Too fat for a car seat?

Dr. P's Pediatric Journal Club

The study
The authors looked at growth data on U.S. children ages 1-6 years from the 1999-2000 National Health and Nutrition Examination Survey (N-HANES) and compared it to the maximal weight recommended for child safety seats.

What the study found

• About 283,000 children in the U.S. are at risk for not finding an appropriate child safety seat due to obesity.
• Of these, the majority (183,000) were 3 year olds weighing more than 40 pounds. (This works out to about one in every twenty 3 year olds.)
• There were only 4 oversized models of car seats made to accommodate wide load toddlers and these all cost about $250.

Dr. P comments
As we say in the trade: oy vay!

I've blogged and harangued you before about the stunning increase in childhood obesity, about the long-term risks of diabetes, heart disease, and hypertension, about the wisdom of feeding your family a low animal fat, minimal junk food diet, and about the need for everyone to get sufficient exercise.

But most of my warnings about obesity were of consequences some time off in the future. These clever authors have identified a risk that can affect a child's safety today, especially in those families who can't afford or don't think it's neccessary or don't think to buy a specially enlarged, expensive car seat for their big guy or gal.

Improper restraint in the car is especially worrisome because:

• More than 1.5 million kids/year are involved in a car accident.
• Car accidents are the leading cause of death in children. For example, they account for almost 1/3 of all preschooler deaths.
• Car seats reduce the risk of a fatal injury by 71% in infants using rear-facing seats and 54% in toddlers secured in forward facing seats. [Editorial comment: Keep your infants in a rear-facing car seat as long as you can, preferably until they are married!]
• Forward facing seats are not meant to be used by a child weighing more than 40 pounds. Why not? As explained in http://www.carseat.org/: "Children who are under 4 years old or who are very active may not stay put without a 5 point harness system that holds them in place. Booster seats do not work well for those children because vehicle shoulder belts do not prevent them from leaning forward or placing the shoulder belt behind the back or under the arm."
  

The only good news in these stunning numbers is that car seat manufacturers will likely seize the opportunity and begin to make more "hefty" models to meet the demand of an ever-widening population of preschoolers. Then, if good old American capitalism and competition do their magic, prices will drop and more families will be able to afford them.

For more information on the proper use of car seats, go to http://www.aap.org/family/carseatguide.htm

Related Topics: 10 Ways to Raise Food-Smart Kids, Calculate your Child's BMI

Technorati Tags: toddlers, car seats, childhood obesity, obesity