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Ask Suzanne: Your Family Health Questions Answered

Sponsored by St. Mary's Regional Medical Center

By Suzanne Stevenson, APRN, MSN, NP-C; CCS Pediatrics September 22, 2016
A parent asks: My daughter is nine but somewhat small for her age. Most of her friends are allowed to ride in the front seat of a car. She really wants to as well. I've looked online for some guidance to see if she is old enough/big enough and got confused. There seems to be some conflicting information about what's safe. Can you help break it down for me?

Suzanne Answers: Oh, the excitement of riding shot gun! My brother and I spent years fighting over the coveted spot. It’s good that you are considering her size and age when contemplating allowing her to sit up front, as size is just as important as chronological years. To put your mind at ease, according to American Academy of Pediatrics (AAP), all children under the age of 13 should ride in the backseat. Riding in the front seat is associated with a 70% increased risk of injury. So, you are doing the right thing keeping her out of the front.

Also, consider that children should be in a “belt-positioning booster seat” until the lap and shoulder belt fit properly. This is usually when a child is around 4 feet 9 inches, which depending on the size of your child may not be until age 12!  

The AAP outlines 4 criteria for moving out of the booster seat to lap/shoulder belt alone: 
  1. Your child should be able to sit with their back against the seat with their legs bending at the seat edge.
  2. The seat belt fits low and snug over hips and thighs.
  3. The shoulder portion of the seat belt crosses the middle of the chest and shoulder without riding up.
  4. The child can remain in this proper position for the duration of the ride (ie not getting out and bouncing around the car).
State laws govern what is “legal” however this is often not in alignment with what is the best and safest way for your child to ride in the car. The AAP has some great tips on their website for what is safe. Older children and adolescents are still at risk for major injuries and/or death in car accidents. So, not only do we need to keep them in the backseat for longer but parents should also consider if they are in the appropriate car or booster seat. 

-www.healthychildren.org
-Hodges N, Smith, G. Car Safety. Pediatrics in Review. 2014; 35; 155. DOI: 10.1542/pir.35-4-155

Suzanne Stevenson, APRN, MSN, NP-C 
Suzanne loves spending time with her husband and young boys.  Professionally, she has a wide range of clinical experience in pediatric care. She is currently caring for her young patients at CCS Pediatrics in Lewiston. Previously, she worked in emergency departments, newborn nurseries, transitional NICU, and a primary care office setting. Suzanne earned her Master of Science in Nursing, Family Nurse Practitioner specialty at Yale University in New Haven, Connecticut and her Bachelor of Science in Nursing at the University of Connecticut, Storrs, Connecticut. She is a member of the American Academy of Nurse Practitioners and Sigma Theta Tau International Honor Society of Nursing.