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Safety Tips 

• All children aged 12 years and younger should ride in the back seat for two important reasons. First, the back seat is generally the safest place in a vehicle during a crash. Second, children sitting in the front seat have been injured and killed by passenger air bags as they inflate in a crash. If your vehicle has a passenger air bag, children aged 12 years and younger should always ride in the back.

• Infants should ride in rear-facing child safety seats until they weigh 20 pounds and are one year old. Never place a rear-facing child safety seat in front of an air bag.

• Toddlers and preschoolers aged 1 to 4 years should ride in a forward-facing child safety seat until they weigh about 40 pounds (usually around age four), or until their ears reach the top of the back of the child safety seat, or their shoulders are above the top seat-strap slots.

• Children who have outgrown their child safety seats should ride in a booster seat that positions the shoulder belt across the chest and the lap belt low across the upper thighs. Children should use a booster seat until the lap and shoulder belts in the car fit properly, usually when they are at least 4 feet, 10 inches tall and weigh at least 80 pounds. To ride comfortably and safely, children must be able to bend their knees over the edge of the seat while sitting with their backs firmly against the seat back (without slouching). In most cases, this means that children 4 to 8 years old should ride in a booster seat.

• Children who have outgrown their booster seats should always use a safety belt. The child must be tall enough to sit without slouching, with knees bent at the edge of the seat, with feet on the floor. The lap belt must fit low and tight across the upper thighs. The shoulder belt should rest over the shoulder and across the chest. Never put the shoulder belt under the child's arm or behind the child's back.

• Teens and adults should never drink and drive. And they should always wear a safety belt.

Motor vehicle-related injuries are the leading cause of death among children at every age after the first birthday. In 1998, nearly 2,000 children younger than 16 years were killed and more than 300,000 were injured as passengers in motor vehicle crashes in the United States. One of the biggest reasons for the high number of injuries is that many children ride either incorrectly restrained or without any restraints at all. In 1998, nearly half of children younger than 5 years old who were killed in motor vehicle crashes were riding unrestrained. Using child safety seats reduces the risk of death by 71% for infants up to one year old and by 54% for toddlers aged 1 to 4 years. During 1975-1997, nearly 4,000 lives were saved by child restraints.

Drinking drivers also add to the death toll among child passengers. Roughly one-fourth of all child passenger deaths involve a drinking driver. Many people are surprised to learn that the majority of drinking driver-related child passenger deaths involve a child being driven by the drinking driver, rather than a drinking driver in another vehicle.

Safety Resources 

AAP has several publications on child passenger safety. These include "Selecting and Using the Most Appropriate Car Safety Seats for Growing Children: Guidelines for Counseling Parents" at www.aap.org/policy/01352.html and "The One-Minute Car Seat Safety Check-Up" at www.aap.org/family/carseat3.htm.

IIHS is a non-profit organization that works to reduce highway crash deaths, injuries, and property damage losses. Their publications can be accessed at www.iihs.org/pubs.htm.

CDC has additional information on child passenger safety at www.cdc.gov/ncipc/factsheets/childpas.htm.

NHTSA provides consumer materials on child passenger safety, including information on children and air bags. These materials include "A Parent's Guide to Booster Seats"; "Are YOU Using It Right?" (which describes correct installation of child car seats); and "Child Transportation Safety Tips (1-14)." These publications can be accessed at www.nhtsa.dot.gov/people/injury/childps/. NHTSA also operates the Auto Safety Hotline, 800-424-9393, which provides automobile safety recall information to consumers. Callers may report vehicle and child safety seat problems directly by calling the hotline.

SAFE KIDS has developed and implemented the SAFE KIDS BUCKLE UP program. This child passenger safety initiative provides hands-on instruction to parents and care givers through Car Seat Check Up events. Information about this program and other SAFE KIDS materials can be accessed at www.safekids.org.

SafetyBeltSafe U.S.A.

This national, non-profit organization promotes child passenger safety. Visit their web site, www.carseat.org, for answers to frequently asked questions about car seats.

References 

CDC. National child passenger safety week.  February 14-20, 1999. Morbidity and Mortality Weekly Report, 1999;48(4):83-84.

CDC. Ten leading causes of death, 1995. Atlanta: US Department of Health and Human Services, Public Health Service, CDC, 1997.

CDC. Alcohol-related traffic fatalities involving children.  United States, 1985-1996. Morbidity and Mortality Weekly Report, 1997;46(48):1130-1133.

U.S. Department of Transportation, National Highway Traffic Safety Administration. Traffic Safety Facts, 1998. Washington, DC: The Administration; 1999.

U.S. Department of Transportation, National Highway Traffic Safety Administration. Traffic Safety Facts, 1997CChildren. Washington, DC: The Administration; 1998.