14.7: Safety
- Page ID
- 225507
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)- Identify the leading causes of injury and injury-related death among children in early childhood.
- Describe common types of unintentional injuries.
- Explain the importance of caregiver supervision and environmental safety in reducing the risk of injuries.
- Summarize best practices for car seat safety, including the rationale behind extended rear-facing use and the appropriate transitions to booster seats.
- Recognize how laws and misconceptions can influence unsafe practices in vehicle safety for children.
Injuries and Accidents
| Type of Injury | Prevention Tips |
|---|---|
| Burns |
|
| Drowning |
|
| Falls |
|
| Poisoning |
|
| Motor-accident, in vehicle |
|
| Motor-accident, pedestrian |
|
Car Seat Safety
In spite of all the technology and sophisticated systems available in vehicles, car crashes are still a leading cause of death and injury to children (National Highway Traffic Safety Administration [NHTSA], 2021). The American Academy of Pediatrics and safety experts strongly recommend that children remain in a rear-facing car seat for as long as possible, yet many parents transition their children to forward-facing seats too early. This issue is compounded by confusing and inconsistent language in passenger safety laws, leading to misinterpretation and premature forward-facing transitions (Hoffman et.al, 2022).
For example, in Kansas, it is required that infants from birth to 1 year old and weighing up to 20 lbs ride in a rear-facing position. Between 20-40 lbs and over 1 year old, children may ride forward-facing. But this does not mean that they should; it just means that they can. Studies show that many caregivers assume the legal minimum is the safest recommendation (Hoffman et.al, 2022).
Rear-facing car seats are designed to distribute crash forces across the child's back, head, and neck, significantly reducing the risk of severe injury or death (Bull & Durbin, 2008). Young children have underdeveloped musculoskeletal systems (including their neck muscles and spinal structures) coupled with disproportionately larger heads, making them highly vulnerable to injury in a crash. In a frontal crash, a forward-facing child's head is thrown forward, placing extreme stress on the neck and spine, which can lead to internal decapitation- a fatal injury where the spinal cord separates from the skull (Arbogast et.al, 2017).
Figure \(\PageIndex{2}\): Rear-facing 3-year-old child. Image by Heather Carter is licensed CC BY-NC-ND 4.0
Many convertible car seats now have extended rear-facing limitations, allowing children to remain rear-facing until they weigh 40-50 pounds. Most children will outgrow the maximum height of the seat, as seat straps in a rear-facing position must sit just below the shoulders, before they will exceed the upper limit of the seat.
Once the child has outgrown the forward-facing seat with a 5-point harness, they should transition to a booster seat. When should a child move to a booster seat? It is safe to move to a traditional booster seat when "yes" can be answered to all the statements below.
- There's a shoulder and lap belt.
- The child is at least 40 lbs.
- The child is at least 5 years old.
- The child can sit properly for the entire trip without leaning forward, slouching, playing with the shoulder belt, or sitting on their knees.
Young children under the age of 5, or even 6, are safer in a 5-point harness if they still fit in it (The Car Seat Lady, 2025).
References, Contributors and Attributions
Arbogast, K. B., Jermakian, J. S., Ghati, Y., & Andersson, M. (2017). Rear-facing versus forward-facing child restraints: An updated assessment. Traffic Injury Prevention, 18(2), 177-183. https://doi.org/10.1080/15389588.2016.1232001
Bull, M. J., & Durbin, D. R. (2008). Rear-facing car safety seats: Getting the message right. Pediatrics, 121(3), 619-620. https://doi.org/10.1542/peds.2007-3282
Hoffman, B. D., Gallardo, A. R., & Carlson, K. F. (2022). Misinterpretation of state car seat laws: A barrier to optimal child passenger safety. Journal of Injury Prevention, 28(2), 103-110. https://doi.org/10.1136/injuryprev-2021-044376
National Highway Traffic Safety Administration. (2021). Traffic safety facts: Children. https://crashstats.nhtsa.dot.gov
The Car Seat Lady. (2025). Booster science: How and why they work. Retrieved from: The Car Seat LadyBooster Science: How and Why They Work - The Car Seat Lady