For parents who are unsure how to safely transport a large child, the AAP offers the following reminders and suggestions:

• All children, of any age or size, must be properly restrained when riding in a motor vehicle. This means that:
  • Children 12 years and younger should ride in the back seat.
  • Infants and toddlers should ride in rear-facing car seats as long as possible, until they reach the weight or height limit for rear-facing set by the manufacturer of their car safety seat. Those limits can be found in the instruction manual and on a label on the side of the seat.
  • Toddlers and young children who have outgrown the rear-facing weight or height limit for their seats should ride in forward-facing car seats with harnesses as long as possible.
  • School age children who have outgrown their car seats with harnesses should ride in booster seats until the adult seat belt fits properly, usually between 8 and 12 years of age. This means that the lap belt fits low across the upper thighs and the shoulder belt crosses the middle of the chest and shoulder.
• Never use a car seat if your child weighs more than the seat’s weight limit or is taller than the height limit. Check the labels on the seat or manufacturer’s instructions if you are unsure what the limits are.
• The “best” car seat is the one that fits your child, that fits your vehicle, and that you will use correctly for every trip. If you need help finding a car seat that fits your larger child, a Child Passenger Safety Technician may be able to help. 
• Car safety seat manufacturers increasingly are making car seats that fit larger children. These include:
  • Convertible seats with rear-facing weight limits up to 40 to 50 pounds
  • Forward-facing seats with harnesses (convertible seats, combination seats, or forward-facing only seats) with an upper weight limit of 50 to 90 pounds
  • Booster seats with a maximum weight limit of 100 to 125 pounds
• For toddlers or young children whose behavior will not yet allow safe use of a booster seat but who are too large for a forward-facing seat with a harness, you can consider using a travel vest. Most travel vests have upper weight limits of 60 to 168 pounds.

The most important thing to remember is that each car seat is different with different ways to install them, different height and weight limits, and some are convertible while others are not. Resources for larger capacity car seats can be found on the AAP website. Please always instruct your patients to refer to the manufacturers guidelines for each car seat. Safekids.org is a great resource for finding car seat technicians and tips for car seats. Don’t forget that strong4life.com also has some wonderful car seat videos done this year that can help parents as well. 

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