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I've been there. You do tons of research to pick the best car seat. You make sure it's installed correctly. The baby comes and things are going well. Then 5 or 6 months later, the baby is prescribed a helmet. You go through the whole process of getting the helmet and finally put the baby in the car with it for the drive home. And... does the car seat look strange? Wait - can he even move his head? Oh no.
When my older son, now 10, was prescribed a helmet, I hadn't even realized the car seat could be an issue - but I learned quickly that it could. Now as a CPST, I participate in two plagiocephaly/helmet facebook groups regularly, and I see that parents whose babies have a helmet are facing the same issues my son did.
I want to help.
What could be the problem?
The issue is that when a baby is wearing a helmet, certain car seats pin the head in place or press the chin down, both of which can affect breathing and oxygen saturation. Now to be clear, there are some car seats that do this even without a helmet. But the helmet, due to its added weight and size, usually makes this worse.
In general, most car seats that have a headrest that moves up and down do not work well with a helmet.
How do I know if my current car seat is ok?
I always tell people to try their current seat first. You never know, and you can always go a day or two without using the helmet in the car until your replacement seat arrives.
First, make absolutely sure it is adjusted correctly. For rear facing, the straps must be coming out of the seat at or below the shoulders. Also check that your seat is reclined correctly, according to the instructions.
Once you do this, take a good, fair look at the head positioning with the helmet on.
When the child is sitting in the seat, awake, strapped in, is the chin on the chest? Can the head lean back?
Can your child rotate the chin up and the head backward?
If your child falls asleep, will the chin be pressing on the chest?
Can your child turn the head side to side?
Remember, the question is not whether the baby can do these things independently. The question is whether the baby can do this in the car seat, harnessed correctly, with the helmet on.
Which car seats DO work well?
Let’s get right to it. What car seats DO work well?
The Evenflo Litemax 35 (without the optional head pillow) is fabulous for the helmet as it has a straight back.
The new Joie mint latch also has a straight back and works very well without the inserts.
The Nuna Pipa RX (without the inserts) and the Doona (without the head insert) are also excellent.
I’ve found the Chicco Keyfit 30 and Graco non-headrest seats are really hit or miss. The back of those seats is contoured and slightly crescent shaped, so it really depends on the torso height of the baby. Babies with a longer torso sometimes hit the contoured part of the seat, so the chin is pressed down. They are certainly worth a try if you already own one.
Should I just go right to the convertible seat now?
This might seem like a great idea. You’re going to have to get a convertible anyway, so why not just get one that works with the helmet?
The reason I tell people not to do this is that a convertible seat lasts from around age 1 (or whenever you begin using it) until about 6 or 7. But with most babies, the helmet lasts only a few months. There are many, many excellent convertible seats that have a headrest and aren’t compatible with the helmet. Would you want to base a purchase that will last you 6 years on something you need for a few months?
HOWEVER, there is a solution! You can get a less expensive or smaller convertible seat and then use it as a travel seat or spare seat afterwards. If you want to go this route, the Cosco Onlook, Evenflo Sonus, Cosco Scenera Next and Maxi Cosi Romi are all great choices.
CAN you use one of these as your regular convertible seat? Absolutely! The Onlook/Romi/Scenera Next are outgrown earlier than the typical convertible seat, and the Sonus takes up quite a bit of room front to back when rear facing. But these may very well be the convertible seats you want anyway!
The Diono Radian 3r is not a travel seat, and it can be extremely difficult to install and adjust. It’s not one I usually recommend, but I would feel remiss in not mentioning it as it’s completely flat up the back and does work very well with the helmet.
Is there some sort of insert I can add to my current seat?
Unfortunately, no. There is no car seat that permits an insert from a different manufacturer to be added. I have heard of some of the helmet places recommending this. The employees there are wonderful and make a huge difference in our kids’ lives, but they don’t have car seat training and are often unaware that extra inserts are not allowed.
Some technicalities
Two questions I often get asked:
Many car seats have what’s known as the “1 inch rule”, meaning that they are outgrown when the top of the head is less than an inch from the top of the seat. Sometimes I get asked if this is measured with or without the helmet. It should be measured with the helmet if the baby has the helmet on in the car seat.
Likewise, although the helmets are lightweight, I also get asked about weighing the baby for the car seat. The baby should be weighed with the helmet on.
Questions?
Any questions? Feel free to leave them in the comments below!
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