OHSU researcher finds 95 percent of parents of newborns make a mistake

An Oregon Health and Science University pediatrician is calling on car seat manufacturers and hospitals to change the way they do business after his research that shows the vast majority of new parents make serious errors in car seat use.

Dr. Benjamin Hoffman, director of Doernbecher Children’s Hospital’s Tom Sargant Safety Center, was the lead researcher looking at whether parents were truly prepared to drive their newborns home safely from the hospital. The research was published Friday, Dec. 18, in The Journal of Pediatrics.

Out of 291 randomly selected mothers and babies at OHSU, Hoffman found that virtually none of them knew how to install a car seat and properly position an infant in it. Ninety-five percent of parents made at least one mistake and 91 percent made a serious error — one that would result in an significant increase in risk of injury or death during a crash.

About half of families made more than five errors in car seat use or installation.

Hoffman says most families haven’t thought about the details of installing a car seat and positioning an infant until the moment they are ready to leave the hospital and by then it is too late.

“Think back to the day or two you spend in the hospital and how well prepared you were truly to go home,” Hoffman says. “It’s a very difficult time to ask parents to learn stuff. It’s a really bad teachable moment.”

The professor of pediatrics says he hopes to use the research to pressure OHSU and other hospital systems to offer standard trainings to parents-to-be on car seat use and installation.

Hoffman, for whom it is his first published study on the subject, also says it is incumbent upon car seat manufacturers and vehicle manufacturers to come up with safer and more user-friendly products.

“Once you know that 95 percent of people who use your product use it incorrectly, it’s not OK anymore,” he says. “I think once you know that, you can’t not know it anymore.”

Hoffman says he became interested in car seat use after spending time as a doctor on a Navajo reservation in New Mexico.

“I got tired of seeing kids who’d been injured in car crashes who had been totally unrestrained,” he says.

Correct use of car seats, according to the National Highway Transportation Safety Administration, can lead to dramatically improved outcomes in a crash. Babies in car seats correctly are 71 percent less likely to die and 61 percent less likely to be injured. Children between 1 and 4 years old are 54 percent less likely to die and 47 percent less likely to be injured, under ideal car seat installation and use conditions.

According to the Centers for Disease Control, in 2013, 136 babies died in vehicle accidents and more than 8,000 were seen in emergency rooms for crashes. That is out of 3.9 million children born each year in the United States.

Automotive accidents are a leading cause of death in children over the age of 1, according to the CDC.

But there is some debate on whether the widespread use of car seats since 1975 has had much effect on public safety, despite the now three forms of car seats (newborn, childhood, booster — though some are convertible) that parents are now asked to buy during their child’s life.

In 2005, the Freakonomics team Stephen Dubner and Steven Levitt, produced a piece in The New York Times arguing that there is no statistical difference between the injury and death rates of children in car seats versus children in standard safety belts. In fact, the team has also argued that because the seats place children’s center of gravity higher in the car, they could be more dangerous.

Hoffman firmly believes in the safety of car seats but does say that he feels a major change needs to happen in the realm of child safety restraints, including changes to make automobiles that have standard restraints designed with a child in mind.

“Part of the problem is adults buy cars and adults buy cars that appeal to adults,” he says. “Until there is some really disruptive innovation ... we need to be able to help families. To help them do it right.”

“Expecting families who have just gone through the process of having a baby to be able to do it right — that’s just not a reasonable expectation,” he says.

Shasta Kearns Moore
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