Choosing, and correctly using a car seat for your new bundle of joy may be one of the most important decisions parents make. Often it is not only the parent that will be using the car seat but grandparents, relatives, baby sitters and friends.  Choosing a baby seat that is quick and easy to use, light weight and comfortable will help ensure proper use by all.

Car seats are designed, and are only safe for, specific ages, sizes and weights of a child. As your child grows it is important to go to the next level of car seat. A child outgrows their car seat as soon as they are above the weight or height limit. Babies often outgrow the height limit before the weight limit. As soon as the child has outgrown one variable it is time to move to a new seat.

Pro Tip: In an accident objects that are not secured become projectiles and may injure or kill your child. A stuffed animal or a handful of cereal will not cause harm in the case of an accident. A metal truck, hard covered book, glass cup etc can be life threatening.

Car Seat Definitions:

• Rear-Facing: the seat it turned to face the back of the car.
• Convertible: can face the back or the front of the car.
• All-in-One: can face the back or front of the car and can be used as a booster car seat for an older child.
• 4 in 1: designed to transition with a child through the entire period a child will need a car seat, usually age 10.
• Combination: usually can face the front of the car and then can be used as a booster seat. (The terms Combination and All-in-One are often used interchangeably.)
• Booster: a seat that raises the child to allow the seat belt to be positioned correctly.
• Rotating, swivel or turning car seat: these seats swivel on the base to face the door making getting the child in and out of the car, securing straps and cleaning up messes easier.
• Car seat stroller combo: these car seats can be placed in a stroller base making a simple transition from the car to the stroller. Another term for this type of unit is Stroller 3 in 1 with car seat.
• Travel car seat: these seats are lighter, easier to carry and are more compact than a traditional child safety seat. Child safety seats can often be rented from car rental companies when renting a car. It is important to call ahead to reserve a seat as there is often limited availability. Per Consumer Reports, Child safety seat rental averages $13/day with a $65 max cost.
• Newborn car seat: although they have the title Newborn, these seats are often usable until the child is 1 year old. 
• Newborn car seat insert: these are inserts that are meant to fit inside a child car seat to provide extra padding and stability for smaller babies especially the head and neck region. It is imperative to use an insert that is designed for the specific car seat you are using as the entire system is meant to work together to ensure in an accident your child is protected.
• Rotating Convertible Car Seats: these seats can convert from rear facing to forward facing as well as rotate or swivel for ease of loading, securing child and cleaning.

Other names for child car seats:

Baby seat

Baby safety seat

Baby car seat

Infant safety seat

Infant car seat

Infant carrier

Infant car carrier

Infant restraint system

Child safety seat

Child car seat

Child seat

Child restraint system

Child car carrier

Child carrier

Toddler seat

Toddler safety seat

Kid car seat

Kid safety seat

Car seat

Booster seat

Required Safety Features
All car seats sold in the U.S. must meet Federal Motor Vehicle Safety Standard (FMVSS) 213, which covers performance, buckle release pressure, and labeling. Labels on car seats must be permanent, visible, and include the manufacturer's name and manufacture date, model number, weight and height limits. Rear-facing seats must have an airbag warning.

Although all Child Safety Seats sold in the US must meet federal safety standards, there are additional safety options that may be available.

Optional safety features:

• Labels that contain contact information, allergy and medical information can be affixed to the car seat. Labels from Name Bubbles or Sticky Monkey Labels help provide correct information in the event of an emergency. Car seats are moved to different places by different people. Family, Grandparents, Babysitters, Friends and Daycares may be supervising the child at different times. Everyone that cares for your child may need instant information when the parents are not available. Car seat labels allow correct information to be immediately available.
  
• Side‑impact protection uses extra foam, deployable wings, energy-absorbing pods to redirect forces to decrease the injury or death risk from side-impact collisions.
• Anti‑rebound bars limit the child safety seat rotation, or rebound, to absorb more crash forces and reduce seat movement. This feature is used for rear-facing installations and usually must be removed if the seat is used in a forward facing position.
• Built-in Lockoffs secure the child safety seat without needing to pull the car’s seat belt tightly to secure the seat. Some child safety seats come with tensioning devices for the seat belt but these are not necessarily lock-offs. Lock-offs, when properly used, will secure the child seat to allow less than 1 inch of movement.
• Level indicators for rear‑facing seats. Newborns and children that have not developed head control need to have their car seat angled to support the head and neck as they do not have the head control to hold their head up in a non-reclined car seat. These level indicators can be bubble indicators, a ball indicator and or a visual line indicator.

Priority features in a child car seat:

1. The car seat must fit in your vehicle. Not all seats fit all cars. Check manufacturer’s descriptions and lists of car models their seats will fit.  It is important to test the car seat in all cars the child will be transported in before the seat is needed for your child. Test soon after purchase to allow exchange or refund within the required period.  Measure your car seat’s width and depth to ensure the seat will fit in the space. Check if the headrest in the back and front seat will interfere with the positioning of the child safety seat.  It’s important to check for fit in all the ways the seat will be used. If you have a combination or All-in-One seat check that it fits in the back and front seat as well as when being used as a booster seat.
2. Ease of installation is an important factor when choosing a car seat: Installing the child seat a few times may not seem extremely difficult, but going through the same process hundreds of times a year is a different matter. 
3. Assess the weight of the child seat and who will need to carry it. A 25 pound seat with a 25 pound child in it may be too heavy for some grandparents to carry. Car seats often are used to transport and as an instant chair for the child on outings. If the seat is too heavy there is less chance of it being used consistently and correctly. 
4. Machine-washable covers. It is very likely that the seat cover will have food spilled on it. Food particles cause bacterial growth. The child’s hands can easily contact the bacteria and then, of course, directly journey to the child’s mouth or eyes. It is important to wash the seat cover often. Having multiple seat covers that can be easily washed is an important consideration. Most parents would never leave a child in the same clothes for weeks with food and bacteria continually building up; however, the same parents don’t realize how important it is to wash their child’s seat cover.
5. Adequate padding. This feature becomes even more important as your child gains weight. A comfortable child will squirm less and complain less. This feature is especially important for long car trips.
6. Breathable fabrics: This feature helps prevent overheating, skin irritation and moisture build-up. Breathable airflow allows for a more comfortable ride. Breathable fabrics may also help prevent car sickness and rashes.
7. Slim car seats and car seats that are designed for smaller cars are available. These seats usually fit larger cars as well making them a good choice if one of the cars the child will be regularly in is a compact car.
8. Car seats for twins are two separate car seats that match. Each individual seat is a safety system for a single child. If you have a car seat and stroller combination both car seats will fit in the double stroller. Since twins often do not grow at the same rate, it is important to remember that one twin may need to go to the next sized seat before the other twin is ready.

How do you know if you have installed the car seat correctly?
According to the U.S. Department of Transportation's National Highway Traffic Safety Administration, “while most parents and caregivers are confident that they have correctly installed their child’s car seat, almost half (46%), have been installed incorrectly.”

It is imperative to follow manufacturer’s instructions when installing a child safety seat. Many manufacturers have videos online that can walk you through the installation process and trouble shoot difficulties.

Some common mistakes made when installing child car seats.

• Not confirming weight and height limits. It is dangerous for the child if they exceed the maximum weight and height limit for the seat but it is also dangerous if the child is too light or too short for the seat.
• Using the wrong type of seat. Children should be in a rear facing seat until at least 2 years old.
• Not installing the seat securely to the car. Child seats that are installed too loosely do not protect the child in the event of an accident. There should not be more than 1 inch of movement front-to-back or side-to-side if the seat is properly installed.
• Harness straps are too loose. Harness straps should be snug without any slack between the harness and the child.
• Not positioning the chest clip properly. The chest clip should be at the level of the arm pits. Positioning the chest clip over the neck or the stomach can cause injury to the child.
• Not placing car seats in the designated spot described by the manufacturer. 
• If the child safety seat must be placed in the front seat it is imperative that the air bag be turned off.  A deployed air bag can cause severe injury or death to the child with forward facing and rear facing seats.
• Puffy or bulky clothes can take up space between the seat, harness and straps. In a car accident the extra space created by the clothes can make the child safety system less effective. The child’s clothes should be thin and not bulky. If extra warmth is needed place a blanket over the child once they are harnessed in the seat.
• Not using all the straps, tethers and anchors advised by the manufacturer. The child safety seat and the car’s equipment work as a system that prevents injury to the child in the event of an accident. Not using the top tether can cause the seat to move forward or be dumped forward increasing the chances of child injury or death.

What if I am having trouble installing the child safety seat?

Hospitals, Police and Fire stations, and public health clinics often have specialists (Child Passenger Safety Technicians (CPSTs) that are trained to help parents install children’s safety seats. They often will have classes or individual appointment times available to assist new parents. If they do not have help available, they can usually direct new parents to resources to help them.

Costs:
Child seats that can function for multiple purposes are often more expensive than a child seat that only will work as a rear-facing infant seat; however, the cost savings over the long term of buying 1 seat rather than 3 may be significant.

What do I do if I can’t afford a child safety seat?
There are many organizations that help provide child car seats.

• Kidtravel.org https://kidtravel.org/car-seats/free-car-seats/ has listings for every state that assists parents with obtaining child safety seats.
  
• WIC/Medicaid may offer programs that provide assistance with child car seats.
  
• Police/Fire, Hospitals and Public Health clinics are good resources to call. They may have vouchers for free or discounted seats or they may have free child safety seats available.
  
• Local Health Departments may have seats available or be able to refer you to agencies that can help.
• Local charities and churches may have programs that help provide essential baby gear.

Only use a used child safety seat if you know its history, it has never been in an accident, has no missing parts or labels, and it’s not expired. (Yes, car seats have an expiration date. Materials degrade over time, technology changes over time, automobile seats change over time, and the regulations governing child safety seats change over time.)

Cleaning:
The car seat will likely need to be cleaned hundreds of times during its life. Car seats that have easily removable machine washable padding or padding liners are essential. The more difficult it is to disassemble and re-assemble the car seat, the less likely it will get cleaned frequently. Car seat padding or liners that can be washed in a washing machine ensures that even busy parents can keep up with the constant clean up that is needed to keep the seat clean.

It is important to remember cleaning products give off fumes. Your child will be immersed in the fumes when they are in the car seat if the seat has not been aired out properly. The child will also be touching areas that have been cleaned. Their hands can then touch their eyes or their mouths. It is important to remember these factors when choosing products to clean the child safety seat.

Car seat covers:
These can be divided into 2 main types.

1 Seat covers that are designed to cover the entire seat with or without the child in it. These can be used to protect the seat and child from the elements. Covers often have a window to allow the baby to look out while being protected and allowing the parent to observe the child.

2. Child car seat covers that are meant to protect the child seat from spills and accidents. These are often waterproof. Covers should be machine washable and dryable. Some car seat covers are universal and are designed to fit most car seats, others are designed to fit a specific car seat or a range of car seats. For older children the cover may have an opening to allow the child to use a built-in cup holder or have pockets to keep toys, books and snacks.

Ease of installation:

Car seats with bases allow for easier placing and removing of the car seat. Multiple bases will be placed in the vehicles the child will travel in: parents, grandparents, babysitter etc. Bases are designed for a specific car seat. It is important to buy extra bases that are specifically for the child car seat that you have.

Grandparents and caregivers that are transporting children of different ages may benefit from seats that are transitional and cover a wide variety of ages. 360-rotating seats may be a good choice as they can convert from rear-facing to front facing and are typically convertible.

When should I move to the next car seat?
Some seats are designed to adjust as the child grows. If the seat is a combination or All-in-One check the manufactures’ directions on how to adjust the car seat to match your child’s current weight and height.

Always follow the manufacturer’s instructions for appropriate usage of their car seat.

If the child is at, or above, the weight or height limit of the seat it is time to move up.

If the top of the child’s head is within 1 inch of the top of the shell of the car seat it is time to move to the next level of car seat. Occasionally, even though the child is still within the height limit of the seat the child may have a longer trunk and shorter legs than average causing them to sit taller in the seat.

Spotting Non-Compliant Seats that may not be safe. 

Like many manufactured items in the United States, fraudulent and knock-off items can be found. The seat may look like the authentic item; but, it may have deficits that can cause a problem in the event of a crash.

Some items to look for:

• Missing Labels: If the seat does not have the required safety labels, in English, do not purchase.
• Grammatical and Spelling Errors: Errors often indicate counterfeit products.
• Unclear Info: If the label does not explicitly state it meets FMVSS 213 standards, it may not be compliant or it may be a counterfeit car seat.

Final thoughts:

Choosing a car seat can feel overwhelming as it happens at a time when there are 1000s of other important decisions to be made at the same time.

A few tips to make the journey easier:

1. Start researching well ahead of the date of your child’s birth or when it will be needed because your child has outgrown their current seat. Child car seats are expensive. This causes parents to often delay purchase until it becomes an urgent situation. 
2. Researching well ahead of when the car seat is needed allows you to investigate multiple brands and options. Sleeping on information allows for the brain to integrate the multiple variables better.
3. When you have settled upon a few brands it allows you to be hyperaware of sales and promotions to get the best possible price for the best possible car seat.
4. Most children did not grow up with the best of everything; yet, we grew to adulthood. Set a reasonable budget. A safe child seat that protects your child in the event of an accident is the most important variable. If you have met that objective your child will be as protected as possible from the physics of a car accident - which is what really matters.

The most important factor to ensure your child’s safety is to use the child car seat correctly every time.