Everything You Ever Wanted to Know About #%!@% Car Seats

Car seats are confusing! But also important.

Photo by Sean/busbeytheelder/Flickr via Creative Commons

There are many things we do in private that we hope others never see. Installing a car seat is up there for me. Having just moved from New York City, where I rarely drove anywhere, to the country, where I rarely walk anywhere, car seats have suddenly become part of my daily life, and even though I know they may one day save my son’s life, I do not get along with them. When I’m fighting to install one into my car by myself, the process invariably involves instruction manuals (for my car seat and my car), YouTube installation videos (necessary since my manuals seem to be written in Pirahã), ample cursing, and me punching the car seat. Whoever said violence is never justified clearly never owned a Britax.

Most parents will agree car seats are a bitch to install; worse, the stats suggest that three out of four times, we’re doing it wrong. But the angst surrounding car seats does not end with installation—pretty much everything about them is ridiculously confusing. The American Academy of Pediatrics recently changed its recommendations on when to use which types of seats, but chances are, your state law disagrees. Rumor has it that next year, the National Highway Traffic Safety Administration will tell parents to stop using the Lower Anchors and Tethers for Children system (LATCH) to secure car seats once the combined weight of your car seat and your child exceeds 65 pounds, which begs the question—do you know how much your car seat weighs? I don’t even know how much my kid weighs. Then there is the Freakonomics claim that car seats are in fact useless, the Consumer Reports debacle in which the organization apparently had to recall some reviews after screwing up its safety tests, and, oh yeah, the fact that some car seats simply do not fit in some cars. But hey, guess what? Your kid should be in a car seat until she’s 8 years old and don’t even think about letting her ride in the front seat until she’s 13. K?

Punch a car seat; it’ll make you feel better. Then read on, because I’m going to try to answer some of the many exasperated questions many of us have pondered about car seats in recent years.  

First, the very basics: Why these insufferable plastic contraptions are well worth the hassle. Car seats can be life-saving, and to understand why, we have to go back to high school physics. When your car flies down the highway at 70 mph, you go this fast, too. This means you and your car have a heck of a lot of momentum, a figure that reflects speed and mass. When you come to a rapid halt in a collision, your car’s momentum has to drop quickly, which requires force—a force that deforms your car, among other things. Your own momentum must drop, too; you have the choice of flying through the windshield and letting the force of hard pavement stop your momentum, or you can use a seat belt, which does the same thing but a little more amiably.

Seat belts do more than just keep you from becoming a projectile; they are also slightly elastic, so they lengthen the time over which your momentum slows (as opposed to if you’d slammed into the pavement), which ultimately reduces the total force on your body at any one time. That’s good. Seat belts also ensure that this force hits two of the strongest parts of your body—your pelvis and your shoulders—and that your more delicate tissues, such as your genitals, abdomen and neck, remain unscathed (unless your car gets crushed to the point of crushing you, too). So: Seat belts are awesome.

Car seats, however, are better—which is important because car crash injuries are more dangerous to children than adults. Motor vehicle accidents are the No. 1 cause of death in children; more than one-third of kids who died in accidents in 2011 were unrestrained. “For a kid, things can come apart much more easily. When we sustain whiplash, they can break their necks,” says Ben Hoffman, a pediatrician and car seat specialist at the Oregon Health and Science University in Portland. Forward-facing car seats, which the American Academy of Pediatrics now recommends kids use from ages 2 to at least 4, have five-point harnesses. They distribute the force associated with impact across an even larger area—there are more straps coming into contact with your kid’s body—which means less force being applied to any single point. According to Partners for Child Passenger Safety, a long-standing research partnership between the State Farm Insurance Company, the Children’s Hospital of Philadelphia and the University of Pennsylvania, forward-facing car seats really do save lives: When these car seats are not seriously misused—i.e. when parents actually strap their kids in and attach car seats to their cars (apparently some don’t even try?)—car seats of all types reduce a 2- to 6-year-old child’s risk of death in a serious crash by an average of 28 percent compared with seat belts.

But it’s the rear-facing seats that are the real life-savers for kids under 4. Most crashes are frontal, which means that the force applied to riders typically comes from the front. Rear-facing seats distribute the force of impact along the entirety of the backside of your child’s body. Again: same force, but it’s distributed across a much greater area still, which means, yes, less damage. Rear-facing seats also prevent kids’ heads from flying forward as happens to forward-facing passengers. Head-flying is bad for neck muscles and bones, as they have to snap the head back in place (would you want to use your neck as a bungee cord?). One recent study  reported that newborns to 2-year-olds were 76 percent more likely to be seriously injured in a car crash when they were in forward-facing car seats compared to rear-facing car seats. Seventy-six percent is a lot. In 2011, the American Academy of Pediatrics changed its recommendations to say that kids should remain in rear-facing car seats until at least the age of 2 (they used to say age 1); many state laws are not this strict—they are still, I guess, catching up with the science—but I’d do what the doctors say.

Photo by Glenn Fleishman/Flickr via Creative Commons

What about booster seats, which the AAP says you’re supposed to use for 4 to 7-year-olds who have outgrown their forward-facing harness seats? They don’t protect quite as well as the harnessed seats and not nearly as well as rear-facing seats, because they use only the seat belt as a restraint. They are, however, important to ensure that seat belts actually sit where they are supposed to. When kids under 8 wear seat belts without booster seats, the belts can cut across their necks and abdomens, which is precisely where you do not want a massive amount of force to hit your kid. A 2009 study conducted as part of Partners for Child Passenger Safety found that kids between 4 and 8 were 45 percent less likely to sustain moderate to serious injuries in crashes when they were restrained in high-back or backless booster seats to lap-and-shoulder seat belts alone—and this reduction in injury risk went up to 67 percent for kids in post-1998 car models.

Do you know how much your car seat weighs? I don’t even know how much my kid weighs.

 What’s important to keep in mind, though, when considering all these studies is that parents who use car seats may differ from parents who don’t use car seats in many important ways. They may drive safer cars and drive more slowly, for instance, both of which could also influence injury risk. Researchers attempt to control for these confounding factors to isolate the effects of car seats themselves, but these controls are never perfect.

In fact, a small body of research downright contradicts many of the studies I have just mentioned. In 2005, University of Chicago economist Steven Levitt and journalist Stephen Dubner, co-authors of the bestselling Freakonomics published a controversial piece in the New York Times Magazine arguing that “there is no evidence that car seats do a better job than seat belts in saving the lives of children older than 2.” Their assertions were based on several studies Levitt conducted. One mined data from a federal database called FARS, which records the details of U.S. crashes that kill at least one passenger, and found that kids over 2 were no less likely to die in crashes while in car seats than were kids wearing lap-and-shoulder belts. Another Levitt study using crash data from a national database and those of several states found that for kids aged 2 to 6, car seats did not prevent serious injuries any better than lap-and-shoulder belts did. Car seats did, however, reduce the risk of minor injuries by 25 percent.

Source: http://www.slate.com/articles/double_x/the_kids/2013/10/car_seats_from_rear_facing_to_forward_facing_to_booster_everything_you_need.html
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