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Before using this child restraint for preterm or low
birth weight infants, ensure the Child Requirements
are met and follow the guidelines in this section.
According to the U.S. National Highway Traffic Safety
Administration, a properly installed child restraint reduces
the risk of death by over 70 percent for infants involved in
crashes. Federal Motor Vehicle Safety Standard (FMVSS)
213 establishes design and dynamic performance
requirements for child restraint systems. However, the
standard has no minimum weight limit and does not
address the special medical needs of preterm or low-
birth weight infants. To ensure that preterm and low-
birth weight infants are transported safely, the guidelines
published by the American Academy of Pediatrics (AAP) in
Pediatrics 2009; 123:1424–1429 must be followed.
All children should ride rear-facing in the vehicle as long
as possible. Preterm and low-birth weight infants are at
additional risk of breathing difficulties and heart problems
when placed in a child restraint. Evenflo requires that the
evaluation recommended by the AAP be conducted for all
infants born earlier than 37 weeks and all newborn infants
who weigh less than 2.26 kg (5 pounds) at birth before
their first car trip to check for breathing difficulties or heart
rate problems when traveling in a rear-facing child restraint.
The AAP recommends that appropriate hospital staff observe
your infant in the child restraint for a period of 90 - 120
minutes or the duration of travel, whichever is longer. This
period of observation must be performed with the infant
properly positioned as described in these instructions and
with the child restraint placed at an angle that is approved
for use in the vehicle. The hospital staff will check for any
breathing difficulties or heart rate problems. Your child’s
pediatrician will let you know if there are any special
considerations for travel. The number of trips and the
duration of time the infant is seated in the child restraint
should be minimized. A caregiver should ride in the back
seat to monitor the infant during travel.
You can learn more about the AAP’s recommendations
for observation of newborns and the guidelines for safe
transportation of preterm and low-birth weight infants,
as well as other resources for parents and medical
professionals, at
https://www.healthychildren.org/english/safety-prevention/
on-the-go/Pages/default.aspx
Premature Infant Use
