On March 21, 2011, the American Academy of Pediatrics released their official Car Seat Policy statement recommending children to remain rear-facing until the age of two or until they have outgrown the height and/or weight regulations of their car seat. This recommendation has been in place since 2009, however, it is now an official AAP policy and pediatricians, car seat technicians and healthcare providers are urged to promote these new regulations.
Children positioned rear-facing have better protection from head, neck and spine injury in the event of a motor vehicle accident. According to the AAP, “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.”
Most parents initially purchase infant-only car seats due to the ease of portability. Most infant-only car seat have weight regulations of 5-20 pounds (although many new models have higher limits to 30-35 pounds) and height requirements of up to 29 inches (again, newer models may have limits up to 33 inches). Convertible car seats can be used in both rear-facing and forward-facing positions and are the next type of child restraint purchased once the child outgrows the infant seat. Most convertible child restraints have rear-facing weight limits of 5-35 pounds (with newer models having weight limits up to 45 pounds) and height limits of 36-40 inches. Once the convertible seat is turned to forward-facing, the child can remain in that seat until 40-80 pounds and up to 40-53 inches (depending on the model). Once the child has outgrown the forward-facing car seat, a belt-positioning booster seat is required until the child is 4 feet 9 inches or until 8-12 years of age. According to the National Highway Traffic Safety Administration, a child is ready to use the lap-and-shoulder seat belt when the following criteria have been met:
- Child is tall enough to sit without slouching
- Child keeps back against the vehicle seat back
- Child keeps knees completely bent over the edge of the seat
- Child keeps feet flat on the floor
- Child is able to stay comfortably seated this way
- Lap belt fits low and snug across the upper thighs/lower hips and shoulder belt fits across mid-chest and shoulder
Unfortunately, motor vehicle accidents continue to remain a leading cause of death and injury in children. Following these recommendations and ensuring your child rides safely in the vehicle every time, can reduce your child’s risk of serious injury and/or death in the event of an accident.
AAP (2011). Policy Statement—Child Passenger Safety
AAP (2011). Technical Report—Child Passenger Safety
AAP News (2009). New advice: Rear-facing Car Seats Safer for Children Until They are 2.
AAP News (2009). What to Consider When Positioning Carseats for Toddlers.
National Highway Traffic Safety Administration (2007). National Child Passenger Safety Certification Training Program; pg. 188.
Safe Kids Greater Houston CPS Update Refresher Course: Child Restraint Table. Attended March 21, 2011
Author : Diba Tillery RN, BSN, IBCLC, CPST