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The car-seat crusader

Justice SystemSinai Hospital in Baltimore

Driving on Park Heights Avenue recently, Debbi Baer happened on the kind of scene that tends to transform her, Clark Kent-style, from apparently mild-mannered Pikesville grandmother into fearless crusader.

Stopped at a red light, as she recalls the story, she looked into the next car and saw a baby in a woman's lap. No seat belts or safety seats were in sight. She swung into action.

The 4-foot-11 Baer used her Ford Taurus to block the woman's path. She reported the violation to a nearby policeman. As the officer cited the woman, Baer drove away.

"I don't care if she was upset," she said. "Somebody has to protect that child."

The Car Seat Lady had struck again.

For nearly half of her 65 years, Baer, a nurse, has devoted most of her spare time and energy to one cause: raising awareness about child safety seats to make it safer for kids to ride in vehicles, and by any means necessary.

"When a vehicle crashes or gets hit, it creates tremendous impact forces, and they're delivered through children's bodies," said Baer, who first immersed herself in the subject in 1982. "Use a car seat properly, and children have a good chance of surviving most crashes. It's scary how few [adults] take the time."

The facts support her feeling. In a nation where the majority of people will be in a motor vehicle crash at some point in their lives, surveys have found that more than 90 percent of child-restraint systems are installed incorrectly, used incorrectly, or both.

Baer's mission is to reverse the tide, and she carries it out in several guises — as a public speaker, seat installer, product tester, political advocate and generally cheerful but indomitable pain in the neck.

"She's tiny in stature, but she's a passionate advocate," said Maryland state Sen. Bobby Zirkin, who knows Baer in two ways: She installed his seats when he was a boy, and he has seen her testify before lawmakers. "It's her labor of love, and she charges hard."

She learned the basics in the early 1980s from Dr. Kenneth B. Roberts, a pediatrician at her workplace, Sinai Hospital of Baltimore, who has long advocated for child passenger safety. After having her second child, she cut her work hours and took up the cause. By 1987, she was a certified child passenger safety technician performing installations.

Today, at a time when numerous public agencies offer help with car seat setups, Baer is still a dynamo, averaging 25 of the procedures per weekend. She figures she has completed more than 20,000.

On any given weekend, you'll see cars lined up on her street, patiently waiting. Her installations (the $15 fee can be waived in cases of need) can take more than an hour. They include one-on-one instruction and tend to end up with Baer inside the vehicle, standing on the seat to get the straps tighter.

"The way she maneuvers around inside a small car is a wonder," said Zirkin, whose two children sit in Baer-installed seats. "When she is finished, you can't budge a thing."

On a recent afternoon, Baer's younger daughter, Abigail Aghion, a pediatrician, stops by for an adjustment. Aghion's 4-month-old son, Eitan, has been riding in an infant seat anchored to a base, and she wants to learn how to use it base-free (equally safe, installed correctly).

Baer, whose older daughter, New York pediatrician Alisa Baer, is also a car-seat safety advocate, knows more do's and don'ts than she can share in one article; for further study, she recommends the websites for Safe Kids (safekids.org), Safety Belt Safe (carseat.org) and her own operation (thecarseatlady.com). But she's happy to rattle off some favorite tips.

"As it is, our kids face so many forms of unavoidable risk," she said. "Here, we can offer so much protection with so little effort."

Here are her top tips:

Carefully read the instruction manuals for your car and your car seat. Cars and seats come with unique instructions; follow to the letter. If the language is hard to follow, contact an advocacy group, call the manufacturer or watch an installation video online.

Keep your child in a rear-facing seat for as long as possible. According to state law, children must be rear-facing until they're at least 2, but that doesn't mean they must transition then. Keep them rear-facing until they've reached their seat's maximum height or weight limit. Rear-facing seats distribute impact forces better, cradle the child, and reduce stress on its fragile neck and spinal cord. Available for kids up to 50 pounds, rear-facing seats are five times safer than forward-facing ones.

For rear-facing seats, keep the angle correct. Using the level-check guide on the seat or on the base, be sure the seat back rests between 45 and 60 degrees from the horizontal (30-45 degrees from the vertical).

For forward-facing seats, in addition to the seat belt or latch belt, fasten the top anchor strap, or tether strap. Tether straps come off the back of a safety seat and are attached to a permanent anchor directly behind the vehicle seat. Although frequently not used, they decrease upper-body movement and injury.

If it's a rear-facing seat, use the rear-facing belt routing path; it it's forward-facing, use the forward-facing path. Belts in the wrong path can cause seats to rotate, allowing the child to violently strike the seat in front of him or her.

Know a seat-belt system from a latch system. Reading your vehicle and car-seat manuals, determine which of the two you have. In a seat-belt system, use the vehicle's seat belt, routing it through the appropriate path in the child safety seat, then clicking it into the seat-belt buckle. In a latch system, the car seat has its own straps; hook these to the metal anchors that come pre-installed in most post-2003 vehicles.

Use straps correctly. For all car seats with harnesses, make sure the straps emerge from the correct slot (at or slightly below the shoulders for rear-facing seats, at or slightly above for forward-facing), then tighten snugly, allowing space for only one finger between the straps and the child's body. Position the chest clip at armpit level.

For older children: After forward-facing seats, children transition to booster seats, which reposition a vehicle's lap-and-shoulder belt so it fits over the body's strongest parts. State law requires children to be in restraint systems until age 8 (or until they're 4 feet 9 inches tall or taller), but at 8 only half are large enough to graduate to an adult system. Take the five-step test at thecarseatlady.com to determine readiness.

Be sure the car seat is installed tightly. If you can move the seat more than one inch side to side or front to back, you need to tighten the seat belt or latch belt. Can't make it work? Contact Maryland KISS (Kids in Safety Seats) at 800-370-SEAT or go to nhtsa.gov to find a certified technician.

jonathan.pitts@baltsun.com

Copyright © 2014, The Baltimore Sun
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