In 2019 car crashes killed 731 children in America. For these passengers it was determined that 40 percent were not riding in a car seat or booster seat protective restraint. The proper use of a car seat for child passengers under age 12 is a critical protective factor when car crashes do occur. Car seats are a device that anchors the child passenger to the internal frame of the vehicle either with a traditional seat belt system routed through the car seat or using a newer designed system called LATCH Lower Anchors and Tethers for Children which uses metal hooks, adjustable tethers and anchor connectors located between the upper and lower cushions of the vehicle seats located in the 2nd row of the vehicle.

A study by the National Highway Traffic Safety Administration (NHTSA) found that 46 percent of car seats are not being used properly. Some of the errors with installations of these car seats include incorrect amount of recline, loose and inadequate anchoring, improper lap belt position were most observed for rear-facing car seats, forward-facing car seats, and booster seats. These results were derived from 24 regions across the U.S. and in evaluating 4,167 car seat observations.

For rear-facing car seats 16 percent did not have adequate recline setting. These seats are designed for newborns and their first year as passengers when the recline angle is important to support the infant’s head in an airway neutral position by having a design recline angle of 30 to 45 percent. When improperly installed it can cause the infant to rest in an airway restrictive position.

For forward-facing car seats 17 percent were installed loosely. This type of car seat has a harness and tether that limits the child’s forward movement during a crash and helps to absorb and dissipate the forces of the crash that would otherwise cause harm to the child both internally and externally. A loose installation is one where the seat can be moved side to side more than two inches when pushed or pulled at the belt path, because the belt is not properly tensioned to hold the seat tightly. The best practice is to anchor the seat securely so that it cannot move more than one inch laterally when pushed or pulled.

For high back and backless booster seats the purpose it to use the seat as a transition from a forward-facing car seat to the point where the child is tall enough to use a vehicle seat’s lap and shoulder belt system. Usually age 8 to age 12 when the child has outgrown the need for a booster seat. For these seat types 12 percent of installs had the lap belt path wrong where placed across the abdomen or the ribcage. The proper path is across the hips/thighs of the child which is strong bone verses soft abdomen tissue and muscle.

This study highlights how often car seats are either not used at all or are used in an improperly installed way. Fortunately there are child passenger safety technicians and many communities hold car seat check station events. These events allow drivers to bring their vehicle to the event with their children in car seats and allows the technician to inspect the seat conditions and installations and if needed conduct education and demonstrate corrections to improve installation and proper use of the car seat. If you have car seats and transport child passengers just to be sure research for a car seat check station in your community and schedule an inspection of your car seat to ensure you are using the seat as designed and installed properly to provide the intended protections to reduce the risk of injury should a motor vehicle crash occur.