Motor vehicle crashes are the number one killer of children ages 2 to 14, and every year, many children are injured in crashes. So how can you help a child in your car travel safely? Use a properly installed child safety seat, booster seat or the vehicle seat belt every time a child rides in your vehicle.

The University of Vermont Children's Hospital Child Passenger Safety Program offers car seat inspections, education and outreach. Call (802) 847-1215 to schedule an inspection or for more information about our program.

For Pediatric Clinicians: Child Passenger Safety Guide

Correct Car Seat Use

For maximum child passenger safety, simply remember and follow these Four Stages for all kids, in every vehicle! (Photos courtesy of the National Highway Traffic Safety Administration)

Use rear-facing seats for infants and toddlers until they reach the highest weight or height allowed by the car seat manufacturer. Never place a rear-facing seat in front of an active airbag.

More about rear-facing car seats:

In 2018, the American Academy of Pediatrics (AAP) updated their recommendations to state that infants and toddlers should ride in a rear-facing child safety seat for as long as possible, until they reach the highest weight or height allowed by their car seat. For most children, this will be well after their second birthday and probably closer to, or even beyond, age 3. Rear-facing supports the head, neck, and spine and allows the car seat to absorb most of the crash forces. Some states, including New York, have laws requiring rear-facing to at least 2 years old.

As rear-facing children get bigger, parents often ask, "What about leg injuries?” Legroom is not a safety issue, as children are able to bend their legs easily and find a comfortable position. The AAP has concluded that rear-facing does not increase the risk of leg injuries.

Choosing a car seat for your new baby can be complicated. The best seat is one that fits your car, your child, your budget and that you will use correctly every time you drive.

Use forward-facing car seats for children until they reach the highest weight or height allowed by the car seat manufacturer. Always use a top tether with a forward-facing car seat.

More about forward-facing car seats: 

A car seat harness spreads crash forces over a large portion of the body, protecting developing bones and muscles. The harness holds the hips and shoulders and slows the body down as the car comes to a stop. The harness also helps to keep the head and upper body away from the interior surfaces of the vehicle. This is why it’s important to keep children in a harnessed seat for as long as possible. Most car seats harness forward-facing to 65 pounds.

Your child has outgrown their forward-facing seat when one of the following things happen:

  • The tips of the child's ears pass the top of the car seat shell, OR
  • The child's shoulders pass the top harness slot, OR
  • The child’s total height exceeds the limit stated by the car seat manufacturer, OR
  • The forward-facing weight limit is met*

Always use a top tether with a forward-facing car seat (the tether is a strap with a hook on the back of a forward-facing car seat). See this Safe Kids infographic on why and how to use a tether for a forward-facing car seat.

*Note that most seats have a weight limit for using the lower anchor attachments for installation. Reaching the weight limit for lower anchor use probably doesn’t mean your child has outgrown their seat – it just means you have to switch from lower anchors to the seat belt to install the seat.

Use belt-positioning booster seats for children under 8 years old who have reached the forward-facing limits for their harnessed car seat. Always use a booster seat with a lap and shoulder belt – never a lap-only belt.

More about booster seats:

With a belt-positioning booster seat, the adult seat belt, rather than a harness, restrains the child. The booster positions them so that the seat belt fits correctly – the lap belt lies low and snug across the upper thighs, and the shoulder belt crosses the middle of the chest and shoulder, off the neck.

It is best to wait until your child is 5 to 6 years old to use a booster seat. This is not only because they will have the right physical development, but they will also be mature enough to keep the seat belt properly positioned – no slouching, putting the belt behind their head or under their arm, or leaning over to reach a toy or bother a sibling. 

Use the seat belt when a child is at least 8 years old and the seat belt fits them correctly. All children younger than 13 years should ride in the back seat. Make sure you and everyone else in the car buckles up, too.

More about seat belts: 

To wear an adult seat belt without a booster seat, children must be eight years old AND the seat belt must fit them properly. Follow this five-step checklist in any vehicle in which your child rides. If you answer "no" to any of these questions, the child should remain in a booster seat, regardless of age.

  • Does the child sit all the way back against the vehicle seat?
  • Do the child's knees bend comfortably at the edge of the vehicle seat with the feet touching the floor?
  • Does the belt cross the shoulder between the neck and arm?
  • Is the lap belt as low as possible, touching the thighs?
  • Can the child stay seated like this for the whole trip?

Seat belts save thousands of lives each year. Research shows that when caregivers buckle up, children are more likely to as well – so remember to put on your own seat belt, and make sure everyone else who rides with you does, too.

Office logo of W.H.A.L.E

We Have a Little Emergency

Even when passenger restraints are used properly, a crash or other medical emergency may make it impossible for an adult to relay key information about the children in their vehicle to first responders. We Have a Little Emergency (W.H.A.L.E.) easily provides first responders with the information they need to provide children with the best possible care. Request your Free W.H.A.L.E. Kit.

Car Seat Safety Resources

Always refer to your car seat manual and vehicle owner’s manual for specific information about your car seat or booster. To learn more about child passenger safety, refer to the following helpful resources.

Car Seat Safety Blog Posts

Additional Car Seat Resources