Key takeaways: Ride rear-facing in the back seat as long as your seat allows. Harness straps at or below the shoulders, chest clip at armpit level, and no slack (the pinch test). No bulky coats. The installed seat shouldn’t move more than an inch. Car seats are for travel, not sleep.
Car crashes are a leading cause of death for children in the United States. Correctly used car seats dramatically reduce the risk of death and serious injury. Yet a large national study by the National Highway Traffic Safety Administration (NHTSA) found that nearly half of car seats and booster seats were misused in ways that could reduce their protection. Here are the most common newborn mistakes and how to fix them.
Mistake 1: Harness Straps Too Loose
Fix: After buckling, do the pinch test. Try to pinch a horizontal fold of the harness strap at your baby’s collarbone. If you can pinch any slack, tighten until you can’t.
Mistake 2: Chest Clip in the Wrong Place
Fix: The chest clip should sit at armpit level, across the breastbone. A clip on the belly can let the straps slip off the shoulders in a crash, and it can injure the abdomen.
Mistake 3: Straps in the Wrong Slots
Fix: For rear-facing seats, harness straps should come out of the seat at or below your baby’s shoulders. Check and adjust as your baby grows.
Mistake 4: Bulky Coats and Snowsuits
Puffy coats, snowsuits, and thick layers compress in a crash, leaving the harness dangerously loose.
Fix: Dress your baby in thin layers, buckle them in snugly, and then place a blanket or coat over the harness. Avoid aftermarket covers or inserts that go between your baby and the seat unless made by the seat’s manufacturer for that seat.
Mistake 5: A Loose Installation
Fix: Grab the seat at the belt path (where the seat belt or LATCH strap goes through) and tug side to side and front to back. It shouldn’t move more than 1 inch.Use either the seat belt or the LATCH system (not both, unless your seat’s manual says it’s allowed), and lock the seat belt if required.
Mistake 6: The Wrong Recline Angle
Newborns need enough recline to keep their airway open, since they can’t hold their heads up yet.
Fix: Check the recline indicator on the seat and adjust as the manual directs. Your baby’s head shouldn’t flop forward.
Mistake 7: Turning Forward-Facing Too Soon
Fix: The AAP recommends that children ride rear-facing as long as possible, until they reach the highest weight or height allowed by their car seat. Most convertible seats allow rear-facing well past age 2. Rear-facing seats protect the head, neck, and spine much better in a crash.
Mistake 8: The Front Seat
Fix: Children under 13 should always ride in the back seat. Never place a rear-facing car seat in front of an active airbag.
Mistake 9: Using Products the Seat Didn’t Come With
Head inserts, strap covers, mirrors, and toys that didn’t come with your seat haven’t been crash-tested with it and may interfere with safety or become projectiles.
Fix: Use only items that came with the seat or that the manufacturer approves.
Mistake 10: Letting Babies Sleep in Car Seats Outside the Car
Car seats are designed for travel. Out of the car, the angle can let a baby’s head slump forward and block the airway. Infants have died from positional asphyxia in car seats, swings, and other sitting devices.
Fix: When you reach your destination, move a sleeping baby to a firm, flat sleep surface. Never place a car seat on a soft surface, a table, or on top of a shopping cart.
More Car Seat Tips
- Read both manuals: your car seat manual and the car seat section of your vehicle owner’s manual.
- Register your seat with the manufacturer so you hear about recalls.
- Check the expiration date, usually stamped on the seat or label.
- Replace after a crash. NHTSA recommends replacing a seat after a moderate or severe crash.
- Be cautious with used seats. Only use one if you know its full history, it hasn’t been in a crash, it has all its parts and labels, it isn’t expired or recalled.
- Premature babies: many hospitals do a “car seat challenge” before discharge to make sure a preterm baby can sit safely in the seat.
- Limit long trips for young babies, and take breaks.
Never Leave a Baby Alone in the Car
A car’s inside temperature can rise about 20°F in 10 minutes, even with windows cracked, and babies heat up much faster than adults. Make a habit of placing your phone, bag, or a shoe in the back seat so you always check before locking the car.
Get a Free Car Seat Check
Certified Child Passenger Safety Technicians can check your installation and teach you how to use your seat correctly, often for free. Find one through NHTSA (nhtsa.gov) or Safe Kids Worldwide.
The Bottom Line
A correctly installed, correctly used car seat is one of the most protective things you’ll ever do for your child. Snug harness, armpit-level clip, rear-facing in the back seat, no bulky coats, and a seat that doesn’t budge.
For more on newborn health and safety, see my book From First Breath to First Birthday.
Sources
- Durbin DR, Hoffman BD; Council on Injury, Violence, and Poison Prevention. Child passenger safety. Pediatrics. 2018;142(5):e20182460.
- Greenwell NK. Results of the National Child Restraint Use Special Study. Report No. DOT HS 812 142. National Highway Traffic Safety Administration; 2015.
- National Highway Traffic Safety Administration. Car seats and booster seats. https://www.nhtsa.gov/equipment/car-seats-and-booster-seats
- National Highway Traffic Safety Administration. Car seat use after a crash. https://www.nhtsa.gov
- Bamber AR, Pryce J, Ashworth MT, Sebire NJ. Sudden unexpected infant deaths associated with car seats. Forensic Sci Med Pathol. 2014;10(2):187-192.
- Liaw P, Moon RY, Han A, Colvin JD. Infant deaths in sitting devices. Pediatrics. 2019;144(1):e20182576.
- McLaren C, Null J, Quinn J. Heat stress from enclosed vehicles: moderate ambient temperatures cause significant temperature rise in enclosed vehicles. Pediatrics. 2005;116(1):e109-e112.
- Bull MJ, Engle WA; Committee on Injury, Violence, and Poison Prevention; Committee on Fetus and Newborn. Safe transportation of preterm and low birth weight infants at hospital discharge. Pediatrics. 2009;123(5):1424-1429.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
