Definition Seatbelts and other forms of restraint for children in motor vehicles are important safety measures designed to reduce the chance of injury and death.
What is the information for this topic? In Australia between 1956 and 1983 the proportion of passengers aged 0-17 years, killed in motor vehicle accidents increased from 37% to 50%. By 1982 all Australian states and territories had passed legislation specific to the restraint of child passengers. Infant deaths decreased from 1984 in NSW when infant restraints became more stringent in design and safety. It had been estimated that the risk of fatality decreased by 71% as a result of the correct use of a child safety seat in a motor vehicle.
The safest place in a car for children under 13 years of age is in the back seat. The middle of the rear seat is the best place for infants and younger children in safety seats. If a child must ride in the front seat, the seat should be moved as far back as possible.
The type of car safety seat used depends on the age and weight of the child.
Infants should be placed in rear-facing infant seats that have built- in restraining belts. The infant seat should be fastened into the car with the car's seatbelt. Infants should use this type of safety seat until they reach 9kg. Or, it should be used until they are at least one year old and are able to sit alone without support. Infants should never be held in the lap or arms of an adult passenger. In a crash at as little as 50 kph, the forces are great enough to severely harm the child. The infant could be thrown through the windshield or crushed between the adult and the dashboard or the adult and the backseat.
Children between 9kg and 18kg should sit upright in a forward-facing safety seat.
Children over 18kg and 1 metre tall should ride in a booster safety seat. This device should be used unless the child is large enough so that the standard car lap and shoulder belts fit properly. If the shoulder strap runs across the child's neck rather than the shoulder, the child still needs to use a booster seat. Children should not be allowed to place the shoulder strap behind their back or under their arms.
It is important to follow the manufacturer's installation instructions for all types of car safety seats. Some car models have only lap/shoulder belts in some of the seating positions. In these models, only older children should use the lap/shoulder belts. Younger children should sit in places where there are lap-only belts
A child should not ride in the front seat of a car that has front airbags on the passenger side. This is true whether the airbag is on the dashboard or the door. A child should be permitted to ride in the front seat only if the passenger-side air bag has been disengaged. This is because airbags deploy with so much force that they can kill or seriously injure a child.
If the vehicle has no rear seat and there is no other means of transportation for a child, then a child should be positioned as far back from the air bag as possible. Air bags are very hazardous to infants in rear-facing safety seats. They should never ride in a front seat with an air bag. They must be in the rear seat or not ride in that vehicle.
It is important that children learn early that they should not ride in a car without wearing a seatbelt. Most hospitals insist that parents of newborn infants get an infant safety seat. Parents must bring the seat to the hospital before they are allowed to take the baby home. As infants grow into toddlers, they become more active. They may be less patient with being restrained. If being buckled up in the car becomes routine, it will be easier for the toddler to accept it.
Keeping trips short and taking frequent stretching breaks will make longer trips more tolerable trips for young children. Children should be praised for good behaviour in the car. This helps reinforce that behaviour. Parents should also wear their own seatbelts. This provides a powerful role model. Everyone in the car should always be buckled-in before the trip starts.
If a young child becomes fussy while driving, the driver should stop the car rather than letting the child out of the seat belt or safety seat while the car is moving. Allowing the child out of the safety seat only sets a bad precedent. Also, dealing with a fussy child is a dangerous distraction for the driver. It could lead to an accident.
When children ride with people other than their parents, such as grandparents or babysitter, they should bring their safety seats along. The driver should know how to properly install the seat in his or her own car.
As with many other things in life, a little prevention goes a long way. The use of seat belts in cars over the last several decades has saved lives and prevented countless serious injuries. Establishing a routine of seatbelt use is an important contribution parents can make to their children's safety.
Author: John Wegmann, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 17/10/2004 Contributors Potential conflict of interest information for reviewers available on request
