Published online April 3, 2006
PEDIATRICS Vol. 117 No. 4 April 2006, pp. 1197-1202 (doi:10.1542/peds.2005-1379)
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Tipping the Scales: Obese Children and Child Safety Seats

Lara B. Trifiletti, PhD, MAa, Wendy Shields, MPHb, David Bishai, MD, PhD, MPHb, Eileen McDonald, MSb, Florence Reynaud, BA, CPS-Tb and Andrea Gielen, ScD, ScMb

a Columbus Children’s Research Institute, Center for Injury Research and Policy, Ohio State University, Columbus, Ohio
b Johns Hopkins Bloomberg School of Public Health, Center for Injury Research and Policy, Baltimore, Maryland

OBJECTIVE. To shed light on the extent to which childhood obesity affects the types of appropriate child safety seats for young children, by providing an estimate of the number of US children whose weight renders them unable to use safely the majority of child safety seat types currently available.

METHODS. The types of appropriate child safety seats were assessed by using National Highway Traffic Safety Administration 2005 Child Safety Seat Ease of Use Ratings. Estimates of the numbers of children weighing above the maximal weight for those child safety seats were calculated by using the tabulations of growth curves based on National Health and Nutrition Examination Survey 1999 to 2000 data that were assembled by the National Center for Health Statistics and the US Census for the year 2000.

RESULTS. A total of 283305 children 1 to 6 years of age would have a difficult (if not impossible) time finding a safe child safety seat because of their age and weight. The vast majority of these children are 3 years of age and weigh >40 lb (182661 children). For these children, there are currently only 4 child safety seat types available, each of which costs between $240 and $270.

CONCLUSIONS. This study determined that there is limited availability of child safety seat types for the ever-increasing number of obese young children. There are substantial numbers of children who weigh more than the upper weight limit for most currently available child safety seats. While we await reductions in the childhood obesity epidemic, options for maximizing the protection of obese children in automobiles must be identified.


Key Words: child safety seats • obesity

Abbreviations: NHTSA—National Highway Traffic Safety Administration • CDC—Centers for Disease Control and Prevention • NHANES—National Health and Nutrition Examination Survey • NCHS—National Center for Health Statistics • CSC—Children’s Safety Center


Accepted Aug 29, 2005.


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