My niece, Franci, age three, has always been in the 90th percentile of babies for both height and weight categories. So it’s no wonder her parents (my brother and sister-in-law) were eager to face her car seat forward after her first birthday; a milestone many parents look forward to--a sort of "coming of age" moment.
With legs as long as the Nile, Franci was turned forward-facing in accordance to 2002 guidelines and recommendations from the American Academy of Pediatrics (AAP), which suggested it was safe for children to be turned forward in their car seats after 12 months or once they reached 20 pounds.
Now, the AAP is suggesting children be positioned in rear-facing car seats for twice the amount of time.
The AAP now advises parents to keep their toddlers in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat. It also advises that most children will need to ride in a belt-positioning booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years of age.
A 2007 study in the journal Injury Prevention showed that children under age 2 are 75 percent less likely to die or be severely injured in a crash if they are riding rear-facing.
“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,” said Dennis Durbin, MD, FAAP, lead author of the policy statement and accompanying technical report.
“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.”
While the rate of deaths in motor vehicle crashes in children under age 16 has decreased substantially – dropping 45 percent between 1997 and 2009 – it is still the leading cause of death for children ages 4 and older. Counting children and teens up to age 21, there are more than 5,000 deaths each year.