Family holidays are supposed to be fun, but that doesn’t mean you should ignore the usual safety measures you would be taking at home, especially when it comes to transporting kids in vehicles, says Dr. Ben Hoffman. The NHTSA (National Highway Traffic Safety Administration) certified Child Passenger Safety Technician Instructor and the Medical Director of the Safety Center at Doernbecher Children’s Hospital in Portland, Oregon, USA tells suitcases&strollers why it is absolutely necessary to lug kids car seats everywhere you go when traveling with kids and why you should never use a cloth baby carrier as a child restraint in the car.

What's wrong with carrying kids and infants on your lap so long as you have your seatbelt on and your arms are wrapped tightly around them?

There are hundreds of cases of young children critically injured or killed because their parents could not hold them and they were ejected from the vehicle. It is essentially the same as being totally unrestrained. 

There is no parent on earth who would be able to hold their child safely in the event of a car crash. A 10 pound child in a 50 kilometres per hour (30 miles per hour) crash represents about 200 kilograms of force (450 pounds) — that is more than a 3 kilogram bowling ball falling from a 3 storey window. 

But kids don't wear seat belts on the public bus. Should they be using kids car seats on buses too?

In all fairness, buses would be safer with seat belts for all passengers facing the front or the rear of the bus. School buses all would be safer if they had harnessed restraints for kids. Side facing seats are hard to protect with belts. In general, city buses do not crash very often and they tend to be travelling at lower speeds. Because of their mass, they tend not to suffer the worst of a crash. 

[For car safety tips on the best way to figure out how to install a car seat when traveling with kids, see the suitcases&strollers interview with a safety expert here.]

What is the best way to secure an infant in a car seat who is 6 months old and under?

A rear facing infant car seat or convertible car seat rear facing is the gold standard best and safest way to transport any infant under 2 years of age. All children under age 1 year must be in a rear facing car safety seat, but rear facing is always safer, so families should keep children facing the rear of the vehicle as long as possible, up to the weight and height limits of their car safety seat. 

Why is a rear facing kids car seat safer than a forward facing car seat?

In a crash, a rear facing child has all of the crash forces spread over their entire back form head to toe, the largest surface area possible.

To illustrate this, take your index finger, put it on your cheek and push — it hurts, right?

Now take your open palm, and do the same thing — same force, less pain, as the force is spread.

Absolute minimum to turn from rear to forward facing is 1 year of age and 20 pounds weight (9 kilograms). Most seats now accommodate babies up to 30 pounds and at least 28 to 32 inches (71 centimetres to 81 centimetres). Parents should delay the transition to forward facing as long as possible — a child between 1to 2 years of age has a 500% decreased risk of injury in a crash if they are rear facing, compared to forward facing. 

What about once children are too big to fit into baby capsules but look a little small for a regular kids car seat? What is the best kids car seat for children in this situation?

Once a child outgrows a rear facing only infant car safety seat, the family should transition to a rear facing convertible seat. These seats can face backwards through [a child’s body weight of] 35 to 45 pounds and can be converted to forward facing to [body] weights of 40 to 85 pounds. All these seats use a 5 point internal harness to secure the child in the seat. 

What about when you are travelling and don't have kids car seats with you? Is it safe to put your child on your lap and your seat belt around both of you?

Simply put, it is never safe to travel with an unrestrained child. The child could be ejected from the vehicle, strike the interior of the vehicle with deadly force or strike another person in the vehicle with deadly force. Imagine shooting a child out of a cannon at 100 kilometres per hour into a glass window — that is what happens to an unrestrained child in a crash. 

It is OK to use a cloth baby carrier such as a BABYBJÖRN or Ergobaby to strap babies on to a parent in a moving vehicle?

With hundreds of pounds of force involved in crashes, a cloth carrier cannot protect a child, dissipate all the forces and prevent ejection from the vehicle. The only safe way to transport an infant in a car is in an approved car safety seat. 

Proper booster seats are awkward and sometimes logistically impossible to carry around with you when traveling with kids. What other alternatives do you suggest?

I know of no safe way to transport a child in a car without an operational restraint system. I would not do it. Simple as that.

Many belt-positioning booster seats have a high back that can help protect children from side impact crashes and provide some upper body support. While this is preferred, many high back boosters have a back that can be removed to convert it to a no back booster. Further, many companies sell no-back booster seats. These are fairly easy to transport.

A backless booster is perfectly acceptable, although one with a back may provide better upper body support and side impact protection. It is ultimately the decision of the parent to find the product that fits their child, fits their vehicle and that they can use correctly every time. 

New innovations including an inflatable booster and a backpack/booster have also come on the market recently.

It is crucial to always use any booster seat with a seat belt that has both lap and shoulder belts. Never use a booster seat with only a lap belt. 

Are the travel safety harnesses for cars as safe as kids car seats?

There are several harnesses that are approved in the US for use in safely transporting children in cars, used mainly for children with special health care needs. A family needs to make sure that anything they buy has been adequately tested and approved for their specific needs. In the US, the NHTSA provides this certification, and so we recommend never using any product that is not NHTSA verified. To visit the official NHTSA website, click here

Do children need kids car seats in planes?  

While it is always advisable to use a car safety seat on an airplane, it is often impractical since the family must purchase a plane ticket for their infant or child. 

[For more family travel tips on flying with car seats on the plane, see the suitcases&strollers interview with a Child Passenger Safety Technician.]

Most car safety seats have been certified by the US Federal Aviation Administration for use on airplanes. This will be noted on a sticker on the side of the seat, as well as in the owner’s manual. If the seat does not say it has been approved, it cannot be used. Only seats that are installed with a seat belt (rear facing or forward facing with an internal harness) can be used. Belt positioning boosters can never be used. 

For a list of family-friendly airlines compared, see the suitcases&strollers story here

When is it safe to put kids in the front seat?

All passengers are safer in the rear as the majority of crashes are from the front and being as far away as possible from the point of impact is always safer. Children under 13 years of age have a 40% increased risk of injury if they are in the front seat, so the best practice recommendation is to have all children in the rear seat until at least age 13. 

At what age or weight can you safely stop using kids car seats?

All vehicle seat belts are designed for adults and children cannot be safely protected by them until they are the right size. Since kids grow at different rates, it is hard to assign a specific age/weight/height when the seat belt will fit correctly. Most kids will fit correctly in a seat belt alone between 8 to 12 years of age. In order to use a seat belt, was ask families to check for four key components:

  1. The child can sit on the vehicle seat with their butt all the way back against the seat back and have their knees bend comfortably over the edge of the seat with their feet on the floor. If they cannot do this, they are not ready. 
  2. Once seated as above, the shoulder belt should traverse the child’s collarbone and not rest on their neck at all. 
  3. The lap belt should be high on the legs, low on the pelvis and off of the child’s soft belly. 
  4. The child must be able to remain seated that way for the entire ride. 

For more travel tips on entertaining kids in the car, see the suitcases&strollers story here

Video: The Car Seat Lady