In Babies and children

When I first arrived in South Africa in 2012, on our drive from Cape Town International Airport to Fish Hoek (where we were staying with Greg’s parents) I felt sick. Not because of the winding roads of Ou Kaapse Weg, but because I was seeing cars flying past us on the highway doing speeds in excess of 100 km/hour with unrestrained children. Since then I have seen children jumping around the back seat, lying on the parcel shelves, sitting between the two front seats, babies in arms and I have even seen a child sitting on the driver’s lap! 

Before 1 May 2015, there was no legislation in the National Road Traffic Act in South Africa enforcing drivers to ensure that those younger than 3 years old were safely restrained in a car seat. And, although there was this existing legislation for children age 3 years and above, unfortunately there is a disregard for this legislation and we see far too many children not safely restrained in vehicles on our roads.

Children, especially under the age of 3 years, are unable to look after themselves. They rely on an adult to take responsibility for them and keep them safe. It is the driver’s responsibility to ensure that every person in their vehicle is safely restrained. This includes children and infants. 

Why should children wear a seat belt/be in a car seat?

  • Children have more flexibility in their cervical spines and their heads are bigger in proportion to their body than an adult. Because the child has a bigger head, their centre of gravity is higher, resulting in more of a whipping motion when there is a sudden acceleration because of a collision in a vehicle. Therefore, it is more likely to cause injury to the neck. 
  • Children’s muscles are less developed and they have less control of their head when it is suddenly thrown forward. This results in a disproportionally larger injury to the child’s neck. 
  • Adults often anticipate a collision whereas a child is not necessarily paying attention to what is happening on the road around them. Therefore, they are unable to brace for impact and injury. Read more about this in our article on whiplash.

The main categories for car seats are:

Birth up to Age 2 (minimum) – Rear-facing Car Seat

The safest way for an infant to travel is in a rear-facing position. This is recommended until the minimum age of 2 years but ideally until the child reaches 4 years of age (extended rear-facing). Only move to a forward facing position when they exceed the height and weight limit of their rear-facing seat.

Age 2 up to At Least 5 – Forward-facing Car Seat

When children outgrow the height and weight limit of their rear-facing car seat they should move on to a forward-facing car seat. This is recommended from the minimum age of 2 years until at least 5 years of age. Only move on to a booster seat when they exceed the height and weight limit of their forward-facing seat.

Age 5 up Until Seat Belts Fit Properly – Booster Seat

When children outgrow the height and weight limit for their forward-facing seat they should move on to a seat belt positioning booster seat until the seat belt fits them properly (in the UK it is now law that children in this category are seated in a high backed booster seat. Booster cushions are no longer manufactured or sold there).

NOTE: Check the weight limit that your car seat harnesses as it is often less than the weight limit for the car seat itself. The maximum weight limit refers to using the car seat with a seat belt, once your child has reached the maximum weight limit for the harness.

Once Seat Belts Fit Properly Without a Booster Seat

Children no longer need to use a booster seat once a seat belt fits them properly. The South African Road Traffic Act classes a child as anyone under the age of 14 years or under 1,5 meters tall. Seat belts fit properly when the lap belt lays across the upper thighs (not the stomach) and the shoulder belt lays across the chest (not the neck).

When choosing a car seat for your child you must take the following into consideration:

  • Is the car seat correct for your child’s current age/weight/size?
  • Is the car seat suitable for your vehicle?. i.e. Will it fit in the seat? Will the seat belt fit around the seat? Does it have the required connections? 
  • Does the car seat fit in all the cars that your child will be travelling in?
  • Does the car seat meet all of your needs? i.e Do you need a car seat that can be easily lifted in and out of the car with your baby in it or do you want a fixed car seat?

Never carry your child in your arms in a vehicle. In the event of a collision, you will not be able to hold on to your child. Even in a low speed collision a child’s body becomes a human projectile as it functions as a single piece of inertial mass. They may be thrown from or around the inside of the vehicle. This can cause more damage than if they were a pedestrian involved in a collision!

In a front end collision at 40 kph on impact, the forces of the baby may reach 20 G. In a moving vehicle that stops suddenly on impact, an unrestrained child will continue to move at the original speed of the vehicle until it is stopped by the interior of the vehicle. So, a 6-month-old weighing 7 kg would effectively weigh 140 kg and be travelling at 40 kph during that collision. It would be impossible for the adult to hold on to that child under those circumstances. If the adult is also unrestrained, they risk crushing the child against the dashboard or the back of the front seat. 

Never use a car seat that has been involved in a collision. You may not be able to see any damage to the car seat, however, there may be structural damage that you are not aware of that will compromise the integrity of the car seat.

Never use a car seat that has expired. Yes, car seats have an expiration date. Most car seats have the date of expiration stamped on the manufacturer label located on the sides or the base of the car seat. Alternatively, it might show the date of manufacture. If that’s the case, generally the car seat will expire six years after the date of manufacture.

Be cautious of second-hand car seats. The best advice is not to buy a car seat second-hand. 

If you are buying a car seat second-hand, only buy from a reputable source (i.e. family or friends). Do not buy from second-hand shops or from classified ads online. Only accept one from a family member or friend if you are absolutely certain that you know its history, it comes with the original instructions, and it is not too old.

Before you agree to accept a second-hand car seat:

  • Examine it carefully for damage (but remember, not all damage to child seats is visible to the naked eye).
  • Make sure the manufacturer’s instructions are available.
  • Check the manufacturer’s advice about how old the seat should be before it needs to be replaced.
  • Make sure the seat is suitable for your child’s weight and height.
  • Try the seat in your car – if you cannot get it to fit securely, do not buy it.

Most road crashes are caused by basic driver errors, such as not looking properly or being careless. As a driver, there are several simple steps you can take to reduce the risk of you and your family being involved in a collision.

On every journey:

  • Watch your speed.
  • Leave plenty of room between you and the car in front of you.
  • Leave plenty of time for your journey, so you’re not stressed or tempted to speed.
  • Don’t do other things that will distract you (like using a mobile phone) while driving.
  • Don’t drink and drive, and avoid medicines that make you drowsy.
  • Don’t drive while tired – plan long journeys to include rest breaks.

Make sure:

  • Your child is using a suitable child car seat or seat belt.
  • The child seat is securely fitted – check every journey.
  • The child locks on the car doors are activated.
  • You wear your own seat belt – set a good example.
  • Your head restraint is correctly adjusted.

It is also important to remember that vehicles are not a safe place for children to play. Children should never be left alone inside a vehicle, even when the engine is switched off. Electric windows, choking and fire hazards in cars have all proved fatal to small children. It is not safe to leave children inside your vehicle while you make a quick call to somewhere, like a shop or school.

It’s a good idea to educate children so that they know not to play in or around parked vehicles. It is not safe to play hide and seek in or around a parked vehicle.

Demonstrate proper driving habits for children, they will grow up to be drivers themselves. Offer a lifetime of guidance. 

Always use seat belts for every person, every journey. No exceptions. 

Edit 25/07/2018: Updated to reference South African’s legislation and definition of child.

References:

https://www.cdc.gov/motorvehiclesafety/child_passenger_safety/resources.html

https://www.cdc.gov/features/passengersafety/index.html

https://www.facebook.com/groups/carseatbestpracticeZA/

https://chiro-trust.org/whiplash/car-accidents-chiropractic-children/

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