Background Motor vehicle accidents are associated with significant mortality and morbidity in adults and children. The annual number of accidents with injury in Singapore remained at over 7600 for the past 5 years. Child car restraints prevent death and lower the severity of injuries sustained in road traffic accidents.

Objectives The main objective of our study was to explore the knowledge, attitude and practice of parents of newborn babies regarding infant or child car restraints during their homeward trip from the hospital. The secondary aim was to evaluate the reasons behind non-compliance to infant and child car restraints amongst those who intended to travel home in a motor vehicle, and compare our findings with a systematic review of child car seat restraints.

Methods A 22-item self-administered questionnaire was completed by a convenience sampling of 200 parents of babies about to be discharged from a well-baby nursery in Singapore during the 4-month study period. Parents of babies who were admitted to the Neonatal Intensive Care Unit, transferred to other hospitals or passed on, along with unwell mothers, were excluded.

Results Out of 200 parents, 98.5% intended to bring their newborn baby home by a motor vehicle. Parental knowledge of the local legislation on child car restraints was generally high (74%), with the majority aware of the correct location (93.5%) and orientation inside the vehicle (72%). Although 106 parents were already in possession of a child car restraint, only 81 (76%) intended to use it for the homeward journey. The remaining chose not to because of a personal belief, misperception of risk and/or logistical difficulty. Ownership and usage of child car restraints was positively correlated with household income.

Conclusions The surveyed parents generally had a high level of knowledge regarding child car restraints. However, the misperception of need which led to inconsistent practice was worrying. A multi-faceted approach, including parental education and regulatory requirements, are important to increase compliance to child and infant car seat restraints in Singapore.