Three mistakes grandparents make when it comes to a baby’s car seat

Q: How are there so many new car seat “rules” that didn’t exist when my kids were young? And do I really need to follow them?

A: When my first baby was born, back in the 1980s, I could see that my parents — his loving, cautious, anxious grandparents — didn’t really understand all the fuss about car seats. With fond perplexity, they watched us wrestle the rather primitive rear-facing infant car seat of the moment into and out of our little two-door hatchback. Occasionally, one of them would murmur that I myself, as an infant, had always traveled safely in my mother’s arms — in the 1950s.

Car seats have truly made the world safer, protecting children against motor vehicle accidents, which are still a major cause of death (not to mention serious injury) in children over 4 years old in the United States. (Infectious diseases used to be the No. 1 cause of death in children of all ages until vaccinations became routine.) Compared to seat-belt use alone, proper car seat use reduces the risk of death or injury in a crash by 71% to 82% for children.

Today’s grandparents are my generation, and although we all transported our own children in car seats, the technology has evolved, making car seats safer than ever. This means the recommendations have evolved, too, which can make it challenging for grandparents — and even parents — to be sure they’re following them all. Car seats really can keep our beloved children safe — but only if we use them, use them consistently and use them correctly — and that isn’t always an easy assignment.

I talked to Benjamin Hoffman, who is a professor of pediatrics at Doernbecher Children’s Hospital in Portland, Oregon, a past president of the American Academy of Pediatrics, and a certified child passenger safety technician (CPST). Or, as Hoffman likes to call himself, a “car seat nerd.” He celebrated the improved technology of the seats, and the demanding standards and testing that make them so much more protective than the seats I had available for my own children — but he acknowledged that car seats can be challenging to install correctly, and that studies have revealed that as many as three-quarters of them are not correctly installed or used.

Here are a few bits of wisdom to help you make sure your kids or grandkids are getting the full safety benefits that car seats offer.

Installing the seat incorrectly

To keep a child safe, the car seat has to be properly installed. Car seats are stronger and better than they used to be — but choosing the safest position in a specific car and securing the seat can be complicated. The first best place to start is the manual that comes with the car seat in question. That should provide detailed installation instructions as well as dos and don’ts to ensure you’ve got the right setup — because proper installation can vary from brand to brand, car to car and seat to seat.

The American Academy of Pediatrics also provides information on car seat installation, including safe position and harness use as well as a list of car seats available.

For help installing a car seat, or with any other questions, a consultation with a CPST is a valuable resource. You can find one at the Safe Kids website — they often work at police and fire departments or children’s hospitals (so that you can consult one before you take your new baby home) — and many communities offer car seat clinics and inspections. Most consultations are free.

Switching to forward-facing too soon

The new guidelines, which for some grandparents can feel a little bewildering (not the same as what we did, even though we followed all the rules), are to keep babies and toddlers in rear-facing seats as long as possible. Why? In a rear-facing position, the seat can better cradle and protect a young child’s fragile head, neck and spine.

Some states have laws for how long a child must be rear-facing; for example, in New York, it’s age 2. But safety experts feel strongly that toddlers should remain in this position until they truly outgrow the height and weight limits for rear-facing that are listed in the seat’s manual and on the stickers on the side of the seat — which they may not reach until age 3 or 4.

Convertible car seats can be used in the rear-facing position up until a certain height and weight, and then can be flipped to front-facing when the child is larger. When a child outgrows that rear-facing position, the recommendation is to forward-face the car seat until they outgrow the weight and height limit, and then a booster seat as long as possible until the seat belt fits correctly.

As mentioned, children who are smaller for their age may stay longer at each stage. After that, they should use lap and shoulder belts and ride in the back seat, not the front, until they’re at least 13. This protects them better in crashes and keeps them away from front air bags, which can hurt them.

In fact, Hoffman said, “as long as possible” is good general advice: don’t be in a hurry to “promote” a child to a forward-facing seat, or from a forward-facing seat to a booster seat. Each of these changes puts the child at higher risk for injury, so there shouldn’t be any hurry to get to the next stage, he said. “Just because you can doesn’t mean you should.”

Putting the harness on over bulky clothing

Once the seat is properly installed, the harness that secures the child has to be properly fastened. If the seat is rear-facing, the harness straps need to be at or just below the child’s shoulders, while in a front-facing seat, the straps should be at or just above the child’s shoulders. And because children grow quickly, you’ll need to recheck the position regularly to make sure it’s still correct.

When tightening the harness, you’ll want to use a pinch-test: If you can gather up enough of the strap to pinch it in between two fingers, it has too much slack. And if the child is wearing bulky clothing — such as a snowsuit or winter coat — the straps won’t be secure enough if there’s a crash. The force of the crash will compress the clothing, so there will essentially be space between the child and the harness — which can mean increased injury. Some parents may bring a blanket for the car so that they can keep their little ones warm without the hassle of taking a coat on and off; others may put the coat on backward over the harness.

A few more important considerations

Above, I highlighted some of the rules that might be most surprising to those of us who are far removed from our own kids’ car seat years. But they’re not the only important rules for car seat safety. Here are a couple of other ones to remember:

• Get additional guidance for premature infants.

• Be aware that a rear-facing car seat should never be used in a front seat where there is a front air bag. (The AAP says it’s much safer to avoid putting any car seat in the front seat, but if necessary, it should be a forward-facing seat that’s moved as far back from the dashboard as possible.)

• Check that any car seat that is not new is not too old, and has not been recalled. You can search for specific brands and models on the National Highway Traffic Safety Administration’s recall website.

• Never use a car seat that has already been through a moderate or severe crash.

Yes, it’s complicated. Yes, the rules and recommendations have changed over time. But it’s worth adapting our own behaviors along with them to make sure our precious cargo stays safe. Go ahead, read through the information on the websites, spend some time with your car seat manual, find yourself a helpful CPST and, above all, put the kid in the right safety seat, with the harness fastened correctly each and every time you take one of the little car trips in your long journey together.