NEW YORK (Reuters Health) - U.S. states with laws requiring kids to 
ride in car booster seats have had fewer child deaths in accidents, 
especially among 6- and 7-year-olds, researchers reported Monday.
Nearly
 all U.S. states require that children who have outgrown traditional car
 seats use a car booster seat, which raises a child high enough so that 
seatbelts can be positioned properly - with the shoulder strap across 
the shoulder (not the neck), and the lap belt across the hips.
Florida
 and South Dakota are the only states that don't mandate booster seats. 
But the other states vary in their age requirements, and many don't 
require booster seats for 6- and 7-year-olds.
But in the new 
study, researchers found that after states began passing booster seat 
laws, fewer children ages 4 to 7 died in car accidents - and the biggest
 differences were seen in older kids.
Between 1999 and 2009, 
states that started requiring booster seats had an 11 percent lower risk
 of child traffic deaths compared with states without a law. When the 
booster law included 6- and 7-year-olds, deaths dropped by about 
one-quarter, versus states with no booster seat mandate.
"I think 
parents may think that as kids get older, they need booster seats less,"
 said senior researcher Dr. Lois K. Lee of Children's Hospital Boston.
"But this shows that it's kids at the upper end of the age range who could benefit the most," Lee said in an interview.
Already,
 the American Academy of Pediatrics (AAP) says that children should ride
 in car seats with a harness until they are 4 years old, or have 
outgrown the seat. After that, they should use a booster seat until 
they're between 8 and 12 years old, or have reached 4 feet, 9 inches in 
height.
Based on the current findings, Lee said, "I think states 
should consider extending their age limits to match the AAP guidelines."
TELL YOUR CHILD IT'S THE LAW
The
 findings, which appear in the journal Pediatrics, are based on data 
from the National Highway Traffic Safety Administration (NHTSA) for 1999
 through 2009. In 1999, no U.S. state had a car booster seat law; by 
2009, nearly all had passed one. 
Among states that passed a law, 
traffic deaths among 4- and 5-year-olds fell from an average of 5.7 per 
100,000 before the law, to 4.2 per 100,000.
The researchers then 
looked at states whose laws covered 6-year-olds. The average death rate 
among kids that age dipped from 2.3 to 1.5 per 100,000.
In states 
that covered 7-year-olds -- 16 of them in 2009 -- the average death rate
 among those kids did not decline. But when the researchers accounted 
for other factors, like other new driving laws, booster seat laws were 
linked to a one-quarter lower death rate among 7-year-olds.
Lee 
said that regardless of what your state law is, the best way to keep 
your child safe in the car is to follow the AAP guideline on booster 
seats.
Of course, getting your 8-year-old to agree to get in a 
booster seat can be a challenge, Lee acknowledged. "That's one way 
legislation helps parents," she noted. "They can tell their child it's 
the law."
For booster seats to work, they do have to be installed 
and used correctly. And research has found that families often make 
mistakes, such as improperly positioning or latching the seatbelts.
Parents
 who need advice on using booster seats can go to online sources like 
the NHTSA website (www.nhtsa.gov) and Safe Kids USA 
(www.usa.safekids.org).
The NHTSA site also lets parents search 
for local inspection stations where they can get help installing and 
using car safety seats.

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