Caring for Eastern Shore children from birth through age 21 — New patient information

Chestertown Office
6602 Church Hill Road, Suite 400

Telemedicine

Chestertown Office
6602 Church Hill Road, Suite 400

Telemedicine

Car crashes are a leading cause of injury and death for children, and a correctly used car seat is one of the best ways to protect your child on every trip. Car seat guidance changes as children grow, so this page walks through each stage, along with installation and everyday safety tips. Always follow your car seat manual and your vehicle owner's manual.

Stage 1: Rear-Facing Car Seats

Infants and toddlers should ride rear-facing for as long as possible, until they reach the highest weight or height allowed by their car seat manufacturer. Many convertible seats allow children to ride rear-facing until 40 pounds or more, which means most children can stay rear-facing past their second birthday. Rear-facing seats support the head, neck and spine in a crash.

  • Use an infant-only seat or a convertible seat installed rear-facing.
  • Never place a rear-facing seat in the front seat of a vehicle with an active passenger airbag.
  • Bent legs touching the vehicle seat are fine and are not a reason to turn your child forward.

Stage 2: Forward-Facing Seats With a Harness

When your child outgrows the rear-facing limits of their seat, use a forward-facing seat with a five-point harness for as long as possible, up to the highest weight or height allowed by the seat. Always use the top tether, which reduces forward head movement in a crash.

Stage 3: Belt-Positioning Booster Seats

Once your child outgrows the forward-facing harness, use a belt-positioning booster seat until the vehicle seat belt fits properly. This usually happens when a child is about 4 feet 9 inches tall and between 8 and 12 years old. Boosters lift the child so the lap and shoulder belt cross the strongest parts of the body.

Stage 4: Seat Belts

Your child is ready for a seat belt alone when they can pass this test:

  1. Sits all the way back against the vehicle seat with knees bending comfortably at the edge.
  2. The lap belt lies low across the upper thighs, not the stomach.
  3. The shoulder belt crosses the middle of the chest and shoulder, not the neck or face.
  4. Can stay seated this way for the whole trip.

All children younger than 13 should ride in the back seat.

Installation and Harness Tips

  • Tight installation: the seat should move less than 1 inch side to side or front to back when tested at the belt path.
  • LATCH or seat belt: use one method unless your car seat manual says both may be used together. Check LATCH weight limits.
  • Snug harness: you should not be able to pinch a fold of harness strap at your child's collarbone (the "pinch test").
  • Chest clip: place it at armpit level.
  • No bulky coats: puffy jackets compress in a crash. Buckle in first, then cover your child with a blanket or the coat worn backward.
  • Check the date: car seats expire. Look for the expiration date on the label or in the manual.
  • After a crash: replace a car seat after a moderate or severe crash, and follow the manufacturer's guidance after a minor crash.
  • Used seats: avoid seats with an unknown history, missing labels, missing parts or recalls.

Register Your Car Seat

Fill out the registration card or register online with the manufacturer so you'll be notified of recalls. You can also check for recalls on the NHTSA car seat page, which also helps you find a certified child passenger safety technician for a free installation check. Learn more on our product recalls page.

Maryland Car Seat Law

Maryland law requires children younger than 8 to ride in an appropriate child safety seat or booster unless they are 4 feet 9 inches or taller, and requires older children to be secured with a seat belt or child safety seat. Safety recommendations often go further than the law, so follow the stages above. Check the Maryland Kids In Safety Seats (KISS) program for current details.

Never Leave a Child Alone in a Car

Cars heat up quickly, even on mild days. Make it a habit to "look before you lock," and keep car keys out of children's reach. Questions about your child's seat? Bring them to your next well visit, or read our article on car seat FAQs.