When it comes to protecting children in the car, there’s no doubt that we’ve gotten a lot better at it in recent decades. For instance, according to the Insurance Institute for Highway Safety, there were 14 car passenger deaths for every 1 million children in 2009 -- a 54 percent reduction from three decades ago.
There is, however, always room for improvement. So the question remains: How can you best protect the most precious cargo in your car?
The power of safety seats
According to the federal Centers for Disease Control and Prevention, four children ages 14 or younger were killed in car crashes every day in 2008. Additionally, the Insurance Institute for Highway Safety says car crashes still are the leading cause of death for children age 3 and older.
A key step toward lowering these figures is the use of proper safety seats and restraints. According to Lorrie Walker, training manager and technical adviser with Safe Kids USA, children under age 2 should remain in a rear-facing child safety seat positioned in the middle of the back seat of the vehicle. Some smaller children may even need to stay in a rear-facing seat until age 3.
“We see injuries all the time when a child is brought to a forward-facing position too soon,” Walker says. “Their neck muscles aren’t strong enough, and as a result they suffer neck and spinal cord injuries in even minor fender-benders.”
Dr. Christopher Haines, director of the emergency department at St. Christopher’s Hospital for Children in Philadelphia, has seen firsthand the protective power of child safety seats. Several years ago, Haines treated a woman who almost was killed in a car accident. Her 9-month-old son had been ejected from the vehicle -- which was traveling at 80 miles per hour. Because the boy was in a safety seat, he suffered no injuries, according to Haines.
“Child safety seats basically form a protective cocoon around the child,” Haines says. “They’re extremely effective.”
Proper installation is key
These seats, however, are only as effective as their installation. Automotive expert Lauren Fix cautions parents to avoid certain practices, like putting blankets under the seat or not precisely following the manufacturer’s guidelines. If you’re unsure about installation, she says, check with your local police department, where officers are trained on proper installation.
“The safety seat needs to have full contact with the car. If you put blankets underneath it to keep it from sliding, you’re not doing the most you can,” Fix says. “Also, if you’re using an old car seat or one that’s been in an accident -- don’t. It’s not the safest choice.”
If your child's car seat is damaged in a crash and meets certain guidelines for replacement, the auto insurance company covering the at-fault driver should be contacted about a replacement seat, according to Car-Seat.org. If you live in a no-fault insurance state, then you should pursue replacement through your own auto insurance company.
"Some insurance companies are very proactive about covering crashed seats regardless of the manufacturer or crash details, while others may act as though they've never heard of such a thing," according to Car-Seat.org.
The National Highway Traffic Safety Administration recommends that once a child outgrows a forward-facing car seat with harnesses (usually around age 4 or 5), it’s time to move on to a booster seat. Fix says a booster should remain the seat of choice until a child is big enough to wear a seat belt, which means the lap belt should sit snugly across the upper thighs (not the abdomen) and the shoulder belt should sit snugly across the shoulder and chest (not across the neck or face).
“I kept my kids in a booster seat until they were 8 years old,” Fix says. “They weren’t always happy with me about it, but it was still the safest way to travel.”
Other car safety tips for kids
In addition to using proper safety seats, there are several additional ways parents can make sure their children are as safe as possible in and around a vehicle:
1. Never leave a child alone in a vehicle under any circumstances. According to Walker, 463 children have died of overheating or hypothermia in cars in the United States since 1998. Many of those deaths occurred because a parent simply forgot his or her child was in the back seat.
“This is a huge problem that no one really talks about because no one thinks it will happen to them,” Walker says.
To prevent such a tragedy, Walker suggests putting your cellphone on the floor of the back seat. Not only does this stop you from talking or texting while driving, but it reminds you to check the back seat before getting out of the car.
2. Carefully monitor what their children are eating, drinking and playing with in the back seat.
“I saw a kid once who was eating popcorn in the back seat and came into the emergency room dead because he choked,” Haines recalls. “If your child is not old enough to be eating something, while they’re riding in the car is not the best time to test out new food choices.”
3. Don't forget to walk around the car before getting in. That way, you can avoid backing over a child who can’t be seen from inside the car.
Here are some online resources that can help you make your car a safer place for children:
• Learning about your state's laws regarding child safety in vehicles.
• Ensuring your child's booster seat is properly strapped and secured.
• Shopping for a car seat.
• Finding a registered child safety seat inspection station.