They can be awkward to install and time consuming to use, but booster seats save lives and help prevent serious injuries according to a new report presented at a recent American Academy of Pediatrics (AAP) meeting in New Orleans.

Booster seats are used when a child outgrows backward facing or convertible car seats.  Kids are still too small to be properly restrained by vehicle seat belts, so the booster seat gives them the height and stability they need to be buckled-up safely.

47 states have booster seat laws, with varying ages covered, while 3 states have no laws.

The states that have booster seat laws have shown, over a period of time, a drop in serious injuries from auto accidents among children ages 4 to 11-years-old.

In the 3 states without booster seat laws, Florida, Arizona, and South Dakota, there were no changes in serious injuries reported.

Even though booster seats have been shown to be effective at preventing deaths and serious injury, use by parents and caregivers remains low. Nationally, about half of children ages 4 to 5 use them, and about 35% of children ages 6 to 7 are safely buckled-in a booster seat when traveling by car.

Confusion about state law requirements, expense and inconvenience are some of the reasons parents or caregivers often give for not using booster seats. A study noted in the journal Pediatrics showed that while parents may use a booster seat for their own child, they were more relaxed about the rules when car-pooling.

Parents sometimes believe that a seat belt works just as well whether a child is in a booster seat or not. In reality, children are much more likely to be seriously injured or die during an auto accident from an ill-fitting seat belt.

States that require booster seats vary in their requirements, but the AAP has a set of guidelines they recommend for all parents or caregivers.

The typical height of a child ready for a booster seat is 4 feet 9 inches. The age is usually between 8 and 12-years-old. 

Some guidelines for choosing a booster seat are:

  • Choose a seat with a label that states that it meets or exceeds Federal Motor Vehicle Safety Standard 213.
  • Accept a used seat with caution. Never use a seat that's more than 6 years old or one that was in a crash (even if it looks OK, it could be structurally unsound). Avoid seats that are missing parts or are not labeled with the manufacture date and model number (you'll have no way to know about recalls), or do not come with an instruction manual. If you have any doubts about a seat's history, or if it is cracked or shows signs of wear and tear, don't use it.
  • If you accept a used seat, contact the manufacturer for recommendations on how long the seat can safely be used and to find out if it's ever been recalled. Recalls are quite common, and the manufacturer might be able to provide you with a replacement part or new model.

 There are lots of articles and videos online to explain how to install a booster seat and how to make sure your child is properly secured.  Elementary schools, community centers and child safety groups often offer free seminars about infant car seats and booster seats for families.

The Insurance Institute for Highway Safety has just released its 2012 list of top rated booster seats. Of the 17 tested, all but 2 earned the rating of Best Bet. That list can be found at

As children get older, they sometimes associate a booster seat with “being a baby.” They can make a fuss over using one and definitely slow down the process of getting on with the trip. But children should never have the last word on their own safety. That’s a parent’s job. You never think that a serious accident will happen, but even if you are a careful driver - someone else may not be.

In 2009 The Transportation Department reported that nearly 6,000 people were killed and a half million were injured in auto accidents caused by distracted drivers, particularly by people using a mobile phone. Think how much that has likely changed in the last 3 years, with the growing popularity of texting while driving.

Booster seats, when they are needed, can truly make the difference between a child’s life or death, or a life with serious permanent complications.