What is the car seat challenge test?

You may be anxious to get your baby out of the hospital and on the way home, but there are a few things you may need to do before that can happen. The car seat challenge test is meant to make sure your baby is ready to leave the hospital. This test is done for a variety of reasons, but its purpose is to test your baby’s breathing (respiratory function) while riding in a car seat.

When in a car seat, your baby will be laying at an angle. This can cause some infants to have trouble breathing. Not all babies will need to go through the car seat challenge test. The car seat challenge test is most often given to premature babies who are smaller than a full-term baby at the time of discharge from the hospital. It may also be done if your baby has hypotonia (Down syndrome or congenital neuromuscular disorders), micrognathia (Pierre Robin sequence) or has undergone congenital heart surgery.

Who has to do the car seat challenge test?

Your baby may need to do the car seat challenge for several reasons, including:

• If your baby is less than 37 weeks gestation.
• If your baby has a low birth weight — less than 5.5 pounds (2,500 grams) at birth.
• If your baby requires oxygen at the time of discharge from the hospital.
• If your baby is demonstrating decreased muscle tone.
• If you baby has a heart condition.

Why does my baby need a car seat challenge test?

The car seat challenge test is used to identify infants who are at high risk for respiratory or airway problems when in their car seats. This test is used to make sure your baby is ready to leave the hospital and can safely travel home without any medical issues.

What do I need to do before the car seat challenge test?

Before the test can take place, there are few things you will need to prepare. Make sure you, your partner or a family member brings:

• A fully assembled car seat up to the hospital room. Make sure the car seat is not expired and is appropriate for your baby. You should only use car seats that are designed for infants weighing 20 pounds or less (rear-facing car seats). This should be the car seat you are taking your baby home in.

When will the car seat challenge test be done?

The car seat challenge test will be done before you take your baby home. The timing of this test can change because it’s done on premature babies and those with other medical conditions at birth. If your baby is close to 37 weeks premature, the test may be done within a few days of birth. If your baby is several weeks premature, and needs to stay in the hospital for a longer period of time, then the test will not happen till the baby is older and ready to go home.

How long does the car seat challenge take?

This test typically takes 90 to 120 minutes. In some cases, your healthcare provider may extend the test to match the length of your trip home. Talk to your healthcare provider about the length of your trip before starting the test.

How is the car seat challenge test done?

Once you have your car seat in the hospital room, a nurse will start the test by placing your baby properly in the seat and hooking up a few monitors. These monitors include:

• A pulse oximeter.
• Three small patches (electrodes).

A pulse oximeter is a small device shaped similarly to a bandage, which is wrapped around a foot or wrist. Its job is to check on the amount of oxygen in your baby’s blood throughout the test.

The electrodes are small patches that monitor your baby’s breathing (respirations) and heart rate. These patches will be placed on your baby’s chest.

For the next 90 to 120 minutes, your baby will stay in the car seat with the devices attached. Each of these devices will send information to your healthcare provider throughout the test. Once the time has passed, your provider will look over the information and discuss the results with you.

What happens after the test if my baby passes?

If your baby passes the car seat challenge, the nurse will teach you how to correctly position your baby in the car seat. Make sure to ask your healthcare provider if you have any questions about your car seat. Once you are in your car, you may want to have an adult ride in the back seat next to the baby. This is just to make sure the baby does not have any problems during the trip and if there are any issues, the adult can reposition the baby quickly.

What happens after the test if my baby fails?

If your baby fails the car seat challenge, the test will probably be repeated later. Your healthcare provider may also talk to you about different options for transporting your baby home. One option is a type of car seat called a car bed. This allows your baby to be secured in the car in a flat position instead of sitting at an angle.