What You Should Know About Child Passenger Safety: Q&A with Pediatrician, Author & CPS Advocate Dr. Laura Jana

Dr. Laura Jana is a pediatrician, mother of three, award-winning co-author and advocate for child passenger safety who holds certification as a CPS technician. Her books include Heading Home with Your Newborn (2nd Ed, AAP, 2010) and Food Fights (AAP, 2007). After serving as a consultant to Dr. Benjamin Spock, Dr. Jana co-founded the Dr. Spock Company in 1999, later establishing her own company, Practical Parenting Consulting. Recognized nationally for her ability to share credible, practical advice with expectant and new parents, Dr. Jana is a media spokesperson for the American Academy of Pediatrics (AAP). She also serves on the advisory board for American Baby magazine, the Walt Disney Internet Group and Nancy Snyderman’s BeWell Expert Network. Dr. Jana regularly consults with academic organizations, nonprofits and major corporations alike.

Q. New parents are faced with so many issues and concerns. How do they tend to approach child passenger safety?

A. Fortunately, most new and expectant parents these days know to take child passenger safety and the purchase of their first infant car seat very seriously. Some are aware of the fact that children restrained in child safety seats are at an 80% lower risk of fatal injury than those who are unrestrained. Others simply know that all 50 states have laws requiring the use of infant safety seats – it is now standard hospital policy that parents must always have one in their possession before driving their new babies home. Either way, the important take-away is that new and expectant parents are motivated to learn about and are often overwhelmed by all there is to know about car seats. Helping parents learn how to properly protect their infants in the car should, therefore, be a priority for all maternal and child health professionals as well as healthcare providers and parents.

Q. Of all the many issues facing parents today, why is child passenger safety a top priority?

A. When we talk about child passenger safety, what we’re really talking about is the fact that transporting children in cars poses a very real, yet very preventable threat to our children’s safety. Motor vehicle crashes unfortunately remain one of the leading causes of preventable injury and death for infants and children, despite the fact that we know just what it takes to drastically lessen the risk. Child safety seats reduce the risk of fatal injury by 71% for infants under a year of age and by 54% for children ages one to four years. Given that car travel has become a daily way of life for most families, child passenger safety must be a parenting and pediatric priority.

Q. Best practices in child passenger safety are constantly evolving. As you note in your book, there is an entire generation of grandparents (and in some cases, parents) who still need to be convinced of the importance of buckling up. How has child passenger safety changed over the past generation, and how do we reach all child caregivers with important CPS messages?

A. The evolution in child passenger safety practices comes from the fact that we are continually learning new and better ways to design, engineer and install seats, as well as to ensure their proper use. Keeping current in this rapidly developing field can be quite a challenge, especially given that we have an entire generation of grandparents for whom seatbelts weren’t even available, much less a way of life. It wasn’t even until the mid-60’s when lap belts were first required in passenger vehicles. Similarly, it was just 40 years ago when the very first federal standards for child restraints were implemented. Given that our ultimate goal is to ensure that all children are properly secured in child safety seats each and every time they ride in a car, it is of particular importance to insure that all caregivers – parents, grandparents, friends and childcare providers alike – are adequately informed about proper car seat use.

Q. What are THE key messages about child passenger safety that we need to reach expectant and new parents with?

A. First and foremost, it’s important to know that the best car seat is the one that best fits your child, fits your car, meets all federal safety standards (all seats made and sold in the US are required to), and will be used each and every time your child is in the car. In my book Heading Home with Your Newborn, my co-author and I focus new parents’ attention on what we’ve called “the 4 R’s of Installation,” which include reading, recalls, rear-facing and recline. A significant number of adults have a habit of skipping over reading instruction manuals and neglecting to send in registration cards. Yet both of these tasks should be considered mandatory when you get a new car seat, since both the car seat and the vehicle instruction manuals are absolutely necessary to ensure correct installation. Sending in the registration card allows manufacturers to contact you directly with important safety or recall information. We also know that infants and young children are safest when properly reclined and seated rear-facing as long as possible within the limits of their seats.

Q. What are the most persistent myths about child passenger safety we need to address today?

A. It’s now more important than ever to address the myth that children can be turned face-forward in their car seats when they reach one year and twenty pounds. In fact, the very latest car seat recommendations from the American Academy of Pediatrics now include having infants remain rear-facing all the way up until the age of two, if not longer, so long as children still fit within the height and weigh limits of their seats. This recommendation is based on the fact that children under the age of two are five times safer riding rear-facing than forward facing in the event of a crash. Fortunately, there are now plenty of car seats on the market that allow for longer rear-facing use by offering higher rear-facing height and weight limits. For parents who may be concerned that their children’s feet/legs are starting to touch the seat, it’s useful to reassure them that this rarely poses a problem, and even in the event of a serious crash, the choice to better protect their child’s head and torso by remaining rear-facing far outweighs any risk to their child’s legs.

Q. You are a certified CPS technician. What motivated you, as a pediatrician, to make this commitment – and how has it impacted your pediatric practice?

A. My goal as a pediatrician has always been to improve the health and wellbeing of as many children as possible. More than a decade ago, the research and evidence became clear that proper use of car seats was one of the single most important things parents could do insure their children’s safety. As a pediatrician, I was also well aware of the fact that any child passenger safety advice I had to offer was likely to be taken even more seriously because of my professional credentials as a pediatrician. As a result, I committed to not only training in the CPS field but becoming a child passenger safety instructor. My additional training and continued commitment to the promotion of important health and safety information has helped me take what can be an admittedly complex and technically challenging field and make child passenger safety significantly easier for parents and caregivers to understand.

Q. Your new book dedicates an entire chapter to user-friendly information on what can be a complex topic. Is there anything new on child passenger safety that has been updated since the book’s first edition?

A. Absolutely. In fact, the car seat chapter in the Second Edition of Heading Home with Your Newborn required more significant updates than any other chapter in the book, simply because there have been so many improvements in the field of occupant protection. Car seats and the technologies used to create safer and safer seats are constantly changing, from significant increases in rear-facing height and weight limits to the availability of LATCH installation features and seats designed to offer additional side impact crash protection. Recognizing that picking out the perfect infant car seat can be quite daunting for new and expectant parents – especially given all of these advances – we made it our goal to offer a thorough yet easy-to-understand explanation of car seat types, features and use. The fact that motor vehicle crashes continue to be one of the most significant and preventable causes of morbidity and mortality in infants and children gave us more than enough reason to focus our efforts on providing a carefully updated resource for parents.

Q. What can partners in health do to help families navigate the child passenger safety issue and share the right CPS messages?

A. Anyone who is professionally dedicated to improving the lives of families and children is inevitably faced with a myriad of issues and topics to address. That said, I would strongly encourage all partners in health to make CPS messages and access to CPS resources a priority, if for no other reason than doing so is one of the single best ways to reduce children’s risk of injury or death. For some professionals, that may mean getting trained in child passenger safety and directly educating parents and caregivers. It is equally beneficial to make sure that families know how and where to access up-to-date, accurate information. In addition to what’s included in the Second Edition of Heading Home with Your Newborn: From Birth to Reality, be sure to refer to the American Academy of Pediatrics child passenger safety resources, the AAP website, and the National Highway Traffic Safety Administration (NHTSA) website, which offers families the ability to find trained child passenger safety professionals in their area by simply entering their zip code.

For more about Dr. Jana’s work, go to Her book, Heading Home with Your Newborn, is available on and at retailers nationwide, as well as at the AAP Bookstore.

For AAP’s child passenger safety resources, go to

For the National Highway Traffic Safety Administration’s child passenger safety resources, to go