Every day, three children die and another 260 are seriously injured in car crashes. More children die from motor vehicle crashes than from any single disease and more children in the United States are killed and crippled in car crashes than from any other cause of injury.

Use of child safety seats and seat belts, consistently and properly, has been proven to reduce the risk of death and injury. In fact, nearly 70 percent of children killed in crashes wouldn't have died if they'd been properly buckled-up. And, buckling-up not only saves children's lives, it's also the law.

Buckle-Up Every Time

Always use a child safety seat, starting with your baby's first ride home from the hospital. Help your child form a lifelong habit of buckling up. If your child tries to unbuckle or climb out of the seat, say "no" and stop the car immediately.

When used properly, child safety seats provide excellent protection in most crashes. The seats keep children from being slammed into the windshield or dashboard, thrown against other passengers, or flung out of the vehicle. They also keep children in their places, so that the driver can pay attention to the road.

Use The Safety Seat Properly

Unfortunately, many children are injured because their child safety seats were used improperly. The misuse varies, but the most common mistakes are: infant seats facing forward rather than rearward; safety belts incorrectly routed through the safety seats; safety seats incorrectly anchored to the vehicle seat; children not harnessed tightly into safety seats; locking clips (sold with child safety seats) not used or used incorrectly; and allowing kids out of seats before they are big enough to use a seat belt.

Proper use of child safety seats:

• READ THE INSTRUCTION MANUAL FOR BOTH THE SEAT AND YOUR VEHICLE BEFORE INSTALLATION.
• The safest place for any child under 13 is in the back seat. The best place for a car safety seat is the middle of the back seat. Safety seats do not always fit correctly because of seat contours and belt anchor positions. To be effective, the safety seat must fit correctly, even if that means moving it to one side of the back seat.
• Check the label on the seat to make sure it meets current federal safety standards.
• All seats should be strapped in tight enough so that they do not move more than 1 inch from side to side or front to back.
• The harness should be snug - only one finger should fit under the harness at the shoulder
• The harness retainer clip on your child's chest must be placed at armpit level.

No matter how busy or preoccupied you are, buckle-up your child, and yourself, every time you get into a motor vehicle even when you're just going around the corner. Most crashes happen within 25 miles of home, at less than 40 miles per hour. A 25 pound baby weighs 500 pounds in a 20 miles per hour crash. There is no way you can hold on to a child in a crash.

Choose the Best Seat For Your Child

The "best" seat for your infant or child is one that fits the child's size and weight. Infant seat/convertible should be used for babies from birth to 20 pounds and 1 year of age and under.

• NEVER place a rear-facing car safety seat in front of an air bag.
• Seat must face the rear of the vehicle.
• Harness straps should come through the slots in the back of the seat just below the level of your baby's shoulders.
• The seat should be reclined at a 45-degree angle. A rolled up towel may be used to help adjust the seat to the proper angle.
• If you are using a removable carrier/infant seat with a base, make sure the carrying handle is locked in the down position while in the car.
• If your child reaches 20 pounds before turning 1 year old, you must make sure you seat is rated up to 30-35 pounds when rear-facing.
• Do NOT place your child in a forward facing seat until 20 pounds and 1 year of age. A child younger than 1 does not have neck muscles strong enough to withstand a crash in a forward-facing seat.
• Convertible - These seats can be adjusted for use by infants or toddlers. See above for children under 1 year and 20 pounds.
• Use this seat forward facing and upright for toddlers over age 1 and from 20-40 pounds.
• Harness straps should come through the uppermost slots in the back of the seat.

Toddler Car Seat/Belt-Positioning Booster Seat

- These seats are forward-facing only and are for children over 1 year and 20 pounds. They can be used up to 80 pounds:

• Up to 40 pounds:
  o Use the harness until your child is 40 pounds.
  o Harness straps should come through the back of the seat above the shoulder
  o Booster seats with shields are never recommended for children under 40 pounds (see below).
• Over 40 pounds:
  One of the most common mistakes made is to place a child in a regular seat belt too early. Your child needs a booster seat if:
  o The shoulder belt crosses your child's face or neck
  o If the lap belt rides up on your child's stomach (this can cause serious stomach injuries in the event of a crash)
  o If your child's legs do not bed over the seat naturally at the knee (If your child's legs are not long enough for him or her to sit naturally, he or she may slouch down to be more comfortable. This can cause the lap belt to ride up on the stomach.) BOOSTER SEATS RAISE YOUR CHILD TO A SAFE LEVEL SO THAT THE LAP AND SHOULDER BELT FITS CORRECTLY.
• Using a booster seat:
  o Harness should be removed and the seat should be used as a belt-positioning booster with the lap/shoulder belt.
  o A booster seat with a shield may be used as a belt-positioning booster: remove the shield and follow the manufacturer's directions.
  o If your car only has a lap belt in the back seat, you will need a special harness (86 Y harness) available by calling Ridgeway Distributors, (502) 491-5052.
• Seat belt - For older children who are at least 4 feet, 6 inches tall and 80 pounds.
  o Lap portion of the belt must go over the thighs, never the stomach
  o Shoulder portion of the belt must go over the shoulder, never the face or neck
  o Shoulder and lap belt adjusters are never recommended

Buying A Used Seat

If you buy a used child safety seat, make sure the label is still on the seat, that is was made after January 1, 1981, and that the manufacturer's instructions are still with the seat so you can determine that all of the pieces are there and that they are in the correct place. Also be sure the seat was not involved in a crash and that it has not been recalled. The latest recall lists are available from the Auto Safety Hotline of the National Highway Traffic Safety Administration at 1-800-424-9393

In An Emergency

If you believe your child needs emergency care, contact your child's doctor. If you're unable to reach your physician or in the event of a serious emergency, bring your child straight to the emergency department at Kosair Children's Hospital, any hour of the day or night. Kosair Children's has the staff, the facilities, the equipment, and the technology to handle any pediatric emergency, from the smallest cut to the most serious injury.

Why Kosair Children's Hospital Cares

Kosair Children's Hospital is Kentucky's only freestanding, full-service hospital dedicated exclusively to caring for children, adolescents and young adults. We have a strong commitment to the health and safety of all children. For more information on vehicle passenger safety or to inquire about free fact sheets on a variety of health and safety subjects, call (502) 629-KIDS or 1-800-852-1770.