No child under three years old may travel in a car unless buckled into a child safety seat - that's the law.

The type of car seat you have and where and how you place it in your vehicle could be the deciding factor between life and death, writes Marchelle Abrahams.

Did you know that less than seven percent of South African children are transported in car safety seats?

From July 2015, by law all South African children below the age of three and travelling in a vehicle have been required to be in a child seat. But how many kids have you seen standing between the front passenger and driver seats or waving at you from the back seat of the vehicle they’re happily bobbing around in? Why are parents flippant when it comes to their children and road safety?

“In many instances, children are sitting in the front passenger seat without seat belts, standing in the car while it’s moving or, at the very least, are not in an age, weight and height-appropriate car seat,” the Automobile Association (AA) of South Africa said when releasing their report in 2016.

But the eyewitnesses to the tragic results of not buckling children up properly are paramedics who come across accident scenes where senselessat which deaths could have been prevented.

“Just last week, our paramedics were called to an accident where they found a child sitting on their parent’s lap,” says ER24. “They don’t realise that they are doing the wrong thing and putting their child in danger.”

Car seats can reduce the risk of death by as much as 71 percent, but they have to be installed and used correctly, according to Safe Kids Worldwide.

Recently, paramedics responded to a tragic collision in Kempton Park wherein which two children, eight and five, were killed on the scene. Miraculously, a six-month-old baby girl was found alive in bush nearby still in her car seat. 

So in the interests of child safety, we sought out the expert advice for some car seat 101.

A 2015 study published in Paediatrics showed that a newborn to 3-year-old sitting in the centre rear seat is 43% safer than sitting on the side at the back. Picture: Flickr.com

Rear-facing car seats

Neonates and infants should be restrained in a rear-facing car seat, suitable for their weight until they exceed weight/ height limitations, usually at around one to two years old or 9kg, advised Dr Robyn Holgate, ER24’s chief medical officer. 

“This is to avoid the risk of a cervical spine injury should they be in an accident.”

A representative for Netcare Hospital Group says as a rule their hospitals don’t allow new parents to leave the premises without first checking their car is fitted with a safety seat for infants.

The mistake that many parents make is to place the car seat either on the left or the right side of the back seat. But a 2015 study published in the journal, Paediatrics, showed that a newborn to three-year-old sitting in the centre rear seat is 43 percent safer than sitting on the side at the back.

The study also found that the most common location in the vehicle for a car seat was the rear passenger side, with 41 percent of parents putting their child’s car seat there. 

The problem with vehicles manufactured in SA is that they only have LATCHatch (lower anchors and tethers for children) for the two side seating positions in the back seat. If this is the case, parents can use the seatbelt to install the car seat in the centre position, notes saferide4kids.com.

Before installation, you need to read both the car seat manual and your car's manual. Picture: Barksdale

Forward-facing car seats

Toddlers should be secured in forward facing car seats appropriate for their height and age. With some car seats, it’s a matter of converting a forward-facing seat with a  5-point harness and top tether. Your child may need a forward-facing car seat with a harness that has a higher weight or height limit before moving to a booster seat.

Booster seats

Children seated in a booster seat in the back seat of the car are 45% less likely to be injured in a crash than children using a seat belt alone, says Safe Kids Worldwide.

AA  spokesperson Leyton Beard stresses the importance of strapping a child in a booster seat, saying “if a child is 1.3m or shorter, the seat provides additional lift”.

A school-going child should remain in a booster seat until the age of 5 to 12 or a height of 1.4m. This is to ensure the car’s seat belt fits appropriately over their chest and thighs.

Your child may need a forward-facing car seat with a harness that has a higher weight or height limit. Picture: Flickr.com

“If the child is not in a booster seat, the seat belt will go over their tummies and cross over the neck. In the event of a crash, if not boosted, that seatbelt will go over the tummy and neck area (flesh). But in a booster, the seat belt crosses over the hips and shoulders (bones) – providing additional support.”

When your child is seated in the booster seat, make sure the lap and shoulder belts fit. The seat belt must lie flat across your child’s chest, on the bony part of the shoulder and low on the hips or upper thighs. Be sure to buy a booster seat from a reputable dealer, adds Beard, “as you don’t want something that is not going to work”.

Seat belts

Children who are tall enough to wear an adult seat belt should still ride in the back seat until they are 13 years of age. Adjust the seat belt so the lap belt crosses the child’s upper thighs and the diagonal belt crosses the upper chest at a point between the neck and shoulder.

Booster seats are the link between a car seat with a harness and a seat belt alone. Picture: Vimeo

Final word on car seats

Holgate warned that a car seat should always be secured into the car using the manufacturer’s recommendations. But most important, children should not sit in the front seat.

“There has been a significant reduction in deaths of children in motor vehicle accidents since we’ve introduced additional car safety features and additional child safety features. 

“These guidelines have been researched and proven to be beneficial to our little people in vehicle accidents,” he added.