Safe Infant Car Seats and Their Dangers

Research Links Baby Car Seats to Breathing Problems and Death

May 4, 2009

Baby car seats are the safest way to transport infants but should be used with caution for young babies, especially those pre-term or low-birth weight.

It is beyond doubt that the safest way to transport a baby in a motor vehicle is in a rear-facing car seat until he or she is one year old and weighs at least 20 lb (American Academy of Pediatrics). In addition, babies should travel in the rear of the car, not in the front passenger seat, if an air bag is fitted.

The Canadian Research: Baby Deaths and Sitting or Lying in a Car Seat

Researchers in Canada examined 508 infant deaths which occurred between 1991 and 2000 and concluded that young infants, less than 1 month old, are at greater risk in a sitting position than if they were laying flat (Côté et al).

"These findings are consistent with previous studies that suggest that very young infants may experience respiratory difficulties if placed in car seats or similar devices, and that these should not be used in the home as an alternative to a cot." Foundation for the Study of Infant Deaths.

The New Zealand Research: Restricted Breathing of Infants in Baby Car Seats

In New Zealand between 1999 and December 2000 doctors investigated 9 babies under 6 months of age who were reported to be blue and breathing poorly after being allowed to sleep restrained in a car seat in the home. The babies were found to be scrunched up and as their heads fell forward this restricted their breathing (Tonkin et al).

The Safety of Infant and Child Car Seats

The research must be put in to context, a very small number of infants have experienced problems. The guidance on the use of car seats (Royal Society for the Prevention of Accidents, U.K.) for very young babies includes:

There are a wide range of car seats on the market, some of which may be beyond the budget of some parents, but price does not necessarily mean a seat is better or safer. Any child car seat should meet the current safety standards:

There are an increasing number of car seats which either lay flat or boast an almost flat position. Makes include Britax, Bebe, Jane and Aprica.

The research indicates babies should be lying down flat on their backs, not in a sitting position. Sitting up seems to increase the risk that they will stop breathing or have difficulty breathing. Any car seat for small babies should meet safety standards, be correctly fitted and be in such a position that a babies head cannot fall forward; the baby should be as flat as possible. Car seats should not be used for sitting or sleeping outside of the car and the amount of time a very small baby spends in the seat should be limited.

Côté, Aurore et al (2007, 19 July) "Sudden Infant Deaths in Sitting Devices", published Archives of Disease in Childhood, cited by Foundation for the Study of Infant Deaths, UK.

Tonkin, S.L. et al, (2006, 19 July) "Apparently Life Threatening Events in Infant Car Safety Seats" British Medical Journal 2006;333:1205-1206.

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