Yesterday, my 8 year old daughter was very upset about our demands that she stay in a booster seat when riding in a car. Her main concern was that most of her friends parents didn't make them ride in a booster seat. My family is vertically challenged, and I explained to her that she needed to be 4'9" in order to wear the belt alone. We even went to the American Academy of Pediatrics web site to show her that I wasn't making this up (she doesn't care that I am an associate professor at a medical school) and I let her try using a seat belt alone in the garage to demonstrate how the belt was practically against her neck. Regardless, she stated that this was not fair, and that even some of her friends who were as tall or even shorter than her were allowed to ride without a booster.
Coincidentally, the AAP's journal Pediatrics (not yet available online, but data via Medpage Today) released a study today updating information regarding the use of booster seats in childre 4 to 8 years old. They collected data for over 9 years including 7,151 children in 6,591 crashes. Most kids (70%) were using a seatbelt alone (no booster). The study found that serious injury including concussions, brain injuries, internal organ injuries, spinal cord injuries, and extremity fractures occurred in 1.15% of children; 1.36% of those wearing seatbelts and 0.67% of those in boosters. or double the risk of serious injury with seatbelt alone. Most of the injuries were head injuries and children wearing seatbelts alone had over double the risk of suffering abdominal injuries.
Thus, this study reaffirms the need to keep young children in booster seats until they are tall enough to wear a seat belt alone, which is at 4'9" which occurs sometime between 8 to 12 years of age. It's not that my daughter minds the booster so much. However, she feels like a "baby" when her friends are allowed to ride without a booster. Parents, (especially my children's friends parents) please keep your kids in booster seats until they are 4'9".