Car seats don't prevent low oxygen in small babies

NEW YORK (Reuters Health) - Very low birth weight infants (less than 3 pounds, 5 ounces) traveling home from the hospital are just as likely to experience low blood oxygen levels and related problems whether they are placed in a car seat or a car bed.

"In 1990, the American Academy of Pediatrics recommended that all newborn infants discharged from hospitals should be transported in infant car safety seats," Dr. Walid A. Salhab, of the University of Texas, Southwestern Medical Center, Dallas, and colleagues write.

"However, 12 to 30 percent of premature infants have been reported to have episodes of (low oxygen levels and slow heart beats) while in car seats, and studies by (other researchers) suggest that a car bed can be adapted to accommodate very small infants," they add.

In the current trial, reported in the Journal of Pediatrics, the researchers examined whether 151 very low birth weight infant discharged home had fewer events when they were placed in a car seat than in a car bed. The infants were studied for 120 minutes in a car seat and then in a car bed. The team monitored the infants for low blood oxygen levels, slow heart beats, and periods of absent breathing.

Overall, 15 percent of infants had an event in a car seat, compared with 19 percent in a car bed. Six percent of infants in the car seat and three percent in the car bed developed problems that required the assistance of a nurse. The average time to first event was nearly the same in the car seat and as in the car bed, roughly 55 minutes.

"Whichever device is used, very low birth weight infants require observation during travel," the authors conclude.

In an accompanying editorial, Dr. James Greenberg, of the University of Cincinnati College of Medicine in Ohio, recommends advising parents "to limit the duration of automobile travel with these vulnerable offspring, as well as the importance of close observation. Long trips should be discouraged, or if unavoidable, interrupted with frequent rest stops."

SOURCE: Journal of Pediatrics, March 2007.