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“Safe Arrival” - Car seat safety for internationally adopted children

By: Alla Gordina, MD, FAAP Date posted:

The issue of car safety can be confusing even in the case of a child, who is developing within usual parameters. Infants and children, who were recently adopted, do present additional challenges because of failure to thrive, developmental delays and sensory issues, to name a few. Children are not used to car rides to begin with and being restrained is making the things even worse.

The use of the car safety restraints in this situation has to be adjusted based on each child’s chronological and developmental age, growth parameters and other variables.

GENERAL RECOMMENDATIONS:

    1. The back seat is the safest place for children to ride.
    2. Infants must ride in rear-facing restraints until they are at least 1 year of age and weigh at least 20 pounds (depending on the car seat, it can accommodate children weighting more then that).
    3. It is best for any child to ride rear-facing until he/she reaches the highest weight and height limits allowed by this particular car safety seat
    4. A rear-facing child safety seat must never be placed in the front passenger seat of any vehicle equipped with an air bag.
    5. No children under 12 years of age should ride in the front seat of the car.
    6. Assume all vehicles have air bags.
    7. Convertible seats can be used in the upright and forward-facing position for a child older than 1 year of age who weighs 20-40 pounds and as long as the child fits well.
    8. Child should stay in a car safety seat with a harness as long as possible and then ride in a belt-positioning booster seat. You can tell when your child is ready for a booster seat when one of the following is true:

      a. She reaches the top weight or height allowed for her seat.
      b. Her shoulders are above the harness slots.
      c. Her ears have reached the top of the seat.

    9. Child is ready to use a seat belt when the belt fits properly. This means

      a. The shoulder belt lies across the middle of the chest and shoulder, not the neck or throat.
      b. The lap belt is low and snug across the thighs, not the stomach.
      c. The child is tall enough to sit against the vehicle seat back with his legs bent at the knees and feet hanging down and can stay in this position comfortably throughout a trip.


SPECIAL CONSIDERATIONS:

    1. Small children with motor delays, low muscle tone and failure to thrive are safer riding rear facing until he/she reaches the highest weight and height limits allowed by this particular car safety seat
    2. Reclined position of the rear-facing car seat (infant only or convertible) is safer for children, who are unable to sit on their own regardless of age, until he/she reaches the highest weight and height limits allowed by this particular car safety seat.

HARNESS STRAPS:

    1. Harness straps must fit snugly on the strongest parts of the child’s body – the shoulders and the hips.
    2. Make sure that the belt separates your baby’s legs. Also, MAKE SURE THAT ARMS AND LEGS CANNOT GET UNDER THE HARNESS
    3. Most rear-facing seats should have straps originating at or slightly below the infant’s shoulders, while front-facing seats should have straps at or slightly above shoulders.
    4. The harness retainer clip for infant seats keeps the straps on a child’s shoulders and should rest at mid-chest, armpit level.
    5. When moving the straps, be sure to thread them properly through the shell, not just behind the pad.

DRESSING YOUR BABY FOR THE CAR RIDE

    1. Always dress your baby for the warmest part of the trip (car –during the winter and outside – during the summer) and cover him/her with the blanket for the coldest leg of your trip.
    2. When using the infant only carrier car seat - first secure your baby in the car seat and then secure the car seat in the car.
    3. When using convertible or front-facing car seats – make sure to adjust your child’s clothing before buckling him/her up

CAR SEATS … WITHOUT CARS

    1. Always make sure that your child is securely buckled at all times while in the car seat.
    2. If using the infant carrier car seat - make sure to put the car seat on the floor only - never place the car seat with your infant on the chair or on the table.
    3. Always carry your baby in the infant carrier, using the handle as a handle of the bag (on your side, not in front of you).
    4. When flying with your children, make sure to take your car seat on board, even if it means buying an additional ticket for your baby. A car seat/booster seat is the safest place for child to be during the flight.
    5. Many infant-only car safety seats lock into shopping carts, and many stores have shopping carts with built-in infant seats. This may seem safe, but your baby could tip over or fall out of the cart. Thousands of children are hurt every year from falling from shopping carts or from the carts tipping over. Instead of placing your baby's car safety seat on the cart, consider using a stroller, backpack, or frontpack while shopping with your baby.

CAR SEATS DURING ADOPTION FROM THE FORMER SOVIET UNION

Most of the families, who successfully used the car seats during such adoptions, used them during the flight home only.
Passengers and luggage do take priority during the adoption travels within the country, therefore the majority of parents reported that there was no place in the car for the car seat

BE AN EDUCATED CONSUMER

No one seat is the "best" or "safest." The "best" seat is the one that fits your child's size, is correctly installed, and is used properly every time you drive. When shopping for a car safety seat, keep the following in mind:
Price doesn't always matter. Higher prices can mean added features that may or may not make the seat easier to use.
When you find a seat you like, try it out. Put your child in it and adjust the harnesses and buckles. Make sure it fits in your car. Follow the instructions that came with the car safety seat.
Keep in mind that pictures or displays of car safety seats in stores may not show them being used the right way.
Always read the instructions that come with the child safety seat.
Always read the section on safety belt and child safety seats in the vehicle owner’s manual.
Beware of accessories, which can potentially harm your baby (inserts, that obstruct the view of the straps; head rests, that can prevent your child from breathing properly; and so on). Those accessories are readily available in stores and on the Internet, but the safety authorities do not approve them

SAFETY SEAT RECALLS

Pay attention to information about child safety seat recalls via the media and notices sent from the manufacturer.
When you buy a seat, be sure to return the registration card to the manufacturer.
Keep information such as the manufacture dates, model number, and name of the child safety seat readily available.
Most manufacturers are required to fix problems free of charge. If you are not sure if your seat has been recalled or you think your seat has a defect, call the department of transportation (DOT) Auto Safety hotline at 888/327-4236.

Additional information is available at:

    www.njsaferoads.com/newlaw,
    www.safekids.org,
    www.nhtsa.gov,
    www.aap.org/family/carseatguide

The Educational project “Safe Arrival” is made possible with the help of the materials provided by the American Academy of Pediatrics
_____________________
The information appearing here is intended for educational purposes only. It should not be used as a substitute for professional medical advice tailored to your child's individual needs. If you have questions or concerns regarding your child's physical or mental health, please seek assistance from a qualified healthcare provider.

Article Source: International Adoption Articles Directory

GLOBAL PEDIATRICS is an international adoption medical support service that has specialized in assisting families adopting from the Former Soviet Union through every step of the adoption process for the past ten years. Dr. Gordina's unique professional background and attention to detail ensure the highest possible level of service. She is recognized by her patients and peers as a leader and pioneer in the field and has presented her adoption-related research at sessions of the AAP, JCICS, NACAS and other meetings. Dr. Gordina has both participated in and organized several humanitarian missions to pediatric clinics and orphanages in the Former Soviet Union. For all questions regarding our services please check www.globalpediatrics.net>www.globalpediatrics.net

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