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What is the Car Seat Test for Preemies?


Updated June 10, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Most preemies must pass a car seat test before discharge.

Most preemies must pass a car seat test before discharge.

Photo courtesy of J. C. Heygood
Question: What is the Car Seat Test for Preemies?
Answer: The American Academy of Pediatrics recommends a car seat test, or car seat challenge, for all babies born before 37 weeks gestation. The car seat test makes sure that premature babies are able to sit in a car seat safely, without any episodes of desaturation, apnea, or bradycardia.

Why Do Preemies Need a Car Seat Test?

Premature babies may have a variety of medical conditions that make a car seat challenge necessary. Their airways are weaker than the airways of full-term babies, and may collapse when preemies are placed in the semi-reclined position that car seats use.

In addition, babies who were born early have a greater risk of oxygen desaturation, apnea, and bradycardia than full-term babies. The semi-reclined car seat position can increase the number of episodes that preemies may have.

Read More: Car Seat Safety for Preemies

What Happens During a Car Seat Test?

During the car seat test, a premature baby is securely fastened into a car seat. The baby's own car seat should be used whenever possible. The car seat will be placed at the correct angle for riding in the car, and the baby will be buckled into the car seat just like he or she would be during an actual car ride. Regular NICU monitors will be used to measure the baby's heart rate, breathing, and oxygen saturation during the car seat test. If the baby will be going home with an apnea monitor, that monitor may be used instead.

A car seat test should last for at least 90 minutes. If the baby has no episodes of apnea, bradycardia, or desaturation during the car seat test, then he has "passed" the test.

What Happens if My Baby Fails the Car Seat Test?

If a baby fails the car seat test, then the test will be repeated after a few days have passed. Babies who fail the car seat challenge repeatedly may need to ride in a car bed, a type of car seat that allows them to lie flat while riding in the car.


Bull, Marilyn MD and Engle, William MD. "Safe Transportation of Preterm and Low Birth Weight Infants at Hospital Discharge." Pediatrics May 2009. 123; 1424-1429.

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