Why you should spend more than you are planning on your infant car seat

Many of my clients and friends are well aware that I am very conscious of car seat safety. What is the big deal? 

Despite a 43% drop in road crash deaths of children 12 and younger from 2002-2011, more than 9,000 children in that age group died in crashes during that period, says a new report from the Centers for Disease Control and Prevention.  Researchers found that one in three children killed in crashes in 2011 were not buckled up, and that nearly half of black and Hispanic children who died in crashes in 2009-2010 were unbuckled, compared with 26% of white children. USA Today Article

300 children are involved in car accidents every day and 2 die. 75% of all car seats are installed incorrectly. It is important to remember these five points when selecting a car seat for your child and installing it correctly:
 According to Safe Kids Worldwide, these are the top five mistakes parents make installing car seats:

Right Seat. Check the label on your car seat to make sure it's appropriate for your child's age, weight and height. Like milk, your car seat has an expiration date. Just double check the label on your car seat to make sure it is still safe.

Right Place. Kids are VIPs, just ask them. We know all VIPs ride in the back seat, so keep all children in the back seat until they are big enough to ride without a booster seat.

Right Direction. You want to keep your child in a rear-facing car seat for as long as possible, usually until around age 2. When he or she outgrows the seat, move your child to a forward-facing car seat. Make sure to attach the top tether after you tighten and lock the seat belt or lower anchors.

Inch Test. Once your car seat is installed, give it a good shake at the base where the seat belt fits. Can you move it more than an inch side to side or front to back? A properly installed seat will not move more than an inch.

Pinch Test. Make sure the harness is tightly buckled and coming from the correct slots (check car seat manual). Now, with the chest clip placed at armpit level, pinch the strap at your child's shoulder. If you are unable to pinch any excess webbing, you're good to go. NBC Story

Things to consider when shopping for an infant car seat. Inexpensive infant car seats start at around $50 and range up to $200

• An infant car seat is only usable rear facing and holds and infant until they weigh between 20-35 pounds. The car seat is easily removed from the car with a carrying handle to move a sleeping infant into the house or into a stroller system . INFANT CAR SEATS ARE NOT TO BE PLACED IN A SHOPPING CART. They are not designed that way and there have been multiple deaths recorded.
• If you are using a hand me down or used car seat check to see it is not expired. Most infant car seats expire between 5-7 years. They expire even faster in our Southern Utah heat due to how the heat affects the plastic. Never use a car seat that has been in an accident no matter how small.
• You have to be able to tighten the straps very tightly so that you can fit two fingers underneath the strap and you can not pinch any of the strap between your fingers.

• Seat must be at 45 degree angle
• No more than 1 inch of movement side to side when installed
• No head rests of strap pads added to the seat as anything not included and tested with your seat can greatly affect the safety
• Harness must be through the right slots in the seat. If rear facing the harness slots must be below the child's shoulders. If forward facing (which is not possible with an infant seat) they should be at or above the child's shoulders.

• Chest clip must be at nipple level.

• No coats, blankets, swaddlers or anything else between baby, seat and harness. Dress the baby in warm but thin clothing. 

As you are looking at a car seat consider how long it will be in use for the child. Once breastfeeding is established, we expect babies to gain at a rate of about 5-7 oz per week (close to an ounce per day), for about the first 3 months. Between months 3-12, weight gain tends to slow down. It is normal for the rate of weight gain to slow down, but it is not normal for weight gain to stop completely or for babies to lose weight. The average breastfed baby doubles their birth weight by about 5-6 months, and at 1 year, they typically weigh 2.5 times their birth weight. So for a baby that weighs 7 1/2 pounds at birth on average s/he will weigh nearly 18 pounds by their first birthday. In my personal experience they often weigh much more. Many children also grow very tall quickly.

So why bother with a more expensive infant car seat system?


You buy the cheapest infant car seat that Walmart offers: Cheapest 

Cosco Juvenile Light 'N Comfy Infant Car Seat, Dots:Rear-facing: 4 lbs-22 lbs; for child measuring 29"
Side impact protection
5-point harness
4 harness heights for the best fit as baby grows
Includes retractable canopy
Latch equipped with convenient latch storage
Cost: $47


Problems with this seat:

• Difficult to tighten harness because you can only access from the back of the seat. This is huge!!! That means every time you need to buckle your baby in you will need to take the seat out and turn it around to access the back to you can can tighten the straps enough. To get the baby out of the seat you will have to turn it around to access the back to loosen the straps.

• Insufficient padding making many babies fussy and uncomfortable during the rides.

• Harness made of cheaper material making it easier for them to twist and tangle. A twisted seat is not safe.

• It has a latch that is difficult to use you must place one piece on top of the other before you insert it into the buckle.

• No built in head support. 

• 22 pound weight range means many babies will need a new seat before 1 year old. The average 12 month old male weighs between:19.8-22.9 pounds, 12 month old female weighs between:18.2-21.4 pounds.

• 29 inch length measurement is also small. The average 12 month old male measures between: 29.2-30.5 inches, average 12 month old girl measures between:28.5-29.8 inches

So based on height and weight you will have to get an additional rear facing car seat once your baby is about 12 months old on top of the other issues the largest of which is how difficult it is to get the harness tight enough.


 Let's compare to a more expensive infant car seat from Target: More Expensive

Graco Snugride Click Connect 35:

• 
  
• Features: Adjustable Harness, Removable Seat Pad, LATCH Compatiblity, Level Indicator For Proper Installation, EPS Safety Foam, Rotating Canopy, Removable Head Support
• 
  
• Safety and Security Features: LATCH Equipped Car Seat, 5-Point Harness, Rear Facing Only, 2- Piece Chest Clip, Side Impact Protection
• 
  
• Rear Facing:Minimum Weight: 4 Lb.; Maximum Weight: 35 Lb. Maximum Height: 32 "

Cost: $150

Improvements made with this seat:

• Easy to tighten harness as it is right in the front of the seat.

• Adequate padding for comfort

• Thicker less likely to tangle straps

• Simple buckle

• Built in head support

• 35 pound weight range means it will fit most children until the age of 36 months (3 years) based on weight alone. Average male is between 29.5-34.3 pounds, Average female is between 28.4 -33.4 pounds

• 32 inch height means it will fit most children until the age of 21 months (1 3/4 years) based on height alone.Average male height is 32.7-34.3 inches, average female height is 32.1-33.8 inches

I personally had the Graco 35 for my last child and he (who was very small for his age) fit in it until he was 3 years old. If you have to replace your infant car seat earlier you will have to buy an additional convertible car seat. When you do get a convertible seat with a minimum of 65 pound weight limit. Keep your child rear facing as long as possible a minimum of 2 years but as long as 4 years. The large size of their heads in comparison to their bodies makes them much more likely to be injured in a car accident if they are forward facing.

Many parents want to start out with an infant seat and there are some benefits. If you are really trying to save money it is best to just buy a convertible seat with a high weight limit to 65 pounds then your child stays in one car seat until they are ready for a booster seat.

The best bang for your buck in my experience in this Diono-RadianR100-Convertible-Seat

• The Diono Radian family of car seats are the only convertible+booster seats with a full steel frame making them one of the safest car seats available today
• Rear facing 5-to 40 pounds. Forward facing 20-65 pounds (up to 57") in 5 point harness. Booster to 100 pounds.
• Aluminum reinforced sides and energy-absorbing harness system for added safety
• EPS foam for side impact protection
• Folds flat for travel and fits 3 across in a mid-size vehicle

You will only have to buy one car seat ever for your child-infant to booster. Because of the high quality of materials this car seat does not expire for 8 years in harness mode with an additional 2 years in booster mode. That is 10 years for one car seat. This is also the narrowest car seat around making it possible to fit three of these across in a sedan, SUV or minivan.

Day 1 in Haiti

Day 1 Mamababy Haiti

A 3rd time mom N., and  her husband have arrived with mom in active labor at 7 cm. In my practice in the states women very rarely have internal cervical exams. The clinics policy is a check at arrival and then no sooner than 4-6 hours later if not necessary. They had one midwife who came who was very upset about the frequency of exams so she did a mini class for the staff midwives about other ways to assess dilation. Her main emphasis was the purple line. As the woman dilates and the baby moves down deeper in the pelvis and pushes on the sacrum the tissues spread from the buttox crease revealing a purple line.

Photos credit of scienceandsensibility.org

The clinic tried it with the next mom who came into the clinic. The woman ended up delivering alone in the bath room 10 minutes after arrival when the purple line said she was 3 cm.  Needless to say they check everyone now at least once.

She is a very calm birther and smiles when I talk to her in English. I am to only watch and chart for this birth. Her labor progresses slowly and she doesn't end up having her baby until much later. Another woman J, comes in with short spaced contractions. We check blood pressure FIRST THING. This is really different than in the states where I usually listen to baby first before assessing mom. They check blood pressure first thing as high blood pressure and pre-eclampsia is a real problem in Haiti and they send them to the hospital right away if there is a problem before mom starts seizing. Blood pressure is fine. A cervical exam is done by the student and I follow her to double check. She is only 2-3 cm. We tell her she can stay and encourage her to walk to speed up her labor. When I ask her when she ate last she says yesterday at noon. I bring she and her friend a mango and cassava bread with peanut butter. They hang out in my favorite decorated room.

Prenatals start at 9 but the women start arriving as early as 6 but most come at 8. Dressed in their best they sit on the covered porch and talk with each other. They are lovely people. I am so excited to be working with them. They laugh quickly and are so kind to each other as they tease and poke about the different aspects of pregnancy. There are 28 today. A small devotional with a scripture, prayer and song is done at 9 and then prenatals start. The interpreters gather their names and pull their charts as well as do weight and blood pressure. The two native midwives are away for some midwifery training so it is just Mary, Martha (the advanced student), myself and a native student Genni. We do two prenatals at a time with an interpreter by ourside. I watch Mary do one but she gets distracted with Martha and I work through the rest with Genni. It is very different doing prenatals when you do not know the language and culture. Thank heavens pregnancy is universal and most mother love talking about their cute growing bellies. I ask questions and they are repeated by the interpreter.  That takes some getting used to, but the interpreters are kind and very experienced. It makes me smile that they are all male. I asked a mother once if she minded having a male interpreter and she said no most of the doctors are male so she sees the interpreters in the same way.  Most of the moms are happy and healthy. They are all severely anemic. We talk and measure bellies and listen to babies. Every mom is sent home with 10 days of prenatals and iron supplements with a prescription to purchase 30 days worth. Most don't have the money to buy them so they wait until their next appointment a month later to get more. Common complaints were acid reflux and lack up appetite. I only saw one with morning sickness. More common in Haiti is "spitting" during the first trimester. An abundance of saliva causes the women the spit frequently and some of them carry around a cup. A first time mama lay down so I could do fundal height. It was the first time she came to the clinic, she was 29 weeks. When I went to touch her belly, they have the softest skin ever by the way, I palpated belly only to feel fetal head and a tiny ear right under the skin. I pulled back surprised. Sure enough you could palpate every fetal part. It was concerning. Measurement was right on and FHT strong but I called in Merry and we agreed a sonogram (costs $25) would be best. Baby implanted out of uterus? Bicornate uterus? Additional note: baby was indeed implanted out of the uterus. They did a c-section at the hospital and baby did not survive but mother did. After I wrote the prescription for the ultrasound Mary called "Baby is coming!". The mother handled her labor like an expert.  Mary broke her very, very bulging bag of water to avoid a shower and baby boy came easily over intact perineum born on a birth stool. Baby born at 11:49 and while drying baby on mom we heard a plop at 11:50. Placenta had come out in bowl. I had never seen a placenta come out so quickly. One shot of pit was given but there was no bleeding as per their protocolls. The odd thing for me was mother had no desire to touch her baby. Very different than in the states. I have seem women who have had a very undisturbed birth often wait a moment or two to touch their baby. Almost like they are waiting to come out of labor land back into reality. More often is is an ecstatic smile or sound. I wonder how much of that is cultural? We are told over and over and shown in videos that you are supposed to be very happy and reach for your baby. I wonder if that would be the case in the States if there was not that expectation. The baby was very healthy and so beautiful. The family is just beautiful together and very happy. I don't get to observe the post partum procedure because there is other work to do.

 I went back to continue prenatals and did a couple post partum exams. A mom with a 5 mo with a cough. A mom who birthed at the clinic 3 days earlier with foul stitches. In the states many women due to good nutrition do not tear. If they have a slight tear we often encourage natural healing methods such as seaweed and staying in bed for a week. Staying in bed for a week is not an option in Haiti. Women tear more frequently due to poor nutrition so they do more suturing. The Haitian people are very very clean often doing bucket baths several times per day, but even with that being around all of the dust and rural living infection is common. The woman was sent home with antibiotics. Things calmed down.

We ate lunch of corn mush with black beans and a sauce made of okra and crab and beef. It was very good. Breakfast had been pancakes and dinner was spaghetti, only spicy with hot dogs in it. They tend to make everything spicy here.

 Around 6 Claudin, an interpreter who has been giving us Creole lessons in the evenings, asked Martha and I if we wanted to go on a walk around the block. We agreed and it was fun to be out in the community. The women smiled and a few men cat called but everyone was very nice. After our walk we talked about culture, marriage, and homosexuality. There are many different religious views in our little group including.. Mennonite,Mormon, Baptist (preacher in training), ex- Methodist preachers daughter, and vudoo. It was a nice evening but the mosquitoes were out in full swarm so Martha and I hid under a big white mosquito net while sitting on the deck looking ironically like two lesbian brides. We laugh a lot and Claudin likes to poke fun at our names comparing them to Creole words. Mine is similar to diarrhea, Mary means husband and Martha is similar to liar.

I went to bed when the power was turned off only to be called back by the 2nd mom from earlier who had gone home around dinner when her labor stopped. She was back but after exam was found to be no different. 2cm. She was exhausted. I gave her Benadryl and sent her to bed at the clinic. I took a bucket shower; like it sounds you sit in the shower and poor cup fulls of water from a bucket over you. It was actually very refreshing. They have running water from a well when the power is on. The city doesn't have enough power for everywhere in the city to have it at the same time so they cycle through and randomly turn off the power. You could go weeks with out there being city power. City power is also shockingly expensive even with how rarely it is on it is not uncommon to cost close to $500 a month.  The clinic uses a generator to pump water from the well into the storage containers on the roof to be used for showers and toilets. They also turn on the generator at night once a laboring mother is close to pushing.  A bucket shower is quite nice. Then I crashed and slept hard.

Utah Baby Names

Choosing what to name your child is very important. Most parents don't want to choose something so unusual that no one can pronounce the child's name, but they also don't want their child to be one of 3 other children in their class with the same name. The web has a lot of great resources to help you choose the best name for your Utah baby. I have many options and ideas listed here on my website.

Many Utah parents when naming their baby's get very creative in both the name and the spelling. I came across this today and thought it was good for a laugh.