Mar 23, 2019 5 min read

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By Heather Holtschlag

Though injuries from road traffic accidents have decreased dramatically in the United States in recent years – largely due to the use of child safety equipment such as helmets and car seats – road crashes remain the number one cause of unintentional injuries in children age 10 to 19, killing about 260,000 children a year and injuring about 10 million, according to the World Health Organization.

“Pennsylvania law states that all drivers are responsible for securing children in the appropriate child restraint systems,” said Kristen Urso, M.Ed., CPSTI, Southwestern Regional Training Coordinator of the PA Chapter of the American Academy of Pediatrics Traffic Injury Prevention Project (PA TIPP). “Non-use of an appropriate seat for a child under age 8, or gross misuse of a seat when the child is too big or too small for a seat or expired seats, for example, is a primary violation of the law, with fines averaging $140 per child. For children ages 8 to 18, those fines range about $75 per child who is not wearing a seat belt.”

As a rule, all children from birth to age 4 must be secured in an approved child passenger safety restraint system anywhere in the vehicle, according to Urso. Children ages 4 to 8 must be secured in a seat belt system and an appropriate belt-positioning booster seat anywhere in the vehicle.

In August 2016, Pennsylvania became the fourth state to require rear-facing seats for children under age 2 until the child outgrows the maximum weight or height limits of the car seat as designated by the car seat manufacturer.

The American Academy of Pediatrics heightens Pennsylvania laws to an even more strict level by offering the following evidence-based best practice guidelines:

All infants and toddlers should ride in a rear-facing car seat until they reach the maximum weight or height allowed by their car seat’s manufacturer.

Children who have outgrown the rear-facing maximum weight or height limit of 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 limit allowed by their car seat’s manufacturer.

All children whose weight or height is above the forward-facing limit for their car seat should use a belt-positioning booster seat until the vehicle lap and shoulder belt fits properly, typically when they have reached 4 feet 9 inches in height and are between 8 and 12 years of age.

When children are old enough and large enough to use the vehicle seat belt alone, they should use a lap and shoulder belt.

All children younger than age 13 should be restrained in the rear seat of the vehicle.

Non-regulated products (items that don’t come with the car seat and aren’t recommended by the car seat manufacturer) should not be used in or around the car seat. This includes window shades, mirrors, hanging toys from the infant carry handle, puffy blanket inserts that go between the child and the harness or the child and the back of the seat. The harness should fit snug against the child’s body because in the event of a crash, the harness will not get snugger on the child. Instead, it will stay in place, and a bulky coat or insert would add unnecessary room between the child and harness and result in excessive excursion.

“In addition to these guidelines, safety experts widely suggest that children under age 13 remain in the back seat,” Urso said. “This places the child farthest from frontal crashes, which are the most common type of crash, and away from frontal air bags that best support an adult size passenger.”

Car seat expiration dates vary among the variety of manufacturers and the types of seats available, including rear-facing only, convertible seats, combination seats and booster seats. Car seats typically expire six years from the date of manufacture (not from the date of sale or date of first use) or longer for seats that have more features, such as the 3-in-1 seats. “When car seats expire, we typically encourage parents to destroy the seat by cutting the seat fabric and harness and placing in a dark garbage bag before throwing it away. This eliminates dumpster diving or roadside garbage piles from which other parents often find them,” Urso suggested.

Urso also does not recommend purchasing used car seats online from previous owners.

“Second-hand seats are not recommended because the buyer may not know the history of the seat or how the seat was stored when it was not in use,” she said. “Most car seats are meant to withstand one crash, and that’s whether or not the child was in the seat the time of the crash. Knowing the history of the seat is important. Additionally, if labels from the car seat are missing, the new owner is unable to check the expiration dates or find out if the seat is on a product recall list.”

When shopping for car seats, Urso recommends that parents visit www.healthychildren.org, where they can review car seat options like height and weight limits as well as seat prices, or www.nhtsa.gov, where labels and the car seat manuals are rated by their ease of use.

“In addition, our website, www.pakidstravelsafe.org, includes information for parents regarding where to have their car seat installed or checked, as well as webinars and access to handouts for professionals who want to share car seat information,” Urso said.