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Road Trip

July 19, 2010

By Dr. Elizabeth Walenz with Methodist Physicians Clinic

It is summer; July is melting into August and baseball tournaments are coming to a close. Many may be considering a last minute road trip or vacation.  One thing to think about is car seats and making sure that everyone is properly restrained in your vehicle.  I have been having more and more conversations with my parents about the proper position for their 12 month old child who weighs 20 lbs.  The current law states if a child is 20 lbs and 12 months old, he may change from the backward-facing position to forward-facing position in the rear seat of the car.  However, recent studies by the AAP have suggested it is safer for children to face backwards until they are 2 years old.  The concern behind this proposal is that if children are in a forward facing car seat, and less than 2 years of age, they are not able to protect their spine and run the risk of a cervical spine injury if in a car accident.  A common concern parents will have is that the child is tall and hardly fits backward in the car seat.  The answer to that concern is that if a child were properly positioned backward-facing in the car and was in a car accident, she may suffer a broken femur.  A broken leg will heal.  Spinal cord injuries can be lifelong.

The safest place for an infant is in the middle of the rear car seat facing backward.  There are car safety seat inspection sites across Omaha where the car seat can be checked to make sure that it is secure.  The child should always be buckled in with the five seat harness. The harness should be snug, and a parent should be able to get two fingers in between the shoulders and the straps

After a child has outgrown the infant car seat, he will move to a convertible car seat.  Convertible car seats can face backward until 2 years of age, when it then becomes forward facing. Children should remain in a forward facing car seat with a five point harness buckle until they are close to 4 years of age.  They have outgrown the forward facing car seat once their ears are above the level of the car seat and their shoulders are above where the harness straps come out of the seat.

Children then advance to a booster seat with a seat belt.  The booster seat positions children so that the buckle lies across their hips and across their chest.  A child is in an improper position if the seat belt comes across the neck or stomach.  A child is ready to graduate from the booster seat once she reaches the height of 4’9” and can sit comfortably in the back seat of a car with the seatbelt in the proper position.  Children usually graduate from the booster seat when they are 8 to 12 years of age.  Once a child is 12 years old, he may sit in the front passenger seat of the car.

The AAP has some nice references in regards to car seats at

Locations for car safety seat inspections and proper positioning in the car can be found at

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