Safety Seats for Older Children

My 5-year-old is too big for her safety seat, but our car’s seat belts still seem too high for her. What should I use to keep her safe?

Safety seats for Older Children

Dr. Greene`s Answer:
All children who have outgrown their convertible safety seats should ride in a belt-positioning booster seat that uses a combination lap/shoulder belt until they are about 57 inches tall. Short adults should also use them. These seats reposition the child (or adult) to make the adult belts fit appropriately.

There are now many approved brands of booster seats, including Basic Comfort, Britax, Century, Evenflo, Cosco, Graco, Guardian, Fisher-Price, LaRoche, Safeline Mission Control and Jupiter. Some booster seats can accommodate children as heavy as 100 pounds. Whatever seat you choose, always send in that pesky little registration card. New innovations may show problems with your model’s design, and you want the manufacturer to be able to find you with recall notices or additional instructions. If you have lost the card, or have a used car seat, call the Auto Safety Hotline to register — (888) 327-4236.

Children should never be placed in a booster seat using a lap belt only. In cases where only a lap belt is available, the AAP (American Academy of Pediatrics) recommends using a car seat with built-in harnesses that can accommodate older children. Other options include asking the car dealer regarding the installation of a shoulder harness or buying another car that has combination shoulder/lap belts. If buying a different car or installation of a shoulder harness is not possible, travel vests are available for use with lap belts, but may not provide as much protection. Shield boosters are available on the market and were designed to be used when only a lap belt is available. However, these are not recommended by the AAP because they do not provide adequate upper-body protection.

Be sure that any seat meets Federal Motor Vehicle Safety Standard 213. Children with special health problems may need different restraint systems (information can be obtained from the Special KARS [Kids are Riding Safe] Program of the National Easter Seals Society — (800) 221-6827).

Dr. Alan Greene

Dr. Greene is the founder of (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

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