The American Academy of Pediatrics provides helpful information on this topic through their website www.healthychildren.org. Click their link below for tips.
Motor Vehicle Accidents (MVA)
“MVA’s” are the leading cause of death in the United States for all children except newborns. MVA death rates are highest among two age groups: infants/toddlers and adolescents. Small children are apt to become “missiles” and sustain disproportionately severe injuries even in relatively minor MVA’s. Adolescents start to drive and be driven by peers at an age when they feel immortal and neither their judgment nor their reflexes are fully mature.
It is crucial to understand these well established facts:
- A majority of all fatal MVA’s involve at least one driver under the influence of drugs of alcohol. A parent should never use mind altering substances and drive, especially not when transporting children. Forget about the “legal limit” for blood alcohol, your chance of being involved in an MVA starts to climb sharply the minute the first glass touches your lips. Talk to your children starting at an early age about drinking and driving so that as teenagers they will know not to accept rides with intoxicated friends. (Start telling them this when they reach the teens and they will never listen to you – it needs to be ingrained from the start).
- A disturbingly large proportion of serious MVA injuries sustained by children occur in auto vs. pedestrian accidents (with the child as the pedestrian). The most common place for a motor vehicle vs. pedestrian accident is right in your own driveway! The sad but simple fact is that children are backed over all the time. Hold onto your child when walking in parking lots and look before you start to back up in the driveway or parking lot. At home, be sure you know exactly where the children are when you are pulling out of the drive. Be especially careful of you drive a Jeep, van, or other high-riding vehicle as it is doubly hard for you to see little heads which may be behind you.
- Chance of death and severity of injury are both significantly reduced in MVA’s by the wearing of proper restraint devices. Below 18kgs (approx. 40 lbs. or 4 yrs.) it is necessary and below 27kgs (approx. 60lbs or 6y) it is advisable to use a federally approved restraint system to safely secure a child. If yours is more than a few years old, check it’s condition and determine whether it was designed to be anchored with a tether strap (if it was, do so — it will be much less effective in a crash if you don’t). An infant’s car seat should face the rear of the car from birth to 9kgs. (approx. 6 months or 19lbs.) because the straps cannot be relied upon to fully hold a child that small and the propulsive forces in most MVA’s are towards the front. From 9-18kgs. (20-40lbs.) it is best to turn the seat towards the front and put it in its most upright setting. “Booster seats” are marketed and still approved for use over 13kgs. (28 lbs.) as an alternative to traditional car seats, but their use is discouraged as recent statistics have implicated them in worsening chest and abdominal injuries during a crash. Children in the 18-27kg range (approx. 40-60lbs. or 4-5yrs) unfortunately are the least well protected by currently available options. They are still too small for lap/shoulder belts, and yet too big for infant seats. While new (supposedly safer) designs for booster seats are being worked on by several manufacturers, none has been yet fully tested and certified by the federal government. For now I recommend keeping these children in infant seats as long as they fit relatively comfortably, then transferring them if possible to simple lap belts ( with no shoulder belt) such as might be found in the center rear position of many cars. Lap belts are safe, but be sure they are positioned snug and low across the pelvis – don’t rely on the child to fasten it him/herself. Shoulder belts are advisable once the child is tall enough that they can be easily positioned so as not to cross the face or neck. Repositioning the shoulder belt behind the child, seat, or headrest is not a safe or effective solution, unfortunately.
- Finally a word about rear “jump-seats” in“extended cab” mini-pickup trucks. It was recently found that children riding in such seats, even strapped into an approved child safety seat, had a much higher rate of serious injury during accidents than children riding in standard rear bench seats, such as those found in automobiles or extended cab full size trucks. It was recommended that ideally children should not ride in mini-pickups at all, or if that is totally unavoidable they be placed in the front passenger seat rather than the rear “jump seats”. (Front seats are known to be less safe than rear seats, but this is not true when the rear seats are of the “jump seat variety.)