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Children / Consumer / Health

Toddlers Should Stay Rear-facing Longer

Children should ride in rear-facing car seats longer, until they are 2 years old instead of 1, according to updated advice from a medical group and a federal agency.

The American Academy of Pediatrics and the National Highway Traffic Safety Administration issued separate but consistent new recommendations Monday.

Both organizations say older children who’ve outgrown front-facing car seats should ride in booster seats until the lap-shoulder belt fits them. Booster seats help position adult seat belts properly on children’s smaller frames. Children usually can graduate from a booster seat when their height reaches 4 feet 9 inches.

Children younger than 13 should ride in the back seat, the guidelines from both groups say.

The advice may seem extreme to some parents, who may imagine trouble convincing older elementary school kids — as old as 12 — to use booster seats.

But it’s based on evidence from crashes. For older children, poorly fitting seat belts can cause abdominal and spine injuries in a crash.

One-year-olds are five times less likely to be injured in a crash if they are in a rear-facing car seat than a forward-facing seat, according to a 2007 analysis of five years of U.S. crash data.

Put another way, an estimated 1,000 children injured in forward-facing seats over 15 years might not have been hurt if they had been in a car seat facing the back, said Dr. Dennis Durbin, lead author of the recommendations and a pediatric emergency physician at Children’s Hospital of Philadelphia.

Toddlers have relatively large heads and small necks. In a front-facing car seat, the force of a crash can jerk the child’s head causing spinal cord injuries.

Car seats have recommended weights printed on them. If a 1-year-old outweighs the recommendation of an infant seat, parents should switch to a different rear-facing car seat that accommodates the heavier weight until they turn 2, the pediatricians group says.

Luckily for parents, most car seat makers have increased the amount of weight the seats can hold. This year, about half of infant rear-facing seats accommodate up to 30 pounds, Durbin said. Ten years ago, rear-facing car seats topped out at children weighing 22 pounds.

“The good news is it’s likely parents currently have a car seat that will accommodate the change,” Durbin said.

The American Academy of Pediatrics recommendations appear Monday in the journal Pediatrics.


American Academy of Pediatrics:

Mile High Mamas
Author: Mile High Mamas

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  1. Oh good lord…. overkill! I think it is bad enough that it is 1 year old AND 20 lbs— my kids are both underweight. And people… here is the reality: A cop is not going to weigh the kid when he pulls you over for failing to signal or something like that. COME ON!

  2. I agree, I always want to do the safest thing for my little guy. He just turned one and he’ll definitely be sitting backwards until he is two. Unfortunately, I’ve seen a lot of angry parents responding to a friend’s blog about this topic that they think it is torture and they won’t be following the recommendation. I guess I don’t get it? Kids prefer a lot of unhealthy things, but as moms, we’ve got to make sometimes unpopular choices to keep them safe.

  3. I think it’s good. My daughter will be 3 in July. Her seat is still rear facing and will stay that way until she reaches the maximum weight for her seat being rear facing (35 lbs)

  4. All I’ll say about this is I’m glad my kids are 4 and 6. Safety or not, those rear-facing days were torturous when I’d go on road trips with them by myself!

  5. Overkill? Not a chance. People need all the guidance they can get on this issue!

  6. Amber, I agree….I’m glad I don’t have a child I’d need to switch back. I’m glad we’re out of the rear-facing days, but to be honest, we kept Claire facing that way past her first birthday anyway, even though she’d surpassed the weight requirements. Our pediatrician had told us the guidelines but reiterated that the safest way was rear-facing “as long as we could.” In fact, it wasn’t until we took one of our uber-long 8-hr road trips that we finally switched her, purely for convenience and the fact that we were well within the guidelines at the time.

    I’m a huge stickler for safety rules. I just am. “Better to be safe than sorry” was just something that has been drilled into my brain. Given the fact that so many people are distracted on the roads, if I can do something that can keep my child safe from them, I’ll do it. For fun, when I’m sitting at lights, we count how many people we see looking at their phones and/or not paying attention. The number saddens me.

    But, that’s another issue. 🙂

  7. Amber- I too, am glad that my kids are 4 & 6. Both boys were 20lbs by age 1, and their poor legs were so long, I felt bad they were crammed backwards. It’s not law, it’s just a recommendation right?

    I’m just happy to see kids in car seats/boosters in the back seats of vehicles. To often I see kids not buckled in at all, or riding in the front. And that worries me.

  8. My father made sure to tell me the new guidelines and I had to laugh a bit to myself. Keeping them rear-facing as long as possible for their safety has been well-known information for a long time. Our seat goes to 35-pounds rear-facing and my husband and I had planned to keep our son rear-facing as long as we can even before he was born. These new guidelines don’t change our game plan at all.

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