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Car seat danger: Babies shouldn't sleep in car seats when not traveling

The American Academy of Pediatrics recommends against routine sleeping in sitting devices for infants and a new study shows why.
sitting devices
/ Source: TODAY

Car seats are the safest place to be for babies when they’re being driven around, but it’s another story if parents use them as an alternative for a crib or bassinet once they get home.

When infants die while sleeping in sitting devices, almost two-thirds of the cases involve babies slumbering in car seats, a study published Monday in Pediatrics found.

But just a small fraction of those deaths occurred while the infant was in the car, said Dr. Jeffrey Colvin, lead author of the study and a pediatrician at Children's Mercy Hospital in Kansas City, Missouri.

“It really appeared that the deaths in these car seats occurred in the context where the car seat wasn’t being used for its purpose in transporting a child, but instead it was being used as a substitute for a crib or bassinet,” Colvin told TODAY.

“But they aren’t as safe as a crib or bassinet when the child is out of the car and sleeping … There’s a lack of awareness (about this). I think every parent, including myself, has been guilty of doing this at one time or another.”

Most deaths happen in the child’s home

About 3,700 babies die during sleep each year in the U.S. due to sudden infant death syndrome (SIDS), accidental suffocation and other causes. Using data from the National Center for Fatality Review and Prevention, the researchers examined 11,779 sleep-related deaths of infants less than 1 year old from 2004 to 2014.

They found 348, or 3%, babies died while sleeping in sitting devices. Of those deaths, about 63% happened in car safety seats; 35% took place in bouncers and swings; and 2% were in strollers.

Just one-tenth of the car seat deaths happened while the device was being used as intended — with the baby strapped into the seat while traveling in a car — the study noted. More than half of the deaths happened in the child’s home, often with the parent or caregiver not paying attention. In some cases, the infant was almost falling out of the device, or the car seat was almost falling off the surface where it had been placed.

“A lot of times we just saw this context where the infant had been left in the car seat for hours and hours, and the supervisor was asleep or intoxicated during the time,” Colvin said.

Using car seats in a 'non-traveling context' may pose a risk

Since car seats are a safety device, parents probably just assume they are the safest place for an infant even when not traveling, Colvin noted.

Parents also may not want to wake up a baby who has fallen asleep in a car seat during a drive and just leave the infant in the device when they bring him or her into the home.

But the American Academy of Pediatrics recommends against routine sleeping in sitting devices for infants. Using car safety seats for sleep in a “non-traveling context” may pose a risk to babies, the study authors added.

It’s not completely clear why car seats aren’t the best place when the child is out of the car and sleeping, Colvin said. A crib or bassinet may be safer because it’s flat rather than angled like a car seat, plus there aren’t any straps or side padding that could potentially serve as a strangulation or suffocation risk, he noted.

But parents should “absolutely not” be worried if they see their baby slumbering in a car seat during a drive, he added.

“The car seat is where infants should be always when they’re traveling and it’s the absolute safest place for that infant to be, whether they are awake or asleep,” Colvin said.

“But you just have to remember that car seats are for cars and when you get out of the car, the safest thing to do if your infant is still sleeping, would be to put them in a bassinet or a crib.”

Tips to keep your baby safe:

The study authors offer this advice:

  • Children who fall asleep in a car seat while being driven should remain in the car seat until they are no longer traveling.
  • If they are still asleep at this point, they should be placed in a crib or bassinet.
  • When traveling, take a portable crib or bassinet to use once you reach your destination.
  • At a minimum, infants should not sleep unsupervised in sitting devices like car seats or strollers.