The safe transportation of infants has formed a critical part of public health policy for many years. Clearly crash tolerance of the seat, the ease of installation, the position of the seat and the relative position to airbags has been the focus of intensive research. However as with all safety devices, there are some limitations. Respiratory instability is a potential concern due to the upright position in the car seat. This is particularly true in the premature newborn and has resulted in the recommendation to perform car safety seat testing before discharge from hospital for these infants.