Recent recalls of infant inclined sleepers have some parents worried that babies falling asleep in car seats might be dangerous, too. Our experts explain
MORE THAN 5 MILLION infant inclined sleepers, including the Fisher Price Rock ’n Play Sleeper, were recalled last spring after a Consumer Reports investigation linked them to dozens of deaths. Consumer Reports has been working to get all inclined sleepers-now associated with 92 deaths-banned. That prompted some CR readers to ask whether car seats pose a similar risk, because many also have an incline.
Sleeping on an incline does pose risks, as it can cause an infant’s head to tilt forward, chin to chest, and compress the airway, increasing the risk of suffocation, says Emily A.
Thomas, Ph.D., an automotive safety engineer at CR and an expert in pediatric biomechanics. That can happen because infants don’t have the neck strength to keep their head up on their own. “But there are crucial differences between inclined sleepers and car seats,” Thomas says.
First, infant car seats-which are all rear-facing, the safest position for a baby in a crash-have a five-point harness system. The snug harness helps keep infants upright and from moving into a position that could block their airway. “Infant car seats have been designed and tested not only to protect your baby in a collision but also to ensure that if your baby does fall asleep in the seat, the risks of slumping down, chin to chest, and blocking airflow, are low,” Thomas says.
Second, the incline angle in rear facing car seats has been tested extensively by car seat manufacturers and government regulators, which was not the case with inclined sleepers such as the Rock ’n Play Sleeper. The design of car seats balances protection of a baby’s head and spine in a collision with a recline angle that keeps the head from falling forward, Thomas says. And last, unlike the Rock ’n Play Sleeper and similar products, car seats are not marketed specifically for infant sleep. Instead, car seats-even those that you can remove from a vehicle to lock into a stroller-are designed for safe travel.
“While the risks of sleeping on an incline are serious, they are vastly outweighed by the protection a well designed and properly installed car seat offers in a crash,” Thomas says.
WHAT TO KNOW BEFORE YOU BUY CAR SEATS
– KNOW YOUR CHILD
Keep track of your child’s height and weight. These factors, along with age, will determine the type of car seat you need. Health problems that affect muscle control or breathing, such as cerebral palsy and muscular dystrophy, can also affect your choice.
– KNOW YOUR CAR
Check the child-safety sections of your vehicle owner’s manual, and study up on relevant features such as the car’s seat belt and anchoring hardware that allow you to attach a car seat to the vehicle. That anchoring system is known as LATCH (Lower Anchors and Tethers for Children).
– KNOW YOUR STORES
Choose 0 retailer that accepts returns. Some car seats are not compatible with the backseat cushion angle or seat belt placement in some cars, so you may find that you need to return your car seat if it isn’t a good fit for your car.
KNOW YOUR SEAT’S EXPIRATION DATE
Yes, car seats have one, typically between six and 10 years. Do not use an expired car seat, because it might not provide as much protection, include the latest safety features, or be tested to the most current standards.
It’s especially important to find out the year a car seat was manufactured—and whether it was involved in a crash—if you are considering buying a secondhand seat or using a hand-me-down.
Proper Use of Car Seats
– Stay rear-facing as long as possible. That means until the child reaches the seat’s height or weight restriction, which could be up to age 4. Rear-facing seats should be at a 30- to 45-degree angle. “Most manufacturers provide a label or a bubble indicator to show you how to position the seat,” says Sarah Haverstick, a certified child passenger safety instructor at Evenflo, which makes car seats.
– Buckle up the five-point harness. That helps prevent injuries and ejections during crashes, says Jennifer Stockburger, head of car seat testing at CR. Even during uneventful drives, the five-point harness keeps babies from sliding down or rolling over or onto their side, which could lead to suffocation. If you use a positioner such as an infant insert to help babies fit more securely, “use only what is approved for and provided by your car seat manufacturer,” Haverstick says. Others might not perform properly in a crash or support the baby’s head enough to allow airflow.
– Monitor your child. Check on your child when in the car seat, and periodically stop to let your baby stretch, Stockburger says. If your baby is sleeping when you get to your destination, don’t loosen the harness and let him sleep unattended. He could become entangled in the straps or turn and cut off airflow. Instead, move him to a safe sleeping space, such as a firm, flat crib or bassinet.
WHICH KIND OF CAR SEAT IS RIGHT FDR YOUR CHILD?
The first three seats below are best for most families: an infant seat for your baby’s first year, a convertible until age 5 or 6, and a belt-positioning booster until your child fits your car’s seat belt alone. The other two seats can be good choices for some—for example, an all-in-one for a caregiver who occasionally travels with children and a toddler booster/combination seat for parents who want to pass a convertible to a younger sibling.
CHILD’S WEIGHT 4 to 35 pounds
Infant car seats, which are rear-facing only, are best for babies from birth to age1. They can also be used for children up to age 2 if they meet the seat’s height and weight requirements. But CR’s testing shows that a convertible seat may offer added head protection for babies 1 year or older. And though some infant seats are designed for babies weighing up to 35 pounds, most children outgrow the height limit first. These seats attach to a base installed in the car and can be removed to serve as an infant carrier or snapped into a compatible stroller
CHILD’S WEIGHT 5 to 50 pounds when rear-facing and 20 to 85 pounds when forward-facing
Convertible seats are typically best for children between ages 1 and 3 when in the rear-facing position, and for children ages 3 through 6 when forward-facing. The seats may also be used for kids of other ages if they fit the seat’s height and weight limits.
These seats are good options for several reasons. CR’s tests show that convertible seats, when rear-facing, offer better head protection for children 1 year and older than do infant seats. And they allow kids to stay rear-facing longer.
When your child reaches the height or weight limit of the rear-facing mode, the seat can be turned forward-facing.
BELT-POSITIONING BOOSTER SEAT
CHILD’S WEIGHT 30 to 120 pounds
These seats, which raise children up so that a car’s seat belt fits correctly, should be used after a child outgrows a convertible seat, generally around age 6. Boosters should be used until a child is tall enough (4 feet, 9 inches) to properly fit just the car’s seat belt, typically sometime between ages 8 and 12. These seats come in three main styles: high-back, backless, and models that can convert from high-back to backless. CR recommends using boosters in high-back mode: That better positions the shoulder seat belt and provides some side-impact protection.
CHILD’S WEIGHT 4 to 50 pounds when rear-facing, 20 to 80 pounds when forward-facing, and 30 to 120 pounds in belt-positioning booster mode
All-in-one seats can serve as a child’s car seat from birth up to age 12, providing good value. But CR’s tests have found that by trying to do too much, they often don’t do any single task all that well. These seats also lack the convenience of a detachable carrier, are usually large, and might not fit smaller babies or small cars well. Still, they make good backup seats and may work well for caregivers who only occasionally drive with children in their cars
ODDLER BOOSTER/COMBINATION SEAT
CHILD’S WEIGHT 22 to 90 pounds in harness mode and 30 to120 pounds in belt-positioning booster mode
These seats, which are forward-facing only, can be used with a harness or, with the harness removed, as a booster using just the car’s own seat belt. Harness mode is best for kids who are at least 2 years old until about age 6. After that, children can sit in booster mode until they are tall enough (4 feet, 9 inches) to properly fit the car’s seat belt, typically between ages 8 and 12. These seats are a good and safe choice for kids who have outgrown a rear-facing seat but aren’t ready for a belt positioning booster, and can be an option if you need to pass a convertible seat to a younger sibling.