1. National Child Passenger Safety Certification Training Program National Child Passenger Safety Certification Training ProgramModule 8 Children in Rear-Facing Car Seats8-1

2. Module 8 Objectives Describe why children should travel rear-facing. Identify types of rear-facing car seats. Apply 5 steps for rear-facing car seat use. Explain best practices and caregiver choices about rear-facing car seats. Identify rear-facing car seat errors and consequences.8-2 3. Childrens Bodies Change as They Grow8-3 4. Why Children Should Travel Rear-Facing8-4 5. 2 Types of Rear-Facing Car SeatsRear-facing-only Convertible8-5 6. Rear-Facing-Only Car Seats Check car seat label for starting weight. In general, top of childs head should be well contained within shell and at least 1 inch from top of shell. Harness needs to be snug at or below childs shoulders. Caregivers should NEVER use rear-facing seat above height or weight limits designated by manufacturer. 8-6 7. Rear-Facing Convertible Car Seats Many new car seats are approved for rearfacing for up to 40+ pound children. Children commonly sit with legs crossed or resting on back of vehicle seat low injury risk. Older children with poor head control and other children with special needs may benefit from staying rear-facing as long as possible.8-7 8. 5 Steps for Car Seat Use 1. Selection: Choose the right car seat. 2. Direction: Face the car seat the right way. 3. Location: Install the car seat in an appropriate location in the vehicle. 4. Installation: Secure the car seat to vehicle in the right way. 5. Harnessing: Place the child correctly in the car seat.8-8 9. Rear-Facing Car Seat Selection Select for the childs height, weight, development levels, AND that caregiver can use correctly. Select with an adjustable harness height to offer options for rapidly growing infant. Some have multiple positions for crotch straps for better fit as child grows.8-9 10. Rear-Facing Car Seat Direction Under age 1 ALWAYS ride rear-facing. Stay rear-facing AS LONG AS POSSIBLE until reaching the top height or weight limit.8-10 11. Rear-Facing Car Seat Location Not all seats are suitable for installing a car seat. Check manufacturer instructions. Always ask, Who rides in this vehicle? Where will each person sit? Turn off air bag if necessary to place child in the front seat.8-11 12. Rear-Facing Car Seat Installation Rear-facing car seat spreads crash forces. Correct angle helps keep airway open. Know car seat recline angle. Use recline angle and adjustor. Adjust to accommodate the seat and vehicle slope.8-12 13. Recline Angle8-13 14. Seat Belt or Lower Anchors Car seats can be installed with a seat belt or with lower anchor attachments usually NOT both. While the systems are different, they are equally safe.8-14 15. Install a Rear-Facing Car Seat8-15 16. Common Rear-Facing Car Seat Installation Errors Seat belt or lower anchor attachment that is too loose or not locked Rear-facing-only car seat that is facing forward Seat belt or lower anchor attachments routed incorrectly Incorrect recline angle especially for an infant Using 2 seat belts or using a seat belt and lower anchor attachments together (must be allowed by BOTH the vehicle and car seat manufacturer)8-16 17. Common Rear-Facing Car Seat Installation Errors (continued) Incorrect use of lower anchor connectors and tethers Not using appropriate tether anchor or using a tether when it should not be used (most convertible car seats do not tether when rearfacing) Locking clip installed incorrectly Carrying handle not used in the approved position for vehicle travel8-17 18. Common Rear-Facing Car Seat Harnessing Errors Harness not used and child just sitting in car seat Harness straps that are too loose Retainer clip not at armpit level Harness routed through wrong slots Harness not doubled-back through buckle type metal adjuster, if it requires double-back to secure the harness Harness is twisted 8-18 19. Common Rear-Facing Car Seat Harnessing Errors (continued) Harness not placed on child correctly Harness frayed or damaged M etal adjuster not flush with slot or out of position Crotch strap adjusted too long Harness not at or below shoulder Crotch strap not through slot closest to child Harness incorrectly routed8-19 20. AAP Recommendations for Small & Premature Children Monitor all children born before 37 weeks before they leave hospital for possible breathing problems or slowing of heart rate when sitting in a semi-reclined position Physician determines how children will ride 8-20 21. How to Fit Small & Prematurely Born Infants in Car Seats Use a rear-facing car seat with small internal harness dimensions. Use a car seat designed for the childs low weight. Center child in a car seat with rolled receiving blankets and a crotch roll, if necessary.8-21 22. How to Fit Children in Car Beds Secure child in car bed with the internal harness or bunting. Place childs head toward center of vehicle NOT next to door. Use seat belt to anchor car bed lengthwise on vehicle seat. 8-22 23. How to Fit Children with Breathing Problems May require child to lie flat or use a nonconventional car seat. Semi-reclined position of car seat could make breathing problems worse. Children may need to travel with secured special medical equipment. 8-23 24. Key Questions Related to Rear-Facing Car Seats What are the age, height, and weight of the child? Does the child have any special needs such as being very small, premature, or other physical or developmental needs? What does the car seat owners manual or label say about the minimum and maximum heights and weights for the child using this car seat? Is the car seat a rear-facing-only or convertible type? Does the rear-facing-only car seat have a base? Can it be installed without a base?8-24 25. Key Questions Related to Rear-Facing Car Seats (continued) Is the car seat facing the correct direction in the vehicle? Is the car seat in an appropriate seating position in the vehicle according to the vehicle and car seat manufacturers? Is the car seat installed tightly? Is the car seat secured by a seat belt or with lower anchor attachments? Is the car seat at the correct recline angle? Is the harness being used correctly? 8-25 26. Car Seat Errors & Consequences8-26 27. Car Seat Errors & Consequences (continued)8-27 28. Car Seat Errors & Consequences (continued)8-28 29. Car Seat Errors & Consequences (continued)8-29 30. Car Seat Errors & Consequences (continued)8-30