Caitlin Whyte (Host): Welcome to Long Live Childhood, A podcast dedicated to pediatric health and wellness, presented by Children's Health of Orange County. I'm Caitlin Whyte. And today I'm thrilled to have Jessica Lopez, a community health educator from CHOC joining us as we discuss car seat safety, what every parent needs to know.

Well, Jessica, certainly an important topic we are talking about today. To start us off, what are the key differences between infant carriers, convertibles, and booster seats, and when should parents transition their child from one to the other?

Jessica Lopez, MPH, CPST: So a couple of differences between all of those. Infant carriers are rear facing only car seats that typically come with a detachable base. So infant carriers do offer that portability and convenience as they can be used with strollers as part of a travel system.

And generally just have an easy in and out. This is probably the most common car seat we see newborn infants in. When infants reach the maximum height or weight limit of the infant carrier or when their heads is within an inch of the top of the car seat shell, parents are going to want to transition the infant into the next car seat, which is the convertible. Convertible car seats can be used rear facing for infants and toddlers and then be converted to forward facing. So while these car seats don't have a base like infant carriers, they can actually be used for newborns as well. Most if not all convertible car seats start at five pounds. So unlike the infant carrier, which typically last parents about six months to maybe a year, if they're lucky, the convertible offers a longer lifespan.

So with convertible car seats, when children reach the maximum height and weight limits rear facing, parents want to start using the convertible in the forward facing mode. So once the child reaches the maximum height and weight in that, in the forward facing mode, that's when they want to transition into a combination seat or a booster.

Booster seats are actually designed to elevate a child in order to position the vehicle seatbelt correctly. So booster seats no longer have that five point harness like infant carriers and convertibles do. They're just used with that lap and shoulder belt. So typically once a child reaches this stage, the child should remain in a booster until the seatbelt fits properly. There's actually a five step test that is a simple way to help parents identify when their child is ready to ride safely without a booster. But you'll notice a very common theme in regarding to promoting children from one car seat to the next, and it's to follow the car seat manufacturer recommendations.

We don't want to prematurely promote children to the next car seat unless they're really ready to do so.

Host: Well, thank you for those differences, Jessica. Could you explain also the importance of these rear facing car seats and at what age children should transition to forward facing seats?

Jessica Lopez, MPH, CPST: The current recommendation is to rear face for as long as possible. In a car crash, rear facing car seats actually distribute crash force more evenly across children's bodies and helps avoid the risk of those head, neck, and spinal injuries. California law, only requires children to rear face until age two.

So once they're two, legally, they can transition to forward facing car seats. However, I do want to note that two years is the absolute minimum requirement, and children could still rear face until they reach the height and weight limits of their rear facing car seat.

Host: And what are the most common mistakes parents make when installing car seats and how can they avoid those?

Jessica Lopez, MPH, CPST: A very common mistake when installing car seats is that the car seat or the base, if it's an infant carrier, is too loose and needs to be secured more tightly. So after installing your car seat, if you grab the seat from wherever the belt path is and give it a quick shake. If the car seat or base moves more than an inch from side to side or front to back, then we just need to tighten it a little bit more to make it secure.

Another common mistake is installing the car seat or base with both the seatbelt and the latch system; some car seat manufacturers do allow you to use both methods together for installation, but most of them don't. So we would recommend to check your car seat manual to see if the car seat allows it.

But one method of installation isn't safer than the other. I always like to tell parents to go with whatever method they feel most comfortable with and can get a better installation with. And then with forward facing car seats, a very common mistake is to not use the top tether. The top tether actually secures the car seat from the top and reduces that forward head motion in a car crash.

So it's a really critical element for forward facing installation that can be the difference between no injuries, minor injuries, or serious injuries in the event of a car crash. So as a child passenger safety technician, the top tether on forward facing car seats is actually something I install or anchor first so that I actually don't forget about it.

Host: Wonderful. And to wrap us up, Jessica, are there any other tips or tools parents can use to make sure their car seat is as safe as possible?

Jessica Lopez, MPH, CPST: Yeah. So while car seat manuals are helpful and provide parents with all the information they need to know about their car seat, I highly recommend you read that through. There's also child passenger safety technicians all over Orange County and actually worldwide, that can help parents correctly use and install their car seats.

So to find any local child passenger safety technicians, I encourage parents and everyone to visit cert.safekids.org to find the nearest technician to them. Parents, can also go to a free car seat checkup event that are available to the community year round. They can attend these events to get their car seat inspected by a child passenger safety technician or instructor.

During these events, technicians actually check for recalls, expiration dates on car seats, check for fit and positioning of the child in the car seat and installation. But the goal is just to work together with parents and the community to make sure that every ride is a safe ride. And then lastly, if parents have any questions about whether their child is in the right seat; the National Highway Traffic Safety Administration or NITSA, has a really cool tool called Find the Right Seat. Parents can just input general information like their child's age, weight, and height and get recommendations of appropriate car seats for their child. And it compares and contrasts different car seats. So couple of cool tools.

Host: That was Jessica Lopez sharing invaluable insights on car seat safety. For more pediatric health and wellness tips, visit health.choc.org. If you enjoyed this podcast, please share it on your social channels and explore our entire podcast library for topics of interest to you. I'm Caitlin Whyte, and this is Long Live Childhood, a pediatric health and wellness podcast presented by Children's Health of Orange County. Thanks for listening.