Your baby's car seat is designed to do a phenomenal job of protecting that sweet little body during a crash. The car seat is not for napping, though. While many babies go to sleep in the car, experts say that's the only time your baby should be snoozing in the seat. More than one baby has died while asleep in their car seat after it was brought into the house or day care.
Tragic Case Studies
A 2015 study from Penn State Medical Center, published in the journal Pediatrics, looked at 47 cases where babies under the age of two died while sleeping in car seats, swings, bouncers and other seating devices while in the house.
Two-thirds of the deaths studied happened in car seats. Some of the babies died because their airway was compromised by the angle of the car seat. Others died because the harnesses were not properly secured and the baby became entangled or strangled in them. What's most shocking is that these deaths can happen very quickly. The times between when the baby was noted to be alive and a re-check where the baby had died ranged from an astonishing four minutes up to several hours.
The Quebec coroner who investigated the 2009 death of a 2-month-old boy says leaving infants in their car seats for hours on end puts them at risk for death by asphyxiation. Small babies don't have the strength to hold their heads straight, even when sitting in a reclined position, making it easy for their airways to be blocked, Coroner Jacques Robinson said.
The little boy died after spending the night inside his car seat, which was placed inside his crib, a trick that sometimes soothed his colic.
His mother checked on him an hour before he was found not breathing.
Limit Time in the Car Seat
Infant car seats are not designed to be used as cribs, or for extended amounts of time. The risk of baby's head falling forward in a way that would affect breathing is also one reason why it's important to be sure that rear-facing car seats are installed at the proper angle, according to manufacturer's instructions.
Robinson suggests that parents limit infants to a couple of hours of sleep in a car seat at a time, and never overnight.
Even during road trips, it's a good idea to take baby out of the car seat every couple of hours, he said. The Canadian Pediatric Society recommends that babies not be allowed to sleep longer than one hour during car rides. US safe sleep experts agree that car seat sleep should be limited in the car, and should not be allowed at all outside of the car.
There's at least one infant car seat on the market in the U.S. that can be reclined so baby can lay flat when the car seat is used outside of the car. That could help reduce the potential for compromised airway outside of the car, but you should still limit the time baby is in the car seat.
Always Use a Car Seat Properly
It's important to note, though, that the risk of asphyxiation in a car seat is much lower than the risk of being injured or killed in a vehicle crash if a baby is not properly restrained in a car seat.
All experts, including the coroner who released the Canadian report, agree that babies and toddlers should be properly restrained in a car seat when they are riding in a vehicle.
When it's time for baby to sleep outside of the car, make sure you use safe sleep procedures.
You should place baby on his or her back, on a flat surface, ideally in a crib that meets today's crib safety standards. No soft bedding or pillows should be in the sleep space, including crib bumper pads, and you should check for other hazards nearby, such as cords, choking hazards, or places where baby could fall.