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Dr. Robert Needlman
Specialist in pediatric behavior and development.
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Infant Car Seat in a Pickup Truck
QUESTION
Dear Dr. Needlman,
I would like info regarding car seats and pickup trucks. I have a one-year-old who is over 20 lbs. Is it safe for him to ride in the truck (there is no airbag)? If so, should the car seat face forward or rear? Thank you so much for any info on this matter!

— Marquette in Indianapolis

ANSWER
February 26, 2002
Dear Marquette,
As you know, the big problem with car seats in pickup trucks is that many pickups have passenger-side air bags (all of the new ones do), and it is absolutely never safe to put a rear-facing infant seat in front of a working air bag. In a rear-facing seat, the infant's head is very close to the air bag. If the air bag deploys--which can happen even in a low-speed parking lot collision--the full force of the air bag will strike the baby's head, which can be fatal.

In your case, since you don't have to worry about the air bag, the front passenger seat of your pickup should be OK, although it is not ideal. Rear seats are safer, in general, than front seats because they are further away from the force of the crash. But an infant or child can be reasonably safe in the front seat, when properly restrained and if there isn't a working air bag.

Once a baby is older than 12 months, and weighs more than 20 lbs, according to the official recommendations from the National Highway Transportation Safety Administration (NHTSA) it is safe for them to sit in a car seat facing forward. However, it is actually safest for a baby to remain rear-facing for as long as possible. In a crash, rear-facing is safer because the forces of the crash are spread out over the baby's entire back and the neck is fully supported against the back of the car seat.

Look on your car seat for a label that tells you the weight and height limits for a baby sitting rear-facing. Most infant seats are safe for babies up to 30 lbs. If your baby's head sticks out over the top edge of the seat, then the seat is definitely too small.

Car seats are very hard to put in correctly. I'd strongly recommend that you go to a free car-seat inspection site and let a certified child passenger safety technician check your seat. Chances are, you will learn something that will make your baby much safer in your pickup. To locate the nearest inspection site, call 1-888-DASH-2-DOT (1-888-327-4236), or go to www.nhtsa.dot.gov. Also, you can read much more about child passenger safety on our site.

— by Robert Needlman, M.D., F.A.A.P.

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