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| |    Automobile Safety for Premature and Low Birth Weight Infants by Laura Jana, M.D., F.A.A.P. reviewed by Kathryn Clark, M.D., F.A.A.P. Bringing home a new baby necessitates learning how to safely restrain your child in an infant car seat--not just because many hospitals across the country are required by law to make sure you have one before discharging your newborn, but because you undoubtedly want to protect your child from any potential risks. When it comes to transporting a premature or low birth weight infant, however, extra considerations are in order to ensure her safety. Special considerations Certain characteristics of prematurity and low birth weight place these infants at higher risk when traveling in standard infant car seats. Among other things, being put in a semi-upright position can sometimes result in a premature or small infant's airway being blocked or cause a drop in the level of oxygen in her blood. Since most standard safety restraint seats are designed for babies who weigh more than five pounds, it's important that you choose an infant car seat carefully and learn the safest way to restrain your infant if she's at risk. Determining if your child is at risk In addition to any infant with known risk factors, the current recommendation is that all infants born more than three weeks before their due date (less than 37 weeks' gestation) should be observed over time--some recommend 20 minutes, others recommend multiplying your travel time to home by two--while in a car seat before being discharged from the hospital. This allows a trained medical professional to assess whether the infant can tolerate the semi-upright position without experiencing breathing problems or a drop in heart rate. If an infant does experience difficulties, arrangements should be made for her to travel in a special safety device designed for premature infants that will allow her to lie flat instead of in a semi-upright position. Traveling in a semi-upright position Choosing an appropriate infant car seat and using it correctly is important for the parents of all infants, regardless of age or size. For small or premature infants who have been monitored and found to do OK in the semi-upright position, here are several additional car-safety recommendations adapted from the American Academy of Pediatrics.
When regular infant car seats won't do If your child is found to be at risk for breathing problems or other complications when seated in a semi-upright position, ideally you should try to keep travel to a minimum until she gets older and grows bigger. But cutting out all travel is likely to be impossible, so you'll still need to have an alternative safety device for when you do take out your baby in the car. Crash-tested car beds are available for just this purpose, allowing infants at risk to be safely secured in an automobile while lying flat (either on their bellies or backs, as determined by a physician) in the car bed. Discuss the idea of using a special restraint system with your child's neonatologist or pediatrician, who can also make sure you are able to properly secure any medical equipment (such as oxygen tanks or monitors) in the car as well. You also might consider contacting a certified child-passenger safety (CPS) technician or instructor. A list of these specially trained individuals can be found on the website for the National Highway Traffic Safety Administration (NHTSA). For a complete set of recommendations from the American Academy of Pediatrics, see its policy statement titled "Safe Transportation of Premature and Low Birth Weight Infants."
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