The No. 1 killer and crippler of children in the United States is motor-vehicle crashes - and air bags add another danger. But you can reduce your child's risk by 70 percent simply by using a car seat properly. No wonder you can't leave the hospital without one. Here's a look at some of the options:
Traveling bedDesigned for premature babies and infants who must lie flat, traveling infant beds are preferable for tiny babies whose neck muscles haven't yet developed. "Some babies born more than three weeks early may have trouble breathing when they sit in a semi-upright position because their head can flop forward and cut off the airway," says Dr. Joel Bass, chairman of the American Academy of Pediatrics (AAP) committee on injury and poison prevention. Rear-facing infant seats that convert to a car bed accommodate a child from birth to 20 pounds.
Infant seat
Although it's now possible to buy one car seat that will last from your baby's birth until she reaches 40 pounds, many experts still advise using an infant seat for the first 6 months. "Infant seats are best because they are designed to fit a small baby," says Dr. Marilyn Bull, a member of the AAP committee on injury an poison prevention. "And the rear-facing, semi-reclined position better supports the head, neck and back, reducing the risk of spinal injury should a crash occur."
Because they clip on to a detachable base, infant seats do double duty as baby carriers. Infant seats range in price from $45 to $130 and come with a three-point harness system.
Convertible seat With T-shield
Designed to fit children weighing from 5 to 40 pounds, convertible seats can be used in the rear-facing, reclining position for children who weigh 20 pounds or less, and in the forward-facing, upright position for children weighing 20 to 40 pounds. Convertible seats range in price from $49 to $130 and have removable padded inserts to keep small babies cozy. Many parents find the T-shield faster and more convenient to use than a five-point system.
Convertible seat with five-point harness
Because a five-point harness system restrains a child at the hips as well as at the shoulders, experts consider it the safest. It's also the best choice for parents who want a convertible seat for their newborn, says Stephanie Tombrello of Safety-BeltSafe, an advocacy group for car safety: "Infants generally are too short in the torso to fit properly into a seat with a T-shaped or overhead armrest-style shield."
Convertible seat with adjust-a-shield
Some convertibles offer three separate strap positions, which makes this type of seat even more flexible when it comes to accommodating a growing child.
Toddler booster seat
Once your child outgrows her car seat (when she weighs 40 pounds or her ears are higher than the top of the seat), experts recommend a booster seat. She should stay in the booster until she's tall enough to be safely secured with a seat belt - when the shoulder belt crosses her shoulder rather than her neck and the lap belt lies flat across the bottom of her torso. Two booster styles are available: a high-back bucket seat, and a backless model with an arm that latches across the front.
A car seat that strolls
In addition to converting easily to a stroller, this style of car seat is the only one that can hold a child weighing up to 32 pounds in the rear-facing position.
Which car seat for your car?
At last count, there were at least 50 types of car seats on the market, many of which work in some cars, but not others.
Before you go shopping, call the National Highway Traffic Safety Administration's Auto Safety Hot-line (800-424-9393) and ask for a list of car seats that fit the make and model of your car.
For a yearly updated list of approved infant and child safety seats, send an SASE to the American Academy of Pediatrics, Department C - Car Seats, P.O. Box 927, Elk Grove Village, IL 60009-0927.
Air bag update
Most new cars now come equipped with dual air bags, an option many parents choose out of concern for their children's safety. But last fall, the National Highway Traffic Safety Administration (NHTSA) issued a startling warning: While air bags have saved more than 1,600 lives, they have also killed at least 32 children, nine of them infants in rear-facing car seats. Even worse, some of those deaths resulted from slow-speed fender-benders.
The problem: Because an air bag inflates almost immediately upon impact, it's released from the dashboard at an explosive 200 miles per hour. The force is so great that a baby in a rear-facing car seat can suffer a fatal blow to the back of the head. And older children and petite adults can sustain a hard blow to the face.
The National Traffic Safety Board (NTSB) urges parents "in the strongest possible terms" to insist that children under 13 ride belted in the backseat. If a full car forces you to seat a toddler or an older child up front, slide the car's seat back as far as possible and use the appropriate child seat or booster seat.
Parents may soon have more choices, as safer air bags are on the way. The NHTSA is considering new regulations that would allow consumers to deactivate passenger-side air bags and is working with automakers to create air bags that would expand with less force. Future options may include on-off switches.