The Risks of Child Car Seats

Of course, we must use car seats in some form to protect our children while we're driving, but what does all of that confinement mean for their behavioral and physical development?

Participating in a TEDx event at a nearby library, I heard one of the other speakers, the founder of our local Waldorf School, reflect on the hazards to a child's physical and mental development from confinement to a car seat. The issue really isn't car seats for actual automobile travel; there's strong evidence that they have have helped reduce children's automotive deaths dramatically. It's the convenience of the technology as an all-purpose transport, while running with a carriage, supermarket shopping, etc. Could there be perhaps subtle long-term effects of prolonged use of the seats outside automobiles? (The FAA recommends but does not mandate them for air travel -- a different, harness-type seat, incidentally.)

I started to wonder whether there is scientific evidence on the presence or absence of long-term negative effects from extensive child-seat use, whether in frequent, long auto trips or outside automobiles. And I was surprised to find nothing in PubMed and PsycInfo, the two most relevant databases.

The reasons are easy to see. Safety researchers study the rate of injuries. And child psychologists and human factors researchers who might be interested in subtle changes have no control group. Child car seats are mandatory in all states. Medical researchers have connected their use outside of automobiles to the rise of head deformation, but the people most concerned about the issue appear to be parents writing for websites and magazines like Mothering. One study cited there suggests that children transported in soft wearable carriers develop greater attachment to their mothers than those who remain in portable car seats.

Long-term risks from safety technology are at least as old as the protective miracle of asbestos. The so-called Clinton style safety pin -- still the prevailing style -- was promoted by its manufacturer with the image of a little girl, yet by the early 20th century it was called the "danger pin" by the great surgeon Chevalier Jackson. (See the wonderful article about Dr. Jackson and his collection of extracted objects by my friend Mary Cappello, author of Swallow.)

If you think concerns are exaggerated, consider baby walkers, banned in Canada but used by a majority of parents in some countries. As the pediatrician Dr. Alan Greene wrote on the New York Times site:

Sometime in the second half of the first year, healthy babies develop a strong urge to move across the floor. At first, this is a struggle for them as they work their arms and legs, stretching, rolling, scooting or crawling. They find delight in accomplishment as they achieve their goal of a toy out of reach. Later, the focus of their work will turn to pulling themselves upright.

Babies who use a walker skip some of this magnificent developmental journey. With their toes in an unnatural position, they glide across the floor with ease, moving upright before their time.

What's the outcome?

Besides the added dangers of moving faster, falling farther and reaching higher, babies who use walkers learn to crawl, stand, and walk later than they would have otherwise, and continue to show delayed motor development for months after they have learned to walk. The delay seems to be a little more than three days for every 24 hours of total walker use.

But the biggest delays -- and the biggest surprise to many parents -- are delays in mental development and lower scores on mental developmental testing, still present 10 months after initial walker use.

In child safety, it may be the dose that makes the poison.

(If you're interested in the ramifications of this theme, I have a video on the Risks of Safety here.)

Image: Losevsky Pavel/Shutterstock.