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Car seat safety for premature and LBW infants
  1. R Narasimhan,
  2. J Moorcraft,
  3. A H A Latif
  1. Department of Paediatrics, Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant, CF72 8XR, UK; rajunarasimhanntlworld.com

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Recent advances in neonatal intensive care have resulted in improved survival rates of premature and low birth weight infants. These infants are frequently transported in the parent’s own vehicle when discharged from hospital. Commercially available infant car seats are primarily designed for a typical infant weight of 3.1 kg and hence may not be suitable for premature and low birth weight infants. We conducted a postal questionnaire survey of 200 neonatal and special care baby units in the UK, to assess current practice of “car seat safety” at hospital discharge for premature and low birth weight infants. They were posted to both the “consultant-in-charge” and “nurse-in-charge” for these units. The response rates for the consultants and nurses were 60.5% and 90.5% respectively. Analysis of the responses suggests that 90% of the neonatal units across the UK do not have a programme for assessing “car seat safety” at discharge for these high risk infants. The typical discharge weight of these infants can range from 1.5 kg to 3.0 kg. A small proportion of these infants are also discharged home on oxygen. If they are not transported in an appropriate car seat with appropriate precautions, these infants may be subject to oxygen desaturation, especially when placed in a semi-upright position.1–3 They are also at risk of respiratory compromise because of the potential for slumping forward and lateral slouching if they cannot be adequately restrained in the seat.4 The American Academy of Pediatrics has published recommendations for transport of these infants based on current research and evidence4 and they recommend that these high risk infants be monitored in their car seats for apnoea, desaturations, and bradycardia for an hour, prior to discharge. This would enable the identification of infants at risk so that parents can be appropriately counselled regarding the suitability of the car seats. Families should be advised to minimise travel for infants at risk of respiratory compromise. Infants failing the test could be retested in a different car seat. There is a paucity of studies in this area and clearly further research is essential to guide us in establishing and implementing an appropriate “car seat safety” programme for these vulnerable infants.

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Footnotes

  • Copies of the questionnaire used in our survey can be obtained by contacting the corresponding author

  • Competing interests: none declared

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