Responses provided by Diana S. Martinez, health education specialist at Texas Children’s Hospital

Do you know any of the leading causes of death among children? In the United States, unintentional injury from a motor vehicle (car) crashes makes the top of the list. In 2015, approximately 1,346 children under the age of 15 were killed in motor vehicle crashes. That’s more than three children per day.

To make matters more heartbreaking – many of these deaths are completely preventable. In fact, securing children in age- and size-appropriate car seats and using seat belts cut their chances of serious and fatal injury in half.

When it comes to child passenger safety, you should move your young children through four different stages: rear-facing, forward-facing, booster seats, and seat belts.

Your infant/toddler should start with the rear-facing car seat, which will spread the crash force of a collision more evenly across the back of the car seat and your child’s body. These seats also limit motion of the head, reducing potential neck injuries to keep your child more contained within the shell of the restraint. When a child is rear-facing, the harness straps should be at or below your child’s shoulders. The straps should be snug, where you can’t pinch the strap together at the shoulders, and the retainer/harness clip should be at armpit or chest level.

The American Academy of Pediatrics (AAP) recently updated their recommendations on car safety seats, stating infants and toddlers should ride in rear-facing car seats until 2 years of age or for “as long as possible, until they reach the highest weight or height allowed” by the car seat’s manufacturer.

Once your child reaches the seat’s weight/height limit, you can consider transitioning to a forward-facing car seat. For these, the harness straps should be snug at or above the shoulders, and the clip should be at armpit level. Keep your child in this forward-facing harness until the seat’s weight/height limit is reached.

Next comes the booster seat. This is used to lift the child up so their seat belt fits them correctly. The booster seat should always be used with a lap and shoulder seat belt, giving your child the full protection needed. Similarly, keep your child in the booster seat until they reach the actual car seat’s weight/height threshold.

Even though Texas law states a child should ride in the appropriate seat until the age of 8 or height of 4 feet 9 inches, we strongly suggest keeping your child in the booster seat until the weight/height limit is reached. Otherwise, the seat belt won’t fit your child correctly, and your child is more prone to placing it under their arm or behind their back. This will not protect your child if you’re involved in a wreck. Don’t transition your child to the next step too early! This can easily become a matter of life and death.

If you’re interested in learning more about Texas Children’s Center for Childhood Injury Prevention, click here.