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PREMATURE INFANT USE
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% 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 5 lb 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 to 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 Infants
• DO NOT use this or any other child restraint with a premature
infant until after consulting your doctor. Premature infants
may have difficulty breathing when in a sitting position.
Premature Infant Use
