Preemies and car seats

[ThankfulMama]

Our twins are in the NICU and in my online reading I have read and seen a lot of posts/pictures about the use of rolled blankets, positioners and whatnot being used in car seats with small preemies for the car seat tests and going home. It's my understanding that nothing should be added to carseat that didn't come with it--is there some exception for preemies?  Just want to be sure when we get to that point. . .

[Maedze]

Complex, but no, being a preemie does not allow the use of positioners.  

Before your babies go home, they are going to have to pass a car seat challenge test, which basically consists of parking them in their seats for a few hours and making sure they don't desaturate to dangerous levels.   If they *do* desaturate, they'll have to use car beds until they're a little more mature.   xhttp://www.google.com/imgres?imgurl=http://news.consumerreports.org/a/6a00d83451e0d569e2011570bc3bfa970b-800wi&imgrefurl=http://news.consumerreports.org/baby/2009/06/car-seat-preemie-safety-low-birthweight.html&h=200&w=250&sz=19&tbnid=kaBvO3gavbE6MM:&tbnh=88&tbnw=110&prev=/search%3Fq%3Dpreemie%2Bcar%2Bseat%26tbm%3Disch%26tbo%3Du&zoom=1&q=preemie+car+seat&docid=0du19RlWuMvEsM&hl=en&sa=X&ei=8FJ_T6mBNYvqtgfH6v3dAQ&sqi=2&ved=0CIUBEPUBMAU&dur=623

Car beds are not anywhere near as safe as a rear facing seat, so you'll want to make sure they have a fighting chance at passing the car seat challenge.  The BEST way to do this is to A.  Make sure you have seats that fit tiny newborns well (not all infant seats do) and B. (AND THIS IS A BIGGIE).  MAKE SURE THE HARNESS IS TIGHTENED AND SECURED CORRECTLY!

Way too often parents or nurses don't correctly tighten the seat during a challenge.  If the baby then slumps, it's going to squeesh it's lungs, and possibly fail the test.    

The chest clip should be at nipple level (not down by the tummy).  The harness should be SNUG.  This means if you tried to pinch any harness at the shoulders, your fingers slide right off the webbing.  

You should not add a head rest, a positioner, shoulder pads, or anything that goes between the baby and the seat (like a Bundle Me) to the seat.  

The ONE exception:  you can roll something like a receiving blanket long ways.  After the baby is correctly secured, you can put your long blanket tubes, one on each side of the baby tucked securely into the car seat but not between baby and seat or between harness and baby, to prevent the head from slumping one way or the other.   The other thing you may do is stuff a wash cloth between the baby's legs behind the crotch buckle, if there seems to be a gap and the baby is slouching even with the harness tightened all the way.    
 

Originally Posted by ThankfulMama 

Our twins are in the NICU and in my online reading I have read and seen a lot of posts/pictures about the use of rolled blankets, positioners and whatnot being used in car seats with small preemies for the car seat tests and going home. It's my understanding that nothing should be added to carseat that didn't come with it--is there some exception for preemies?  Just want to be sure when we get to that point. . .

[Bokonon]

Originally Posted by Maedze 

Complex, but no, being a preemie does not allow the use of positioners.  

Before your babies go home, they are going to have to pass a car seat challenge test, which basically consists of parking them in their seats for a few hours and making sure they don't desaturate to dangerous levels.   If they *do* desaturate, they'll have to use car beds until they're a little more mature.  

I don't know that this is standard at all NICUs - my preemies didn't have to do a car seat test at their level III NICU, and my second was under 5 lbs. when discharged.

[Maedze]

That would certainly be contrary to recommendation.   

Originally Posted by Bokonon 

I don't know that this is standard at all NICUs - my preemies didn't have to do a car seat test at their level III NICU, and my second was under 5 lbs. when discharged.

[Bokonon]

Originally Posted by Maedze 

That would certainly be contrary to recommendation.   

I understand, but it was never even mentioned in my kids' NICU, 4 years apart.

[ThankfulMama]

Originally Posted by Maedze 

Complex, but no, being a preemie does not allow the use of positioners.  

Before your babies go home, they are going to have to pass a car seat challenge test, which basically consists of parking them in their seats for a few hours and making sure they don't desaturate to dangerous levels.   If they *do* desaturate, they'll have to use car beds until they're a little more mature.   xhttp://www.google.com/imgres?imgurl=http://news.consumerreports.org/a/6a00d83451e0d569e2011570bc3bfa970b-800wi&imgrefurl=http://news.consumerreports.org/baby/2009/06/car-seat-preemie-safety-low-birthweight.html&h=200&w=250&sz=19&tbnid=kaBvO3gavbE6MM:&tbnh=88&tbnw=110&prev=/search%3Fq%3Dpreemie%2Bcar%2Bseat%26tbm%3Disch%26tbo%3Du&zoom=1&q=preemie+car+seat&docid=0du19RlWuMvEsM&hl=en&sa=X&ei=8FJ_T6mBNYvqtgfH6v3dAQ&sqi=2&ved=0CIUBEPUBMAU&dur=623

Car beds are not anywhere near as safe as a rear facing seat, so you'll want to make sure they have a fighting chance at passing the car seat challenge.  The BEST way to do this is to A.  Make sure you have seats that fit tiny newborns well (not all infant seats do) and B. (AND THIS IS A BIGGIE).  MAKE SURE THE HARNESS IS TIGHTENED AND SECURED CORRECTLY!

Way too often parents or nurses don't correctly tighten the seat during a challenge.  If the baby then slumps, it's going to squeesh it's lungs, and possibly fail the test.    

The chest clip should be at nipple level (not down by the tummy).  The harness should be SNUG.  This means if you tried to pinch any harness at the shoulders, your fingers slide right off the webbing.  

You should not add a head rest, a positioner, shoulder pads, or anything that goes between the baby and the seat (like a Bundle Me) to the seat.  

The ONE exception:  you can roll something like a receiving blanket long ways.  After the baby is correctly secured, you can put your long blanket tubes, one on each side of the baby tucked securely into the car seat but not between baby and seat or between harness and baby, to prevent the head from slumping one way or the other.   The other thing you may do is stuff a wash cloth between the baby's legs behind the crotch buckle, if there seems to be a gap and the baby is slouching even with the harness tightened all the way.    
 

Perfect, thank you!  I have the Chicco keyfit 30, and I'm guessing both will be over 4lbs before they get to go home.Thanks so much for the information.