Safe Travels: The Importance of Car Seats for Infants and Children
At our medical practice, we care about the safety of your children from conception to the time they have grown out of their car seat – and beyond. Because car travel carries a variety of risks, it’s essential that you’re not only following state car seat laws, as far as restraining and protecting your child, but that you’re also using the best practices to ensure your child car seat safety when you’re on the road. 

Texas Car Seat Law
Because car seat laws for children vary by state, it’s important to understand what is required in your community. In Texas, all children younger than eight years of age are required to be secured in a “child passenger safety seat system.” If the child is under eight years old but is at least four feet and nine inches tall, then the child can use the regular vehicle seat belt.

By definition, a “child passenger safety seat system” is an infant or child passenger restraint system that meets the federal standards for crash-tested restraint systems as set by the National Highway Traffic Safety Administration. The car seat system must always be properly secured in the car, and the child must always be properly restrained in the seat as directed by the car seat manufacturer’s instructions.

Best Practices for Every Stage of Development
To make sure you’re keeping your child as safe as possible during short or long car rides, follow these child car seat safety best practices.

Stage 1: Pregnancy
You should always be wearing a seatbelt, even when it’s uncomfortable (especially during pregnancy). During your pregnancy, it is recommended that you wear the lap belt of your seatbelt under the area of the pregnancy while your shoulder strap crosses your body at the mid-chest. This will be the most comfortable way to effectively wear your seatbelt without restricting the baby or causing pain.

Stage 2: Birth to at least two years old
At the earliest phase of development, it’s vital that your baby always be secured in a rear-facing car seat. Rear-facing car seats are designed to support and protect a baby’s neck, head and back during the impact of a crash. This young age is the time your baby is just beginning to develop strength in the bones of the neck. Until these bones are further developed, they aren’t strong enough to resist the level of force delivered by a car crash. Not being properly restrained by a rear-facing car seat during this phase of development can cause severe injury, permanent disability and even death.

Stage 3: Two, three, four or five years old (based on growth)
Once your child has grown out of the rear-facing car seat, it’s time to graduate them to a forward-facing car seat. This can happen anytime after the age of two. At this phase, your child should be using a forward-facing harnessed child restraint car seat until they’ve grown to exceed the upper limits of the restraint.

Stage 4: Four or five to eight to 12 years old (based on height)
Once your child has reached the upper limits of the forward-facing car seat, they’re ready to use a belt-positioning device until they’re tall enough to have the vehicle’s seat belt fit them properly alone. Usually, this will be required until the child reaches about four feet and nine inches tall.

Stage 5: 4’9” and taller
Before you take away the belt positioning device, make sure your child can pass these five safety steps:

  1. Make sure the shoulder belt crosses properly between the shoulder and neck.
  2. Make sure your child’s lower back is against the seat.
  3. Make sure the lap belt is on your child’s thighs.
  4. Make sure your child’s knees bend at the edge of the seat.
  5. Make sure your child is able to stay in this position throughout the car trip.

If your child passes these five steps, this means they’re tall enough to ride in a regular vehicle seat with the vehicle seat belt. Be sure your child always rides in the back seat until they are 13 years old.


Dr. Axline