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 Children who outgrow child restraints with harnesses either in weight or height should use a belt positioning booster seat with a three point lap and shoulder belt. Booster seats serve as an important step between a restraint with harness and an adult lap/sash belt on its own (without a booster seat).
Research has proven that using a belt positioning booster seat instead of a seatbelt alone reduces the risk of severe injury by 60%. Using a booster seat increases the protection from injuries in a crash. Skipping the booster seat step or getting rid of the booster too early is a common but dangerous move. Most children are not mature enough for an adult belt alone until they are 4' 9" tall (approx 148cm) which is usually between the ages of 8 and 12. Children prematurely “graduated” to adult belts are more susceptible to injuries such as broken spinal cords, head injuries, brain injuries and ruptured livers and spleens. Boosters protect your child's bones and spine and keep internal organs like intestines, liver and spleen from being crushed. Children can also slip below an incorrectly fitted belt. Boosters also help reduce slouching, one cause of poor lap belt fit. Booster seats also reduce the misuse of the sash belt and reduce the risk of ejection. “When children are “ prematurely graduated” to safety belts…, the lap portion of the belt rides up over the abdomen and the shoulder portion crosses the neck or face. This places the child at risk for “submarining” or sliding out of the lap belt during a crash and for injuries to the neck as a result of the poor fit of the shoulder belt” – F. Winston JAMA - Journal of the American Medical Association 281, 1999 According to a news article by One News, researchers at Starship Hospital found that: - Every child aged 5 and under should be restrained in an appropriate child restraint
- 90% of children aged 6-8 (the age group with the highest number of injuries at Starship) should still be using booster seats
- 50% of 9-10 year olds should still be using booster seats and
- 10% of 11-12 year olds still require a booster seat
See the news article by clicking here: Researchers warn car seats to age 12
How will I know whether or not my child needs a booster seat? This simple 5 step test should help you to determine whether or not your child needs a booster seat: The 5-Step Test 1. Does the child sit all the way back against the auto seat? 2. Do the childs knees bend comfortably at the edge of the auto seat? 3. Does the belt cross the shoulder between the neck and arm? 4. Is the lap belt as low as possible, touching the thighs? 5. Can the child stay seated like this for the whole trip? ©SafetyBeltSafe USA |
If you answered "no" to any of these questions, the child needs a booster seat to make both the shoulder belt and the lap belt fit right and to keep them safest. On young children the shoulder portion of the adult belt often crosses the neck rather then the shoulders which is both uncomfortable and dangerous. To make themselves more comfortable, kids will often put the shoulder belt behind their back or under their arms – making it dangerous. 
This simulation shows a child improperly seated in an adult belt with the shoulder belt behind the back.
This child is thrown forward dramatically in a 56 kmph crash.The inappropriate fit of the seat belt and lack of upper body restraints puts the child at risk for severe head, spine, abdominal and brain injury. | 
This simulation shows how a 6 year old child properly restrained in a belt-positioning booster seat barely moves during a 56 kmph crash.
It is obvious to see that the child is much better protected because they are using an age, weight and height appropriate seat. |
If there is no shoulder belt when a crash occurs, your child’s upper body and head can fly forward hitting the interior of the car causing neck, spine or brain injury. Without a booster, the lap belt sits high across the child’s stomach instead of flat on the thighs and the belt itself can cause internal organ injuries in a crash. Safe2Go, Land Transport New Zealand, CHOP (Children's Hospital of Philadelphia), SafeKids and the American Academy of Paediatrics all recommend the use of a booster seat until a child reaches 4ft 9" (or 148cm) in height.
Why should I be using a booster even if I'm not required to under the current laws?
As above, most children are not mature enough for an adult belt until ages 8 - 12 or 4' 9" tall (approx 148cm). Currently the law only stipulates that children 5 and under must use an appropriate child restraint and children 5-7 must use one if one is available in the vehicle. Whether or not a child can be properly seated behind an adult belt without the aid of a booster seat is not dependant on their age. It is dependant on weight, height and behaviour/maturity.
Carseat to booster - When?| "Every step in car seat "advancement" is actually a step down in your child's protection" - CPSafety |
When your child completely outgrows their forward-facing harnessed car seat you can switch to a belt positioning booster seat. It is recommended that children remain in an approved harness of some form until they are at least four years of age. The forces are spread more evenly across the body in an accident. But with a three-point belt there is higher risk of ejection from the seat in an accident which can result in fatal consequences. Most booster seats in New Zealand have a weight range starting at 14-15 kilograms with a maximum weight limit of 26-36 kilograms. This girl is about to outgrow her car seat
height wise. She's probably a bit small so
might be better kept in a bigger harnessed
seat. |
How will I know whether or not my child should be in a booster?
As above, a booster seat is for use once a child has outgrown their forward-facing (inbuilt) harnessed restraint. You will need to refer to your instruction manual as not all restraints have the same height or weight limits.
They have outgrown their child seat if the their eyes are above the top back shell of the seat or if they have reached the maximum weight limit for their seat. If this is the case, then some suggestions might be: - Find another car seat e.g. convertible booster with a taller back
- Buy a booster seat and use in conjunction with a child harness for more upper torso support. You may also want to look for seats with anti-submarine devices that prevent the child from slipping under the belt
Please remember: Booster seats have minimum weight limits, usually 14 or 15kg, make sure you read your instruction manual or stickers on the seat. If your child is below the minimum weight requirement of the booster seat, then it is not an appropriate nor approved restraint to use. However, there is more to using an appropriate seat then meeting the minimum weight requirements. Appropriate also means height wise, age wise and maturity wise. Many children move in to boosters because their younger siblings need their seat or because their peers are in boosters too. Please don’t demote your child to a booster seat because it is needed for a younger sibling. Think about buying or renting another seat until they are physically ready for a booster seat. Don’t use what other restraints your child's peers are using (if any) as an indication that they should move in to a booster. Chances are other children might have prematurely ‘graduated’ to boosters themselves. Children are very much individuals in their physical maturity, weight, height and so forth. While some children may be ready for boosters, that doesn’t mean yours is. See here for more information on "Extended Rear-facing." How does a booster work? - Protects children too large for a child restraint with harness but too small for a simple seat belt.
- A Belt Positioning Booster (BPB for short) raises your child so that the lap/shoulder belt is properly positioned across the chest and thighs, ensuring that in a crash the belt will protect and restrain as it was designed to do.
- Booster seats are not tightly installed in the vehicle as other child restraints are, booster seats are held in place by the child's weight and the vehicles lap and shoulder belts.
It is important to remember that you must never use a booster seat with a lap belt, but always with a lap AND shoulder belt. It is illegal to use a booster seat with a lap only belt. If you use a lap belt, the child will be folded in half and hit their head on their knees or the seat in front of them in a crash. Children can also suffer serious internal injuries if this happens. If only a lap belt is present in the vehicle, then you will need to use it in conjunction with a child harness.  High back booster seats must be used when vehicle seat backs are low or do not have head restraints. This type of seat (pictured to the left) provides head, neck and back support for the child. A lot of full boosters on the market also offer some side impact protection for the child. It's obvious to tell whether or not a seat offers some SIP (Side Impact Protection) as it will have some "side wings" surrounding the head.
If there are no head restraints behind the head, the child is at risk of hyper extension. Hyper-Extension is a form of whiplash, when the head is snapped backwards in an accident i.e. if you are hit from behind. This can cause injury to muscles, ligaments, discs, nerves and the cervical spine to name a few. These injuries can have short term consequences, long term consequences, can leave your neck forever weakened and more prone to injury and can even kill you. Use only shoulder belt positioners provided with the belt positioning booster. see the manufacturers instructions. With a backless booster (not pictured), the child uses the vehicle's seat back or built in head restraint for head,neck and back support. A backless booster offers no SIP (Side Impact Protection). Most backless booster seats come with a shoulder belt positioner to adjust the shoulder belt height on the child. Weight recommendations for booster seats vary depending on what Safety Standard they meet. Check your instruction manual, stickers on your restraint or contact the manufacturer if you are unsure or can not obtain this information. Even if the child is not present, secure the booster seat at all times so that it isn't a projectile. Children should always right in the back seat up until age 13.
What to make sure of when using booster seats:
- The shoulder belt goes across the centre of the shoulder and chest, not on the neck.
- The lap belt should be high on the thighs or low on the hips, not on the tummy.
- That you use a high back booster if your vehicle has low seat backs with no head rests. Some models may offer increased side impact protection.
From booster to adult belt
BOOSTERS SAVE LIVES!!
Reference:
Washington State Booster Seat Coalition BoosterSeat.gov A Parent's Guide to Buying and Using Booster Seats (US) National Partnership on Booster Seat Safety Booster Seat: Boost Our Chances Boosters are for Big Kids Children's Car Seat Safety Guide - How should preschool and school children ride safely? Booster Seats Keep Kids Safe Booster Seats, Dr. E. R. Segedin When Should a Child be Put into a Booster? Booster seats: What Parents Should Know National Child Passenger Safety Certification Training Program - Student Manual Children's Hospital of Philadelphia - Car and Booster Seats For Your 4-8 Year Old Recent developments regarding car accident insurance claims Spinal Topics - What is Whiplash?
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