Car seat and booster seat safety

It's hard to believe but before the 1970s, many babies did not ride in car safety seats. And if they did, their seats were simple plastic shells strapped in by a car's lap belt. Nowadays, it is against the law to allow a baby to ride in a car without a Health Canada-approved car safety seat.

Choosing a car safety seat

During their very first ride home from the hospital, a newborn must be safely strapped into either an infants-only safety car seat (also called rear-facing infant seat) or a convertible seat properly adjusted for a newborn.

An infants-only seat is generally appropriate for babies up to 22 pounds (10 kg). This type of seat is only safe for use during travel, not for use as a sleeper. An infants-only seat should always be installed in the backseat of a vehicle in the rear-facing position. Rear-facing position provides protection for an infant in the event of a crash.

A convertible seat would safely fit a child from birth up to about 40 pounds (18 kg). Convertible seats can be adjusted into different positions and to suit newborns. A harness system attaches at 5 points on the baby - at each shoulder, each hip, and between the infant's legs. The safest positioning for a convertible seat is in the backseat in the rear-facing position.

Rear-facing is considered the safest position regardless of size or age. But when a child reaches at least 22 pounds and 1 year of age, a convertible seat can be switched to a front-facing position in the backseat. Once a child is in a forward-facing child seat, it is best to keep them in it until they outgrow it, usually when they reach about 65 pounds (30 kg).

Just as rear-facing seats are safer than forward-facing seats, forward-facing seats are similarly safer than booster seats. This is because forward-facing child seats spread the force of a sudden stop or crash over the strongest parts of the child's body, thereby decreasing the chance of more serious injury.

Once your child weighs between 40 and 80 pounds (18 kg and 36 kg), he or she will likely have outgrown a convertible car seat. And yet adult seat belts will still not fit properly. You'll need to bump them up to a booster seat, which must be used with both a lap belt (fit snugly across a child's upper thighs) and a shoulder belt (to reach middle of chest and shoulder). Vehicles with low-backed seats or no headrests should be outfitted with a high-backed booster seat to suit your child's size.

Installing car safety seats

Always follow the manufacturer's instructions for installing your car safety seat. When installing a car safety seat in the rear-facing position, double check that it is in tightly and cannot be moved or shifted more than an inch in any direction. The harness should be positioned at or below an infant's shoulders, and the harness clip should be around mid-chest level.

Follow the manufacturer's instructions for installing your car safety seat in the front-facing position, as recline angle and other details may be different from rear-facing installation.

Most vehicles made after 2002 will feature a system called UAS (Universal Anchorage System) or LATCH (Lower Anchors and Tethers for Children). Instead of using your vehicle's seat belts and locking clips, UAS allows you to install your child's seat using secure tethers and anchors. If your vehicle or safety seat is older, you can purchase a tether kit to enhance your child's stability and security.


  • Stay clear of air bags. A rear-facing seat should never be placed in the front seat with an active passenger air bag. In the event of an accident, an inflated air bag could cause serious injury to an infant riding in this position. Always place the seat in the center spot of the backseat so it is out of range of any side air bags. If you must install multiple seats, consult your car seat manual for the best way to position near a side air bag. And if you have no alternative but to place an infant safety seat or booster seat in the front, do so after deactivating the air bag, adjusting the seat to the rearmost track position, and tightly installing the infant safety seat according to manufacturer's instructions.

  • Adjust your baby for safe posture. Babies should be positioned so their heads do not flop forward and so they will not slouch sideways or down into their seat. Safety seats often have angle indicators to support baby's head. If yours does not, you can use padding placed around, not under or behind, your baby. During the winter, remove your child's bulky snow-wear before putting them into the seat. Also, buckle your baby in before covering with a blanket.

  • Use car seats only for travel. If your infant dozes off while in the car seat, it can be tempting to allow the nap to finish uninterrupted once you reach your destination. But car safety seats are not safe or appropriate for sleeping. Babies sleeping in a seated position can have constricted airways since their heads can fall forward. Place your sleeping baby in a crib that meets Canadian safety standards.

  • Be aware of expiry dates. Over time, a car safety seat becomes less safe due to general wear and tear. Thus, all safety seats sold in Canada must include an expiry date. If you receive a hand-me-down car seat from a generous friend, ask about its age and how it has been used, or what kind of history it has (e.g., has it ever been involved in a car accident of any type?). Look for visible cracks or missing parts.

Crib and cradle safety

Parents of newborns may wish to keep their baby close by in those first few weeks. An infant can sleep safely and - hopefully soundly - in a cradle up until 6 months of age, or when they're able to sit up on their own.

Otherwise, a crib is the safest place for an unsupervised baby to sleep. Cribs that meet Canadian safety regulations can be used until around the 18- to 24-month mark, or when your baby reaches 90 cm in height (and might try to climb out on their own!).

Choosing a crib

Vintage shoppers beware: Cribs built before September 1986 do not meet current Canadian safety standards and should not be used.

Put crib mattresses to the test: When selecting a crib's mattress, "firm" is the keyword. The mattress itself should be firm, as any gaps or worn spots could pose a suffocation risk. It should also be tight-fitting - the space between the mattress and all four sides of the crib should not be more than 3 cm. And the mattress support system should hold a mattress firmly in place. To test side-to-side stability, shake a crib. To test up-and-down stability, push up hard on the mattress from beneath the crib.

Outfitting a crib

Stick to the plans: Once you've chosen the right crib for your baby, it's up to you to assemble and outfit it for optimal infant safety. Follow the manufacturer's assembly instructions completely and do not modify the crib in any way. Test out the assembly once you're finished. Test that the crib's sides lock into place properly. Be sure that the mattress fits tightly and snugly into place.

Secure the area around the crib: Sweet, soothing mobiles must be kept well clear of infants' reach. Keep cribs away from anything with cords or straps, including window blinds, curtains, and electrical cords.

Put your baby safely to bed: An infant should sleep on their back with nothing in their crib except for the mattress, its tightly-fitted cover sheet, and a light infant blanket tucked under the edges of the crib's sides and covering only up to their chest. Babies should wear only diapers and a set of sleeper pyjamas. Avoid crib extras, like pillows, toys, and bumper pads - all suffocation risks - as well as any items with draping or cords. Ensure that crib sides are locked securely.

Keep up the upkeep: Abide by the instructions about changing the mattress height as your baby grows. Check the stability of the crib frame periodically to be sure no screws have loosened over time and use. Inspect the mattress surface for wear and tear and replace it if it looks worn out.

Where babies shouldn't sleep

In bed with Mom or Dad: No matter how much you love to cuddle up next to your newborn, a safe and sturdy crib or cradle is a must. Sharing a bed with parents or other children puts an infant at danger. An infant may fall from the side of a bed or become trapped between or suffocated by pillows, blankets, or the sleeping body of a family member.

In a seated position: A baby may be lulled to sleep by the rolling wheels of a stroller or by the hum of a car's motor. But babies should not be left to sleep for long in an upright position. The underdeveloped muscles of an infant's neck may not be enough to keep a baby's head from lolling forward and constricting airways. The same warning holds for bouncy seats and swings.

In a spot not built for beddy-bye: Babies fall asleep in the darnedest places. But places not specifically designed to safely hold a sleeping baby can be a risk. Changing tables, playpens, sofas, chairs, futons, and even beds with side rails simply don't provide the protection an unsupervised infant requires.

Stroller safety

Watch the motorcade of strollers rolling around parks and shopping malls, and you'll see just how many varieties there are if you look closely. Umbrella strollers whisk by - simple, small, and easy to fold up and tote. Contrast those basic models with the full-size travel strollers (miniaturized baby SUVs equipped with clip-in car seat and storage for stowing diapers and sippy cups) or the active strollers with ATV-style wheels or hitches for bikes. You may even be able to catch a sighting of a vintage pram or carriage-style stroller every now and then.

Shop around and imagine using strollers in your natural environment. If you're a car commuter, you may want a stroller that easily converts from sidewalk to car seat. If you take the public transit, you might opt for a fold-up umbrella stroller for ease of getting on and off buses and trains. Manoeuvring wide-berthed, all-terrain strollers can be tricky on busy city streets, and a thin-rimmed pram may not be the best bet if you'll be detouring through the park.

Whether you're on the market for a simple or super-deluxe model, here are a few selection and safety tips that should apply to all strollers:

  • select a sturdy stroller: Even the lightweight umbrella strollers for quick trips should be well-designed and built to prevent tipping backwards. Check that the stroller you choose includes a lap belt or a safety harness. Test brakes and wheel attachments, and ensure that collapsible strollers lock properly when folded.

  • follow the reader: Because of the huge variety and levels of complexity available for tot transport, it is so important that parents and caregivers consult and abide by the instructions and suggestions included in their particular stroller instruction manuals. Read over the rules thoroughly and pay attention to specifications for your child's height and weight, as well as how much you can safely stow in a stroller's under-seat storage space. Keep in mind that full shopping bags can weigh more than a small child, and can easily tip a stroller backwards when left unattended. Retain make, model, and manufacturing date in case of product recalls. Regularly check your stroller for any visible signs of damage.

  • strap your child in securely: Open your stroller fully and lock it before putting your child into it. And don't skip the safety harness and lap belt just because you're not going far. Pillows, blankets, and padding can all pose suffocation risks, so leave them out of the stroller if possible.

  • stroll safely: Bypass the escalators in favour of the elevator. Engage the stroller's brakes whenever you stop, even if only for a moment. When waiting for a green light at crosswalks, keep the stroller well clear of the curb. When crossing a road and taking those first steps onto the pavement, take a second glance for oncoming traffic - it is the stroller, not you, that enters the roadway first. If you must stop while on a hill, do so at an angle perpendicular to the incline of the hill and not in a downhill direction, and fully engage the brakes. Keep a hand on the stroller for added assurance. And when doing the stroller-to-car transition, secure your child in the vehicle safety seat before unloading groceries or other items.

Safe use of baby slings and baby carriers

If we were to look at parenting in cultures around the world, we would encounter many mothers who wear their infants snugly attached to their bodies through the use of slings and baby carriers.

Baby-wearing has many advocates who praise the benefits of so-called "attachment parenting." Some proponents claim that "sling babies" tend to be less fussy and are more able to bond with their baby-wearing parents. Breast-feeding is said to be more convenient and natural when the baby spends time so near the breast.

But baby-wearing has its risks, too. Slings with rings or knots can easily become loose. When this happens, the fabric of the sling can slip and the baby can fall. If a parent or caregiver wearing a baby falls, so does the baby. And suffocation risks increase if the baby is poorly positioned in a sling. A baby's nose and mouth can press against fabric or against their caregiver's body. A curled position can mean a baby's head may fall forward and block the airways.

If you choose to use baby slings or carriers, follow these safety strategies:


  • Choose a sling or carrier that suits the age and size of your baby as well as your own size. Have a separate sling or carrier for each person who carries your baby.
  • If your child is too young to hold his or her own head upright, choose an option with adequate head support.
  • Look for a sling or carrier that comes with detailed instructions about height and weight recommendations.


  • Use the carrier or sling only as directed; front-carriers should never be used on your back and vice versa.
  • Be sure that your baby's face is always visible and his or her airways remain unobstructed.
  • Check that straps fit properly and that all buckles and snaps are safely fastened before using your carrier.
  • Once you've placed your baby's legs through the leg openings of a carrier, adjust the openings to the smallest setting that suits your baby's leg size.
  • When you need to bend over while baby-wearing, hold your baby carefully and bend at your knees.
  • Check on your baby frequently when wearing a sling or carrier.
  • Never use a stove or oven when carrying your baby in a sling.
  • Do not zip your coat around your baby in a carrier or sling.
  • Inspect your sling or carrier before each use to check for signs of wear and tear: torn straps; ripped seams; and faded, fraying, or balding spots on the fabric.

Pacifier safety

Pacifiers, like their name indicates, help to soothe and pacify a fussing baby. And a pacifier is better, causing less tooth problems than a baby's thumb or fingers!

A pacifier should not be used when a baby could be otherwise pacified. Check first to see if your baby is hungry, wet, tired, or just restless, and deal with those issues before turning to the pacifier. A baby who is teething may chew on their pacifier, so watch for signs. Chewing on a pacifier can cause pieces to break off and pose a choking hazard. Offer your baby a teething ring instead.

A pacifier must be used properly to prevent problems. Pacifiers seem like simple things, but improperly used pacifiers can lead to breast-feeding issues, tooth decay and bite problems, and possibly ear infections. A worn out pacifier can fall apart and become a choking hazard. Never dip pacifiers in honey or sugar to sweeten your baby's sucking, both of which can lead to tooth decay. And it should go without saying, but just in case: to prevent the risk of strangulation, never tie or hang a pacifier around your baby's neck.

A pacifier must be kept in good, clean condition - or else toss it. Before each use, wash your baby's pacifier in soap and hot water. Some moms pop their baby's pacifier in their mouths for a quick clean, but this can spread germs. Inspect pacifiers regularly to watch for signs of wear and tear such as changes in nipple texture, rips, or holes. Time, heat, sunlight, and certain foods can damage pacifiers. Replace them at least every 2 months.

Your baby will eventually need to part with binky. To prepare binky-dependent tots for weaning, begin limiting the time you allow your baby to use their pacifier. If you have to, talk to your child about setting a stop date and reward them for progress toward their goal of a pacifier-free future.