Car Seats for newborns (1st Stage)
Car Seats and Car Carrycots for New Borns
Your info starts here.............
At Car Seat info we only recommend "stage 1" car carrycots and car seats/infant carriers that lie very flat for new born babies.
Why? simply because medical research has shown that some new born babies who sit "scrunched up" in a upright infant carrier are potentially at risk of breathing problems.
In 2004 a total of 15 children aged between 0 & 4 years died in a car accident in the U.K.
Pro rata, this would relate to 2 babies aged between 0 and six months of age being killed.
In the same age group (0 to 6 months) about 280 babies per year die of "cot death" and perhaps surprisingly the major majority are not in their cot when they pass away.
Put in context, we believe the issue of cot death is therefore very important and we are disturbed that there would to appear to be links between upright infant carriers and cot death.
Concerns over upright infant carriers have certainly grown in recent years and what we state on this web site has been reported either by the general media, suppliers or by the medical journals.
The link below is one from the BBC who in fact has reported concerns about upright infant carriers twice. http://news.bbc.co.uk/1/hi/health/6216892.stm
In the U.K. health professionals do not record the location of cot death victims but many other countries do and from this we learn that probably 24 U.K. babies every year suffer a cot death whilst sat in their infant carrier.
A vast number of medical research reports have concluded that upright infant carriers can cause breathing problems for baby and one from the School of Medicine at Kobe University in Japan has compared upright infant carriers (chair shaped) with lay flat (bed shaped) car carrycots and shown that babies in flat carrycots did breathe better.
The Quote below is from the Kobe report.
“Mean of oxygen saturation with the chair shaped car seat was significantly lower than the bed shaped car seat”.
In America newborn babies (especially premature and low birth weight ones) are often checked prior to hospital discharge whilst sat in their infant carrier so to ascertain how they medically react. Whilst not every baby at risk can be identified of potential breathing problems this surely something we should do in the U.K.
So what are the risks and why do they occur?
We are not medically trained but understand the problem to be this. New born babies tend to breathe from the bottom part of their lungs and when sat in a wedge shape the lungs tend to become compressed by other internal organs causing the lungs to be less efficient. Additionally, a new born can not hold their head and because their head flops the airway to the lungs becomes narrower.
Because the quantity of air to the lungs decreases and because the lungs are less efficient the blood oxygen level also decreases. This is called Oxygen desaturation.
For most babies this is probably not a major problem but no one can be sure and recently research has been published which indicates that Oxygen desaturation may not just be linked to cot death but also affect a child's ability to learn and even affect their behaviour in later life.
In relation to Oxygen desaturation are some models of infant carriers likely to cause more problems than others?
Almost certainly yes, some very upright infant carriers will probably cause a lowering of blood oxygen levels in new-borns more than deep lie back ones. Research from Canada has shown that the angle of the infant carrier can make a significant difference. However, it is not the only contributing factor. If the car it is being placed has a deep sloping seat the infant carrier will become more upright. Again in the U.S. parents are encouraged to place "rolls" under an infant carrier to decrease its angle. Crazily, this practice is not approved of in the U.K.
Fortunately though at least one car seat supplier has no objection to their infant carriers being tilted back so that baby lays at a "healthy" angle, though in NO circumstances should the infant carrier be tilted more than 45 degrees as this would affect safety. This does cause a gap between the foot end of the infant carrier and the seat it is placed on but many (but not all) “experts” agree this is not a major problem.
However, we know of no supplier who approves of infant carrier bases being tilted so in consequence though we accept they can make mums life a bit easier we do not think they are a healthy option for baby in particular in cars with sloping rear seats.
So where is the evidence that Oxygen desaturation is a problem?
Well obviously you have a computer otherwise you would not be reading this so nothing is stopping you going into your favourite search engine using the key words "oxygen desaturation car seats" and finding out for your self.
Alternatively, if you want our four years of research in ten minutes stay with us.
Firstly, bear in mind that some, but certainly not all, of the medical research reports we list below relate to "selected" new born babies. Babies born premature and of low birth weight are of particular concern and accordingly some medical research reports focus on babies within that group.
In Bold are some edited mini quotes from published medical research reports and other web sites. Where possible we have supplied a link.
Because lowering of oxygen saturation values was seen uniformly in all newborn infants, car seats should only be used for travel and travel should be minimised during the first months of life. http://pediatrics.aappublications.org/cgi/content/abstract/108/3/647
Low blood oxygen levels in newborns may contribute to ADHD development. http://www.medicalnewstoday.com/medicalnews.php?newsid=15419
Adverse impacts of chronic or intermittent hypoxia on development, behaviour and academic achievement have been reported in many studies. Because adverse effects have been noted at even mild levels of oxygen desaturation, future research should include precisely defied data on exposure to all levels of desaturation. http://pediatrics.aappublications.org/cgi/content/abstract/114/3/805
Prolonged use of infant seating devices with infants who are too young to sit unsupported may have several potential adverse consequences. http://archpedi.ama-assn.org/cgi/content/abstract/151/3/233
Oxygen Desaturation in Term Infants in Car Safety Seats (commentary report, a great overview)
Because not all infants at risk of oxygen desaturation can be identified at birth, an alternative approach would be to recommend that infants should be routinely transported in a supine (flat on back) position car seat in the early months of life. (Quote from a American medical research report).
So what other info can we give you re 1st stage seats?
Well, often you are told not to keep baby in an infant carrier for more than two hours. Why?
The truth is we do not know! There is certainly no official "time limit" and the sad thing is that the people who tell you this often do not really know why the unofficial time limit exists! The most common reason given is that infant carrier’s damage baby’s spines. We are sympathetic to this argument; we too believe a baby’s spine should be fully supported by using a carry cot. We understand a number of physiotherapists have also voiced their concerns regarding infant carriers but finding medical evidence to prove that infant carriers damage babies spines has, so far, proven impossible. If you know better than us please let us know! We would add however that "back problems" in young people (16-24 years) has increased very dramatically in the last few years and this does appear to "tie in" to the introduction of infant carriers and buggy's.
The issue of time is purely down to Oxygen desaturation and according to the Kobe report (as quoted above) this can occur within 30 minutes or so.
Aprica (a major Japanese manufacturer) also suggest that not only do infant carriers potentially cause Oxygen desaturation but can also impede a baby’s growth. They say infant carriers inhibit digestion and that in "rear end" accidents infant carriers are potentially unsafe due to anti rotation and the fact that babies head can “reverse whiplash”. We find their web site (www.aprica-eu.com) rather tedious but if you can get hold of their catalogue (we have the 2006 one) it makes for interesting reading.
So do upright infant carriers have any good points?
Yes they most certainly do. They are easy and convenient for parents to use and in a high speed head on crash offer the very best of protection, almost certainly better than most car carrycots. In an accident they save lives. Once baby overcomes the Oxygen desaturation issues (normally at about six months as by then baby can breathe much better) we would recommend several of them but on balance we feel car carrycots, or infant carriers with a deep lay back angle offer parents a better option.
Car carrycots offer good "all round" protection and probably excel in rear end accidents a type of accident infant carriers are “suspect”. If used with the hood and apron on, in an accident the fabric offers protection to baby both from flying glass and other debris and this has been proven in a horrific accident which occurred in Oxfordshire some years ago when baby escaped unscathed.
Most importantly car carrycots are healthy. To date we have not found a single medical research report which favours infant carriers over carrycots.
If you have no option but to use an infant carrier and we accept sometimes parents have no choice, we believe one with a very deep lay back angle is far superior to upright (conventional) ones. Please also remember a infant carrier may not be used if a airbag is active.
If you are currently using a conventional infant carrier find out from your supplier if you can recline it back and in the first few months keep your journeys as short as possible. Under NO CIRCUMSTANCES stop using it