Confusion Leads to Underuse of Booster Seats

Many parents think their children are too big

MONDAY, April 7, 2003 (HealthDayNews) -- They don't fit into a child safety seat and they aren't quite ready for an adult seat belt -- at ages 4 to 8, they are the "in-between" kids who often slip through the passenger safety cracks.

What many parents don't realize is their children aren't riding safely in the car if they're not strapped into a booster seat. In spite of new laws passed across the country mandating the use of booster seats for young children, parents have been slow to follow them, a new study shows.

Motor vehicle crashes are the leading cause of death for children aged 4 to 8. Improperly restraining a child under 80 pounds or 4 feet 9 inches can result in life-threatening injuries. Yet parents are often uncertain when to graduate their child from a smaller harness seat used for toddlers to a booster or regular, adult-sized seat belt.

"Booster seats became synonymous with car seats for younger children and many parents expect children of 4 to be finished with boosters," says Stephanie Tombrello, executive director of SafetyBeltSafe USA, a California-based nonprofit organization that advocates for child passenger safety.

This confusion leads many parents to move their child to a regular seat belt prematurely, the study finds.

Researchers from the University of Washington observed parents picking up their kids at day-care centers and schools in Washington and Oregon during the spring of 2000. They surveyed 2,880 children and asked 2,212 parents about their kids' height, weight and booster seat use.

Their results, published in the April issue of Pediatrics, show that only 21 percent of booster-eligible children utilized the seat and overall only 16 percent of children surveyed were properly restrained. Two thirds of the children who weren't using a booster seat, were strapped into an adult seat belt instead.

By comparison, the study found, 80 percent of the younger children were properly strapped into a smaller car seat. Only 55 percent of children eligible for an adult seat belt were restrained correctly.

According to the researchers, a 6-year-old was only half as likely to be in a booster seat as a 4-year-old. They also found that 8-year-olds "almost never used a booster seat."

Most parents who did not put their child in a booster seat said that they thought their child was too large to fit into one, highlighting the need for more public education around child passenger safety. Moreover, 8 percent said they never heard of booster seats.

Previous research has found that parents get tired of fighting their kids to strap into a booster seat and eventually relent by letting them use a regular seat belt.

"As a parent, it's important to pick your battles with your kids, but this is one to hold your ground on," says study author Dr. Beth E. Ebel, a pediatrician at the University of Washington Harborview Injury and Prevention Research Center in Seattle.

Adult seat belts aren't designed for children under 8 and, according to Ebel, child passenger safety would be best improved if car manufacturers designed passenger seats that fit children.

"One half of the passengers in the back of cars are kids, but the seat belts don't fit them and the seats are too big," Ebel says.

"Consumers need to take their complaints to the car manufacturers. Our kids are our most precious cargo," she says.

More information

Read about restraining children properly from the American Academy of Pediatrics or SafetyBeltSafe USA.

SOURCES: Beth E. Ebel, M.D., M.Sc., M.P.H., pediatrician, University of Washington Harborview Injury and Prevention Research Center, Seattle; Stephanie Tombrello, executive director, SafetyBeltSafe USA, Torrance, Calif.; April 2003 Pediatrics
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