Transporting Preemies (Safe Ride News)
Car Safety for Tiny Babies
Preemies and Low Birth Weight Babies Need Special Care
C h i l d
2 0 1 2
Make sure your baby’s car seat fits his or her size and needs.
Choosing a car seat for a tiny baby
in an
car seat
The basics
• Choose a car seat that is the right
size and type for your baby’s
length, weight, and health.
• A doctor may say your baby should
ride in a car bed (see below, right).
• Avoid a used car seat or bed unless
it has all its parts and instructions,
has any recalls repaired, and has
not been in a crash. Check its
expiration date. If none, avoid using
it if it is more than 6 years old.
• ALWAYS follow car seat instructions
and the car owner’s manual.
• Put the harness over baby’s
shoulders and between the legs.
Make it snug.
• Install the car seat tightly in the back
• Be sure the car seat faces the rear to
protect the head, neck, and spine.
• For best protection, keep your baby
rear facing up to 24 months or as
long as he still fits the car seat
height and weight limits. NEVER
turn baby forward before one year
from baby’s due date.
• Do not use the car seat as a seat in
the home; only use it in the car.
Cosco (Dorel)
Dream Ride®
for a baby 5 to 20 pounds.
Some infant-only car seats fit
preemies well and are easy to use and
carry. A few convertible car seats also
fit preemies.
Look for these features:
• A low weight limit to match your
baby’s weight. Many car seats are
limited to babies 5 pounds or more,
but some start at lower weights.
• A five-point harness.
• A front harness adjuster that is
easy to use on every ride.
• A low shoulder strap position that
will fit best on a small baby. (See
page 2 for more about harnesses.)
• Level (recline) guides that are easy
to see and understand.
• A level adjuster that is easy to use
to change the tilt of the car seat.
Install the car
seat in your car
before you buy it,
if possible. Follow
the instructions of
the car seat and
the car manuals.
A car seat that is
installed correctly
Rolled baby blankets
will not move more along the sides and a
than an inch when cloth between the legs
support a preemie in
near the strap that an infant car seat.
attaches it to the car.
Some babies must lie flat
Most babies can ride safely in
a regular, rear-facing car seat with
low harness slots. However, some
premature babies may show signs of
trouble when sitting this way.
The American Academy of
Pediatrics recommends that hospital
staff monitor each baby born earlier
than 37 weeks in a car seat before
the baby goes home. This is to check
for signs of trouble, such as slow
heartbeat, too little oxygen in the blood,
or periods of not breathing. Make sure
to ask your baby’s doctor about this.
If your baby shows any of these
signs, he or she may need to ride lying
flat in a crash-tested car bed (pictures
left and right). Use the car bed until the
doctor tells you your baby can sit up
safely. Also avoid using a baby seat or
swing at home during this time. (Car bed
models are listed on the next page.)
Tips for car bed use:
• Place with baby’s head toward the
middle of the vehicle.
• Baby should lie on her back unless
the doctor says to do otherwise.
Angel Ride Infant
Car Bed® for infants
from birth to 9 pounds
This is copyrighted, read only
material. These sheets cannot
be reproduced or copied.
FACT SHEETS © 2012 Safe Ride News Publications, 800-403-1424 •
This is copyrighted, read only material. These sheets cannot be reproduced or copied.
A2 Revised 1/12
Car Safety for Tiny Babies
Checking harness fit
Look for a harness with low shoulder
strap positions so it will fit close to your
baby’s body. Take a tape measure when
you shop.
• Shoulder harness positions: start
with the lowest position. The lower the
straps, the better the fit for a baby. At
most, the lowest position should be
less than 8 inches from the bottom of
the seat pad. For
tiny babies, look
for one as low as
5 or 6 inches.
• Crotch strap
distance: less
than 5.5 inches,
if possible.
Some seats have
more than one position.
National Center for Safe Transportation of
Children w/ Special Health Care Needs:
AAP Clinical Report, “Safe Transportation
of Preterm and Low Birth Weight
Infants at Hospital Discharge,” http://
NHTSA Auto Safety Hotline: Recall
and general car safety information,
questions, 888-327-4236 or 800-4249153 (tty),
SafetyBeltSafe U.S.A.: Car seat questions,
detailed information, recall list,
Find a Child Passenger Safety
Inspection Location: 866-732-8243,
Current Car Bed Models:
Angel Ride Infant Car Bed,
Child Source, 800-815-6330
Dream Ride Car Bed,
Dorel Juvenile Group, 800-544-1108
Hope Car Bed
Merritt Manufacturing, 317-409-0148
List of car seats and car beds that may
fit tiny infants:
Correct car seat use
• Avoid travel with baby, if possible.
• Do not use the car seat in the home.
• Dress your baby in clothes with legs
so the harness straps fit between
the legs. Avoid a thick snowsuit or
wrapping baby in a blanket. Put
extra blankets over the straps.
• Avoid thick padding under or behind
your baby. It would make the
harness too loose, so your baby
could be thrown out in a crash.
• Put shoulder straps in the lowest
position, as close as possible to
your baby’s shoulders or just below.
If the lowest position makes straps
come out above the shoulders, use
a different seat.
• Put your baby’s bottom all the way
back in the car seat.
• For support, use small rolled baby
blankets or diapers beside baby’s
body and head and between the
legs (pictured on top of page 1).
• A support pad that came with the car
seat can be used. Only remove it
if the instructions say it is okay. Do
not use a pad that did not come with
the car seat. It can be dangerous.
• Put the harness over both shoulders
and between baby’s
legs. Make it snug,
so you cannot pinch
any slack in the
straps (picture, right).
• Put the chest clip
at armpit level, not
close to the neck or
too low.
Pinch test for
snug straps
• Install baby’s car seat in the center
of the back seat if you can get a
tight fit there.
• Install the car seat tightly. It should
not move more than an inch forward
or side to side. ALWAYS follow car
seat instructions and the car manual.
Rolled towel or stiff foam roll
seat reclined
to support
baby’s head.
Always follow
recline guide.
Your baby should sit reclined, but
not too flat or too upright (see picture,
above). Make sure baby’s chin does
not flop forward, which could block his
breathing. Baby’s head should rest
against the back of the car seat.
ALWAYS follow the recline angle
guide on the car seat and check the
instructions. If baby’s head still flops
forward, try a different car seat.
Some car seats have a base that
adjusts to set the angle. If yours does
not, you may need to place a firm roll of
cloth or foam under it (picture, above).
Note: If baby has a breathing monitor or
other equipment, secure it so it will move
as little as possible in a crash. Use a seat
belt or wedge it on the floor of the car.
Dangers of Front Air Bags
An opening air
bag can
kill a baby who
is in a rearfacing seat or
on someone’s
Know if your car has front air bags.
Look in the car owner’s manual and for
warnings on the visors or the words “Air
Bag” (or the letters “SRS” or “SIR”) on
the dashboard.
Baby’s car seat must face the
rear and should be in the back seat.
If baby does ride in front, the air bag
MUST be off. Look for an on/off switch
or dashboard indicator.
FACT SHEETS © 2012 Safe Ride News Publications, 800-403-1424 •
This is copyrighted, read only material. These sheets cannot be reproduced or copied.
A2 Revised 1/12
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