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Selecting a Car Seat for Your Baby



Juliette M. Brown

Juliette M. Brown

MHS, CHES
Injury Prevention Coordinator, Dell Children’s Medical Center of Central Texas

Selecting a Carseat

Ahhh... parenthood... full of joy, stress and hundreds of daily decisions related to caring for your child. Ever lay in bed at night thinking “should I change diaper creams?” or “ would a new type of bottle cut down on the burps that could fuel an entire city”? I think all parents second guess some decisions they make and wonder if they’ve done the “right” thing. Hopefully I can help to reduce some of that stress by giving you some tools and tips on selecting a safe car seat for your baby.

As an Injury Prevention Educator and a Certified Child Passenger Safety Technician, the one question I hear most often is: “what is the best car seat for my baby?” My answer is usually not what parents hope to hear, as there is no one-size-fits-all car seat solution. The real answer is that the best car seat is the one that fits your child properly, fits in your vehicle correctly, and is easy for you to use correctly. Sometimes parents use price as a guide, thinking the more expensive a seat is, the safer it must be. Sometimes parents just can’t resist the mini pink and purple elephants on the fabric of the car seat and buy based on appearance. The first thing parents should look for is a label on the car seat that states “meets FMVSS 213” on (some car seats have a label indicating they are approved for use on airplanes also). FMVSS 213 is a Federal Motor Vehicle Safety Standard set by the National Highway Traffic Safety Administration (NHTSA) which ensures minimum standards for child safety seat performance are met. After that, it boils down to ease of use, fit to your child, and vehicle compatibility.

Ease of Use:

Before braving the aisles of car seats at Target or Babies R Us, etc. parents should consider online resources. NHTSA has developed an ease of use rating for car seats that covers an evaluation of the instructions, labels, installation features, and securing a child in the car seat. They use a 5-star rating that makes it easy to see which seats are likely to frustrate and which ones make it easy to install and use correctly. Check it out athttp://www.nhtsa.gov. Under “Quick Links”, click on “Child Safety Seats”

What about used car seats?

There can be several issues with getting a used car seat. Frequently you are unable to find out from the previous owner if the car seat has ever been in a crash. Avoid used seats if you don’t know the seat’s history. Never use a car seat that :

  • Is too old. Look on the label for the date it was made. Check with the manufacturer to find out how long it recommends using the seat.
  • Has any visible cracks on it.
  • Does not have a label with the date of manufacture and model number. Without these, you cannot check to see if the seat has been recalled.
  • Does not come with instructions. You need them to know how to use the seat.
  • Is missing parts. Used car safety seats often come without important parts. Check with the manufacturer to make sure you can get the right parts.
  • Is recalled. You can find out by calling the manufacturer or by contacting the National Highway Traffic Safety Administration (NHTSA) Vehicle Safety Hotline at 888/327-4236. You can also check the recall list on the NHTSA Web site athttp://www.odi.nhtsa.dot.gov/cars/problems/recalls/childseat.cfm
  • Do not use seats that have been in a moderate or severe crash. Seats that were in a minor crash may still be safe to use. The NHTSA considers a crash minor if all of the following are true:
    • The vehicle could be driven away from the crash.
    • The vehicle door closest to the car safety seat was not damaged.
    • No one in the vehicle was injured.
    • The air bags did not go off.
    • You can’t see any damage to the car safety seat.

(source: American Academy of Pediatrics – Car Seat Guidehttp://www.aap.org/family/carseatguide.htm)

Does it Fit My Child?

The American Academy of Pediatrics (AAP) recommends that all infants should ride rear-facing starting with their first ride home from the hospital. They should remain rear-facing until they reach the highest weight or height allowed by their child safety seat’s manufacturer. At a minimum, children must ride rear-facing until they have reached at least 1 year of age and weigh at least 20 pounds. However, the Injury Prevention Department at Dell Children’s actually recommends that children stay rear facing as long as possible. Most convertible car seats, and even some infant-only seats, have a rear-facing weight limit of thirty pounds or higher; we recommend that you keep your child rear-facing in their convertible seat until you reach the weight and height limits of the seat. Rear-facing is the safest way to ride and helps prevent head and spinal cord injuries to babies. In fact, toddlers between the ages of 12 and 23 months who ride rear-facing are more than five times safer than toddlers in the same age group who ride forward-facing. Make sure you read the manufacturer’s instructions and/or the labels on the side of the child safety seat to be certain your child is within the height and weight limits before selecting a seat.

(Source: O’Keefe, Lori. “New Advice: Rear-facing car seats safer for children until they are 2.” American Academy of Pediatrics News. Volume 30: 4, April 2009. www.aapnews.org.)

There are 2 types of rear-facing car safety seats: infant-only seats and convertible seats.

Infant-only seats

  • Are small and have carrying handles (and sometimes come as part of a stroller system).
  • Are used only for travel (not for positioning outside the vehicle).
  • Are used for infants up to 22 to 32 pounds, depending on the model.
  • Many come with a base that can be left in the car. The seat clicks into and out of the base so you don’t have to install the base each time you use it. Parents can buy more than one base for additional vehicles.

Convertible seats (used rear-facing)

  • Can be used rear-facing, then “converted” to forward-facing for older children. This means the seat can be used longer by your child. They are bulkier than infant seatsand do not come with carrying handles or a separate base.
  • Have higher rear-facing weight and height limits than infant-only seats, which makes them ideal for bigger babies.

Common Questions:

What if my baby weighs more than 20 pounds but is not yet 1 year old ?

Use a seat that can be used rear-facing by children who weigh more than 20 pounds and keep your baby rear-facing as long as possible. Almost every convertible seat will work in this situation

What do I do if my baby slouches down or to the side in his car safety seat?

Pad around your child (never under or behind) with rolled-up cloth diapers or blankets. Never add padding underneath your child’s body or behind their head. Do not use any sort of car safety seat insert unless it came with the seat or was made by the manufacturer of the seat.

Can I adjust the straps when my baby is wearing thicker clothing, like in the winter?

Yes, but make sure the harnesses are still snug. Also remember to tighten the straps again after the thicker clothes are no longer needed. Dress your baby in thinner layers instead of a bulky coat or snowsuit, and tuck a blanket around your baby over the buckled harness straps if needed.

Are rear-facing convertible seats OK to use for preemies?

Premature infants should be tested while still in the hospital to make sure they can ride safely in a reclined position. Babies who need to lie flat during travel should ride in a crash-tested car bed. Very small infants who can ride safely in a reclined position usually fit better in infant-only seats; however, if you need to use a convertible seat, choose one without a tray-shield harness. The shields often are too big and too far from the body to fit correctly.

(source: American Academy of Pediatrics – Car Seat Guide)

Need More Help?

To find out when the next car seat check-up event is in your area call Dell Children’s Medical Center of Central Texas at 512-324-TOTS (8687) or view the Community Car Seat Calendar.

Car Seat Safety Information can be found at the following websites: