10/10/14  Portland, Ore.

New research will presented Monday, Oct. 13, at the American Academy of Pediatrics National Conference & Exhibition in San Diego

A study of 267 families at Oregon Health and Science University Hospital has revealed that 93 percent made at least one critical error — a mistake that put their infant at increased risk for injury in a crash — when positioning their infant in a car safety seat or when installing the safety seat in their vehicle.

“Car safety seats can be difficult to use correctly for many families, and we need to provide the resources and services they need to help ensure the safest possible travel for newborns and all children,” said Benjamin Hoffman, M.D., F.A.A.P., lead author of the study; medical director of the Tom Sargent Children’s Safety Center at OHSU Doernbecher Children’s Hospital; and professor of pediatrics in the OHSU School of Medicine.

Hoffman and colleagues enrolled randomly selected mother-infant pairs in the OHSU Hospital Mother-Baby Unit from November 2013 to May 2014. Infants born at less than 37 weeks’ gestation and those who stayed in the neonatal intensive care unit for more than four hours were excluded from the study.

A certified child passenger safety technician at the Tom Sargent Children’s Safety Center at OHSU Doernbecher observed new mothers or their designee position the newborn in the car safety seat and install the seat in the vehicle before leaving the hospital, and recorded all misuses based on car safety seat and vehicle manufacturer recommendations.

Prior to departure, technicians helped caregivers correct all mistakes.

The most common errors in positioning the infant included:

• Harness too loose (69 percent)
• Retainer clip too low (34 percent)
• Use of after-market product not approved with seat (20 percent)
• Harness too high (18 percent)
• Caregiver not knowing how to adjust the harness (15 percent)

The most common installation errors were:

• Car safety seat installed too loosely (43 percent)
• Angle of car safety seat incorrect (36 percent)
• Safety belt used but not locked (23 percent)
• Incorrect spacing between car safety seat and vehicle front seat (17 percent).

Families with increased risk for one or more critical errors tended to be of lower socioeconomic status, had less education, were non-white, did not speak English, and were unmarried or without a partner. Families who had worked with a certified car seat technician prior to their child’s birth were 13 times more likely to position their baby correctly and install the car seat correctly in their vehicle.

“We need to move beyond the idea that we cannot afford to develop and support child passenger safety programs,” said Hoffman. “Car crashes kill more kids that any other cause; we can’t afford not to.”

View the abstract: “Unsafe from the Start: Critical Misuse of Car Safety Seats for Newborns at Initial Hospital Discharge.”

The research was funded by a grant from Friends of Doernbecher.