Recommended Infant Carseats for Preemies & Multiples – CarseatBlog’s List of Best Bets
Everyone understands that low birthweight babies often come with challenges. However, most expecting parents don’t consider the possibility that the carseat they bought or chose to put on their baby registry might not fit baby well if she or he arrives early or is smaller than average at birth.
Of course, you often have no idea ahead of time that you’re going to have a preemie or smaller-than-average term baby. But if you’re expecting multiples, have a history of preterm labor or just a history of delivering small babies then you really want to be prepared with a carseat that is likely to fit the baby/babies well regardless of whether they’re 4 lbs or 9 lbs at discharge.
There are 3 important factors when choosing a carseat that is likely to fit a smaller baby well. First is the miniumum weight rating. Most carseats are rated from 5 lbs up. But many babies are discharged from the hospital weighing less than 5 lbs and the hospital staff might not let you leave with your under-5 lbs-baby in a carseat that has a 5 lbs mimimum weight rating. Ideally, you want a carseat with a minimum weight rating of 4 lbs or a seat rated simply from “birth” up to whatever the max weight limit is.
However, the minimum weight rating is only one factor in what you’re looking for in a carseat. You’re also going to need lower-than-average bottom harness slots (ideally 6″ or lower), OR a carseat that comes with an insert cushion that goes under baby’s bottom which raises them up so that their shoulder level is even with, or slightly above, the bottom harness slots. To clarify, in a rear-facing carseat, you want the harness straps to be situated “at” or slightly below the child’s shoulder level. In order to evaluate this properly, you may want to remove the harness strap covers if your seat came with them (and don’t use any aftermarket strap covers if your carseat didn’t). In my blog review photos, I almost always ditch the harness strap covers because, in my opinion, they just tend to get in the way more than anything else.
Speaking of getting in the way, I want to take this opportunity to educate you on the plethora of aftermarket carseat stuff that lines the shelves of every baby store. With the exception of a blanket to put over baby in cooler weather, you only want to use the things that came in the box with your carseat. Aftermarket carseat products may look helpful or useful but they can be a real detriment to proper usage so they are not recommended. Products like the Bundle Me are great for the stroller but should never be used with your carseat. Ditto for aftermarket harness strap covers and aftermarket infant support cushions. However, there are some safe, recommended alternatives to such products so if you’re looking for suggestions or advice (on this or any other carseat-related topic), please visit our forums HERE and we’ll be happy to help educate you.
Since you probably don’t have a good lifelike preemie doll at home to test your carseat with – you can rely on us to steer you in the right direction when it comes to carseats and smaller babies. All of the seats on this recommended list have been tested by either Darren, Heather or myself using the preemie doll made by Huggable Images and we’re confident that these seats will provide a snug and proper harness fit for the vast majority of babies who measure at least 4 lbs and 17″ (the size and weight of this particular doll).
Updated List of Recommended Carseats for Preemies & Multiples
Chicco KeyFit 30 (4-30 lbs) and the original model Chicco KeyFit (rated from 4-22 lbs only; usually sold with stroller as part of a travel system). FULL REVIEW OF KEYFIT 30 HERE
Safety 1st onBoard 35, onBoard 35 Air & onBoard 35 Air SE (“Air” models have premium base and Air-Protect Technology). All onBoard models are rated from 4-35 lbs. FULL REVIEW OF ONBOARD 35 AIR HERE
Safety 1st Comfy Carry Elite Plus – budget-friendly; 4-22 lbs. Stick to the “Elite Plus” model since that’s the only version of the Comfy Carry that has an adjustable base. FULL REVIEW HERE
Britax Chaperone - Anti-rebound bar; 4-30 lbs - FULL REVIEW HERE
Britax B-Safe – rated from 4-30 lbs. FULL REVIEW HERE
Evenflo Embrace 35 – Another budget-friendly option; 4-35 lbs. FULL REVIEW HERE
Graco SnugRide 35 – specifically the new model with the updated infant insert; new models are rated from 4-35 lbs. We do NOT recommend the SR35 models rated from 5-35 lbs for preemies or low birthweight infants. FULL REVIEW OF NEW SNUGRIDE 35 HERE
Reader Comments
Thank you! Very well done! What about the new Combi infant seats and the Combi Cocorro?
Thanks for the great post, Kecia! Since preemies have been around since the dawn of man, I’m surprised it’s so difficult to find carseats that can accommodate them safely. Those low bottom harness slots and easy adjusting harness straps are important when dealing with tiny babies who with little tone.
Thanks Kecia – I’m off to link this to our Multiples club web page
what about the new safety 1st Comfy Carry Elite? when it was checked out by other people on the board, it had really nice low bottom slots and was thought to fit preemies well.
Kat, Kecia should be getting the Comfy Carry Elite Plus any day and we hope to have a report soon! It might make an excellent program seat, too.
For the record, this list consists of seats that we can generally recommend without reservation. While there may be other seats that technically fit the criteria for fitting preemies, these are seats that we feel comfortable recommending based on overall ease of use, ease of installation, etc. Currently the Coccoro still has a 5 lb minimum wt rating but we will evaulate the new model once it’s released.
In addition to the Comfy Carry, Evenflo is supposed to be coming out w/ a 4# version of the Embrace (also will go to 35# and have a straight handle), so that might be a decent program seat, too.
I agree that the above mentioned seats are definitely nicer when it comes to ease-of-use, quality, etc. for preemies.
My nephew has the Chaperone, but he was a big baby (8# 3.5oz at birth), so he never needed the extra foam infant insert; in fact, he needed the straps moved up a level. I was pleasantly surprised at how well my preemie sized doll (just a wal-mart doll, not a huggable images doll) fit, especially w/ the foam insert. The insert also changes the interior angle of the seat. I could see how it was helping keep the baby at a better angle that would do a good job of keeping a small baby’s airway open. I believe the Chicco insert is supposed to change the interior angle as well, but I don’t remember it having such a discernible effect on the baby’s head.
What about a seat like the Graco Snugride 30 which is also rated to 4lbs? The Chicco and Britax are both great seats, but they can be on the spendy side. The OnBoard35 is another great seat, but it doesn’t fit on the frame of a double snap and go, which many parents of multiples use in the beginning. In fact only the Chicco on this list seems to fit onto the Snap and Go. Is there a reason the Graco was excluded?
The chicco doesn’t fit on the snap and go correctly…it just sits on their but does not actually snap in like it is suppose to. That is the reason that we went with the Graco snugride 30 seats as well. They are rated to 4 pounds and actually snap into the stroller. Easy to install. I would have liked to see them included or reviewed for this article.
I know this is about carseats but I have to add that we ended up with the Chicco Keyfit 30 seats for our twins after lots of stroller research. Highly recommend the Keyfit 30 seats and the Cortina Together stroller.
SeattleRain,
We have a review prepared for the Graco SnugRide 30, but haven’t yet published it due to some questions regarding fit for preemies. The 4 pound doll we use for reviews is nearly two inches too short to fit in the SnugRide 30. It does fit acceptably in terms of crotch and hip straps on the inner adjustments, though. We have discussed this with Graco, and their research indicates that the doll is not typical of most 4 pound infants. The Britax B-Safe Kecia mentioned also fits the doll well, but our review is still in progress. We will also be reviewing the Safety 1st Comfy Carry Elite Plus soon. What we do know is that the doll does fit the other seats we have reviewed and recommended, so for now, those are the ones we can suggest for low birthweight babies without reservation.
What about the Mia Moda Cerdo? I know that’s rated from 4 lbs., what are the straps like on that?
Also, Combi will provide documentation in writing upon request that the Shuttle 33 may be used with shoulders below the bottom slots as long as the straps can be properly tightened.
KQ – We don’t have any experience with the new version of the Mia Moda infant seat so we can’t comment on it at this time. However, we have reviewed the Shuttle 33 and while it may be a decent fit for some low birth weight babies, it’s not a seat that we feel comfortable recommending without reservation. http://carseatblog.com/7153/combi-shuttle-33-review-is-this-the-one-for-you/
This list has been updated as of July, 2012. I’d like to add a note that our recommendations are based primarily on the fit to the Huggable Images preemie doll. We realize that this doll is not an ideal “average” size and maybe not even a “typical” size and shape of a 4lb. low birthweight infant. In particular, the shoulders do not hold up well like those on a real baby of this size. We use this doll because it is is commercially available and used by many programs and technicians. That means it is an easy way to compare infant models directly. That also means that models not included on this list may still fit an actual 4-5 pound low birthweight infant. Every baby is a different size and shape, so a real baby might or might not fit well in a product not appearing on our list! On the other hand, while you can be sure that models on our list will fit most babies down to 4 pounds, it’s possible the tiniest babies at this weight may still not fit in some of them. Please read the manual or contact a local special needs trained technician if you have any question before taking baby home!
I see this list was updated this year, is there a reason the Cybex Aton was not included? I’m curious because I own one and had a preemie sized child who fit in it perfectly. When we came home from the hospital, my daughter was 18 inches long, 5 lbs 8oz. The only adjustment I had to make to get a snug harness fit was remove the shoulder pad things. She stil fit snug the next day when we went to the pediatrician and she only weighed 5 lbs 3 oz which would have warranted the 2 hour testing prior to leaving the hospital had she weighed that the day before.
I realize all babies are shaped differently, I just think this seat might deserve a second look. I LOVE this seat, especially the fact that you can have most fronts seats almost all the way back when it is installed behind that seat!
Prior to discharge from the NICU, our little 4 pound daughter was required to pass a carseat test. Her oxygen saturation was measured for a full hour in the seat. In the Britax B-Safe (our first choice), her oxygenation levels had dropped to the high 80s (%) within five minutes, and in the Chicco KeyFit 30 (our second choice) she lasted about 15 minutes before she was again in the 80s. Graco Snugride 30 (a model we had not even considered until my husband’s third trip to the store) saved the day! In addition to being a parent, I am also a Pediatrician, and I truly was surprised at the difference in positioning. The padded insert allowed her neck to be extended, and the crotch strap fit without rolling up a receiving blanket between her legs. I would highly recommend the Graco Snugride 35 carseat to all parents with a premature or small infant. I will admit we like the look of the Britax and Chicco much, much better; in fact, we own multiple Britax carseats for our other children. My advice as both a parent of a premature infant and a General Pediatrician: Get over the fabric (and the name, if that is a problem for you). Of course you need to leave the hospital, but once you are home, again try out infant carseat you researched for hours online. If your infant’s neck is bent down toward her chest in the carseat, her oxygen saturation levels may be lower than you expect, and you should return the seat for another model.
Has the Maxi-Cosi Prezi been evaluated for preemies? I was interested in this car seat for my preemie coming home in a few weeks.
@ Ryan Kellie – yes, if you check out Heather’s Prezi review you’ll see that it fits the preemie doll very well. We will be adding the Prezi to our preemie/multiples list in our next update. HTH & Congrats on your impending arrival! http://carseatblog.com/20169/maxi-cosi-prezi-infant-seat-review-so-euro-so-stylin/