PROTECT

OUR FUTURE

ROAD TO SAFER TRIBAL COMMUNITIES

Use car seats and booster 

seats on every ride.

THE FACTS

Motor vehicle traffic death 

rates among American Indian 

and Alaska Native children 

aged 0–12 were 2 to 8 times 

higher than those of other 

races and ethnicities.1

An estimated 46% of car seats 

and booster seats are used 

incorrectly in a way that could 

reduce their effectiveness.

2,3

When compared with seat belt 

use alone, car seat use reduces 

the risk for injury in a crash by 

71–82%,4,5 and booster seat use 

reduces the risk for serious 

injury by 45%.6

Seat belt use reduces the risk

for death and serious injury by 

about half for older children 

and adults.7

KEEP YOURSELF AND YOUR 

CHILDREN SAFE:

Use a car seat, booster seat, or 

seat belt on every trip, no matter 

how short.

Find the right car seat or booster 

seat for your child’s weight, 

height, and age. See the chart 

on the next page for tips.

 Get help installing a car seat 

or booster seat from a certified 

child passenger safety technician.

 Properly buckle children aged 12 years and under in the back seat. 

The back seat is safest for children.

 Never place a rear-facing car seat in the front seat. Front passenger 

air bags can injure or kill small children.

 Do not use traditional baby carriers (such as cradleboards) instead 

of car seats. Traditional carriers do not keep children safe in cars or 

trucks in a crash.

 Always wear a seat belt when pregnant. Be sure to wear the lap belt 

below your belly. Place the shoulder belt across your chest. Never wear 

the belt behind your back, under your arm, or across your stomach.8
Need help choosing or installing your car seat? 

Find a child passenger safety technician at cert.safekids.org

Birth until age 2–4

Buckle children in a rear-facing car 

seat with a harness until they reach 

the maximum weight or height limit 

of their car seat. Keep children 

rear-facing as long as possible. 

Never place a rear-facing car seat in 

the front seat. Front passenger air 

bags can injure or kill young children 

in a crash.

After outgrowing 

rear-facing car seat and 

until at least age 5

When children outgrow their 

rear-facing car seat, they should 

be buckled in a forward-facing car 

seat with a harness and a top 

tether in the back seat until they 

reach the maximum weight or 

height limit of their car seat.

After outgrowing 

forward-facing car seat and 

until seat belt ts properly

When children outgrow their 

forward-facing car seat, they 

should be buckled in a booster 

seat in the back seat until the 

seat belt ts properly without a 

booster seat. Proper seat belt t 

usually occurs when children are 

age 9–12.

When seat belt ts properly 

without a booster seat

Children no longer need to use a 

booster seat when the seat belt ts 

them properly. A seat belt ts 

properly when the lap belt is across 

the upper thighs (not the stomach) 

and the shoulder belt is across the 

center of the shoulder and chest (not 

across the neck or face, and not off 

the shoulder).

Keep children properly buckled in the back seat until age 13.

Child passenger safety recommendations: American Academy of Pediatrics 2018.

*Recommended age ranges for each seat type vary to account for differences in child growth and weight/height limits of car seats 

and booster seats. Use the car seat or booster seat manual to check for important information about installation, the seat weight 

and height limits, and proper seat use.

Birth

Age by Years*

1 2 3 4 5 6 7 8 9 10 11 12 13+

REAR-FACING CAR SEAT FORWARD-FACING CAR SEAT BOOSTER SEAT SEAT BELT

www.cdc.gov/transportationsafety/child_passenger_safety

Make sure your child is always buckled in a car seat, booster seat, or seat belt 

that is appropriate for their age and size.

LEARN MORE AT

www.cdc.gov/transportationsafety/

child_passenger_safety or call 1-800-CDC-INFO

The Centers for Disease Control and Prevention’s

National Center for Injury Prevention and Control and 

the Indian Health Service’s Injury Prevention Program 

work in partnership with American Indian and Alaska 

Native communities to implement proven programs.

LOCAL INFORMATION

References

1. WISQARS, Web-based Injury Statistics Query and Reporting System [online]. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (producer). Available at 

https://www.cdc.gov/injury/wisqars. Accessed August 30, 2023.

2. Greenwall, N. K. Results of the National Child Restraint Use Special Study (Report No. DOT HS 812 142). Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration; 2015. 

Available at https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812142. Accessed August 30, 2023.

3. Greenwall NK. National Child Restraint Use Special Study (Traffic Safety Facts Research Note. Report No. DOT HS 812 157). Washington, DC: US Department of Transportation, National Highway Traffic Safety 

Administration; 2015. Available at https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812157. Accessed August 30, 2023.

4. Arbogast KB, Durbin DR, Cornejo RA, Kallan MJ, Winston FK. An evaluation of forward-facing child restraint systems. Accident Analysis and Prevention 2004;36(4):585-9.

5. Zaloshnja E, Miller TR, Hendrie D. Effectiveness of child safety seats vs safety belts for children aged 2 to 3 years. Archives of Pediatrics and Adolescent Medicine 2007;161:65-8.

6. Arbogast KB, Jermakian JS, Kallan MJ, Durbin DR. Effectiveness of belt positioning booster seats: an updated assessment. Pediatrics 2009;124:1281–6.

7. Kahane CJ. Fatality reduction by safety belts for front-seat occupants of cars and light trucks: updated and expanded estimates based on 1986-99 FARS data (Report No. DOT-HS-809-199). Washington, DC: U.S. 

Department of Transportation, National Highway Traffic Safety Administration; 2000. Available at https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/809199. Accessed August 30, 2023.

8. National Highway Traffic Safety Administration. If You’re Pregnant: Seat Belt Recommendations for Drivers and Passengers. US Department of Transportation, Washington, DC; updated. Available at 

https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/pregnant-seat-belt-use.pdf. Accessed August 30, 2023.

November 2023