Booster seats and car seats use in KFL&A

Data sources and citation: Rapid Risk Factor Surveillance System (RRFSS), 2002 to 2008, 2012

Sample: Households with children between 0 and 11 years of age in the KFL&A area.

Released: June 2016

Introduction

Car Seats

Correctly choosing, installing and using a child seat is the best thing you can do to keep your child safe in the car.

A rear-facing car seat, installed in the back seat of your car, is needed for infants.¹

The rear-facing position is recommended until your baby is:
- at least 10 kg (22 lbs),
- at least 1 year of age, and
- walking unassisted.
- The car seat should face the back of the vehicle and rest at a 45 degree angle.

These recommendations are a minimum. Children should stay in the rear-facing position for as long as the manufactures weight and height limits will allow. The rear-facing seat provides the most protection for your child's weak head and neck muscles.¹

Forward-facing seats are used for older children once they have outgrown the weight and height requirements of their rear-facing seat.²

The forward-facing position is recommended until your child:
- is at least 18 kg (40 lbs), and
- can fit properly in a booster seat.

There is no rush to move to a forward-facing seat. Keeping your child rear-facing while still within height and weight limits is the safest option. Please note, all children under 12 years of age are safest in the back seat.³

Booster Seats

Booster seats are required for children who no longer need forward-facing seats⁴ and:

are under 8 years old,
weigh between 18 kg to 36 kg (40 lbs to 80 lbs), or
stand less than 145 cm (4 feet 9 inches tall).

Don't hurry! It is safest for your child to remain in a booster seat until they reach all three requirements and can fit properly in a seat belt.

Booster seats raise the child up so that the adult seatbelt works more effectively.⁵ Booster seats protect against serious injury 3 ½ times better than seatbelts alone.⁵ A lap and shoulder combination belt must be used with all booster seats, and all children under 12 years of age are safest in the back seat, away from active airbags.^4,5

Seatbelts

Seatbelts are designed for adults and older children. Children may be ready to move from a booster seat to a seat belt once:

they can sit up straight, with their back against the seat, and legs hanging over the seat, without slouching,^4,5
they can have the shoulder belt flat across the shoulder and chest,^4,5
the lap belt crosses over the hips, not the stomach.^4,5

Your child can start using a seatbelt without a booster seat once he or she:

turns eight years of age, or
weights 36 kg (80 lb.), or
is 145 cm (4 feet, 9 inches tall).⁵

How children under 1 traveled in a car

Figure A. Children, under 1, who traveled all of the time restrained in a rear-facing child car seat, KFL&A

Figure A. Please see Table A below for text description.

Table A. Children, under 1, who traveled all of the time restrained in a rear-facing child car seat, KFL&A, % (95% confidence interval)

Year	Children under 1
2002	82.6% (65.8, 99.4)
2003	91.7% (79.7, 100)
2004	80.0% (57.1, 100)
2005	85.3% (72.6, 97.8)
2006	93.3% (83.9, 100)
2008	92.6% (82.0, 100)
2012	96.4% (89.1, 100)
Total	89.5% (85.0, 94.0)

Interpretation for Figure A

Overall, in KFL&A, 89.5% (85.0, 94.0) of children under 1 year of age traveled all of the time restrained in a rear-facing child car seat.

Figure B. Children, under 1, who traveled all of the time in a back seat rather than a front seat, KFL&A

Figure B. Please see Table B below for text description.

Table B. Children, under 1, who traveled all of the time in a back seat rather than a front seat, KFL&A, % (95% confidence interval)

Year	Children under 1
2002	100%
2003	95.2% (85.3, 100)
2004	100%
2005	96.7% (89.8, 100)
2006	96.4% (89.1, 100)
2008	96.0% (87.8, 100)
2012	88.5% (75.3, 100)
Total	95.7% (92.6, 98.9)

Interpretation for Figure B

Overall, in KFL&A, 95.7% (92.6, 98.9) of children under 1 year of age traveled all of the time in a back seat rather than a front seat.

How children 1 to 3 traveled in a car

Figure C. Children, 1 to 3, who traveled all of the time restrained in a forward-facing child car seat, KFL&A

Figure C. Please see Table C below for text description.

Table C. Children, 1 to 3, who traveled all of the time restrained in a forward-facing child car seat, KFL&A, % (95% confidence interval)

Year	Children 1 to 3
2002	95.8% (90.0, 100)
2003	93.6% (88.0, 99.0)
2004	94.9% (89.9, 99.9)
2005	96.3% (92.0, 100)
2006	94.8% (89.7, 99.9)
2008	93.8% (88.8, 98.7)
2012	92.3% (87.4, 97.2)
Total	94.2% (92.3, 96.2)

Interpretation for Figure C

Overall, in KFL&A, 94.2% (92.3, 96.2) of children 1 to 3, traveled all of the time restrained in a forward-facing child car seat.

Figure D. Children, 1 to 3, who traveled all of the time in a back seat rather than a front seat, KFL&A

Figure D. Please see Table D below for text description.

Table D. Children, 1 to 3, who traveled all of the time in a back seat rather than a front seat, KFL&A, % (95% confidence interval)

Year	Children 1 to 3
2002	93.5% (86.1, 100)
2003	94.0% (89.5, 99.9)
2004	94.8% (89.7, 99.9)
2005	96.2% (91.8, 100)
2006	96.0% (91.3, 100)
2008	97.8% (94.8, 100)
2012	94.5% (90.2, 98.8)
Total	95.5% (93.7, 97.2)

Interpretation for Figure D

Overall, in KFL&A, 95.5% (93.7, 97.2) of children 1 to 3, traveled all of the time in a back seat rather than a front seat.

How children 4 to 7 traveled in a car

Figure E. How children, 4 to 7, usually traveled in a car, KFL&A, 2005, 2007, 2008, 2012

Figure E. Please see Table E below for text description.

Table E. How children, 4 to 7, traveled in a car, KFL&A, 2005, 2007, 2008, 2012, % (95% confidence interval)

How children traveled in a car	Children 4 to 7
Seat belt only	7.2% (4.7, 9.6)
Booster seat & seat belt	74.7% (70.6, 78.8)
Car seat with harness straps	17.9% (14.2, 21.5)

Interpretation for Figure E

Overall, in KFL&A, 74.7% (70.6, 78.8) of children 4 to 7 traveled in a car with a booster seat and seat belt.

Figure F. Children, 4 to 7, who traveled in a booster or car seat, and always in the back of the vehicle, KFL&A

Figure F. Please see Table F below for text description.

Table F. Children, 4 to 7, who traveled in a booster or car seat, and always in the back of the vehicle, KFL&A, % (95% confidence interval)

Year	Children 4 to 7
2005	84.0% (76.5, 91.6)
2007	93.2% (88.3, 98.1)
2008	92.8% (87.5, 98.0)
2012	97.8% (95.3, 100)
Total	92.6% (90.1, 95.1)

Interpretation for Figure F

Overall, in KFL&A, 92.6% (90.1, 95.1) of children 4 to 7 travel in a car with a booster or car seat, and always in the back of the vehicle.

How children 8 to 11 traveled in a car

Figure G. Children, 8 to 11, who traveled wearing a seat belt with a lap and shoulder belt combination, and always in the back of the vehicle, KFL&A*

Figure G. Please see Table G below for text description.

*or a booster seat and seat belt or strapped into a car seat

Table G. Children, 8 to 11, who traveled wearing a seat belt with a lap and shoulder belt combination, and always in the back of the vehicle, KFL&A, % (95% confidence interval)*

Year	Children 8 to 11
2005	92.4% (87.6, 97.3)
2007	100%
2008	98.1% (95.5, 100.0)
2012	98.3% (95.9, 100.0)
Total	97.1% (95.5, 98.6)

*or a booster seat and seat belt or strapped into a car seat

Interpretation for Figure G

Overall, in KFL&A, 97.1% (95.5, 98.6) of children 8 to 11 traveled wearing a seat belt with a lap and shoulder belt combination, and always in the back of the vehicle*.

*or a booster seat and seat belt or strapped into a car seat

References

Government of Canada. Stage 1: Rear-facing car seats. [document on internet]. Transport Canada, Government of Canada. 2016. [cited 2016 May 17]. Available from: https://www.tc.gc.ca/eng/motorvehiclesafety/safedrivers-childsafety-car-time-stage1-1084.htm
Government of Canada. Stage 2: Forward-facing car seats. [document on internet]. Transport Canada, Government of Canada. 2016. [cited 2016 May 17]. Available from: https://www.tc.gc.ca/eng/motorvehiclesafety/safedrivers-childsafety-stage2-forward-facing-1085.htm
Government of Canada. Stage 4: Seat belts. [document on internet]. Transport Canada, Government of Canada. 2016. [cited 2016 May 17]. Available from: https://www.tc.gc.ca/eng/motorvehiclesafety/safedrivers-childsafety-stage4-seat-belts-1087.htm
Government of Canada. Stage 3: Booster seats. [document on internet]. Transport Canada, Government of Canada. 2016. [cited 2016 May 17]. Available from: https://www.tc.gc.ca/eng/motorvehiclesafety/safedrivers-childsafety-stage3-booster-seats-1086.htm
Ontario Ministry of Transportation. Choose the right child car seat. [document on internet]. Ontario Ministry of Transportation. 2009 [modified 2015 August 18; cited 2016 May 17] Available from: http://www.mto.gov.on.ca/english/safety/choose-car-seat.shtml