Friday, December 27, 2019

The world can use a little bit more Mr Rogers

I met my husband Sandy in 1976; I was 17. Believe it or not, we were at Kennedy airport flying out on the same flight. Sandy was ahead of me in line and tells that he asked the agent to seat me next to him. In the 43 years that we have been together, we have missed a few birthdays and general holidays but we have NEVER been apart on New Years eve. Some years have been wild and crazy. Other years have been low key and we have looked at each other long before midnight and said…”somewhere it is already midnight, we don’t need to stay up”, but we have always been together. In those 43 years we have done many things, including raising two wonderful daughters and some epic travel adventures, but we have only been to a movie in the theater just about 43 times.

Sandy generally hates going to movies and agrees to go to one movie a year. If it was important to me, he would go more often. One of the reasons that we work so well together is that I simply go see movies without him. This year, to my surprise he opted to come with me to see the new Mr. Rogers movie with Tom Hanks. Sandy knew that I wanted to see it. I grew up in the real Mister Rogers Neighborhood of Squirrel Hill, in Pittsburgh Pennsylvania. I ran into Mister Rogers many times at Children’s Hospital of Pittsburgh where I worked my first job as a nurse. He was as genuine, kind and quirky in real life as he was on TV.  Spoiler alert, Sandy did not like the movie all that much (although he loves Mr. Rogers.) I loved it. No surprises there. It is not really directed at young kids, but I thought it told a lovely story about forgiveness, based on a true relationship that Mr. Rogers developed with a somewhat angry reporter many years ago. Tom Hanks was superb, and the Mister Roger’s message shined through.

Here is the post for several years ago. I added a few more worthy quotes.


I first ran this post several years ago when we had a week full of horrible headlines. Unfortunately we are so used to things like mass shootings that we are no longer shocked when awful things happen. 

In a previous post about talking to our children about scary situations, I actually quote Mr. Rogers. He shared a lesson that he learned from his own mother: “look for the helpers”. Those might be a person in uniform, or another parent with children. That remains great advice and is one of his more well known pearls of wisdom.
 A generation of children grew up better people because of the lessons he taught. Here are some of my favorite pieces of Mr Roger's wisdom:
"There are three ways to ultimate success: The first way is to be kind. The second way is to be kind. The third way is to be kind."
“There is only one thing evil cannot stand, and that is forgiveness.'"
"There's a part of all of us that longs to know that even what's weakest about us can ultimately count for something good." It is okay not to be perfect!
“Solitude is different from loneliness, and it doesn't have to be a lonely kind of thing.”
Accept people as they are.
Look and listen carefully.
We all have feelings.” Talking and acknowledging them is the first step towards finding ways to deal with them that don’t hurt anyone.
Anything that's human is mention-able, and anything that's mention-able can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we're not alone.
Wonder about things
“You can’t go down the drain in the bathtub.” Don’t be shy about sharing things that might be scary
“Be yourself.” It is not how you look, what you wear or what toys you have that make you special
What can you grow in the garden of your mind? Use your imagination.
You rarely have time for everything you want in this life, so you need to make choices. And hopefully your choices can come from a deep sense of who you are.
One of the most important things a person can learn to do is to make something out of whatever he or she happens to have at the moment.

"Often out of periods of losing come the greatest strivings toward a new winning streak."

"Often when you think you're at the end of something, you're at the beginning of something else."

"There are times when explanations, no matter how reasonable, just don't seem to help."

"Love isn't a state of perfect caring. It is an active noun like struggle. To love someone is to strive to accept that person exactly the way he or she is, right here and now."

Mr. Rogers was a gift to generations of kids but I wonder if any of my patients know who he is? I believe that Daniel Tiger is making sure that the whisper of his gentle message lives on!

Friday, December 20, 2019

Holiday Safety checklist 2019

This week's topic
Holiday safety list 2019

Have you thought of everything?

The lights are twinkling and the radios are playing the holiday tunes. People are putting up the holiday decorations. It is time for the holiday safety post.Take a moment to give this a careful read. There may be some things that hadn't occurred to you.

For most people, the holidays are a time for celebration. That means more cooking, home decorating, entertaining, and an increased risk of fire and accidents.

For every aspect of holiday celebrations, I can tell you the story of a patient who called with a related accident. It is not my intent to scare folks with my tales. As I tell parents who attend my safety class, if you know ahead of time what accidents can happen, you have a way better chance of avoiding them. I have seen some wild and improbable things over the years.

Baking cookies is just one example. A patient's mom called to tell me that her 10 month old had sustained a burn on his hand. She was holding him in the crook of one arm as she removed the cookie sheets from the oven. As she recounted, he turned into a cartoon character with a telescoping reach and he was able to stretch across her body and grab a hold of the piping hot tray. Simple solution: don't hold your child when you are working with hot stuff in the kitchen. Their arms are longer than you think. If even one accident has been prevented, this post was worth it.

Candles are another hazard. It was a winter evening many years ago in a cabin at Lake Tahoe. Dr. Jessica and family lit some holiday candles and went to sleep. Somehow one of the candles ended up burning a hole through a plastic mat that was on the table. Luckily the smell of burning plastic woke them up before any real damage was done, but it was a frightening lesson. This was a vacation rental. In this instance, there seemed to be no working smoke detector. She had no idea if and where there was a fire extinguisher. There are several obvious lessons here. Never go to sleep with candles or a fireplace still burning. Get acquainted with the safety features of any place your family is staying.  
Below are some safety considerations for dealing with the holiday season ahead. Some of these may seem like common sense but there might be a few tidbits in here that I am betting you haven't thought about.

Beware of button batteries. They are everywhere nowadays in all sorts of small electronics (and musical cards) and can be quite hazardous if swallowed. Take time in advance to do a mental inventory of items that you have around that may be powered by these. Put a piece of duct tape over the battery compartments to make sure they can't fall out.

Certain holiday plants like poinsettias can be mildly toxic (especially to someone with a latex allergy). You may not have them in your own house, but if you are visiting a friend or even a supermarket make sure little hands don't grab the pretty red leaves and put them in their mouths.

Be very careful transporting hot food to a holiday potluck. I have patients who have been burned from hot food spilling on them in a car.


One of my patients had a tragedy several years. An eight year old healthy dog got into a wrapped package that was filled with chocolate. The amount ingested proved to be too toxic for this little dog to handle and they didn't make it. Please don't let this happen to you. Make sure that any mystery packages are nowhere near where a pet can get to them.

Christmas tree checklist:

  • When purchasing a live tree, check for freshness. A fresh tree is less of a fire hazard

  • Cut 1-2 inches from the base of the trunk immediately before placing the tree in the stand and filling with water to ensure absorption. Don’t add chemicals that might be toxic to kids or pets. A dash of plain 7 up can help keep the tree healthy.

  • check the water level daily to avoid the tree drying out

  • When purchasing an artificial tree, look for the label "Fire Resistant"

  • Never use electric lights on a metallic tree. The tree can become charged with electricity from faulty lights and a person touching a branch could be electrocuted.

  • Place your tree at least 3 feet away from all heat sources, including fireplaces, radiators and space heaters

  • Make sure the tree is steady enough that it can't be pulled over by a toddler. You may need to attach it to something solid. Trust me, trees get knocked or pulled over. Older kids running around can cause this issue, it isn’t just toddlers.

  • Trim your tree with non-combustible or flame resistant materials.

  • Before using lights outdoors, check labels to make sure they have been certified for outdoor use.

  • Make sure all the bulbs work and that there are no frayed wires, broken sockets or loose connections.

  • Plug all outdoor electric decorations into circuits with ground-fault circuit interrupters to avoid potential shocks.

  • Strings of lights and garlands are a staple of holiday decorating, but they can also pose a strangulation hazard.

  • Avoid trimming the tree with things that look like candy which may pose a temptation to the kids.

  • Keep sharp, glass or breakable ornaments out of reach of small children.

  • Holly berries and other small decorations can be choking hazards.

  • Don't overload extension cords; make sure that your extension cords are high quality.

This is not a safety issue, but it is worth mentioning. Is your child exhibiting any new allergy symptoms? Take a minute to consider whether or not they started during the holiday season. Trees, scented candles and other seasonal extras can trigger some allergies.

Hanukkah doesn’t fall on the same date every year since it is based on a lunar calendar. Many folks laughingly refer to it as coming either “early or late”. It also has more spelling variations than any other holiday. This season the first candle will be lit on the evening of December 22nd.

  • Make sure that all candles are safely out of harm's way.

  • The menorah should be on a glass tray or aluminum foil.

  • Make sure candles are not close to wrapping paper.

  • Don't go to sleep with candles still burning.

  • Don't leave the matches or lighters hanging around.

If you are frying latkes (fried potato pancakes that are a holiday tradition, yum) make sure that no one gets splattered by oil
Never leave the hot oil unattended

Remember that adding water to a grease fire will make it worse! Baking soda is okay, but a fire extinguisher is best. Make sure you know where it is and how to use it.

Kwanzaa may be the safest of the holidays, (no hot oil or stressing the electrical outlets) but there are still candles involved, so make sure they are placed in a safe place and toddlers don't have access.

If I missed any holidays, let me know! I will add them to this post in the future.

This is also a great time to test your smoke alarms and carbon monoxide detectors!!!

Stay safe and have a wonderful holiday season.

Friday, December 13, 2019

The Best Present is your Presence 2019

The best present is your presence

I saw a bumper sticker some years ago that said:

Good parenting requires twice as much time and half as much money.

So true!

This is the season for gift giving, but we all actually could do with a lot less stuff!! The best present I think that families can give to each other is the gift of self (otherwise known as time and attention.)

For kids who are old enough to understand, give a certificate that promises a special activity that you might do some time in the future. For older kids, escape rooms are a ton of fun. A membership to one of the local museums or the Exploratorium is another good gift to give to the family.

It is great for families to do outings altogether, but one-on-one time is so important if you can manage it. Mix and match so that you make sure that everyone gets special time with one other family member. This includes one on one time for you parents as well.

The list of Nurse Judy's inexpensive and creative activities has some old and new ideas.

  • Collect and decorate rocks with colorful paints and glitter for a rock garden.

  • This is a great one to use as a reward for good behavior. When they see the pretty rocks, they will remember that they earned them.

  • Make a collage. Old magazines and old photos are great for this activity.

  • Make a musical instrument. Use your imagination: a shoe box with rubber bands can be a guitar; glasses filled with different levels of water make different tones; tapping different surfaces with chopsticks makes different sounds.

  • Go on a 'use all your senses' walk. What do they see, smell, hear, and feel?

  • Make personalized place mats. Take some family photos, glue onto cardboard, and cover with clear contact paper. Kids will love to use these with meals.

  • Create a scavenger hunt walk. Plan a list ahead of time of thing to a dog, an airplane, or even a girl with purple hair.

  • Go on an ABC walk. Find things that start with all the different letters...or find the actual letters on signs and license plates. This is a great game in a supermarket.

  • Download free coloring pages from the internet. With a little searching, you can get a picture of just about anything.

  • Draw with chalk. Make a hopscotch board.

  • Make your own play dough. You can find the recipe online.

  • Make a fort using the couch cushions,

  • For a really special occasion, set up the tent and have a backyard camp out (or as we once did, set it up in the house!)

  • Write a story and illustrate it together.

  • Decide on a recipe and bake or cook something. Kids will often try foods more eagerly if they helped with the cooking. Let them help sprinkle in different spices and be the taste-tester.

  • Have a tea party. Invite the dolls, and get out the good china that you never use.

  • Trace your hands and feet and color them in.

  • Have some down time while watching a video or a special TV program. There are some lovely educational TV programs and videos out there.

  • Play a computer game. Don't be afraid of controlled use. Children that don't learn how to be comfortable with computers at a young age are at a distinct disadvantage in this high tech culture.

  • Okay, now put that screen away and get some fresh air! Families can play some sports outside. Find a patch of grass, a basketball hoop or one of the city tennis courts and get active.

  • Blow bubbles.

  • Playing board games with the family is the stuff that great memories are made of.

  • There is little out there that is as much fun as a giant box to get inside of . If you buy a new appliance or see a neighbor buying one, ask for the box.

  • make a rain gauge and weather station

  • Play dress up. In my opinion, every house needs a good dress up box, (after Halloween is a great time to pick up costumes and things on sale)

  • Read!

  • If you can manage to make it work, try hard to have at least one meal of the day sitting down with the entire family. Have everyone say a little about their day. Having one child help with cooking a special dinner, including making and decorating a menu is a great way to have one on one time.

  • Take advantage of where we live; there are always fairs, festivals and museums that are going on.

  • Make a scrapbook with keepsakes and photos of all the fun activities

  • Unless you are using the phone or tablet as part of the activity make sure you put them down and be fully engaged in what you are doing (emails can wait)

For Those lucky enough to live in or near the Bay Area, here is my list of quirky, only in SF things to do.

  • Fort Funston: Bring some dog treats and take a walk. You are pretty much guaranteed to see lots of fuzzy friends to pet. If you are lucky you will see hang gliders. (Free)

  • Take a ferry ride. The route from the Ferry building to Jack London square is super easy, and there are snacks and a bathroom available!

  • Turrell Sky dome: For this you need an admission to the De Young museum. Many folks have no idea that this magical place exists. Go out to the garden by the cafe and follow the path and signs down to the sky dome. Once you are in there, make sure you sing and listen to the acoustics

  • The camera below the cliff house: Lots of folks don’t bother stepping in there, but it is worth it. The Camera Obscura gives a real time 360 view of the surrounding area. It is only open when the weather is clear. It isn’t free, but it is reasonably inexpensive

  • The Wave Organ: This is an old exploratorium exhibit that remains at the end of a jetty behind the St Francis Yacht club. When the tide is right (good luck, I have rarely been there are the right time) pipes will play music. It is an enchanting place regardless, especially if you are there when no one else is out there. It is free

  • Musee Mecanique - If they love it there...consider earning points for future play there

  • Labyrinth down at Land’s End is worth checking out.

  • Walking tours are free and plentiful. These are a fun way to get outside and learn a little history of the city.

  • The Gingerbread house in the lobby of the Fairmont Hotel is worth a trip. It is only there until the New Year. This is free unless you opt to splurge on the very expensive tea.

  • I love the Stairway walks of SF book. If you child is old enough that they don't start asking to be carried half way through the walk, these are a great family activity.

  • Sing-a-longs at the Castro Theatre (Thanks to JD and family for this addition)

  • Groupon and Goldstar and great ways to find the deals out there!

Happy Holidays...go out and make some wonderful memories!

If you have something that you think would be a good addition to this list, let me know!

Friday, November 29, 2019

The Power of story telling 2019

My mom could go into a room full of chaos. “Once upon a time..” she would start in a steady calm voice.
It wouldn’t be long before everyone in the room was hanging on her every word; whatever they had been worrying about a moment ago was forgotten. She would then take her audience on a magical journey with a story that she often made up as she went. If it were a classic tale, you could count on her to take dramatic liberties. I don’t believe she told any story quite the same way twice. In her kindergarten classroom she would have her students shut their eyes as she told her tales. "Use your imagination", she would tell them. "I am thinking of a big black dog, he has 2 floppy ears. He also has 2 tails and 3 eyes!"
One distinct recollection of a time when mom’s storytelling saved the day comes to mind. My younger daughter Alana had several friends spending the night. In one of my bigger lapses in good “mommy judgement” I had rented a movie that I thought they would all enjoy. It turned out to be fairly dark and scary (always pre-screen, don’t rely on faulty memory of what may or may not be appropriate.) One of the girls started to cry and some of the other girls started to get sad and upset. A few of them wanted to stop the movie, but of course most of the others wanted to keep watching. The situation seemed like it could go downhill quickly. Fortunately my mom was visiting. She took control, turned off the movie and started to tell stories. These weren’t toddlers; they must have been about ten. They sat raptly listening to story after story. The evening was saved.
Books are wonderful too, but in truth, they are perhaps not quite the same as a story. A story is yours to tweak as you please. Stories are powerful mediums for working through issues. Folks who have asked me for parenting advice over the years know that using stories is a favorite tool. For as long as I can remember I have been counseling parents to create a fictional child with a similar name. Talk about what that parallel child has been going through. This tends to be a very non threatening way to talk about all sorts of issues.
Once upon a time there was a little girl who had an “owie” ear. The doctor had given her some medicine to make it better, but when she tried the medicine it tasted yucky.”....
Once upon a time there was a little boy who didn’t like to stay in bed……
Once upon a time there was a little girl who didn’t want to go to school...
Once upon a time there was a little boy who liked to put pieces of cheese in his nose….
These stories are great ways to launch into a dialogue about all sorts of positive and/or negative ways that the protagonist can deal with a variety of situations. This is an excellent problem solving technique.
When I was working on this post, I mentioned the storytelling theme to one of the wise mamas in my life. She immediately referred to these as “Annie Stories”. It turns out that back in 1988 this was quite the thing, and there was a book about how to use this method:

I use storytelling at work on a regular basis. I can’t even count how many times I used to be called into an exam room where a crying, or cowering child was terrified of a “dreaded shot”.... I would start my story:
“Once upon a time there was a patient who was so big. He played football for his high school. He was bigger than me, he was probably bigger than the grown up in your house, he was really big...and he was really scared of getting shots." At this point 90% of the kids had stopped thrashing about and were now listening to me talk. Yes, they might have been huddled on their parents' lap, or on the floor under the chair. They were probably not making eye contact, but I had their attention.
“He wasn’t afraid of getting bumped around on the football field but he hated shots. He was so scared of them that he would try to hide. He tried to hide inside the garbage can, but he wouldn't fit..” Now 99% were actively listening and some were almost laughing.
From here I was able to start a dialogue with them about why we were giving the shot. “It is magic protection so that if certain germs get inside of your body, you won’t get sick.” We talked about the fact that we wish there was a less yucky way to get the protection and that it is really normal for lots of people to be scared of shots. We talked about the fact that being brave is trying hard to hold still and it is still really okay to cry and yell if they need to. Before you knew it, they were ready and my wonderful assistant Josie had already gotten it done.
It all starts by engaging them with a story.
Not everything has to have a purpose. Sometimes stories are just for fun.
If I happen to be taking a walk outside and see something unusual such as a pair of shoes, sitting by themselves on a street corner, I can’t help to think to myself. Here is a story. How did those shoes get there? Take turns telling the same story. Families can have a wonderful time creating a collaborative tale. Another wise mama tells me that she used to have her kids give her three things that they wanted the story to include; perhaps a special name or a certain feeling.
Our kids these days are both blessed and cursed with the enormous choices of digital wonders. I am not opposed to limited use of regulated tech time, but it should not be in place of plain old imagination.
Recent studies show that books and stories started young have a real impact on brain development:
This Black Friday, as people run around to shop for all kinds of new technological marvels, don’t forget to “power down” and be thankful for the magic moments that you capture as you snuggle with your kids and simply tell a story. "Once upon a time......

Friday, November 22, 2019

Food Safety guidelines 2019

Here is my updated food safety guide, just in time for the turkey leftovers

I was recently back in Pittsburgh PA continuing the adventure of clearing out the family home. My long term readers know that this has not been a quick process (understatement!)

Horrifyingly, this trip I found some fairly disgusting food in the fridge that could have qualified as a science project in a high-school fair. Yuck. In some cases like this, it is clear that something has spoiled and no one in their right mind would even open the container, let alone put it in their mouth. Unfortunately, most of the time dangerous food isn’t quite so obvious.

It seems that stories in the news about nationwide recalls of contaminated foods are becoming more and more frequent. Many times safe handling and proper cooking can eliminate most of the risk. This post will give you some good knowledge and resources
Food Safety guidelines
Thanksgiving is a holiday associated with lots of yummy leftovers so it's usually a good time to update my food safety post. If you watch the news you know that food contamination issues can happen all year round. This post will give you some safe guidelines for foods that you buy and cook. If you do a lot of eating out, restaurants are supposed to have their cleanliness rating publicly displayed. Check the bottom of the article for some great links on food storage guidelines; everything from egg safety and turkey leftovers to breastmilk storage.

It is certainly not a sterile world. As soon as they are able, your baby will start putting anything that they can reach into their mouths. You can't even begin to imagine the phone calls I have gotten about icky things that some of my little patients have managed to get their hands and mouths on. Chap-stick, particles from an exploded hot pack, kitty litter, the little packet in shoe boxes that says do not eat. You name it, they lick it.

So yes, the world is full of germs, and while I don't generally get too concerned about a little dirt here or a big sloppy dog kiss there, foodborne bacteria can be nasty, and we need to minimize any exposure.There were over 300,000 reports of children under the age of five being impacted by tainted food last year alone.

Infants and young children are particularly vulnerable to foodborne illness because their immune systems are not developed enough to fight off infections. This is especially important for infants under 6 months of age. Extra care should be taken when handling and preparing their food and formula. Here are some basic food safety guidelines:

Wash hands for at least 20 seconds before food preparation. Soap is best. Hand sanitizer will do. Re-wash as needed after handling food that might carry germs. The most common offenders are poultry, meat, raw eggs.

Make sure kitchen towels and sponges are changed and cleaned frequently. Sponges can go through the dishwasher. Cloth can get easily contaminated and then spread germs. Watch out for potholders or other cloth items that come into contact with raw food.

Keep your refrigerator temperature at 40 degrees or colder. It is worth investing in an appliance thermometer so that you can keep track. All the science says that the 40 degree number is essential for keeping the bacteria from multiplying.

Your freezer should be below 0 degrees. To ensure the safety of your frozen food, you need to be sure that it has been actually kept constantly frozen. One clever trick to make sure of this is to keep a baggie filled with ice cubes in the freezer. If they remain cubes, you are in good shape; if they melt and refreeze as a block of ice that means that at some point your freezer was not cold enough. This can happen in a power outage or even if the door wasn't kept tightly closed. I am sad to say that if there was stored breast milk in there that has thawed and refrozen, I would no longer consider it safe. Label things in your freezer and rotate so that you are using up older stuff first.

Check the dates of baby food jars and make sure the lid pops when you open them.

Don't put baby food back in the refrigerator if your child doesn't finish it and you used the "used" spoon to take the food directly from the jar. Your best bet - simply don't feed your baby directly from the jar. Instead, put a small serving of food on a clean dish. Add more as needed with a clean spoon. Remember that once saliva has come into contact with the food it is no longer sterile and some bacteria can grow quickly.

Powdered formula is NOT sterile. Don't mix up more than you need in advance. If the infant is less than 4 months, I would mix it with boiling water and let it cool.

Don't leave open containers of liquid or pureed baby food out at room temperature for more than two hours. Bacteria thrive in temperatures between 40-140 degrees

Don't store opened baby food in the refrigerator for more than three days. If you are not sure that the food is still safe, remember this saying: "If in doubt, throw it out." See links below for guidelines on how long food stays safe.

Make sure that foods are properly cooked. A food thermometer is the best tool for this.

 Chicken ( white meat/ dark meat)...170/180
 Eggs....not runny

For all of you "older kids" who will be baking this holiday season, watch out for the batter (I am a notorious offender.), Even one lick from raw food containing a contaminated egg can get you ill.
Myth: Freezing food kills harmful bacteria that can cause food poisoning.

Fact: bacteria can survive freezing temperatures. When food is thawed, bacteria can still be present and can begin to multiply. Cooking food to the proper internal temperature is the best way to make sure any bacteria is killed.

Myth: vegetarians don't need to worry about food poisoning.

Fact: Fruits and vegetables are an important part of a healthy diet, but like other foods they may carry a risk of foodborne illness. Always rinse produce well under running tap water. Never eat the pre-washed 'ready to eat' greens if they are past their freshness date or if they appear slimy.

Myth: Plastic or glass cutting boards don't hold harmful bacteria on their surfaces like wooden cutting boards do
Fact: Any type of cutting board can hold harmful bacteria on its surface. Regardless of the type of cutting board you use, it should be washed and sanitized after each use. Solid plastic, tempered glass, sealed granite, and hardwood cutting boards are dishwasher safe. However, wood laminates don't hold up well in the dishwasher. Once cutting boards of any type become excessively worn or develop hard-to-clean grooves, they should be discarded.

Myth: Locally-grown, organic foods will never give you food poisoning.

Fact: Any food, whether organic or conventional, could become unsafe with illness-causing foodborne bacteria at any point during the chain from the farm to the table. Consumers in their homes can take action to keep their families safe. That is why it is important to reduce your risk of foodborne illness by practicing the four steps: Clean, Separate, Cook, and Chill.

Some excellent resources for food safety tips can be found at:  This site keeps track of any food recalls This is as great site for seeing how long food will last. I used it just this week to figure out if an open can of chickpeas was still good. (After a week, the answer was no)   This site has loads of kid friendly activities

Enjoy your Thanksgiving!

Friday, November 8, 2019

Car Seat Guidelines 2019

This week's topic
Car Seat Safety Guide 2019

Kids grow! Make sure they are strapped in properly!

The Rules

Car seats are an essential part of keeping your child safe. Countless children’s lives are saved annually by being properly installed in a car seat during a crash. Governor Jerry Brown signed a law that went into effect on January 1st, 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 the 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 kids might appear to be squished but most children are actually quite comfortable sitting criss-cross, or with their legs up the seat. For those parents/caregivers who are concerned about leg room, Graco has released the Extend2Fit, a new seat which has a 4-position extension panel that provides 5" of additional leg room.

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 the link below. This video is a good illustration about why rear facing is so important:

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. 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; don’t dismiss the importance of Step 4!

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.

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.

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. Your 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.

Be aware that most newer car and car seat models use the LATCH system ( Lower Anchors and Tethers for Children). The Latch system attaches the car seat to the vehicle through anchor points that are installed in the car and connectors on the car seat. This is supposed to make the installation easier as well as eliminating potential errors that can result from installing a car seat with a seat belt. The LATCH system has a 65 pound weight limit. What many parents are surprised to find out is that this limit includes the weight of your child as well as the weight of the car seat (some can weigh up to 25 pounds!).

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.

Picking the right car seat

If you are looking to buy a new car seat, check out these helpful links. The folks from sent me the following resource guides:

We recognize how difficult it can be to find the right information on car seats, so we evaluated both infant and convertible styles to help inform parents. To find the best, we consulted with child safety experts, dove into federal ease-of-use ratings, surveyed hundreds of parents, and then took a closer look at the top options. You can see our guides here:

If you are someone who doesn’t own a car and is popping the car seat in and out of car services, finding one of the cars that is easier to install in becomes even more important.

Making sure it is installed correctly!

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. The reality is unless you are a certified child passenger safety technician, you’re not aware of some of the nuances of different kinds of seat belt systems, different features on different car seats.

When you go to get help with your car seat make sure you go to a certified car seat technician. Then you will know you are getting the best information available.

AAA Appointments need to be made ahead of time. You do not need to be a AAA member to take advantage of this free service

CHP (California Highway Patrol) 415-557-1094 This is a very popular, and by appointment only. Please make an appointment as far in advance as possible. The current wait when I called to update this post was pretty short, but it varies and sometimes can be longer than a month. The inspections are done at 455 8th Street in San Francisco.

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 650-997-8321 does a car seat inspection for free. As with the other options, this is by appointment only.

Willing to pay to have someone come to you?


The following links can you assist you in finding the right car seat:

The National Highway Traffic Safety Administration 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.

NHTSA/Get Your Car Seat Inspected has 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 - Car Seats for the Littles gives lots of great info about the specific brands of car seats on the market

Other considerations

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 an 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!!

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 as long as they are supervised, 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.

WINTER CAR SEAT TIP: The straps need to be tight up against your baby; puffy coats or blankets need to be OVER the straps!

Never leave your child unattended in a vehicle. Children can die from prolonged exposure to excessive temperatures in a hot car.

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. 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. I know most of us never register the products we buy but make sure you register your car seat! If there is ever a recall, this will ensure that you are notified, and this is one of those products where you must know if there is an issue!

Let me close by confessing that I am NOT a car seat expert. The seats that my children grew up with were much simpler (but not nearly as safe!) When I see new parents struggling with all the straps and trying to figure things out, I am often as clueless as they are.

Here is the takeaway message. Putting your baby or older child in a car seat is an essential skill that you need to learn in order to travel with them safely. Find an expert to help you master this and make sure that you are using the car seat restraint properly. Safe travels