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Parents Surrender in Booster Seat Battle

Study finds willingness to negotiate safety issue curbs use

MONDAY, Oct. 7, 2002 (HealthDayNews) -- Most parents know young children should ride in booster seats. However, many don't know at what age it's safe to graduate a child to a seat belt.

A new study finds parents are unsure about when it's safe for kids to leave behind the booster seat, a platform-type seat for older children that helps the lap and shoulder portions of their seat belt fit properly. It also finds parents who are least likely to use booster seats are those who'll bargain with their kids over anything -- even safety -- to avoid a fuss.

According to safety experts, the time to let a child use a seat belt is when the belt fits across the shoulder and low across the hips. This occurs when the kid is about 80 pounds, 4 feet 9 inches tall, and at least 8 years old.

So, now that you know, you'll insist your 7-year-old sits in a booster seat, right? After all, motor vehicle crashes are the leading cause of death among children aged 4 to 14 years old, according to the National Highway Traffic Safety Administration.

Not necessarily, say the authors of the new report, which appears in the October issue of Pediatrics.

A major barrier to using booster seats isn't just knowledge, it's parenting attitude and style. Older children can give their parents a very hard time about sitting in a booster seat, especially if their friends or siblings don't have to, or if they've already been using a seat belt, says Dr. Flaura Winston, senior study author and director of TraumaLink: The Interdisciplinary Pediatric Trauma Research Center at the Children's Hospital of Philadelphia.

Many parents, wary of the tantrums, will simply surrender.

"Parents say, 'We fight about what time he goes to bed. We fight about whether he eats his peas. I just can't bear to fight with them about something else,'" Winston says.

Researchers say this parenting attitude -- that safety is negotiable -- is a big hurdle in increasing usage of booster seats.

Researchers conducted focus groups and telephone interviews with 111 parents and children about their knowledge and attitudes toward booster seats.

They found parents who drew a distinction between "negotiable" rules ? such as bedtime, bath time or eating their vegetables -- and "non-negotiable" rules ? such as riding in a car seat -- were the most likely to use booster seats.

Parents who considered all those things on the bargaining table were less likely to use booster seats.

"One key difference between parents who use booster seats and parents who use seat belts for their children is negotiability," Winston says. "Parents who used booster seats drew a distinction between safety, which was non-negotiable, and child actions like eating habits and naps… For these children, booster seats were accepted as the only option."

Winston says she tells parents to insist on only the most important issues, and safety is one of them.

"Parents are bombarded with messages about how to be a good parent," she says. "We can make it a lot easier for them. They need to pick their battles. Safety should be non-negotiable. But if a child refuses to eat their peas, well, you can give them a vitamin instead. That's not something to worry about."

Parents who didn't insist on booster seats also perceived less risk of a getting into a serious car crash than parents who did use booster seats. They tended to make comments about "driving a safe car" or "being a safe driver," according to the study.

These parents also justified their use of seat belts rather than booster seats by citing state law. Most states require kids be in booster seats only until age 4, although about 13 states have since adopted more strongly worded laws.

Inconvenience and cost were other reasons cited for not using booster seats.

Stephanie Tombrello, executive director of SafetyBeltSafe U.S.A., says booster seats are available for as little as $20. Some weigh just a few pounds and can easily transported if the child is going to be in someone else's car.

Tombrello's organization has created a curriculum for kindergarten to third grade that teachers can use to introduce older kids to the idea of the booster seat. What many parents don't realize, she says, is that kids are actually more comfortable in the booster seat than when using an adult seatbelt.

The booster seat props them up so they can see out of the window. It lets them sit with good posture and with their knees bent. It helps the seat belt fit properly, rather than having the lap belt cut across their midsection and the shoulder portion in front of the face.

Many children will try to compensate for the discomfort by putting the shoulder belt under their arm or behind their back, she says. In even a low-speed crash, this puts pressure on the wrong areas of the child's body and is very dangerous.

"For children, the difference in comfort is just unbelievable when they're in a booster seat," she says.

What To Do

For more information about buying booster seats and properly using them, visit SafetyBeltSafe U.S.A. or the Children's Hospital of Philadelphia.

SOURCES: Flaura Winston, M.D., Ph.D., director, TraumaLink: The Interdisciplinary Pediatric Trauma Research Center, Children's Hospital, Philadelphia; Stephanie Tombrello, M.S.W., executive director, SafetyBeltSafe U.S.A., Torrance, Calif.; October 2002 Pediatrics
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