Car Seat Rule #3: Newborns

This is the third in my sometime Car Seat Rules series (Rule #1, on chest clips; Rule #2, on rear-facing).

I want to talk specifically about newborns in car seats. Often demonstrations are given using older babies or toddlers, but most of us first use car seats with newborns, and it's helpful to know some specific rules pertaining to newborns that may not apply to older babies.

A newborn may sit in an infant "bucket-style" car seat or in a rear-facing convertible car seat. The same rules apply in either type of seat. These rules really apply to any rear-facing baby or toddler, with some additional detail given for the specific case of a newborn. (For "newborn," I mean a baby from birth to approximately three months of age.)

1. What's Wrong with This Picture?

A brand new NJ in a Graco infant car seat. 

See if you can spot any problems with how he's buckled! (Answers below.)

2. What's Wrong with This Picture?

Here is newborn SB in his Chicco KeyFit30 infant seat, with two-year-old NJ looking on. Can you spot any problems with how he's buckled? (Answers below.)

So what are the rules for newborns in car seats?

1. The shoulder harness straps must be adjusted AT or BELOW the baby's shoulders.

This means that if the straps are above your baby's shoulders on their lowest setting, then the seat is too big for your newborn. Many seats come with additional newborn support padding. If your seat comes with this additional padding, you may need to use it both for your baby's comfort and to bring him up to the level of the lowest shoulder harness slots. DO NOT USE ANY AFTERMARKET PADDING with your car seat. The general rule is, if it didn't come in the box with your car seat, you shouldn't put it on your car seat. (This also applies to head supports and shoulder strap padding!)

If you do use the support padding that comes with your car seat, check your user's manual for the upper weight limit for this padding, and remove it when your baby reaches that weight limit. A heavier baby will compress the padding in the event of an accident, which may mean that the harness is not tight enough, potentially causing your baby injury or even causing him to be ejected from his seat.

2.  The chest clip must be fastened and lined up with his armpits or nipples.

I've talked about the chest clip before. At length. If your car seat has a chest clip, use it properly.

3.  Did I mention? Don't use any aftermarket products on your seat.

Don't use any padding, supports, add-ons, or accessories that didn't come in the box with your car seat. This includes the ever-popular Bundle-Me, head supports, shoulder strap padding, and body support pillows. These (a) interfere with the harness, meaning you may not be able to adjust, buckle, or tighten it properly; and (b) are not crash-tested with your seat, meaning you don't know how safely your car seat will perform in a crash if you are using one of these products.

4.  Make sure your car seat is installed at a 45 degree angle.

Newborns don't have enough head control to sit at a more vertical angle. If the seat is not reclined properly, his heavy head can fall forward onto his chest, obstructing his airway.

5.  It's okay for the head to fall to one side or the other, but not forward.

If your baby looks uncomfortable because his head is tilted far to one side or the other, especially if he falls asleep in the car seat, you may put a rolled up receiving blanket on either side of his head to offer additional support. You should put the blankets in after he is buckled in properly. They should not be attached to the car seat in any way, and they should not go between the baby and the car seat.

6.  Don't be afraid to tighten the harness!

The harness should be tight enough to pass the "pinch test." The pinch test is when you attempt to gather the strap between your thumb and forefinger at the baby's shoulder. If your fingers slide off the strap, then it is tight enough. If you can pinch and hold the strap material between your thumb and forefinger, the harness is too loose.

One tip: After you buckle the harness, tug on the straps around the baby's tummy to pull the slack out of the hip area, then tighten.

7.  If your baby is cold, put blankets on over the harness.

You should not put too many layers of clothing on your baby when he is in his car seat. Bulky clothing will prevent the harness from being properly tightened. If your baby is cold, buckle him into his seat in one or two layers of clothing and then put blankets or a jacket over the baby. You can tuck a blanket around the baby tightly to help keep him calm if he usually likes to be swaddled, but you should not put a blanket between the baby and the harness or behind the baby.

My friend was generous enough to allow me to film her newborn, at about seven weeks old, being buckled into his car seat. Please watch and share this video, and subscribe to the Jessica on Babies YouTube channel!



Note: Unless it states otherwise in your car seat manual, the handle of the car seat may be in any position when the seat is in the car, as long as it is locked in that position.
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Answers to "What's Wrong with This Picture?"
1. Harness is not tight enough - you can see how loose it is around his right shoulder. Too much slack in the hip area. Chest clip is too low - if the slack were pulled out of the straps and the harness properly tightened, you could see that the clip is not at his armpits. It's hard to see anything else from the angle of the photo. The head support came with the car seat, but it is probably both unnecessary and useless.

2. Harness is not tight enough - you can see the slack at his chest area. Chest clip is too low. All of the additional padding - shoulder pads, head support, and body support - came with the car seat and are acceptable to use. Because the car seat was not in the car in this picture, I can only assume I made the corrections before we went anywhere. :)

And, finally, in this picture, baby SB is buckled nice and securely, harness properly tightened, chest clip properly positioned. He is in one layer of clothing and is kept warm by placing a blanket over the harness.

It's Your Turn, Take 2! Your Breastfeeding and Formula-Feeding Experiences

Let's make this easier. I haven't had a very enthusiastic response to my little survey, posted Wednesday. I've made a web-based survey for you to fill in instead, rather than having to answer in a comment or email. Responses will be anonymous, and you can feel free to comment on any question to clarify or enhance your response. Enjoy!

Click here to take the survey!

It's Your Turn! Which Is Easier, Breastfeeding or Formula-Feeding?

I want to try something different with this post. I get a lot of hits on my blog for people looking for "is breastfeeding easier than formula?" and related searches. They mostly land on this post. I've also written a few others, like this one, and this one, that touch on that topic. Because this seems to be a popular question, I want to put it to my readers to help me answer it. In the comments, or in an email to jessicaonbabies (at) gmail (dot) com, or as a comment on this post on the Facebook page, answer the following questions as honestly as you can, either from your own experience or the experiences of friends and relatives. You can keep it anonymous if you want to, and feel free to expand on your answers if you want to be more specific. I'm interested to see what the general trends are. I'll follow up on this post in a week or two with a compilation of your responses and my reaction, as well as my own answers!

1. In your experience, or the experiences of people around you, do you see breastfeeding as:
a. Very difficult
b. Difficult
c. Manageable
d. Easy

2. In your experience, or the experiences of people around you, do you see formula feeding as:
a. Very difficult
b. Difficult
c. Manageable
d. Easy

3. Do you know how to properly prepare a bottle of formula?
a. Definitely
b. I think so
c. Not sure
d. No

4. Do you know what a proper latch looks like when breastfeeding?
a. Definitely
b. I think so
c. Not sure
d. No

5. Before you had a baby of your own, did you ever see someone breastfeeding a baby? (Including on TV)
a. Never
b. Once or twice
c. Occasionally
d. Often

6. Before you had a baby of your own, did you ever see someone giving a baby a bottle (regardless of what was in it)? (Including on TV)
a. Never
b. Once or twice
c. Occasionally
d. Often

7. Before you had a baby of your own, did you ever see someone prepare a bottle of formula? (Including on TV)
a. Never
b. Once or twice
c. Occasionally
d. Often

8. Before you had a baby of your own, did you personally ever prepare a bottle of formula for a baby?
a. Yes
b. No

9. Before you were pregnant, were you aware of the breastfeeding versus formula "wars"?
a. Yes
b. No

10. In your opinion, which is "easier," overall?
a. Breastfeeding
b. Formula-feeding

3-Across in a Toyota Camry

On Thanksgiving, we drove up to Los Angeles to spend the day with family. Our 2006 Highlander has over 100,000 miles on it, and we decided to see if we could take advantage of the better gas mileage and lower overall miles on my husband's 2012 Camry for the drive up this year. Since buying the Camry earlier this year, we hadn't tried to put three across in the back seat. Our two older sons had ridden in it multiple times, and we had SB's Graco Nautilus and a booster seat for NJ installed in the car already. In order to fit three across, however, we had to take out the Nautilus and move the two Radians from the Highlander to the Camry.

We were able to make it work by putting SB, who is almost four, front-facing in his five-point-harnessed Radian65, behind the driver; GI, who is 14 months, rear-facing in his Radian R100, in the middle; and NJ, who is six, in a booster seat behind the passenger. While I would have preferred to put NJ in the middle, it would have been next to impossible for him to get in and out easily and to buckle his seatbelt - really, the same problem he had in the Highlander.

SB's Radian65 was installed using the LATCH connectors, GI's Radian R100 was installed using the seatbelt, as there were no LATCH connectors for the middle seat, and NJ, of course, used the seatbelt with his booster.

It worked out well, and so I am pleased to report that, for those of you trying to get three across in the back of a sedan, it is entirely possible in a 2012 Toyota Camry using Diono Radian seats. I don't think it would have been possible with wider seats, such as the Graco Nautilus. It probably would have worked with an infant seat with a base, as well, although we had no reason to try it.

Pictures!

Installed but empty. You can see the black-and-beige Radian front-facing on the driver's side, the dark gray Radian rear-facing in the middle, and the booster on the passenger's side.

And here they are, loaded up and ready to go. SB peeking out from the side of his Radian, GI watching me from his rear-facing Radian, and NJ proudly modeling proper seatbelt use in his booster seat. 

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Also, don't miss my video demonstrating how to properly harness a four-year-old in a five-point harness, the inaugural video of my new YouTube channel. Subscribe now to see future videos, which will typically integrate with a related blog post!

Book News

Just a quick announcement: The Kindle Edition of my book, The "Yes, It's Normal!" Guide to Breastfeeding is now $1.99 (reduced from $2.99) at least until the end of this year!

Babies in Non-Baby-Proofed Houses

Thanksgiving with a toddler, for a third time, has inspired me to write this post.

Ever since NJ was a toddler, we've spent Thanksgiving with my family in Los Angeles, as well as other family get-togethers such as Mother's and Father's Day. NJ was the first baby in my family in over 20 years, and my relatives' houses hadn't had children in them in a long time. Houses without young children have a tendency to collect tchotchkes and decorations, plants, and other non-baby-friendly items on side tables, bookshelves, coffee tables, etc. While decoratively sound, this tchotchke-collecting isn't so great when there's a toddler around.

The first few times we visited relatives with our baby- and toddler-aged son, we had to make the rounds, picking up or putting away all kinds of things, like fireplace tools and decorative items, candles, collectible coasters, photo books, and so on. As NJ got older and less likely to get into things, it was easier to visit without having to give the place a once-over first. By the time SB was a mobile baby, we had gotten pretty good about semi-baby-proofing and keeping an eye on the kids.

The only other problem is what the kids should do with themselves during the family visit. I remember as a kid being bored out of my skull while the adults sat around chatting. My brother and I were the only kids at most of these events; my aunt doesn't have kids, so there weren't any near-same-age cousins to hang out with. My kids are in the same situation - my brother doesn't have kids, so they have only each other for company. NJ and SB are now old enough that they're pretty happy to hang out upstairs watching movies. GI, however, is at exactly the wrong age for a family gathering. He's old enough to want to be up and exploring, young enough to have little patience for sitting at the table for two hours, young enough not to be able to take instructions, but old enough to toddle around all over the place, find things to pick up, throw, or chew on, and otherwise cause destruction.

Thus, Thanksgiving this year was interesting. On the one hand, it was very pleasant to be able to set NJ and SB up with a movie, knowing that they were happy and entertained and we didn't have to listen to whining. On the other hand, GI kept us on our toes a bit.

Fortunately, after five years of visiting with kids of various ages, my aunt's house is far less dangerous than it once was. We had to keep an eye on him as far as not knocking over the TV, getting into the cat's litterbox (although he actually showed no interest in it), and a few other random things. It was actually one of the easier Thanksgiving-with-toddler scenarios we've been in.

One thing that has really helped is that we've started keeping a few toys at my aunt's house. A few dollars' worth of Hot Wheels cars and two Tonka trucks that they only see when we're there make a big difference. Plus, we don't have to schlep a bunch of toys with us when we go, along with the food we were bringing, the diaper bag, and anything else we might need for a two-hour drive and several-hour stay with three boys.

So, some advice for visiting relatives' houses when you have young kids and they don't!

1) Don't be embarrassed to nurse the baby if you need to. (This has never applied to me in my thankfully very supportive family, but I know other families may be less open.)
2) Leave toys at relatives' houses so the kids have something novel to play with when they're there.
3) Let older kids have a little leeway - even if TV or video games are limited at home, for example, be sensitive to the fact that they have less to do and are genuinely more bored when they're at relatives' houses.
4) Help the hosts pick up or move items that may be dangerous to your mobile baby or toddler so that you can feel comfortable letting baby roam a bit.
5) Bring at least one change of clothes for each kid. You never know which one is going to throw up, spill, or have a bathroom accident or leaky diaper. It's often not the one you expect!
6) If you'll be there during naptime, arrange in advance for a quiet place to put the kid(s) down for a nap - a guest room, den, or other room with a closed door, for example.

What special tips or tricks do you have for visiting this holiday season?

NJ's RSV Story

Back in March, I had promised a post telling the story of The Time That NJ Had RSV. I'm always on the prowl for blog topics, and when I suggest one to my future self, all the better! Stick with me. This is a good one.

Back in February of 2007, we were getting prepared for a major change. We were moving from Philadelphia to San Diego. This was a move we had planned on, in theory, for many years, but had only actually had about six weeks to prepare for, from the time we knew my husband had a job waiting there for him to the time he was to start said job. NJ was almost four months old. We had planned to rent a U-Haul trailer, load it with (hopefully) everything we owned that we didn't want to part with in our two-bedroom apartment, and set out across country. We expected it to take about a week, what with having to allow time for baby care, resting, and so on. We invited a friend of mine to come along, just to have an extra set of hands and eyes. She agreed.

We planned to leave on Friday, February 23, hoping to be in San Diego by March 2. Early in the week before we had to hit the road, NJ came down with a bad cold and cough. We took him to the doctor, where he was diagnosed with probable RSV. It didn't seem to be a severe case, so the doctor gave him an albuterol inhaler with a spacer chamber, saying that if we should need it on the drive, it would be much more portable than a nebulizer, and just as effective.

By Friday, not only was NJ still sick, but I had come down with an awful cold as well. I was coughing, congested, and generally miserable. Things were not looking up. We had decided to keep NJ's four-month "well"-baby visit for that day. Only, he was far from well. Indeed, the doctor was concerned enough about his wheezing that she gave us a nebulizer and sent us to the hospital. She told us that we should stay in the hospital overnight and that we simply could not leave for San Diego that afternoon as planned.

But at the ER, NJ was happy, playful, and had responded well to a nebulizer treatment. The pediatrician at the ER was hesitant to admit him, saying that he really wasn't that sick after all. We could handle the nebulizer treatments every four hours at home, and we should return to our pediatrician in the morning for a follow-up.

So, we spent the night in an empty apartment. Our stuff was packed and loaded in the trailer. We had no TV, no furniture except our bed and a couch that wouldn't fit in the trailer and a couple of bookshelves that we'd decided to leave behind. We had no food. My mom stayed with us and did NJ's night-time treatments, and we returned to the doctor the next morning.

He was a bit better in the morning, but the doctor insisted that we needed to continue the treatments, and we shouldn't leave town just yet, in case he got worse and needed to return to the hospital.

Well, okay. But we were supposed to be moving to San Diego! We HAD to get on the road by Sunday or we wouldn't make it to San Diego in time for my husband to start his new job.

What choice did we have? We scrapped our plans. The trailer was unloaded and returned to U-Haul. We hired movers to come pick up the stuff on Sunday morning. My husband would head out by car Sunday afternoon, and I would fly with NJ and my friend to Los Angeles the following Tuesday to wait for him. We would stay at my aunt's house in LA until we reunited, then drive down to San Diego together and wait for the movers.

And that was that. My husband hit the road Sunday afternoon, headed to Pittsburgh for his first overnight stop with a cousin there. NJ and I went to my mom's to spend a couple of nights until our Tuesday evening flight. I was still feeling very sick, but NJ started to do better. By Tuesday, I was starting to feel human again, thank goodness.

My friend and I flew out with NJ, as planned. He handled the trip like a pro, and everything went very smoothly. My husband arrived in LA on Wednesday evening, having made incredibly good time. Without a baby or trailer to slow him down, he had driven a good 800 to 900 miles a day!

NJ recovered just fine, obviously, although he was left with some reactive asthma that rears its ugly head occasionally. It amazes me to think how much our lives have changed since that move. Our family has grown by two children, we've bought a house, and we're quite settled here in southern California. It still makes for a good story, though!