Regula celor 2 ore


The 2 hour rule is a concept recommended by all consultants and experts in Child Car Safety.

In this article we try to shed light on this very interesting topic and offer the medical explanation behind the technical recommendations.

An essential thing to keep in mind is that an unsuitable child seat or an incorrectly installed seat does not protect in the event of an impact or worse can become dangerous for both the child and the rest of the passengers in the vehicle.

Another thing that is less known is that babies and young children must be transported in these car seats for a period of time and that the car seat is used strictly in the donkey, not as a crib or seesaw in the house because the consequences of this inappropriate use can be extremely dangerous, being able to be responsible even for the death of the little one.

In 2014, a study was conducted that investigated 1,465 cases of sudden infant death. In 14 of these cases, the incorrect use of the car seat was clearly demonstrated as the cause of death. It may not impress your percentage, but in a dramatic situation such as the sudden death of an infant, a situation in which the cause is often unknown, these 14 deaths of clear cause mean a lot.

More recent studies have come up with even clearer results and useful conclusions for parents who need to understand how to properly use child car seats.

The American Academy of Pediatrics (AAP) has recommended that premature babies be monitored in the car seat brought by their parents to identify possible episodes of apnea, bradycardia, and decreased oxygen saturation. The test is called Infant Car Seat Challenge” and is widely used by maternity hospitals in the UK and other European countries.

Studies published in journals precu Pediatrics And The Journal of Pediatrics suggest that babies born prematurely have a higher risk of respiratory or cardiac complications when sitting in a car seat. This is due to the semi-sitting position imposed by some shells that can prevent the baby’s normal breathing, because babies breathe with the lower third of the lungs, and this position prevents normal breathing effort.

The “Infant Car Seat Challenge” test evaluates babies in a static car seat (ie sitting in the office, not in the car as it will actually be used), which means that this test does not take into account the vibrations produced. when the car is moving. A new study funded by Lullaby Trust (2016) evaluated the impact of movement and semi-sitting position on both premature babies and full-term babies.

In order to make the test as realistic as possible, a simulator capable of reproducing the vertical vibrations exerted on a seat installed with its back to the direction of travel at a speed of 50 km / h was built.

The researchers found during this study that both premature and full-term babies showed signs of potential cardiovascular damage when placed in a chair at a 40 ° angle. In short, when full-term newborns or premature babies sat in a chair at this 40 ° angle, their heart and respiratory rate increased, and their oxygen and blood saturation decreased. This is because young children cannot keep their head straight and therefore in a semi-sitting position the upper airways can become obstructed.

The negative effects were even more important when the angle in which the babies were placed was 40 ° compared to the angle of 30 °. This suggests that the semi-sitting position is a more dangerous risk factor than the length of time the child sits in the car seat.

 These side effects were discovered especially when simulating the movement and are not normally identified in the static test. It is an extremely important finding because it suggests that newborns who sit in a semi-sitting position for a period of time may suffer significant respiratory and cardiovascular disorders in the event of a short journey, such as 30 minutes.

However, these results should not scare you and make you not use car seats, but rather use them correctly and choose models suitable for the newborn, with as little curvature as possible, models that you can find here .

Another important recommendation made by doctors for parents is to avoid long trips without a break.

Dr Renu Arya of the Great Western Hospitals NHS Foundation Trust, Department of Pediatrics, makes the following recommendation: I support the recommendations of the American Academy of Pediatrics not to use car seats as a crib for children”.

  1. Belt tensioning

Make sure the seat is properly installed and the seat belts tight. If the belts are not properly tensioned, the baby may slip under them or the head may fall forward.

Never go on the road without making sure the belts are properly fastened.

2. The rule of 2 hours

Car Safety Experts Children and car seat manufacturers have all come to the common conclusion of setting a standard maximum travel time for babies. This is how the “Rule of the 2 hours” appeared.

This rule is not only valid for car seats, but for any type of sports stroller without a sleeping position, in which the child does not sit horizontally.

This recommendation is based on the above studies, but also on other observational studies. When the baby is in a semi-sitting position for a long time, his breathing may be affected and the correct development of the spine may also be affected.

Babies often fall asleep in the car, and this is okay as long as they are supervised. However, the car seat is not a safe place to sleep.”

To conclude, here are our recommendations based on the above data: for newborns (both full-term and premature babies):

  1. For newborn babies and premature babies, opt for car seats that have a position as close as possible to the horizontal, seats that you can discover HERE.
  2. Avoid traveling long distances in the first months.
  3. Always monitor small babies while driving.
  4. If you still have to travel a longer distance, take breaks in the first months at 30 minutes, then, after 6 months (when the baby starts to be able to sit) at 2 hours (2 hours rule).
  5. Make sure you stop the car safely (parking, gas station) and remove the child from the seat while stopping.

And finally, here are some general recommendations regarding baby sleep, recommendations also based on medical studies conducted in the United Kingdom and the United States of America:

 The sleeping position recommended by doctors is the horizontal lying position (on the back). The Lullaby Trust for tips on regarding the correct sleeping position in general: “Babies should always lie on their backs, not on their bellies or on one side.

Positioning your baby on his back for sleep (supine position) every night is one of the most effective measures you can take for a healthy and safe sleep.

There are clear data from studies in various countries that indicate that placing babies on their backs for day or night sleep significantly reduces the risk of sudden infant death (SIDS).”

After babies develop better and can roll, they will find a new favorite sleeping position.

 At this point you do not have to worry because the spine is already developed enough to support proper breathing and you should not force them to sleep on their backs. After growing up, it is ok to sleep on your tummy because they can already move on their own if they do not feel comfortable.

Babies should sleep on a firm, horizontal surface, on mattresses made of thermally inert materials such as coconuts and not in those “nests” (Baby Nests or Baby Pods) made of textile material that have begun to become more and more popular. (not recommended by American Academy of Pediatrics and banned in Canada because of the risk of suffocation and possible association with Sudden Newborn Death Syndrome).

This article takes information from the 2016 Study funded by The Lullaby Trust and conducted in hospitals: Great Western Hospitals NHS Foundation Trust, The University of Bristol and The University of Southampton.

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