Rainbow Pediatrics Knowledgebase
  • Knowledgebase: Child Safety, Injury Prevention and Treatment

    Questions about child safety and injury prevention, as well as treatment for minor injuries.


    25. Regardless of the law, what is RECOMMENDED for seat belt use? - Top

    Are there differences between what this law allows and what is recommended for buckling up children?

    Legal requirements can be considered to be "minimum standards" for motor vehicle occupants. What is allowed under the law is not necessarily what is recommended to provide the best protection for a child or adult. For instance, switching a child to a seat belt at 40 pounds is legal, but seat belts do not fit small children very well and belt-positioning booster seats are recommended for children too small for the belts to fit well. Recommendations are that for best protection:

    A child less than one year of age, OR less than 20 pounds, should ride in a rear-facing infant-only or convertible safety seat. Many convertible seats are rated to at least 30 pounds rear-facing so that almost all children can be kept facing to the rear as long as possible.


    Children at least one year old AND who weigh at least 20 pounds should ride in a front-facing seat with a full harness or harness-shield until it is outgrown, usually at about 40 pounds. At least one model can be used with the harness up to 60 pounds.


    Children should switch to a belt-positioning booster seat when the full harness seat is outgrown and continue riding in the booster seat until the seat belt fits correctly without the booster seat. Belt-positioning boosters are designed to make the lap/shoulder belt fit correctly on the child and should be used until the child is really big enough for a seat belt. Add-on shoulder belt adjusters are not recommended since they are not covered by any Federal standards and may, in fact, do more harm than good.


    Children should not be switched to a seat belt until the child is big enough for a correct fit of the belt and is mature enough to sit reasonably still. This may not be until the child is 70-80 pounds and about 4½ feet tall. When wearing a lap and shoulder belt, it is important that both the lap and shoulder belts be worn and positioned correctly. Never tuck the shoulder belt under the arm or behind the back. Lap belts alone should be used if nothing else is available. Currently there are no booster seats on the market that are certified for use over 40 pounds in a lap belt only-equipped position, so options for larger children are limited. Safer options for lap-belt-only positions are as follow:


    Purchase and use a full harness CRS with a weight range higher than 40 pounds. Call the Highway Safety Research Center for more information and currently available products.
    Order, install, and use a harness that can be used for children over 40 pounds. These require extra installation, but do provide good upper body protection in lap belt only positions. Call the Highway Safety Research Center for more information and currently available products.
    Check with your local car dealer or vehicle manufacturer to see if retrofit shoulder belt kits are available for the rear seat. If so, these can be installed and a child can be secured in a belt-positioning booster.


    At no age or size should any child or adult ride unrestrained in the vehicle or ride in a non-belted position such as the back of a station wagon or pickup truck bed.
    - Updated: May 22, 2001

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