We have been using car seats to keep our babies safe for at least 15 years. However, babies tend to wake when you fit them in to the car seat while its almost certain they’ll wake when you lift them out again. Because of this in – out, in – out repetition of the car seat that is soon seen to be wake up trigger to the baby, sleep deprived parents often end up carrying their car seats rather than waking their little ones. Then, of course, there is the dilemma of getting your baby off to sleep by driving by them about only to risk waking them again as you take them out! Many parents simply resort to leaving them in the car seat rather than risk disturbing them.
One reason car seat health issues have risen is because many parents buy car seats that fit into pram frames, popularly sold as travel systems. Suppliers of travel systems advise parents not to leave babies in the car seat for too long. However, having paid a premium for the travel system, parents often ignore the advice and end up leaving their baby sleeping in the car seat because now they can’t lift the baby out of the car seat without waking them. So the travel cot ends up being left in the boot of the car because they can’t lift the baby without waking baby up, so the baby continues to stay in the car seat.
So what are the concerns around leaving babies in car seats too long?
HYPOXIA (restricted airway leading to a loss of oxygen in the blood needed to feed developing organs)
In 1995 the USA Paediatrics Society conducted a study on infants’ oxygenation levels in their car seats. Normal oxygenation levels in the blood should range between 97-99% in a healthy term infant in optimal positioning. Any oxygenation level below about 90% is considered “hypoxia”. Healthy, full-term newborns placed incorrectly positioned car seats had oxygen levels that went as low as 83.7%! Such levels would normally bring an ambulance crew into emergency mode. And there was a consistent finding that the longer the baby spent in the car seat, the lower their oxygen levels would go, until the baby was removed from the seat. Loss of oxygen to the brain is for long periods can cause developmental problems.
The study was repeated in 2005, with the same results. The conclusion in both studies was that babies should spend the least amount of time possible in a car seat and they recommended that car trips with new babies be kept to an hour or less. In addition, it was recommended that infant car seats be used only in the car and not beyond that. And yet, these studies and others like them have gone almost completely unnoticed in the United States, UK, and Canada. This may be why it is not uncommon to see infants in car seats for hours on end, being moved from the car to a travel system to home without ever being removed from the seat. How much damage is being done to these infants while they seem to sleep so peacefully? Just like high blood pressure any parent cannot see what is going on inside.
Hypoxia is known to cause damage to the developing brain. Experiencing hypoxia can result in signs of ADHD, decreased IQ, delayed motor development, and impaired attention. If these conditions sound familiar, perhaps we are beginning to understand why, as more and more children spend their infancies in some form of baby seat, reclined and in a hypoxic state.
In addition to the hypoxia seen in healthy, full-term newborns, there is also a risk due to positional asphyxia. Sadly the some babies have been left in car seats too long with reduced air intake. A newborn baby’s head is very heavy, and its neck is quite weak in comparison. Newborns, especially those born prematurely or with respiratory issues, are prone to having their heads tip forward onto their chests, drastically narrowing the airway (which is about the width of a drinking straw) and blocking proper flow of air. This can cause hypoxia and even death, and is a risk in any baby containment device that places the infant in a seated position, including (but not limited to) car seats, baby swings, bouncy seats, and yes, even cloth slings, if the parent doesn’t follow positioning guidelines.
Many parents are reluctant to remove a sleeping child from a car seat. However, some experts such as Professor Peter Fleming, a leading expert in Pediatric care, says that for very young babies journeys should be avoided and only 30 minutes.
A recent study by the NHS conducted at Southampton and Bristol University backs up Dr. Fleming’s advice. They found that while sat at this angle for 30 minutes – either stationary or when in motion – the babies’ heart and breathing rate increased, and their blood oxygen levels were lower compared with lying flat in a cot.
Rise in flat head syndrome (PLAGIOCEPHACY)
The medical professionals have noticed a rise in skull deformity. Because baby’s heads are soft, when left in one position for too long, they deform and reshape accordingly. Since it has been discovered that laying a baby on its back reduces Sudden Infant Deaths (SIDS) babies spend most their time on their backs. However, this is supposed to be mainly when they are asleep and unmonitored. Add to this the overuse of car seats in which babies are constantly resting on the same spot you have a good idea of how this problem is growing.
Furthermore, the invention of the travel system has created a phenomenon of babies spending so much time in them that some just won’t easily sleep elsewhere. It is not uncommon for many parents to leave babies awake in them – to fall asleep!
Many parents are not aware that when the baby is awake it is good for them to spend time on their bellies which increases neck muscle strength and cognitive developmental skills. Instead many are simply leaving their babies to dwell in car seats unaware of the health related issues.
An Arizona clinic that treats plagiocephaly produced an article published in the Journal of Prosthetics and Orthotics. The report recorded that 28% of infants who attended that clinic spent up to 4 hours a day in a car seat. Indeed many or us know someone who would leave a child in a car seat for longer if it is convenient to use in a pram frame too pram. The Doctor recording this, Dr. Littlefield, recommended less time in car seats as a good idea to reducing the possibility of flat head syndrome occurring.
The American Academy of Pediatrics in 2003 suggested that infants “should spend minimal time in car seats (when not a passenger in a vehicle) or other seating that maintains supine positioning.”
It is clear that the best way to reduce the chances of plagiocephaly is to cut time spent on their backs and that includes car seats.
UK NHS and the Lullaby Trust also suggest that babies should be taken out of car seats when they are not passengers.
Physical issues babies suffer for being in car seats too long
There is no evidence via research to suggest that babies are being harmed in terms of spinal deformation by car seats but many experts point to certain issues which can be exacerbated by too much time in a car seat. Clearly flat head syndrome is one of those issues.
Another is shortened neck muscles on one side. With the head constantly to one side the neck muscles on that side can shorten (Positional Torticollis). Since more parents leave their babies in car seats too long this issue is something to try and avoid.
Be aware, however, that the head to one side is not such a bad thing as it is better for breathing and avoiding hypoxia. The best thing is to check that they are not always leaning in the same direction when asleep. In addition, according to some chiropractors, any habitual positioning can affect spinal development and even be a sign of an existing issue. Varying positions is a better option and why having a baby in the same position for long periods in car seats is not a good idea. For such reason, Dr. Jeanne Ohm from the Chiropractic Pediatric Association advises that “Using a variety of carriers supports correct postural development for the child”.
Another thing to consider is circulation. If you look at the 40% angle of baby seats you’ll notice that the legs often rest about 90 degrees to the body. Can you imagine how that adds pressure to blood flow and how you would feel if your legs were at that position for hours on end?
Also, the back in a curved position for such long periods without enough rest on a flat surface surely cannot be good for the development of the spine?
So in summary things like neck muscle shorting, flat head syndrome, circulation issues, and possible spinal injuries can be avoided by taking your baby out of a car seat at the earliest opportunity.
Car seats travel systems cost cuddles
The advantage of removable car seats and travel systems is also the problem. Apart from ailments associated with leaving babies in car seats, there is the lack of human touch.
Many a time a parent with a baby has turned up at friend’s house having driven for an hour to get there. They then lift the baby out of the car in its seat and place him on the floor. When the baby wakes they use the seat as a rocker and then maybe clip the seat onto a stroller to go out for an hour. Then at the end of the walk, they put the baby, who is now back to sleep after the walk, but still in the car seat, back on the floor to have a coffee before leaving. The baby is then put back into car and they go home. For this whole period, the baby has not been held or picked up.
In addition, the baby is not spending enough wake time on its belly as recommended. I guess the message here is that not only is leaving a baby in a car seat unhealthy but it also affects the bonding process which is elevated via parental child contact.
Physical Strain for Parents
In the past, a mother took her baby bag with all she needed. That has always been a heavy burden but with newly invented necessities they have become heavier and heavier. She now has to add the cumbersome car seat to this list which has doubled the bulk and weight overnight!
One of the main reasons that parents buy portable car seats is so they can remove a sleeping infant from the car without waking him. There are certainly times when this is handy, but the strategy can easily backfire. Many a time parents have been shopping but when the baby wakes they end up carrying the baby and the car seat separately.
A car seat can weigh as much as a newborn baby and when hanging in front or by the side the spine is under a lot of stress. They are designed to be easy to hold but you have to hold it away from your body so your legs are not kicking it as you walk. This means your spine is tilted and holding weight away from the body.
Dr. Cassidy Hog of Align Chiropractic says that “Back pain is a common ailment with parenting due to repetitive bending at awkward angles. Particularly because of hormones related to pregnancy”. He is referring to a hormone called relaxin which makes the joints loose to enable birth.
There aren’t many manoeuvres as difficult or awkward as putting a baby in car a seat or lifting car seats in and out of cars. He recommends a product called the Snugglebundl because it allows the parent to remove just the baby without the car seat straight into the pram without bending or waking the baby. They are also easy to lift and therefore allow more parent to child contact than when babies are left in car seats.
The main thing is to remember that the biggest reason for leaving a baby in a car seat is due to the fear of waking them. However, there are lots of associated health risks with leaving a baby in a car seat.
To find out how not to wake them when putting them in or taking them out of a car seat then CLICK HERE