My Kids are Going to be in Carseats FOREVER! or How Did We All Survive?

On Monday, the American Academy of Pediatrics issued new guidelines on car seat safety and positioning. Mitch Lipka, an expert in child safety products, comments on the new guidelines.

Parents eager to flip their car seats from rear-facing to forward facing have some new information to consider that could change their thinking.

The American Academy of Pediatrics is now saying toddlers should remain rear-facing until they are 2 years old. For nearly a decade, the group has suggested following the guidance on the seats themselves and keeping them rear facing until a child is 1 year old and 20 pounds at a minimum.

Making the transition from rear-facing to front-facing car seats, from car seat to booster, and from back seat to front seat are among the most discussed topics by parents seeking advice about parenting. While this report from the nation’s most prominent pediatric group isn’t the law, it does carry a lot of clout and is a game-changer in the conversation about car seat safety.

In issuing its new recommendations, the AAP cited a 2007 study in the journal “Injury Prevention” that showed children under the age of 2 are 75 percent less likely to suffer a severe injury if they are in a rear-facing seat. The main issue: Support for the neck and spine is better in that position for young children.

The organization’s new policy, published in the April edition of its journal “Pediatrics” also recommends the use of booster seats until children are at least 4 feet 9 inches and between 8 and 12 years old.

“A rear-facing child safety seat does a better job of supporting the head, neck and spine of infants and toddlers in a crash, because it distributes the force of the collision over the entire body,” Dr. Dennis Durbin, the report’s author, said in a statement. “For larger children, a forward-facing seat with a harness is safer than a booster, and a belt-positioning booster seat provides better protection than a seat belt alone until the seat belt fits correctly.”

Motor vehicle accidents remain the top cause of death for children 4 and older, the Academy of Pediatrics said, although the death rate has been on a significant decline since the late 1990s. The U.S. Centers for Disease Control and Prevention estimates that every hour 150 children (from birth to 19) are taken to a hospital emergency room due to injuries suffered in car accidents.

The National Highway Traffic Safety Administration (NHTSA) says its guidelines are consistent with the academy’s recommendations. Both the academy and NHTSA say to use the age as a guideline and not push the use of the seats beyond the height and weight limits.

“The ‘age 2’ recommendation is not a deadline, but rather a guideline to help parents decide when to make the transition,” Durbin said. “Smaller children will benefit from remaining rear-facing longer, while other children may reach the maximum height or weight before 2 years of age.”

Here are some additional guidelines from the academy: 

• Make the move from a rear-facing seat to one that is forward facing and has a harness when they hit the weight and height limits for the seat.
• After they hit the limits for the forward facing seat, it will be time to transition to a booster seat. (Be sure that the shoulder belt run across the child’s chest and shoulder and not his or her neck and the lap belt is across the hips rather than the belly area.)
• The booster seat will no longer be needed once the child reaches 4 feet 9 inches and is 8 or older.
• After a child turns 13, it is OK to ride in the front seat of the car. Prior to that, they should remain in the rear.