What Experts Say:

All children 40 lbs and under should be in child safety seats on airplanes.

~The National Safe Kids Campaign

History of Child Safety Restraints

Part 1: The Way It Was

This is the first part in a six-part series on the history of child safety restraints in vehicles by Louise Stoll, the managing director of CARES

Aviation child safety is the embarrassing safety gap in the world of transportation.

While keeping children safe in automobiles has become an increasingly serious concern of the federal government, the medical profession, and child advocacy and safety organizations over the past thirty five years, child aviation safety is still in its infancy.

However – there is progress to report.

We have come a long way toward protecting our young in automobiles. I can remember flopping around the car as a child totally unrestrained. Well into the 1960s children rolled around on mattresses in the back of station wagons, or sat on the laps of people - themselves unsecured and even in the front seat - while their parents drove. No one would dream of letting these things happen today, and child safety in automobiles is backed up by law and financial penalties.

Yet that is the state of affairs today for young children traveling in airplanes.

That said, the story of child restraints in airplanes is closely wedded to that ubiquitous child restraint found in American family cars: the car seat. So, a bit of history:

Primitive automobile restraints for children began to appear in the late 1950s and early 1960s when adult seat belts made their appearance. The children’s devices were often no more than a narrow canvas belt around the waist of a child that was threaded through a vertical strap fastened around the back seat – so the child could stand up and bounce all over the place, but presumably wouldn’t fly out the window if the car stopped abruptly.

The version I used for my children was a swinging canvass sling type seat hung over the top of the back seat with aluminum inverted “U” tubing. The “seat” would pivot upwards in a short stop like a rocking chair and the child wouldn’t be catapulted forward. The child was not belted in, but we thought the laws of physics worked on her behalf.

As more people drove and more automobiles were on the roads, highway injuries and deaths increased and became a national concern. In the early1980s statistics compiled by the Department of Transportation demonstrated dramatically that lives were saved and injuries reduced when people in cars used seat belts. In the 1980s NHTSA, the National Highway Traffic Safety Administration mandated the use of car seats for children, established crash-withstanding standards for car seat construction, and initiated educational programs to promote car seat use. The American Academy of Pediatrics, child advocacy and safety groups, and PTA’s joined in. Proper installation was a problem, and to this day, spot checks around the country indicate that in some areas as many as 70% of car seats are not installed properly. Today most hospitals require newborns to be sent home in a properly installed, aft facing, car seat.

The basic design of car seats hasn’t changed in 30 years – except that they have grown larger and heavier and acquired bells and whistles such as cup holders, leather padding and fancy logos. They have a rigid frame with a padded insert and canvas straps that buckle the child to the frame, and a way to thread the regular seat belt through loops on the back of the restraint to hold it against the back seat of the car. Newer models may have a clipping device to secure them to the back seat of new cars that have a built in receiving end. Car seats weigh between 15 and 25 lbs and grow larger each year.

What has changed is the realization that kids don’t outgrow the need for something more than the seat belt when they reach the 44 lb limit that initially defined car seat usage. So the booster seat was born about a decade ago, which helps protect kids from 44 – 60 lbs and works with the now common place automobile shoulder strap to hold the child in place.

Thus, over the years, a kind of “culture of safe travel” developed in America – focused on the automobile.

Part 2: The Safety Buzz Gets Louder

This is the second part in a six-part series on the history of child safety restraints in vehicles by Louise Stoll, the managing director of CARES

Even as air travel dramatically increased, the discussion of safety in airplanes remained muted, carried on by a small number of people. This is not surprising. While over 40,000 people a year still lose their lives in highway accidents in America, and hundreds of thousands more are injured, the number of people who are hurt or killed in airplane accidents is relatively small. On a per-passenger mile traveled, air travel is far safer than automobile travel. But when things do go wrong on a plane, it can be catastrophic.

According to statistics compiled by the National Transportation Safety Board (NTSB), the government agency charged with investigating major transportation crashes and prioritizing transportation safety concerns, there are both reported and unreported airplane-travel injuries caused by turbulence and rough landings. There are documented survivable crashes in which children were killed because they were not properly restrained, and in which children survive - most likely because they were in an appropriate child restraint system. For over a decade, improving child aviation safety has been one of the NTSB’s “most critical” safety concerns.

In the late 1980’s a buzz began in the child safety community:

“If a lap belt alone isn’t good enough for a child in an automobile, why should it suffice for a child in an airplane?”

“If you aren’t allowed to hold a child on your lap in an automobile any more, why are you allowed to hold a child on your lap in a plane?”

“If the flight attendant on the airplane makes you “stow your luggage under your seat for take off and landing” because it might fly out of your hands and hurt someone, why are young children allowed to be the only “unstowed luggage” on the flight?

Good questions. The answers do not meet the “common sense” test.

The standard in air travel in the US for many years has been - and still is - that children under the age of two travel free if they sit on a parent’s lap (so-called “lap kids”), but children two and over are required to purchase a full fare ticket and sit in their own seats. No matter their size, these children are provided only the same lap belt that is provided to adults. It is widely understood that for these little ones, the lap belt in a plane provides no more effective safety than would a seat belt alone in a car.

Parents, now more safety conscious, began hauling car seats on board planes - despite the inconvenience - when they traveled with small children. NHTSA began certifying certain car seats for airplane use – the ones they knew would fit in standard airplane seats. The prevailing opinion was that a dual use seat – the same one for autos and airplanes – was the desirable model because parents were familiar with how to use it and it would serve both for the trip to the airport and the trip on the plane.

For many years, no one confronted the reality that car seats weren’t designed to be portable, and that even those “certified for aviation use” often didn’t fit in airplane seats very well – if at all . In addition, they were large, heavy, difficult to transport through airports , and were allowed only in the window seat of the row. Their installation caused confusion, delay, and operational headaches for the airlines. The regular airplane seat belt had to be strung through slots on the back of the car seat, requiring parental contortions to make it work – while someone else looked after the small child who would eventually sit in it. All this was much exacerbated after 9/11 when airports became jammed, security was ponderous and traffic moving through airports was slow. In addition, because turnaround time is critical in the aviation world, parents sometimes had their car seats taken away before they could complete the installation so the flight could depart on time.

Frustrated by these operational complexities, it is understandable that some airlines tried to prohibit car seats from their planes. Parents and safety organizations revolted!

In 1992, the FAA adopted a regulation prohibiting airlines from prohibiting car seats to be brought on board if the car seat bore the NHTSA red stamp of certification for aviation use. The voice of safety organizations began to make headway.

By the mid 1990s the issue of child aviation safety looked like this:

Children under 2 years old were permitted to fly free on a parent’s lap – and most, unfortunately, did and still do.

Children over two were required to purchase a ticket (at full price) and were provided only the regular lap belt.

But everyone – the American Academy of Pediatrics, Safe Kids World Wide, Pilot and Flight Attendant Associations, NHTSA and the FAA - acknowledged that until a child was about 44 pounds, he or she was not adequately protected by the lap belt alone. And everyone acknowledged that for the very youngest travelers – the under 2 year olds - the lap kid situation was seriously dangerous.

Part 3: Car Seats Begin to Fly

This is the third part in a six-part series on the history of child safety restraints in vehicles by Louise Stoll, the managing director of CARES

During the mid 1990's, serious research work on child safety was undertaken at CAMI, the FAA's Civil Aerospace Medical Institute in Oklahoma City. A definitive paper, authored by the now deceased Van Gowdy, demonstrated the unsafe situation of lap kids and small children in their own seats when equipped with only the standard airplane lap belt. A variety of restraints were tested, but no new design emerged that withstood scrutiny.

By the late 1990's the Airlines, the FAA , the American Academy of Pediatrics, even the American Automobile Association, began issuing written guidelines for how to fly safely with kids. These guidelines ALL urged parents to bring aviation- certified car seats on board planes for their young children. For the lap kids, this meant finding an empty window seat on the plane next to a parent, or purchasing a ticket for a child who could otherwise travel free. For the 2-4 year olds, who already had to purchase a ticket, it became a curious economic injustice issue. It said to families that alone of all the ticketed and paying airline passengers, their small children needed to bring their own safety devices onto the plane

Articles appeared in well read periodicals on the subject of child aviation safety, urging that child restraints be mandated on airplanes, but they differed as to whether parents should be required to bring their own on board or whether the airlines should be required to provide them. A new concept began to gain momentum, arguing that it was an airline's responsibility to provide "an equivalent level of safety" for all its paying customers.

In 1997, in response to the TWA 800 tragedy, The White House Commission on Aviation Safety and Security, chaired by former congressman, Norman Mineta, issued its report and, among its approximately 50 recommendations, stated it is "inappropriate for infants to be afforded a lesser degree of protection than older passengers". The Report recommended an end to lap kids.

In 1999 the FAA Administrator, Jane Garvey, called on the entire aviation community and other interested parties to discuss the issue of child safety. She issued an Advance Notice of Proposed Rule Making seeking public and industry comment on a proposal to require child restraints for infants (under 20 lbs) and small children (under 40 lbs). Over 170 written communications were received - from airlines to pilot and flight attendant associations, parent groups and child advocacy groups, and interested individuals. The submittals were often long and thoughtful and this docket constituted a public record available for all to read. All but a handful of letters urged the FAA to take serious action and require children on airplanes to be better protected. They differed on how broad the mandate should be (only lap kids? toddlers too?); about who should pay for it and supply the safety restraints (parents or the airlines?); and about how the Rule should be enforced. This Notice of Proposed Rule Making never became a Rule and was, after being informally shelved for a number of years, formally dropped by the FAA.

The reason: An argument had arisen and gained instant following in the aviation world asserting that if lap kids were eliminated and families had to buy tickets for infants, many would choose instead to drive – thus placing their infants in a transportation mode with a higher rate of accident and injury. This argument, known as the "diversion" theory, still governs the FAA's decision to continue to permit lap kids - while simultaneously urging parents to voluntarily purchase a seat for their under two year olds and bring a certified child restraint – which at that time meant only car seat - along.

The National Transportation Safety Board challenged the diversion argument. Recently it has issued a paper based on studies of two periods (immediately following 9/11 and an earlier pilot strike) when air travel dipped and more families had in fact, taken to the road. Its findings were that there was no increase in the number of accidents or injuries to children during these periods, possibly because families with children, as a group, are more careful drivers than the average.

Other arguments challenge the diversion theory, including that in a country such as ours where families are far flung, driving is not an option for many trips which will continue to be taken– the weekend trip from NY to Chicago for grandma's birthday for example; or the trip to Puerto Rico or Alaska. Some argue that if the elimination of lap kids caused entire families to forego air travel, the airlines would likely return to the 1950's "half price for kids" price structure to avoid losing the two or more other paying customers. Many argue that families don't stop flying now when their children reach the age of two and they must purchase seats for them and wouldn't if that requirement started earlier. Holders of these views believe it is unlikely that requiring a ticket for an infant would deter enough air travel to register additional deaths on the road.

The terrorist attack on America on September 11, 2001, created a multitude of airline concerns that pushed child safety to the back burner – but exacerbated the problem. Congressional legislation introduced to require improved child aviation safety died in a post 9/11 world. Airports have become far more complex to navigate, security far more arduous and tedious, planes more likely to be filled to capacity, and car seats, ever larger and heavier, far more difficult to haul through them and down narrow airplane aisles. There is virtually no way a parent with a young child, much less two, can manage it. It is not surprising that anecdotal evidence reports fewer and fewer parents are carrying car seats on board planes, and that most check them through as luggage if needed at the end of the trip. Most youngsters today are flying with inadequate protection—unsafely!

Part 4: The Advent of the CARES “Flight Belt”

This is the fourth part in a six-part series on the history of child safety restraints in vehicles by Louise Stoll, the managing director of CARES

For a number of years the Lap Kid issue has remained a quiet injustice and a dangerous practice. Most parents of infants seem unable to resist the free travel – so for now their children remain the only pieces of unstowed luggage on the plane during take off, landing and turbulence. They remain in danger of being crushed by a parent folding over them in the event of an emergency landing, or flying out of a parent's arms and becoming a missile endangering themselves and others. Until recently there seemed no resolution in sight.

There is, however, some progress to report regarding aviation child restraints for children over the age of two and under the age of five - the ones who are currently required to be in a seat of their own, who are too small to brace themselves effectively in the event of turbulence, yet receive nothing more from the airlines than the regular airplane lap belt.

In September 2006 an entirely new approach to child aviation restraints was approved by the FAA for children 22-44 lbs: 1 – 4 or 5 years old. It was born of what can be called "grandmotherly necessity". A young woman, seven months pregnant, arrived at Dulles Airport for a visit and wobbled off the plane carrying a two year old toddler in one arm, a bulky car seat in the other, and the usual stuffed diaper bag over her shoulder. No one helped her and her mother, waiting just inside the terminal – which you could do in those days – thought "There has to be a better way!" And so it turns out there is!

That night, knowing little then of the history of child restraints described in this paper, I drew a picture of what I thought might keep a child caught in air turbulence from flopping forward or sliding under the seat belt, but was at the same time light enough, small enough, and easy enough to use that the airlines might actually want to store it in the overhead bins and hand it out to young passengers as they came aboard – just as they hand out extender belts out to very large passengers.

Any design that is going to do that, by definition, challenges the long held assumption that the child restraint should be usable in both automobiles and airplanes, and, of course, it won't likely look like a car seat! It was clear to me that the appropriate paradigm for an aviation child restraint was intrinsically different than for a car child restraint– the opposite in fact. It had to be light weight, highly portable and easily and quickly installed in any airplane seat. And it had to store in the airplane overhead bin when not in use. The very opposite of car seats! It was clear to me that car seats had no place in today's airports or airplanes, and this is confirmed by their absence in these venues.

The Child Aviation Restraint System (CARES) I designed is straightforward. It holds the young child against the airplane seat back with a webbing loop that goes around the seat and is hidden behind the tray on the back of the child's seat. It has two vertical straps descending from the webbing loop that came over the child's shoulders and are held together with a clip at the child's chest. The lap belt slides through loops at the bottom of the vertical straps, and buckles across the child's lap in just the way it was intended to be used. In use, CARES resembles a flight attendant's restraint. Snugged down, it keeps the child from flopping forward, or sliding under the seat belt. It resembles the flight attendant's restraints – but is portable.

My family looked at the pictures I had drawn and my husband advised me to see a patent attorney. I did. Remarkably, no one had ever patented anything like it. Eighteen months later I was the holder of patent # 6,402,251, an aviation child restraint designed specifically and exclusively for use on airplanes for youngsters old enough to sit front facing in their own seat.

I took my drawings to CAMI. Although Mr. Gowdy had categorically rejected harnesses based on his earlier tests, he acknowledged that this device, because it affixed the child directly to the airplane seat and used the existing lap belt in the way it was intended, across the child's lap, was different than anything they had seen or tested He encouraged me to develop a prototype and initiate an FAA certification process. He warned me this might be a long process, since the existing certification process was automotive based, and my device was nothing like a car seat. He was right.

I licensed my patent to Amsafe Aviation, the Phoenix based company that makes 90 percent of the aviation lap belts in America as well as pilot and flight attendant restraints and other equipment exclusively for the aviation industry. Amsafe built a prototype, assessed airline interest, and undertook developmental testing with instrumented ATDs (crash dummies) that demonstrated that the product worked as well or better than a certified car seat. They named the product AMSAFE CARES (child aviation restraint system) and, delighted that the device performed as we hoped it would, initiated the first FAA certification of an aviation-only child restraint.

The FAA certification of CARES was 4 year long process with numerous fits and starts. In September, 2006, the FAA issued a press release announcing the first aviation-only child restraint they had ever certified. It was for children 22-44 lbs in their own airplane seats; weighed 1 pound; fit in a small stuff sack that could be carried in a purse or pocket; installed on any size airplane seat in 1 minute; could be used in any seat in the row; and in extensive dynamic tests had proven to keep the child as safe as a car seat. Furthermore, parents had the right to use it for their children, and to prevent them from doing so was a violation of federal regulations.

The next phase of child safety in airplanes began to unfold.

Part 5: CARES Hits the Skies

This is the fifth part in a six-part series on the history of child safety restraints in vehicles by Louise Stoll, the managing director of CARES

On September 7, 2006, the FAA announced the certification of CARES - the first ever "aviation-specific" child restraint they had ever certified. The certification was robust. While airlines were not required to provide the restraints to small children, no airline was permitted to keep a parent from using a CARES. Furthermore, CARES could be used in any seat in the row – not just the window seat to which car seats were restricted (they block egress of other passengers in the event of an emergency).The certification was for all phases of flight: taxiing, take off, turbulence and landing, and covered all US commercial planes as well as General Aviation (private planes), helicopters, and even gliders.

The Press announcement was carried by hundreds of newspapers, radio and TV stations, including the international press and a 10 minute segment complete with an airplane seat and a CARES draped over it by the travel editor on the morning Today Show. The phone began to ring at Kids Fly Safe headquarters – a small office in the inventor's home. Hundreds of CARES were ordered over the very basic Kids Fly Safe website in the first weeks as a professional retail business began to take shape. It was 8 weeks before product was available and a warehouse system in place. The first CARES flew around Thanksgiving in 2006.

The original Kids Fly Safe website was simple – a few pages of print, a few photos, and an ordering page connected to our warehouse. Articles in the press and on the air proliferated. The FAA mandated annual update training for all flight attendants and pilots soon included a training module about CARES, and the approval of CARES was stated clearly in the updated Flight Manual found in the cockpit of every plane in the US commercial fleet. CARES was pictured and described on the official FAA website, "Traveling with Children", as the only child restraint permitted on planes beside a car seat. Little by little the complaints from early users that they weren't being allowed to use CARES because "flight attendants hadn't heard about them and they didn't look like a car seat" dwindled. Over 10,000 CARES were sold in the first 12 months. The Mommy Blogs began to chat.

A year after CARES was certified by the FAA, Australia and New Zealand allowed CARES on their planes, and shortly after that Canada, and then the UK and Switzerland and Israel. At about the same time, Kids Fly Safe, still operating only as a web site, began to get requests from "bricks and mortar" stores to sell CARES - the first one in Burlington, VT close to home, the second one south of San Francisco near the airport, the third one in New York City. It wasn't long before stores all over the country were calling – seems customers came in asking for it and urged the shopkeepers to comply. People were discovering how easy it was to stuff a CARES in a diaper bag for the plane trip and check the car seat through if the grandparents didn't already have one at the other end of the trip.

Parents of multiples discovered how easy it was to fly with CARES; and parents of youngsters with disabilities figured out that a CARES provided upper body support to their kids so they didn't have to make special arrangements with the airlines months in advance each time they flew to bring a brace for their child – CARES worked for them and it was already certified and allowed on the plane! Children with disabilities who are over the weight and height limit of CARES can now also use CARES if they sit in a bulkhead seat, a breakthrough in mobility for many families.

Over 90,000 CARES have been sold since it was certified. CARES can now be purchased in stores and through dozens of websites across the US and Canada; in The United Kingdom, France, Norway, Holland, Germany, and other European countries, in Australia and New Zealand, Singapore, Malaysia, Japan, Okinawa, South Africa and Dubai. It is not only sold to customers but it has become a significant item in children's equipment rental stores around the world. American Airlines sells CARES through its own Museum Store and the web pages of some airlines click through to the CARES website..

But the elephant in the closet is an important one to air. If a parent wishes her small child to have a safe seat - one that protects the child in the event of unexpected turbulence or a rough landing – the seat belt alone does not suffice. Airlines should be required to hand out restraints to little passengers just like they are required to hand out extender belts to extra large passengers who couldn't otherwise buckle their seat belts. You have all seen it happen! It's a no brainer. Of course they should!

The National Transportation Safety Board (NTSB), the safety watchdog agency for all forms of transportation, is holding a national conference on the topic of Aviation Safety for Children on December 9, 2010 to discuss this very matter. There is sympathy on that board for requiring the airlines to provide a safe seat for every passenger. This would mean:

No more lap kids - every child in his own seat
An age- appropriate restraint for every passenger: for the babies under 12 months this means a back facing reclining child seat; for children 1 to 4 or 5 years old, it means a 20 lb car seat…. or a 1 lb CARES.

Stay tuned for a report of what happens at the NTSB conference!

Part 6: Should Child Restraint Devices be Mandatory in Planes?

This is the sixth part in a six-part series on the history of child safety restraints in vehicles by Louise Stoll, PhD, former Assistant Secretary, US Department of Transportation

The National Transportation Safety Board (NTSB) — the US “watchdog” over all mass transportation — held its first ever conference on the topic of Child Aviation Safety in aircraft in Washington, DC on December 9, 2010. This kicked off a yearlong effort by the Board to promote child safety across all modes of transportation.

The role of the NTSB is to investigate major transportation incidents, from multiple- automobile freeway smashups to train wrecks to injuries from severe turbulence and crashes in aircraft. The NTSB then makes recommendations to remedy the problems that cause these accidents to the appropriate operational department of the Department of Transportation.

Sitting front and center on the auditorium floor in the conference room were two airplane seats. In one was a “three year old” child mannequin in a typical 20 pound car seat. In the other was a similar child mannequin in the one pound “buckle and belt” CARES child aviation restraint – the airplane-specific child restraint the FAA certified a little over four years ago.

The morning session of the conference included opening remarks by Deborah Hersman, chairman of the NTSB, a video on child safety — including vivid graphics of instrumented “child dummies” in airplane seats rolling down a track, in simulated turbulence and untoward landings — and two panels of speakers. These included Rick DeWeese - FAA Civil Aerospace Medical Institute; Nancy Claussen - FAA Air Transportation Division; Patricia Friend - Association of Flight Attendants; John Meenan - Air Transport Association; Kathleen Vasconcelos - Aircraft Owners and Pilots Association Air Safety Foundation; and Mary Gooding - CEO of Virgin Atlantic.

NTSB Chairman Hersman stated the NTSB position bluntly: “Safety for our smallest travelers should not be considered optional or a luxury.”

While the panelists all recognized the need for improved safety for the youngest fliers, only Mary Gooding could speak from the platform of actually providing such safety. Virgin Atlantic has long provided child restraints for its youngest passengers, and requires that they be used. Pat Friend reiterated the flight attendant union’s position: child restraints for young children should be mandatory.

“As flight attendants we are required to secure all items in the cabin, galley, and lavatories - from carry-on bags to coffee pots….because we are trained that in an emergency, loose items can be dangerous flying through the cabin. A lap held child has the potential to be one of those loose items that may not only suffer injury to themselves, but also injure others.”

While the FAA panelists acknowledged the danger to — and of — lap children, the agency has yet to mandate that every passenger must fly secured in his or her own seat in an “age appropriate” restraint. Their argument — not made with much conviction and challenged by many experts in transportation — is that if parents were required to purchase seats for the youngest fliers, some number of families would opt to drive to their destinations because of the extra cost: and the risk of injury is greater in a car than in a plane.

This so called “diversion theory” was rebutted by the NTSB throughout the morning in various ways. The NTSB noted that there are numerous destinations to which families could not, or would not drive, such as a weekend destination hundreds of miles away; or to Puerto Rico from New York. They cited statistics that show that drivers with children in their car drive more safely and have fewer accidents than the generalized statistics used in the FAA analysis. In the days after 9/11 for instance, and during an earlier pilot strike when airplanes also didn’t fly for several days, more families took to the road - but the accident rate did not increase.

Then the discussion turned to matters of practicality and money.

Today, children in the US under the age of two fly at no cost if they sit on a parent’s lap – but pay full fare if they are in their own seat. In addition, if they are too young for the seatbelt to provide sufficient protection, parents must bring their own child safety restraint on board or fly knowing their child is not as well protected as they are. The point was made many times that infants in automobiles are REQUIRED by law in nearly every state to be buckled into rear facing car seats in the back seats of automobiles until they are at least one year old, then in front facing car seats until the age of 4 or 5. The NTSB believes that the parameters relating to seatbelts in cars should also apply to children in airplanes.

The NTSB urged the FAA to prohibit lap children on airplanes and to require that every child be in his or her own seat in an age appropriate, FAA approved child restraint. Until the child is 4 or 5, he or she has no prospect of being able to brace effectively in the event of turbulence or rough landing. If the NTSB had its way, babies would be in back facing car seats until they could sit upright, and in front facing car seats or an appropriate child restraint until they could reach the seat in front of them to brace effectively if needed.

The discussion, naturally, moved to cost and responsibility: who should provide the child restraints on the plane? Who should pay for the extra seat if lap kids are no longer permitted? Several panelists and the NTSB noted that today all airlines are required to hand out extender belts to very large passengers for whom the seat belt would not otherwise fit – and that was the model they foresaw for child restraints. The NTSB also urged the airlines once again to offer reduced price fares to young children to encourage parents to purchase a seat for them.