One night during my pediatric residency a young family went out for a drive to a local store. They were driving 25 miles an hour down a two lane road when a pickup truck also traveling 25 miles an hour in the other direction swerved into their lane and collided head on.  Both parents were killed on impact and the three year old in the middle rear seat was ejected from her improperly used car seat.  We were able to stabilize her body, but she was declared brain-dead a few hours after coming to the pediatric intensive care unit.   I was the pediatrician who had to help the social workers attempt to reach living relatives and to explain the tragedy to them.

A few weekends ago while attempting to wash my daughter’s vomit off of her car seat, I realized I had made a mistake.  Clearly labeled on the car seat were two holes that said in large writing “USE HERE FOR FORWARD FACING.”  I had installed the car seat wrong after switching from rear-facing to forward facing.   Admittedly, the change had come some time after she had been screaming for what must have seemed like hours and my wife and I had gotten into a heated discussion about the preferred safety of rear-facing seats, so a little user-error seems understandable.   But, I never went back and looked at the manual after re-installing the seat and switching cars multiple times.  I’m lucky there were no consequences.

Unintentional injury is the leading cause of death in children ages 1 to 24.  Car related injuries make up the highest number of unintentional injuries in this age group.  See:

We all like to think that tragedies like the story above will never happen to us, but the truth is they could happen any time.   Please take a few minutes tonight to read over your child safety seat manual (if you lost it, call the number on the car seat and they will email you a pdf of the manual) and be sure you are using it properly.   Or you can go to this website and find a car seat inspection site that will help be sure you are using your seat properly.    Using your car seat how it is meant to be used could be the single best thing you do for your child’s health and one of the easiest.

Helpful Websites:

Search for a local child safety seat inspection site by zip code:

Great overall child safety seat website, including link to “ease of use” rating for carseats and much more:

AAP education on child safety seat: