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Dr. Michael Narvey, neonatologist and Vice President of Canadian Pediatric Society, challenges the validity of pre-discharge car seat testing. After leading Canadian work resulting in nationwide abandonment of the test in 2016, he argues the test doesn't represent real-world conditions (potholes, movement) and lacks evidence demonstrating it saves lives from apnea or desaturations. Based on 50 years of autopsy data, rare car seat-related deaths result from unsupervised asphyxiation when infants slide down onto straps—not from events in moving vehicles. Narvey distinguishes between eliminating the test versus maintaining essential car seat safety education, emphasizing proper positioning and avoiding unsupervised use outside vehicles. Some US centers are reconsidering this practice.

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