The most important purchase you'll make before having your baby is a car safety seat. You will need one to bring your baby home from the hospital and for every car trip thereafter. More children are killed or injured in car crashes than in any other type of accident, so it pays to buckle them up in a car seat. Every state has a law requiring babies and children to ride buckled up.
The following sections will give you information on choosing, installing, and using a car seat.
 Car Seat Basics
 Infant-only Car Seats
 Convertible Seats
 Forward-Facing Seats
 Car Seats on Airplanes
 Guidelines for Very Small Passengers
 AAP Car Seat Guide
Car Seat Basics
There is no one "best" car seat. However, any seat you consider should meet federal guidelines and should be installed according to the manufacturer's instructions. You might wish to try out the car seat in your car before purchasing it. Many stores provide a doll to use to figure out what it will be like to put your child into the car seat.
If you want to use a used car seat, keep the following points in mind. Never use a car seat that:
- Has any cracks in the shell
- Is too old. Check the label to see when the seat was made. Check with the manufacturer to find out how long it recommends using the seat.
- Has no manufacturer's instructions for installation and use
- Is missing the model number (needed to check for recalls and upgrades)
Rules of the Road
- Always use a car seat, starting with your baby's first ride home from the hospital. Always use a seat belt yourself, as this keeps you safe, prevents you from injuring a child in the course of a crash, and sets a pattern for your child to follow.
- Read and carefully follow the car seat manufacturer's instructions on installation and keep them for future reference.
- Read your vehicle owner's manual for more information on how to install a car seat.
- If you don't know how to install the car seat and can't figure it out, use this Web site to locate a Child Passenger Safety (CPS) technician or site to help you.
- Put your child's car seat in the backseat. In fact, place all children younger than 13 in the backseat. It's the safest place in the car in the event of a head-on crash (the most common kind of crash).
- Use the harness system to hold your child in the car seat. Use a seat belt or LATCH (Lower Anchors and Tethers for Children) system to hold the car seat in the car. LATCH is mandated for all cars and car seats manufactured after September 2002, and it allows for better head protection as well as easier installation. LATCH systems can be retro fitted into older cars at a car dealership, for a small fee.
- Before each trip, check to make sure the car seat is installed tightly enough. It should not easily roll from side to side or away from the seat.
- Dress your baby so that the strap can go between his legs. In cold weather, put blankets around the child after the straps are secured.
- Check for worn straps and padding. Check to be sure that the specific car seat has not been recalled by contacting the manufacturer or the U.S. Consumer Product Safety Commission.
- If your child will regularly ride in two or more different cars, it may be easier and safer to purchase and install a seat for each vehicle, and keep them installed correctly.
- All belts should fit kids snugly, but not chafe. Regularly check and adjust your child's car seat straps as he grows.
- Place the plastic harness strap clip at armpit level, keeping the straps flat. Make sure the straps are not frayed.
- Make sure that metal components of the seat are never in direct contact with your child's skin. They can get very hot and burn your child.
Infant-Only Car Seats
- Are used for young babies up to 22 to 35 pounds, depending on the model
- Are small and portable and fit newborns best
- Are rear-facing only (baby faces the back seat, not the front of the car)
- Come with a three-point harness or a five-point harness
Infant Seat Features
- Detachable base. Several infant seat models come with detachable bases. This type of base also allows for adjustment in the reclining angle, with small infants needing to be more reclined than older infants. After buckling your baby into the seat, you simply lock the seat into the base. The base must be installed tightly and the seat snugly locked in every time.
- Harness slots. Infant seats that come with more than one harness slot provide more room for growing babies. On rear-facing seats, the harness slots should always be at or below your baby's shoulders.
- Handles. Carrying handles vary hugely in style and ease of use. Check the instructions for how to secure the handle during travel.
- Pads and padding. Infant car seats will get dirty, so pick one that you can easily clean. Head supports are very helpful for most newborns and all preemies. If the seat doesn't have separate head supports, purchase such padding before you go to the hospital to give birth. Never put padding between the baby and the harness.
Convertible Seats
- Can be used rear-facing for infants and toddlers, and forward-facing for older children
- Do not fit newborns as well as infant seats (note: If you'll be using a convertible car seat for a small infant, the best harness choice is the five-point harness)
- Are bulkier and may be heavier than infant seats but can be used longer. Place your convertible seat in the rear-facing position until your child is 2 or until your child reaches the highest weight or height recommended by the manufacturer.
- Convertible seats have four types of harnesses:
- Five-point harness. It has five straps: two at the shoulder, two at the hips, and one at the crotch.
- Six-point harness. There are two straps each at the shoulders, hips, and crotch.
- T-shield. This is a padded T-shaped or triangular shield, attached to shoulder straps, that goes across the child's chest.
- Overhead shield. This padded, traylike shield swings down around the child.
Convertible seat features
- Adjustable buckles and shields. Many convertible seats give you two or more buckle positions so you can adjust the straps for a growing child. Many overhead shields can be adjusted as well.
- Higher weight limits. Several convertible seats now come with higher weight limits for bigger children.
Forward-facing Seats
These are for older and bigger children beyond infancy. They
- cannot be used rear-facing
- are only for children 2 years of age and older
- may convert to belt-positioning boosters for children over 40 pounds, allowing you to use this seat longer
- can be used with a lap belt only or a lap/shoulder belt
- Forward-facing seats include:
- Built-in seats. Some new cars and vans come with pre-installed car seats. This eliminates installation hassles for you, but weight and height limits vary widely. Check these limits and stay within them.
- Travel vests. These may be an option if your car has only lap belts.
Booster Seats
When your child has outgrown the forward-facing car seat, it's time for a belt-positioning booster seat. These seats raise the child up and help protect the neck and head. All children whose weight and height exceed the forward-facing seat's limits should use a booster seat until the vehicle seat belt fits properly.
Check for Recalls
Has your baby's car seat been recalled? To find out, telephone the manufacturer or the Vehicle Safety hotline at (888) 327-4236.
Car Seats on Airplanes
For information about using your car seat on an airplane, visit the FAA (Federal Aviation Administration) Web site.
Guidelines for Very Small Passengers
Infants born earlier than 37 weeks and those who weigh less than 5 1/2 pounds (2,500 grams) may require special treatment to travel safely in a car, as they can have difficulty breathing in a standard car seat.
Safety begins before hospital discharge: While still in the NICU (Neonatal Intensive Care Unit), the infant needs to be placed in the proposed car seat with the trained nursing staff monitoring heart rate, respirations, and blood oxygen levels. If these measurements are adversely affected by sitting in the car seat, the infant needs to be placed in a greater reclining position or in a car bed or other device that allows safe transport in a more horizontal position. (In addition, babies who have trouble breathing in regular car seats should avoid infant swings, carriers, and seats, as these cause the same kinds of problems as a car seat.)
Position Points
Once the best car seat or car bed has been determined, it should be placed in the backseat, facing the rear of the car. An adult should sit next to the infant at all times, ready to respond to any difficulty. If home monitoring equipment is needed by an individual infant, it should be used while in the car with the devices firmly wedged on the floor or under the seat and kept there throughout the trip. These devices can become projectiles in a crash or a sudden stop if they're not secured properly.
No infant should ever be left alone in a car, even for a minute.
Hardware Help
Once it's been shown that a baby can be safely transported safety in an upright or semi-upright position, check to make sure the car seat fits its small passenger:
- Infant-only, three-point harness seats or convertible five-point harness seats are the best for the small infant.
- No seats with shields, tummy pads, or arm rests should be used.
- The crotch strap should be less than 5 1/2 inches from the back of the seat.
- The shoulder harness insertion/attachment should be less than 10 inches above the seat base.
- The shoulder strap slots should be above the infant's shoulders but not so high as to cut into the neck.
- The strap clip should be at the infant's mid-chest, not over the abdomen or at the neck.
- A rolled-up receiving blanket, towel, or cloth diaper should be placed on both sides of the infant to reduce slumping. No padding should be under or behind the infant, as the child should be firmly secured against the bottom and back of the seat.
Resources
For more information, see the American Academy of Pediatrics (AAP) policy statement on the transportation of small infants. An AAP-approved video, Special Delivery: Safe Transportation of Premature and Small Infants, is available for viewing at many hospitals.
AAP Car Seat Guide
Click here for more information from the American Academy of Pediatrics.
