National Child Passenger Safety Certification Training ProgramNational Child Passenger Safety Certification Training ProgramNational Child Passenger Safety Certification Training ProgramNational Child Passenger Safety Certification Training Program

Module 8Module 8

Children in Rear-Facing Car SeatsChildren in Rear-Facing Car Seats

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Module 8 ObjectivesModule 8 Objectives

• Describe why children should travel rear-facing.

• Identify types of rear-facing car seats.

• Apply 5 steps for rear-facing car seat use.

• Explain best practices and caregiver choices about rear-facing car seats.

• Identify rear-facing car seat errors and consequences.

Children’s Bodies Change as They Grow

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Why Children Should Travel Rear-FacingWhy Children Should Travel Rear-Facing

2 Types of Rear-Facing Car Seats2 Types of Rear-Facing Car Seats

8-5Convertible

Rear-facing-only

Rear-Facing-Only Car SeatsRear-Facing-Only Car Seats

• Check car seat label for starting weight.

• In general, top of child’s head should be well contained within shell and at least 1 inch from topof shell.

• Harness needs to be snug at or below child’s shoulders.

• Caregivers should NEVER use rear-facing seat above height or weight limits designated by manufacturer.

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Rear-Facing Convertible Car SeatsRear-Facing Convertible Car Seats

• Many new car seats are approved for rear-facing for up to 40+ pound children.

• Children commonly sit with legs crossed or resting on back of vehicle seat – low injury risk.

• Older children with poor head control and other children with special needs may benefit from staying rear-facing as long as possible.

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5 Steps for Car Seat Use5 Steps for Car Seat Use

1. Selection: Choose the right car seat.

2. Direction: Face the car seat the right way.

3. Location: Install the car seat in an appropriate location in the vehicle.

4. Installation: Secure the car seat to vehicle in the right way.

5. Harnessing: Place the child correctly in the car seat.

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Rear-Facing Car Seat SelectionRear-Facing Car Seat Selection

• Select for the child’s height, weight, development levels, AND that caregiver can use correctly.

• Select with an adjustable harness height to offer options for rapidly growing infant.

• Some have multiple positions for crotch straps for better fit as child grows.

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Rear-Facing Car Seat DirectionRear-Facing Car Seat Direction

• Under age 1 ALWAYS ride rear-facing.

• Stay rear-facing AS LONG AS POSSIBLE – until reaching the top height or weight limit.

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Rear-Facing Car Seat LocationRear-Facing Car Seat Location

• Not all seats are suitable for installing a car seat. Check manufacturer instructions.

• Always ask, “Who rides in this vehicle? Where will each person sit?”

• Turn off air bag if necessary to place child in thefront seat.

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Rear-Facing Car Seat InstallationRear-Facing Car Seat Installation

• Rear-facing car seat spreads crash forces.

• Correct angle helps keep airway open.

• Know car seat recline angle.

• Use recline angle and adjustor.

• Adjust to accommodate the seat and vehicle slope.

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Recline AngleRecline Angle

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Seat Belt or Lower Anchors

• Car seats can be installed with a seat belt or with lower anchor attachments – usually NOT both.

• While the systems are different, they are equally safe.

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Install a Rear-Facing Car SeatInstall a Rear-Facing Car Seat

Common Rear-Facing Car SeatCommon Rear-Facing Car SeatInstallation ErrorsInstallation Errors

• Seat belt or lower anchor attachment that is too loose or not locked

• Rear-facing-only car seat that is facing forward

• Seat belt or lower anchor attachments routed incorrectly

• Incorrect recline angle especially for an infant

• Using 2 seat belts or using a seat belt and lower anchor attachments together (must be allowed by BOTH the vehicle and car seat manufacturer)

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Common Rear-Facing Car SeatCommon Rear-Facing Car SeatInstallation Errors Installation Errors (continued)(continued)

• Incorrect use of lower anchor connectors and tethers

• Not using appropriate tether anchor or using a tether when it should not be used (most convertible car seats do not tether when rear-facing)

• Locking clip installed incorrectly

• Carrying handle not used in the approved position for vehicle travel

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Common Rear-Facing Car SeatCommon Rear-Facing Car SeatHarnessing ErrorsHarnessing Errors

• Harness not used and child just sitting in car seat

• Harness straps that are too loose

• Retainer clip not at armpit level

• Harness routed through wrong slots

• Harness not doubled-back through buckle type metal adjuster, if it requires double-back to secure the harness

• Harness is twisted

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Common Rear-Facing Car SeatCommon Rear-Facing Car SeatHarnessing Errors Harnessing Errors (continued)(continued)

• Harness not placed on child correctly

• Harness frayed or damaged

• Metal adjuster not flush with slot or out of position

• Crotch strap adjusted too long

• Harness not at or below shoulder

• Crotch strap not through slot closest to child

• Harness incorrectly routed

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AAP Recommendations for Small & Premature Children

• Monitor all children born before 37 weeks before they leave hospital for possible breathing problems or slowing of heart rate when sitting in a semi-reclined position

• Physician determines how children will ride

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How to Fit Small & Prematurely BornHow to Fit Small & Prematurely BornInfants in Car SeatsInfants in Car Seats

• Use a rear-facing car seat with small internal harness dimensions.

• Use a car seat designed for the child’s low weight.

• Center child in a car seat with rolled receiving blankets and a crotch roll, if necessary.

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How to Fit Children in Car BedsHow to Fit Children in Car Beds

• Secure child in car bed with the internal harness or bunting.

• Place child’s head toward center of vehicle – NOT next to door.

• Use seat belt to anchor car bed lengthwise on vehicle seat.

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How to Fit Children with How to Fit Children with Breathing ProblemsBreathing Problems

• May require child to lie flat or use a non-conventional car seat.

• Semi-reclined position of car seat could make breathing problems worse.

• Children may need to travel with secured special medical equipment.

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Key Questions Related to Key Questions Related to Rear-Facing Car SeatsRear-Facing Car Seats

• What are the age, height, and weight of the child?

• Does the child have any special needs such as being very small, premature, or other physical or developmental needs?

• What does the car seat owner’s manual or label say about the minimum and maximum heights and weights for the child using this car seat?

• Is the car seat a rear-facing-only or convertible type?

• Does the rear-facing-only car seat have a base? Can it be installed without a base?

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Key Questions Related to Key Questions Related to Rear-Facing Car SeatsRear-Facing Car Seats (continued) (continued)

• Is the car seat facing the correct direction in the vehicle?

• Is the car seat in an appropriate seating position in the vehicle according to the vehicle and car seat manufacturers?

• Is the car seat installed tightly?

• Is the car seat secured by a seat belt or with lower anchor attachments?

• Is the car seat at the correct recline angle?

• Is the harness being used correctly?

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Car Seat Errors & ConsequencesCar Seat Errors & Consequences

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Car Seat Errors & Consequences Car Seat Errors & Consequences (continued)(continued)

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Car Seat Errors & Consequences Car Seat Errors & Consequences (continued)(continued)

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Car Seat Errors & Consequences Car Seat Errors & Consequences (continued)(continued)

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Car Seat Errors & Consequences Car Seat Errors & Consequences (continued)(continued)

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