A leading trauma surgeon is calling for a campaign to reduce the number of injuries to children caused by not wearing seat belts or sitting in booster seats.
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In the Midlands region - which encompasses five district health boards including Bay of Plenty, Lakes, Hauora Tairāwhiti, Taranaki and Waikato - between 2015 and 2018, 158 children were involved in crashes and 22 percent of them were unrestrained.
The figures show the age groups worst affected are zero to two and eight to 10.
The director of trauma at Waikato Hospital, Grant Christey said children in the middle age range, between three and seven, had a much lower rate of injury because they were using appropriate seats.
He said 30 percent those injured were under two, and they were the most vulnerable.
"They don't have the choice about putting on their seatbelts and we would be hoping the parents would take the responsibility and make sure they have the correct restraints for these kids."
Serious injuries to children in car crashes can be prevented by them being properly restrained, Dr Christey said.
But he said he did not want to apportion blame.
"Booster and car seats are expensive.
"It may have drifted out of the consciousness of parents because it is a generational issue and the past we have had campaigns, such as the Make it Click campaign, that raised the consciousness and possibly improved seat belt usage but I think it is time for us to focus on this again for new parents and raise the issue fo seat belt safety," he said.
He had no doubt the injury figures would be the same in other regions.
"Midland region is a snap-shot of New Zealand by age group, ethnicity and so on, so we wouldn't expect there to be much difference in other regions of New Zealand."
The injuries caused in car crashes, which often involved high speed could be very serious, Dr Christey said.
"The amount of energy transferred is huge, so what you are seeing is high-speed road crash type trauma. Multiple system injuries, brain injuries, limb, chest and abdominal injuries. Very severe injuries on our very vulnerable child group."
Across the Midland region the number of patients with major trauma was 8 percent, but for children involved in car crashes the rate was 23 percent, Dr Christey said.
"It is essentially several times worse than your average trauma population because of the amount of speed and energy that's absorbed by children in car crashes."