Strep Throat

We made it through flu season (fingers crossed), but what about the dreaded strep? Read on for advice from Dr. Jessica Long on how to handle this often painful infection.

Now that flu is leaving the D.C. area, it seems like strep throat has happily filled the void. If you have a school-aged child, chances are you have had at least one experience with strep throat. It’s almost a parenting rite of passage to get the “There is strep in the classroom” letter home from the teacher! Even though you hear about it all the time, what exactly is strep throat and why are pediatricians so quick to treat it with antibiotics?

Strep, short for streptococcus, comes in different forms but Group A Strep (aka streptococcus pyogenes or GAS for short) is the one that tends to infect the tonsils. The tonsils are a pair of soft tissue masses that are in the back of the throat. When they get infected, by either a virus or a bacteria, they can get larger, red, painful and sometimes even have pus on them. Though viruses are the main culprit of sore throats in kids, if your child continues to complain throughout the day of throat pain or has fever, belly pain, or a rash, it’s a good idea to see the pediatrician.

If your pediatrician wants to check if your child has strep throat, she will order a rapid strep test that can be done right there in the office. After a quick q-tip “tickle” of the tonsils, your doctor will have an answer in just a few minutes. The rapid strep test is good at checking to see if your child is infected but it misses a few people (it catches between 90-95% of people who have strep throat). Therefore, most physicians will also do a culture to see if strep grows from the swab over 24-48 hours. This extra test will make your pediatrician that much more confident that if the test is negative your child truly does not have strep throat.

We treat strep throat for a few reasons. First off, it makes kids feel better faster and who doesn’t want that? Also, after 24 hours of antibiotics your child is no longer contagious and can safely go back to school and activities without infecting friends and family. Plus, strep throat that goes untreated can lead to more serious infections such as an abscess of the tonsils, kidney problems, and even rheumatic heart disease. That’s why it’s important to take the full course of antibiotics if they are prescribed even though your child will feel back to normal in just a few days.

The biggest question on every parent’s mind is how to prevent this in the future? Unfortunately, that can be tough since strep throat can be spread a few days before a child has any symptoms. Throat infections are passed through the air by sneezing, coughing, or touching someone who has it, so remind your child to be vigilant about hand washing, to cough or sneeze into her elbow (not her hands!), not to share drinks and food, and to stay home from school when she doesn’t feel well.

Baby Proofing 101

Once your baby is mobile, it’s time to start making some changes around the house to protect your curious little one. Read on for tips from Dr. Jessica Long on best practices for baby-proofing.

There are a lot of ways parenthood changes us but one I did not expect was how drastically different our house would look. Never mind the scooters on the front porch, the chalk drawings on the sidewalk, or the toys strewn everywhere inside and out. There are more subtle differences I never would have guessed like covers on the outlets, gates on the stairs, and not a loose coin to be found. Baby-proofing your home is a huge but important endeavor and it involves changing habits and routines you never really knew you had.

How do you even start making your home safe for your little one who, at a very young age, can (and will) start reaching for things and sticking them in her mouth? Suddenly a benign water bottle lid becomes a potential choking hazard. The dog food bowl becomes your child’s most desired possession. And don’t get me started on how every electric cord in the house suddenly becomes a beacon of fun.

As you prepare to baby-proof, I recommend looking in each room in your house, ideally from the much lower viewpoint of your child, to see what potential dangers there are. There are obvious things like installing baby gates at the top and bottom of all stairs but also more subtle hazards like window blind cords that should be tucked out of reach. In bedrooms and living rooms, make sure furniture is secured to the wall so that your curious child does not accidentally topple it over when trying to pull up on it. The same goes for TVs, which are notorious for causing injuries to young children.

In kitchens and bathrooms, invest in strong cabinet and drawer locks so that curious hands do not find medications or cleaners. When possible, store toxic or poisonous substances up high as well as locked away to minimize the chances of your little one accidentally getting ahold of them. Outlets should be covered and electrical cords should be taped down or hidden behind furniture so as not tempt curious babies.

One of the big changes that needs to be made, and maintained over time, is keeping choking hazards out of your child’s reach. Gone are the days where you can toss loose change on the table without thinking or absent-mindedly leave batteries on the counter – both pose serious threats to your child. When ridding your space of choking hazards, use the toilet paper roll rule. If an item is small enough to fit through the cardboard tube, it should be placed out of reach of your child. While this is a routine that can take time to master, it will soon become second nature and ensures your child can crawl, walk, climb and explore in a safe space.

Once you’ve seemingly covered your house in bubble wrap, the next step is seeing what your child gets into. All the baby-proofing in the world doesn’t replace good adult supervision, and watching your child will reveal new hazards to abate Plus, every child is different, so while your first may never have looked at an outlet, your second may be found licking one (true story). You will likely continue to update and change your safety precautions as needed and as your child grows.

 

THE DREADED VIRUS – HAND FOOT AND MOUTH DISEASE

Now that school is back in session, germs are spreading and your children are bringing home all types of illnesses, one in particular you should watch out for is Hand Foot and Mouth disease, a viral illness that results in fever and a painful rashes. Dr. Jessica Long gives us the lowdown on this dreaded illness.

When we signed up for parenthood, none of us really knew what we were getting into. Which is probably a good thing because if we were warned about dealing with a sick child who had Hand, Foot, and Mouth disease we may have made a different decision (just kidding, sweet kids!).

If you haven’t been plagued by this viral illness yet, your time will eventually come. Nearly every child is struck by this rash during their early childhood. It is typically harmless and lasts about a week but boy does it make for sleepless nights and lots of phone calls and office visits from uncomfortable families.

Hand, Foot, and Mouth is most common during the summer and early Fall though enteroviruses, which cause it, can infect at any time of year – our practice is seeing a lot of it right now. Your child may feel run down and a bit unwell for a few days, perhaps with fever or less of an appetite. Then the rash will start popping up on their – you guessed it! – hands, feet, and in and around the mouth. Not all three areas will necessarily be affected and other spots, especially their buttocks, can be plagued with these tiny red blistery spots.

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There is no quick fix for Hand, Foot, and Mouth disease. Keeping your little one hydrated is the main goal since kids often avoid eating and drinking due to the uncomfortable spots in their mouth. Giving some acetaminophen or ibuprofen may make them more willing to drink. Pedialyte popsicles are also lifesavers to soothe an aching mouth and get fluid in your sick child. If your child still doesn’t want to drink anything, chat with your pediatrician as there are prescription mouth washes that can be used to help combat the pain.

Even though your child may continue to shed the virus for weeks in respiratory droplets (like a runny nose or cough), most kids are no longer contagious once the red spots have crusted over, which takes about seven days. Your pediatrician will likely recommend that your child stay home until that happens and she is feeling better. To help prevent spreading Hand, Foot, and Mouth to others, wash hands frequently, clean and disinfect touched surfaces including toys, and avoid close contact such as kissing, hugging or sharing utensils and cups.

Most importantly, this too will pass. Just like lice, sleep regression, and that really annoying biting stage, Hand, Foot, and Mouth disease is another badge of honor we earn as parents. We really are super heroes.

HOW TO KEEP YOUR SLEEPING BABY SAFE

The first few months at home with a newborn can be especially stressful, especially when it comes to sleep. Here are Dr. Jessica Long’s  tips on how to keep your sleeping baby safe.

I am expecting my third daughter in the Spring and the thought of going back to sleepless nights is sort of terrifying. Nothing plagues parents of small children like sleep – or lack thereof – and you would be hard pressed to find a new parent who can get through a conversation without mentioning their baby’s horrible sleep patterns. While I worry about the late night awakenings, I at least do not have to stress about how I put my baby down at night to keep her as safe as possible. With these simple tips you don’t have to either.

Back in the day when we were all babies, most parents placed their little ones on their bellies to sleep. In the 1990s, as studies showed that belly sleeping increased baby’s risks of Sudden Infant Death Syndrome (SIDS), the Back To Sleep Campaign championed a safer sleep position. Since then, the number of SIDS deaths has dropped precipitously – by more than 40% – and we now know of other simple steps you can take to keep your child safe at night.

Babies should sleep in their own space – not in the bed with their parents but ideally in the same room. The American Academy of Pediatrics (AAP) recommends keeping your child in a crib or bassinet in your room for ideally the first year but definitely the first six months. Your little one should have a flat, firm mattress with no pillows, blankets, bumper pads or stuffed animals. Instead of loose blankets that can be wiggled around to accidentally cover a child’s face, you can place your baby in a sleep sack. While they are adorable, baby crib bumpers should be avoided due to cases of babies smothering in them. Yes, a bare crib looks boring but boring is safe when it comes to a baby who cannot move to protect her breathing.

There are many products out there that promise to provide further protection against SIDS. Everything from heart monitors that link to your smart phone to bassinets with build in fans is available for purchase. The AAP does not endorse any of these devices as they have not been shown to actually reduce the risk of SIDS. Unless your child was sent home from the hospital with additional medical monitoring of breathing or heart rate, save your money and your sanity and skip these unnecessary gimmicks.

While following the ABCs (Alone, on her Back, in a bare Crib) of baby sleep positions may not get you any additional hours of sleep, it will at least let you rest easy that your child is as safe as possible while you both catch some hard earned zzz’s. Happy dreaming!

WHAT TO CONSIDER WHEN CHOOSING A PEDIATRICIAN

Calling all moms-to-be! One of the most important decisions you can make leading up to your baby’s debut is selecting a pediatrician that is a good fit for your family. Read on for tips from Dr. Jessica Long  on what to look and questions to ask when interviewing potential pediatricians.

Finding out you’re pregnant is such an exciting time!   After the initial thrill and announcing the news to friends and families, you suddenly realize there is so much you need to accomplish before this little one makes his or her debut. If you’re like me, you suddenly have a to-do list a mile long that includes practical things like buying a car seat as well as slightly neurotic endeavors like deep cleaning the floor boards of the entire house (it’s called “nesting” for a reason). One thing you definitely want to cover before your due date is choosing a pediatrician.

As both a mom and a pediatrician, I naturally have some insight into what you should look for in choosing a practice and a doctor for your baby. This is someone you will be spending a lot of time with, especially in the first year of your baby’s life, and who will get to know you and your family for decades to come. She will support you through challenging times and illnesses as well as celebrate your child’s growth and milestones. She will provide sound medical and practical advice when the internet tells you to panic, or to cure your baby’s runny nose by burning toadstools under her crib, or to put your sniffly infant on a three-week juice cleanse. The relationship between a pediatrician and her families is filled with trust, respect and caring – how do you pick someone who can provide this for you?

First off, ask around. Friends, family, and coworkers can be a great place to start before you do your own research. Make sure the physician is certified by the American Board of Pediatrics, which is in charge of training and board-certifying pediatricians across the country. You likely want a practice that is relatively close – like I said, you’ll be spending plenty of time with your pediatrician. Next, schedule a meet and greet to check out the practice and get to know the physicians there.

When you visit the office, make sure there are separate waiting areas for well children and sick children (an additional space designated for infants only is even better!). Especially for your baby’s routine first-year visits, it’s a big comfort to know that there’s an extra layer of protection between you and the teenager who got mono at soccer camp.

Besides just seeing if you “vibe” with the physician you meet, there are some important questions you’ll want to get the answers to as well. Be sure to ask what happens if your child gets sick or hurt outside of normal office hours and you need to ask a question. Is there a physician you can reach by phone or a nurse triage line? What are weekend and holiday hours? How easy is it to talk directly to your pediatrician? As a mom I can promise you your child will become ill at the least convenient time (vomiting as you get on an airplane, ear infection on Christmas morning) but knowing what aid your pediatrician can offer during those moments can be a big relief. Be sure to ask how quickly you can be scheduled for a sick visit and what wait times typically are once you’ve checked in. You already likely know what a pain it can be to wait to see a doctor – now imagine doing that with a sick child.

You probably have already thought about things such as breastfeeding and immunizations, and you want to make sure you have a supportive physician. Is lactation support available? Does she advocate for the immunization schedule recommended by the American Academy of Pediatrics and Centers for Disease Control? You don’t want any unvaccinated children in the waiting room who could expose your little one to an illness he is too young to be vaccinated against.

While you are pregnant it may seem silly to think ahead to “big kid” needs but now is the time to ask. What is the turn around time for school and camp forms and is there an additional charge? What happens if your child has to be admitted to a hospital or see a specialist – what role will your pediatrician play in those situations? How long can your child continue to see the pediatrician before graduating to an adult physician?

Perhaps most importantly, is this a physician you feel you can talk to and trust? You will, after all, be calling him in the middle of the night the first time your baby has a fever or seeking his guidance when your little one goes through a frustrating sleep strike. As a pediatrician, I greatly value the relationship I get to make with my patients and their families (it’s the best part of my job) and want to make sure they feel the same way. Doing your research before your due date allows you to find the right fit for you.

Choosing a pediatrician is ultimately a personal decision. It doesn’t matter if you have the world’s most brilliant doctor on speed dial if you don’t feel comfortable asking for and following her advice. But I hope it comes as no surprise that I think Spring Valley Pediatrics does all the big and little things right.

Whether you are newly pregnant, new to the area, or just looking for a change, we love meeting new families at Spring Valley. We are open 365 days a year so if your little one wakes up with a fever on a weekend morning or Thanksgiving Day, he can be seen. We try to be incredibly accessible to our families, offering a call in time each weekday morning where you can talk to your physician directly. After hours one of our physicians is on call 24/7 and happy to answer your urgent questions. We find that our patients and families are most comfortable when they can see the same pediatrician for all visits and strive to ensure you always see your doctor for well and sick visits. If you want to learn more and check out our office and physicians, call our office for a complimentary new patient consultation at 202-966-5000. We look forward to meeting you and your family!

 

Spring Break Safety Tips

March is finally here, and many of us are planning and prepping for our Spring Break getaways. Read on for tips from Dr. Jessica Long on how to keep your little ones safe while on vacation.

February, the shortest and yet the slowest month of the year, is finally over which means one thing – it’s almost Spring Break! I love exploring new places with my children but traveling with kids takes a lot more planning than the days you could throw a bathing suit in a bag and be ready to jet off to Mexico. Whether your family is going somewhere within the US or traveling abroad, make sure you check these things off your to-do list to ensure a safe and healthy vacation.

First off, plan ahead. At least 6 weeks before an international trip you should arrange a travel consultation with your pediatrician to ensure your child is up to date on vaccines, check to see if any additional shots are recommended based on your itinerary, and discuss other health concerns related to your locale. The Centers for Disease Control has a great online resource that highlights health-related travel recommendations based on your country of travel. Physicians like to see you far in advance of international travel to ensure that any vaccines given will be protecting you in full force by the time you travel and to allow enough time to order any shots we may not routinely keep in stock.

Next up is the never-ending packing list. Things you’ll want to throw into your bag are sunscreen (SPF 30 or above) for all that fun in the sun, DEET (30-50%) for deterring those pesky mosquitos, and antibacterial wipes or hand sanitizer. I never travel without children’s acetaminophen and ibuprofen for fevers and aches, antihistamines for any allergy symptoms, and nasal saline for those inevitable stuffy noses. It might be helpful to throw in hydrocortisone cream for itchy rashes and antibacterial cream for skinned knees.

Unfortunately accidents still happen when you’re on vacation, so the same precautions you take at home should be taken on your trip. That means dragging along (or renting) car seats or booster seats so your child is safely secured for car travel. No classic spring break trip is complete without a dip in the ocean, and no child swimming in the ocean should be without a life vest, protective footwear, and a vigilant pair of adult eyes on her – the CDC notes that drowning is the second cause of death in young travelers. It’s also worth the effort to research ahead of time what medical care is available at your destination. That way, if an emergency does come up, you won’t have to waste valuable time figuring out where you child can get help. Depending on the age and health condition of your child, it may make sense to consider the availability and level of local health care when choosing a destination in the first place.

This may seem like a no-brainer but don’t forget your child’s normal medications. Countless times I have received a frantic phone call from a parent who left an asthma inhaler or other important medication at home by accident. No one wants to take time out of a fun vacation to hunt down a pharmacy for a new prescription so double-check that any daily, or even occasional, medication your child takes is packed in your carry on.

Happy travels and here’s hoping you get at least a little bit of R&R on your family trip!

 

Babies and Spit Up – When to See the Pediatrician

For many first-time parents, baby spit up can be a bit terrifying. There is a very fine line between what is “normal” and when you should seek help from your pediatrician.  Dr. Jessica Long helps to clear up some common spit up misconceptions…

spitup

When I found out I was pregnant with my first daughter, I daydreamed about lazy mornings cuddling with her, taking long walks together through our neighborhood, introducing her to all of my favorite childhood spots in DC, and of course all of the adorable clothes. What did not play a starring role in my motherhood fantasy was the amount of spit up that would end up on her, me, my husband, the dog, and really anything within a four foot diameter after she ate. Her spitting caused her no distress and certainly did not slow down her impressive weight gain but wow did it lead to a lot of laundry.

Spit up is an incredibly common baby phenomenon. In fact, more than half of babies younger than 3 months old spit up daily. For most babies, gastroesopahgeal reflux (GER) is a natural occurrence that, while annoying, causes no health problems and improves with time.   However, in some babies it may cause complications – in which case we call it GERD (gastroesophageal reflux disease) – and requires evaluation by your pediatrician.

For all of those parents out there with “happy spitters” who smile while you grab your tenth burp cloth of the morning, there are thankfully some simple things you can do to help reduce the amount of curdled milk you are scrubbing off the sofa.

First off, there’s only so much room in that tiny baby belly and if it gets overfilled with milk there is nowhere for it to go but out. Do your best to not overfeed your baby. Also, try to minimize gas in your baby’s belly so that, as a gas bubble escapes, it doesn’t bring up half the meal as well. Some babies need to take burp breaks in the middle of their feeding as well as at the end in order to not have a wet burp down your back shortly after eating.

While tummy time is important for motor development and can help to relieve gas, it is best to avoid it right after feeding. That extra pressure on the stomach is more likely to send its contents all over the living room rug. Holding your baby upright for 20-30 minutes after eating also helps to keep everything in her stomach right where it belongs.

Still spending more time with the laundry machine than enjoying that sweet social smile of your baby? It is important to have regular follow up with your pediatrician to ensure that gastroesophageal disease is ruled out. Talk with your pediatrician to see if diet changes would be helpful. Some breastfed babies may be sensitive to dairy or egg and having mom avoid these foods could cut down on spit ups. Similarly, a formula fed baby might prefer a hydrolyzed formula. Adding a small amount of oatmeal to bottle feedings has also been shown to help reduce the amount of spit up. However, chat with your baby’s doctor before altering anyone’s diet.

With spit up, time is the best remedy. As your child grows, spitting up will be less of an issue and your little one will be on to new and exciting problems such as desperately wanting to play with electrical outlets and finding every choking hazard accidentally left around your house. Parenthood is a journey and spit ups will soon be a distant memory. The overabundance of laundry in your home will unfortunately be an ongoing problem.

How to Introduce Peanuts to Children

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We all know that peanuts can be dangerous for children with peanut allergies, but when is the best time to begin introducing them to your child’s diet? Dr. Jessica Long gives us the lowdown on this tricky topic…

 

With two girls under the age of five, peanut butter is a staple in our house. It’s easy, delicious, and packs 8 grams of protein in a two tablespoon serving. However, for many families, peanuts are cause for real concern. Peanuts are the leading cause of food allergies in children and can cause serious allergic reactions and even anaphylaxis. For years, the medical community has been trying to figure out how best to prevent peanut allergy. Doctors used to advise parents to not expose their children to peanuts until they were at least two years old but that was not helping to decrease the number of people with allergies. Earlier this year, new recommendations came out in response to research showing that it’s actually early exposure, as opposed to late, that helps prevent peanut allergies.

So who do we now recommend try peanuts? Most healthy infants over the age of 4 months may benefit from early introduction of peanuts. However, some children may require allergy testing before trying peanuts so always discuss with your doctor before introducing new foods. For example, if your child has severe eczema or egg allergy, a peanut allergy test should first be done by 4-6 months old. Also, children with a strong family history of peanut allergy might need to see an allergist before trying peanut protein.

If your doctor gives the thumbs up for introducing peanuts to your baby, you can offer Bamba (a puff peanut product) or make your own thinned smooth peanut protein mixture. Combine two teaspoons of smooth peanut butter with two to three teaspoons of warm water or pureed baby food to make a perfect two gram serving which is the ideal amount for your little one.

The first feeding should be a small amount, just the tip of a teaspoon. Watch your infant for ten minutes to make sure there are no reactions such as hives, vomiting or nasal symptoms. If there are no reactions, continue to offer the rest of the 2 gram serving of peanut protein at your baby’s normal feeding pace.

Once your baby has successfully tried peanut protein, it is recommended that you offer two gram servings three or more times a week. If your infant develops any allergic symptoms within two hours of eating peanut protein, stop and contact your pediatrician. Remember to avoid whole nuts until kids are over 5 years old as well dollops of peanut butter until kids are over 4 years old due to choking concerns.

 

SCREEN TIME AND BABIES – ADVICE FROM A PEDIATRICIAN

We are all guilty of it…giving your child an iPad to get a small break during the day. Just how harmful is it? Keep reading for Spring Valley Pediatrics Dr. Jessica Long’s expert advice on how much (or how little) screen time is appropriate for our children.

iPad Baby

You are probably reading this on your phone, maybe catching a minute’s break during your baby’s afternoon nap or between answering emails. Texts, emails, adorable Instagram photos – there are plenty of reasons your phone is always within reach but what does it mean for your young child’s development?

We know that babies’ brains do a lot of growing and changing in the first years of life. From birth to two years old, a baby’s brain triples in size and is busy forming neural synapses (connections within the brain). Too little stimulation, as can happen to neglected children, causes the brain to under-develop. However, too much stimulation is also harmful to the maturing baby brain. Studies have shown that prolonged exposure to rapid image changes, like what is seen in children’s TV shows, during this critical period of brain development creates a mind that expects high levels of stimulation. This can lead to attention problems later in life; the more TV that is viewed before the age of 3, the more likely that child will have attention problems at age 7.

The American Academy of Pediatrics (AAP) recommends that, outside of video chatting with family, children under the age of 18 months have zero screen time. We know that children learn best through interacting with the people around them instead of with electronics. Exposing them to TV, tablets, and phones (including apps and shows that are meant to be educational) can actually cause children to speak later and use fewer words. Even having the TV on in the background, which many of us do when we are at home, can affect our baby’s language development. With the TV off, a parent speaks an average of 940 words per hour to a toddler. However, with background media on, the average is 170 words an hour, and important language tools such as facial expressions and body language are negatively affected.

So what is a busy parent, who deserves some down time scrolling through Facebook, to do? First, monitor your own use. When you are with your little one, put down your phone, turn off the TV, and give your child your undivided attention. Sing, read, and play with her. Make eye contact and use body language to communicate, all of which help her learn best.

Once your little one is 18-24 months old, the AAP gives the thumbs up to some screen time. Parents should choose high-quality programming and watch it with their child. Engaging your child in the viewing experience – asking questions, pointing things out, and helping him make connections to real life – make screen time more interactive.

I would be lying if I claimed to have never pulled out a tablet as a last resort on an airplane to calm a toddler throwing a tantrum. Every parent has been there, but do your best to avoid using screen time as an emotional pacifier. It’s important for your child to learn how to identify and handle strong emotions and to come up with activities to manage boredom or calm themselves down. The next time you are at a restaurant or in the doctor’s waiting room, let your child explore a new book, create a drawing with crayons, or play “I Spy” with you to pass the time instead of relying on a screen to keep her entertained. Added bonus – it gets you to put your electronics away, too, and I know I could benefit from some more unplugged time.

 

Carseat Tips – Is your child in the right one?

Read on for Dr. Long’s carseat guidelines to ensure a safe and fun summer of road trips for your family.

Summer is fast approaching and for many families that means lots of fun hours in the car on road trips. No parent would ever knowingly put their child’s safety at risk, but that is what often happens when we buckle our kids in the car. More than 70% of car seats are improperly installed and at least half of caregivers are not correctly securing children in their car seats. All of this greatly reduces the ability of car seats and booster seats to protect your child.

So what can parents do? First, make sure your child is in the right seat for her or his height and weight by reading the info below. Second, double check that your seat is properly installed. Safe Kids DC has sites throughout the city where they do checks most days of the week. Spring Valley Pediatrics hosted a free car seat check with Safe Kids DC in May and will be hosting another in September. Third, use the right seat in the right way every time you are in the car.

One of the most common questions we are asked as pediatricians is when a child can move to the next type of car seat or booster seat. As parents, we look forward to our children growing, maturing, and making it to the next milestone. However, with car seats it’s best to go slow. Instead of looking forward to graduating to the next safety seat, aim to keep your child in their current car seat for as long as they meet the manufacturer’s height and weight restrictions.

We find parents excitedly turn their child front-facing long before it is safe to do so. Staying rear facing for as long as possible – up to 35-50 lb in most convertible car seats – is 5 times safer for your child in a collision. Your tall two year old may look like her legs cannot comfortably fit rear facing but you would be surprised by how happily kids adjust their positions in their car seats.

Similarly, the jump from a booster seat to the regular seat is one every 5th grader is anxious to make. To check if your child is ready to retire car seats and booster seats forever, see if he passes these steps. Can he sit with his back against the vehicle’s seat, knees bent at the edge of the seat, and feet flat on the floor? Is the lap belt positioned over his thighs (not his belly) and the shoulder belt positioned across the shoulder and chest (not his neck or face)? Also importantly, can he sit properly with no slouching, moving around, leaning forward, or playing with the seatbelt? If so, you can consider ditching the booster forever but, as always, no need to rush things. They grow up fast enough.

Car seats do expire, typically six years from their manufacturing date, due to gradual breakdown of the materials and daily strain from installations and use – so be sure to check the date on the side or back of your car seat. You should also replace your safety seats if your car is in an accident, even if there is no visible damage to the car seat or your child was not riding in it at the time. Purchasing a new one is crucial to ensure your child continues to travel safely. Also, replace your car seat if there is obvious wear and tear – the straps are frayed or the harness doesn’t latch as well – since these are signs that it would not properly protect your child in an accident. As tempting as it is, never purchase a used car seat. There is no way to ensure that it is top condition and has never sustained damage in a car accident.

Still have questions? There is a lot to know about car seats and recommendations change as more medical and scientific data become available. Use your pediatrician as a guide and resource for how to keep your kids safe in all aspects of their life. We make it our job to help parents protect their little ones!

 

Infant CarseatThe Right Seat For Every Age


Birth to 12 months:
a rear-facing car seat is the perfect spot for your little one. Infant, convertible and 3-in-1 car seats are all options for safely securing your baby. Infant car seats (aka “bucket seats”) can be used up to the first year of life or until your baby outgrows the height and weight recommendations, whichever happens first. Convertible and 3-in-1 car seats can last longer but be sure to follow the manufacturer’s guidelines on height and weight requirements.

 

Convertible carseat

1 to 3
years:
your little one is still safest rear-facing. Most convertible and 3-in-1 car seats can still be used during this age. Switch your child to front-facing once she reaches the maximum height or weight limit for the car seat. Some convertible car seats can accommodate a child up to 80lbs in the front facing position so make sure you pick a color or pattern you adore because you’ll
be seeing it for years to come!

 

Combination Carseat


4 to 7 years old:
your school age child has likely grown to safely ride front-facing. Continue to use the five-point harness until they reach the height and weight restrictions of the seat. Combination seats (a hybrid car seat that can turn into a booster), convertible car seats, or 3-in-1 car seats should still accommodate your growing child.

Booster

 

 

8 to 12 years old: Though your child might seem so grown up, it is unlikely that he is ready to ditch safety seats altogether. A booster seat is best at this age. They come in many different shapes and sizes, with and without backs, and work with your car’s seatbelt to keep your child safe in the car.

 

13 and up: While the safest place in the car for your teen is in the back seat, a child of this age may legally sit in the front passenger seat.