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10 car seat safety tips from an expert. Some of these might surprise the most seasoned parent.

Did you know that car accidents are a leading cause of preventable death for children between the ages of 1 and 13? That'sa fact.

But we can keep our kids safer by installing and correctly using car and booster seats. And before you roll your eyes and say, “Yeah yeah. Been there, done that," you need to hear what pediatrician Dr. Alisa Baer, also known as The Car Seat Lady, has to say:


“Studies show that even for parents who are on their fourth kid, car seat installation is one of the few things that people tend not to get better at."

This can truly be a matter of life and death, so buckle up — metaphorically, of course — and take a few minutes to read about these ten extremely important tips from Baer.

1. Keep the car seat straps snug.

Image by NHTSA.

“Most kids are riding around with straps that are too loose," Baer says. Properly secured snug straps, despite protests from some kids, don't cause pain. “If you're going to jump out of an airplane with a parachute, you're not going to think, 'Oh, it's snug! Let me loosen it!'" she explains.

Think of the car seat straps the same way. If you need guidance on how to ensure the straps are snug, check out this video. Also be sure to remove any bulky clothing. Things like winter coats usually make it necessary to loosen straps — which in turn makes them far less effective.

2. Keep kids rear-facing for as long as possible.


Image by NHTSA.

Once your child outgrows an infant car seat — which is always rear-facing — they'll move into a convertible car seat. Those can be used either in a rear- or forward-facing position. But “can" and “should" are two different things. Baer says you should always keep your child rear-facing until age 2 — and ideally longer, until they reach the rear-facing limits of the car seat. That shouldn't happen until your kiddo is at least 2 years old, but even then, if they're below the maximums for the car seat, don't flip them around!

A common misconception among parents is that there's a greater risk for leg injuries in the event of a crash in rear-facing car seats because it appears as though a child's legs are scrunched up. Baer assured me that kids are actually at a greater risk for leg injuries when they're forward-facing because in an accident, their feet make contact with the seat in front of them, which is simultaneously moving backward. The result is a compression injury, something that doesn't happen when the child is rear-facing.

“The leg injuries we see when a child is rear-facing are usually due to a direct impact from the intruding vehicle. At that point, it doesn't matter which way your child is facing," says Baer.

3. When your child becomes too big to rear-face, keep them as safe as possible when forward-facing.

Image by NHTSA.

“The goal now that we've turned your child forward, which makes their brain and spine less safe than when they were rear-facing," says Baer, “is to keep them as safe as we can." You can accomplish that by using the tether strap that comes on every single forward-facing car seat sold in the U.S. The tether secures to a top tether anchor point in your vehicle. This is where you'll need to break out that vehicle owner's manual to find where they're located. Since 2000, all vehicles sold in the U.S. are required to have anchors where you can secure the tethers in at least three seating positions. Got a minivan or SUV? Most of these vehicles do NOT have tether anchors in all the rear seats. Find the tether anchors and always use them for forward-facing car seats.

“Forward-facing protection is greatly enhanced by the tether," Baer explains. “It decreases how far the child's head moves in a crash by at least four to six inches. When you factor in that most seats are too loose, that can mean a difference of 12 inches or more." Because you only want your child's head to hit air in a crash and not the seat in front of them, the tethers on forward-facing car seats are vital.

Image by NHTSA.

LATCH can be confusing. It stands for Lower Anchors and Tethers for Children. LATCH is comprised of both parts on the car seat and parts in the vehicle, Baer explains. The government requires all vehicles model year 2003 and newer in the U.S. to have at least two seating positions with lower anchors and at least three positions with tether anchors. The lower anchors are meant to replace the use of the vehicle's seat belt. Most car seats (not booster seats, but actual car seats that have a five-point harness system) can be secured to the lower anchors in vehicles by using the LATCH belt on the child's car seat.

Illustration by The Car Seat Lady, used with permission.


Baer emphasized that no matter how you install the forward-facing car seat — whether with a seat belt or the lower anchors — you should always use the tether. “If you're forward-facing seat is installed with the seat belt, use the tether in addition to the seat belt," she said. “If your forward-facing seat is installed with lower anchors, use the tether in addition to the lower anchors."

So, one more time, because it's that important: Always use the tether on every forward-facing car seat!

4. Don't start using a booster seat too soon — and don't stop using a booster seat too soon.

Image by NHTSA.

For a child to safely use a booster seat, they must be at least 4 years old, weigh 40 pounds, and be mature enough to sit properly in the booster — “no slouching, no leaning over, and no playing with the seat belt." Because of that, Baer says that most kids are generally around 6 years old before they're ready for a booster seat.

When it comes to letting kids dump their booster seats, Baer notes that many parents are doing it too soon. “The goal of a booster is to keep the belt property positioned on a child's body, specifically so the lap belt stays in position on the child's lower hips during a crash."

Baer says that there's a pattern of injuries resulting from children being in accidents while not in booster seats that, while not always fatal, are life altering — things like lower spinal cord injuries resulting in paralysis and bladder and bowel injuries.

The way to prevent those? Keep your kiddo in a booster until the seat belt fits exactly the same without the booster as it does with it. (Check out the five-step test for guidance.) Most kids are 10 to 12 years old before they can ride safely without a booster.

5. Make sure everyone in the car is buckled up.

Besides keeping all of your adult passengers alive, ensuring everyone in the vehicle is wearing a seat belt means they can't become human torpedoes in the event of an accident. “Studies show that if an adult rides in the back without a buckle, the other people in the car are up to three times more likely to die in the same crash because the unbuckled adult is now a human missile," says Baer.

That sounds rather gruesome — and that's because it is. If a car seat is covering a seat belt buckle, for example, reinstall the car seat so that the buckle is available for the adult. It's about everyone's safety.

6. After you install your child's car seat, have it checked by a trained technician.

Image by NHTSA.

While many people think they can swing by a fire or police department to accomplish this, “not even 50% of them have someone trained" to do that, Baer says.

Instead, go to seatcheck.org, where you can enter your zip code to find a trained technician near you.

7. Remember that the center seat is generally the safest spot in the car for kids.

Image by NHTSA.

Children in the center seat won't take a direct hit in an accident, and there's less to hit their head on when they're in a forward-facing car seat. If you have more than one child, remember that your oldest is typically the least protected. “A newborn, for example, is more protected because they're rear-facing," Baer explains. The middle seat often doesn't have the lower anchors, which means you'll need to use the seat belt to secure the car seat (or if your child is in a booster, they'll be using the belt anyway). And remember: If your kiddo is in a forward-facing car seat, use the tether!

8. Don't text or talk on the phone while driving.

“We're not going to make a dent in fatalities until we decrease distracted driving," Baer notes. “We have an obligation to make sure not only our children, but everyone else's children are safe on the road."

9. Car seats expire!

It's not that the car seat industry is out to get your hard-earned cash, Baer says, but rather that "car seats are made of plastic, and plastic is a material that gets brittle with age. You need a seat to be strong enough to withstand an crash." Different car seats have different expiration dates, although they typically last six to eight years. Be sure you know when yours needs replacing — particularly if you're using it with more than one child.

Speaking of which, be sure to put a lot of thought into borrowed or hand-me-down car seats. You should never buy a used car seat online. If you're going to share with friends or use it for more than one child, infant seats that are in good condition are better candidates for sharing than convertible car seats or boosters, which are used for longer and generally experience more wear and tear.

10. If you've been in an accident, there's a good chance that your car seat needs replacing.

Image by iStock.

This holds true regardless of whether your child was in the car seat when the accident occurred because even an empty seat still absorbs some of the force of the crash. Baer says most manufacturers advise that the car seat requires replacement no matter the severity of the crash, but some seats have a “minor crash protocol." You can check her website to learn more.

The top three most common mistakes Baer sees are car seats that are too loose in the car, kids that are too loose in the car seats, and children who are graduated too soon (from rear-facing to forward facing or car seat to booster, for example). With some effort and care, we can all avoid those mistakes and more. It's a lot of info to absorb, but we're talking about our kids' lives.

Sponsored

Three women, three MS journeys: How multiple sclerosis looks different for everyone

Gina, Nathalie and Helga share their reactions to being diagnosed with MS and how they stay informed and positive in the face of ever-changing symptoms.

Courtesy of Sanofi

Helga, Nathalie and Gina all have MS, and their experiences show how differently the disease can manifest.

True

It’s been 155 years since neurologist Jean-Martin Charcot gave the first lecture on a mysterious progressive illness he called “multiple sclerosis.” Since then, we’ve learned a lot. We know MS causes the immune system to attack healthy tissue, including damaging the brain and spinal cord. Resulting symptoms can be debilitating and include fatigue, blurred vision, memory problems and weakness. Huge advancements in our understanding of MS and its underlying causes, as well as treatment advances, have been made in the past few decades, but MS remains a complex and unpredictable reality for the 2.8 million+ people diagnosed around the world.

Ironically, the only real constant for people living with MS is change. There’s no set pattern or standard progression of the disease, so each person’s experience is unique. Some people with MS have mild symptoms that worsen slowly but sometimes improve, while others can have severe symptoms that drastically alter their daily lives.

All people with MS share some things in common, however, such as the need to stay informed on the ever-evolving research, find various lines of support and try to remain hopeful as they continue living with the disease.

To better understand what navigating life with MS really looks like, three women shared their MS stories with us. Their journeys demonstrate how MS can look different for different people and interestingly, how the language used to talk about the disease can greatly impact how people understand their realities.

woman with horse, woman riding horseGina loves riding her horse, Benita.Courtesy of Sanofi

Gina—Hamburg, Germany (diagnosed with relapsing multiple sclerosis in 2017)

When her youngest son was 4 months old, Gina started having problems with her eye. She’d soon learn she was experiencing optic neuritis—her first symptom of MS.

“Immediately after the diagnosis, I looked up facts on MS because I didn’t know anything about it,” Gina says. “And as soon as I knew what could really happen with this disease, I actually got scared.”

As her family’s primary income provider, she worried about how MS would impact her ability to work as a writer and editor. Her family was afraid she was going to end up in a wheelchair. However, for now, Gina’s MS is managed well enough that she still works full-time and is able to be active.

“When I tell somebody that I have MS, they often don't believe me the first time because I don't fulfill any stereotypes,” she says.

Overwhelmed by negative perspectives on living with MS, Gina sought support in the online MS community, which she found to be much more positive.

“I think it’s important to use as many positive words as you can when talking about MS.” It’s important to be realistic while also conveying hope, she says. “MS is an insidious disease that can cause many bad symptoms…that can be frightening, and you can't gloss over it, either.”

To give back to the online community that helped her so much, Gina started a blog to share her story and help others trying to learn about their diagnosis.

Though she deals with fatigue and cognitive dysfunction sometimes, Gina stays active swimming, biking, riding horses and playing with her sons, who are now 11 and 6.

Cognitive dysfunction is common in MS, with over half of people affected. It can impact memory, attention, planning, and word-finding. As with many aspects of MS, some people experience mild changes, while others face more challenges.

Gina says that while there’s still a lot of education about MS needed, she feels positive about the future of MS because there’s so much research being done.

woman in wheelchair holding medal, woman rowingNathalie is an award-winning rower with multiple international titles.Courtesy of Sanofi

Nathalie — Pennes Mirabeau, France (diagnosed with relapsing-remitting multiple sclerosis in 2002)

Nathalie was a teenager and a competitive athlete when she noticed her first symptoms of MS, but it would take four years of “limbo” before she was diagnosed.

“Ultimately, the diagnosis was more of a relief, than a shock,” she says. “Because when you have signs and you don’t know why, it’s worse than knowing, in the end, what you have.”

However, learning more about the disease—and the realities of disease progression—scared her.

“That glimpse of the future was direct and traumatic,” she says. Her neurologist explained that the disease evolves differently for everyone, and her situation might end up being serious or very mild. So, she decided to stop comparing herself to others with MS.

She said to herself, “We’ll see what happens, and you’ll manage it bit by bit.”

By 2005, Nathalie’s MS had progressed to the point of needing a wheelchair. However, that has not dampened her competitive spirit.

Nathalie began her international rowing career in 2009 and has won multiple world titles, including two Paralympic medals—silver in London and bronze in Tokyo. Now, at 42, she still trains 11 times a week. Fatigue can be a problem, and sometimes hard workouts leave her with muscle stiffness and shaking, but she credits her ongoing sports career for helping her feel in tune with her body’s signals.

“Over the years, I’ve learned to listen to my body, letting my body guide when I need to stop and take breaks,” she says.

Nathalie explains that she used to only look backwards because of the initial shock of her diagnosis. In time, she stopped thinking about what she couldn’t do anymore and focused on her future. She now lives in the following mindset: “Even when doors close, don’t miss out on those that open.” Instead of focusing on what she can’t do, she focuses on the opportunities she still has. Right now, this includes her training for the 2024 Paralympic Games in Paris, where she will compete for another rowing medal.

“I only go forward,” she says. “Well, I try, anyway…It’s easy to say, it’s not always easy to do. But that’s what I try to do.”

woman exiting water after swimming, woman with great daneHelga's Great Dane has become a helpful and beloved companion.Courtesy of Sanofi

Helga—Johannesburg, South Africa (diagnosed with relapsing multiple sclerosis in 2010)

When Helga first started having balance issues and numbness in her feet, she chalked it up to her training as a runner. But when the numbness moved to her face, she knew something was wrong. She never guessed it was MS.

“When I was diagnosed, I felt completely overwhelmed and clueless,” Helga says. “I felt that I had nowhere near enough information. I did not know anything about the disease…I had no idea that it was going to be a process of continually monitoring and adjusting your lifestyle.”

In the beginning, Helga’s symptoms developed slowly, and she didn’t appear ill to others. She was even able to run for a few years after her diagnosis, but she couldn’t do marathons anymore, and she began to fall frequently due to balance issues and right-foot dragging. Then her cognition issues became more problematic, especially in her job as a trainer in a printing company.

“My executive function, decision-making and short-term memory were affected to the point that I was eventually medically unfit for work,” she says. She stopped working in 2017.

However, she didn’t stop living life. Even though she could no longer run, she continued to swim competitively. She got a Great Dane puppy and trained him as a service dog to help her walk. She also serves as vice chair of the patient support organization Multiple Sclerosis South Africa, and she advises others who have been diagnosed to join a patient advocacy group as soon as possible to get reliable information and meet others with MS.

Helga says she is “hopeful” about the future of MS. “I must say that I am so grateful that we have all the new medications available, because my life would not be the same if it wasn't for that,” she adds.

Part of how she manages her MS is by looking at the positives.

“If I could tell the world one thing about MS, it would be that MS is an incurable disease of the nervous system, but it's also the greatest teacher of valuing your health, family, friends, and managing change in your life,” she says. “My life is diversified in a way that I never, ever thought it would, and MS has been honestly the greatest teacher.”

Each MS journey is unique – with each person impacted experiencing different struggles, successes, and feelings as they manage this unpredictable disease. But the common thread is clear – there is a critical need for information, support, and hope. We are proud to participate in World MS Day and share these incredible stories of living life while living with MS. To learn more about MS, go to https://www.sanofi.com/why-words-really-matter-when-it-comes-to-multiple-sclerosis.

MAT-GLB-2301642-v1.0-05/2023

This article was sponsored by Sanofi. Participants were compensated when applicable.

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