Published on July 12, 2022

Car Seat Safety for Newborns and Young Children

baby in car seat

Proper car seat use is one of the most important ways to help protect your baby or young child while traveling. The safest car seat is one that is appropriate for your child’s age, height and weight; fits your vehicle; and is installed and used correctly every time.

For newborns, small babies and premature infants, correct positioning is especially important. A rear-facing car seat should support the baby’s head, neck and spine while also helping keep the airway open during travel. Always follow the instructions that came with your car seat and your vehicle owner’s manual.

Start with the Right Seat

Infants and toddlers should ride in a rear-facing car seat for as long as possible, until they reach the highest height or weight allowed by the car seat manufacturer. Many children can remain rear-facing beyond age 2, depending on the limits of the seat.

California law requires children under age 2 to ride in a rear-facing car seat unless the child weighs 40 pounds or more, or is 40 inches tall or taller. Children under age 8 must be secured in an appropriate car seat or booster seat in the back seat.

Install the Car Seat in the Back Seat

The back seat is the safest place for children. If possible, the center back seat may offer added protection, but the best location is the seating position where the car seat can be installed tightly and correctly according to both the car seat and vehicle instructions.

When installing a rear-facing car seat:

  • Use either the vehicle seat belt or the lower anchors, following the car seat manufacturer’s instructions.
  • Do not use both the seat belt and lower anchors unless your car seat manufacturer specifically allows it.
  • Check the recline indicator to make sure the seat is at the correct angle for your baby.
  • Make sure the seat does not move more than 1 inch side to side or front to back when pulled at the belt path.
  • Never place a rear-facing car seat in the front seat of a vehicle with an active passenger airbag.

Position Your Baby Safely

Place your baby with their back and bottom flat against the car seat. Harness straps should be flat, not twisted, and placed through the slots at or below your baby’s shoulders for a rear-facing seat.

After buckling your baby:

  • Tighten the harness until it is snug. You should not be able to pinch extra harness material at the shoulder.
  • Place the chest clip at armpit level, across the center of the chest.
  • Keep your baby’s face uncovered and chin in a neutral position.
  • If your baby’s head falls forward, stop when it is safe and check the seat angle and positioning.

Avoid Unsafe Add-Ons

For a small or premature baby, use only the insert or positioning support that came with the car seat or that is approved by the car seat manufacturer. Do not place extra padding, pillows, blankets, head supports, strap covers or aftermarket accessories under your baby, behind your baby, over the straps or around the head unless the manufacturer specifically allows it.

Bulky coats and blankets can make the harness too loose. In cold weather, buckle your baby into the seat first, then place a blanket over the harness to keep them warm.

Special Considerations for Premature or Small Babies

Premature infants, low birth weight babies and babies with certain medical needs may need extra guidance before traveling in a car seat. Follow your pediatrician’s or hospital care team’s instructions about car seat positioning, car seat tolerance screening and how often your baby should travel.

If your baby was born prematurely or has breathing, feeding, muscle tone or other medical concerns, ask your care team whether an adult should sit in the back seat near the baby during travel and whether car trips should be limited to medical visits until your pediatrician provides different guidance.

Use the Car Seat for Travel, Not Routine Sleep

A car seat is designed to protect your child during travel. It is not intended to be used as a routine sleep space outside the car. If your baby falls asleep in the car seat, move them to a firm, flat sleep surface on their back as soon as you arrive and it is safe to do so.

Know When to Move to the Next Stage

Do not rush your child into the next type of seat. Children should stay rear-facing until they reach the maximum rear-facing height or weight limit for their seat. Once they outgrow the rear-facing seat, they should use a forward-facing car seat with a harness and tether until they reach that seat’s height or weight limit. After that, they should use a booster seat until the vehicle seat belt fits properly.

Children should continue riding in the back seat until at least age 13.

Get Help with Car Seat Safety

Car seat installation can be confusing, and many seats are not installed correctly. A certified child passenger safety technician can help you check the installation and learn how to use your seat properly.

For car seat installation and safety information, visit Safe Kids Worldwide or the National Highway Traffic Safety Administration.

You may also call Torrance Memorial Health Education at 310-517-4711 to ask about infant and child CPR classes. Online and in-person CPR classes are also available through the American Red Cross.

This information is for general education and is not a substitute for medical advice. Always follow your car seat manufacturer’s instructions, your vehicle owner’s manual and guidance from your baby’s pediatrician or care team.