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Expert Q&A:
How can we help our 4-month-old, who cries whenever he's in his car seat?

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Suzanne Dixon
Answered by Suzanne Dixon M.D., M.P.H.
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"There is nothing so amazing as the development of a child," says Suzanne Dixon, M.D., a behavioral and developmental pediatrician who was one of the founding members of the Pampers Parenting Network. "Every day is a new adventure when you have a child around you. I never get tired of learning from the children who have been a part of my life, professionally and personally."Suzanne Dixon, M.D., M.P.H., was born and raised in Minnesota and graduated from the University of Minnesota, School of Medicine. She did her pediatric training at Massachusetts General Hospital in Boston and then completed a fellowship in Child Development at Boston's Children's Hospital. Dr. Dixon joined the faculty at the University of California, San Diego, and did patient care, teaching, and research for 20 years. She ran a large newborn service, performed research in early child development, and was involved in many community outreach activities in maternal child health. Throughout her entire professional life she has maintained an interest in cross-cultural activities, living and working in many parts of the world, including Mexico, India, Kenya, Indonesia, and several countries from the former U.S.S.R. Dr. Dixon is the author of numerous research articles, review articles, and textbook chapters in pediatrics, child and family development, and public health. Her textbook, written with Dr. Martin Stein, Encounters With Children: Pediatric Behavior and Development, has become a classic in child health education and is in its fourth edition. She is Editor in Chief of the Journal of Developmental and Behavioral Pediatrics, an international journal of high standing in the professional world. She also has served as an associate editor for Infant Mental Health and currently reviews for several major pediatric journals. Dr. Dixon is a fellow of the American Academy of Pediatrics and served in national positions in that organization. She is a member of the Society for Pediatric Research, the Society for Research in Child Development, the American Public Health Association, and the Executive Council of the Society for Developmental and Behavioral Pediatrics. She serves as consultant to several national and international organizations and has received an award from Healthy Mothers, Healthy Babies.Dr. Dixon continues to lecture and consult worldwide on aspects of maternal, child, and family health. She practices behavioral and developmental pediatrics in Montana and works with local advocacy groups on education and women''s health. Dr. Dixon has been married for over 30 years and has three sons. She and her husband travel frequently, are outdoor enthusiasts, and enjoy being amateur anthropologists.
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Question


Our 4-month-old cries every time he is in his car seat. We have tried toys, music, someone in the back seat with him—we even bought sunglasses in case the light hurts his eyes. We have also tried a different car seat. Nothing helps. Has he already learned that his crying will get attention? Could he be carsick? Both parents are prone to it.

Answer


Congratulations on your resolve to keep him safe in the car by putting him in his car seat. No trip should find him anywhere else, even if he makes a fuss.
That said, there are a few things you need to check out. Is the car seat positioned and adjusted correctly for his age and weight? He probably had a growth spurt last month and may need to have the seat and strap positions adjusted. His car seat should be placed in the middle of the car's back seat, out of direct sunlight. Is anything rubbing or cutting into him? Some infants are very sensitive to touch and may do better if they have some padding around them for a firmer, more swaddled feeling. Don't put anything between him and the straps, however. Is he lonely in the back seat? Be sure someone is around to be the social director for his trip. Motion sickness does run in families, and if he's linked feeling queasy with riding in the car, he may anticipate being sick. If he vomits during most rides, that may be a consideration. Overheating can be a big problem, so be sure he doesn't have a sweaty head, the first sign of overheating in an infant.
No, he's not reacting like this to just to get your attention and prompt your irritation. He's not that manipulative at this age. Some sensitive babies respond to every change and constraint with distress, and all infants at this age like social interaction. He's letting you know that something isn't right, and you'll need to discover which part of the car seat experience is most distressing and ease it if you can. In the meantime, buckle him up.
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