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What should I do and what should I not do when traveling by car with a premature baby?

¿Qué debo hacer y qué no cuando se viaja en coche con un niño prematuro?


Do you have a premature baby and don't know how to travel by car? The first thing to bear in mind is that each case will be 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 some basic recommendations but you must, of course, follow the indications of your doctor or midwife. It is not the same to have been born one month before than to have been born 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, 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 we have seen 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 about this. Therefore, due to the special circumstances of premature babies, you might ask yourself the question of how they should travel. 

All babies should travel in a semi-lying down position, this is especially important for premature babies. Therefore, child restraint systems for the youngest group, such as 0 and 0+, have reducers. Here we talk about this system in length. These reducers are designed for babies from their first trip 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 it provides enhanced ergonomics. The baby 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 difficulties, it is best for him/her to travel lying down completely. In these cases, you must use baby carrycots and bassinets. In these, the baby tends to be less 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. We must ensure that the head is positioned in the central area, to avoid risks in the event of a side impact. 

Keep in mind that the semi-seated position can affect a premature baby and cause apneas 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 inadvisable that a full-term baby spends a lot of time in a car seat. Therefore, we recommended to stop every hour and take the baby out of the car seat. 

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

The choice of one system or another will depend on each case. Therefore, we must talk to the neonatal expert about the baby's conditions and the best way to travel. If using a carrycot or a bassinet, we must bear in mind that although they may be the most suitable option for the 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 travel cot.

What we must not do, under any circumstance, is to travel with the baby in your arms or without a child restraint system. Consider 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, we should be able to insert two fingers. 

We must then make sure that the newborn is properly placed in the reducer. He/she must have his/her back fully supported and his/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. We should never travel with the baby if we are not sure that the child restraint system is properly installed and the child is properly restrained. 

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

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

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