What should I do when traveling by car with a premature infant?

Do you have a premature baby and don’t know how to travel with your baby by car? The first thing to bear in mind is that each case is different and many factors need to be considered when choosing the best way to travel with a premature baby by car. In this article, we give you a few basic recommendations but you must follow your doctor’s or midwife’s instructions.It is not the same for a baby to be born one month than two or even three months before the due date.

When is a baby considered premature? As indicated by the World Health Organization (WHO), a child is said to be premature when born before 37 weeks of pregnancy.In general terms, a pregnancy lasts 40 weeks.It is estimated that 15 million children are born prematurely each year. In other words, more than 1 in 10 babies are born prematurely. Premature babies are not fully prepared for life outside the womb. In fact, they get cold more easily and may need more help to feed themselves than children born at full term. Because their bodies are not yet fully developed, they may have trouble breathing and suffer other complications, such as infections.

As stated on many occasions, babies must travel in an approved child restraint system adapted to their height and weight from the moment they leave the hospital and travel in a vehicle. The regulation is clear on this matter.Therefore, given the special circumstances of premature babies, you might ask yourself how they should travel.

All babies should travel in a  semi-reclined position. This is especially important for premature babies. Therefore, child restraint systems for the youngest babies, such as 0 and 0+, have reducers.

Reducers are designed for babies from their first journey and up to a maximum weight and height usually indicated by the manufacturer.With this system, they will travel in a more horizontal and secure position, as reducers provide enhanced ergonomics.Naturally, babies must always travel facing backwards for the first 15 months. At Fundación MAPFRE we recommend using car seats that allow the child to travel facing backwards for as long as possible and up to a minimum of 4 years old. 

However,  if the baby is premature and has breathing problems, it is best for him or her to travel in a lie-flat position.In these cases, you must use baby car cots and bassinets.In these, the baby tends to be not as well secured, although there are currently special devices to solve this problem.In this case, the baby travels lying down and perpendicular to the direction of travel.You must ensure that the baby’s head is positioned in the central area to avoid risks in the event of a side impact.

It should be noted that a semi-sitting position can have a negative impact on premature babies and cause apnea or even developmental problems.Apneas are small breathing stops of at least 20 seconds, and depending on their frequency and duration they can pose a serious risk to the child’s health. In fact, it is also not advised for a full-term baby to spend a lot of time in a car seat. Therefore, we recommend stopping every hour and taking the baby out of the car seat.

If a premature baby requires monitors, oxygen or other instruments, he or she must travel with them. Although there is no suitable system for securing portable medical equipment, they must be securely fastened or even anchored.

The choice between these two systems will depend on each particular case. Therefore, we must talk to a neonatal specialist about the baby’s circumstances  and the best way to travel. If using a car cot or a bassinet, you should bear in mind that although they may be the most suitable option for a newborn, they offer less protection in the event of a traffic accident. Therefore, we recommend avoiding all unnecessary trips while the baby needs to use a car cot.

What you must never do, under any circumstances, is to travel with the baby in your arms or without a child restraint system.Bear in mind that in the event of a traffic accident, the child may be crushed or even thrown out of the vehicle. A mother’s arms will never hold a baby as tightly as a child restraint system can.

When securing the baby it is essential that the car seat is  correctly positioned, either with a seat belt or with an ISOFIX system.The manufacturer’s specifications should be followed to avoid any mistakes.The same applies when fastening the harness , which must be tight but not suffocating.Ideally, you should be able to insert two fingers.

Next, you must make sure that the newborn is properly positioned in the reducer.He or she must have his or her back fully supported and his or her head in the right place.The baby should not be able to move around in the CRS and the baby’s buttocks should be supported by the bottom of the car seat.You should never travel with a baby if you are not sure that the child restraint system is properly installed and that the baby is properly secured. 

Given all the above, it is important to acquire your car seat in a  specialized store where they can explain all the guidelines and solve any doubts.In most of these stores, they will show you how to properly install the car seat and secure the baby.

Finally, we insist on the importance of following your paediatrician’s or neonatologist’s instructions when deciding the safest way for your baby to travel.