Booster Seat Considerations for Parents

A well respected authority in the field of motor vehicle accident related spinal research, Dr. Arthur Croft, wrote an excellent article in a chiropractic publication, nearly a year ago, containing information that I feel every parent with young children should be acquainted. The point of the article was to underscore that the differences between the 2 types of commonly used child booster seats, backless and seat bottom/back combination, may not be well understood from information provided by the often referred to (particularly by manufacturers) National Highway Traffic Safety Institute (NHTSA) website. The NHTSA website suggests that the 2 types of booster seats have comparable safety records. A well done, subsequent study (Arbogast et al. "Effectiveness of High Back and Backless Belt Positioning Booster Seats in Side-Impact Crashes." 49th Association for the Advancement of Automotive Medicine Conference. Massachusetts 2005:201-213) reached significantly different conclusions: high back booster seats provided a significant level of protection, reducing injury incidence by 70%; whereas, backless booster seats provided no more statistical safety than using no booster at all.

Additional benefits to using a well made, high back booster seats are that a high back can serve as a head restraint in rear/front end collisions and if the high back employs lateral support, there is additional protection if a side impact collision were to occur. In spite of children's objections to feeling too old for this type of car seating, there should be no compromise when it comes to their safety. Keep in mind that if a lap belt does not cross at the level of the bony pelvis on a child and instead rests across the soft abdomen, internal organs are placed at risk of a crush type injury. In a higher speed collision, the inappropriate height lap belt provides a mechanism for substantial spinal injury. Another check point for belt position is the shoulder harness, preferably crossing the shoulder about midway on the collar bone. If the harness rests too low, it can ride up dangerously into the neck, potentially injuring both vital vascular structures and the spine itself.

The message from this information seems to be very straight forward: only use high quality, high backed booster seats with good lateral support. Publicly accessible information may confuse this issue, but Dr. Croft, who devotes his professional life to studying this subject is adament in making this point. He also recommends that a child ride in a booster seat until 2 criteria are met: the child reaches 57 inches in height and the child can sit all the way back against the seat back and simultaneously bend his/her knees over the seat edge. Simple guidelines that we as parents can understand and use for the safety of our children.