By Elizabeth Evans
Special to the Reporter
I remember the anxiety of buying and fitting an infant car seat for my first child. Often the process involves a detailed web search for the “best” car seat, a few shopping trips, and a visit to the police or fire station to confirm a proper fit. Parents can sometimes overlook recommendations about child restraints as our children get older. The laws change state to state and the recommendations can be confusing. Car crashes are a leading cause of death in children in the U.S., so we must remain vigilant in the use of proper restraint systems.
The American Academy of Pediatrics recently updated its recommendations in August 2018. Infants and toddlers should remain rear-facing as long as possible within the weight/height recommendations of the car seat. There is no longer the recommendation to change to forward facing at two years old. Most convertible seats have weight/height limits that can fit children well past the age of 2. When children are rear-facing, their heads, necks and spines are supported by the hard casing of the car seat thus protecting them from crash forces. When forward-facing, the trunk is only supported by the harness straps which can lead to more neck and spinal injuries as the head moves forward. Keep your child rear-facing as long as possible and then move them forward facing until the weight/height limits are exceeded. Many children can remain in a five-point harness car seat until they are in their early elementary years.
After they have outgrown the car seat, the preferred next restraint system is the belt-positioning booster seat. This is where Washington State Laws are some of the strongest in the U.S. The Anton Skeen Law states that children who are less than 4 feet, 9 inches or are younger than eight years old must remain in a child restraint system. After they reach one of these requirements, then they can use the car’s lap and shoulder belt as long as it fits properly. However, most children will need to be in a booster seat until they are 10-12 years old as the car’s seat belt will not fit them properly. Practically speaking, this means that most children will need to be in a booster seat through elementary school.
How do you know if your child is properly restrained in the car’s seat belt? A child can use the seat belt in the car as long as the following occur: The shoulder belt lies across the middle of the shoulder and chest and does not touch the neck or throat; the lap belt is low and snug across the upper thighs and not the middle of the belly; the child’s knees are bent over the edge of the seat when sitting against the back seat.
Another significant part of the Washington Anton Skeen Law is that children under the age of 13 cannot sit in the front seat of the car unless it is impractical to do so. As our children reach the teenage years, they often request to sit in the front seat of the car. It is easy to remind them that it is state law to remain in the back seat of the car until they are 13 years old as it is the safest position for them.
It’s not just parents who need to know and understand these recommendations. Family and friends who transport our children need to follow these guidelines to keep our children safe. For more information you can visit www.healthychildren.org and look under the safety-prevention tab or visit the website of the Washington State Booster Seat Coalition.
Dr. Elizabeth Evans has been practicing pediatrics for more than 15 years. She lives on Mercer Island with her husband and three daughters. She is actively involved in the community with Girl Scouts and the Lakeridge Elementary PTA. Dr. Kara McCulloch has been practicing orthodontics for 20 years. She is the mother of three kids and is an active supporter of the Mercer Island community.