Baby Blog

There are no people more important to keep safe than your little ones.

Every time we get in a car, we take a risk. Everyone wants to arrive safely at their destination and no one wants to get in an accident. Despite our best intentions, accidents do happen and the stats are a little scary. In 2021, there were 1123 deaths on Australian roads and more tragically, 65 of these were children 16 years or younger. Whilst road deaths have decreased slightly, hospitalisations have increased, where 3141 hospitalisations in 2018 were children 16 and under.

This is the sad reality - traffic injury is the biggest cause of death for Australian children under 15 years. This is not unique to Australia unfortunately, the problem is global. According to the World Health Organisation, road traffic injuries are the world's leading cause of death for 5 to 29 year olds. No matter where you live, that is why getting your child's safety restraints right is so important. It is everyone's responsibility to try to prevent serious injuries and deaths from road accidents, particularly for our most vulnerable in our society - our children. Ultimately, we want 0 deaths on our roads and it is everybody's responsibility to work towards improving the road toll statistics. 

As parents, our every instinct is to protect our children. To protect them we must be wary of what can increase the risk of car accidents such as driving tired and due to distractions coming from the back seat. The other part is ensuring that you have an appropriate car seat for their age, installed according to the manufacturer's specifications (yourself if you are experienced or by a child car seat fitter), and they are correctly buckled up in the seat according to their size (make sure you have read the manual and know the features of the seat and how to adjust it as your baby grows). For more information on child car seats, there are numerous articles on BabyPeg which explore how to choose a car seat and 6 common problems to avoid with child car seats. 

Let's face it, the first years of parenting are a bit of a tired blur filled with brain fog and frequently wondering what day it is. When you need to get around with your baby in tow, if you can, time your trips for in the morning after peak hour or around midday when you are most alert and your baby is likely to be less fussy.

Distractions when in the car with children of any age can be numerous and lead to unsafe driving, including:

• Visual
  • watching your baby in the rear vision mirror - yes they are very cute!
  • trying to see if they are falling asleep
• Physical
  • just wait until they work out how to undo their belt
  • how did they throw that toy that far?
  • Is baby fussing because they are uncomfortable or sitting on a toy?
  • items moving around the car unsecured
• Cognitive
  • you got lost in that thought
  • Who can focus on driving with the sound of screaming baby?

Whilst some distractions will be inevitable and unavoidable, there are some things you can do to make your trips safer. The easiest thing you can do is always to put them in their seat and check it is adjusted for any recent growth spurts, there are no toys underneath them, the straps aren't twisted and the seat is not too cold or too hot (the metal on the buckles can get very hot in summer). Also, if you are coming from cold outside, make sure you take any thick jackets or jumpers off them so that the straps fit well. These steps will ensure they are as comfortable as possible before you hit the road. Another way to ensure a safe car environment is to make sure there are not unsecured items around or behind their car seat that could become projectiles on sudden braking or a collision. 

Common challenges to car travel by age 

Of course, what you can do to reduce the chances of distractions coming from the back seat will depend on the age stage of your child so lets run through each age's challenges:

Newborn baby to 3 months stage: 

If they are anything like my babies, there is a stage where they can just scream when in the car. This is torture for all involved and I'm convinced it was a developmental stage that just had to pass - perhaps an immature inner ear protesting against rearward travel or perhaps a colicy belly or immature cognition to deal with the sensory inputs of the car movement is responsible? Whatever it is, during this phase, car trips were avoided where possible and kept very short if possible! Getting them into the car already asleep helped a little, sometimes music would help, verbal reassurance helped somewhat, someone sitting in the back with them helped too but mostly time and patience whilst they reached a developmental milestone which cured the issue was what was required. If you are lucky, you may not have a clue what I am talking about and the car is just the ticket to get your baby to sleep every time. In this case, make sure their head is positioned well when sleeping and not falling forward where their airways could be obstructed. 

Another challenge which can affect car seat use at this age and up to 6 months old is if your child is diagnosed with hip dysplasia and requires a soft or rigid hip abductor split or cast worn full time for 6-12 weeks. The position of the legs can cause difficulties with fitting your baby into a standard car seat. The hospital discharge team can help with recommendations and there are certain car seats which provide a wider and lower side panel which can accommodate the legs better. Healthy Hips Australia provide car seat options/suggestions as well as the International Hip Dysplasia Institute has parent resources including car seat options to help you in your journey. 

3 to 6 months stage:

In this stage, the car sound and movement might be lulling them to sleep even when they are overtired and outside of nap times when you don't think they would sleep. Some things you can do to reduce distractions is to keep the car seat routine predictable for them, in other words, the same every time. Talk to your baby, sing to your baby, have 1 or 2 go-to car toys, let them see you in a baby mirror placed in front of them, and make sure they are not hungry or over full when you put them in. If your baby is starting to teethe, something to chew on (but can't choke on), such as a toy or rusk stick, may keep them content. It can help to secure the item to their shirt or strap so that it can be reached even if they attempt to throw it overboard.

6 months to 2 years:

Your older babies and toddlers can easily get bored in the car and create all sorts of distractions. As with younger babies, keep things interesting (or boring if they are sleepy) with toys, teething things, simple snacks and a drink bottle within reach. You can also try sing-a-long music, talking to them/conversation, and naming games. Also ensure their car seat is angled and around head support enough to stop 'the head flop' when they do fall asleep. At this age, a lot of parents are thinking of turning their children around especially if rearward travelling is distressing them. The best thing for their safety is to keep them rearward facing for as long as possible even when their legs are getting longer they can always cross them in front for comfort. Try all the strategies and combinations of strategies before forward facing them as in an accident, they are far better off rearward facing with less forces through their head/neck than with forward facing. They may also (especially if the seatbelt is too loose) work out how to get their arms out from under the shoulder straps at this age but don't have the strength to undo their seatbelt. In this case, ensure the shoulder straps are adjusted to level with their shoulder and ensure you have the straps tight enough to fit in a few of your fingers under the straps, but no more. 

Pre-school to older children:

Car time can be a great time to chat about your day and what is going on in the world around you. You can also talk about what you will do when you get to your destination so they know what to expect and look forward to. Making sure they have access to a spill-proof water bottle is also a good idea. This is an age where it can be increasingly difficult to keep them away from screens including tablets. Perhaps some educational games wouldn't hurt for time-limited periods to keep them entertained as long as this doesn't make them car-sick (stick to allowing this on straight roads and avoid when there are lots of turns/curves). This is a great age for sing-a-longs in the car to easy to follow music such as nursery rhymes from Playschool albums, The Wiggles or Genevieve Jereb (who was a very talented Australian OT and singer songwriter who passed away in 2022). If you have a CD player in the car, there are options from Amazon.com.au, or try Audible for Children's audiobook stories to listen to in the car through car play, or try Amazon Music for Free who has all the best children's albums. 

What if my child has unsafe behaviours in the car and/or requires a speciality car seat or accessories due to disability?

If your child has behaviours such as taking off their seatbelt during travel and doesn't understand the risks of these behaviours secondary to a cognitive impairment (known as behaviours of concern), there are a variety of seat belt covers, speciality harnesses and vest options and Australian Standard Car Seats suited to children with disabilities and medical conditions as well as special purpose car seats which could be explored. Or perhaps, your child has poor tone, strength or movement due to disability and now they are getting bigger, requires additional postural support and a swivel base option to assist with transfers and save your back. Due to the complexity of the laws and standards, any of these options are all best to be explored with your child's disability care team which can include their GP, relevant specialists, Occupational Therapist (if they have the appropriate additional training), speech pathologist (if there are swallowing issues) and/or Physiotherapist.

Australian standards for car seats are among the strictest in the world. There are Australian standards for car seats, special purpose car seats, modified Australian standard car seats and harnesses/vests and buckle covers. Each Australian state has their own standards for the use of non-standard car restraints and where high risk items are being used, necessary documentation needs to be obtained to meet legal compliance. Where a high risk car seat or accessory is prescribed, a letter or form is required to be completed by a trained prescriber and carried in the car at all times outlining the prescribed products, the reasoning for the prescription and important information relating to the use of the product. If this sounds like something you as a parent need to explore further as the mainstream car seats (which adhere to Australian Standards) are not suitable or you need to use a non-standard accessory, then the best place to start is to explore the MACA Website at www.macahub.org. There you can navigate through the 'I'm a parent / carer' section for trusted information, how to find support, finding a MACA trained professional, vehicle restraint information including information on seatbelts (including what to look for before you promote your child to a standard seatbelt) and to join the MACA Facebook community. MACA maintains a national product register, providing independent information about vehicle restraint systems used by children with disabilities and medical conditions. A MACA trained professional will complete their assessment and prescribing process, develop a Motor Vehicle Transport Plan and complete the Advice to Parent Form.

If your child is in a wheelchair for all mobility, it is not recommended for them to start travelling in a transit approved wheelchair in an accessible vehicle until they are generally over 23kg (usually between 7-8 years old on average). The safety information related to transit is usually contained in the manual/fine print for the wheelchair and is based on safety testing (or lack of testing to confirm safety). It is therefore, better to continue to transfer your child into a child car seat (or direct to a car seat if they are big enough) where they would be better protected in the event of an accident rather than try to move too early to an accessible vehicle and in wheelchair transit set up. If you are transporting the wheelchair in the car, always make sure that the wheelchair is tied down or secured during transit and there is a barrier between the wheelchair and occupants. A swivel base such as is available with the Carrot Car Seat can assist parents to transfer their child from wheelchair to the car seat in the interim period until they are too heavy for these types of transfers. There are also car modifications that are possible including installing a car hoist or a powered car seat which swivels, comes out of the car and lowers for safer wheelchair to car seat transfers (although this is an expensive option). If in doubt, and transfers are getting heavy or unsafe, as stated above, consult your child's disabilty care team and seek out an OT trained in vehicle modifications for further advice. This is all best initiated before you think you need it, so a plan can be put in place, and work towards a solution before manual handling injuries occur.

Safe and happy travels...