An article in the April 2006 issue of Pediatrics raises some important questions about how parents can safely transport obese and overweight children in car safety seats. Appropriate restraint use for tall and/or heavy children is a challenge, and this study highlights a concern that is more important today with increased childhood obesity. The American Academy of Pediatrics (AAP) encourages car safety seat manufacturers to continue developing seats that fit children to higher weights and heights and supports regulatory changes necessary to achieve this goal.

For parents who must decide how to safely transport a large child today, the AAP offers the following reminders and suggestions:

1. All children, of any age or size, must be properly restrained when riding in a motor vehicle. This means that:
   • Children 12 years and younger should ride in the back seat.
   • Infants and toddlers should ride in rear-facing car safety seats as long as possible.
   • Toddlers and young children should ride in forward-facing car-safety seats with harnesses as long as possible.
   • School-age children should ride in booster seats until the adult seat belt fits properly.

   See the AAP brochure "Car Safety Seats: A Guide to Families 2009" for more information on how to decide when your child is ready to move to the next type of car safety seat or into the adult seat belt.

2. Never use a car safety seat if your child weighs more than the seat's weight limit or is taller than the height limit. Check the labels on the seat or manufacturer's instructions if you are unsure what the limits are.
3. The "best" car safety seat is the one that fits your child, that fits your vehicle, and that you will use correctly for every trip. If you need help finding a car safety seat that fits your larger child, a Child Passenger Safety Technician may be able to help. You can find a Technician near you by visiting www.seatcheck.org or calling the toll-free 1-866-SEATCHECK (1-866-732-8243).
4. Car safety seat manufacturers increasingly are making car safety seats that fit larger children. See "Car Safety Seats: A Guide to Families 2009" for a list of available car safety seats. These include:
   • Forward-facing seats with harnesses (convertible seats, combination seats, or forward-facing only seats) with an upper weight limit of 50 to 80 pounds
   • Booster seats with a maximum weight limit of 100 to 120 pounds
5. For toddlers or young children whose behavior will not yet allow safe use of a booster seat but who are too large for for a forward-facing seat with a harness, you can consider using a travel vest. A list of travel vests is available in "Car Safety Seats: A Guide to Families 2009". Most travel vests have upper weight limits of 60 to 168 pounds.

For more information about car safety seats, visit the "Car Safety Seats and Transportation Safety" Health Topics page.