Every year it seems like there is a new class of carseat that is introduced to parents to confuse them. Back in the day, it was easy: infant seat, convertible seat, booster seat. Now there are seats that fit those stages, plus every in-between stage you didn’t realize your child had!
Infant Seat/Rear-Facing Only
These carseats are designed for newborns and fit babies typically from 4-5 lbs. up to as much as 40 lbs. They are instantly recognizable because they have handles and canopies and make it easy to carry babies around—theoretically—while the base stays permanently installed in the car. While they fit a wide range of sizes, they won’t last long since children grow so quickly. According to the American Academy of Pediatrics (AAP), children should face the rear of the vehicle for as long as possible to the limits of their carseat. The spirit of the AAP guidelines is that children remain rear-facing to the upper limits of a higher weight limit convertible carseat.
Price ranges drastically from around $60 to $500 with features to match, yet they all do the same thing: harness baby to keep them safe in a vehicle. Institutional models may not come with a base and must be installed each time.
Concerns:
- Caregivers leaving babies in carseats for too long—studies, including this one, have shown healthy babies have breathing difficulties when left in carriers for too long
- Carrier placed on top of shopping cart can fall off or cause shopping cart to tip over, seriously injuring child
- Caregivers unbuckle child, either partially or entirely, while child sleeps in carseat and child strangles on harness after moving
- Caregivers unbuckle child, either partially or entirely, thinking it is more comfortable for child while carseat is out of vehicle and forget to re-buckle harness before return trip home
Convertible
These are seats that can be used rear-facing from 4-5 lbs., then turned forward-facing (FF) for an older toddler. Children must face the rear of the vehicle for as long as possible. It is safer for a child to rear-face until the rear-facing weight limit is reached or until the child’s head reaches 1” from the top of the carseat, depending on the carseat’s height requirement.
Convertibles do not detach from bases like infant seats and are “permanently” installed in vehicles. The vast majority of convertible carseats have FF weight limits to 65 lbs. or more. There are a few that have FF 40 lbs. weight limits and they are smaller, lighter seats.
Price ranges from $38-$500 and just like rear-facing only seats, the features go with the prices. All carseats save lives when properly used!
Concerns:
- A newborn may not fit some convertibles properly, even though she meets weight and height requirements
- Some convertibles require specific reclines that require the front seat to be moved very far forward
- Some caregivers only buy 1 convertible and switch it often between vehicles, which may lead to installation errors
All-in-One/3-in-1/4-in-1
These are seats that can be used rear-facing from 4-5 lbs., then turned forward-facing (FF) for an older toddler. They also convert to belt-positioning booster (BPB) mode. It is safer for a child to rear-face until the rear-facing weight limit is reached or until the child’s head reaches 1” from the top of the carseat, depending on the carseat’s height requirement.
All-in-ones have higher weight limit harnesses for FF that go to 65 lbs. generally.
Belt-positioning booster features can be either highback (all-in-one and 3-in-1) or highback and backless (4-in-1). So far, the tallest BPB shoulder belt guides aren’t much taller than the tallest harness slots, so they have not proven to be long-term highback boosters.
Price ranges from $120-$350.
Concerns:
- A newborn may not fit some all-in-ones properly, even though she meets weight and height requirements
- Some caregivers may buy an all-in-one believing it may be the last carseat they will ever need, which may not be the case. Children need booster seats until age 10-12 and these seats may not provide the best fit for all stages of the child’s carseat ages.
- Some caregivers only buy 1 carseat and switch it often between vehicles, which may lead to installation errors
- These carseats tend to be heavier; therefore, they may have lower LATCH weight limits and caregivers may need to switch to a seat belt installation sooner than anticipated
Combination
These are forward-facing only seats for bigger kids that can be used with a harness to 50 lbs. or higher, then converted to a belt-positioning booster (BPB). Some combo seats have minimum age and weight limits. Once the child reaches the maximum weight limit for the harness, you must stop using the harness. If a child is not mature enough to use a combination seat as a BPB, a higher weight harness seat may be appropriate. Also important to note is that combination seats are FAA-approved for use in airplanes when in harness mode only.
And to throw in an extra note of confusion, there are 3-in-1 combination seats too. These seats have 3 modes of use: harness, highback belt-positioning booster, and backless booster.
Concerns:
- Caregivers jump immediately to these seats from infant seats/rear-facing only seats. Children benefit from rear-facing as long as possible.
- Caregivers use the harness past the maximum weight limit because they are confused by advertised weight limits. For example, seat may be marketed as 22-100 lbs., but harness weight limits are from 22-65 lbs. whereas booster weight limits are from 40-100 lbs.
Belt-Positioning Booster
Belt-positioning boosters (BPBs) are used with the vehicle’s lap/shoulder belt only (do not use a BPB with a lap-only belt) and may or may not be LATCH-equipped. If LATCH-equipped, it is to keep the booster secure to the vehicle while the child is not riding in it. A child is typically mature enough to use a BPB safely around age 5+ and will use a booster until around age 11-12.
Boosters come in two varieties: highback and backless. Some highback boosters convert to backless boosters. Highback boosters are typically used by younger booster riders and give a feeling of riding in a traditional carseat. This helps them transition to the freedom of a seat belt and gives their heads a place to lean as they sleep. There is no empirical evidence showing that highback boosters protect kids better than backless boosters, though they “feel” like they should, and they do help children maintain position. Vehicle side curtain airbags make a tremendous difference, though.
Backless boosters are used by older kids, around age 8 or 9+, who prefer having something less conspicuous. Older kids may like lower height boosters, like the Graco RightGuide.
Concerns:
- Caregivers move their child to a BPB before the child has the maturity to handle it. If the child is too young or too small, they can slip out of the seat belt and not be protected in a crash.
- Caregivers tend to move their kids out of a booster before they are large enough to fit in a vehicle seat belt without one
- Some highback boosters require a vehicle seat or headrest to support them all the way to the top of the child’s ears. This can be a problem if you are buying the highback booster because your vehicle does not have a headrest or has a very low seat back in that seating position.
- Children do not stay seated properly in the seat belt
Vehicle Seat Belt (5-Step Test)
The vehicle seat belt alone without any devices is the final step in a child’s progression in the carseat world. The big question is always, How do I know when my child is big or old enough to sit in the seat belt alone? The 5-Step Test answers that question for us.
- Does the child sit all the way back on the vehicle seat?
- Are knees bent comfortably at the edge of the vehicle seat?
- Does seatbelt cross the shoulder properly? (it should be centered over the collar bone)
- Is the lap portion of the seatbelt low–touching the thighs?
- Can the child stay seated this way for the entire ride, every ride (awake and asleep)?
Bonus step–feet planted firmly on floor
This test is important because seat belts are designed to fit adults and since most kids are not adult-sized until puberty occurs, they need to be in boosters to avoid serious life-long injury or death. Many kids pull the shoulder belt behind their backs to make the fit more comfortable, which leaves them vulnerable to head and upper body injuries. They may also slouch down on the vehicle seat so their knees can bend at the seat edge, which can place the lap belt over the soft belly. This can cause a set of injuries called seat belt syndrome, including spinal fractures, and liver, stomach, spleen, and other organ lacerations.
Special Needs Seats
Special needs carseats are specialty items for children whose needs cannot be met with off-the-shelf carseats. These carseats are generally more difficult to find and are expensive; insurance may cover some or all of the cost. Special needs carseats range from car beds used for infants to belt-positioning boosters and vests for older kids2.