Friday, January 24, 2014

What I Want My Sisters to Know about Carseats

Long before a baby's arrival, new parents start thinking about safety- which is good and important.  Car seats are all about safety and they are important too-  but there are some myths and common misunderstandings about them that I would like to address.

Lets start with a crash course in car-seat basics. A car seat is a restraint that you purchase separate from your vehicle to keep your child safe while driving... sort of. Actually, to be honest, it doesn't keep your child safe while driving- it reduces the likelihood that your child will die or suffer permanent damage in the event of an accident. This is why members of certain generations like to joke that "it is a miracle that we survived- not only did we not have car seats, we didn't even have seat belts!" All said with a smirk and a smile that suggests that parents who value car-seats enough to make sure they use them properly (and most parents don't even install them correctly) are over-protective.  No. No it is not so surprising that you survived without a car-seat- obviously the majority of people did. It is only relevant or surprising if you were actually in an accident and survived (read #10 on this list). 

So, we have these devices that you hope you never need- but they are still important. How many will you need for your child?  Well, this chart suggests three, though you may need more- especially if you are ever in an accident. I would like to talk about these three different seats you may use.
  • Rear-facing: this will actually probably be two different seats (but don't worry- your total can still be 3), namely an infant seat (tailored to short and low-weight babies, often with good side support for little heads), and a convertible seat (the name comes from the ability to convert from rear to forward facing). The infant seats are the ones that have handles so that you don't have to take a baby out of the seat to take him/her with you if your baby fell asleep during the ride. They now also have bases that "permanently" stay in the car so that you don't have to re-install the seat every time you take it out which is AWESOME. 
Above is an example of an infant seat- it has a sun shade and a base that stays in the car

 This is an example of a convertible in rear-facing mode. There is no handle because the seat is not made to be taken out of the car without a complete re-installation
  • Forward-facing: this will also probably be two different seats. The convertible that you used rear-facing until the height/weight limit for rear-facing will have a different weight limit (usually) for forward-facing. For example, my Graco Size4Me 70 has a rear-facing weight limit of 40 pounds, but a forward-facing weight limit of 70 pounds. However, it is very common for children to outgrow their car-seats by height long before they outgrow them by weight, and height limits are not as well advertised as weight limits- so be sure to check. When your child outgrows the convertible forward facing they get moved into a combination seat (a combination of 5-point harness mode and belt-positioning booster mode) or a dedicated booster (which may be high-back or backless) depending on the child's size and maturity.
 This is an example of a convertible in forward-facing mode

 This is an example of a combination seat utilizing the 5-point harness
This is actually the same combination seat as the previous picture but in the belt-positioning booster mode (using the car's seat belt)

This is an example of a high-backed booster (notice there is no harness- you must use the car's seat belt)

This is an example of a backless booster

Because of this concern for safety that comes over parents in waves as a new baby's arrival approaches, they often search desperately for "the safest car seat out there."  Consider this likely scenario: Mommy & Daddy in anticipation of the arrival of the most precious bundle they have ever known, go out and spend hundreds of dollars on an infant seat made by the brand that is recommended to them as the"safest."  The baby is born and grows- quickly.  By 13 or 14 months (or even as early as 4 or 6 months) the baby has outgrown the seat and the parents are faced with spending a large amount of money again.  And their frustration with having just spent so much on a seat that they used so briefly is understandable.

So, let me talk about this.  First of all, despite what the ads for the seats will suggest, all of the infant seats meet the same crash test standards and we do NOT have access to the safety results. We get to know ONE thing: that they passed.  Different brands tout different bells and whistles that "exceed" safety standards- but we don't have access to any results that would prove those safety claims. PLEASE read this thread about the safety standards and lack of official ratings (and why the NHTSA and Consumer Reports ratings are both unhelpful and unreliable).

So if you ask a true expert they will tell you that the safest car seat for you will meet the following criteria: 
  • Properly fits in your vehicle (some smaller vehicles won't fit certain seats as well)
  • Properly fits your child (by weight and by height)
  • The one that you are willing and able to use (install, buckle child into, etc.) correctly every single time. This is where the bells and whistles can make a difference. Britax is often touted as the "safest" brand, which is legitimate only in so far as they tend to be among the easier car seats to use properly.  I REALLY liked this thread on talking about what you are paying for with the nicer seats.
This is true for all of the types, whether it be the infant, convertible, combination, or booster.

This means that you don't need to spend hundreds of dollars so that you put your baby in the "safest" seatAlso, the infant seat is the one that you will use for the shortest amount of time, so you may want to consider that when you decide how much to invest. The $52 infant seat at Walmart met the same safety standards as the $440 seat at Target (and yes that is the same thread as before- but in case you didn't click before here it is again).  Does that mean you should just go with the cheapest option? Not necessarily.  Find the one that works best for your child, car, and family in your budget.

This brings me to my big soap box spiel. Rear-facing to forward-facing: it is a big deal. And most people do it far too early. A few years ago the American Academy of Pediatrics updated their recommendation for when to turn your toddler forward-facing. The old recommendation was when the child was at least one year old and twenty pounds.  Parents, it seems, thought of this transition as a milestone for their child and were eager to make the change.  However, it is not a milestone- it is a safety downgrade.  The updated recommendations are that a child stay rear-facing to the limit of their convertible car seat because rear-facing is the safest way to travel in a car. Rear-facing makes a bigger difference in safety than the EPS foam or lock-offs or whatever other "safety" extras a car-seat boasts. 

There are some great articles out there on this- and some great car-seat resources on the internet (I will link to a bunch at the end). But for now let me share one piece of information that made a big impression on me.  There are a lot of places that will tell you that rear-facing is safer, but one of the biggest reasons for rear-facing toddlers doesn't seem to be as well known. I am taking the following quote from, but the emphasis is mine.
[...] In a one year-old each vertebra consists of three pieces of bone which are connected by cartilage. The vertebrae start to fuse together at the age of three, when the small bits at the bottom fuse together. It takes until they're six years old for the three pieces of bone to form a sold 'ring' around the spinal cord. [...]

The bones in the neck of a small child are not developed enough to protect the spinal cord. When they are involved in a car crash in a forward facing car seat, the weight of the head combined with the immature skeleton, can cause the spinal cord to stretch up to two inches. [But] [i]f it stretches just half an inch it will snap. This is known as internal decapitation and causes paralysis or death.
 Note that this has nothing to do with the child's weight or neck strength/head control. The vertebrae fusing is called ossification (this article is the most informative I have seen and also has some great pictures) and since it isn't complete until six years of age it seems to me that six should be the ideal for rear-facing (*wink wink*), though most children will not fit rear-facing in any convertible even close to that long (but if they do...).

I thought the following video did a pretty good job as well

Because this is such a big deal to me, one of the biggest factors I checked on when we started looking for for our convertible was the height (and to a lesser degree, the weight) limits for rear-facing on convertibles. Most convertibles go to at least 35 pounds now, many to 40 or 45 pounds (the highest I have heard of goes to 50 pounds) rear-facing, but many of them have a 40" height limit- which will be the way the child outgrows the seat rear-facing.  This spreadsheet was very helpful to me in my search (and these spreadsheets may help me in the future).

A few reference numbers:
  •  A quick search suggests that infant seats run somewhere around $55 to $400+ but some top recommendations from are about  $90$190, and $250.
  • Convertibles run around $40 to $500+ but the "favorites" are around $95, $180, $280, and $290
  • Combination Seats unfortunately can still be very expensive. The most affordable "recommended" models are about $75 and $105. The more expensive recommended models are close to $300.
  • Boosters can be very inexpensive- and some of the "best bets" are some of the most budget-friendly (like $13 friendly). I highly recommend the Insurance Institute for Highway Safety page of booster ratings.   
Here is a video explaining the IIHS booster ratings
So if you go with the cheapest recommended seats in each category, with no coupons or specials, you are looking at a grand total of about $275.  For example, my daughter may be able to stay in her convertible until she is ready for a booster.  If that works out, and with the great deal we were able to get on her seat, we may be able to keep her in the proper seats for closer to $200 through boostering.

Well, I guess that is enough info for one post. Here are the links I promised.

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