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Their chief executive Francine Bates said: "We recommend that parents also avoid driving long distances without a break. The Lullaby Trust firmly acknowledges the importance of car seats when travelling. These results do not mean you should panic or stop using car seats. These adverse effects were discovered particularly with the simulated motion, which is not identified in the standard car seat challenge. The important finding suggests that if infants spend periods of time in an upright position and in motion, they can experience adverse health effects in as little as 30 minutes.
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This suggests that the upright position is a more significant factor than a prolonged period sitting in a car seat. The negative health effects were more significant when the babies were seated at 40° than at 30°. This is because when they are young, babies do not have the ability and strength to hold up their own head meaning their airways can become restricted. Put simply, when newborn or premature babies sat in a car seat for 30 minutes, their heart and breathing rate increased, and their blood oxygen levels were lower compared with lying flat in a cot. In this study, researchers found that both term and pre-term infants showed signs of potentially adverse cardiorespiratory effects when seated in an upright position at 40°. A study funded by the Lullaby Trust (2016)* assessed the impact of motion and an upright position on both preterm and term infants. To make the test as realistic as possible, a simulator was designed to reproduce vertical vibration similar to that in a rear-facing car seat at 30 mph. The test does not take into account the impact of the upright position and the motion or vibration of a car seat when travelling. The Infant Car Seat Challenge assesses babies in a static car seat. This is due to the scrunched position of upright car seats which can restrict a baby's airways. Previous research in Pediatrics and The Journal of Paediatrics suggests that preterm babies are more at risk from these heart and breathing complications when restrained in car seats. This advice is followed by many UK hospitals. This test is often referred to as the Infant Car Seat Challenge. The American Academy of Pediatrics (AAP) recommends that in neonatal units preterm babies are monitored in a car seat for apnoea, bradycardia or oxygen desaturations before they are safe for discharge. What the research says about how long your baby should be in a car seat You should ensure that your baby is taken out of the car seat as soon as you get to your destination and placed onto a firm, flat, waterproof mattress (which is in good condition) for the first six months minimum. The recommended sleeping position for young infants is flat on their back. However, car seats should only be for travelling and are not generally a safe sleep environment. Often babies fall asleep in the car which is fine for a short amount of time if they are supervised.
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Restricted airflow to baby's lungs, causing breathing issues But to keep it simple, when a baby is in a semi-upright position for a prolonged period of time it can result in: The 2 hour rule is based on the research and current evidence detailed below. This advice is not only recommended for car seats but any travel system, buggy or pushchair where the baby is not in a lie-flat position. They recommend only using the car seat for two hours within a 24 hour time period. You may have heard this be referred to as 'the 2 hour rule.' Safety experts and car seat/travel system manufacturers have all agreed on a set safety standard. But there are a lot of rules and regulations around them which can be confusing to keep on top of. Car seats are a fantastic and essential invention that keeps your baby safe when travelling in the car with you.