Even for short car trips, buckle children up; it’s a matter of life and death: KKH doctor

SINGAPORE - Minutes after a woman removed a crying two-month-old baby from the car seat, their vehicle collided with another.

The baby was in the woman’s arms but suffered a brain bleed from the impact and had to undergo neurosurgery.

The incident happened in 2025 and the child is still undergoing neuro rehabilitation at KK Women’s and Children’s Hospital (KKH).

KKH senior consultant Ronald Tan said this illustrated how being held by a caregiver does not protect young children from serious injuries in an accident.

And with KKH seeing about 400 children injured in road traffic accidents annually, its injury prevention working group started the hospital’s child car seat clinic and newborn car seat programme.

Traffic deaths hit a 10-year high in 2025, with 149 people killed, compared with 141 in 2016. The number of people injured also rose from 9,342 in 2024 to 9,955 in 2025.

Given the dire situation on Singapore’s roads, The Straits Times has been running a series of stories calling on all road users to be more careful.

Dr Tan, who chairs the KKH injury prevention working group, said most of the injured children they treated were not in any form of restraint at the time of the accidents. Referring to the baby, he said: “This was one of the worst-case scenarios for a young child, whose life trajectory is now altered because of this very preventable injury. It affects the whole family, given the stress and guilt they experience.”

He called on parents to ensure that every child is buckled up properly with the right car restraint for every journey, no matter how short it is. “That one simple act is the most powerful step you can take to protect their future. It can mean the difference between life and death,” he said.

Data from the National Trauma Registry showed that 80 per cent of children aged nine and below who were involved in vehicular accidents between 2015 and 2024 were not using car seats.

This is despite laws which require children under 1.35m to be properly secured in a vehicle.

Only taxis are exempt from this, as passengers might not be able to request a child car seat if they flag down a taxi.

Drivers who fail to properly secure children in their vehicles can receive three demerit points and be fined $150. If convicted, they can be fined up to $1,000, and jailed for up to three months.

A KKH study on the use of car seats found that parents did not know how to properly install one. Some found it inconvenient to use.

To remedy this, KKH started its car seat clinic in 2021. Held at the hospital’s carpark thrice a year, trained staff teach parents how to correctly install a car seat, and how to secure their children in it.

Ms Elisa Ong, 39, attended one session in April.

The user interface designer said she had just bought a $700 car seat for her four-month-old son, Aiden, but was unsure if she had installed it correctly. She also has a three-year-old daughter, who rides in their car strapped into a RideSafer Travel Vest.

The vest is an alternative to child seats.

She said: “I thought it was important for my child to be properly secured in a car seat because of the increasing number of road traffic accidents.”

In 2025, the hospital introduced a newborn car seat programme, where KKH loans a car seat to parents of children born in the hospital for a year. Dr Tan said KKH worked with the Traffic Police, Komoco Motors and Mothercare to develop the programme.

After the child’s first birthday, parents who return the car seat will receive a subsidy for their next car seat purchase.

The programme has, so far, benefited more than 350 families.

Head injuries

Dr Tan said head injuries are the most common among children involved in traffic accidents. These include blunt head injuries, skull fractures and brain bleeds.

“A seat belt is supposed to protect a person by spreading the force of a crash over the strongest parts of the body, which are the shoulders and the hips. If there is no seat belt or car seat, the child may get flung within, or even out of the car.”

In September 2021, a two-month-old girl died after her father, who was driving, made a discretionary right turn along Tampines Avenue 10. A motorcyclist, who had the right of way, but was estimated to be going at 97kmh to 129kmh, collided into them.

The girl was held by her mother, who was in the back seat. She was flung out of her mother’s arms and died that day. The father was fined $5,000 for driving without due care, leading to an accident that killed his daughter. 

Besides car seats, Dr Tan noted, it is also important to use age-appropriate restraints.

He said children should use an adult seat belt when they are about 1.4m tall. The lap belt should fit across the upper thigh and the shoulder belt should be across the chest.

He once saw a child who came into KKH’s children emergency department with a bruise across his abdomen.

Said Dr Tan: “He looked well and could walk. But we evaluated him further and found he had ruptured his intestines and needed surgery. This would have been prevented if he had been in a booster seat.”

Dr Tan said he has seen too often how a child’s life can change in a single moment.

He said: “Every time we treat a child with life-altering injuries, it’s a stark, heartbreaking reminder that this could happen to any family. The most difficult truth is that so many of these devastating injuries, and even deaths, are entirely preventable.”