Does Your Child Need a Booster Seat?

Advocates for booster seats call 19.5 million children the “forgotten” kids. They are too large for child safety seats, but too small to use regular seat belts.

These children are prime candidates for booster seat, which helps to position them properly in their seat belts. Tuesday’s congressional hearing was centered on boosters. Separately, crash injury experts issued recommendations for requiring the use these boosters for children. Traffic accidents are the leading cause of death among children aged 5-16. Each week, 16 children aged between 4-8 were killed in motor vehicle accidents. More than 70% of children who died in motor vehicle accidents in 1999 were unrestrained.

While all 50 states have child restraint law, most don’t have booster seats mandated for children older than 5 years. Children too large for child seats may be injured by a loose belt or thrown out of the adult belt in an accident. Dennis Durbin MD, a child injury prevention expert says that booster seats offer a distinct advantage over traditional seat belts. Durbin was involved in the planning of this week’s booster-seat meeting of the Association for the Advancement of Automotive Medicine. This group backed mandatory booster use. According to Durbin, there is now scientific evidence that boosters in real-world accidents are more effective than just seat belts for young children. Durbin is an assistant professor in pediatrics at Children’s Hospital Philadelphia.

Only three states, Arkansas, Washington and California, require booster seats. These laws are not yet in force.

Others states also have legislation in progress, but objections such as “parents rights” arguments have prevented action in states like Illinois and Maryland. Senator Peter Fitzgerald (R-Ill.), stated Tuesday that he was considering legislation to condition federal transportation funding for states on their willingness to require booster seat requirements. The National Highway Traffic Safety Administration has found that only 10% of children use booster seats. A recent survey by the agency found that 20% of parents with young children had never heard of booster seats. What can parents do to help their children? Durbin says that children should be in rear-facing safety seats from birth until they reach at least one year old and weigh at least 20 pounds. He says that once the child reaches these two points, Durbin will say, “You can turn the child around in the forward-facing car safety chair.”

Durbin says that when children outgrow the forward-facing safety seats, this is where parents make the crucial transition to putting their child in a belt. There is an easier transition, the belt-positioning booster chair. This is simply a booster seat that rests on an existing car seat. It will better position the child for use of the car’s shoulder and lap belts. Durbin states that the child should remain in the seat until the belt is properly fitted. It will vary depending on the child’s age, height, and weight. There is no federal standard that certifies which booster seats are best for which children. Durbin and other experts agree that so-called “shield” booster seats are unsafe, but still exist in the United States. Federal regulators have yet to develop a 10-year-old-child-size dummy for crash-testing the seats.

According to the Insurance Institute for Highway Safety, “emphasizing boosters” is not a priority. It stated instead that “the first order of business” is to place older children in restraints, regardless of the type. Let’s just say that we should be focusing on the safety of using seat belts. Susan Ferguson, PhD of the institute, stated that parents don’t want to be more confused than they are. Durbin says that it was time to move on. “The message has been “buckle up” for many decades, and it was a very effective message. He claims that there is now clear evidence that booster seats outperform seat belts, but that seat belts are still better than none.

Advocates for Highway and Auto Safety president Judith Lee Stone stated that states should adopt laws encouraging booster seat use, even if the ideal seat is not yet defined. Others agree that consumers should be heard by automakers. Some of them have, with little fanfare and apparent demand, begun to offer booster seats as an option with new cars. Hugo Mellander, traffic safety researcher, said that car-buyers should ask questions.

Updated 01/24/22