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Medical Author:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Types of Child Passenger Restraints

The National Highway Traffic Safety Administration (NHTSA) and the American Academy of Pediatrics (AAP) have published recommendations on how to restrain child passengers properly based on age, weight, and size. The following are types of child-restraint devices and the recommendations of each based on age, weight, and size. Common restraints include the infant car seat, the forward-facing car seat, and the booster seat. Others include the following:

Infants

• Infant car bed: The infant car bed is designed to hold an infant on a continuous flat surface with the infant's head resting toward the center of the vehicle. The car bed accommodates infants weighing less than 5.5 pounds -- these babies are too small for most rear-facing infant car seats.



• Rear-facing infant car seat: This restraint positions an infant to face opposite the direction the vehicle is moving. It gives the infant's head, neck, and body the support needed in the event of a crash or sudden stop. This restraint accommodates infants up to 20 pounds, 19-26 in. long, and up to 1 year old.



• Some infant seats come in two parts. The base stays securely in the vehicle, and the seat snaps in and out.



• You should never place a rear-facing infant car seat in the front seat of a car equipped with a passenger-side air bag. This places the infant at great risk for serious injury or death from the air bag in a crash, and infants should always ride rear-facing until they reach the highest weight or height recommended by the car-seat's manufacturer.

Toddlers/Preschoolers

• Forward-facing child seat or convertible seat: The restraint positions a child upright, facing the direction of travel. It will accommodate children from 20-40 pounds, 26-50 in. tall, and up to 4 years old. Restraint should be accomplished with a full harness.

School-aged

• Platform booster seat: The platform booster seat lifts a child up to make a standard lap and shoulder belt fit correctly. It is designed for use when a car's seat back is higher than the child's ears. The restraint will accommodate children 40-80 pounds, 35-48 in. tall, and 4-8 years old.



• Combination booster seat with five-point harness: The combination booster seat with five-point harness positions a child upright to face the direction of travel. This restraint is designed to accommodate children from 30-40 pounds and up to 4 years old. When the child reaches 40 pounds and 4 years, the harness system should be removed and the booster seat used as a belt-positioning booster.



• High-back booster seat: The high-back booster seat lifts a child up to make a lap and shoulder safety belt fit correctly. Use this restraint if the car's seat back is lower than the child's ears. It will accommodate children 40-80 pounds, 35-48 in. tall, and 4-8 years old.

Older Children

• Lap and shoulder harness safety belt: The lap and shoulder harness safety belt is designed for children 8 years old and more than 80 pounds. It is designed for children tall enough that their knees bend over the seat when they sit as far back as possible without slouching.



• The lap belt fits low across the child's upper thighs, and the shoulder safety belt fits snugly across the center of the shoulder. Do not allow your child to put the shoulder belts under the arms or behind the back because they will receive no upper body protection and risk being ejected from the restraint in the event of an accident.