Home  »  Babies • Reviews • Safety • Shopping   »   Recommended Infant Carseats for Preemies & Multiples – CarseatBlog’s List of Best Bets Recommended Infant Carseats for Preemies & Multiples – CarseatBlog’s List of Best Bets On May 9, 2011 In Babies, Reviews, Safety, ShoppingThe Car Seat Lady’s Tips for Preemies & Small Newborns Are you taking home a baby weighing less than 5 pounds? PROBLEM: More than 1 in 10 parents take home a baby weighing less than 5 pounds… but nearly half of the infant car seats have a starting weight of 5 pounds; only some start at 4 pounds or less! IMPORTANT: Some car seats come with newborn inserts. Car seats, and anything that comes in the box with the seat, have rigorous crash testing & standards they must meet. Products sold separately – like infant head/body positioners, fleece sleeping bags, strap covers, etc – are not regulated & do not have to pass any crash tests. Such “aftermarket products” should not be used as they will make your baby LESS SAFE, and will void the car seat’s warranty.

NOTHINGshould be placed under your baby or under the straps. Once your baby is buckled snugly wearing a few thin layers of clothes, you can “swaddle” the baby OVER the straps to keep him calm, give extra support for his body, and keep him warm. If your baby is born before 37 weeks or has a medical condition that may affect her breathing or ability to maintain her oxygen level, she will get a “car seat test”, as recommended by theAmerican Academy of Pediatrics (AAP).  During the car seat test, the baby will sit properly strapped into the car seat for 90 minutes to make sure that her heart rate, breathing, and oxygen levels stay in a normal range. The AAP recommends that babies who “pass” their car seat test go home in a rear-facing car seat, NOT a car bed. Car beds should ONLY be used for infants who “fail” – i.e. they can not maintain their heart rate, oxygen level or breathing while in the car seat – as the protection provided by a rear-facing car seat is better documented than that for car beds.

Rear-Facing Infant Seats by Minimum Starting Weight ©The Car Seat Lady, LLC (last update 4/14)To leave the NICU you need a car seat, specifically a car seat that will not affect your baby’s oxygen level while keeping them safe from injury. The problem is car seats, like just about everything else, are designed for term babies, most of whom weight 6 1/2 lbs or more at birth. Many preemies weigh less than 5 lbs when they are ready to go home, so you need to look at the car seat specifications. I know it is easy to get caught like a deer in the headlights with the accessories, colors, etc. etc. I was so excited to be buying a “real” baby product for my boys that only the “finest Italian” brand would do. Turns out, I bought the wrong car seats. My boys didn’t hit 5 lbs for almost a month after discharge and the car seat I picked was only rated down to 5 lbs. In addition to being a safety concern, too large a car seat is an airway hazard. When a baby does not fit well in her car seat, she can slump over, kinking off her airway.

Preemie airways are weaker and in addition, many premature babies have weaker muscles, so they are more likely to slump and kink their airway, dropping their oxygen levels. Barney Stinson T Shirt UkThat is the whole reason for the car seat test!Mobile Homes For Sale Steinbach Mb So the 2 key specifications you need to consider for a preemie are the lower weight limit and lowest harness height. Hot Tub Hotel Morrison ColoradoThe weight is self explanatory, but the harness needs to be at armpit level; for most preemies that means less than 8 inches from the seat. Even with the smallest settings, some babies will still slump over so I have included a nice diagram in my book that shows you how to use receiving blankets to pad your baby so her neck stays straight and she remains centered in the seat.

Another car seat tip is to never use unapproved inserts (i.e. not made by that manufacturer for that specific model)- these can dislodge and cause problems with the airway or even become a projectile if they become loose during an accident. Car seats also have an upper weight specification; however, for many preemies this will not be an issue for a very long time. Many car seats are only rated to 20 lbs, but some are rated higher (like the Chico KeyFit 30, up to 30 lbs, and the Combi Shuttle 33, up to 33 lbs). But let’s put than in perspective. Depending on your baby’s birth weight, those numbers may be so far away that they are not worth thinking about right now. For example, Oliver, birth weight 1 lb 11 oz, didn’t hit 20 lbs until he was 2 years old and didn’t get to 33 lbs until he was five years old! I also recommend looking at Consumer Reports for safety. If you don’t want to buy access on-line, go to your local library. That’s what we did! It actually made a nice little field trip from the NICU.

The table below is adapted from the American Academy of Pediatrics 2010 car seat data.  I have deleted the upper weights, less of a concern for preemie parents, and included lower weights as well as tracked down the lowest harness height. Some manufacturers give a minimum child height instead, so when applicable, that is listed too. For a couple of car seats I could not find the lowest harness height, so those spaces are left blank The Chicco KeyFit had a good recommendation from Consumer Reports and has a minimum weight of 4 lbs as well a lowest harness height of 6.5 inches. Not an endorsement, just the facts. What is most important is that your baby fits in her car seat. Many babies fail their car seat challenge test based on fit, and sometimes you will need to return your seat and pick a different model, so what ever you do get one that you can return if need be. Table 1: Car Seats by Harness Height and Minimum Infant Weight as of July 2010 The law requires that you bring your baby home from the hospital in an infant car safety seat.

But the federal government's standard for car seat safety has no minimum weight limit. It also does not take into account some of the special needs of your preterm or low-birthweight infant. Fortunately, a 2009 clinical report provides helpful tips for selecting and safely using car safety seats for small infants. The report was prepared by the American Academy of Pediatrics' Committee on Injury, Violence, and Poison Prevention and Committee on Fetus and Newborn. It was published in the May 2009 issue of the medical journal Pediatrics. When choosing a car safety seat for your preemie or low-birthweight baby, keep these tips in mind: Choose an infant-only car safety seat with a three- or five-point harness system. Convertible car safety seats with a point-point harness system are also good. Don't pick a car safety seat with a shield, abdominal pad or armrest. Your baby might have trouble breathing behind the shield or may hurt his face and neck in a sudden stop or crash.

A car safety seat with the shortest distance between the crotch strap and the seat back is best. Ideally, pick one with a crotch-to-seat back distance of 5 1/2 inches. That way, your baby won't slip forward feetfirst under the harness. You can also place a rolled diaper or blanket between the crotch strap and your infant. This will help keep your infant from slipping. Car safety seats with multiple harness-strap slots are also good. They offer more choices than other seats and are better for small but growing infants. It's best to pick a car safety seat with harness straps that can be placed at or below your infant’s shoulders. Now that you have bought the car safety seat, here's what you need to know about placing your infant safely in. Place your infant so she is facing the rear. Your infant should be rear-facing until she reaches the highest weight and height allowed for the car safety seat by its manufacturer. Place your infant so that his buttocks and back are flat against the seat back.

The harness should be snug, with the car seat's retainer clip halfway between your baby's neck and stomach. The clip should not be on his belly or in front of his neck. Use only the head-support system that comes with your car safety seat. Avoid any head supports that are sold separately. If your infant is very small and needs more support for her head and body, then place blanket rolls on both sides of your infant. Recline a rear-facing car safety seat at about 45 degrees or as directed by the instructions that came with the seat. If your infant's head still falls forward, place a tightly rolled blanket or pool "noodle" under the car safety seat. That way your child's car seat is at the recommended 45º angle. Never place a rear-facing car safety seat in the front passenger seat of any vehicle. If you have to stop suddenly or are in a crash, the passenger-side front air bags can hit the car safety seat and cause serious harm to your baby. Remember, the back seat is the safest place for all children to travel while in a car.

Whenever possible, have an adult seated in the rear seat near the infant in the car safety seat. If a second caregiver is not available, know that you may need to safely stop your car to assist your infant, especially if a monitor alarm has sounded. Never leave your infant unattended in a car safety seat, either inside or out of a car. Avoid leaving your infant in car safety seats for long periods to lessen the chance of breathing trouble. It's best to use the car safety seat only for travel in your car. Preterm and low-birthweight infants in car safety seats have a higher chance of slowed breathing or heart rate. Because of that, your NICU staff may suggest they watch your preterm infant in his car safety seat for 90 to 120 minutes. They may watch your infant even longer if your travel home after discharge is more than 2 hours. NICU staff may also provide instructions about how best to place your infant in the car safety seat. This will help reduce your infant's risk of breathing and heart trouble while in her car safety seat.