(Child) safety first: Rear-facing car seats should be used longer

While many parents look forward to the year when they can turn their child’s car seat to face forward to commemorate their advancing development, the American Academy of Pediatrics (AAP) is advising parents to hold off on the festivities for at least another year. In its newest car safety seats guide published Monday, the doctors urge parents to make the transition from a rear to front-facing seat based on their child’s size and not solely on age: “All infants and toddlers should ride in a rear-facing car safety seat until they are two years of age or until they reach the highest weight or height allowed by their car safety seat’s manufacturer,” according to the publication. Lead AAP statement author Dr. Dennis R. Durbin, scientific co-director of the Center for Injury Research and Prevention at the Children’s Hospital of Philadelphia, explains the rationale behind the modified recommendations:

A baby’s head is relatively large in proportion to the rest of his body, and the bones of his neck are structurally immature. If he’s rear-facing, his entire body is better supported by the shell of the car seat. When he’s forward-facing, his shoulders and trunk may be well restrained, but in a violent crash, his head and neck can fly forward. Our recommendations are meant to help parents move away from gospel-held notions that are based on a child’s age. We want them to recognize that with each transition they make, from rear-facing to forward-facing, to booster seats, there is a decline in the safety of their child. That’s why we are urging parents to delay these transitions for as long as possible.


Similarly, an article in The New York Times points out that rear-facing seats are sometimes dubbed “orphan seats” because after bad car accidents, the toddlers in these seats are often the only survivors.

The AAP also suggests that school-aged children should use booster seats until they reach a height of four feet nine inches and are between the ages of eight and twelve, which is when seat belts can safely accommodate them. But the fact that these 2011 guidelines are mainly based on a 2007 study frustrates ACSH's Dr. Gilbert Ross. “Why did it take so long to incorporate these safety standards into the guidelines? Perhaps the AAP was too busy dithering over trivial concerns like plastic baby bottles and lotions.”