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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. Fatalities are just the tip of the iceberg; for every fatality, roughly 18 children are hospitalized and more than 400 are injured seriously enough to require medical treatment, according to the AAP study.
“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.”
Franci certainly surpassed 20 pounds before turning two. Most car seats that could be turned to face the rear did not accommodate children weighing more than 20 pounds until recently. Today, however, the limits are closer to 30 to 35 pounds, and a few even go up to 45 pounds.
Doctors fear the advice may not be motivation enough for parents to keep their child rear facing. As previously stated, parents view the turning of the car seat as a sort of milestone; a signal to the world that their baby is smart and ready to take on the world. But according to the new guidelines, what parents are really doing is putting their children’s lives at risk.
Studies from other countries show the validity in keeping children rear facing. In Sweden, for instance, children face the rear until age 4. Sweden has the world’s lowest highway fatality rate for children under 6.
And although Franci’s legs would have been squished against the backseat until she turned two, it is a small price to pay to keep her safety the top priority.
“I always reassure parents that just because it looks uncomfortable to you doesn’t mean that it is for a child,” said Dr. Baer.
Please consider the new AAP guidelines and pass along the message so as to ensure our children are kept safe from harm.
NYTimes.com
http://www.nytimes.com/2011/03/22/health/policy/22carseat.html?_r=1&ref=health
Healthy Children
http://www.healthychildren.org/English/News/pages/AAP-Updates-Recommendations-on-Car-Seats.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token
Add a Comment2 Comments
While rear-facing, a large child's legs "squished against" the back of the seat does not pose a safety risk? If regulations change to mandate rear-facing for 2 year olds, then car seat manufacturers must create more rear-facing seats that accommodate larger children. My son reached the height and weight limit of his rear-facing seat at 10 months at 30lbs and 30". Shopping for another rear-facing seat to accommodate him for 2 months until he reached his 1st birthday was not in my budget. I know people will say "cost isn't an object for MY child's safety", but I'm just being realistic.
March 22, 2011 - 9:04pmIdeally, shouldn't we ALL be facing the rear of the vehicle if we aren't driving, for our own safety? And petite ladies, maybe a booster seat is in your near future?
This Comment
Good Point. I came across a group of moms yesterday who said if they had to choose between a broken neck or broken legs, they'd take the legs. There is also the option to have your child sit "indian style" in their seat. However, I think that most parents do what they think is best for their child and there is nothing wrong with that.
March 23, 2011 - 6:18amThis Comment