It’s Child Passenger Safety Awareness Week and I have decided to talk a little about the car seat harness. The car seat harness holds a child down in the car seat so they cannot slide up, forward and out the car seat in the event of a crash.
There are two different types of harnesses; the 5-point and 3-point harness. What this really means is that the harness comes into contact with your child in 5 or 3 points. The 5-point harness has straps over both shouldres, both hips and one between the legs whereas the 3-point harness only has straps over the shoulders and one between the legs. Not only is a 5-point harness more secure but it also allows the forces from an accident to be distributed more evenly across the body.
Using the harness incorrectly is one of the most common mistakes parents make. In this short post I have outlined 3 really simple steps to take to correctly position your child in a car seat. Please remember to always check the manufacturer’s instructions first before using your car seat.
Place your child all the way back in the car seat
Your child must sit snugly in the car seat with the bum and back firmly against the backrest.
Correctly position the shoulder straps
Rear-facing car seats: the shoulder straps should be at or just below shoulder level (+- 2.5 cm)
Forward-facing car seats: the shoulder straps should be at or just above the shoulder level (+- 2.5 cm)
Tighten harness straps snugly
The straps should be tight enough so there is no excess webbing (check this using the pinch test).
The harness should also not be too tight that it pinches your child’s skin or forces them into an unnatural position.
HARNESS RETAINER CLIPS
Car seats made in Europe, Australia and South Africa do not come with harness retainer clips. You will most likely only see these clips if you are in the United States or Canada. These clips are not for added safety and are not designed to keep your child in their car seat in the event of a crash. In fact they are more likely to open up from the impact and slide down the straps. These clips are positioning devices and used to keep the shoulder straps in position pre-crash.
South Africa adheres to European car seat safety standards so you will not find car seats in this country with retainer clips. European regulation requires all car seat harnesses to be released in one motion and therefore a chest clip is simply not allowed. European car seats use other methods to keep the harness in place.
There are many other gadgets and devices available to use together with your harness to provide added comfort or extra protection. These are generally not safe since most of them are not crash tested and therefore can cause serious harm in the event of a motor vehicle accident.
We all know how long it can take for a child to fall asleep. So when you reach your destination and your little one has finally fallen asleep you couldn’t feel more relieved. You wouldn’t dream of disturbing them by removing him or her from the car seat. Instead you do what is the most convenient, and move your child from your car into a pram chassis or straight into your home without ever moving them from the car seat.
Whilst car seats have saved many lives, they do have some hidden dangers. A study in 2015 found that out of all the sitting and carrying devices for young children, car seats were responsible for the most number of deaths. Hypoxia and suffocation from either poor positioning in the car seat or strangulation by the straps and buckles was the cause of death in all these cases.
This is when there is a loss of oxygen in the blood which reduces the amount of oxygen reaching the tissues. When there is an extreme loss of oxygen a child will suffocate.
The developing brain is very sensitive to a decrease in oxygen. Loss of oxygen can cause brain injury and result in a range of developmental problems as well as seizures.
The position of your car seat is important. The Recline Angle of a rear-facing car seat is critical and an angle between 30-45o from the vertical is recommended. A recline angle more than 45o offers very little protection in the event of a crash.
A newborn or young infant’s head is heavy and the neck muscles are weak. If the recline angle becomes less and the car seat more upright, the head will flop down and obstruct the airway. A newborn should therefore be positioned in the lowest possible position, which still offers crash protection. As babies grow their neck muscles get stronger and the angle of the car seat can become more upright since their head and neck control improves.
A number of studies have looked at the level of oxygen in an infant’s blood whilst in their car seat. A level of oxygen less than 90% is considered dangerous. It was shown that children’s oxygen levels dropped as far down to 83.7% when in incorrectly positioned car seats. The authors also found that the longer the child remained in the car seat the lower the oxygen level would drop.
Another study found that a child in a correctly placed rear-facing car seat is still at risk of suffocation. The vibration produced by a car could cause newborns and young children’s head and shoulders to fall forward, despite correct use of the straps and buckles. This risk was also similar for both term and preterm infants.
Some specialists recommended that young babies spend no more than 30 minutes to an hour in a car seat at a time. If a long journey is unavoidable it may be wise for someone to sit in the back with your child to keep an eye out.
STRAPS AND BUCKLES
Always make sure your child is properly securely in a car seat. If the straps are too loose a child can easily slip or even wriggle down far enough to become strangled by the straps. If the child falls lower down in the seat the child may also suffocate from an obstructed airway if the head falls onto the chest.
Never place your baby in a car seat on a soft surface such as a bed or couch. This type of surface could cause the recline angle to change resulting in your child’s head falling forward and obstructing the airway.
Never loosen or unbuckle any straps if you do decide to keep your baby in a car seat outside of the car. A child can wriggle and slip down far enough to be strangled by the straps and even fall out of the car seat altogether.
Never leave an infant or young child unsupervised in a car seat if they are asleep or even if they are awake.
Never place your baby in a car seat on an elevated surface such as a table. A baby can wriggle enough to cause the seat to move and fall off the surface.
Never place your baby in a car seat on the floor without looking at the recline angle. Some car seats may become more upright when placed on the floor.
Always make sure your car seat is installed correctly. Most car seats come with a built-in indicator that allows you to see if the seat is installed at the proper angle.
Read the manual carefully and if in doubt contact the local manufacturer or distributor. You can also contact Julie at Precious Cargo (www.preciouscargo.co.za) to book a professional car seat installation.
Arya, R., Williams, G. and Kilonback, A. et al. (2017) Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle. Arch Dis Child Fetal Neonatal Ed, [online] 102, pp. 136-141. Available from: https://fn.bmj.com/content/fetalneonatal/102/2/F136.full.pdf [Accessed 13 September 2018].
Batra, E.K., Midgett, J.D. and Rachel Y. Moon (2015) Hazards Associated with Sitting and Carrying Devices for Children Two Years and Younger. The Journal of Pediatrics, [online] 167, pp. 183-187. Available from: http://dx.doi.org/10.1016/j.jpeds.2015.03.044 [Accessed 13 September 2018].
Rholdon, R. (2017) Understanding the Risks Sitting and Carrying Devices Pose to Safe Infant Sleep. Nursing for Women’s Health, [online] 21 (3), pp. 225-230. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28599744 [Accessed 13 September 2018].