On March 21st, the American Academy of Pediatrics released updated recommendations stating that all children should ride rear-facing until at least age 2 or until they reach the highest weight or height allowed by their car seat for rear-positioning.
Currently, many parents turn toddlers around to forward facing at their first birthday or weight of 20 pounds, as this is the law in most states. This was the minimum for the prior recommendations from the American Academy of Pediatrics from 2002. Many parents look forward to this milestone.
So, why the change? Rear-facing better protects young children’s heads, necks, and spines in the event of an accident. In most accidents, the momentum pushes the passengers forward. For an infant or toddler, whose head is a large percentage of their body mass, this puts a great force on their head and neck. Their developing brains are especially vulnerable to these forces.
What about their legs? Some parents are concerned that children are more likely to injure their legs if they are rear-facing. Actually, one study showed leg fractures as rare injuries in rear-facing children and the second most common injury with forward facing children. This occurs when the child’s legs are thrown into the seat or console in front of them. I also remind parents that modern medicine is much better at fixing leg injuries than head injuries.
The recommendations also changed slightly for older children. Children should be kept in a forward-facing car seat with harness until they reach the height or weight limits of that particular seat. They should use a belt-positioning booster seat until they have reached 4 foot 9 inches in height. Children under 13 years old should be restrained in the rear seat for optimal protection.
Child safety seats are estimated to reduce the risk of injury by 71% to 82% compared to children of similar ages in seat belts alone. Booster seats reduce the risk of nonfatal injury for 4 to 8-year-olds by 45% compared to seat belts.
For more information, visit the healthy children website.