by Anya Dunham, PhD
Why feeding baby in a car seat is never a good idea – and what you can do instead.
If you’ve been around this space or read Baby Ecology, you know I often say that in parenting, there is rarely a solid justification for the black-and-white, the one-right-thing, the “should”, or the “never”: usually, there is a range of good options from which you can choose what works best for your baby and your family (like the ONE approach). Well, this is one of the exceptions: feeding baby in a car seat is never a good idea.
Don’t give your baby a bottle or snacks – even soft squeezable pouches – when she’s strapped in a car seat. The reclined position of the car seat and the motion of the vehicle increase the risk of aspiration and choking - a life-threatening medical emergency where the airway becomes obstructed. It is possible to choke on soft food, and unlike gagging, choking is usually silent.1 Even if you notice the moment your baby begins to struggle, and even if you aren’t the driver, there is really no safe way to quickly help a choking baby in a moving vehicle. This is very important.
If you have a bucket-type car seat, it may be tempting to remove it from the vehicle and feed your baby in it at a rest stop, using it as a makeshift baby seat or high chair. However, reclining in a bucket-type seat is not the best feeding position: in addition to, once again, a higher risk of choking because of the recline, the shape of the seat tilts baby’s pelvis and can put pressure on her esophagus, making eating uncomfortable.2
Take your baby out of the vehicle and out of the car seat and give her an opportunity to stretch, play, and move freely for a bit. During long car journeys, safety experts and car manufacturers generally recommend that babies should not be in a car seat for longer than 2 hours at a time. I have also seen the American Academy of Pediatrics (AAP) referenced to back up this advice, but could not find any specifics among the AAP recommendations (apart from important information on preemies and travel described in a box below). The advice to take breaks certainly makes sense: babies’ position in car seats is optimized for safety in case of an accident (the most important aspect), but is not optimal when it comes to movement and stretching. In addition, babies overheat more easily in car seats.
If you’re bottle-feeding, take your baby out of the car seat and cradle her against you. Some of the long-term benefits of breastfeeding have been attributed to the nurturing and close contact — the touching and gazing — breastfeeding provides9; mothers and babies tend to touch and look at each other less during bottle-feeding than during breastfeeding.10 Yet, you absolutely can develop a close, nurturing feeding relationship when bottle-feeding formula. Cradle your baby against you so she can see your face, feel your touch and feel comfortable so she can eat well. Moms, dads, and other committed caregivers can follow this approach.
When feeding solids on the go, you can hold your baby on your lap or have her sit independently in front of you if she has the core strength and interest. Another option is to bring along a travel highchair, especially if it’s something you envision using at your destination.
And even during travel, remember to feed responsively: provide a safe and comfortable spot to eat, offer nutritious food, and then let your baby decide how much to eat.