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Before using this Child Restraint for preterm or low birth weight infants, ensure the
Child Requirements are met and follow the guidelines in this section.
According to the National Highway Trafc Safety Administration (NHTSA), a properly
installed Child Restraint reduces the risk of death by over 70% for infants involved in
crashes. Federal Motor Vehicle Safety Standard (FMVSS) 213 establishes design and
dynamic performance requirements for Child Restraint systems. However, the standard
has no minimum weight limit and does not address the special medical needs of preterm
or low birth weight infants. To ensure that preterm and low birth weight infants are
transported safely, the guidelines published by the American Academy of Pediatrics (AAP)
in Pediatrics 2009;123:1424–1429 (reafrmed June 2018) must be followed.
Preterm and low birth weight infants are at additional risk of breathing difculties and
heart problems when placed in a Child Restraint. CYBEX requires that the evaluation
recommended by the AAP be conducted for all infants born earlier than 37 weeks and all
newborn infants who weigh less than 2.26 kg (5 lbs) at birth before their rst car trip to
check for breathing difculties or heart rate problems when traveling in a REAR-FACING
Child Restraint. Newborn infants should NEVER travel in a FORWARD-FACING Child
Restraint.
The AAP recommends that appropriate hospital staff observe your infant in the Child
Restraint for a period of 90 to 120 minutes or the duration of travel, whichever is longer.
This period of observation must be performed with the infant properly positioned as
described in these instructions and with the Child Restraint placed at an angle that is
approved for use in the vehicle. The hospital staff will check for any breathing difculties
or heart rate problems. Your child’s pediatrician will let you know if there are any special
Child Usage Guidelines
Premature Infant Use
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