Car Seat Anxiety

The car seat industry thrives on parental fear, and I believe much of that fear is misplaced and deliberately manufactured. With a better treatment of risk, I think we could help parents worry less, and have more children.

Background

There’s a really famous paper (Car Seats as Contraception) in this space which basically shows that the creep of car seat legislation has led to a reduction in the probability of having a third child in America, just because the average American car can’t fit 3 car seats in the back. So people postpone, or in some cases, don’t have a third child because it’d require a new car.

If you look at the number of children’s lives that the legislation have saved (57) and compare that to the number of children who weren’t born because of the impact of car seat legislation (~8,000), you end up with a big big child-shaped gap. Net, car seat legislation is costing us children’s lives.

Of course, if you’re an actualist and think that only existing people count morally, maybe 57 saved lives outweighs 8,000 people who were never born. Who never lived, loved, and laughed. I’m not really here for that argument. The point is, it’s not a given that car seats for everybody are a net positive.

Car Seat Anxiety

It’s not enough just to have a car seat. There’s a collective anxiety about the type of car seat, its provenance, and its orientation.

The Type of Car Seat

91% of observed car seats demonstrate serious installation errors amongst newborns. Improper installation is a bigger safety concern than differences in crash test performance between seats. And so ISOFIX seats are recommended, not because they’re safer but because they’re harder to install incorrectly.

So far, so sensible, right? Does it matter that ISOFIX seats are harder to put in a row and fewer cars exist that’ll take 3 ISOFIX seats? Of course not, because who is writing the advice? Is it anybody who needs to consider the financial and emotional impact of their advice, or just somebody who is being asked to comment on the installation of car seats?

Second Hand

So much baby stuff is available on second hand markets. Babies grow out of everything really quickly and so being able to buy/sell things to other parents as you move into/out of sizes is invaluable. Except the advice with second-hand car seats is “if you can’t verify that the seat has never been in a crash, it’s not safe.”

Cue tumbleweed in the second-hand car seat market. Of course, it’s wonderful for car seat manufacturers…just not so good for parents.

Extended Rear-Facing

It’s been shown that the safest way to travel with kids in the car is to have them rear-facing: their back pressed against a chair pressed against a front-seat, and their feet resting against the back row of seats. It might be more boring for the child, exclude them from the family, and might require a complex array of mirrors to keep an eye on them…but it’s safer and so the longer you can keep them facing backwards, the better.

The Risk

22 children (aged 0-15) died as car passengers in Great Britain in 2024. I don’t have specific stats on that age-based distribution so let’s assume linear and say around 11 children aged 0-7 died in 2024. Around 2,900 children aged 0-7 died in the same period of any cause - but around 2,300 of them were under 1, dying primarily of birth complications and defects.

In short, the risk of a child dying in a car crash in miniscule. Even without car seats, a child is incredibly unlikely to die due to a car crash.

Relative versus Absolute Risk

So when we say that car-seats are often installed incorrectly, or second-hand could be dangerous, or rear-facing is safer…what do we actually mean? I don’t dispute that any of those things are true. But if we’re going from a 0.000001% chance of a bad outcome to 0.0000008%…should we really worry? Is it even worth giving the advice? Technically it’s safer to put your children in cycle helmets when getting in the car. Studies show that helmets reduce head injuries substantially, and yet I hope nobody is suggesting that particular intervention.

The point: car seats make children being in a car safer. It’s probably worth getting your kids a car seat (not least because it’s the law). But beyond that, I think that the risk associated with driving is so low, any additional optimisations are almost certainly wasting your time, money, and sanity.

Conclusion

Car seat safety is assessed through relative strengths: how does this car-seat (or car-seat configuration) compare to other car seats? That leads to important differences and overstated effect sizes. What really matters for child safety is absolute strength. And it’s not in the interests of anybody in the car seat industry to measure the absolute strength of car seats…but it is in the interest of parents.