Car seat safety for preemies

Babies born prematurely (earlier than 37 weeks) require special consideration from the moment they enter this world. Today we are exploring the ability of preemies to travel in a vehicle safely. Even though the babies are so small, car seat safety for preemies is feasible with commercially available car seats. In fact, preemie babies who are medically ready to leave the NICU must pass a car seat safety test before discharge.

The car seat safety test

The NICU usually requires a car seat safety test before discharge to make sure your premature baby can ride safely for long periods of time in a semi-upright position. Before hospital discharge, the American Academy of Pediatrics (AAP) recommends a period of observation in the car seat for babies born at less than 37 weeks to check for apnea, low blood oxygen, or slowed heart rate. To accomplish this test, your baby will have his vital signs monitored while sitting buckled in his infant car seat. This test typically lasts 90-120 minutes and determines whether your baby is ready to be discharged. If the test is failed, due to either oxygen desaturation or bradycardia, your baby will likely be kept in the hospital for further monitoring until the test can be given again.

Use the car seat properly

The best practice is to follow all safety instructions from the car seat manufacturer, as each car seat is different. Infant car seats recline the baby to a 45° angle, so make sure the built-in angle indicator is correct when you install the car seat. If your preemie tends to slide down in the seat, it’s all right to place a rolled diaper or blanket between baby’s crotch and the strap. Do not put extra padding of any kind behind or under the baby. You can try putting a rolled blanket between the baby and both sides of the car seat to keep that tiny body positioned properly in the harness. Look for a seat with a three- or five-point harness system that has adjustable shoulder height straps. That way, as your baby grows, you can move the shoulder straps so they are always resting at or below your baby’s shoulders. The harness should be snug and the chest clip even with baby’s armpits. Should you need help, the staff at the hospital can offer instruction in setting up and securing your baby in the infant car seat.

Choosing the proper infant car seat

All infant car seats are manufactured to be used rear-facing in a back seat, the safest place for children to travel in a car. Infants should sit in a rear-facing car seat until at least 2 years of age. The best and safest car seat is not a matter of price, but of proper fit and weight. Make sure your baby meets the minimum weight requirement of 4 or 5 pounds, depending on the car seat. If shopping for a used infant car seat, make sure you know the history and age of the seat and that it has all the pieces. If the car seat has been in any accidents or is past the expiration date found in the user guide, it’s no longer safe to use.

Though preemie car seat safety can be a bit more challenging than for full-term newborns, it is undoubtedly equally important. With some minor modifications, preemies can travel in a safe and secure manner in a car seat. Remember to never leave your child unattended in a car seat and to only leave him in his car seat while traveling. Soon enough he will be graduating to a forward-facing seat.

Have you had a preemie pass or fail the car seat test? Share your experience in the comments!




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