Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit, the AAFP patient education website.

Information from Your Family Doctor

Car Safety for Your Child


Am Fam Physician. 2005 Aug 1;72(3):479-480.

  See related article on child safety seats.

Where should my child ride?

All children younger than 12 years should ride in the back seat of the car. This is safer if there is a crash. If your child is not big enough to fit into a safety belt, he or she should use a child safety seat or a booster seat. You will need to change the seat as your child grows.

How do I know when the safety belt fits?

When the safety belt fits, your child should be able to sit with:

  • back against the car’s seat

  • legs bent over the front of the seat

  • the lap belt low and tight

  • the shoulder belt across the middle of the chest and middle of the collarbone

It is important that the shoulder belt does not rub on your child’s neck. A seat belt usually fits children who are 4’ 9″ or taller.

Which way should the safety seat face?

If your child is very young, the seat should face the back of the car. The back of the safety seat helps support the head and neck during a crash. If the seat faces forward, your child’s head and neck are not protected. Children should face the back as long as possible -– at least until they are one year old AND weigh more than 20 pounds. This means if your baby weighs less than 20 pounds, he or she should ride facing the back of the car, even if he or she is older than one year. Babies younger than one year should ride facing the back of the car, even if they weigh more than 20 pounds. The longer your child can ride in a safety seat that faces the back of the car, the better.

When does my child need a bigger child safety seat?

Child safety seats are made in different sizes. Your seat will have a label on it that tells you what size child it fits. The label will tell you the height and weight limits for that seat. If you cannot find the label, you can look in the instruction book. You also can call the maker of the seat, or call the National Highway Traffic Safety Administration at: 1-888-DASH-2-DOT (1-888-327-4236).

If your child is too tall or too heavy for the seat, it could break or it may not work in a crash. When your child is too big for the seat, you should get a bigger one as soon as possible.

What does a booster seat do?

A booster seat helps the seat belt fit better for older children who are not big enough for the safety belt alone. If the seat belt does not fit correctly, your child can be hurt in a crash. Your child could be thrown from the car or slip under the lap belt and hurt his or her stomach. The shoulder belt could hurt your child’s arm or neck badly.

Where can I get more information?

National Highway Transportation Safety Administration

Web site:

Telephone: 1-888-DASH-2-DOT (1-888-327-4236)

American Academy of Pediatrics

Web site:

Telephone: 847-434-4000


Web site:

Telephone: 1-866-SEATCHECK (1-866-732-8243)

SafetyBeltSafe USA

Web site:

Telephone: 1-800-745-SAFE (1-800-745-7233; English)

1-800-747-SANO (1-800-745-7266; Spanish)

This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.


Copyright © 2005 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


Jan 2022

Access the latest issue of American Family Physician

Read the Issue

Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article