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American Medical Association Family Medical Guide - American Medical Association [59]

By Root 10318 0
among children. The best way to protect your child from the risk of injury and death on the road is by using a child safety seat. When purchasing a child safety seat, select one that is right for your child’s age and weight, and make sure it fits in your car. Before buying a car seat, try it out in your car to make sure it can be installed properly. Nearly four out of five child safety seats are used improperly because the methods of attachment in different types of motor vehicles vary widely. The three most common mistakes people make when installing car seats are failing to belt the seat into the vehicle tightly enough, keeping the harness straps too loose, and not placing the harness retainer clip at the level of the child’s armpit.

All child safety seats manufactured after September 2002 have been standardized. Every new vehicle sold in the United States includes an installation system that uses upper tethers and lower anchors to secure child safety seats. The system, called LATCH (which stands for “lower anchors and tethers for children”), makes it unnecessary to use seat belts to install car safety seats. However, owners of vehicles manufactured before September 2002 must still use the seat-belt method of installation. And parents still have to use seat belts to fasten booster seats for children who weigh 40 to 60 pounds.


Types of Child Safety Seats

Weight (Age) Type of Seat Positioning

Up to 20 pounds (birth to 1 year) Infant-only seat or convertible infant-toddler seat Child and seat face backward. Harness straps are at or below shoulder level.

20 to 40 pounds (over 1 year) Convertible infant-toddler seat or nonconvertible seat Child and seat face forward. Harness straps are at or above shoulder level.

Over 40 pounds (about 4 to 8 years), or under 4’ 9” Belt-positioning booster seat or shield booster seat Child and seat face forward. For the belt- positioning booster seat, use both the lap and shoulder belts, and make sure that the lap belt fits low and tight across the upper thigh (not across the abdomen) and that the shoulder belt fits across the chest and shoulder (not across the neck).

Infant-only seats and convertible infant-toddler seats

Child safety seats for infants under 20 pounds come in two types—infant-only seats and convertible infant-toddler seats. Infant-only seats are more portable and may be more comfortable, but babies outgrow them in the first year, so you will need to buy another safety seat. You can use a convertible infant-toddler safety seat in a rear-facing position until your infant weighs 20 pounds. Then you can use it facing forward when your child weighs 20 to 40 pounds. No matter what type of seat you choose, infants always must face the rear of the vehicle to protect their head, neck, and back in a collision.

Booster seats

Booster seats are designed for children who are too big for a child safety seat but too lightweight and short to use just the vehicle’s seat belts. Children need a booster seat if they weigh 40 to 60 pounds or are shorter than 4 feet 9 inches. Riding buckled up in a vehicle without a booster seat forces the shoulder belt to fall across the child’s neck. To avoid this discomfort, many children place the shoulder belt under their arms, which can cause serious injury in a collision. Booster seats raise the child up so the shoulder belt falls across the chest and shoulder. The seats come in two types—high-backed, belt-positioning booster seats, and shield booster seats. For either type, make sure the child uses both the lap belt and the shoulder belt, not just the lap belt, for proper protection.


School Bus Safety

A school bus is a relatively safe mode of transportation for children. Even when a school bus is involved in a collision, its occupants are unlikely to sustain serious or fatal injury. But your child can be at risk of being hit by a school bus if he or she does not follow school bus safety procedures. Teach your child the following guidelines to make the ride a safe experience every day:

• While waiting for the bus, stay out of the street

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