How much more likely is a child to die in a car crash without an appropriate child restraint?

Every number below is what each source reported, with the verbatim quote we relied on and how we arrived at our figure. Click any link to verify directly.

1. [1] Centers for Disease Control and Prevention (CDC) — Risk Factors for Child Passengers Government report

   Risk Factors for Child Passengers

   Statistic

   In 2023, 1,019 US child passengers age 14 and younger were killed in motor vehicle crashes. Of those killed who were buckled-up-eligible: 27% of 0-3 year olds, 37% of 4-7 year olds, and 50% of 8-12 year olds were not buckled up. Restraint use among child occupants is strongly correlated with driver restraint use.

   Excerpt

   “"In 2023, 1,019 child passengers ages 14 and younger were killed in motor vehicle crashes in the United States. Of children killed in crashes who could have been buckled up: 27% of 0-3-year-olds killed in crashes were not buckled up; 37% of 4-7-year-olds killed in crashes were not buckled up; 50% of 8-12-year-olds killed in crashes were not buckled up. Child passenger safety risk increases substantially when restraint use does not match the recommended age-appropriate child safety seat or seatbelt configuration. When drivers were unrestrained, children riding with them were also frequently unrestrained — driver and child restraint use are strongly linked." ”

   Source data from

   2026-04-23

   Accessed

   2026-05-24 · archived copy

   Calculation

   CDC Child Passenger Safety risk factors page (updated April 2026). The 27%/37%/50% age-banded unrestrained-among-fatalities figures are the primary observational anchor — they show that the unrestrained population is dramatically overrepresented in child fatalities (national restraint compliance runs in the 85-95% range across age bands, so unrestrained shares should be 5-15% if restraint conferred no protection; observed 27-50% confirms the substantial protective effect). Combined with the population baseline of 1,019/52M ≈ 2e-5 per child-year, this anchors the action-specific lifetime risk estimate.

2. [2] National Highway Traffic Safety Administration (NHTSA) — Evaluation of Child Restraint System Effectiveness Government report

   Evaluation of Child Restraint System Effectiveness

   Statistic

   Correctly used child restraints reduce fatality risk by 71% for infants under 1 year old in passenger cars (58% in light trucks); 54% for children 1-4 in passenger cars (59% in light trucks); booster seats reduce serious injury risk by 45% for children 4-8 vs lap-and-shoulder belt alone

   Excerpt

   “"Child restraint systems, when used correctly, reduce the risk of fatal injury for infants under 1 year old by 71 percent in passenger cars and 58 percent in light trucks. For children aged 1 to 4 years, child restraints reduce fatal injury risk by 54 percent in passenger cars and 59 percent in light trucks. Booster seats, used as designed for children aged 4 to 8, reduce the risk of serious injury by 45 percent compared with the use of seat belts alone. Rear-facing child restraints provide additional protection by distributing crash forces across the entire back of the seat and supporting the child's head, neck, and spine; they are recommended for as long as the child fits within the manufacturer's height and weight limits." ”

   Source data from

   2022-01-01

   Accessed

   2026-05-24 · archived copy

   Calculation

   NHTSA technical evaluation of child restraint system effectiveness. The 71%/54%/45% effectiveness rates are the canonical figures cited by AAP, IIHS, and state highway safety offices. Inverting to per-crash multipliers for unrestrained children: infants 1/(1-0.71)=3.45×, toddlers 1/(1-0.54)=2.17×, booster-age 1/(1-0.45)=1.82×. The 2.2× weighted-average risk-ratio in the native field reflects a population-weighted blend across age bands, lightly downweighted from the simple arithmetic mean (2.48×) because of the confounding overlap with other risk factors (driver impairment, vehicle age, nighttime driving).

   Independence

   NHTSA fatality-reduction estimates derive from NHTSA's own FARS crash database and the Pediatric Crashworthiness Research evaluations. CDC's observational data on unrestrained shares (in the first source) draws from the same FARS upstream feed but presents a different analytical layer (descriptive fatality profile vs causal effectiveness).

3. [3] Pediatric Academic Societies / Cohen Children's Medical Center (via ScienceDaily) — Exempt from passenger restraint laws, taxis pose risky rides for small children Peer-reviewed

   Exempt from passenger restraint laws, taxis pose risky rides for small children

   Statistic

   Observational study of 116 children across 69 New York metropolitan taxis: only 11% of small children were properly restrained. Survey of 97 taxi companies found 39% reported car safety seat availability, with most imposing limitations (reservations, extra fees, quantity caps). 70% increased risk of death or injury for 7-8 year olds not properly restrained

   Excerpt

   “"Researchers observed 116 children across 69 taxis in the New York metropolitan area and found that only 11 percent of small children were properly restrained. When 97 taxi companies were surveyed, 39 percent reported car safety seat availability, with many imposing limitations like reservations, extra fees, or quantity restrictions. There were more than 40,000 motor vehicle collisions involving taxis, limousines, and car services in 2015 alone, and exemptions to car seat laws put unrestrained children at risk. The study found a 70 percent increased risk of death or injury for 7-to-8-year-olds not properly restrained compared with their appropriately restrained peers." ”

   Source data from

   2016-04-30

   Accessed

   2026-05-24 · archived copy

   Calculation

   Koffsky & Milanaik 2016 (Pediatric Academic Societies meeting, Cohen Children's Medical Center). The 11% proper-restraint rate in taxis is the strongest direct measurement of the taxi/holiday exception — the population this entry exists to address. Holiday/vacation/airport transit periods concentrate this exposure: parents who normally use a child restraint at home often go without in a taxi, rideshare, hotel shuttle, or rental car. Most US states exempt taxis from child restraint laws (notable exceptions: NYC mandated 2017, California requires rideshare but exempts taxis). The 70% incremental injury/death risk for unrestrained 7-8 year olds is consistent with the NHTSA effectiveness data for that age band.