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Best Car Seats for Preemies of 2023

Weight restrictions, buckle placement, and extra padding can help keep your preemie safe in their car seat.

Did your little bundle of joy arrive earlier than planned? Are you trying to prepare yourself in case of premature birth? Whatever the case, it’s important to find the right car seat for your newest addition.

But how can you tell if a car seat is good for preemie babies? We’re going to go over everything you need to know, plus look at the top three seats for keeping your tiny baby safe in the car.

Our Top Picks

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Product Comparison Table

Product Image of the Evenflo LiteMax Infant Car Seat, 1 Count (Pack of 1)
Designed for Your Comfort
Evenflo LiteMax 35
  • Ergonomic handle
  • Machine-washable fabric
  • Four different recline positions
Product Image of the Chicco KeyFit 30 Infant Car Seat and Base | Rear-Facing Seat for Infants 4-30...
Easiest Seat To Install
Chicco KeyFit 30
  • Easy-to-adjust harness
  • Removable inserts
  • Uses EPS foam in the shell
Product Image of the Primo Viaggio 4/35, Licorice
Super Lightweight
Peg Perego Primo
  • Offers great protection
  • Short and compact handle design
  • Super lightweight

How to Choose a Car Seat for a Premature Baby

So, how exactly do you know a car seat will work for your delicate babe? The good news is, the hospital wouldn’t release you unless they knew the baby was doing well enough to go home.

With that being said, not all car seats go as low as 4 pounds with their weight restrictions, so you’ll have to pay careful attention to weight ranges as you shop.

Weight Restrictions

If your baby is less than 5 pounds at the time of discharge, you may run into an issue. A lot of car seats start at a minimum of 5 pounds so these won’t work for your tiny babe.

While shopping, make sure the weight limit begins with a minimum of 4 pounds. That 1 pound may not seem like a major difference, but you’d be surprised.

Infant Inserts and Padding

Infant carriers all come with some sort of infant support to keep your baby snug in the car. However, a convertible car seat may not. Many parents prefer starting with an infant carrier but if you’re looking at convertible seats, keep your eyes peeled.

If they do come with infant support, it’s usually in the form of infant pillows or extra inserts. Inserts that make the baby’s chest stick out further than their head are best because they stop the chin from pushing down onto the chest.

Strap and Buckle Placement

Check the lowest possible settings for both the strap and the buckle. You’ll need low settings to make sure the straps and buckle are properly placed against your child. Unfortunately, with preemies, it’s possible that even the lowest setting may be too big.

Shorter crotch buckles are also ideal. These sit closer to the base of the seat, keeping your baby more secure.

They’ll also prevent the chest clip from resting on your preemie’s face or throat, an obvious concern for their airways. Make sure the leg straps don’t have too much spacing either.

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The Best Car Seats for Preemies of 2023

Let’s take a look at the top three best car seats for preemies. Each has a minimum weight limit of 4 pounds, so they’re suitable candidates for your newborn.

1. Evenflo LiteMax 35 Car Seat

Designed for Your Comfort

We love this one because it’s designed for the comfort of both you and baby. The seat comes with an ergonomic handle to make carrying easier and cozy head support for your delicate preemie.

This one also saves your sanity: the base stays right in the car for easy installation and comes with an integrated belt lock-off system. This helps parents make sure the seat is installed correctly without wasting a ton of time.

It also comes with buckle pockets to keep the straps out of the way when getting your baby in and out. Both the head and body pillows are removable and the seat pad can be washed in the washing machine.

The seat comes with up-front harness adjustment and is compatible with the Sibby and INVIGOR8 travel systems. The base has four different recline positions to ensure your baby has the safest and most comfortable position.

What We Like

Ergonomic Handle

Anybody who has carried an infant carrier knows how uncomfortable they can be. With this seat’s handle design, though, carrying will be much more comfortable.

Easy to Install

Parents also like how easy this seat is to install. The belt lock-off system not only ensures a secure fit, but it makes your job as easy as possible. All you need to do is to feed the seat belt through and use the belt lock-off.

Machine-Washable Fabric

Machine-washable fabric should be a must on any parent’s list when looking at a car seat. Having a quick and easy way to clean the seat is an ultimate convenience, especially with newborns.

Four Different Recline Positions

We like this seat because it has multiple recline positions to choose from. You’re able to find the best position for your baby and adjust it as they grow. Generally, newborns will need to be as reclined as possible, but it’s nice to have the option to adjust when necessary.

What We Don't Like

Bulkier Than Other Seats

The only drawback to this seat is its bulkiness, which might be inconvenient if you have smaller vehicles. They’re also not all that fun to carry because of the extra weight, even if the handle is ergonomic.

Product Specs

Weight Restrictions 4–35 pounds
Height Restrictions 17–32 inches
Additional Add-Ons Removable inserts
Care Instructions Machine washable pad, dry on low
Recline Positions Four

2. Chicco KeyFit 30 Infant Car Seat

Easiest Seat to Install

This seat is one of four models offered by this brand. It comes with an easy-leveling system, level indicators, and a “SuperCinch” tightener to make installation easier. The easy-leveling system is meant to help you get the best angle while installing the seat’s base.

The level indicator uses two bubble levels so you can get an accurate angle when reclining the seat as well. The SuperCinch tightener is a force-multiplying LATCH tightener to help you get the best fit without much effort.

The seat’s one-pull harness adjuster can be done with one hand to make securing baby easier — it’s also compatible with all Chicco strollers.

For extra comfort, the seat has an all-season boot that safely drapes over your child to keep them comfortable no matter the weather. The mesh canopy vent also keeps them cool in the summertime.

Finally, there’s a removable head and body support that has reversible mesh and knit fabrics. The fabric is machine washable but should be air dried.

What We Like

Easy-To-Adjust Straps

Easily adjustable straps are really helpful to prevent frustration when getting your baby in and out. Plus, having straps that are easy to adjust will ensure that you get the best fit for your infant.

Great for Any Season

We like the boot feature as well as the mesh canopy. The boot will keep them warm in the winter and the canopy will them keep cool in the summer.

Removable Inserts

The removable inserts are nice, too. Your preemie will need them for a while but it’s good they can be removed when they grow older.

Uses EPS Foam in the Shell

Safety is a major priority for us, so we love that this seat comes lined with EPS foam. EPS is a polystyrene foam that absorbs energy well and disperses it in different directions to reduce impact.

What We Don't Like

Boot May Get Stuck While Pulling the Seat Out

Parents generally like this seat but have complained the boot gets stuck on the base when taking the car seat in and out. To avoid this, make sure the fabric is out of the way before removing or inserting the seat. It’s a little extra work for you, but worth it for the safety of your baby.

Product Specs

Weight Restrictions 4–30 pounds
Height Restrictions Up to 30 inches
Additional Add-Ons Sunshade
Care Instructions Machine washable fabrics, air dry
Recline Positions Five

3. Peg Perego Primo Viaggio Car Seat

Super Lightweight

This seat is super lightweight at just under 10 pounds and comes with great safety features and convenient add-ons. The seat can be used up until your child reaches 35 pounds.

The base of the car seat uses the “Right Tight” system, locking the base in place through either LATCH or seat belt. Color-coded belt paths on the base show you where to put the seat belt. It’s designed with a rounded bottom for an appropriate fit and to help save your vehicle’s back seat fabric.

Also included in the base is an integrated anti-rebound bar offering optimal impact protection. The seat’s shell is designed to accommodate low birthweight babies and the side impact protection has six different adjustable positions.

Perforated EPS foam lines the shell to provide great protection and good air circulation for your baby. The seat also has a dual stage cushion system which ensures proper positioning.

No rethreading is required when adjusting the seat positions, which is perfect for parents who love convenience. The handle is designed to be short and compact to help with getting the seat in and out of the car. The seat is compatible with most Peg Perego strollers.

What We Like

Offers Great Protection

We love how much protection this seat provides. With the deep shell and the adjustable side-impact protection, your preemie will be super safe going home. The dual stage cushion system is also nice for making sure your baby stays in the safest riding position.

The Rounded Design Saves Vehicle Fabric

Nobody wants to lift up a seat to learn that it’s ripped through the back seat fabric. This seat has a specific rounded design that’s meant to prevent just that.

Short and Compact Handle Design

We also like the handle design on this one. Because it’s short and compact, it makes getting baby in and out of the car much easier.

Super Lightweight

At 9.5 pounds, the seat’s lightweight feel is great since you’ll be carrying it around a lot. As little as your preemie will be when they come home, they’re going to keep growing. Your arms will thank you if you’re able to lift the seat once your infant starts getting heavy.

What We Don't Like

Canopy Is Inconvenient When Carrying

Some parents don’t like the canopy placement when they’re carrying the car seat. It only has one locking position so it can prove to be inconvenient when trying to get your arm through.

Product Specs

Weight Restrictions 4–35 pounds
Height Restrictions Up to 32 inches
Additional Add-Ons Anti-rebound bar
Care Instructions Spot clean only
Recline Positions Turning knob for infinite recline

Product Comparison Chart

Product Award Weight Restrictions Height Restrictions Add-Ons Instructions Recline Positions
Evenflo LiteMax 35 Designed For Your Comfort 4 – 35 lbs 17″ – 32″ Removable inserts Machine washable pad, dry on low 4
Chicco KeyFit 30 Easiest Seat to Install 4 – 30 lbs Up to 30″ Sunshade Machine washable fabrics, air dry 5
Peg Perego Primo Super Lightweight 4 -35 lbs Up to 32″ Anti-rebound bar Spot clean only Infinite recline

Car Seat Safety for Preemies

If you have experience with preemies, you know they may spend a significant amount of time in the NICU. Babies, in general, aren’t released from the hospital until they’re gaining weight steadily and have reached at least 4 pounds.

Before premature babies are released to go home, they must also pass a specific car seat test. The American Academy of Pediatrics (AAP) recommends testing babies born before 37 weeks in their seat for 90 to 120 minutes (1).

If your newborn fails the test, they may need to take it again. Your doctor may even require a car bed to take them home. If your baby was sent home in a car bed, you’ll need to repeat the test before any more travel.

The test will also be performed on infants who have a low birth weight or a pre-diagnosed medical condition. This test is meant to monitor the baby for apnea, bradycardia, or oxygen desaturation. These issues are common in babies born prematurely, so it’s important to catch them as soon as possible.

Passing the Car Seat Test

Your baby will pass as long as their breathing and heart rate don’t change during the test. To ensure your child has the best shot, here are a few quick tips.

  • Buckle them in the seat just like you would going home: This gives the doctors and nurses the most accurate reading. Straps should be snug and baby shouldn’t slouch at all.
  • Swaddle them during the test to help them sleep for the whole thing: Be sure to swaddle them over the harness straps rather than under, to prevent any safety issues.
  • Recline the seat as far as the manufacturer allows: Newborns need to be at a recline anyway to keep their airways open. You’ll find that manufacturers usually put a level indicator on their infant seats so you know if it’s properly reclined.
  • Don’t take the test right after a feed: Give baby some time to digest the breast milk or formula to reduce any reflux possibilities.

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Headshot of Mary Sweeney, BSN, RN, CEN

Reviewed by

Mary Sweeney, BSN, RN, CEN

Mary Sweeney, BSN, RN, CEN is an oncology nurse navigator and freelance medical writer. Mary has 4 years of experience as an officer in the Navy Nurse Corps. including emergency/trauma, post-anesthesia, and deployment medicine.