Child Passenger Safety

• ​​​​​​​In 2020, 607 children under 13 died in motor vehicle crashes in the United States, and an estimated 63,000 were injured.[1]
  
• Almost 2/3 of the children who died were under the age of 8 and roughly 1/3 were unrestrained at the time of the crash.
• Deaths and serious injuries to children are preventable.
• Children who are restrained are often not appropriately restrained—either they are in a lap/shoulder belt without a booster seat or in the incorrect car seat for their size and weight.
• Child safety restraint systems are the most effective available means of reducing a child’s risk of sustaining severe injuries during a crash.

​​Child car seats have been shown to reduce the risk of death by 71% for infants (under 1 year old) and by 54% for toddlers (1 to 4 years old) in passenger cars.[2]

Too often, children who have outgrown a child car seat are transitioned to an adult seat before a lap/shoulder belt fits them correctly.[3] Booster seats in combination with the vehicle’s lap/shoulder belts are particularly effective protection for children who have outgrown child car seats with an internal harness. Booster seats raise the positional height of children, ensuring the appropriate fit of the adult lap/shoulder belt. A recent study by the National Highway Traffic Safety Administration (NHTSA) found that booster seats are 65–68% effective in reducing moderate-to-critical injuries of 5- to 8-year-old vehicle occupants in all types of crashes.[4] The NHTSA study also found that the effectiveness of booster seats was even greater—86%—in reducing moderate-to-critical injuries for 7- to 8-year-old occupants.

According to NHTSA 2017 data, 20.8% of children 4 to 7 years old were restrained only by lap/shoulder belts, when they should have been riding in booster seats.[5] State laws can make a difference. Based on a 2012 study, the crash fatality rate among 6- and 7-year-old children was 23–25% lower in states with booster seat use laws that include children of those ages compared to states without such laws.[6] However, even when a state requires that some children be placed in booster seats, it is up to the parents to adopt those safety measures.

​​Our recent investigation illustrates what happens when parents prematurely transition to restraint types that are not appropriate for a child’s age, height, and weight.​​

• ​​Be sure all children in your vehicle are properly restrained for their age, height, and weight.
• Have your child safety seat inspected by a trained technician (see www.seatcheck.org for a technician near you).
• Be sure your child is ready to use a lap/shoulder belt by ensuring that the belt fits correctly. A lap/shoulder belt fits correctly when:

• A child’s knees bend at the edge of the seat when their backs and bottoms are against the vehicle seat back;
• The vehicle lap belt fits across the upper thighs; and
• The shoulder belt fits across the shoulder and chest.
  
  

​NHTSA — Car Seats and Booster Seats Finder

​CDC — Child Passenger Safety: Get the Facts​

​Safe Kids — The Ultimate Car Seat Guide

1. ​See the National Hig​hway Traffic Safety Ad​​ministration (NHTSA) Traffic Safety Facts regarding child safety (Report No. DOT HS 813 285), and the Centers for Disease Control and Prevention (CDC) Child Passenger Safety: Get the Facts | Transportation Safety | CDC.​
2. Hertz, E. 1996. Revised Estimates of Child Restraint Effectiveness. (Report No. DOT HS 96 855) National Highway Traffic Safety Administration.
3. Children are usually between 8 and 12 years old when the seat belt fits them properly.
4. Pai, J.E. 2020. Evaluation of Child Restraint System Effectiveness (Report No. DOT HS 813 047). National Highway Traffic Safety Administration.
5. Li, H.R. and T. Pickrell. 2018. The 2017 National Survey of the Use of Booster Seats (Report No. DOT HS 812 617). Washington, DC: National Highway Traffic Safety Administration.
6. Mannix, R., E. Fleegler, W. Meehan, S. Schutzman, H. Hennelly, L. Nigrovic and L. Lee. 2012. “Booster Seat Laws and Fatalities in Children 4 to 7 Years of Age.” Pediatrics, 130, 996—1002.
   
7. ​​See Arizona Revised Statutes 28–907. This statute also requires all children under 5 years old to be properly secured in a child restraint system​​.