Monroe Carell Jr. Children's Hospital at Vanderbilt

Volume 16 Issue 35 .                                                                                    Fall 2021

Safety Source

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Child Passenger Safety Edition


 Our September monthly newsletter highlights the importance of child passenger safety. National Child Passenger Safety week occurs during the month of September. There are interactive tools for your children to learn the importance of child passenger safety, as well as information for parents.

 There is also a special Rice Crispy Treat Car recipe for kids. We hope this will provide a fun way to learn about important safety topics together as a family. Let us know if we can be a resource to you in any way!

Newsletter Highlights


Video for Kids

Interactive baby safety tips video from Juvenile Products Manufacturers Association (JPMA)

September is Baby Safety Month

Coloring sheet to support Juvenile Products Manufacturers Association (JPMA) Baby Safety Month.

Interactive Quiz about Child Passenger Safety

Test your child's knowledge about child passenger safety through an interactive online quiz.

More Information for Parents

Practical tips to keep kids safe in cars.

Is Your Child Ready to Move Out of the Booster Seat? (Ages 5+)

More than 25% of children ages 4-7 are moved out of their booster seats too soon (1). Even though most children, and parents as well, are excited to hit the next milestones, rushing to move out of the booster seat can compromise the safety of the child.

The American Academy of Pediatrics recommends all children whose weight or height is above the forward-facing limit for their child passenger safety seat should use a belt-positioning booster seat until the vehicle lap and shoulder belt fits properly, typically when they have reached 4 ft 9 inches in height and are between 8 and 12 years of age. Some children may reach the minimum required height by age 8, but still not be ready to move out of the booster until closer to age 10. This may be because they cannot sit upright properly in the vehicle resulting in an incorrect seat belt fit.

According to Consumer Reports, you can use this simple 5 step checklist to help determine if your child is ready to move out of the booster. If your answer to any of these questions is no, the safest option for your child is to remain in a car seat with a harness until the answer to all 5 questions is a confident yes.

  • Is the child’s back flat against the back of the vehicle’s seat?
    • The child’s back needs to be against the vehicle seat back.
    • If their back is not against the seat, they may slide their hips forward creating a gap between the seat and their back which will in turn cause the lap belt to ride up onto their belly increasing risks to internal organ damage.
  • Do the child’s knees bend at end of the seat’s edge?
    • The child’s knees should bend comfortably at the seat edge.
    • Most children slouch so their knees can comfortably bend, but this forces the seat belt up from their hip bones and on to their belly.
  • Is the shoulder belt centered between the child’s neck and shoulder?
    • The seat belt should be positioned in between the child’s neck and shoulder.
    • If the shoulder belt sits too close to the neck, it can injure a child’s neck and throat, and the discomfort of the belt at the neck tempts them to move it behind their back for more comfort. If the shoulder belt sits off the child’s shoulder, it is likely to slip off during a crash, and it will not protect the child as it was intended to in a crash.
  • Does the lap belt sit low across the top of the thighs?
    • The lab belt should sit low across the top of the child’s thighs across the hip bones.
    • If the lap belt portion of the seat belt is across soft belly, it increases the potential for damage to the child’s internal organs in a crash.
  • Can the child remain seated comfortably for the whole trip?
    • Is the child mature enough to sit properly in the booster for the entire trip (no slouching, no leaning over, no messing with the seat belt).
    • The child should be able to stay comfortably seated for the entire trip.
    • If the child is uncomfortable, they tend to move into positions where their posture is slouched forward, lying to one side, or with the seat belt behind their back or under their arm. This leaves the seat belt incapable of protecting the child as it was meant to in a crash. Because of this, if the child moves frequently or constantly, they are not ready for a booster seat.

Remember, even when a child can pass the 5-step seat belt fit test based on the child’s height, this can differ greatly from car to car. They may be able to pass the 5-step test in one car and not in another. Or even in one seating position in a car, but not another. Usually by the time they are 4’9” (or 57”) they can fit properly in most vehicle’s seat belts.

Sources:

(1) Consumer Reports

(2) SafeRide4Kids.com

(3) SafeRide4Kids.com

Click for more Safety Tips
9 Common Car Seat Mistakes (Ages 2+)

Parents, make sure that your precious cargo is being transported safely with these 9 tips for car seat use.

Would it surprise you to know that more than 82 percent of all car seats are installed incorrectly? As child passenger safety technicians, we see a lot of common mistakes. Here are 9 of the most common car seat mistakes:

1. Car seats that are too loose.

If a seat is correctly installed, when you pull at the belt path, the seat should move no more than one inch from side to side or back to front. A child-passenger-safety technician trained in car-seat installation can show you how to get a correct and secure installation. 

2. Straps that are too loose.

The harness straps should fit snug with no slack. If they are too loose, a child can be ejected from the seat. To test, using your thumb and forefinger, try to pinch the straps vertically at the collarbone. You should not be able to pinch any harness webbing. Also, avoid putting bulky clothing on children, such as a thick winter coat, before you put them in a car seat.

3. Incorrectly positioned harness straps.

They should be at or below shoulder level in a rear-facing seat or at or above shoulder level in a forward-facing seat. Be sure to check the straps often, as children grow quickly and the harness position can be easily overlooked.

4. Not using the top tether.

An Insurance Institute for Highway Safety study found that only half of car seats were attached by the top tether and most parents didn’t think it was necessary. However, the top tether is very important because it significantly reduces a child’s risk for head and other injuries in a crash. Check the vehicle and child restraint manuals for limits on tether and anchor use.

5. Turning forward too soon.

For the best protection, keep your baby in a rear-facing infant or convertible car seat for as long as possible, until they reach the highest weight or height the seat allows.

6. Placing toys, mirrors or other items in or around a car seat.

Avoid using any after-market products with your car seat. Rarely will they have been crash-tested with the seat and they may change how the seat works in a crash. These items also can become dangerous projectiles in a crash. Store all loose items in a console, pocket or the trunk. Some child-seat manufacturers make products specifically designed for the seats and come with the seat at the time of purchase.

7. Using an old or second-hand seat.

Used seats are unlikely to come with the manufacturer’s instructions (vital for correct installation), may be missing important parts, may have been involved in crashes (even unseen damage can affect the seat’s functioning), may fall short of current safety standards, or may have been recalled due to faulty design. In addition, car seats expire because their parts break down over time. To find a seat’s expiration date, look for a sticker on the seat with manufacturing date or expiration date. If you can’t find it, contact the car seat manufacturer.

8. Getting rid of the booster too early.

A seat belt that doesn’t fit properly can do more harm than good, penetrating internal organs, damaging the spinal cord, or if the shoulder strap is improperly fitted, seriously injuring the head. It is important to keep your child in the booster seat until the seat belt fits properly. Because seat belts are designed for people who are at least 4-feet, 9-inches tall, that may not be until your child is 12 years old or older.

Take a few extra minutes to check your car seats and make sure your little bundle of joy is safe! If further assistance is needed, and to ensure your seat is correctly installed, call to speak with a child passenger safety technician or to schedule an appointment.

9. Not registering your car seat.

Although child restraint systems undergo testing and evaluation, it is possible that a child restraint could be recalled. Registration cards on car seats are there for one reason: to provide the manufacturer with contact information to reach the owner if the car seat is found to have a safety defect or other safety alert. The government standard requires that the consumer be contacted for all recalled car seats on the market, even if you bought it six to 10 years ago. Make sure you complete that form and mail it in. You can also go online and register your seat with the manufacturer.

It's important to take a few extra minutes to check your child’s car seat and make sure your little bundle of joy is safe!

Click for more information on Car Seat Safety
Cleaning Car Seats (Ages 2+)

As the seasons change, a proper cleaning routine is one way to reduce the spread of germs and keep your family healthier. A great place to start is your car, and specifically your child's safety seat.

Before you remove anything from your car seat, refer to the owner’s manual. Each car seat is different and may have guidelines about specific cleaning details. The manual is your best resource to know what cleaning supplies you can use and to obtain directions for how to clean your car seat. If you can’t locate your manual, the manufacturer’s website will have a digital version.

To ensure you can correctly reinstall the safety seat after you are finished cleaning, take pictures of the seat while it is installed. Note locations where straps and belts pass through the seat and where your LATCH connection points are found. Take pictures from various angles - above, below, front, and back - to help you remember exactly how the seat was installed.

After you remove the safety seat, vacuum the area around the seat to clean up any food crumbs. As you clean the seat, be sure not to remove any labels or instructions, as these are necessary to ensure correct seat usage. Allow time for the car seat to dry thoroughly before reinstalling it. Dry the seat cushions and padding separately in direct sunlight or your clothing dryer if the manual states this is acceptable.

As you are cleaning your child’s safety seat, this would also be a good time to check the seat’s expiration date. Locate the manufacturer label on the side or base of the seat. Typically, car seats are only good for six years after the manufacture date. If your car seat has expired, you must buy a new one! Plastic becomes dry and brittle over time, especially under prolonged exposure to heat and sunlight. A new car seat will ensure the greatest safety for your child.

Double-check your manual to ensure you have reinstalled the seat correctly. Your freshly cleaned child safety seat will look better while keeping your child safer.

If you need more information about the proper use of your car seat, visit Safe Kids.

For more tips on car seat installation, refer to the National Highway Traffic Safety Administration.

Click for more information on Car Seat Safety
Air Travel and Child Passenger Safety Tips (Ages 1+)

Parents be sure to take time to review airline policies and FAA regulations to make the safest choice when flying with children. Most airlines allow children under the age of two to ride in an adult’s lap (1). This is appealing to parents because it saves money, but it is not the safest way for children to travel in an airplane (2).

The Federal Aviation Administration (FAA) “strongly urges” you to secure your child using a child safety restraint system (CRS) in their own seat on the airplane and not hold them on your lap (1). A parent’s arms will not be strong enough to hold a child securely in unexpected turbulence. Not all car seats are approved by the FAA to be used in air travel. On the seat itself for a sticker that labels it as approved for use on an airplane, and this is what the airline will need to see to allow it to be used on the flight (1). Belt positioning booster seats will not be FAA approved because they require a lap and shoulder belt, not just the lap belt provided in an aircraft, so parents will need to check those seats.

The FAA also provides the following tips:

  • Measure your car seat. Airplane seats are only 16 inches wide.
  • Check your seat assignments in advance or reserve adjoining seats. If your ticket doesn’t allow reserving seats without a fee, call and ask the airline to waive this fee to accommodate your CRS.
  • Make sure that your child is healthy and medically safe for air travel.
  • Most airlines will board families with children ahead of other passengers.
  • Pack quiet toys and snacks for your child to make the flight more comfortable for them.

Air travel safety does require preparation to ensure your children are as safe as they can be during their flights, but these simple tips will make safe air travel with children less stressful. For more information on safe air travel with children, you can find more tips and helpful advice here:

Click for more information on Injury Prevention
Home Safety for Fall Prevention Awareness Day (Ages 1+)


Fall Prevention Awareness Day is September 22, the first day of the fall season!

Falls are the leading cause of non-fatal injuries for all children ages 0 to 19. Each day, ~8,000 children are treated in U.S. emergency rooms for fall-related injuries according to the CDC. This adds up to almost 2.8 million children each year (1).

Luckily, many falls can be prevented with proper supervision from parents and caregivers. Below you will find some safety tips to help prevent falls in the home.

  • Use home safety devices (i.e., window guards on windows that are above ground level, stair gates, and guard rails) (1).
  • Supervise young children at all times around fall hazards, such as stairs and playground equipment, whether you’re at home or out to play (1).
  • Clean spills up as soon as they happen.
  • Never leave a baby unsupervised on a bed, changing table, car seat, countertop, or furniture that raises them above the floor.
  • Remove clutter from stairs and steps.
  • Never leave your baby/toddler alone in or around a bathtub.
  • Closely watch your toddler while outside. Uneven grass, sloping lawns, and hills can make walking difficult and lead to tumbles.
  • Keep children away from open windows unless you have a window guard or wedge in place (2). Remember, screens help keep insects out, but they do not help keep kids in.
  • Move cribs, chairs, beds, and other furniture away from any windows. (These can be used to climb on to reach the window).

These simple adjustments in the home can keep your child from an encounter with the emergency room. Accidents do happen, but many falls can be easily prevented. Keep your children safe as we kick of “Fall Prevention Awareness Day” with the start of the “fall” season!

  • CDC
  • SafeKids.org

Click for more Safety Tips
How to Make Rice Crispy Treat Cars!

Easy recipes for your child to learn how to cook while having fun in the kitchen! 

Click for Recipe
Meet Our New Interns


Maia Regan

is a fourth-year undergraduate student at Vanderbilt University from Connecticut. She is studying Medicine, Health, and Society and chemistry and hopes to attend medical school in the future. Maia is an intern for the Pediatric Trauma Injury Prevention Program and is excited to incorporate her passion for public health and accessibility advocacy into her work with the program. In her free time, she enjoys volunteering, exploring Nashville, and coaching ski racing back home.

Sammie Rosen

is a fourth-year undergraduate at Vanderbilt University from Cleveland, Ohio. She is double majoring in Medicine, Health and Society and Communications of Science, Engineering, and Technology with a minor in Scientific Computing. Sammie is interning for the Pediatric Trauma Injury Prevention Program and is excited to combine her passions for public health and science communication to study how social media has been used in pediatric injury prevention. In her free time, she enjoys hiking, cooking, and working on her new vegetable garden.

Meet the Injury Prevention Team


Purnima Unni

is the Pediatric Trauma Injury Prevention Program Manager for Monroe Carell Jr. Children’s Hospital at Vanderbilt. She has a Masters in Public Health and is a Certified Health Education specialist with over 20 years of experience in injury prevention. She is a wife and mother of two girls and her rescue puppy. She loves to cook, travel and watch murder mysteries.

Eppiphanie Richardson

is an Atlanta native who decided to take on Nashville as her newest adventure. She is also the Associate Program Manager for the Be in the Zone-Turn Off Your Phone Campaign which educates teens and parents on the dangers of distracted driving. She has a passion for healthcare and serving others. She feels privileged to be able to serve Monroe Carell Jr. Children’s Hospital at Vanderbilt. In her free time, she enjoys exploring Nashville, dancing, running, and spending time with her husband and son.

Maggie Cammack

is the Associate Program Manager for the Kohl’s Safe Seat Program at Monroe Carell Jr. Children’s Hospital at Vanderbilt. She has a passion for child safety, a devotion that probably began when she appeared on a magazine cover at age three that highlighted car seat safety. She hopes to use her education and experience to make a difference in her community by helping keep them safe. She fell in love with the Nashville area when she moved here with her husband and two children in 2019. She has a Bachelor’s degree in Community Health Education and has dedicated her career to serving parents and families through advocacy and education. When she’s not working, she loves reading, adventuring outdoors, finding unique local spots, spending time with her family, and playing with her three dogs.


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This newsletter is brought to you by the Pediatric Trauma Injury Prevention Program at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

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