Issue: February 2016
December 30, 2015
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Car safety seat misuse widespread at newborn discharge

Issue: February 2016
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The majority of parents made at least one error while installing or using a car safety seat at discharge of their newborn, according to recent research in The Journal of Pediatrics.

“This study shows that … correct use [of car safety seats] still poses a challenge for almost all families,” Benjamin D. Hoffman, MD, of the department of pediatrics at Doernbecher Children’s Hospital in Oregon, and colleagues wrote.

The researchers studied 291 families with newborns discharged from an academic health center in Oregon between 2013 and 2014. Study participants completed a survey regarding socioeconomic data and car seat experience. Certified child passenger safety technicians observed and assessed caregivers positioning their newborns and installing the car seats.

Study results showed that 95% of caregivers incurred at least one error, with 86% related to newborn positioning and 77% related to car safety seat installation. The researchers wrote that serious misuse occurred in 91% of cases; common mistakes included harness, clip and seat belt use errors, along with incorrect recline angles.

Hoffman and colleagues found several demographic factors associated with car seat misuse, including enrollment in Medicaid (OR = 10.3; 95% CI, 2.4-44.4), nonwhite/Hispanic mothers (OR = 6.3; 95% CI, 1.8-21.6), non-English speaking families (OR = 4.9; 95% CI, 1.1-21.2) or families with college associate degrees or less (OR = 4.5; 95% CI, 1.7-12.4). Study results also showed that prenatal work with a certified child passenger safety technician reduced car seat misuse at discharge (OR = 0.1; 95% CI, 0.0-0.4).

“Our findings suggest that some degree of both prepartum and postpartum education and support for correct car safety seat use for both infant positioning and installation can help families safely use their car safety seats,” Hoffman and colleagues wrote. “Further research is needed to develop programs that can be delivered efficiently but effectively by hospital staff during this vulnerable window of time for infants and their families.” – by David Costill

Disclosure: The researchers report no relevant financial disclosures.