Obese children and Car Seats

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Car seats are required by law. Even more importantly, car seats save kids’ lives. But it’s not always easy to find car seats for heavy or obese children.

We all know children come in all sizes. Some small, some big. Some taller, some rounder. And sometimes as they grow their roundness stretches to a tall, slim child.

Childhood obesity

Unfortunately our car seat training materials say about 1/3 of children in the US are considered obese. According to more recent numbers reported at the Centers for Disease Control, the rate is coming down. CDC reports 20.3% of children age 6 to 11 and 13.4% of children age 2 to 5 as obese for 2017-2028.

According to a 2006 study, in the previous three decades, the rates of childhood obesity doubled for children 2 to 5 years of age and for adolescents 12 to 19 years of age. The rate tripled for children 6 to 11 years of age. (1)

The study showed 283,305 children ages 1 to 6 who may have trouble finding a car seat appropriate for their age and weight. 182,661 of those children were age 3. Unless the child is exceptionally tall, a 3-year-old weighing more than 40 pounds would generally be considered overweight. At this age a child should still be in a 5-point harness, preferably rear facing if possible.

Obese children and car seats

At the time, the researchers found only a few affordably-priced car seats that would appropriately accommodate an overweight child. Meanwhile, we know it is critical for a child to be properly restrained to prevent injury during a crash.

Later a 2011 study (2) looked at nearly 1,000 1-to 8-year-olds involved in crashes and found no increase of injury as long as the child were in a child restraint appropriate for the child’s height and weight. That study concluded there was a sufficient range of car seats to accommodate a broad spectrum of sizes of children.

However, as a car seat technician, parents frequently ask me for suggestions for heavier children. Parents seek my — and other car seat experts’— help finding a seat that will fit their child, taking into consideration age, height and weight.

Over recent years car seat manufacturers have been making car seats with increased weight limits. For instance, many infant carriers, like the Orbit Infant Car Seat or the Chicco Keyfit, used to be rated up to 22 pounds and are now rated up to 30 pounds. Some convertible seats may have rear-facing weight limits up to 50 pounds and forward-facing limits up to 65 pounds. You can now find booster seats with weight limits up to 120 pounds.

Even so, it’s not always as easy to find a seat that fits as the 2011 study would lead parents to believe.

Download our cheat sheet to learn the 4+ stages of car seats and which one your child is in.

Properly securing your child

Remember best practice and stick to it as best you can no matter how small or big your child is.

• All children under age 12 should sit in the back seat.
• Keep children rear-facing for as long as possible until they reach the upper weight or height limit of their seat in a rear-facing position.
• Once they outgrow the rear-facing seat, keep children in a forward-facing harness as long as possible to the upper weight or height limit of the seat.
• After they outgrow the forward-facing seat, use a seat belt positioning device — a RideSafer vest or booster seat — until the child can pass the 5-step seat belt fit test.

Car seat options for heavier children

Generally speaking, you want to look for car seats with a wider base for these children to fit more comfortably. If you are looking at booster seats, look for seats with low or angled “arm rests”.

5-point harness seats

There are many car seat options in the 5-point harness category that allow forward-facing harnessing up to 65 pounds. Some all-in-one (from rear-facing to booster in one restraint) examples include:

• Britax One 4 Life
• Chicco Fit4
• Graco 4Ever Extend2Fit
• Safety 1st Grow and Go
• Maxi Cosi Pria 85 (goes to 85 pounds but some say the seat doesn’t adequately fit wider kids) – seat has a recall for higher weight children
  
  • Although, no injuries or incidents were reported, the manufacturer says: “when the seat is installed in the forward facing position and secured to the car using the lap belt without also using the top tether, the seat may not adequately protect the child from head injury in the event of a crash.” Dorel Juvenile Group, Inc. and NHTSA  are working on the scope of the recall related to manufacturer dates and the remedy to consumers. Using this car seat in rear-facing mode as well as forward-facing mode for children up to 65 lbs. remain certified for use for all labeled installation methods.

In 2014 NHTSA required crash testing 5-point harness child restraints rated over 65 pounds with a new 10-year crash test dummy, which weighs 78 pounds and is 51″ tall. As the dummy is quite large, it won’t fit in many convertible seats. Manufacturers began lowering the weight limits of their seats back down to 65 pounds.

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Harness vests

For young children who are not quite ready for a booster but are too large for a forward-facing seat may be able to use a vest restraint like:

• RideSafer vest — comes in 4 sizes ranging from 26 to 110 pounds, expansion panel available to allow for bigger waists
• EZ-On options that go up to 168 pounds

Booster seats

There are several booster options that have a weight limit of 120 pounds.

• Britax Highpoint (highback booster)
• Clek Olli (backless booster)
• Combi USA Kobuk (highback booster; goes up to 125 lbs.)
• Diono Solana (backless booster)
• Diono Monterey (highback booster; expandable back adjusts width and height)
• Graco RightGuide (backless booster)

Using a conventional car seat is your best option for obese children, especially considering price. If you cannot find a suitable car seat that fits your child appropriately, you may need to consider a special needs car seat with a higher weight limit.

By Amie Durocher, Creative Director at Safe Ride 4 Kids and certified CPS Tech since 2004

Copyright 2021 Safe Ride 4 Kids. All rights reserved. You may not publish, broadcast, rewrite or redistribute this material without permission. You are welcome to link to Safe Ride 4 Kids or share on social media.

Sources:

• (1) Lara B. Trifiletti, PhD, MAa, Wendy Shields, MPHb, David Bishai, MD, PhD, MPHb, Eileen McDonald, MSb, Florence Reynaud, BA, CPS-Tb,Andrea Gielen, ScD, ScMb. “Tipping the Scales: Obese Children and Child SafetySeats.” Pediatrics volume 117 (4), (April 2006): p1197-1202.
• (2) Mark R. Zonfrillo, Michael R. Elliott, Carol A. Flannagan and Dennis R. Durbin. “Association Between Weight and Risk of Crash-Related Injuries for Children in Child Restraints.” Pediatrics volume 128 (6), (December 2011): p1148-1152. https://pediatrics.aappublications.org/content/128/6/1148