Rear-facing recommendations, are they changing?
Yes, in as much as the American Academy of Pediatrics is now recommending that babies should remain rear-facing until they reach the maximum height and weight allowed by the car seat manufacturer.
Previously their guidelines were to keep children rear facing at least until age 2. Even that recommendation was relatively new (2011). The AAP used to only recommend rear facing until age 1. Thus why a good number of state laws only require rear facing to age 1. Many states have been changing their laws over the past few years to align with the AAP rear facing to age two recommendation.
And no. Car seat experts, for at least as long as I’ve been a car seat technician (2004), said best practice is to keep your child rear facing for as long as possible. CPS technicians recommend parents to keep their child rear facing to the upper weight and/or height limit of the convertible seat.
Personally, both of our older children were rear facing until they grew out of their convertible seat in a rear-facing position by height right around age 3. Our youngest we unfortunately had to turn a bit before age 3 as he was kicking his siblings in the head in our 3 across situation. It wasn’t pretty and quite distracting for whoever was driving.
Why the rear-facing recommendations change?
The AAP made the 2011 change to rear face until age 2 based on a 2007 study in the journal Injury Prevention. The study found that children under age two are five times safer in a crash if they are rear facing compared to forward facing.
However, recently that 2007 study was called into question. Dr. Ben Hoffman, chairperson for the AAP’s council on injury, violence and poison protection said, “The original research group went back and acknowledged there had been statistical inconsistencies.”
The original research team did a new analysis of the original 1998-2003 data and included new data through 2015. On examining the data again, they concluded rear-facing car seat use was associated with a decreased risk of injury for all ages examined. The overall number was insufficient to confidently recommend a specific age to transition.
So the AAP updated their 2011 rear-facing recommendations to what was always considered “best practice.”
What are the most common concerns with extended rear facing?
Probably the most common reason parents share about wanting to turn their child around to face forward is the child’s legs.
“What about his legs? He looks so uncomfortable.”
Really? Think about all the silly ways kids will choose to sit. Yes, it may look uncomfortable for us and like our legs would never straighten out again but they are comfortable. Remember kids are very flexible. What looks like a cramped space to you may be perfectly cocooning even with room to stretch for them.
A rear-facing child restraint supports the child’s head, neck and spine during a crash. Once the child is turned the torso is being restrained but there is no neck or head support and the neck. At a young age the head is still heavy and the muscles in the neck are not yet strong enough to support the head adequately in a crash. The neck could become overstretched.
“Arms and legs are rarely injured in the rear-facing position, and the head, neck, and spinal cord are protected better rear-facing. We can fix arms and legs, but we can’t fix heads, necks, and spinal cords,” says Dr. Hoffman.
It’s also common for parents to comment on wanting to see their children to interact with them. Some are concerned about their child choking and them not seeing it if their child is rear facing. Parents can help prevent that by not giving their child food in the car.
What about the law?
As we often say, law is often minimum practice. These rear-facing recommendations are best practice. While a parent is required to follow the law, following the recommendations is a parental choice. Of course, it’s a choice that could be a matter of life and death.
As mentioned previously some states have been changing their laws to reflect the “to age 2” recommendation. Will states update their laws to this new recommendation? That’s hard to say. Lawmakers like to have straight forward parameters, ages and weights or heights. With this new recommendation there are no set parameters. Parameters change depending on what seat you have.
Many children could remain rear facing longer. If each transition is a downgrade in safety, delaying a transition could reduce the number of children injured or killed in car crashes.
By Amie Durocher, Creative Director at Safe Ride 4 Kids and certified CPS Tech since 2004
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