CAR Seat Safety for Premature Babies
Medically reviewed by Drugs.com. Last updated on Apr 6, 2025.
What do I need to know about car seat safety for premature babies?
Premature babies (born before 37 weeks) have a high risk for problems while sitting in a car seat. These problems include periods of not breathing (apnea), slow heart rate, or a low oxygen level. Your baby will be screened for these problems before you take him or her home.
What do I need to know about car seat tolerance screening (CSTS)?
CSTS is a test used to check if your baby can safely sit in a car seat. Screening will be done in the hospital. Healthcare providers may use the car seat your baby will use at home. They may instead use a hospital-owned car seat for screening. Your baby may need to stay in the hospital longer if he or she does not pass screening.
How is CSTS done?
- Healthcare providers will place your baby in a car seat. Providers will monitor your baby's oxygen level, heart rate, and breathing for 90 to 120 minutes.
- If your baby's oxygen level or heart rate drops for a period of time, he or she will need to repeat screening. Your baby will have to repeat screening if he or she has periods of apnea. Screening may be repeated 12 to 24 hours after the first screening. This will depend on your baby's symptoms.
- Providers may do tests to see if your baby has a condition that is causing his or her symptoms. Your baby may need a special car seat called a car bed. Car beds are used if he or she cannot sit in a reclined position.
How can I keep my baby safe in a car seat?
- Follow the installation instructions that come with the car seat. The safety seat should not move more than 1 inch in any direction after you secure it. Always follow the instructions provided to help you position the car seat. The instructions will also guide you on how to secure your child properly.
- Always place your baby's car seat in the back seat. The best spot to place your baby's car seat is in the middle of the back seat. Never place your baby's car seat in the front seat. This can cause serious injury or death.
- Make sure the harness straps are not loose. Make sure the chest clip is at the center of your baby's chest. The chest clip should be at the same level as your baby's armpits. Make sure your baby is dressed in thin layers of clothing while in the car seat. Thick coats or jackets can cause the straps to be too loose in an accident. You can place a coat or blanket over your baby's lap after he or she is secured in the car seat.
- Prop rolled towels around your baby. The towels will keep him or her from slouching or falling over in the seat. Do not put the towels under or behind your baby. Do not use a seat insert unless it came with the seat.
Call your local emergency number (911 in the US) if:
- Your baby is not breathing or not responsive.
When should I seek immediate care?
- Your baby stops breathing for periods of time while in the car seat.
- Your baby's lips or fingers turn blue.
When should I call my baby's doctor?
- You have questions or concerns about your baby's condition or care.
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Further information
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