According to the Centers for Disease Control and Prevention (CDC), motor vehicle accidents are the leading cause of death in children in the United States. Their studies show just how preventable many pediatric deaths and injuries can be with the proper use of passenger restraints:

Buckling children in age- and size-appropriate car seats, booster seats, and seat belts reduces the risk of serious and fatal injuries:

  • Car seat use reduces the risk for death to infants (aged <1 year) by 71%; and to toddlers (aged 1–4 years) by 54% in passenger vehicles.
  • Booster seat use reduces the risk for serious injury by 45% for children aged 4–8 years when compared with seat belt use alone.
  • For older children and adults, seat belt use reduces the risk for death and serious injury by approximately half.


Here are the age-appropriate and size-appropriate guidelines for passenger restraints in children, courtesy of the AAP and CDC (and worth bookmarking to your browser):

  • Birth to age 2 (Infants and Toddlers)rear-facing infant or convertible car seats until they are at least 2 years of age or until they reach the highest weight or height allowed by their car seat’s manufacturer. (Check instruction manual.)
  • Age 2-5 (Toddlers and Preschoolers)forward-facing convertible seats or car seats with 5-point harnesses for as long as possible, up to the highest weight or height allowed by the car seat manufacturer.​
  • Age 5 and up (School-Aged)Booster seats which utilize the vehicle’s seat belt until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches (or 57 inches) in height and are between 8 and 12 years of age.
  • Age 8 and up (Older Children)Lap and shoulder seat belts once they fit properly (height greater than 57 inches): when the lap belt lays across the upper thighs (not the stomach) and the shoulder belt lays across the chest (not the neck).


Here are some other key rules:

  • Install car seats and booster seats properly. Read the instruction manual that comes with the car seat as well as your car’s owner’s manual. Find a Child Passenger Safety (CPS) technician to confirm correct installation.
  • Buckle all children under 13 years old in the back seat. 
  • Never place a car seat, booster seat, or belted child in front of an airbag. Airbags are designed to protect adults; when deployed in a collision, front and passenger- side airbags can cause serious injury and even death in children.
  • Seat children in the middle of the back seat whenever possible, as this is the safest spot to be in the event of a side collision.
  • Use the proper restraints for every trip. No matter how short the trip, how much of a pain it is to properly restrain your child, or how little your child enjoys being restrained, be patient and consistent, and never hold a child on your lap. Make sure other adults take the same care you do in restraining your child properly.
  • Be a good role model — Always wear your seat belt!


We’ll spend the next two days on The PediaBlog discovering the right way — and wrong way — of using a car seat.