Friday, July 22, 2016

Car seat guide 2016


Car seats are an essential part of keeping your child safe.
I get  calls all the time from parents hoping for my blessing to give them the go ahead to finally turn their kids into a forward facing seat.
The thought is appealing and they are counting the days and keeping on eye on their babies size waiting and waiting. I need to inform you that you will need to be waiting a little longer. Repeat after me, " The bottom line is safety."
I completely get it that this is not what you think you want to hear, but according to manufacturer's recommendation, infants should be rear facing in the back seat until they are at least two years of age. If you haven't heard, Governor Jerry Brown recently signed a new law that will go into effect in 2017. This law requires children be rear facing to a minimum of 2 years old.  It is recommended that they remain rear facing until as close to age 4 as possible!  More and more studies are showing that rear facing is the safest place and position in the car. In fact, it is 5 times safer than forward facing.
In the case of an accident, a child's head and spine are better protected  if their car seat is rear facing. One study shows that children ages two and under are 75 percent less likely to die or be severely injured in a collision if they face the back. I know they might appear to be squished, but I wouldn’t recommend turning them unless they absolutely can’t fit. Children who are 40 pounds or 40 inches are exempt from the law and can face forward, but while they may be exempt from the law, they are not exempt from the laws of physics. Rear facing is safer. Please take a moment to click this link.

This video is a good illustration about why rear facing is so important

Kira Beer, Co-Founder of The Mama Coalition and a local car seat expert, shares the following

For taller kids (we see that the majority of toddlers hit the height limits before the weight limits), we recommend convertible seats that allow for up to 49" of standing height. Graco, Britax, among other seat manufacturers  are making some wonderful convertible seats that allow for up to 49" of standing height (Most Graco Convertibles have high height limits, as do the Britax Boulevard and Advocate seats).  In terms of squished legs-- we're finding this is more of a perception issue for parents than children. Safety wise, we've not yet seen any leg injuries from a rear facing child, whereas we've seen leg injuries in forward facing children.  We also find that children are quite comfortable sitting criss-cross, or with their legs up the seat. The children in the studies have preferred their legs propped up, rather than dangling down forward. It's counter-intuitive to adults, but children are very flexible little beings and are very rarely uncomfortable sitting rear facing.  For those parents/caregivers who are concerned about leg room, Graco has released the Extend2Fit, a new seat which allows for Extended Rear facing, and includes a foot that when extended, provides children an extra 5" of legroom.
Check out her coalition’s website

Toddlers who have outgrown the rear facing weight or height limit for their car seat should use a forward facing car seat with a harness for as long as possible, up to the highest weight or height allowed by the car seat manufacturer.
The current California Law also requires a car seat or booster seat until your child is 8 years or 4 ft 9 inches. Previously the requirement was  6 years or 60 pounds. Height parameters make more sense than the previous weight ones. For a child to safely transition into a booster,  we look beyond the child's age/height/weight. There's another set of criteria to help determine if your child is ready to transition to a booster.
There is a '4 Step Test', in which all criteria should be met, and to be completely honest, Step 4 is the single most important part of the list, and the one most often disregarded by parents -- with dire results. Developmentally, most children don't meet all of these steps until somewhere between 5-7 years old, and generally closer to 6 or 7 than 5. A lot of this has to do not only with physical maturity, but emotional maturity.
The criteria is as follows:

1. Child is an absolute minimum of 40 lbs
2. Minimum of 4 yrs old
3. There is a lap & shoulder belt in child's seating position
4. The Child can be trusted to sit properly for the entire trip, every trip - even while asleep. This means no slouching (back straight up against seat), no leaning to either side, no playing with the belt, etc... Even unsupervised.

We like to tell parents that this is one of those times in your parenting life where your child NOT graduating is actually a good thing. The longer your child is harnessed, the safer and more protected they'll be.You child needs to be tall enough so that the seat belt goes across the chest, not across the neck.  The purpose of a booster is to properly position a child in the adult-intended seat belt. What you’re looking for is proper belt fit across the lap and shoulders - the belt should be low and tight on the hip bones (not on the belly), and should be hitting the shoulder bone, not the child’s neck.

When children are old enough and large enough to use the vehicle seat belt alone, they should always use Lap and Shoulder Seat Belts for optimal protection. To determine if your child is ready to sit unassisted, they must pass the 5-Step test:

The 5-Step Test.
1. Does the child sit all the way back against the auto seat?
2. Do the child's knees bend comfortably at the edge of the auto seat?
3. Does the belt cross the shoulder between the neck and arm?
4. Is the lap belt as low as possible, touching the thighs?
5. Can the child stay seated like this for the whole trip?

*If you’ve answered NO to any of the above, your child should remain safely boostered.

If your children complain about this rule, show them photos of race car drivers all bucked up in their restraint system. Be matter of fact about it and explain that there is no compromise for safety (there is also a mighty large fine if you are caught breaking this law.)

All children younger than 13 years should be restrained in the rear seats of vehicles for optimal protection. Airbags can actually be quite dangerous to a child so it is worth making sure that this isn't an issue with your car and the placement of your child's safety seat.

Most accidents happen within a few miles of your house. Even a short trip down the block requires the full "buckle up". Hey parents, model good behavior and always make sure you fasten your own seat-belt!

Did you know that car seats expire? Most of them have a 6-9 year life span. This date can usually be found underneath or behind the seat. I questioned this when I first found out about it. The explanations made sense to me. First of all buckles and straps can wear out. Prolonged exposure to sunshine can weaken the plastic. Also, the technology is always changing and this ensures that nothing gets too out of date. Save the instructions/registration in a safe place. Make sure you register your car seat. If there is ever a recall this will ensure that you are notified.

*If you have an old car seat that you want to get rid of, Alioto's Garage has been offering  a Recycled Car Seat Program. Anyone, not just regular customers, can drop a car seat off at any  Alioto's location during regular business hours. They will recycle the usable parts and keep it out of our landfill

The AAA states that 75% of car seats are installed or used improperly. As your child grows, there are services offered here in the San Francisco Bay Area that will check out your car seat or booster seat and make sure it properly installed. Have the infant car seat checked before the baby is born and then again with each transition to a larger seat. 
Below are some local resources for making sure that not only is your car seat properly installed but that it is the right fit for your child's size and age. They can make sure that all the straps are where they need to be and that you pass the "pinch test", making sure that the seat's harness is tight enough

To be super safe, consider having the car seat fit and installation checked every 6 months.
Fortunately there are lots of places to help.

553-7208          2300 16th St suite 280
The contact person is Ingrid. Appointments need to be made ahead of time. You do not need to be a AAA member to take advantage of this free service.
If you want to take the trek up to Mill Valley. The AAA office there is at 750 Redwood highway.The technicians there are Wayne 415-380-6031 and Travis 415) 488-2905.They do the inspections on Wednesdays and Fridays, but they also say you will do best to plan in advance. You can probably get it taken care of within the month.

CHP (California Highway Patrol)                  415-557-1094
This is very popular and is by appointment only. Please make an appointment as far in advance as possible. The woman on the phone there said that her preference is for people to call as soon as that pregnancy test comes back positive! ( I assume she was partially joking, but you get the gist.) When I called this week to make sure all my info is up to date, the woman on the phone told me that the current wait time is almost 2 months.

SFPD                415-575-6363
They try to have an officer at all of the local police stations who is trained to do the car seat safety inspections. Call the number above for more info.
The Colma police department will do a car seat inspection for free (650-997-8321)
By appointment only. Same day appointments are sometimes available.

Baby World
has a technician at both of their existing locations
4400 Telegraph Ave, Oakland,510-547-7040  Mon-Sat(10-5:30) Sun(12-5)
556 San Mateo Ave, San Bruno, 650-588-7644
Appointments are needed but reasonable. You may be able to get same day service mid week. Weekends are trickier.  Inspection and installation are free if you purchased the seat through them. If you got a seat from somewhere else, they will still do a free inspection, but any adjustment or installation will be $40.00.

The Mama Coalition - Kira Beer, CPST
Serving Marin County
Free of Charge, Appointments required

If you are not inclined to schlep, Bryan will  come to you. It is not free, but the convenience is worth a lot to some families.

 This info is current for July 2016


-NHTSA website has a place to click to find updated local car seat inspection stations for those of you who are not in the Bay Area.
(national highway traffic safety association)
They also have a page where you can plug in your child's age and size and they will tell you what type of seat they should be in. - Car Seats for the Littles gives lots of great info about the specific brands of car seats on the market (Keyword :car seat ) has a very comprehensive guide to safe installation as well as a list of current care seats on the market for 2016

Car safety doesn't end with being safely buckled. I know it is hard to avoid distraction with a baby fussing in the back seat. Consider getting one of the specially made mirrors so that you can keep on eye on your rear facing baby. Make certain that they can't reach anything that is a choking hazard. Don't let them hold the keys; they can lock you out!! This happened to one of our little patients in the Noe Valley Pediatrics parking lot a couple of years ago. Mommy parked and handed the fussing 15 month old the keys in order to distract her. Mom exited the car and as she walked around to open the back door, her child clicked the lock button on the key. Mom was locked out. Luckily it was a cool San Francisco day. Dad had an extra key, but of course he worked on the peninsula. He was on his way to the rescue when the little girl clicked the "unlock" and we were able to get into the car. Of course if it was an emergency we would have called the police
or AAA to break in right away. In this case, our little patient had been as happy as can be, hitting lock over and over again and grinning at us through the window.  

If your child is asleep in the car seat and you have arrived at your destination, leaving them snooze for a few minutes is fine, but keep them tightly buckled. Having a baby in a car seat without being tightly strapped in not safe. The loose straps can be a safety hazard.

Never leave your child unattended in a vehicle. Children can die from prolonged exposure to excessive temperatures in a hot car.
Thanks to one of my patients who read the post last year and then shared this link

Special thanks to Kira Beer for her assistance with this post!

One of the wise Mamas out there shared additional tips. (Thanks Jackie!!!)
Your toddlers weight is an important factor when making the switch from the latch system to the car belt.

Also, although the middle of the back might be the safest place in the car. Some cars don't have adequate space

So much to keep track of!!


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  3. I think one should also be familiar with the laws as well. Before they came out with the new guidelines, having your child ride rear-facing until two, I was under the misguided understanding that when your child reached 20 pounds you could turn them around to face forward. I thought my daughter would like this better, I honestly wasn’t thinking that it would be any less safe. This was two years ago, I’m much more knowledgeable now. But, my point is, the rules back then were 20 pounds and 1 year old, not 20 pounds or 1 year old. If I would’ve gotten pulled over, I would’ve been in deep trouble. Luckily a friend informed me that I was doing it wrong, and I was able to correct it before anything bad happened.