Acting Head of Road Safety13th February 2019

The carriage of Low Birth Weight Babies

Nick Lloyd

RoSPA involvement with child car seats

Child car seat website www.childcarseats.org.uk

Provide free advice to practitioners and the public info@rospa.com and free helpline number 0808 801 0822

Child car seat training

http://www.childcarseats.org.uk/mailto:info@rospa.com

Carrying a low birth weight baby?

Warning to parents as baby stops breathing in child car seat A mother whose newbornbegan foaming at the mouth after a two-hour car journey warned parents yesterday not to leave babies in car seats for too long with their 3-week-old girl in her car seat. When they got home, they spotted the baby’s lips were blue. (Daily Mail)

We have looked at:

Key issues

What does the evidence tell us in relation to how long a child should be left in a rear facing car seat?

The national picture

Advice to parents and practitioners

Key Issues

Putting things into context:

Improved survival rates & early discharge of premature babies (those born before 37 weeks)

Rear facing child seat is the normal seat of choice

Smaller babies are more likely to suffer from: apnoea, oxygen desaturation and hypotonia

Lie Flat Seat

What does the research tell us?Bamberg et al (2013) cited in Batra et al. (2015) ‘Hazards

Associated with Sitting and Carrying Devices for Children Two Years and Younger’, Journal of Pediatrics

Research suggests that:‘An infant who is properly restrained in a child car seat, is at very little risk of suffocation or strangulation’Bamber found no cases of infants who were previously healthy dying in a child car seat when it was being used appropriately.

What does the research tell us?Arya et al (2017) ‘Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle’, Arch Dis Child Fetal Neonatal Ed

40 babies placed in a car seat:- 30 degree horizontal static surface- 40 degrees horizontal static surface- 40 degree horizontal surface with motion simulator

Found that; motion and 40 degrees had the greatest physiological affect.

What the research tell us

Salhab et al (2007) cited in Bull, M. J. and Engle, W. A. (2009) ‘Safe Transportation of Preterm and Low Birth Weight Infants at Hospital Discharge’, Pediatrics, doi:10.1542/peds.2009-0559.

For smaller babies who experience apnoea, bradycardia (abnormally low heart rate) or oxygen desaturation when semi-reclined in a rearward facing car seat, a lie flat seat, sometimes known as a car bed, may be more appropriate

What the research tells us

Kornhauser Cerar et al. (2009) ‘A Comparison of Respiratory Patterns in Healthy Term Infants Placed in Car Safety Seats and Beds’, Pediatrics, 124(3)

Respiration of full-term infants was compromised in both the lie-flat and rearward facing infant carrier.

Infants seemed to perform better in the first hour in the safety device than the second; regardless of whether this was a rearward facing infant carrier or a life flat seat.

Car Seat Challenge

In USA babies less than 37 weeks are routinely screen for a period of 90-120 minutes in a car seat as recommended by the American Academy of Paediatrics.

UK national picture:

Most neonatal units will screen some babies prior to discharge (mostly less than 37 weeks unless underlying health conditions)

Hospital use different variables and thresholds

Those being discharged with medical equipment

Weight – threshold varies

Princess Anne Hospital Car Seat Challenge

Key advice for those carrying a low birth weight baby

Car seats are safe when used according to manufactures instructions

How long should babies be left in their car seat?In the first few months journeys should be kept short, ideally no longer than 30 minutes. If parents/carers need to travel for longer they should take regular breaks where the baby is taken out of the seat

Some maternity hospital are more than 30 minutes from home!

What next?

Launching the resources today

PHE newsletter in March

Lets work together …..

www.childcarseats.org.uk/types-of-seat/lie-flat-seats/

Fitting a lie flat seat

A word from the manufacturers

Any infant born prematurely or at a low birth weight should be cared for on an individual basis, and a seat selected based on their needs, meaning that a parent will need to work closely with doctors and specialists at the hospital.

Some rearward facing infant seats on the market have new born or premature baby inserts, which offer a snug fit for smaller babies and helps to support their head, neck and spine

Thank youNick Lloyd – Road Safety Manager

nlloyd@rospa.com