Showing a link to decreased oxygen levels, a recent study concludes babies should never be allowed to sleep in car safety seats when the seat is not in a car.

According to Dr. Christine McIntosh and her colleagues from Auckland University and the Cot Death Association, a child's time in such car safety seats should be kept to a minimum.  Previous research showed that placing a simple foam insert in the car seat that had a slit for the back of the child's head served to reduce mild breathing problems in babies.

Because babies' heads are larger (relative to their body) than adults' heads, they protrude behind the line of the back.

The insert, which is available commercially, helps to keep the baby's body forward.  The insert also allows the head to remain upright even when the infant is asleep, rather than slumping forward, which also can obstruct breathing.

The journal Pediatrics published the results from a larger study which confirmed that using the insert reduces breathing risks for babies who were (on average) eight days old.  However, this device does not eliminate the risk that car seats pose.

When comparing sleep studies in two groups of 39 babies each, researchers noted those who car safety seats had the inserts had fewer instances of breathing being stopped because of a blocked airway.  They also had less severe reductions in oxygen saturation levels than the non-insert group.

"This study also highlights the importance of not using car seats as a place of sleep for infants," noted Dr. McIntosh.  "Sudden unexpected deaths in infants can occasionally occur in car seats (and) capsules.

In the published journal article, the scientists not that car safety seats are essential for the safe transport of infants in cars, but they expressed concern at the amount of time infants were reported to be spending in the car seats.  Often this time was more than 30 minutes a day, and frequently for sleep outside of the car. 

"There is now compelling evidence that hypoxia (oxygen deficiency) is associated with behavioral problems and adverse effects on development and school performance," concluded Dr. McIntosh.  "We believe that caregivers should be strongly advised that car seats should not be used for infant sleep outside the car."

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