Skip to Content

What is positional asphyxia and how to avoid it

What is positional asphyxia and how to avoid it


As humans, we go from being suspended in a state of "weightlessness" for a short period of time inside our mother's womb thanks to the amniotic fluid, to facing Earth's pull for the rest of our lives.

When a newborn first faces the force of gravity, his/her body is not sufficiently developed yet to undertake functions as basic as sleeping in a non-horizontal position safely.

This must be taken into account when placing the child in a car seat. It is very important to do so correctly, with the correct posture and with the harness correctly fastened to prevent the child's body from doubling over onto itself and hindering breathing. This is known as positional asphyxia or restraint asphyxia.

When the full weight of the body is shifted forward, the rib cage cannot expand to take a breath, the diaphragm cannot work and, if the head is also hanging forward, the trachea closes, resulting in asphyxia within a few minutes.

In 2001, Pediatrics magazine published a study of 100 babies, 50 of which were born prematurely at 36 weeks, where all of the babies were monitored in car seats for 60 minutes. After that period of time, blood oxygen levels dropped from 97 percent to 94 percent on average (normal values are between 96 percent and 100 percent), and in seven cases, levels reached as low as 90 percent. Twelve percent of the premature infants also experienced apnea or bradycardia.

All of this is exemplified by a family who is in the media a lot and whose story has spread like wildfire on the internet. The Dodd family lost their second child, Shepard, before he was three months old due to positional asphyxia.

They left their son at daycare and one of the caretakers put Shepard down for a nap in the car seat his parents had brought him in. The right thing would have been to put him down to sleep in a crib, or any available horizontal surface. Unfortunately, that is not what happened.

Now the Dodds have undertaken the commendable task of publicizing their story to help other families, by raising awareness about the risks that can be posed by leaving a child in his/her car seat longer than necessary and how to avoid such situations.

The recommendations are very clear:

  • Although a child may look very comfortable in the car seat, the seat should only be used in the car and never for long periods of time.
  • Don't use the car seat as a place to put your child down for a nap.
  • When you put your child in the seat, make sure that the restraints hold his shoulders securely against the back rest so that he/she can't lean forward.
  • On long trips, take regular breaks to allow your child to recover his/her normal posture and breathe properly.


Back to top