During a crash, child restraint systems are designed to offer additional protection that seat belts can't provide. Child restraint systems:
- reduce the risk of ejection during a crash
- distribute the load of the crash through the child's strongest bones, rather than soft tissues
- limit the crash forces the child experiences
- limit the contact of the child with other structures in the car
But are child restraint systems really better than seat belts at reducing injuries? Yes, say experts from the University of Michigan in Ann Arbor and the University of Pennsylvania School of Medicine in Philadelphia.
Researchers used government data to identify children between 2 and 6 years of age who were involved in crashes that occurred in the United States between 1998 and 2003 — 7,813 of the children were involved in crashes with at least one passenger fatality and 1,433 were involved in nonfatal crashes. Researchers noted whether each child was properly restrained in a child restraint system, such as a rear-facing car seat, forward-facing car seat, or belt-positioning booster seat, or in a seat belt.
Overall, about 1 child out of every 1,000 involved in a two-way motor vehicle crash died. Forty-five percent of all children had been buckled into child restraint systems. Children properly placed in a child restraint system had a 28% reduced risk of death during a vehicle crash, compared with children restrained in seat belts alone. Even when the child restraint systems were misused or placed in the vehicle improperly, they still offered a 21% reduced risk of death, compared with a seat belt.
What This Means to You. This study supports previous evidence that child restraint systems are safest for young children traveling in motor vehicles. When riding in a motor vehicle, all kids should be seated in the rear passenger seat. Infants under 1 year old should be placed in rear-facing infant-only seats or convertible child safety seats. Children older than a year who weigh more than 20 pounds can be safely restrained in forward-facing child safety seats. Kids weighing between 40 and 80 pounds, usually between 4 and 8 years of age, can use belt-positioning booster seats or combination seats that allow the harnesses to be removed.
When your child can sit with his or her back against the vehicle's seat back with his or her knees bent over the edge of the seat without slouching (usually when your child reaches a height of 4 feet, 9 inches), he or she may be ready to use the shoulder and lap belts.
Source: Michael R. Elliott, PhD; Michael J. Kallan, MS; Dennis R. Durbin, MD, MSCE; Flaura K. Winston, MD, PhD; Archives of Pediatrics and Adolescent Medicine, June 2006.
Reviewed by: Mary L. Gavin, MD
Date reviewed: July 2006