Most parents would agree that young children should be secured safely in a car seat to protect them if they are in an accident. Studies have shown that a correctly used safety seat reduces the fatality risk by 71 percent and serious injury by 67 percent. But once a child begins to outgrow his or her car seat, parents may incorrectly assume their child is safe using a regular seat belt. In reality, studies show that older children who are secured in belt-positioning booster seats are 45 percent less likely to sustain serious injury in a serious collision.

A booster seat positions a child in such a way that the seat belt falls on the lap and chest. The shoulder belt should fall in the middle if the child’s chest and shoulder area, and the lap belt should fall over the child’s hips and upper thighs. If a child is secured with just the car’s set belt and no booster, the belt dangerously falls over the stomach and neck instead. If the vehicle is in a collision, the seat belt can lead to extensive internal injuries of the abdomen and neck, increasing the chance of fatal injuries. By using a booster seat, the belt is positioned over strong bones instead of internal organs.

The official American Academy of Pediatrics policy recommends that all children be secured in a booster seat until they are 4’ 9” in height, usually between the ages of 8 and 12. Of course, a 5-point harness restraint is always safest and should be used instead of a booster until the child has reached the maximum height and weight for the seat.

There is no nationwide law mandating the use of booster seats once a child outgrows a car seat. The law varies from state to state, with some states having no law for restraints after the child turns 4 years old. A study in the journal Pediatrics confirmed that a nationwide law would be very effective in saving lives. The study concluded that there were remarkably fewer cases of death if an older child was in a booster seat during a collision.


  • There is no federal law enforcing the use of booster seats once a child has outgrown a car seat.
  • Many parents assume that a child is safe in just a seat belt once they no longer need a car seat.
  • Without a booster, a seat belt falls over the stomach and neck of a child, which could cause fatal injuries in the event of an accident.

Last reviewed by Heather Felton, MD, FAAP. Review Date: April 2020


  1. American Academy of Pediatrics. AAP Updates Recommendation on Car Seats.
  2. American Academy of Pediatrics. Car Seats: Information for Families.
  3. Medical News Today. Parents Often Forego Booster Seats When Carpooling Kids.
  4. National Highway Traffic Safety Administration.


  1. My daughter is almost 5 and still in a 5 pt harness car seat and I can’t bring myself to considering a booster seat yet.

    1. I know, it’s almost a rite of passage. Means they are not babies anymore! 🙁

  2. This article is very helpful! My 4 year old is currently in a 5 point harness, but my MIL recently asked me if she could get rid of the one in her car and simply use a booster seat. Needless to say, I told her not just yet. 🙂

    1. Great! The longer you can keep her in the better!


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