Does it need to be removed when not in use?
No, it is permanently attached to the harness, designed for children, and can be removed by pressing the release buckle when not in use.
Does this car seat belt adjuster really work?
Of course you can! Its a high-end kids seatbelt adjuster! A car seat protection device designed specifically for children! This safety belt adjuster helps solve problems such as seat belts getting stuck on the neck, chest, face, and shoulders.
You have to put it back every time you put your childs seatbelt on?
You can always keep it on your seatbelt.