These types of injuries are known as "seat-belt syndrome." In these cases, the seat belt CANNOT work properly! Children can slide down and out of the restraint, or the belt can be forced into the stomach, causing damage to internal organs. Or, they slide forward so their knees bend comfortably over the edge of the seat, making the lap belt ride up on the abdomen. However, children often slip the shoulder belt under their arm or behind their back, losing all upper-body protection. In order to work properly, a shoulder belt needs to be across the collarbone and the lap belt needs to be on the hipbones. Age is only helpful when considering the child's ability to sit properly. Weight is a useless measurement of whether a child is ready for the adult seat belt or not. If the child meets the 5 Step Test in one vehicle, but not another, the child will need a booster for every vehicle in which the 5 Step Test is not met.
Keep children in booster seats until they pass the "5 Step Test" (usually around 10-12 years old and close to 5 feet tall) in every vehicle in which the child rides. While there is little that can be done for adults (we’re still working on boosters to fit grown-ups who might want them LOL) belt positioning boosters make that adult belt fit your child.
Women and children (especially in older vehicles) simply do not fit. Safety belts are designed to fit the average adult male. I would not be comfortable with a child under 7 or 8 in a backless, and a child under 4-5 has no business in a booster at all.
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