For 4-8 Year Olds: Use a Booster Seat in the Car
By Dr. Bettye M. Caldwell
Motor vehicle accidents are the leading cause of death for children in the United States—every day, approximately 4 children die and over 600 are injured in cars. Thankfully, most parents have begun transporting their infants and toddlers in car safety seats. However, many parents think that young children can safely graduate from car seats directly to seat belts at age 4. But, in fact, adult seat belts are not safe for young children. For children 4-8 years old, recent studies show that we can dramatically reduce the risk of injury and death in car accidents by securing them properly in booster seats.

Unfortunately, most families don’t use booster seats at all, they don’t use them correctly, or they don’t use them long enough. Learn how you can best protect your 4- to 8-year-old by using a booster seat in the car.

Why are 4- to 8-year-olds not safe in seat belts?
Seat belts have been designed to fit the standard automobile driver—a 165-pound adult male. The lap belt was designed to cut across an adult’s hips and the shoulder belt to cut across an adult’s chest so that the strongest parts of the skeleton—the pelvis and the ribcage—would take the force of a crash.

Unfortunately, a child's body is too small to fit the standard adult seat belts. When a young child sits directly in a seat belt, the lap belt generally cuts across the abdomen and the shoulder belt across the neck or face. And since this is often uncomfortable, many children put the shoulder belt under their arm or behind their back. As a result, when young children in seat belts are in car accidents, they slide out from the belt and are thrown inside or outside of the car, which is often fatal; or they stay in the belt and suffer from what doctors call “seat belt syndrome” including severe injuries to the abdomen and spinal cord from being thrown over the lap belt, and severe injuries to the head and face from hitting their knees.

Why are booster seats safest?
A recent study of children age 4-7 found that children who ride in booster seats had less than one-half the risk of injury in a car accident compared with children in seat belts alone. In particular, booster seats sharply cut the risk of injuries to the abdomen, neck and spine.

Booster seats are also called “belt-positioning booster seats” because they raise up the child in the seat so that the lap and shoulder belts cross the child’s body where they would on an adult. This makes the seat belts more comfortable for the child and more likely to be used correctly. In the case of a car crash, boosters and properly-positioned seat belts secure the child safely in the seat, spread the force of the crash across the child’s pelvis and chest, and protect the child’s more delicate abdomen, spine, neck, and head.

Who should use a booster seat?
Over the past few years, more and more states have passed laws requiring children to be in car seats up to age 4 and 40 pounds followed by booster seats until 6-8 years, and seat belts thereafter. Know your state law. But if your state doesn’t yet require boosters, don’t wait—protect your child now!

Make sure that your children ride in a booster seat from 4 years and 40 pounds to 8 years and 80 pounds—this is what the studies have shown is safest.