Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
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Monroe Carell Jr.
Children's Hospital
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Booster Seats 101


According to Safekids Worldwide children seated in a booster seat in the rear seat of a vehicle are 45 percent less likely to be injured in a crash than children restrained in a seat belt alone.

Most parents are not aware of the ages at which their children should remain in their booster seats. Though state laws vary, a general guideline for booster seat usage is between eight and 12 years. We encourage you to check your state's car seat laws for additional guidelines. 

Why are boosters important?

Correct Booster Seat Use

Booster seats help position the belt so that it safely restrains the child. They come in two sizes: high back and low back. Both are used with the lap and shoulder belt only. They do not include a harness. If your child’s ears come up past the vehicle seat, a high back booster is needed to help prevent whiplash and provide head and neck support. If the vehicle seat comes up to the top of the child's ear a low back may be used.

The Insurance Institute for Highway Safety is a great resource when selecting the safest booster seat for your vehicle.

Tennessee law requires children to be 9 years old or at least 4' 9" tall to transition from a booster to an adult seat belt only. This law establishes a minimum standard for safety. However, experts in child safety and injury prevention, who treat children injured in car crashes, strongly urge parents to continue using a booster seat for a child who is 9 years old or older but who is shorter than 4' 9" tall, until their child reaches that height. We thus encourage caregivers to wait until their child's ninth birthday before measuring their height.

The best practice to keep children as safe as possible is to keep them using a booster seat until they're at least 9 years old and 4' 9" tall. At that point they can safely transition from a booster seat to using a lap-and-shoulder safety belt.

Moving a child from their booster too soon can result in life-threatening injuries including seat belt syndrome. This is damage to the spinal cord or soft stomach tissue due to improper placement of the lap belt over the abdomen, or a lap belt that rides up onto the abdomen. Other injuries can also occur.

A few tips

The seat belt must contact the child's shoulder and chest. If it does not, try a different booster or a different seat in the car.

The lap belt should rest low and flat on top of the child's hips and thighs. If the booster places the lap belt on the stomach, select a different seat.

When selecting a high back booster, choose one with guides that allow the shoulder belt to slide freely. Some shoulder belt guides limit the shoulder belt's movement which can pose a risk to the passenger.

Overall, boosters provide many benefits to children who have outgrown their forward facing car seat, and have yet to meet the requirements of the adult seat belt. We encourage caregivers and parents to not rush through the booster stage but to make informed decisions. 

Last Edited: May 17, 2018
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