Choosing the right car seat is an important task for every expecting parent. But for families who are expecting a premature arrival or a tiny newborn, this decision can be extra intimidating! Lots of infant car seats advertise that they work for a four-pound baby. But in reality, some of these car seats just don’t fit well. So, how in the world do you comb through all the options to find the best one?! Which is the safest car seat for my preemie? Well, we asked a car seat expert with years of NICU experience to help narrow it down.
The Best Preemie Car Seats
What makes a good preemie car seat?
Most of the infant car seats available today advertise a 4lb minimum. But what seats actually work for a baby that tiny? According to Sandy, a NICU nurse and CPST as well as a member of the Safe in the Seat safety squad, the best car seats for preemies share a few important features. Read on to get the scoop on seats for preemies.
Low harness height.
We know that our rear-facing infants need the harness straps to come from at or below shoulder level. But some infant and convertible car seats don’t have low enough harness settings to fit a teeny tiny torso. For a car seat to fit a four to five-pound baby safely, it should have a harness slot lower than 5” from the bottom of the car seat.
Close crotch buckle.
The crotch buckle between the baby’s legs is super important to help keep the baby’s body from slumping down in their car seat. If there is too much space between the diaper and the crotch buckle, a baby’s bottom will slide forward until it reaches that buckle strap — which can cause lots of problems, like a dangerous chin-to-chest posture or allowing the harness straps to wind up higher than the baby’s slumped shoulders. While many car seats allow caregivers to place a rolled washcloth between the baby’s diaper and the buckle to prevent this slumping, we would rather stick to car seats with a crotch buckle setting very close to the backrest of the car seat so that this intervention isn’t needed!
Lots of infant car seats offer a “no-rethread harness,” which is a convenience feature that lets parents adjust the harness height by moving a headrest up or down (instead of manually rethreading the straps through different slots in the shell). The problem is that most seats with a no-rethread harness have a big, non-removable headrest that can push babies’ heads forward in the car seat. For bigger babies, this may not be an issue — but for preemies who already have tiny airways (and maybe even breathing concerns), we want a nice, flat backrest so that their head can rest back in line with their torso. This usually means we avoid no-rethread infant car seats when thinking about preemies!
Most infant car seats offer a nice deep recline, somewhere around 45 degrees, to help newborns keep their heads back and their airways open. A car seat with a recline mechanism that is simple to adjust makes it easy for parents to keep their baby’s car seat at the maximum safe recline level until their little one is old enough to handle a more upright posture in the car.
Believe it or not, this is the least important feature on the list! We get it; lots of parents want a seat with cushy-looking inserts — especially for a tiny preemie who might look like they’re swimming in their car seat without an insert. But the most important factors to keep any newborn, preemie or not, safe in the seat are their harness fit and a properly installed and reclined car seat. Inserts are just a bonus! That said, some car seats have required or optional inserts to help with harness fit and posture for the tiniest passengers. And we know how tempting it can be for parents to purchase unsafe, added head inserts or other products out of fear for their child’s car seat fit. So we also consider which car seats include inserts that really help improve the harness fit for the smallest passengers!
The Best Car Seats for Preemies
You didn’t think we’d give you a whole list of car seat considerations and leave it at that, did you? Of course we have a list of seats that meet the conditions to fit preemies, IUGR babies, or any tiny newborn safely. Our Infant Car Seat Buying Kit is our best resource for expecting parents, with a whole list of car seats that provide an excellent fit on tiny babies — as well as help for choosing the best one!
We’ll also include some of our top preemie car seats below!
- Weight range: 4 – 22lbs
- Height range: 17 – 29”
- Retail price: $70
This amazing little infant car seat is one of the least expensive options on the market, but it’s one of the best for preemies! With three crotch buckle settings and a harness height of only 4”, this car seat can be adjusted to fit the tiniest of babies beautifully. Less is more with this seat: it doesn’t include any infant inserts or extra padding. But thanks to the amazing harness adjustments, these items aren’t needed!
To keep costs low for consumers, this seat lacks some of the features you’ll see on the other seats on this list. The base doesn’t have a recline adjustment (though it fits well without needing adjustments in most vehicles!) and the NurtureMax is not compatible with any stroller systems at this time. But it also has some really great features considering the price — like a lightweight shell, one-handed carry handle adjustment and cute color options to suit anyone’s taste. And thanks to the price point, this is Sandy’s favorite car seat to recommend to preemie parents who find themselves with a different car seat that doesn’t fit their preemie safely — it works so well that it’s a great bet to bridge the gap until baby can fit safely in a different seat, or to keep on using all the way until it’s outgrown!
- Weight range: 3 – 35lbs (with approval from Evenflo)
- Height range: 17 – 32”
- Retail price: $100 – $140
The second Evenflo seat on our list has one critical feature: It’s approved for babies as small as three pounds. Three. Pounds! While that sounds impossibly tiny, some ambitious NICU graduates are ready to head home before they hit the four pound minimum for other car seats. With a highly adjustable harness that can be fitted to the tiniest babies, the Litemax line is the best option for parents whose new additions fall into that category.
The Litemax line offers a few more features than the bare-bones NutureMax, such as stroller compatibility and different infant inserts (which can vary for different specific versions of the Litemax line of car seats). And as the name suggests, it’s lightweight and easy to carry! This car seat has a large front-to-back footprint, though — and it requires 1.5” of clearance between the car seat and the front vehicle seat when it’s installed on a side seat in the back of your car, so it’ll take up even more space. In a vehicle with limited back seat depth, proceed with caution when considering this otherwise, it’s a great seat!
- Weight range: 4 – 35lbs
- Height range: 32” or less
- Retail price: $160
This car seat is a newer addition to the market. And the more we see it out in the wild, the more we love it — especially for preemies! It provides some impressive high-end features, like supportive newborn inserts and an extendable canopy, at a mid-range price point. While its lowest harness setting is a bit higher than we prefer to see when we’re discussing preemies, the well-padded body insert included with this car seat helps boost tiny babies up to achieve a proper harness fit.
We also love that the insert is designed to promote good head positioning, thicker behind the baby’s torso and thinner behind the baby’s head so that the baby’s little noggin isn’t pushed forward by any extra padding. This seat is also impressively small front-to-back. So it’s a good choice for smaller vehicles, and its cover is made with recycled materials. What’s not to love about that?!
This car seat is compatible with Century brand strollers. But at this time, no other stroller brands offer adapters to allow a Century infant car seat to be used with different stroller options. And while the base has an adjustable recline, we don’t love that it has a recline line instead of an easy-to-read dynamic recline indicator — something we’d wish to see at this price point. But where it matters, this seat is a clear winner!
- Weight range: 4 – 30lbs
- Height range: 30” or less
- Retail price: $230 – $260
This tried-and-true infant car seat is a classic, and it’s easy to see why! The KeyFit 30 is extremely easy to use and adjust. And it features supportive head and body inserts that help improve the fit on even the smallest of babies within its weight range. While we appreciate the highly adjustable harness options on some of the other seats on this list, we also appreciate that the KeyFit 30 manages to provide an excellent harness fit straight out of the box — with fewer adjustments to do and undo as the baby grows, it may be easier to ensure that the KeyFit 30 is being used correctly throughout its lifespan. And the intuitive latch system on the KeyFit 30 base, along with the bubble recline indicator, makes it easy to get a solid install in no time.
The KeyFit 30 carrier is heavier than any of the earlier options on this list. And another common complaint is that the canopy is small and doesn’t provide great coverage. But it’s narrow and compact, so it can work well in many small backseats. It’s also compatible with a wide variety of stroller brands with the appropriate adapters. This car seat comes in several “trim levels” that offer different features on the same seat platform — the ClearTex fabric line meets federal flame retardant requirements without any added chemicals, while parents of winter babies might be interested in the cold weather boot that comes with the Zip and Zip Air options!
- Weight range: 4 – 35lbs
- Height range: Up to 32”
- Retail price: $230
This is the first and only car seat on this list that features a no-rethread harness! Like we mentioned before, this convenience feature can cause problematic chin-to-chest head positioning in small newborns — but if this feature is a top priority for a preemie parent’s infant car seat, then this seat is our favorite option! In fact, less expensive Graco infant car seats with a rethread harness tend to have a worse newborn fit than their higher-priced products. (If you’re curious, this is because Graco’s infant seats with rethread harnesses tend to leave a lot of space between baby and crotch buckle, leading to a slumpy posture.)
So, amongst Graco infant car seats, this is our favorite — we appreciate the way the headrest provides nice support while the newborn insert helps improve the harness fit and prevent slouching or head slump. Plus, the base is super easy to install with Graco’s signature SnugLock technology. And the anti-rebound bar on the base is a great above-and-beyond safety feature!
Caregivers should be aware that this car seat carrier is quite heavy, at nearly ten pounds. And while the head wings provide nice side support for newborns, some parents complain that their bigger babies’ heads start to look squished as they grow during that first year. We also want to point out that Graco’s product line can be challenging to navigate, with a lot of different car seats that have similar names and what seem like few differences. We’ve specifically included this one because its insert style and harness fit make it our favorite Graco selection for preemies!
6. Clek Liing
- Weight range: 4 – 35lbs
- Height range: Up to 32”
- Retail price: $459 – $489
This premium infant car seat is our pick for luxury-minded parents who want a well-fitting seat for a tiny new addition. With a hefty body insert and uniquely styled head insert, as well as an ultra-low harness height, the Liing offers an excellent fit starting at four pounds without requiring any complicated harness adjustments. We adore that ease-of-use factor! The Liing’s base is also one-of-a-kind. Letting parents adjust the recline to suit their baby’s weight after installing the base in the car — a feature only available on a handful of car seats at any stage.
Between this recline adjustment, rock-solid rigid latch install system, and energy-absorbing load leg, the Liing combines advanced safety features and ease of use in a way that we haven’t seen in any other car seat on the market. And it offers a European belt path. Which adds stability and minimizes movement when this car seat is installed without its base. Plus, it’s compact and narrow, fitting well in small spaces. What’s not to love?
Of course, we recognize that the price point is a huge barrier for many families (and that’s why we’ve made a point to include our favorite preemie-friendly seats to fit any budget!). And while the cover is removable for washing, it’s a bit more cumbersome of a process than the other seats on this list. But otherwise, we can’t think of many things we dislike about the Liing!
Safe from that first ride home
For parents with a preemie, a newborn with IUGR, or any other health complication, it can be extra daunting to pick the right car seat. We hope that this list helps you narrow it down — and if you need more details on these seats or more help with this important decision, check out our Infant Car Seat Buying Kit. Better yet, grab the Infant Bundle so you can choose the right seat AND know how to use it properly like a pro! With the right seat adjusted to achieve the right fit on your baby’s teeny tiny body, your sweet little addition will be safe from their first ride home.
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