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Best Car Seats for Preemies of 2024

Keep your preemie safe in their car seat.

Not all car seats are made to accommodate premature babies. If your baby was born earlier than expected, you might have figured out that there are some specific features you’ll need to look for in a car seat.

We’ve been there, so we understand the overwhelming feelings that come with having a preemie. The last thing you want to be doing when it’s nearly time to bring them home from the hospital is shopping for a car seat.

We’ll help you understand what to look for by explaining the safety features that affect preemies in car seats. We’ll even share our recommendations of the best car seats for preemies to make the process fast and easy for you. We’ll keep it short and sweet, so you can get back to caring for your little one.

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Product Comparison Table

Product Image of the Evenflo LiteMax 35
Designed for Comfort
Evenflo LiteMax 35
  • Ergonomic handle
  • Machine-washable fabric
  • Four recline positions
Product Image of the Chicco KeyFit 30
Easiest to Install
Chicco KeyFit 30
  • Easy-to-adjust harness
  • Removable inserts
  • Uses EPS foam in the shell
Product Image of the Peg Perego Primo
Lightest Seat for Preemies
Peg Perego Primo
  • Offers great protection
  • Short and compact handle design
  • Super lightweight

How to Choose a Car Seat for a Preemie

How 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.

However, not all car seats have weight restrictions as low as 4 pounds, so you’ll have to pay careful attention to weight ranges as you shop.

Weight Restrictions

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

While shopping, ensure the weight limit begins at a minimum of 4 pounds. That 1 pound may not seem like a major difference, but you’d be surprised how it could affect their safety.

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, watch for extra support.

If they 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 ensure 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 seat’s base, keeping your baby more secure.

They’ll also prevent the chest clip from resting on your preemie’s face or throat, a 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 2024

Let’s take a look at the three best car seats for preemies. Each has a minimum weight limit of 4 pounds and includes extra protection and padding, so they’re suitable candidates for your preemie.

Evenflo LiteMax 35 Car Seat

Designed for Comfort

We love this one because it’s designed to be comfortable for you and your baby. It has an ergonomic handle to make carrying easier and cozy head support for your fragile 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 ensure 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. The head and body pillows are both removable, and you can wash the seat pad in the washing machine.

The seat comes with up-front harness adjustment and is compatible with several travel systems. The base has four 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, carrying will be much more comfortable.

Easy to Install

We also like how easy this seat is to install. The belt lock-off system ensures a secure fit and makes your job as easy as possible. You only need 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 can 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 to 35 pounds
Height Restrictions 17 to 32 inches
Additional Add-Ons Removable inserts
Care Instructions Machine washable pad, dry on low
Recline Positions Four

Our Ratings

Safety Features
4.5 / 5
3.5 / 5
5 / 5
5 / 5
Total Rating
4.5 / 5

User Experience

I'm thrilled with this car seat, which I got at an excellent price, and it even came with a base. It's compatible with the Evenflo Reversi lightweight stroller from Walmart, so you can easily switch between the car seat and the stroller seat as your baby grows. The car seat is lightweight, safe, and comfortable - it even protected my 9-day-old newborn during a rear-end collision. As a bonus, the intuitive design made installation a breeze, and the load-bearing leg extends the life of the car seat, saving me money in the long run.

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.

You can use the seat’s one-pull harness adjuster with one hand to make securing your baby easier. It’s also compatible with all Chicco strollers.

For extra comfort, the Zip Air version of this seat has an all-season cover 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 with 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 in preventing frustration when getting your baby in and out. Plus, having straps that are easy to adjust will ensure you get the best fit for your infant.

Great for Any Season

We like the warm cover feature of the Zip Air and the mesh canopy. The padded blanket-style cover will keep your baby warm in the winter, and the canopy will keep them cool in the summer.

Removable Inserts

The removable inserts are nice, too. Your preemie will need them for a while, but it’s good that you can remove them when your baby grows older.

Uses EPS Foam in the Shell

Safety is a major priority for us, so we love that this seat is 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

The Cover May Get Stuck While Pulling the Seat Out

Parents generally like this seat but have complained the cover gets stuck on the base when taking the car seat in and out. To avoid this, ensure 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 your baby’s safety.

Product Specs

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

Our Ratings

Safety Features
5 / 5
4 / 5
4.5 / 5
4.5 / 5
Total Rating
4.5 / 5

Personal Perspective

My experience with this car seat has been fantastic so far. The side buttons for the handle are a major improvement from the top button on my previous Graco, and the padding feels comfortable and secure. Installing the base was a breeze, and I appreciate the storage spot for the user manual. The straps are easy to adjust and the overall look is even better than the photos suggest. Another important aspect is the safety; after reading countless positive reviews about this car seat's performance in car accidents, I feel confident in trusting it to protect my precious little one.

Peg Perego Primo Viaggio Car Seat

Lightest Car Seat for Preemies

This seat is super lightweight at just under 10 pounds and comes with great safety features and convenient add-ons. You can use the Viaggio car seat until your child reaches 35 pounds.

The car seat base uses the “Right Tight” system, locking it in place with either the LATCH system or a 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. The side impact protection has six adjustable positions.

Perforated EPS foam lines the shell to provide excellent protection and good air circulation for your baby. The seat also has a dual-stage cushion system that 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 in your vehicle. The dual-stage cushion system is also nice for ensuring 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 has ripped through the back seat fabric. This seat has a specific rounded design that’s meant to prevent that from happening.

Short and Compact Handle Design

We also like the handle design on this one. Because it’s short and compact, it makes getting your 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 be inconvenient to get your arm through.

Product Specs

Weight Restrictions 4 to 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

Our Ratings

Safety Features
4.5 / 5
4.5 / 5
4 / 5
4.5 / 5
Total Rating
4.25 / 5

Community Feedback

Got this car seat and was instantly impressed with its sleek design and high-quality materials. Unlike other car seats that resemble overstuffed pillows, this one has a refined look reminiscent of an Italian sports car. The straps are conveniently hidden and easily adjustable, making it a breeze to secure my little one. However, I was annoyed by the excessive warning stickers plastered all over the seat. After spending some time peeling them off, the car seat looked as stylish as it was intended to be.

Product Comparison Chart

Product Award Weight Restrictions Height Restrictions Add-Ons Instructions Recline Positions
Evenflo LiteMax 35 Designed For Your Comfort 4 to 35 pounds 17″ to 32″ Removable inserts Machine washable pad, dry on low 4
Chicco KeyFit 30 Easiest Seat to Install 4 to 30 pounds Up to 30″ Sunshade Machine washable fabrics, air dry 5
Peg Perego Primo Super Lightweight 4 to 35 pounds 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 aren’t usually 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 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 retake it. Your doctor may even require you to use a car bed to take them home. If your baby is sent home in a car bed, you’ll need to repeat the test before doing 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 monitors 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 if their breathing and heart rate don’t change during the test. Here are a few quick tips to ensure your child has the best shot.

  • 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 your 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 them 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 that you know if it’s properly reclined.
  • Don’t take the test right after a feed: Give your baby some time to digest the breast milk or formula to reduce any reflux possibilities.


How Do You Travel Safely With a Preemie?

Traveling safely with a preemie involves ensuring they’re in a car seat that supports their smaller size and fragile health.

Look for car seats with lower weight minimums and good recline angles to keep their airways open. Always follow the car seat’s instructions and consider additional newborn inserts for support.

Do Premature Babies Need Special Car Seats?

Premature babies often need car seats designed for lower weights and smaller sizes. These seats typically offer additional head and neck support crucial for preemies’ safety and comfort.

It’s also beneficial to choose a seat with an adjustable base to ensure the correct recline position.

How Should a Preemie Sit In a Car Seat?

A preemie should sit in a rear-facing car seat that’s reclined appropriately to keep their airway open, typically at about a 45-degree angle.

Ensure there’s no slumping over and that the harness straps are snug and positioned correctly over the shoulders and between the legs.

How Long Should a Preemie Sit In a Car Seat?

It’s generally recommended to limit car seat time for preemies, particularly for long journeys, due to their vulnerability.

Keep journeys as short as possible and take frequent breaks. Some experts suggest not exceeding one to two hours at a time in a car seat for very young or preterm babies.

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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.