This article was published, citation information below.
Ang, M. (2006). Regular column on "Mensan Parenting". In Triple-M magazine, October 2006 issue.
This month I want to address an issue that has been bothering me deeply ever since I became a parent – the issue of car safety seats. Motor vehicle and traffic incidents are the No.1 cause of death and permanent disability in young children. Even if you’re a very careful driver, it is impossible for you to control other drivers. Accidents are called “accidents” because they are unexpected – nobody ever wants an accident to happen or thinks one is going to happen – by definition they happen when you think they will not. And do you realize you don’t even need to be in a real accident for your child to be seriously at risk? Simply applying your car’s emergency brakes can cause an improperly restrained child to fly into your windscreen or out the window. Most vehicle-related serious injuries and deaths that occur in Malaysia today could have been prevented by the correct use of child safety seats – properly installed and correctly used child safety seats have been proven to very significantly reduce the risk that your children will be seriously injured or killed during a car crash, and they completely eliminate the risk of injury in minor incidents like when you need to apply emergency brakes but don’t actually hit anything. It completely baffles me how otherwise responsible parents seem to simply turn off all basic logic and concern when it comes to travel safety. The following FAQs were extracted from these websites:
Why can’t I just hold my child in my arms?
Ejection from the vehicle is one of the most harmful events that can happen to a person in a crash. Statistics prove that those ejected in a crash are four times more likely to die. The forces in a crash can be hundreds of pounds or much more, too great for someone to hold a child safely. Plus, the reaction time needed in a crash makes it virtually impossible to restrain another passenger.
Children should be in an appropriate safety seat until they are about 8 years old, unless they are already 4 feet, 9 inches or taller. After that, they should be properly seated with a lap and shoulder belt. Children 12 and under should remain in the rear seat.
Why not just use our car seat belts?
If placed in adult safety belts prematurely, children can suffer serious internal injuries, slip out of the safety belt, or be ejected from the vehicle during a crash. Vehicle seatbelts are designed primarily with adults in mind, and geometric factors may make good fit difficult for children. A shoulder belt should cross the chest at mid-sternum and lie flat on the shoulder about halfway between the neck and arm. A child needs to have a sitting height of 74 cm (29 in) to comfortably and effectively use most lap/shoulder belts, a standing height of 148 cm (58 in) and a clothed weight of 37 kg (81 lb). To achieve the best fit, the child should be sitting fully upright with its pelvis as vertical and as far back into the seat as possible, and preferably with its feet touching the floor. The lap belt must not be placed or be allowed to ride up around the waist. If an erect seated posture cannot be achieved, or if the shoulder belt crosses the throat, the child needs to use a belt-positioning booster.
When can my child be in a regular seatbelt without a booster?
Children are not ready to be in a regular lap/shoulder seatbelt until:
Safety experts all recommend the five-point harness as the safest type of seat. The five-point harness has five points of contact over the child's strongest body parts, the hips and chest. One strap goes over each shoulder, a strap over each hip, and they all connect to a crotch strap. The five-point harness gives the securest fit and can be adjusted to snugly fit many different sizes of children. A seat with either a T-Shield or Tray Shield has two shoulder straps that are attached either to the shield itself, or attach to webbing that attaches to the shield. Instead of straps over the hip to provide lower body restraint, the shield is the lower body restraint and the child is supposed to and WILL impact it in a crash. Shield seats do not provide the snug fit that five-point seats do, and they also create the potential for the head, chest, or soft tummy to impact the shield at a high rate of speed and those vulnerable body parts can and have been damaged by contact to the shield.
Why use a five point harness?
Five-point harnessed car seats offer a much snugger harness fit than a shielded seat. In all five-point harness seats, the straps come down over the shoulders and across the hips to fasten to the buckle that comes up between the legs. The harness sits snugly against the bony parts of the pelvis (the crotch and hip straps) and across the shoulders and rib cage (the shoulder straps). When a child moves forward in the seat, as they would in a crash, the properly tightened harness is already "holding" the child and it immediately restrains them, spreading the crash force out across the strong bones of the body. There is nothing to impact; nothing for the child to suddenly hit. The child does not move before loading the restraint.
Can I use an infant head support? Is it OK to put a padded cushion under the child for comfort?
Unless such items come with the carseat or are recommended by the manufacturer of the carseat as an accessory, do not use them. Aftermarket pads and cushions are not tested with the seat and any compressible material inside the harness may allow for more slack in the restraint. With a small infant, it is usually OK to put a rolled towel or receiving blanket along the sides of the head (outside the harness straps) to keep it upright. You may also put a rolled towel between a small infant and the crotch strap if there is a large gap, though you should never put towels or pads under a child in a carseat.
My child won't use a carseat/booster. My child escapes his carseat. What can I do?
Some children can twist out of harnesses at an early age. Others can easily undo the buckle mechanism. Children may also be able to put too much slack in a seatbelt, and some children don't want to use a child restraint or seatbelt at all. Driving is a dangerous activity, and like any other, it requires proper supervision at all times. Parents can try many things. You can try calling the manufacturer of your carseat to see if they have a buckle that requires more force to release, or a 2-piece chest clip instead of a "paperclip style" chest clip. Using a seatbelt yourself sets a good example. Refusing to put the car in motion unless the child stays in their restraint is another. Also, try to keep your child entertained or distracted if possible, and NEVER make an exception and allow them not to use their child restraint.
Can I put my carseat in the front seat of my vehicle?
Airbags can be deadly to infants in rear-facing carseats, and to children 12 and under using the seatbelts. The front seat is generally not recommended for children 12 and under. The airbag MUST be disabled if you must use a rear-facing child seat in the front.
Neck Injury in Forward-Facing Child Restraints
Facing a child forward for travel is not without risks. There has long been a concern in bioengineering literature that a child’s cervical spine could be pulled apart from the force on the head in a crash when the shoulders are held back.15 One popular misconception, however, is that muscle strength can overcome this force, and that a child who can hold up its head and sit erect is “strong” enough to face a frontal crash. Rather it is the hardness of the vertebrae, in combination with the tightness of the connecting ligaments, that determines whether the spine will hold together and the spinal cord will remain intact within the confines of the vertebral column. The immature vertebrae of young children consist of both bony segments and cartilage, and the ligaments are loose to accommodate growth. This combination allows the soft vertebral elements to deform and separate under crash conditions, leaving the spinal cord as the last link between the head and the torso. The spinal cord ruptures if stretched more than 1/4 inch. The risk of spinal cord injury in children increases with crash severity and decreases with age. Accident experience has shown that a young child’s skull can be separated from its spine by the force of a crash, the spinal cord can be severed, or the child may live but suffer paraplegia or tetraplegia due to the stretched and damaged cord. Because of the potentially severe consequences, and the relatively simple countermeasure to such injury among the youngest children, it makes sense to keep them restrained rear-facing as long as possible.
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