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Winter is a tricky time for car seats. As a general rule, bulky clothing, including winter coats and snowsuits, should not be worn underneath the harness of a car seat.

In a car crash, fluffy padding in a coat immediately flattens out from the force, leaving extra space under the harness. A child can then slip through the straps and be thrown from the seat.

Here are some tips to help strike that perfect balance between keeping little ones warm as well as safely buckled in their car seats.

How to keep your child warm & safe in the car seat

Note: The tips below are appropriate for all ages. In fact, wearing a puffy coat yourself with the seat belt is not a best practice because it adds space between your body and the seat belt.

1. Store the carrier portion of infant seats inside the house when not in use. Keeping the seat at room temperature will reduce the loss of the child’s body heat in the car.

2. Get an early start. If you’re planning to head out the door with your baby in tow on winter mornings, you need an early start. You have a lot to assemble, and your baby may not be the most cooperative. Plus, driving in wintry conditions will require you to slow down and be extra cautious.

3. Dress your child in thin layers. Start with close-fitting layers on the bottom, like tights, leggings or long-sleeved bodysuits. Then add pants and a warmer top, like a sweater or thermal-knit shirt. Your child can wear a thin fleece jacket over the top. In very cold weather, long underwear is also a warm and safe layering option.

4. As a general rule of thumb, infants should wear one more layer than adults. If you have a coat on, your infant will probably need a coat, and blanket. Just remember to remove the coat and blanket inside the car before putting your child in the car seat.

5. Don’t forget hats, mittens and socks or booties. These help keep kids warm without interfering with car seat straps. If your child is a thumb sucker, consider half-gloves with open fingers or keep an extra pair or two of mittens handy—once they get wet they’ll make your child colder rather than warmer.

6. Tighten the straps of the car seat harness. Even if your child looks snuggly bundled up in the car seat, multiple layers may make it difficult to tighten the harness enough. If you can pinch the straps of the car seat harness, then it needs to be tightened to fit snugly against your child’s chest.

7. Use a coat or blanket over the straps. You can add a blanket over the top of the harness straps or put your child’s winter coat on backwards (over the buckled harness straps) after he or she is buckled up. Some parents prefer products such as poncho-style coats or jackets that zip down the sides so the back can flip forward over the harness. Keep in mind that the top layer should be removable so your baby doesn’t get too hot after the car warms up.

8. Use a car seat cover ONLY if it does not have a layer under the baby. Nothing bulky should ever go underneath your child’s body or between her body and the harness straps. Be sure to leave your baby’s face uncovered to avoid trapped air and suffocation. Many retailers carry car seat bundling products that are not safe to use in a car seat. Just because it’s on the shelf at the store or sold online does not mean it is safe!

9. Remember, if the item did not come with the car seat, it has not been crash tested and may interfere with the protection provided in a crash. Never use sleeping bag inserts or other stroller accessories in the car seat.

10. Pack an emergency bag for your car. Keep extra blankets, dry clothing, hats and gloves, and non-perishable snacks in your car in case of an on-road emergency or your child gets wet on a winter outing.

There are two new immunizations available for children this season, in addition to the traditional flu vaccine.  Saugatuck Pediatrics will be ready to administer all three on opening (Flu, COVID19 and RSV-Beyfortus.)  Here is more information to help you make an informed decision for your child(ren) about these recommended immunizations.

1.   COVID 19 vaccine
This year the COVID19 vaccine is a monovalent (single strain) vaccine targeting the current circulating variant XBB (an omicron variant.)

• All children aged 6 months and older are eligible for the vaccine.
• We will offer the Moderna version for children ages 6 mo to 18 years.
• If you started the COVID19 initial series at Village (or elsewhere), we can complete the series at Saugatuck IF THE VACCINE WAS MODERNA for ages 5 and under.
• For BOOSTER doses (after the primary series ages 5 and under, or anyone ages 6+) we can administer the Moderna brand (the CDC now allows mixing of vaccine type after the primary series is complete.)
• The incidence of myocarditis (heart inflammation), rarely seen in teens and young adults after the initial COVID19 vaccines, was significantly less (2 cases out of 650,000 vaccines) after the bivalent booster, likely due to the increased spacing between vaccines.  This number is actually the same as the background risk of myocarditis (i.e. the risk of the condition without getting the vaccine.) The risk of myocarditis is much more common with natural COVID infections.
• If your child has recently had COVID you can wait up to 3 months to get the booster, but there is still a risk of waning immunity, and it is safe to get vaccinated as soon as COVID symptoms are gone and your child is no longer contagious (10 days from initial symptoms, with the first day of symptoms considered “day 0”.)

2.   RSV (Nirsevimab or Beyfortus)
This is not a vaccine, but is still considered an “immunization.” It is an injection of long lasting antibodies against RSV that should provide protection throughout the RSV season (October thru end of March in Connecticut.) RSV, or Respiratory Syncytial Virus, is a cold virus that most of us get yearly, but infants are much more likely to suffer from severe symptoms, including wheezing, ear infections, and hospitalization (studies showed a 75% decrease in need to see an MD/hospitaization for RSV with this immunization, with antibodies lasting at least 150 days or more!) This immunization is approved for two groups:

• All infants aged newborn to 7 months born during or entering their first RSV season.
• Infants or children aged 8-19 months who are at increased risk for severe RSV disease and entering their second RSV season. This includes children with chronic lung disease, are severely immunocompromised or have cystic fibrosis with lung disease.
• This shot can be administered at the same time as other childhood vaccines, including COVID19.
• Maternal RSV vaccine was approved by the FDA on August 21, 2023. The CDC does not recommend nirsevimab for most infants born to a mother who received maternal RSV vaccine, except for infants where less than 14 days have elapsed between vaccination and birth.

AAP FAQs are available here.

Here is a great chart from “Your Local Epidemiologist” summarizing this season’s immunization offerings: