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Car Seats - Newborn Safety Tips

Designed for newborns, infant car seats click into and out of a base that can remain in the vehicle. They are padded and can use tightly rolled blankets for head and neck support.

Preterm babies may experience bouts of apnea, bradycardia or oxygen desaturation in the car seat. NICU staff often test them for 90 minutes or so in the car to ensure they pass.
Place it Backwards

Car seat safety experts including the American Academy of Pediatrics and the National Highway Traffic Safety Administration advise keeping children rear-facing in their infant car seats until they are two years old or up to their vehicle’s highest height or weight limit. Research has shown that rear-facing infants are 71 percent less likely to sustain neck injuries in the event of a car crash when compared to forward-facing babies and toddlers.

Many infant car seats come with bases that snap into your car and then lock in and out for easy transportation of your child. When installing the infant car seat on the base, make sure the base is at a safe angle by checking the built-in indicator or adjustor. If the base isn’t at a safe angle, push down firmly on the center of the base to pull out any slack in either the Lower Anchors and Tethers for Children (LATCH) strap or seat belt connection.

Once you’ve positioned the infant car seats cheap car seat on the base, place your baby inside and buckle the harness straps over their shoulders. The harness slots are usually located at or above your child’s shoulder level, so be sure to use the right slot and don’t forget to buckle the chest clip. It’s best to dress your baby in thin layers. Bulky clothing, like winter coats or snowsuits, can compress in a crash and leave the harness straps too loose to restrain your child. If the harness straps are loose, place tightly rolled blankets in between the strap and your baby’s body for head and neck support.

If you don’t have a spot to stand behind the car seat while pulling on the latch or seat belt, try putting one hand on the center of the base, while using the other hand to pull the buckle or latch strap until it’s tight. If you have someone else available, they can also help by holding the base to keep it from shaking side to side and front to back while you pull.

Once your child outgrows their infant car seat, it’s time to switch to a convertible or all-in-one car seat configured as a rear-facing seat. It’s important to keep your child in a rear-facing car seat with a harness and tether until they reach their vehicle’s highest height or weight limit.
Tighten the Harness Straps

A car seat is only as safe as the straps that hold it. In order to tighten a harness, you should always follow the manufacturer’s directions to remove any slack and then do the pinch test. This test is simple enough: you just secure the straps over your child and then try to grab a piece of the seatbelt fabric at their collarbone with your fingers. If you can’t do this, the harness is not tight enough.

Many infant car seats have firm padding that can help improve the fit of a small baby. This padding lifts the child up and helps them reach the lowest shoulder strap slots, which are safer for newborns. The pad can also prevent the chest clip from hitting the soft parts of a baby’s neck or throat. However, it is important to check the manufacturer’s instructions before removing any infant inserts, as this can cause the chest clip to be positioned too high and expose your baby to an increased risk of being ejected from the car seat in a crash.

Another common issue with car seats newborn seat straps is that they are not evenly tightened. This can be caused by a few things. The most common reason is that a baby’s body has been turned to one side, scooted forward or shifted to the other side, which can cause one side of the harness to become looser than the other. It’s also a good idea to avoid putting anything thicker than a sweatshirt between your child and the harness straps, as this can make them feel uncomfortable or cause a gap that could allow them to slip out of the seat in a crash.

Some infant car seats have a harness adjuster that allows parents to easily adjust the strap height from the back of the seat. This is often easier to use than the re-thread type of harness that requires parents to uninstall and reinstall the car seat in order to adjust the straps. However, no matter what type of harness adjuster a car seat has, it’s still important to pull the straps evenly from the front and back of the seat to ensure they are both equally tightened.
Do the Pinch Test

Car seat testing can be one of the last steps that NICU babies need to go home, but it doesn’t have to be scary! It’s important to make sure baby’s harness is tight enough and that they are sitting at the correct angle. The pinch test is a good way to check for these factors.

You can do this by placing your child in their car seat and positioning the chest clip at armpit level. Try to pinch the strap webbing at their collarbone or shoulder – if you can, it’s too loose and needs to be tightened. You can also pinch the crotch strap to see if there is too much space between the crotch buckle and their diaper, as this can lead to slouching in the seat over time, causing dangerous chin-to-chest positioning. If your infant seat allows it, you can try a crotch roll (a rolled washcloth placed between baby and the crotch buckle) to prevent this from happening.

When you are ready to do the pinch test, be sure baby is well-fed and isn’t wearing a jacket or snowsuit, as this can increase the amount of space between their back and the seat, making it harder to pass the pinch test! You should also avoid putting baby in their car seat while they are sleeping, as this can affect their breathing and heart rate.

If you are able to, ask if the hospital has a certified child passenger safety technician (CPST) on staff so they can do your baby’s car seat test! This will give you the opportunity to ask any questions about your child’s specific seat, so you know how to use it properly. Ask if you can be present when the test starts, too – this will help to ensure that your child is comfortable and happy while they are being tested.
Dress Your Baby

During the winter, it’s important to keep your baby warm when they ride in their infant car seat. It’s also important to remember that the bulky clothing you might put on them could interfere with how the car seat’s harness works to hold them in place, increasing your baby’s risk of injury in a crash.

Dressing your newborn in thin layers is usually best, especially when they’re swaddled. Once they’re over the swaddling stage, you can add extra warmth with blankets or even a poncho that goes over their harness straps after they’re buckled in. Avoid products that line the car seat and act as sleeping bags, which can be unsafe and prevent you from tightening your infant’s harness straps properly.

A crotch roll can help keep your newborn warm and safe in their infant car seat, but make sure you use it correctly. To do this, roll a washcloth into a tight roll and insert it between the crotch buckle webbing and your child’s bottom. This will keep their legs warm, and it helps reduce the chance of their feet getting cold.

While it may seem counterintuitive to remove a snowsuit or jacket before strapping your baby into their car seat, it’s important to do so. The fluffy material can compress in a crash and leave too much wiggle room between your baby’s body and their harness straps, which increases the risk of injury.

Once your child outgrows their infant car seat newborn car seat, they’ll need a booster seat until they’re old enough to safely ride in a front-facing or back-facing car seat without a harness. While most children don’t outgrow their infant car seats until they’re between nine months and a year, you can easily tell it’s time to upgrade when the top rated infant car seats of your child’s head is within an inch of the seat’s highest position.

It’s also important to keep your infant warm in their booster seat, which isn’t a convertible car seat. You can try using a blanket over the shoulder straps to prevent them from slipping, or a poncho that covers the chest clip at armpit level. Putting a small layer of fleece over the shoulder straps can also help keep them warm and safe in their booster seat.