Almost 2 in every 3 cars in Auckland have wrongly fitted car seats, endangering children.

A child killed or injured in a car accident is a tragedy still all too common on New Zealand roads - but the anguish suffered by parents whose child has been injured because they were belted in wrongly can be even worse.

So says Dr Mike Shepherd, Starship Hospital's director of child health (medical and community) whose colleagues see the grievous head and abdominal injuries suffered by children either not belted in or, even more tragically, belted in by caring parents who strapped them in wrongly.

"We see two main sets of injuries," says Shepherd, "severe head injuries and abdominal injuries - usually from seat belts that do not fit properly.'

Latest figures of children killed or injured because of inadequate restraints are hard to nail down - not all reporting from crashes goes into that kind of detail.

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However, last year it was reported that 18 children aged 14 and under die each year in crashes and about 26 are hospitalised every month in New Zealand. Official figures say child car seats, when correctly installed and used, can reduce the risk of death by 70 per cent for infants and up to 54 per cent for toddlers.

The latest Police, Plunket and Auckland Transport checkpoints for child restraints in Auckland also demonstrate that incorrect restraint of children is still a problem.

The checkpoints are not designed to punish but to educate parents by pointing out the errors in installation or use. Last year, after checking nearly 1800 cars across Auckland, 62 per cent had restraint faults.

North Shore and South Auckland showed slight drops from the last survey while central Auckland had only a small sample base. The worst area was west Auckland which had 77 per cent of cars with restraint faults of some description that could result in an injured child in a crash.

The Safekids Aotearoa organization (for whom Shepherd is also a spokesman) now estimates that "more than 15" kids die every year in crashes in New Zealand. Shepherd says: "The latest figures I have are from 2013 and there were 6 children who died in the 14 and under bracket and 149 hospitalisations - so things have come down quite a bit."

Now the focus is going on parents who do not restrain their children at all, who belt them in incorrectly or who put a car seat in the front when the back seat is the safest option.

Another common mistake is to put a seat belt on a slightly older child but, unless they are over 148cm tall, they often slide out of the belt on impact or suffer serious abdominal injuries from the belt. That's where booster seats come in.

Shepherd is at a loss to understand parents who do not restrain their kids in safe harnesses at all: "We still hear things like, 'We were only going a short distance down the road'."

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Earlier this year, an Auckland policewoman was reported to have found 13 people, 11 of them not wearing seat belts, crowded into a people mover on Auckland's northern motorway.

Three were unrestrained women holding children, one a baby, on their laps while a child had a smaller child under a blanket on her lap and a boy was moving between the rows of seats. Six children in all should have been in booster seats or baby car seats.

Shepherd can far more understand how parents get it wrong when belting the child or the car seat in.

"It is quite a complicated task to get them properly set up" he says. "Particularly when car seats require you to loop the belt through the right way...that requires a bit of skill or knowledge and that is why we always refer to the NZTA for credential checks and Safekids also has videos on how to belt the seats and the kids in properly.

"But even though the statistics are coming down, the fact this sort of thing still occurs - and we still see the horrific head and abdominal injuries."

Another disturbing trend, he says, is for parents to buckle infants into the front passenger seat of cars when child restraints are designed for the back. Being in the front also puts the child at risk of damage by airbag if there is a crash.

"There is an increasing trend overseas towards more injuries and fatalities from the impact of airbags when a child is in the front seat - and I have no reason to think New Zealand is immune from that pattern."

He can only guess at the motivation for parents who belt their child into the front seat: "I can only think it is because they want their child to see them, or because they are within easy reach - and there may even be a bit of the child wanting to be a grown-up.

"But it just goes to show that we have to keep up the strong messaging regarding child restraints. It has been very effective - I can't stress enough that, overall, the trend is down as regards death and injuries but that is no consolation to the parents who have a child lost or hurt in an accident because they were incorrectly restrained.

"There is a whole new generation of parents out there now and we have to try and reach them as well. "