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With the hottest days of summer upon us, advocates for children’s safety want to reinforce the risks of leaving infants and young children in automobiles.

The number of child deaths in cars nationally last summer, 2010, reached 41 by Sept. 1 – the most on record.

John Peter, M.D., an emergency medicine specialist at SSM Cardinal Glennon Children’s Medical Center in St. Louis and professor at Saint Louis University School of Medicine, notes that one reason for the trend of more infants and children being left in cars is related to placing car seats in the back seat.

Dr. Peter notes that a recent study at San Francisco State University (SFSU) found that of nearly 500 deaths from 1998 to 2010, 51 percent were cases where the child was “forgotten” by the caregiver – usually a parent.

While it’s difficult to imagine anyone could “forget” a child, Dr. Peter says that placing the child in a car seat in the back – the safest place in the event of a collision – creates an out-of-sight, out-of-mind situation, especially for very busy parents.

“We all lead hectic lives,” Dr. Peter says. “You place the child in the back seat and are thinking about your daily tasks, you arrive, get out of the car; go into the store and suddenly it occurs to you – I forgot my child.”

Safety experts urge busy parents to recognize the potential – however remote it may seem – and to take steps to minimize any risk.

“Parents can develop their own strategies; some put reminders on their smart phones to make sure a child was dropped off at day care,” Dr. Peter says. “It seems obvious that one would take the child out of the car – but it’s important to be aware that problems occur.”

Other safety checks include placing a stuffed animal on the front passenger seat when an infant is placed in back. A bag of diapers can be substituted.

Another approach: a verbal cue. Parents can get in the habit of saying “child” when they get out of the car, as a verbal reminder.

The SFSU review found that the second leading scenario leading to death – nearly one third of cases – involved a child playing in an unattended vehicle. Dr. Peter urges parents and grandparents to lock parked cars at home in driveways and in the garage.

“Many children get into trouble because they are playing and get into an unlocked car and then can’t get themselves out,” Dr. Peter says. “Sometimes they get into the trunk and become overwhelmed by the heat.”

The third leading situation of deaths – 17 percent – was found to be those where a child was intentionally left, potentially by parents who believed they were only making a quick stop and that the child would be fine. Such situations might result in even more deaths, Dr. Peter notes, but fortunately the parent returns in the nick of time to prevent death, but perhaps not serious illness.

And sometimes children intentionally left and are spotted by bystanders who call 911.  Dr. Peter noted one study found nearly 1,500 “near miss” situations in a single year reported by locksmiths.

Even if a child does not die in a hot car, they can quickly suffer serious health consequences including brain damage. Dr. Peter explained that infants in particular do not “thermo-regulate” as efficiently as adults, and increasing their susceptibility to hyperthermia or heat stroke.

Dr. Peter cites the often-repeated warnings that cars heat up quickly in the sun. On a typical 90-degree day in summer, the car interior would be unbearable within a few minutes, but even on a mild day, the danger remains.

Taking measures such as cracking windows does not help – the temperature will still rise in sunlight, he continues. “There are no quick fixes for this,” he says. “You can’t say you’ll just be in the store for a few minutes, or you’ll leave the windows open. Just don’t do it.”

He suggests that parents, especially those with infants and very young children, take time to learn about the hot car dangers and other life-threatening risks, so they can avoid tragedy.

 “It’s an important topic because children die every year from this, and some don’t die but suffer serious health consequences. And that’s just the children. The emotional impact on the families having lost a child is devastating.”

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