PM Pediatrics

Dr. Christina Johns
Senior Medical Advisor, PM Pediatrics

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Older Kids & Booster Seats: Not Just for Toddlers Anymore!

Have I mentioned yet that I’m the UNCOOLEST mom EVER?

If you haven’t yet gotten that vibe from my H Y S T E R I C A L #nerdalert posts on social media, then let me give it to you straight right now.  According to my children, NOTHING says “UNCOOL” like making my 11-year-old ride in a booster seat in the back seat of my vehicle. On ANY given day I’m not sure there’s ANY way for a child of a Peds Emerg Momma to have ANY kind of cool going on based upon the elevated threat level of potential injury that ALWAYS EXISTS. If you ask my kids, the answer is definitely NO.

I think it might be possible that my son — an almost 7th grader — might be the oldest kid I know who had to ride in a booster seat. Sounds kinda crazy, huh? Well let me share a little bit of data that might make it seem just slightly less nutty of an idea.

According to research published in the April 2017 issue of the American Journal of Preventive Medicine, in 2015 over 240 children between the ages of 8 and 12 years old DIED in motor vehicle crashes.

This number makes crashes the leading cause of injury deaths in this particular age group. Now, I’m not trying to say that every one of these fatalities was caused by these children NOT sitting in booster seats, but what I do want to emphasize is that proper positioning of seat belts and restraints is critical for making them function appropriately. I can’t tell you how many trauma stat responses I’ve attended where I’ve heard the phrase “but he was buckled in his seat belt,” and yet was thrown from the back seat to the windshield, ejected from the vehicle completely, or worse.

Image credit: SaferCar.gov

All too often, children are restrained ineffectively in cars.

They are either too small for the harness to fit across the shoulder and over the chest, or the straps are too loose, or the lap belt isn’t actually over their lap. A squirmy body does NOT help the physics of secure restraint, as anyone who has dealt with a toddler can surely attest. Here’s where the booster seat comes in.

When non-fatal crash data is analyzed, older children who rode in booster seats had a reduction in injuries over kids who used regular seat belts. The results were adjusted for type of vehicle and seating position, which also matters. Riding in the back seat alone decreases the chance of injury, so please, if your kids are younger than 13 — no matter how big they are — please have them ride in the back seat.

The National Highway Traffic Safety Administration recommends that kids should be in booster seats until they are big enough to fit in a seat belt properly, which is usually when they reach about 4 feet 9 inches in height (safercar.gov). For a seat belt to fit properly, the lap belt must lie close across the upper thighs, not the stomach. The shoulder belt should lie snugly across the shoulder and chest and not cross the neck or face. Remember again: your child should still ride in the back seat because it’s safer there.

A few other points to make related to older kids in seat belts:

-Make sure your child does not tuck the shoulder belt under her arm or behind her back. This leaves the upper body unprotected and adds extra slack to the seat belt system, putting your child at risk of severe injury in a crash or with sudden braking.

-Never allow anyone to share seat belts. All passengers must have their own car seats or seat belts.

So I’m a short chick, every bit of 5’3,” and my kids aren’t tall either. Height is the primary reason why I insisted and insist that they ride in booster seats, but the overall safety data helps fuel my fire. The more effectively protected they are in a vehicle ,the more likely they’ll have fewer injuries should I have the misfortune of being in a crash.  I may be the UNCOOLEST mom around, but I’m fairly sure I’m one of the safest. At least in this arena.

Since we’re on the topic, I figure I might as well come clean and confess to a few more “uncool mom-isms” that I claim as my own:

  1. On the morning carpool line, I call out to my son’s friends (who are on safety patrol) from my vehicle: “[insert friend’s name here], we need some assistance over here with our backpacks and lunches!” (Most embarrassing, yet all the kids laugh.)
  2. When my kids are FaceTiming their friends, I always photobomb the camera lens with an E X T R E M E close up. Of my own face.
  3. Apparently I use too many hand gestures when speaking in general.

I’m stopping at 3 because my children are getting waaaaayyyyy too involved with coming up with examples.

After reading this I hope you’ll keep your kids in booster seats until they’re a little older than you might have originally thought.  Come join my swell brigade and let’s make sure that every one of our injury prevention bases is covered. Every one.

 

Signed,

The UNcoolest Mom ever.

Reference: Anderson M, et al. Am J Prev Med. April 17, 2017

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