Car accidents kill millions of children in the United States and Canada every year. Safety restraints and car seats can save lives if installed and used properly. Every child from birth to about 8 years of age should be correctly secured in a car seat. There are four main types of car seats; rear-facing infant car seat, a convertible car seat (rear and/or forward facing), combination booster seat (forward facing) and a booster seat (forward facing only).

Here are some safety features that are recommended for all types of car seats (except booster seats that use your vehicles seat belt):

• 5-point Harness. Experts agree and studies confirm that this type of harness is safest. The 5-point harness usually gives the best fit and reduces the chance of ejection. T-shields and other shield-type car seats are no longer as widely recommended.
• Wide, Twist-free straps. Avoid harnesses have straps that twist easily. A twisted strap reduces the area that restrains a child in a crash, and this can result in burns or more severe injuries.
• Two-piece chest clips. These can also reduce strap twisting and are usually easier to use. They are often more difficult for a child to detach thus providing a safer ride.
• Front harness adjustments. Some seats have a mechanism on the front of the car seat to adjust the tightness of the harness. Experts recommend that the harness be snug, so that you can't pinch the strap away from the shoulder. A tight harness reduces the forward movement of the head in a crash and reduces the overall risk of injury. The easier the tightness is to adjust, the more likely it is that you will adjust it properly every time (winter coats and other bulky clothing under the harness straps are not recommended).
• Built-in locking clips. A lot of older vehicles will require the use of a metal locking clip to make sure the seatbelt holds the car seat properly and doesn't loosen over time. These clips are easily lost, and often used incorrectly. A few models have built-in locking clips that are much easier to use and often result in a tighter fit.
• Seat Belt Routing Path. In addition to built-in locking clips, some car seats have seatbelt routing paths, which may make for better installations in some vehicles. Certain seats also make it easier to actually route the belt from one side to the other with your hands. Vehicles with sloped rear seats or seatbelt buckles that come out from in front of the crease between the cushion and the back of the seat can make for difficult installations.
• Size. Certain seats are simply too large to fit in vehicles with small rear seating areas, especially when they are rear facing. At least one larger model (Century SmartMove) must remain free to rotate backward in a crash for safety reasons, and in some cases this means it cannot be touching the seat in front of it. For most car seats, this is not an issue, and may even be an advantage in a crash. Finally, it is at times necessary to choose a narrower model so that more car seats or passengers can fit side-by-side in the rear seat.
• Tether strap with easy adjustment. Most new convertible and harnessed front-facing car seats have standard top tethers, and they can be installed on older ones. Tethers improve safety in a crash when installed properly. The mechanisms to adjust the length vary from model to model. Some have an easy-to-use push-button mechanism while others have more difficult slider buckles.
• Rear-facing tethers and Anti-Rebound Bars. These are found on a few infant and convertible seats (Britax Companion infant seat uses one). Depending on the model, these features may improve crash performance, reduce the rebound of the rear-facing seat into the vehicle seat and increase the stability of the installation.

Infant Car Seat (rear-facing)

This particular car seat is for babies at birth to 20 lbs. An infant seat is probably the safest for newborn babies because it is small enough to fit snug around and infant. Infant carriers with bases are more convenient and some say they are safer. Most infant carriers come with bases that can be installed separately. The base is left in the vehicle, and the carrier is easily installed or removed from the base without taking the baby out of the harness. An extra base can usually be purchased separately for another vehicle. The infant carriers can be installed in the car without the base, but a few models may require the base for installation so check to make sure.

Here are some steps to help ensure your infant is properly restrained in their infant-only rear-facing seat:

• Place harness straps at or below infant's shoulders and make sure they are snug.
• Place chest clip at your infant's armpit level to keep harness straps in place.
• If necessary, place rolled towel around baby's head and neck for support.
• Do not put heavy clothing or jacket on baby because it prevents harness straps from being snug and could cause baby to jerk forward during a crash.
• Never place any extra cushioning under or behind your baby. This also prevents harness straps from being snug. If additional padding is needed, use only the padding that comes with your child safety seat.
• Secure your infant in the seat and then place a blanket over him/her (do NOT cover infant's head).

Convertible Car Seat (rear and/or forward facing)

This seat is definitely the most versatile and tends to be the seat your child will stay in for the longest period of time. The convertible car seat is for children birth to around 40 lbs. Infants can use this seat as long as it is rear facing (most parents prefer the convenience of an infant-only seat first). When using this seat your child should be rear facing until they reach 20 lbs.

Here are some suggested for properly restraining your child in a convertible car seat in the rear-facing stage:

• Place harness straps at or below infant's shoulders (lower slots) and keep them snug.
• Place chest clip at infant's armpit level to keep harness straps in place.
• Do not put heavy clothing or jacket on child. This prevents harness straps from being snug.
• If using a convertible seat rear facing for a newborn/infant, place rolled towel or light blanket around baby's head and neck for support. Never place any extra cushioning under or behind the baby.
• Shields are not recommended for newborns. When selecting a convertible seat for a newborn, choose one without a t-shield (roughly triangular or “T” shaped pad that is attached to the shoulder harness straps, fits over the child's abdomen and hips and buckles between the legs) or tray shield in front of the baby. A 5-point harness strap is said to be the safest for all ages. The shield comes up too high on the newborn and may make proper adjustment of the harness difficult and unsafe.

Suggestions for proper restraint in a convertible car seat (forward facing):

• Place harness straps at or above child's shoulders. (For most seats, harness straps should be in the uppermost slots. Read manufacturer's instructions.)
• Place chest clip across the chest at armpit level to keep harness straps in place.
• If you don’t have a chest clip because you have a tray shield remember some tray shields are adjustable, the tray shield should be as close to the child as possible. (T-shield and tray shield car seats are usually not deemed as safe as 5-point harness seats with a chest clip; check with your Pediatrician or the Consumer Safety Council for suggestions and advice)

Combination Booster Seats (forward facing)

These seats offer a harness for children 20-40 lbs and then you can use a seatbelt when the child reaches 40 lbs and is at least 35” tall. You can remove the harness when child reaches approximately 30 to 40 pounds. (Recommended that the child is at least age 3-4) and use as booster up to 80 pounds or upper weight limit listed on seat.

Tips for using the combination booster seat and properly restraining your child:

When used as a forward facing seat:

• Place harness straps at or above child's shoulders. Forward facing seats have several slots; always choose the slots closest to your child's shoulders.
• Place chest clip across the child's chest at armpit level to keep harness straps in place and keep them snug.
• When your child reaches upper weight limit of seat with harness (40 pounds) remove harness and use as a belt-positioning booster seat with the vehicle's lap and shoulder belt (see tips for properly restrained child in a belt-positioning booster seat.)

Booster Seat Used With Seat Belt

Booster seats used in conjunction with seat belts in your vehicle are for children who are too large for toddler seats but too small for seat belts. A booster seat can better protect your child because it raises them up so the seat belt fits right. There are two types of high back booster seats that fit in your car. One is used only lap shoulder belt that provides back and neck support for your child in case your vehicle doesn’t have that support and the other converts from a forward-facing toddler seat to a booster seat and is equip with a harness. When your toddler outgrows this seat you can remove the harness and use the lap/shoulder belt in your vehicle.

Another type of booster seat is the no-back belt-positioning seat. It is used with a lap/shoulder belt in cars that have built in head and neck support.

Here are some guidelines for restraining your child in a booster seat:

• The shoulder belt should cross the child’s chest and rest snugly on the shoulder. The lap belt should rest low across the pelvis or hip area not on the stomach.
• Your child’s ears should not be higher than the vehicle’s seat’s back cushion or the back of the high back booster seat.

If your car seat is involved in an accident it should always be replaced no matter what type of seat you have. Many parents ask “What is the safest seat for my child?” The answer is “ the seat that best fits your child, your vehicle and your budget.” There is no one safety seat that is the safest to use, however there are certain companies and brands that have a higher safety and consumer rating than others. Of course the safety features mentioned above are strongly recommended and are included on almost every car seat on the market today. They have to be approved and meet government standards in order to be sold in the United States. The best advice for parents who are shopping for a safety seat is to do some research first and become educated about the safety features and the type of seat that will best suit your child.