Car Seat Safety

It is exciting for parents to see children transition from one stage to the next. Yet with car seats, it is often safer to delay moving to the next step as long as possible. Once children outgrow the manufacturer’s height and weight limits on a safety seat, it is time to consider a new one, but there are few clear age, height, or weight recommendations that all children should follow.

Children under two years of age should remain rear facing. Since 2011, the American Academy of Pediatrics (AAP) has recommended that children remain rear facing in child safety seats until the age of two.

In June 2016, Governor Tom Wolfe signed a Pa. law requiring children to remain rear-facing in car seats until age two. Officers will hand out verbal warnings to those in violation for the first year the law is in effect. After that, each violation will cost $125 in fines.

This AAP’s recommendation and new Pa. law are based on studies that show:

  1. Children birth to age two are 75% less likely to die or experience a serious automobile-related injury if they are rear facing.
  2. Children age 12 months to 23 months are five times less likely to suffer death or a serious injury than toddlers who are facing forward.

In a crash, a child’s disproportionately heavy head and weak neck musculature can contribute to spinal or brain injuries. When rear facing, the seat cradles the head and neck, and disperses crash forces across the entire body.

When to Transition Car Seats

When children outgrow the height or weight recommendations for their rear-facing child safety seat, secure them in a forward-facing seat with a harness for as long as allowed by the manufacturer of the seat. When children outgrow their forward-facing seat with a harness, then secure them in a booster seat that allows the vehicle’s seat belt to fit properly (lap belt low and snug across the hips, and shoulder belt across the center of the chest and the collar bone, not the neck). Booster seat use reduces the risk for serious injury by 45% for children aged 4–8 years when compared with seat belt use alone.

Many children are ready to be out of a booster seat and in a regular seat belt at approximately 4-foot-9 inches tall and between eight and 12 years of age, though this may vary depending on the automobile and child. A child should be able to sit with his/her back straight against the vehicle seat back cushion, and knees able to bend at the front edge of the seat before leaving a booster seat. All children under age 13 should ride in a back seat. A lap and shoulder seat belt should always be used.

Care Seat Installation

Car seats may be installed with either the vehicle’s seat belt or the LATCH (Lower Anchors and Tethers for Children) system. Both installations are safe. If you install the car seat using the seat belt, check the vehicle’s owner’s manual to see if a locking clip is needed to keep the belt locked into position. Many vehicles do not need a locking clip, but one must fully extend the seat belt and the allow it to retract in order to keep the belt tight around the car seat. When in doubt on installation, call both the automobile and car seat manufacturers for advice.

Other great resources about car seat safety include: and

Don’t forget that many local municipalities offer car seat installation checks as well!

Amanda Kramer, MD and Bradley Kramer, MD from UPMC Children's Community Pediatrics – Moon, South Fayette, and Wexford.