Q. "Every time I take our little boy to the pediatrician the doctor asks if we've been strapping him into his carseat. It's almost the first question he asks and I'm beginning to dread it.
"The doctor doesn't even like me to snuggle him on my lap in the car. Last week he saw me holding him while my husband drove us to the drugstore and he looked horrified.
"He just doesn't understand how horrendous it is to drive with a 2-year-old who hates his carseat. After going through his shenanigans at the supermarket (and making him stay in the cart) and then wrestling to get him and the groceries into the car, I'll be frank: My sanity comes before the carseat.
"Since I drive slowly and hardly ever go out of the neighborhood, I can't believe it's as dangerous as this doctor says it is. I think I'd die if something happened to our little boy but I don't know a single child who's been hurt in a car accident."
A. Your doctor puts the carseat question first because that's right where it belongs. More children between 1 and 14 are killed by automobile wrecks than by any accident or any disease. In fact, more children died in car crashes in the past decade -- 20,000 -- than from polio in the '50s, and yet every parent, as well as every doctor, was terrified of that disease. No precaution was too much to take, but in today's epidemic -- and this is what the accident rate has become -- only about 15 percent of children use restraints in the car, and not more than half use them properly.
Studies show that parents are twice as likely to use restraints as their children, yet the danger to children in a crash is much greater, especially in their first year, for their bone structure is so delicate and their center of gravity so high.
You can see how dangerous it is if you multiply the weight of your child -- say 20 pounds -- by the speed of the car. At 30 m.p.h. you get 600 pounds, the weight of an unrestrained child as he flies forward. This is about the same as dropping him out of a third-story window.
It's even worse if the child is held in your lap. He would be plucked right out of your arms in a wreck, for even belted in place, you couldn't hold back a child moving forward at 30gs. And if you aren't belted, you'll go forward too, pressing him against the dashboard like "a battering ram," according to the Insurance Institute for Highway Saftey.
If unrestrained, the front seat is the worst place for a child to be, even in a minor crash, says Dr. Richard Mier of the accident-prevention task force of the D.C. chapter of the American Academy of Pediatrics.
Automobile accidents are also "the number-one cause of surgical repair for children," says Mier. (From 100,000 to 15,000 children are hospitalized for injuries a year, and that doesn't even count emergency-room visits.)
Sixty percent of all deaths and injuries, says Mier, could be prevented by restraints.
New government regulations, which went into effect Jan. 1, award an FMVSS-213 sticker to all models surviving a crash test, and this is the kind a child should have. Some seats are just for infants, some for young children, but most can be converted from one to another.
A child should be placed in a restraint in that first car ride home from the hospital, with the seat secured and facing backwards until he can sit up alone and his back can absorb the impact of a wreck. And if a child is riding in a car that has no carseat, he is better off with a seat belt, than unrestrained at all. This is what he will wear regularly when he reaches 4 or 5 and weighs about 40 pounds, but he may have to sit on a 2-inch pillow at first, so the belt can be pulled tightly across his hips.
It is truly a pain to wrestle a child into his carseat every time you go somewhere, but if he is used to it, there will be a minimum backchat, even at 2. Unfortunately, you're in for a hassle for a while, since your child has had some freedom, but even at this age he will obey if he thinks there is no recourse.
Begin with the good points: He will be able to see a lot more because he is higher and you can talk to him like a grown-up because you both see the same things.
And then you tell yourself that the child who is buckled in place can't crawl into the front seat to play with the radio, the steering wheel or the glove compartment, and when he yell, his voice is 2 feet from your ear and not 2 inches.
The readjustment won't be easy for either of you and there will be scenes. That's when you pull the car over and turn off the radio. You don't talk, you just wait, with no reaction at all, and if you can'd do that without exploding, you get out and take a very short walk. And when he stops yelling, you drive on, turn on the radio and act pleasantly, as if nothing happened.
If it begins again, you go through the same process, but once home you say you're sorry you had to stop, since it left no time for the ice-cream cone you had planned, or the stop at the pet shop.
And when he does accept the new rule, make time for a treat, although you won't promise it beforehand, even if he asks. You just surprise him as a way of saying you enjoy his company.
It's trouble to get back on the track, but it's worth it You said you thought you would die if something happened to your child. That's the trouble. You wouldn't.