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Does Your Child Need a Booster Seat?

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What should parents do? Durbin tells WebMD, "Beginning at birth, all children should be placed in a rear-facing car safety seat, until they are at least one year of age and at least 20 pounds." Once the child has reached both of these points, he says, "You are ready to turn the child around in a forward-facing car safety seat."

"When they outgrow that forward-facing safety seat, this is the critical transition where many parents now put their child in a seat belt," Durbin says. "There is a better transition -- to the belt-positioning booster seat." This simply rests on the existing auto seat, better positioning the child for the car's lap and shoulder belts.

According to Durbin, the child should stay in that seat until he or she properly fits in the car's seat belt. This will depend on the child's height, weight, and the size of vehicle, but it could be as late as 10 years of age.

There is no federal standard for certifying which booster seats would benefit which children. Moreover, so-called "shield" booster seats are considered unsafe but are still available in the U.S., Durbin and other experts say. Federal regulators have yet to develop a 10-year-old-child-size dummy for crash-testing the seats.

That's why the Insurance Institute for Highway Safety told Congress that "emphasizing boosters is a misplaced priority." Instead, it said, "The first order of business is to get older children in restraints regardless of what type of restraint is used."

In other words, let's focus just on assuring the use of seat belts. The institute's Susan Ferguson, PhD, said, "We don't want to have parents even more confused than they already are."

But Durbin tells WebMD that it's time to move ahead. "The message for several decades has been 'buckle up,' and that was a very successful message." He says that evidence now clearly suggests that booster seats are better than seat belts alone, although seat belts are certainly better than no restraints at all.

Judith Lee Stone, president of Advocates for Highway and Auto Safety said that states should pass laws to encourage booster seat use, even if there is no clear definition yet of the ideal seat.

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