Car Safety

Motor vehicle injuries are the leading cause of preventable death and disability in children in the USA. Using the right car seat the right away can prevent your child from getting hurt!

Vehicle Safety Information & CarSeat Review Sites:

The CDC 
The CarSeat Lady (PICU mommy doctor who specializes in car safety)
CarSeats For the Littles
The CarSeat Blog
Safe Kids Worldwide
Bureau of Highway Safety
NTHSA Car Safety

My tall 7 year old son, very comfortable in his full car seat, making a silly face

The Biggest Mistakes Parents Make:

1) Not installing the carseat properly

Most parents think they have installed the car seat correctly themselves, but 71% of car seats are not installed or used correctly!

The best thing to do is have your car seat installed and checked by a certified professional. You can find car seat inspection locations here and here.

You can get advice on how to install all types of car seats here.

2) Putting the baby/child in with straps too loose, too high or low, and the chest clip not at the chest

Many parents place their child in the seat, but leave the chest clip too low and/or the straps too loose. The Car Seat Lady has a nice video explaining how to get your new infant in the seat just right. Remember, the chest clip should always be at armpit level. See above graphics (borrowed from the internet) for more information.

3) Turning a toddler forward facing too soon

Children should be at least 2 years old and have reached the maximum weight or height for rear-facing in their chair, before being turned around. Regardless of age or size, it is 5 times safer to be rear-facing!!

This video demonstrates why kids under 2 years old are in greater danger when facing forward in a crash.

This blog post by Dr. Stuppy is my favorite explanation on why kids should be rear-facing and stay in car seats as long as possible.

This website goes over common car seat direction myths.

4) Putting a child in a booster, instead of a car seat, too soon

Parents often want to move their kids to booster seats as soon as possible, for the convenience of having a lighter, more portable, cheaper seat, but it's NOT convenient if your child is hurt in a minor accident because you moved them too soon (and it will cost you a lot more money than a new car seat, too).

Children will always be safer in a 5 point restraint (aka harness system), than using a regular seat belt. I often remind my patients that race car drivers use a harness system, and don't rely on simple seat belts to keep them safe.

More information on how to decide when your child can move to a booster can be found on CSFTL and TheCarSeatLady.

5) Letting the child use a regular seatbelt too soon

This is also a matter a cost and convenience, as well as peer pressure, but don't let what other people do put your child at risk. Most children need to ride in a booster seat until at least age 10, since they need to be at least 57" (4 foot 9) to fit with a regular seatbelt. TheCarSeatLady has another good explanation on how and why booster seats work. Aside from height, they also need to be mature enough to sit straight and still i  the car, since if they are leaning over in a crash, the seatbelt will not be in the proper place, and may not protect them as well as it can.

6) Letting a child/tween sit in the front seat

Children that are not fully skeletally mature (e.g. have not gone through puberty yet), and are younger than 13 years, should not sit in the front seat. Dr. Burgert does the best job explaining why on her blog. Regardless of age, size, or type of seat, everyone is safer in the back seat.

No one wants to think about getting into a car accident, especially when you're transporting your most precious cargo. But with tens of thousands of deaths from motor vehicle collisions every year, no parent can afford to take chances. The odds are reasonably high that you will be involved in some kind of car accident before your littlest one turns 18. If your children are with you, you want to have done everything in your power to reduce the risk that they will suffer serious injury, and you will demonstrate to them the importance of car safety for when they have families of their own.

Traveling with Children

Fortunately for us modern moms and dads, anywhere we want to go is just a plane, train, or automobile ride away. Despite the conveniences of modern transit, traveling with children remains a difficult endeavor. Here are a few tips to make your journey a little smoother:

1) Know your rights.
This sounds funny, but a lot has recently changed in U.S.A. airport security rules. For example children under 12 do not need to remove their shoes during screening. According to the TSA's website, you may carry as much juice and milk for toddlers as you "need until you reach your destination". The precise definition of how much you need varies by who is screening you at security.  During one trip with my then 1 year old, the security agent at LAX insisted that 3 small juice boxes was too much for a 5 hour flight, and threw all of our drinks away. I did not know enough to argue and instead I spent $$$ buying some non-organic, non-dilute juice for my child at the airport :( This also brings up the point to remember to be flexible, and give your self extra time for the unexpected.
For the latest information, check out the government's website:
http://www.tsa.gov/travelers/airtravel/children/index.shtm

2) Know your company.
Certain airlines and hotel chains are better at hosting children than others. Conversely, some airlines have recently banned children from first class on their flights, so don't expect an upgrade (or even friendly service) on those airlines. Malaysia Airlines is going to institute a "child free zone" even in their economy cabin on some flights. In general, European and Asian companies have been known to be friendlier to children on flights than USA airlines, often providing coloring books, special snacks, small toys, and other treats for families. Some airlines offer pre-boarding for families with infants and toddlers, while others have none. This may be more annoying than you think. When traveling with our then 2 year old, we had to wait until first class, business class, and everyone with a silver/gold card from the airline boarded (more than half of the passengers) before we were allowed to get on with a toddler, car seat, and hand luggage. Trying to get past the tiny aisle with people everywhere and a large car seat was not fun, and I think it disturbed the other passengers as well. Allowing us to board early, install the car seat and settle in would have prevented a lot of hassle for everyone. However, when we got to our destination we stayed at a hotel that provided us with squeaky bath toys and other amenities in the room that made us feel like family.
Here is a recent article from yahoo on the most family friendly airlines:
http://travel.yahoo.com/ideas/best-airlines-for-families.html

3) More tips just for flying with children:
- Try and book a flight with as few stops as possible, as take-off, landing, and boarding are the toughest times.

- Make sure you have assigned seats together in advance. Many companies have been separating families on flights, and then you rely on your fellow passengers to switch seats so you can sit together.

- I take our car seat when flying with my son, to make sure he is strapped in securely during our flight. This also ensures that he has a safe car seat for automobile travel when we arrive at our destination. It is also easier for him to fall asleep during the flight in his car seat, and more difficult for him to annoy other passengers by kicking them or climbing on the chairs. We use a GoGo Kidz Travelmate to turn the car seat into a stroller at the airport.

- To avoid pain from the changes in pressure in the ear during flights, teenagers and adults can chew gum or drink water to encourage swallowing, and thereby open up the eustachian tubes in their ears to relieve the pressure. For babies the best way to do this is breast (or formula) feeding. Breast (or formula) feeding has the added bonus of providing sugar to the infant, which is a natural pain reliever. For toddlers, diluted juice in a straw cup works well. Older children can suck on lollipops to get them swallowing (and happy and distracted by candy). Nasal sprays can also help relieve congestion and prevent pain during the flight, but speak to your pediatrician about this (salt water sprays can help babies with stuffy noses, while kids with ear infections or sinus problems may need a prescription nasal spray). If all this ear tube talk is confusing, check out the ear anatomy pics here:
http://pinterest.com/motek42/ear-infections/

- I recommend waiting as long as possible before flying with infants. The younger an infant is, the less developed their immune system, and the more likely they are to get sick. The air on airplanes is re-circulated so it is very easy to pick up germs from other travelers, even ones who are seated far away from you. Infants younger than 2 months old who catch an illness with fever may have to undergo extensive testing, including blood, urine, and spinal fluid exams if they get sick. I know this is not possible for all families, but waiting until your infant is 9 months or older can save you a lot of hassle and illness later on. In addition, the USA is currently experiencing a surge in measles cases, most of which can be traced to foreign travel- see these links for more information:
http://www.reuters.com/article/2012/04/19/usa-health-measles-idUSL2E8FJDSD20120419
http://wwwnc.cdc.gov/travel/page/measles-for-air-travelers.htm
And don't forget to check the CDC website, and make an appointment with your pediatrician at least 2 months prior to any foreign travel, so you can get medications and vaccinations for your trip.

4) Have your bags packed with items that will keep your child calm, quiet and comfortable. 
I prefer small, light items. If you are used to distracting your child with your phone or other electronic items, keep in mind that you will not be able to use them on take-off or landing, and they might run out of batteries on long car trips, so make sure to pack low-tech items as well. I recommend packing a carry-on or car bag with:

• baby wipes (good for cleaning up messes for kids of all ages)
• snacks
• your own sippy cups or bottles
• four more diapers than you think you need
• several different sizes of ziplock bags (for messes, soiled clothes, soiled diapers, and they are just generally handy to have)
• a medical bag (children's acetaminophen, children's ibuprofen, children's benadryl, bandaids)
• sunscreen (the sun through a car's windows can burn a child, and then sun through a plane's window has more radiation than down on the ground, so slather yourself and your child with sunscreen to avoid sunburns and -much later- skin cancer)
• lollipops for age 4 and above
• extra clothes (even for older children, as it's easy to get spilled-on during a flight or car trip, and you never know if, when, or where you'll get stuck)
• books
• re-usable stickers
• dry-erase crayons and board
• a soft blanket
• your child's lovey (favorite blankey, stuffed animal, or other comfort item). 

I've linked to a few of these items, as well as book suggestions, on pinterest:
http://pinterest.com/motek42/traveling-with-children/

This blog has many more great travel tips, and this link is for a funny story illustration why you shouldn't feel bad about that huge carry on with all of the extra supplies:
http://eatpackgo.com/pack/pack-diaper-ninja/

Traveling with children is a lot more stressful then traveling alone, but with patience, planning, and a large bag it can be a fabulous adventure.

Have any good tips or links of your own? Please tell us in the comments!

(photo of my son in his car seat, looking out of the airplane window, photo taken by me 2009 (c) )