6 Safest Car Seats For Preemies In 2024

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Written by: Fatima O. Millers, CPST

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When it comes to finding the best car seat for a premature baby, safety is of utmost importance. Preemies have unique needs that require special attention, and a car seat that is designed to properly support and protect their tiny and underdeveloped bodies. 

While we know it’s hard to predict having a premature or a low birth-weight baby, it’s a good idea to plan ahead if you are expecting multiples or if you have a history of preterm labor.  

Having a car seat that is also suitable for preemies can help ensure that your baby is safe and comfortable during car rides, regardless of their size at birth.

In this article, we will review some of the best car seats for preemies that provide comfort, safety, and convenience for both the baby and the parents. 

In a Hurry? Pick one of these

6 best car seats for preemies (Updated 2023)

Doona (Best Carseat-Stroller Combo for preemies)

  • Suitable from 4 lbs to 35 lbs
  • Carrier weight: 16.5 lbs
  • Dimensions: Folded: D23.6” x W17.3” x H26” 
  • Lowest harness position: 7” with insert 
  • Price: $550

This is a practical solution to have both a car seat and a stroller in one. The Doona allows you to switch from a car seat to a stroller and back again in just seconds. 

When transporting a preemie baby having the convenience of a car seat/stroller combo can be very helpful, particularly if meets their weight specifications. The Doona accommodates newborns starting from 4 pounds. 

The aluminum frame makes the Doona a sturdy, safe car seat stroller combo for your preemie baby. 

It also features an adjustable handlebar (also acts as an anti-rebound bar inside the car) and 3 Layer Side Impact Protection. 

When it comes to comfort, the Doona comes with a Bamboo Infant Insert and head Support that provides extra padding for your premature baby. Plus, the fabrics are hypoallergenic, breathable, and machine-washable. 

For travel lovers, this car seat is FAA-approved so you can fly with it with no issues and to make the car seat easier to transport, you can get the Doona Travel Bag (sold separately).

Key selling features

  • 5-point harness
  • LATCH base
  • Anti-rebound protection
  • Side impact protection
  • Aluminum Frame
  • Aircraft approved
  • Baby safe materials
  • Doona vehicle seat protector 


  • Great for traveling and short rides
  • Very comfortable for preemies
  • Easy to install and use


  • It has Flame Retardant
  • On the pricey side
  • It is heavy and bulky

Chicco Keyfit 30 (Best budget car seat for preemies)

  • Suitable from 4 lbs to 30 lbs
  • Car seat weight: Carrier – 9.5 lbs / Base – 7 lbs
  • Dimensions: D27” x W16.5” x H24”
  • Lowest harness position: 6” with insert 
  • Price: $229.99

The Chicco Keyfit 30 is a well-known infant car seat that requires no introductions. It’s hands down the best infant car seat on the market today for its price and features. And guess what? It’s also suitable for premature babies

It’s designed to comfortably fit babies weighing 4 pounds to 30 pounds. And it comes with an infant insert that you may remove as your baby grows. 

Installation-wise, Chicco’s base is equipped with a SuperCinch LATCH tightening system, making installation a breeze. The base also features Bubble level indicators and Recline Sure leveling foot for the perfect base angle.

The Chicco has the regular Kefit 30 with flame retardants and the Keyfit 30 ClearTex with no added chemicals. 

Key selling features:

  • 5-point harness
  • Energy absorbing foam
  • SuperCinch LATCH tightener
  • Integrated lock-offs
  • One-pull harness tighter 
  • Removable newborn insert


  • Removable head, body, and neck support
  • Comfortable fabric
  • Clicks easily into base and stroller


  • Heavier than most infant carriers
  • Canopy and handle flaw design
  • Belt installation doesn’t seem as secure

Britax B Safe Gen 2 (Best Great Fit Car Seat For Preemies)

britax b safe car seat for preemies
  • Suitable from 4 lbs to 35 lbs
  • Car seat weight: 10.9 lbs
  • Dimensions: D26.6″ x W17.9″ x H25.9″
  • Lowest harness position: 4.5 with head insert
  • Price: $269.99

Britax B safe Gen 2 infant carrier combines ultimate safety and comfort and that’s what your preemie baby needs. 

At around $200 you get a well-built car seat that provides a great fit for preemies and comes with tons of extra features. 

Britax B Safe Gen 2 accommodates babies from 4 to 35 pounds. Safety-wise, the seat features a protective shell with foam that surrounds the head, neck, and torso. Plus, the base is steel reinforced and the seat has full body protection.

Additionally, the Britax B Safe is made of SafeWash High-Performance and Fire Retardant chemicals free fabric and the infant padding is soft to the touch and can keep the little one hugged and cozy.

There is also a more pricer option, B Safe Gen 2 Flexfit that offers a no-rethreaded harness plus a European belt guide installation.

Compatible with any single or double Britax stroller that accepts a car seat. Plus, you have lots of premium stroller choices when using Britax car seat adapters. 

Key selling features

  • SafeWash fabric that can be machine dried
  • No added FR Chemicals
  • Compatible with many strollers 
  • Exclusive SafeCell LATCH
  • UPF 50+ Extra-Large Canopy
  • 1-Hand Harness Buckle Release
  • Quick-Push LATCH Connectors
  • Recline Angle Adjuster


  • Well priced 
  • No added FR Chemicals
  • Safe and easy installation


  • Heavier than other carriers
  • Rethreaded harness for B safe regular model

Peg Perego Primo Viaggio (Best lightweight car seat for preemies)

best infant car seat for premature babies
  • Suitable from 4 lbs to 35 lbs
  • Car seat weight: 9.5 lbs (Carrier only)
  • Dimensions: D25.9″ x W17.0″ x H23.9″
  • Lowest harness position: 5”. with Stage 1+2 inserts 
  • Price: $299

If you can stretch your budget a bit, the Peg Pereg Primo car seat is also a good option for preemies. 

The Primo Viaggio comes with a dual-stage cushion system. The first stage cushion is for newborns weighing 4 pounds or more and the second stage cushion supports growing children. 

It offers a European seat belt lock for a seatbelt install without the base so it’s perfect if you take taxis or Ubers often. 

This car seat is $100 more expensive than the best-selling Chicco Keyfit 30 but that’s because it looks really good and uses fancy Italian fabrics. 

To create a travel system, the Peg Perego can be paired with a Peg Perego stroller to create a travel system. 

Key selling features

  • Integrated anti-rebound bar
  • European belt guides
  • No-rethreading required
  • Side impact protection
  • Ergonomic handle
  • Two insert cushions


  • Premium quality & Design 
  • Comfortable for preemies
  • Easy installation and use


  • Pricey
  • Not many strollers are compatible
  • It takes up a lot of backseat space

UppaBaby Mesa V2 (Best Premium car seat for preemies)

uppababy mesa v2 car seat for premature babies
  • Suitable from 4 lbs to 35 lbs
  • Car seat weight: 11 lbs (Carrier only)
  • Dimensions: D27.5″ x W16.95″ x H24″ 
  • Lowest harness position: 5.5”
  • Price: $329.99

The Uppababy Mesa V2 is another premium option that made it to our list. 

When positioning a 4 pounds preemie in the Mesa V2, the infant insert (recommended for 4-8 lbs) provides a secure and comfortable fit. 

The harness straps fit nicely on the shoulders and the chest clip is also small to fit properly on your baby’s tiny chest. 

The Mesa V2 has an awesome feature called SMARTsecure, a tightening mechanism for both LATCH and seat belt installs. This makes installing the seat a few seconds task only. 

The Mesa V2 attaches directly to VISTA and CRUZ strollers without adapters. It is even compatible with the MINU and RIDGE with the addition of convenient adapters.

Key selling features

  • SMARTsecure mechanism 
  • No-rethread harness
  • Hideaway sunshade with SPF 50+
  • Practical buckle storage
  • 4 position recline foot
  • European Seat Belt Routing
  • EPP foam protection
  • Fire Retardant Free Fabrics


  • Easy to install with SMARTsecure
  • Provide a great fit for preemies
  • Premium quality fabrics


  • Super expensive
  • Not compatible with many other stroller brands

Clek Liing (Best space-saver car seat for preemies)

clek liing infant car seat for preemies
  • Suitable from 4 lbs to 35 lbs
  • Carrier weight: 10.9 lbs (with padding and canopy)
  • Dimensions: D27.5″ x W16.95″ x H24″ 
  • Lowest harness position: roughly 4”
  • Price: $459.99

As a big fan of the Clek brand, I was thrilled to find that their infant carrier, the Clek Liing is also suitable for premature babies. 

The Clek Liing can safely accommodate infants as small as 4 pounds and up to 35 pounds in weight. It comes with a two-piece infant insert (head support and body insert) that is mandatory for up to 11 pounds. 

We tested the Clek Liing with a 4 pounds and 5 pounds preemie and the fit was good and safe for both. The inserts provide the necessary head and body support and the harness sits snugly on the baby’s shoulders.  

The Clek is also easy to install with and without the base. If you plan to use it baseless, the Clek Liing is sold without its base and it’s called Clek Liingo

The Clek is also one of our reviewed car seats for small cars so if you have a small car, this would be a good option. 

Key selling features

  • Flame-retardant-free fabrics with SPF100+ canopy
  • 1-handed release from stroller or base
  • European belt routing 
  • belt tensioning plate


  • Easy to install
  • FR chemicals free 
  • Fits in small cars


  • Expensive
  • Spot clean only 

Buyer’s Guide

What to look for when buying a car seat for preemies

Most preemies go through a car seat check before they are discharged from the NCU to make sure they are safe. If your baby does not pass the test, they will have to keep him/her a little longer or request to take them home in a car bed instead. 

If you have a preemie and need a car seat look up these important requirements:

  1. Minimum Weight Requirments

When buying a car seat for your preemie baby, the first thing to check is the minimum weight limit of a car seat before purchasing it. While many infant car seats have a minimum weight of 4 pounds, some may have different requirements. 

  1. Lowest Harness position

Another important feature to check is the harness fit and the lowest harness position. For your preemie’s safety and comfort, the harness straps must be adjusted to their smallest position.

So, look for a car seat with a crotch strap or buckle position that can be adjusted to be snugger and fit a smaller baby. 

  1. Infant Insert

Premature babies are so tiny and have limited control over their movements, which can make it difficult for them to sit up or hold their heads up on their own. 

The infant insert is meant to provide extra head and neck support, as well as extra padding around the back, sides, and bottom to help keep the baby snug and secure. That’s why when looking for a car seat or infant carrier, choose one with a cushiony infant insert.

Best practices for a preemie in a car seat

Request a car seat test (aka car seat challenge) before leaving the hospital: A car seat test should be performed on your preemie baby before discharging him/her from the hospital. The test is meant to test your baby’s ability to ride home safely in a car seat. This test is usually performed on all preemie babies but if for some reason you are not offered this, you must ask for it.

Remove shoulder harness padding: Shoulder harness pads/covers should be removed as they can interfere with the harness fit. The harness must sit snuggly on the baby’s shoulder and the extra padding may prevent that, therefore creating slack. 


Do you need a special car seat for a preemie? 

Yes, preemies need a car seat or an infant carrier that has lower weight limits, lower harness slots, and extra padding or inserts to keep them secure and comfortable. You can choose between an infant carrier (designed for babies and toddlers) or a convertible car seat with low weight limits (designed for babies, toddlers, and preschoolers).

Can premature babies go in a car seat?

Yes, premature babies can go in a car seat that accommodates their special needs. Choose a car seat that’s recommended by specialists for preemies. 

What is a preemie car seat test?

Also known as a car seat challenge, a test that evaluates a preemie’s ability to breathe comfortably and be safe while in a car seat. A car seat test is typically performed by nurses before discharge from the hospital. During the test, your preemie baby is placed in a car seat, then the breathing and heart rate are monitored for a period of time (typically one to two hours). If your preemie passes the test and is able to breathe normally and maintain a stable oxygen level while in the car seat, then he/she is considered safe to travel in the car seat.

How should a preemie sit in a car seat?

A premature baby should be rear-facing in a car seat, preferably in an infant carrier. When placing your preemie baby make sure his/her back and the buttocks are sitting flat against the car seat. 

About Fatima O. Millers, CPST

Founder and Editor-in-Chief, Fatima delivers insightful car seat reviews and recommendations. Combining her CPST expertise with an engineering background, her advice is both safe and practical.