Q&A Guidelines for Car Seat Use

By: Piyavate Hospital

The Importance of Child Car Seats

For many new parents, traveling with a baby is unavoidable. However, in Thailand, traffic accident fatalities are the second leading cause of death after drowning. Studies have found that holding a child on your lap or hugging them while riding in a car is unsafe, as a collision or sudden stop can generate a severe force that may cause serious injury or even death.

Research shows that correctly installing a car seat and booster seat can reduce injuries by up to 60%. Therefore, today doctors will recommend guidelines for choosing and installing car seats or booster seats for children, based on recommendations from the American Academy of Pediatrics (AAP) in 2018.

Guidelines for Choosing and Discontinuing Car Seats

Question 1: When should you start using a car seat?

Answer: It can be used from birth up to around 13 years of age, or until reaching a height of over 145 centimeters. The most suitable position is the rear seat of the car.

Question 2: How should you choose a car seat to suit each age group?

Answer: Age, weight, and height are important factors in choosing an appropriate car seat or booster seat for a child, which can be considered as follows:

1. Newborns to 4 years old (weight not exceeding 18 kg) should use an infant carrier seat or a convertible seat.

• Installed in the back seat
• Facing the child towards the rear of the car

This type of car seat best protects the head, neck, and spine. Children should ride facing backwards for as long as possible, or until their height or weight exceeds the manufacturer's limit.

2. Children aged 4–8 years old (weighing approximately 18–30/40 kg) should use a forward-facing car seat.

• Install on the rear seat
• Has a 5-point harness
• Head and body support cushion

3. Children aged 8–13 years old (weight over 30–40 kg or height less than 145 cm) should use a booster seat.

• Installed in the back seat
• Helps position the body properly for car seat belt usage

Question 3: When should you stop using a car seat or booster seat?

Answer: You can stop using a car seat and wear an adult seatbelt when your child meets all of the following criteria:

• Sit with your back fully supported by the backrest
• Bend knees past the edge of the seat without tiptoeing
• The seatbelt strap should cross diagonally over the center of the chest, not too close to the neck or shoulder.
• Position the lower lap belt across the thighs and hips, not the abdomen.
• Able to maintain this posture throughout the journey without shifting out of position.

Techniques to Help Your Child Accept Sitting in a Car Seat

Although parents understand the principles of choosing a car seat, in practice, some children may resist and refuse to sit in it because they want to sit on a lap or look at the view around them. To help reduce this problem, here are the recommendations:

• Start using a car seat from birth, especially from the day you leave the hospital, to help them get used to it.
• Parents should always wear a seatbelt to set a good example.
• Find activities for your child to do while traveling, such as toys, books, or music.

If your child is fussy, crying, or wants to be held, you can use toys or have a parent sit next to them to comfort, sing, talk, or use methods that suit your family. However, avoid taking them out of the car seat while the vehicle is moving, as this may confuse the child and lead to more resistant behavior in the future. Consistent practice and parental patience will help children learn that sitting in a car seat is normal and safe.