In 1769, the first steam-powered car was invented, with subsequent improvements as better automobiles were built throughout the years. It took almost 200 years later for the first safety belt to be invented by the mid 19th century. It was only in 1966 that an Act was enforced, requiring all vehicles to comply with certain safety standards. In 2015, the South African National Road Traffic Act enforced the regulation that all infants (0-3 years) be restrained appropriately when travelling in cars. By Charlene Yared West. 

The danger of being unrestrained in cars

According to the World Health Organisation, children who are not restrained during a car crash can either be thrown against the interior of the vehicle or be ejected from the vehicle. The use of seatbelt and child restraints is the most effective action of preventing the severity of injuries during a car crash. Chances of survival increase drastically when restrained appropriately. The World Report on Road Traffic Injury Prevention states that the use of child restraints in vehicles reduces infant deaths by about 71%. A study conducted in Sweden showed that about 50% of fatally injured children aged up to 3-years had been involved in side impact collision. 

What car seats are age appropriate?

The main determining factor for choice of an appropriate car seat is the child’s weight. Older children who are above the height and weight specifications for using car seats require a properly fitting three-point lap and diagonal seat-belt when riding in a vehicle. A review of various studies has shown that child safety seats that are correctly installed and used for children aged 0-4 years can reduce the need for hospitalisation by 69%. The risk of death for infants is reduced by 70%, and that for children aged 1–4 years by 47–54%.

(Table extracted from the American Academy of Pediatrics http://www.healthychildren.org) 

Protecting vulnerable travellers

The skulls of infants are far more malleable before 24 months and so they need less force to sustain a brain injury, explains Anna Bizos, physiotherapist at Life New Kensington Clinic. “Travelling at a speed of 60km/h can inflict horrendous injury on the unrestrained child. The acceleration is too great – and it has been shown that an adult holding a child in the backseat, will not be able to hold onto them at the moment of impact, but will release their grip, which means the child will be flung around the car or be ejected from the vehicle. The airbags, if deployed, can also cause suffocation for the child on the adult’s lap,” she says. The bottom line is, children cannot be unrestrained in cars! Parents must be consistent and model good car safety habits – for everyone in the car, every time, even if there are tantrums.” CEO of the QuadPara Association of South Africa, Ari Seirlis agrees; “The consequences of a spinal cord injury especially for children and young people, are too dire to contemplate,” he says. “QASA promotes that seat belts are essential to use in a vehicle and our road safety programme has the slogan buckle up, we don’t want new members.”

Rehabilitation Paediatric Programme at Life Hospitals

Life Healthcare’s Rehabilitation paediatric programmes are focused on providing holistic, interdisciplinary individually targeted interventions that are developed for each child, based on a variety of standardised and internationally recognised assessments, says Nomsa Mbuyisa, Nurse Manager at Life New Kensington Clinic. “We hold interdisciplinary team meetings weekly to assess the child’s progress and, based on this, whether any adaptations should be made to the programme.”

<Sidebar> Sister Mbuyisa shares her top car safety tips for infants

• Everyone in the car must always buckle up! 
• Always check that the car seat is correctly installed. 
• Ensure that the child is in the correct age car seat. Infants need to stay in a rear facing seat in the back seat, making sure to install the seat at a 45-degree angle to help support the baby’s head and back.
• Make sure your car seat works in the type of car that you have. Not every child safety seat is compatible with every car.
• Replace the car seat after a crash. Even a minor accident can compromise the structure of the seat. Avoid buying used car seats since you don’t know its history.
• Never leave a child alone in the car as they can overheat quickly when it’s warm. 
• Never share a seat belt. Do not use one seat belt to buckle two kids.
• Ride in the backseat. Children who are younger than the age of 12 should always ride in the backseat. In an accident, the airbag can injure a small child. 
• Stay calm. Teach kids to be quiet and calm in the car. They must not jump around, yell or  

scream in the car as this can distract the driver. This can put everyone in the  car at risk.

In the unfortunate event of a car accident, the Road Accident Fund is able to assist with medical expenses, loss of support, funeral benefit and general damages for pain and suffering. To lodge a claim, claimants can contact the Call Centre on 0860 23 55 23.