Travelling safely in the car

Instructions for the safe transport of children in cars

Children are still getting killed in car accidents, because their parents don’t transport them in a safe and appropriate way. In America, this is still the most common cause of death in children over 4 years of age. In Greece, every year around 1,000 children and young people lose their lives in accidents, the largest number of which are traffic accidents.

You can protect your children by putting them in correctly installed children’s car seats, appropriate for their weight and age. This guide will help you ensure that your child is correctly protected on every journey.

What categories do children’s car seats come in?

Car seats are available depending on the child’s weight and age:

1. Up to 13 kilos (from birth until about 9 – 12 months)

These are rear-facing car seats. They can be used either in the back of the car, or in the passenger’s seat. If they are used in the passenger’s seat, the front airbag in the passenger’s seat SHOULD DEFINITELY be deactivated.

Worthy of mention is, that in March 2011, the American Academy of Pediatrics issued a directive to the public, according to which parents should keep their children in rear-facing car seats until the age of 2 years, or until they reach the maximum permissible weight for the specific seat.

Rear-facing car seats protect small children better, because they support the head, the neck, and the spine in the case of a crash, by distributing the impact force relatively to the entire body of the child. A 2007 study showed that children under 2 years of age have 75% fewer chances of dying, or being severely injured in a car accident, if their  car seat is located facing the rear.

Fatal incidents are just the tip of the iceberg: it is estimated that for every death of a child in a car accident, 18 children are hospitalised due to car accidents, and over 400 require medical treatment due to injury.

You are not offering any protection to your child, and you are exposing him to undue risk every time you carry him in the car in your arms, or in a pram, or in a carry cot.

2. 9 – 18 kilos (from about 9 months to 4 years old)

These are front-facing car seats. They can be used in the back seats of the car or in the passenger’s seat. Some of these have options for less or more elevated positions.
Worthy of mention, is that in March 2011, the American Academy of Pediatrics issued a directive, according to which parents are encouraged to use an auxiliary car seat until the child reaches 135cm in height, or the age of 8 years.

3. 15 kilos to 36 kilos (4 years old or older)

These are forward-facing auxiliary seats, and can be used in the back or the front of the car. The auxiliary seat elevates the child, and helps use the available diagonal and horizontal adult seat belt in the proper way.

4. 22 to 36 kilos (6 years old or older)

An auxiliary forward-facing cushion can be used in the front or back of the car. The auxiliary cushion elevates the child’s head, and helps use the available diagonal and horizontal adult car seat belt in the proper way.

5. Above 135cm in height (child older than 12-13 years)

Use the adult car seat belt for all journeys.

 Buying a car seat

• Choose the right seat according to your child’s weight and age. The manufacturer’s and the salesperson’s instructions will help you.

• Try fitting it in the car you are going to use it in.

• Look for the indication of official approval by the European Union. Most car seats are manufactured according to Regulation 44 of the Economic Committee for Europe (abbreviated ECE R44).

EU approved car seats must have a special tag, beginning with the letter E and ending with the maximum number of kilos of the child. The word “UNIVERSAL” on the tag means that the seat can be installed in all car types.

• Be particularly aware of second-hand car seats. They may have been heavily used, and not meet current modern standards. The installation instructions may also be missing.

Installation of the seat

• Children’s car seats should be fitted firmly and tightly on the adult seat. Put all your weight on the children’s car seat while you are tightening its belt.

• Keep the installation instructions in the car.

• If you have any doubts about installing it, ask a professional before you put the child in the seat.

• Always check the car’s manual for advice about whether children can use the front seat. This information varies from car to car.

• Never install a rear-facing car seat on a seat with an activated airbag in front of it.

• Forward-facing seats should be placed as far as possible from the airbag.

Putting the child in the seat

• Make sure that the car seat belt has been properly adjusted to the child – only one or two fingers should fit between the child’s chest and the belt.

• If you are using an auxiliary seat or cushion, the adult seat belt should pass from   one hip to the other – not across the abdomen – and end at the child’s shoulder – not his neck.

• The child’s arms should never be outside the seat belt. Also, the seat belt should never be behind the child’s back. If this is the case, and if an accident takes place, the child may be injured.

Practical advice

• The safest position for all children is always in the back of the car.

• Put the child in the car seat EVERY TIME you travel. You are not protecting the child if you put him in his car seat sometimes, and other times you don’t.

• Always take time to secure the child comfortably.

• Make sure that the adult seat belt passes through all the right parts of the car seat.

• Never modify the seat or the belt at will.

• Children’s car seats should be firmly secured on the adult seat.

• Never put a rear-facing car seat in a seat with an activated airbag in front of it.

• Never leave a small child fastened in his car seat in the car unsupervised to leave the car for some reason. Deaths due to dehydration, kidnappings, and other risks have been known to happen.

Read more at:

Stelios Papaventsis MRCPCH DCH IBCLC 2011

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