Child Passenger Safety

General Recommendations

  • Maryland's Child Passenger Safety Law (PDF) effective October 1, 2013. The law requires children up to age 8 to ride in an appropriate child safety restraint, unless the child is 4 foot, 9 inches or taller or weighs more than 65 lbs.  Every child from 8 to 16 years old who is not secured in a child restraint must be secured in a vehicle seat belt.
  • American Academy of Pediatrics (AAP) updated their recommendations for children to remain rear-facing car safety seats as long as possible
  • The 5-Step Booster Test (PDF)
  • Never use car seats purchased at yard sales, secondhand stores or flea markets. They may not protect your child properly because of a recall, stress damage from use, or weakness from being in a crash.
  • Children under age 13 should always ride in the back seat properly restrained. This practice is associated with a 40% reduction in the risk of serious injury.


Most mistakes in installing car seats involve either the seat itself or the harness straps being too loose. The idea is to prevent as much movement as possible and to have the smallest opening as possible to keep the child in place.

  • The seat should move no more than an inch in any direction.
    • Grasp it at the belt or LATCH connection to test it.
    • It helps to put the weight of your knees in the seat to get it installed more tightly.
  • The harness should fit snugly over the shoulders so you cannot pinch up slack or get your fingers underneath.
  • The harness clip should be high up on the chest in line with the armpits.


Infant seats reduce the risk of death in a vehicle by 71%.

  • Infants need to rear face until around age 2 and at least 20 pounds.
  • The safest place for an infant seat is in the center of the back seat.
  • Never place a rear-facing infant in front of a passenger side airbag.
  • If you have an infant seat that snaps into a base and you will be transferring it from 1 vehicle to another, a second base can be purchased.
  • Each base can be properly installed and remain in place in each vehicle ready for the carrier seat.
  • Consult your vehicle manual and the instructions that came with your seat to install your seat properly.
  • Consider making an appointment with a child safety seat technician to be sure your seat is properly installed.

Toddlers & Preschool Age

Seats for children ages 2 to 4 years reduce the risk of death in a vehicle by 54%.

  • Install a forward-facing convertible seat in the back seat of your vehicle.
  • If you have been using a convertible seat rear-facing for an infant, be sure to make needed adjustments to use it properly in the forward-facing position.
  • Consult the instruction booklet that came with your seat for adjustment advice.
  • Children are required to ride in a forward-facing safety seat with a harness restraint system until they are around 4 years old and weigh 40 pounds.
  • It is time to change seats when the harness no longer fits, the shoulders are above the top slots, the ears are above the seat back or the weight limit is exceeded.
  • Top tethers limit forward motion of the child’s head and should be used if the seat and vehicle are equipped with connectors.

Children 4 Years to 8 or 10 Years of Age

Many children in this age group are no longer riding in a safety seat but, they are too small to fit the vehicle seat belts that are made for adult-sized bodies. Children in this age group need to use a booster seat for safety and to follow the law in Maryland. Booster seats reduce the risk of death in a vehicle by 59%.

Booster seats do not use a harness system and are not fastened into the vehicle. They sit on the vehicle seat to boost or lift up a child so the seat belt can fit correctly. This greatly reduces the chance of ejection in a crash.

  • Boosters should be used in the back seat.
  • Always use both the lap and shoulder belt with a booster seat.
  • If your vehicle seats are low (do not have a head rest) you need a high back booster.

Is your child ready for a seat belt only?

Check frequently to see whether your child has reached the height and weight limits on the booster seat.

If your child is 8 to 10 years old and 4’9” tall you can test your child’s readiness to use the seat belt only. You'll know your child is ready when you've met all 4 of the following criteria:

  1. Knee bend - Have the child sit. Do his or her knees bend naturally at the front edge of the seat when he or she sits all the way back against the vehicle seat? If not, keep using a booster seat. If so, move on to the stomach check.
  2. Stomach check - Buckle the lap and shoulder belt positioning the lap belt across the upper legs or bony hip. If it rides up to stomach, go back to booster seat. If it doesn't, do a shoulder check.
  3. Shoulder check - The shoulder belt should rest on your child's shoulder or collarbone (it should never be placed behind the back or under the arm). If the shoulder belt rides up to the face or neck, keep using the booster seat. If not, do a final position check.
  4. Position check - Monitor whether your child stays in position for the whole time while on a car ride. If changes in position and/or slouching causes the safety belt to ride up on the stomach or neck, go back to using a booster seat.

If this test was passed successfully, be sure your child uses safety belts in the back seat in every vehicle on every ride!

Additional Information

Contact Us

  1. Division Director 

    Dr. Miriam Dobson, RN, CPH, CHW-C

    350 Montevue Lane 

    Frederick, MD 21702

    Ph: 301-600-1733

    Fx: 301-600-1403