Resources Archive

Head Injuries in Rear-Facing Carseats

Facebooktwittergoogle_plusmailFacebooktwittergoogle_plusmail

You’ve heard Rear-Facing (RF) is safest. Maybe you’ve heard that RF car seats provide the best head protection. That’s probably true, in general. Maybe someone told you RF is “5x safer”. That statistic is based on only one study that used limited data and covers very specific circumstances, so it may or may not apply to your situation. What’s important is that rear-facing is very safe when the child is within the limits allowed by the carseat. In fact, simply using any age-appropriate carseat according to both instructions and state laws will be very effective at reducing the risk of severe injuries and fatalities.

Very safe in an upright convertible carseat!

So, what’s the deal? It turns out, that while rare, moderate and serious head injuries can happen in rear-facing carseats. There are typically 3 possible causes.

  1.  The top of a baby’s head might move out of the protection of the carseat shell and strike a front vehicle seat, pillar or console. This may be more of a concern with rear-facing only infant carriers, especially when fully reclined with a baby near the height limit.
  2.  The carseat shell strikes part of the vehicle interior, possibly resulting in the back or side of baby’s head hitting the inside of the carseat with enough force to cause a contusion or other injury.
  3.  In unusually energetic frontal crashes, the carseat could rebound with enough energy that the front of baby’s head may strike part of the vehicle interior.

Don’t Panic! High speed and very energetic crashes are not common, but can result in serious injuries, especially when misuse or non-use of restraints are involved. The good news is that if you are using a carseat and have installed and adjusted it as best as you can, you probably have very little to worry about.

So what can you do to reduce the chance of injury? The same simple things we’ve always told you and that you’ve probably done:

  • Install and use your carseat in the back seat, according to manufacturer instructions AND state law
  • Drive unimpaired and undistracted

How can you further reduce the chance of head injury in rear-facing carseats?

  1. In particular, make sure your carseat installation and harness are tight.
  2. If your child is approaching the stated rear-facing height limit, or when the top of the head is 1″ from the top of the carseat shell, then a taller seat may be necessary.
  3. For older babies and toddlers who have good head and neck control, install your carseat as upright as allowed by the instructions.
  4. If your carseat offers a load leg or anti-rebound feature, use it.
  5. Choose a Recommended Carseat that has a layer of energy-absorbing foam both behind and on the side of baby’s head.  Deep side wings and load legs (on certain infant seat bases) can also be advantageous.
  6. When shopping for a newer vehicle, select one with good safety ratings made in 2011 or later, when side-impact airbags and stability control are usually standard features.

“Bracing”, or having the rear-facing carseat touching the front vehicle seat, is a very complex topic.  Some vehicles don’t allow this at all, due to passenger airbag sensors.  In other vehicles, there are various conflicting factors to consider.  If allowed by both the vehicle and carseat owners manuals, bracing could potentially reduce the risk of the carseat energetically striking the vehicle seat back and related head injury (point B above).  On the other hand, it could increase the risk of direct head contact for an older, taller baby ramping out of the infant seat and striking a part of the vehicle interior (point A above). This is especially a concern with rear-facing only infant carseats that have shorter shells, tend to sit lower in the vehicle and tend to be installed with more recline than a rear-facing convertible carseat.

Above all, try not to lose sleep over this!  Loose installations, loose harnesses, too much recline and exceeding the rear-facing height limits are always a potential concern, so just make sure you read the instructions and consult a child passenger safety technician if you have any questions about your installation and usage of child restraints.

2017 Recommended Carseats for Airplane Travel

Facebooktwittergoogle_plusmailFacebooktwittergoogle_plusmail

airplaneIt’s the travel season and for many families with small children, that includes flying somewhere. Since so many carseats are heavy and bulky, it makes sense in some cases to invest in a lightweight carseat just for traveling. Plus, this spares you the hassle of re-installing your main carseat when you get back to your own car, weary from traveling.

Ideally, a spare travel carseat should be lightweight (under 15 lbs), easy to install with the lap-only belt on an airplane seat and narrow enough to fit in a typical coach seat. With that criteria in mind, here are several options to consider.

Infant carseats – no need to buy anything new as long as your current infant seat can be installed without the base. I guess it’s possible to drag the base with you on the plane but that’s just making life harder than it needs to be. As long as your infant seat allows installation without the base (most do but there are some exceptions so make sure you know for sure), it’s easy to install the carrier rear-facing with the lap-only belt on the plane.

KF-airplane  Toddler on plane

If you’re leaving the base at home – make sure you practice baseless installation a few times so when you arrive at your destination you know how to install the carseat properly in the car, using a typical lap/shoulder belt.  Here is a video that demonstrates my technique for quick and easy installations of an infant carseat without the base.

Stay clear of products like THIS and THIS. These products are NOT acceptable alternatives to using an actual carseat on the plane to restrain your child. Along the same lines – using a sling or infant carrier also isn’t a safe alternative for your baby or toddler because you aren’t allow to wear your child during take-offs or landings when the risks are highest. There is a good reason for this but the details are ugly so I’m not going to go into it right now. If you would like more info on why slings and infant carriers are not a safe alternative to using a carseat on a plane, please see the NTSB website.

Baby B'Air vest - NO  Airplane hammock

UPDATED JUNE 2017

Convertible seats – if you intend to install the convertible seat rear-facing on the plane then you’ll be best served by a seat that is fairly compact which will increase your chances of the seat actually fitting rear-facing in the space you have to work with.

 

Cosco Scenera Next - stockCosco Scenera NEXT:

Rear-facing 5-40 lbs., or up to 40″ tall. Forward-facing 22-40 lbs., or up to 40″ tall

 

 

Evenflo Tribute - MaxwellEvenflo Tribute:

Rear-facing 5-40 lbs., or up to 37″ tall. Forward-facing 22-40 lbs., or up to 40″ tall

 

 

Graco Contender - Glacier

Graco Contender:

Rear-facing 5-40 lbs. (won’t be outgrown by height in the RF position before child hits 40 lbs.). Forward-facing 20-65 lbs., or up to 49″ tall.

 

 

Safety 1st Guide 65 - seaport fashionSafety 1st Guide 65:

Rear-facing 5-40 lbs, or up to 40″ tall. Forward-facing 22-65 lbs, or up to 43″ tall

 

 

No matter which seat you decide to take on the plane for your child – you will want to know where the FAA approval language is stated in case one of the flight attendants asks to see proof that your carseat is certified for use in an aircraft. Look for RED lettering on one of the sticker labels on the carseat. The FAA language is required to be written in red. The language can vary slightly but in general this is what you’re looking for:

Pria 85 - FAA certification  Evenflo Symphony FAA certification - cropped Britax B-Safe 35 Elite - FAA certification

 

For forward-facing kids, you’ll be best served by a seat that’s lightweight, fairly narrow, with tall top harness slots and a weight limit of 50 lbs. or more. Keep in mind that combination seats (aka harness/booster) can only be used on the plane in harnessed mode. Booster seats (or combination seats used without the 5-pt harness in booster mode) are not FAA certified and cannot be used on an airplane because all booster seats require a lap/shoulder belt, which airplanes don’t have.

 Keller

Evenflo Maestro:

Forward-facing only for kids at least 2 years old. With 5-point harness from 22-50 lbs., up to 50″ tall

 

 

 300 Loy

Evenflo Secure Kid LX:

Forward-facing only for kids at least 2 years old. With 5-point harness from 22-65 lbs., up to 50″ tall

 

 

Evenflo Sonus

Rear-facing 5-40 lbs., or up to 40″ tall. Forward-facing for children at least 2 years old, 22-50 lbs., up to 50″ tall

 

 

Evenflo SureRide:

Rear-facing 5-40 lbs., or up to 40″ tall. Forward-facing for children at least 2 years old, 22-65 lbs., or up to 54″ tall

 

Graco ContenderGraco Contender:

Rear-facing 5-40 lbs., Forward-facing for children at least 1 year old, 22-65 lbs., or up to 49″ tall. *Forward-facing beltpath is behind the back of the shell. This unique design means your FF child won’t have the metal latchplate of the airplane seatbelt in their back during the flight.

 

Safety 1st Guide 65 Safety 1st Guide 65:

Rear-facing 5-40 lbs., or up to 40″ tall. Forward-facing for children at least 1 year old, 22-65 lbs., up to 43″ tall

 

 

CARES Harness*:

Unique product for kids over 1 year old who weigh between 22-44 lbs., and are under 40″ tall. *CARES harness is certified for use ONLY on the plane. It cannot be used in motor vehicles. It’s very useful for situations where you don’t need a carseat to use on the ground when you arrive at your destination. We have a review of the CARES Harness here.

 

If you want to travel with your usual carseat, or just want to make it easier to travel with any carseat in general  – there are many products that can help you transport it through the airport and onto the plane. Some are just generic luggage carts – other products like the Brica Roll ‘n Go Carseat Transporter, the Go-Go Travelmate products and the Traveling Toddler Strap are made specifically for a carseat.  There are also carseat travel bags with wheels but obviously you can’t put your kid inside it too. Britax, Peg Perego, Clek & Diono all make travel accessories specifically for their carseats too.

go-go babyz used go-go babyz travel strap used

Remember, only carseats with an internal harness can be used on a plane. You cannot use a booster seat on an airplane because booster seats require a lap/shoulder belt and airplanes only have lap belts. If your child rides in a booster seat and you are bringing it with you, you can gate check it or bring it on the plane and put it in the overhead bin (if it fits).

For more info on flying with kids and carseats – check out our related blogs on the subject:

Carseat on airplane

Lap Babies on Airplane – A Warning All Parents Must See

Flying with a Car Seat? Know Your Rights!

Flying with Kids & Carseats – the checked carseat controversy

Travel Carseats: The Ultimate Guide to What You Want to Take on A Plane

An Open Letter to the FAA

 

Britax G4.1 Convertibles vs. Britax ClickTight Convertibles: A Basic Comparison

Facebooktwittergoogle_plusmailFacebooktwittergoogle_plusmail

Britax has had two lines of convertibles—the G4.1s and the ClickTights— for 3 years now and there are still many questions about the similarities and differences between the two. Let’s compare them and see what makes each convertible line its own and which one may be best for you and your child.

  

Similarities Between G4.1 Convertibles and ClickTight Convertibles
Both G4.1 and ClickTight convertible lines are outgrown rear-facing when the child’s head reaches 1” from the red adjuster handle on the headrest when it’s fully extended.
Both G4.1 and ClickTight convertible lines have the rubber HUGS on the harness (exception is the Roundabout)
 
Both convertible lines have RF weight limits of 5-40 lbs.
Both convertible lines have FF weight and height limits* of 20-65 lbs. and 49” or less (*exception is the Roundabout G4.1 which has a FF weight limit of 20-55 lbs. and height limit of 46” or less)
Both sets of convertibles have built-in lockoffs: the G4.1s have color-coded clip-style lockoffs, while the ClickTight panel serves as a lockoff
Both convertible lines have smooth bases with grippy rubber edges
 Both convertible lines are steel-reinforced. The bars are more visible on the G4.1 line.
© www.CarseatBlog.com

 

Differences Between G4.1 Convertibles and ClickTight Convertibles
The G4.1 line has a black shell and visible steel bars on the sides The ClickTight line has a white shell with the ClickTight panel that opens to reveal the belt paths
Britax Boulevard with ARB  
LATCH installation with the G4.1s is super easy for 2 reasons: 1. G4.1 has deluxe push-on LATCH connectors, and 2. Each LATCH strap is connected separately to the steel bars on the side, so pulling the straps tight is very easy. ClickTights are designed to be installed with the seat belt and the lower LATCH connectors are the hook-on style and hidden in a compartment on the back of the base to discourage owners from using LATCH
G4.1 top harness slots are about 1.5” lower than the ClickTight seats and overall seat height is about 1.5” shorter while seats are about 1” wider
G4.1 convertibles have 1 recline for rear-facing, but the recline can be tweaked per the manual ClickTight convertibles have a greater recline range for both rear-facing and forward-facing
G4.1s CAN be installed with Ford Motor Company inflatable seat belts after lower LATCH connector weight limit is reached ClickTights CANNOT be installed with Ford Motor Company inflatable seat belts after lower LATCH connector weight limit is reached
G4.1: the date of manufacture (DOM) and model information sticker is on the plastic shell by the child’s left shoulder ClickTight: the date of manufacture (DOM) and model information sticker is under the child’s left knee on the ClickTight panel, under the cover
© www.CarseatBlog.com

We also have more information about how the G4.1 and ClickTight models fit in your vehicle rear-facing in our Ultimate Rear-Facing Convertible Carseat Space Comparison article. You can also compare individual seats against each other by using our comparison tool.

Carseats and Torticollis

Facebooktwittergoogle_plusmailFacebooktwittergoogle_plusmail

When I’m not carseating, I work as a physical therapist in a pediatric setting. As you can imagine, there tends to be a lot of overlap with carseats and my “real” job, but you might be surprised to hear that the most common intersection of the two has to do with babies who are born with a tight neck muscle.

Torticollis is a condition where a muscle in one side of the neck gets tight, usually because of the position of the baby in utero. Torticollis tends to cause babies to have a strong preference for rotating the neck in one direction and tilting the head in the other direction. It’s most common in first babies, twins and babies of petite mothers (all because of space constraints in utero). One of the biggest issues that results from torticollis is that babies can end up with an asymmetrically flat head, known as plagiocephaly. For some kids this is mild and it improves on its own; for others, they may require a specially made and adjusted helmet to help the head round out.

In virtually every evaluation for a baby with torticollis and plagiocephaly, parents (understandably) express concern about what, if anything, they can do in the carseat to keep their baby’s head from tilting or rotating. And sometimes they’ve already tried things- usually aftermarket inserts, sometimes wash cloths, when the secret is, you probably don’t need to add anything.

As we know, adding anything to a carseat that didn’t come with the seat (or was not expressly crash tested with the seat and approved by the carseat manufacturer), is generally not a good idea. It will void the carseat warranty, it goes against every manual (which, in most states makes it illegal) and it may potentially result in injury in a crash. So, basically what I’m saying is, even if you’re worried about your baby’s head shape, please don’t put aftermarket products in the carseat. They won’t help much and they may put your child at increased risk.

Truthfully, unless your baby spends hours, like, literal sustained hours each day in a carseat, the seat isn’t really what is causing the flatness to develop. So fear not, the carseat is just fine the way it is. I know that at times seeing baby’s head tilted or rotated in the car can be troubling. But rest assured that a tilt to the side or rotation isn’t unsafe. The only position that is worrisome is if baby’s chin tips down onto its chest, which in small infants can compromise the airway (and is probably a sign that your child’s carseat isn’t reclined enough- find a CPST in your area to have it checked out!).

blanketsIf you’re worried about baby’s head falling to the side, you can try rolled up receiving blankets on either side of baby, placed after baby is buckled. I will be honest that I don’t necessarily love this set up because baby could rotate their head and spend a sustained amount of time with their face in a blanket, but it is a parental decision and if you feel strongly that something needs to be done to keep baby’s head in midline, this is your safest option.

If you want to make sure that baby rotates their head to their non-preferred side, you can definitely make that happen in the carseat. If your seat allows it, and several explicitly don’t, so consult your manual, you can hang a soft toy (like, literally made of a material and so soft you would throw it directly at your child’s head and they wouldn’t be injured) from the handle, offset towards the side you want baby to look. I had one creative parent who tied a few ribbons on the non-preferred side of the handle. They presented no risk to baby, but were bright and got baby to rotate his head that way. Other options include, if you have another backseat passenger that baby will like to look at, seat that person on baby’s non-preferred side. Or if baby is not sitting in the middle seat, and you can get a good installation and feel comfortable with baby outboard, place their seat so that they have to look towards their non-preferred side to see out the nearest window.

Most of all, any baby, but especially a baby with torticollis, will benefit from the least possible amount of awake time in any baby device that puts pressure on baby’s head like a swing, bouncy seat, cradle or carseat. Babies need a lot of floor time when they’re awake so they have room to learn to roll and sit and crawl and they especially need time on their tummy to strengthen their necks, which will help correct torticollis.

If you think your baby may have torticollis or plagiocephaly, talk to your pediatrician about it and see if a referral to a physical therapist in your area might be appropriate. And if you’re worried about carseat positioning with a baby with torticollis and/or plagiocephaly, find a CPST near you to check your set up and see if there’s anything else that can be done to keep baby safe and keep baby’s head nice and round.