Childhood obesity has safety implications beyond the obvious health risks. For one thing, parents of obese children may find it difficult to find a car safety seat that is appropriate for their child's age and development yet will accommodate their weight or size. A study in a recent issue of Pediatrics, the journal of the American Academy of Pediatrics, projects that there are nearly 300,000 children whose age-weight combinations place them at risk for difficulty in obtaining an appropriate child safety seat. Three-year-olds who weigh more than 40 pounds are the largest group affected, the study says. In all, about 1 percent of children up to 6 years old are affected, according to the study.

The problem: Children between 1 and 4 years old typically ride in the forward-facing position of a convertible child safety seat, which usually accommodates children who weigh 20 to 40 pounds. Some obese children exceed 40 pounds or otherwise don't fit in these seats.

Belt-positioning booster seats typically accommodate children more than 40 pounds, but they're not intended for kids younger than 4 or for very active children because boosters typically rely on vehicle shoulder belts to keep children in place. Those belts don't prevent children from leaning forward or placing the shoulder belt behind their back or under their arm.

The answer: Parents can do one of two things, depending on their child. Some forward-facing car seats can be used with their internal harness for children up to 65 pounds. Below, we've listed numerous seats that claim to accommodate heavier children.

The other option for parents is to use a toddler-booster seat with a five-point harness. Many such seats are sold with harnesses. Consumer Reports recommends that any child younger than 4 years of age, even children who exceed the 40-pound limit, should not use a booster seat without a harness system.

Booster seats should be used until children are 4 feet 9 inches tall and are able to safely use an adult safety belt.


Recommendations

Car seats for obese children

The following seats are appropriate for obese children according to their manufacturer's specifications as most can be used with a harness and vehicle belt up to 65 pounds, or in two cases, 80 to 105 pounds.