disneyland outbreak. (See it here.) Predictably, people who are against vaccines sought out my video so that they could pick a fight. I chose to engage calmly, state my opinions, and be done with it. I know that throwing facts at people doesn't change their minds. Indeed, there have been studies on this very topic, and the more you argue, the more people dig in their heels.

The vibe I get from parents who are genuinely concerned and thoughtfully considering whether they should consent to having their children vaccinated - as opposed to being solidly in the "anti-vaxxer" camp - is that they are trying to keep their children safe. They hear stories of children who suffered brain damage, organ damage, or death from a rare reaction or complication of receiving a vaccine. They don't want to take the risk for their own children. The word "autism" gets tossed around. We see link after link to blog posts and opinion pieces about how we're all being duped by the pharmaceutical companies, how there's a great conspiracy in the FDA and the CDC to force all of us to be injected with poison, and how a child was perfectly healthy and typical before they got the DTaP or the MMR shot, and afterward showed signs of brain damage or a blood disorder or had uncontrollable seizures.

Well, obviously we don't want to become involved with or duped by government conspiracies! And don't you know that there's formaldehyde in those shots?!

What no one bothers to say when making these arguments is that there's another side. There's the parents whose newborn babies were exposed to measles or whooping cough because of an unvaccinated child in their community. There are the children who contract these diseases and become severely ill and spend weeks or months in the hospital. There are the babies who die a slow, horrible death wracked by rib-cracking coughs until they turn blue from lack of oxygen and suffocate in their own mucus. There are the children left paralyzed by polio or suffer encephalitis from measles. There are the women who lose pregnancies because of rubella infection.

Underneath all the sob stories and "what if's" are parents who are just trying to figure out what is best for their own children. How do we protect our kids and our families? What should we be afraid of? What are the real risks?

I'm going to take this discussion outside of vaccines to look at a bigger picture. There is risk in everything we do every day. Indeed, one of the riskiest things we do every day with ourselves and our children is drive our cars. Did you know that car accidents are one of the leading causes of death and injury for children? Car accidents. But I bet most of you put your kids in the car almost daily. I know I do. School and daycare drop-offs and pickups, shopping, errands, visiting friends, grabbing a bite to eat, playdates, road trips, vacations, all sorts of reasons to get in the car.

And do you, each and every time you get in the car, double check that your kids are in appropriate child restraints, installed and buckled correctly? Do you take your car in for regular maintenance? Are your brakes and tires in good repair? Do you have a hands-free device for your cell phone, or do you put your cell phone away while you drive so as to avoid distractions? Do you glance in your mirrors and check your blind spot every time you change lanes?

So, what if we decide the risk of driving is too high and we stay home? There's a risk of earthquakes or windstorms. In the winter, ice could bring a tree branch down on your house. If you live in tornado country, you could end up trapped under the rubble of your home. If you live in the hurricane zone, another Katrina could turn your life upside down. You could forget about the pot of soup on the stove and set your house on fire. You could slip in the bathroom and hit your head on the toilet and knock yourself out.

Things can happen anywhere. And we can't live our lives in fear. It's impossible to account for every possible scenario. It's impossible to be completely, 100% safe, all the time.

So, we do the best we can with the information we have. We weigh the risks and benefits as we understand them. And if doing something has risk and not doing something also has risk, it is very hard to choose. But if the goal is to keep our kids as safe as possible, it's important to do what we can to minimize risk in all situations. Like buckling them correctly in a properly installed, appropriate car seat when on the road, and having them wear a helmet when they ride a bike, and putting a fence around the pool.

When it comes to medical procedures, and vaccines specifically, certainly, it is much easier not to do something. The passive route feels less risky. If I don't give my baby this injection, then it can't hurt him!

It's important, then to consider the other half of the equation. If you don't give your child this injection and he contracts measles, say, through contact with a tourist at Disneyland, then measles can hurt him. And not just him. Measles can affect him, and his siblings, and his cousins, and his friends, and his friends' families, and their friends, and at some point, someone will die. Maybe it won't be your kid. Maybe your kid will miss two weeks of school and recover and that's the end of it, and you'll be relieved that everything is fine. But maybe some other baby down the line of contagion isn't so lucky.

And if you do give your child that injection, and you go to Disneyland and come in contact with a tourist who is carrying measles, and your child doesn't get measles, well, then clearly you made the right choice in getting that shot!

It's not simple. And yet, it is. Because if we look at the research, at the documented risks, at the statistics, it becomes clear that the risk of contracting a disease, and the risks of complications from that disease, are higher than the risks associated with the vaccine. If we look past the sob stories and the fear-mongering and the impassioned pleas, if we look at the cold, hard facts, at the science, it's purely, radically simple.

Vaccinations work.

Protect your children and all of the people your children come in contact with every day.

Get vaccinated.

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Statistics:

Complications of measles:
http://www.cdc.gov/vaccines/pubs/pinkbook/meas.html#complications
Note: 30% of measles cases experience some complication, such as diarrhea, ear infection, or pneumonia. Pneumonia is the leading cause of death from complications of measles. The risk of death from measles is 0.2%, or 2 in 1000.

Adverse reactions to MMR Vaccine:
http://www.cdc.gov/vaccines/pubs/pinkbook/meas.html#adverse
Note: 5 to 15% of susceptible persons may develop a high fever but be otherwise asymptomatic. As for serious complications, 1 in 30,000 may develop thrombocytopenia (a blood disorder in which blood does not clot), but the risk of thrombocytopenia due to measles infection is much higher than the risk of thrombocytopenia due to the measles vaccine. Other risks are so rare as to almost be incalculable.

Yes, it is possible to have an adverse reaction to a vaccine. It's important to acknowledge that. But it is far, far more likely to have complications from the disease itself.

Let's Not Let Any More Babies Die in Hot Cars

It's (finally) spring, and some parts of the country and world are starting to warm up quickly. With the sun coming out come the reminders about the dangers of leaving kids (and pets) in the car. Cars warm up very quickly in direct sunlight, even when the temperature is fairly mild, and a child or animal trapped in a hot car can suffer dehydration, heat stroke, hyperthermia, and even death if left long enough.

Every year in the U.S., more than 30 children die from being left in hot cars. Most of these incidents are unintentional. That is, the parent or caregiver didn't mean to leave the baby in the car. Rather, they forgot the child was there and only upon returning to the car discovered that they had made a tragic error.

When news of such horrendous events gets out, two responses typically emerge. The comments start off with some type of judgment against the parent, such as, "He must be an abusive parent" or "She was obviously neglectful," or "If she can't remember her kids, she probably shouldn't have them." It is assumed that a parent who would leave a child in the car long enough to die in the hot sun must by definition be a "bad" parent. Next, you'll find a series of sanctimonious declarations that, "My children are always the first thing on my mind. I would never do that" and "How could anyone forget their kids? That would never happen to me!"

Five years ago, Gene Weingarten wrote a Pulitzer Prize-winning piece for the Washington Post on this subject. He tells the terrible stories of parents from all walks of life who returned to their cars to find their babies dead in their car seats. Some forgot they were supposed to drop the baby off at daycare and continued on to work. Some thought they had made the drop off only to show up at daycare for pickup with the child still in the back seat of the car. Every year, there are dozens of stories like this.

Weingarten interviewed a memory expert who explains that, "...in situations involving familiar, routine motor skills, the human animal presses the basal ganglia into service as a sort of auxiliary autopilot. When our prefrontal cortex and hippocampus are planning our day on the way to work, the ignorant but efficient basal ganglia is operating the car; that's why you'll sometimes find yourself having driven from point A to point B without a clear recollection of the route you took, the turns you made or the scenery you saw." 

In other words, when we're preoccupied with other things, we go on autopilot for the routine things. I'm sure we've all had the experience of getting in the car and starting to drive to work when we really meant to go the opposite direction to the grocery store, or of setting the table for the usual four people when only three are home that night, and so on. We do things without thinking about them while our conscious mind is busy with something else, like planning the meal we're about to make or thinking about tomorrow's schedule or making a phone call.

Weingarten's expert explains that when we are stressed, "What happens is that the memory circuits in a vulnerable hippocampus literally get overwritten, like with a computer program. Unless the memory circuit is rebooted -- such as if the child cries, or, you know, if the wife mentions the child in the back -- it can entirely disappear." 

So something that is not routine - like the fourth person not being home for dinner, or not going to work on a weekday - can be easily forgotten by the conscious memory if it's not reinforced, and the autopilot takes over.

The article is wonderful, for its excellent writing (as anyone would expect from Gene Weingarten), its sensitive handling of a delicate subject, and its exploration of how and why these tragedies happen. It is not, as Weingarten point out, because the parents are "bad" or "neglectful." It's not because they don't love their children. There's usually a perfect storm of stress, preoccupation, distraction, and change of routine that leads to a parent doing the unimaginable and leaving their child to die in the car.

We, the public, of course, hear about this happening when a child dies, but I wonder how often it happens that the child is forgotten but found and rescued before overheating, or that the baby is discovered or remembered by the parent before anything terrible happens. How often does it happen on a cold, cloudy day where the child might be hungry and upset but thankfully not overheat? How many times have parents left for just a few minutes before something reminds them to go back to the car and get the baby? I'm sure it's not as uncommon as we'd hope.

The trouble with the assumption that only neglectful, abusive, unloving parents would forget their baby in the car is that it means that those of us who know we are good, loving, attentive parents may not take precautionary measures. After all, if it's not going to happen, why bother worrying about it? The problem with knowing it wouldn't happen to us means that we are just as susceptible.

But what can we do to prevent it?

It's important to remember that these "forgetting" incidents usually happen when we are doing something outside our normal routine. If Mom usually takes the baby to daycare but today Dad is doing it, Dad's routine is disrupted. If Mom doesn't usually take the baby to the store with her but today she does, then Mom's routine is disrupted. If there is usually a baby-sitter at home but today the baby was going to Grandma's house, then the parents' routine is disrupted by dropping the baby off somewhere instead of going straight to work. Also, the typical scenario seems to be that not only is the routine disrupted, but that there are additional distractions, especially stress, that prevent the hippocampus from recording the memory that the baby is in the car. 

I suggest a two-pronged approach. 

First, we need to inform and educate. People need to know that this happens to wealthy parents and poor parents, working parents and stay-at-home parents, white parents and minority parents, adoptive parents and birth parents, parents of many children and parents of one child. Be aware that it could happen, and the circumstances under which it is more likely to happen. Rethink your judgment of others when you read about it in the news. Don't let your knee-jerk reaction be, "I wouldn't let that happen to my child," but rather, "How can I make sure I don't make the same mistake?" 

Also on the subject of education, many people don't realize just how hot a car can get and how fast it can get there. The interior of a parked car on a sunny, mild day can reach 110 degrees Fahrenheit in about 90 minutes even with the windows cracked open. Within 15 minutes, the temperature will already be uncomfortably warm. Think about how it feels to get into your car after it's been sitting in the sun for a few hours. It's hot! You open the windows to cool it off, blast the A/C, try to bring the temperature down to a comfortable zone. Well, imagine that you had been sitting in that car for an hour or two. You'd be very, very hot. Now, remember that babies are not as efficient at regulating their own body temperature as adults are. Plus, they tend to be overdressed for the weather (we don't want them to be cold!) and are cocooned in their bucket-style car seats. They can't unbuckle themselves and open a door to cool off. They can't take off an outer layer of clothing or fan themselves. They'll just keep getting hotter and hotter with no way to get relief. Many well-intentioned parents simply are not aware of the danger they are placing their babies in by leaving them in a car for any length of time (even 10 minutes) on even a mild day.

Second, we need to devise strategies for ourselves to prevent this memory blip from happening in the first place, or to recover the memory before anything terrible happens. Keeping in mind that these events often happen when you are out of your routine, come up with something you do as part of your normal routine and try to disrupt that as well, to jog your conscious memory into thinking about the baby. Once you've decided that you are going to take preventative measures, it's simply a matter of taking steps to minimize the risk. Some suggestions I have are:

• When the baby is in the car, put something you'll have to take with you when you get out of the car beside, under, or near the baby's car seat in the back, for example, your briefcase, purse, cell phone, work badge, or office key. This way, when you reach for said item and it's not where you'd expect it to be, you'll remember it's in the back with the baby.
• Leave yourself some kind of visual reminder, such as a brightly-colored Post-It note on the steering wheel or dashboard when you start driving. Maybe write on it "BABY".
• Give yourself a visual cue for when you glance in the rear-view mirror and see the baby's car seat that will remind you that the baby is in the seat. Perhaps a red ribbon around the handle, or something else that will catch your eye that is only there if the baby is.
• Keep a teddy bear in the car seat when it's empty. When you put the baby in the car seat, put the teddy bear in the front seat with you. If the teddy is in the front seat, then check the back for the baby!
• Talk to yourself about the baby and the fact that you are taking the baby somewhere as you drive to reinforce the memory. Better yet, talk to the baby!
• Have a plan with your partner that whenever you take the baby somewhere s/he will call to check in. For example, if Mom takes the baby to daycare, Dad should call Mom in the morning and ask how drop-off went, or if the baby did anything cute, just to jog the memory.

For resources and information about kids' safety in and around cars, see www.kidsandcars.org. For more on vehicular hyperthermia/heatstroke specifically, see http://www.kidsandcars.org/heatstroke.html.