Question for techs...

What do you do for children with medical problems (apnea, choking, seizures, etc) that parents feel their child needs to be FF to be seen before the max weight of the seat? What would your advice be?

Limit rides to necessities only, have an adult sit in the back and/or use a soft plastic mirror -- mirrors are not usually recommended, but is an acceptable risk in such situations....

Under NO circumstances should a child be turned FF before the minimum 12 months and 20 pounds!

We had a poster here for quite awhile who had two daughters with these kinds of medical issues. Low muscle tone and seizures, I think one had Down Syndrome. She kept them/is keeping them rear-facing to 33 pounds.

Actually, she ended up getting the Scandinavian seats to keep them both RF to ~50# She took awesome pics of the Two Way Plus/Elites installed in a few different vehicles, too, but could only share in email -- this was when I was planning my trip to Denmark & my Danish friend was helping me find a retailer for these seats there ... I'm still disappointed my finances prevented me from going (Leila could still be RF now!) *SIGH*

papooses said:

Actually, she ended up getting the Scandinavian seats to keep them both RF to ~50# She took awesome pics of the Two Way Plus/Elites installed in a few different vehicles, too, but could only share in email -- this was when I was planning my trip to Denmark & my Danish friend was helping me find a retailer for these seats there ... I'm still disappointed my finances prevented me from going (Leila could still be RF now!) *SIGH*

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but it would be illegal, with all sorts of liability isues...

No, Tiffany's SO is a medical doctor and would have written a perscription, which they could have used to petition NHTSA for permision.

Right Rebekah My SO was all ready to right the Rx & I had everything ready to petition NHTSA + I'm confident I could get a proper install in my vehicle since it has 2 top tether anchors built into the 2nd row for install in the 3rd row center....

okay, so in that case it may not be *illegal*, but if your SO would write a prescription for a special carseat for a condition that your DD does *not* actually have, then that would violate medical ethics.

my sister is a MD but she refuses to write prescriptions for drugs for family members (antibiotics, for example) because of ethical concerns. we have to see our own doctors. she also brings her kids to doctors even though she is technically capable of diagnosing and treating them.

i don't argue that using a danish/swedish seat that RF's longer may be safer for a child passenger in the US, but it is also a US-practicing CPST's moral obligation to promote adherence to US laws, whether we like them or not.

The issue of importing higher weight limit rear facing seats from Norway/Sweden came up during the recent online chat event with reps from Safeguard and the Safe Ride News. We learned that NHTSA approves petitions for seats when the child has a medical condition for which remaining rear facing is indicated. A merely large baby who exceeds the U.S. seat limits for rear facing, or enthusiastic parents who want the perks of super extended rear facing, aren't going to get NHTSA's approval. I'm not condoning NHTSA's decisions to limit petition approvals to medical needs, nor am I suggesting abusing the petition practice in any way, just wanted to shed more light on the process.

My 2 yr old neice has seizures and was turned around at 12 months and 20 pounds. Her seizures are not grand maul---they are a very slight tremor in her limbs and she gets the dusky look. I have to agree with my SIL about turning her. Her older children can't always be with her to watch her when RF---it just wasn't worth the risk.

Susan

southpawboston said:

okay, so in that case it may not be *illegal*, but if your SO would write a prescription for a special carseat for a condition that your DD does *not* actually have, then that would violate medical ethics.

my sister is a MD but she refuses to write prescriptions for drugs for family members (antibiotics, for example) because of ethical concerns. we have to see our own doctors. she also brings her kids to doctors even though she is technically capable of diagnosing and treating them.

i don't argue that using a danish/swedish seat that RF's longer may be safer for a child passenger in the US, but it is also a US-practicing CPST's moral obligation to promote adherence to US laws, whether we like them or not.

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Mmm, I see where you're coming from -- I just disagree with the actuality of it in the particular instance.... A carseat is not a drug or unnecessary surgery, etc. The only reason the use of such a seat wouldn't be legal is because there aren't any US regulations to test RF seats up to ~50# (the Rx & approved petition makes it legal). The seat is safe & meets more stringent testing than that of the US & it fits the child + vehicle correctly + I know how to use it correctly. This is not an ethical issue. It would be if my SO refused to write a Rx for anyone else who's child could benefit from extended RF. That's not what's happening. And it wouldn't have been any sort of abuse of power either because Leila was experiencing real physical pain when she had to turn FF -- her legs were going numb leading to severe back aches. While some may not see it as a medical issue, we do. Just because most people may not have the resources to get a Scandinavian seat doesn't mean my child should suffer when she does have the resources. (However in the end I did not have the $) Also ... the more parents petition for higher weight RF seats, the more likely we are to see higher weight RF seats here in the US!

That's the rule in this house. DH is a doctor, but doesn't write prescriptions for any of us.

Lena said:

What do you do for children with medical problems (apnea, choking, seizures, etc) that parents feel their child needs to be FF to be seen before the max weight of the seat? What would your advice be?

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Choking? No eating/drinking in vehicle.

Seizures? There is generally NO treatment unless the seizure is prolonged. A mirror would allow you to observe the child.

Apnea? The RF angle would be safer, since it would provide more support for head/neck.

I've heard of allowing under age/weight FF for children who extend (increased tone). In this case, the child was born with severe brain damage (actually, it didn't develop ). When her feet met solid surface, she would push and push hard. In this case, it was determined that her pushing reflex would cause pain/injury as she strained against the harness and seat back. She didn't go out much and her health gradually declined as her body outgrew her limited CNS function.

Also, I can see the need for a child with a spica cast, to be FF, but in that case, an e-z on vest prone would be an option.

Down syndrome/low tone/hydrocephly would be reasons to EXTEND RF so that the child had more support.

papooses said:

Also ... the more parents petition for higher weight RF seats, the more likely we are to see higher weight RF seats here in the US!

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well, you know my position on THAT. petitions based on medical exceptions will NOT have a significant influence on general policy. however, concerted efforts to change the laws by influencing the law making bodies will.

I want to make it clear that I agree with not writing Rx for drugs. My SO doens't write Rx for anyone unless they are a patient. Although we have a personal relationship, when I lost my insurance & couldn't find anyone accepting new patients with a chronic illness where we moved, it was a situation thar warranted my becoming a patient simply so he could have access to my medical records so that I could continue my medication. Better that than a Dr. just ordering medications directly without a Rx to give away -- which I've seen All I'm saying is, yes, ethics exist, but each person and each circumstance is individual. There isn't anything unethical about writing a Rx for a carseat (again, not a drug) ... it only appears unethical because too few doctors bother to write Rx for carseats & yet too many doctors Rx drugs based on the free samples the companies toss in their laps. That's unethical. That's not oppinion, either. There's been at least 1 article about it in medical journals.

I'm sorry, without explaining how you feel I don't know. What exactly is "that"?

How might an increase in people petitioning for something safer not influence policy That's one method change is made. There are many -- stand alone, fall alone, stand together & things happen.... Writing to the lawmakers is excellent, but if they don't see data showing that the demand exists then they're not likely to be swayed.

This is not say that my situation was so grand a scheme -- it was merely about the fact that my daughter was suffering sever back pain at a young age, coupled with numb legs from no other reason than that she has long legs, but while RF they were safely supported & there was no pain. When pediatricians "advize" parents to turn babies FF at only 4, 6, 8, 10 months old how helpful are they likely to be about getting a foreign seat? It has nothing to do with legality to them, it's just *strange* because well, heck, they bounced around unbuckled & survived just fine.... My SO believes each person has the right to total well being. How is that unethical? It is unethical that a Ped. doesn't even know the AAP policy statement! It is unethical IMO for a Ped to assume that severe back pain is a "discipline problem". Pain is a medical issue. Rolled up blankets, empty boxes, etc. helped a bit, but when she fell asleep & those things fell out of the way she still woke up with numb legs & painful back. It would have been unethical for my SO to Rx a medicine, but a carseat is not a medicine & there is absolutely no doubt that a CPST would be able to use the carseat correctly after having done the research.