How to Boost Booster Seat Use

Program greatly increases car safety measure

TUESDAY, Feb. 18, 2003 (HealthDayNews) -- While most parents faithfully buckle their infants into child safety seats in the car, many mistakenly assume older children are safe in standard seat belts.

Unfortunately, that's not the case.

However, once parents are educated about the need for booster seats for older children, the rate of use for these safety devices goes up significantly, says a new study appearing in the Feb. 19 issue of the Journal of the American Medical Association.

"Riding in the car is the most dangerous thing your child does. Car crashes remain the leading cause of death for children outside of infancy," says study author Dr. Beth Ebel, a pediatrician at the University of Washington Harborview Injury and Prevention Research Center in Seattle. "The bottom line is children between 4 and 8 rarely fit properly in car seat belts, and booster seats have been shown to protect children from serious injury."

"If children are too small for the adult harness, they can become severely injured," explains Dr. Bella Silecchia, director of pediatric emergency and ambulatory services at Nassau University Medical Center in East Meadow, N.Y. Silecchia says improperly restrained children are at risk for head injuries, ruptured livers, bladders and spleens, and even strangulation in an accident.

Yet, according to the study, as few as 6 percent of all children between 4 and 8 years old currently use booster seats in the car.

To raise awareness, Ebel and her colleagues designed a 15-month, multi-faceted community awareness program designed to educate parents and child caregivers using brochures, pamphlets, coupons, public service announcements, classes, health fair events, a booster seat hotline and a Web site.

Four communities around Seattle were selected for the campaign, and eight communities in Portland, Ore., and Spokane, Wash., served as controls. The Seattle communities had a population of about 260,000 people. The control areas included almost 700,000 people.

At the start of the study, only 13.3 percent of children who should have been in booster seats in the Seattle communities were using them. Meanwhile, 17.3 percent of kids from 4 to 8 in the control communities had booster seats.

Fifteen months later, booster seat use in the Seattle communities nearly doubled to 26.1 percent. Booster seat use in the control communities also went up slightly, to 20.2 percent. The authors suggest this is because national campaigns to increase booster seat use were also running at the same time.

So, should your child be in a booster seat? If he's between 4 and 8 years old and between 40 and 80 pounds, then the answer is probably yes. Ebel says height is generally the best guide, and to fit comfortably in an adult seat belt kids need to be about four feet, nine inches tall. Your child should be able to sit with his back against the seat and his knees bent over the edge.

She admits cost can be a barrier, which is why her study included a discount coupon. Booster seats start around $20 for low-back models and go as high as $100 for some high-back seats. Low back boosters are fine, according to Ebel, if the child's head doesn't come above the back of the seat. If it does, you'll need a high back booster seat.

Kids may balk at using a booster seat, especially if they've been out of one for some time, but Ebel says it's important to realize this is one area "where your child's life can hang in the balance." She says it might help to let your child have some choice in the matter by letting them help choose a booster seat or decide which side of the car they'd like to sit on.

"This is really something that should be a national priority," adds Silecchia. "It shows that having this information available to the parents and the public is much needed."

More information

To learn more about booster and other child safety seats, go to the American Academy of Pediatrics or to SafeChild.net.

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