Picking out the right car seat is an important decision for every new family, but it appears that a lot of American parents aren’t taking traffic-related deaths — the leading cause of death among children in the United States — too seriously. A recent study conducted by researchers from the Oregon Health & Science University has revealed that a lot of new parents are making serious mistakes when it comes to strapping their newborn into a car seat.

“Car safety seats are much more difficult to use correctly than they should be,” said lead researcher Dr. Benjamin D. Hoffman, in a statement. “Vehicle and car seat manufacturers must work together to develop systems that are easier for consumers to use and understand. Further, health systems should provide resources and support both before and after birth, especially to the most vulnerable infants, to ensure the safe use of car seats.”

Hoffman and his colleagues surveyed 291 families that had been discharged from the hospital with a healthy newborn between November 2013 and May 2014. Researchers asked parents to position their newborn in the car seat and install the car seat if they already didn’t do so. Certified car safety technicians were called in to evaluate each set of parents’ positioning and installation of car seats while making notes and corrections for all instances of misuse.

Technicians found that 95 percent of parents made at least one error in car seat positioning and installation while 91 percent made a “serious error.” Even among the 15 percent of parents who worked with a technician, 83 percent still had at least one error in use. Some of the most common errors committed by parents included loose harness and car seat installation, low chest clip, and incorrect recline angle. Factors that influence improper car seat use among parents included lower socioeconomic status, lower educational attainment, and non-English primary language.

According to the research team, car accidents resulted in around 8,500 infants requiring hospitalization and emergency department visits and 135 infant deaths in 2013. They estimate that car seats can reduce risk for infant death and injury by 71 percent when used properly. Although the researchers urged all new parents to work with certified car seat technicians before they’re discharged from the hospital with their newborn, they did recognize that some of the blame falls on car seat manufacturers for not making their products more user friendly.

Back in Jan. 2014, the Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) announced its proposal to upgrade child car seats to improve survival and injury rates among side collisions, or “T-bone” crashes. In that same year a Centers for Disease Control and Prevention Vital Signs report showed that motor vehicle deaths among children had been reduced by 43 percent over the past decade due to both car seat developments and Buckle Up! campaigns.

Source: Hoffman B, et al. Handle with Care: Car Seats and Newborns. The Journal of Pediatrics. 2015.