Last spring the American Academy of Pediatrics and the National Highway Traffic Safety Administration released updated recommendations for child passenger safety. The biggest change in the recommendation included having infants remain rear-facing in their child restraint until two-years-old. Many parents I have talked with at car seat checks are confused and/or frustrated by this recommendation.

In Tennessee, the law states all children must remain rear-facing until one-year-old and twenty pounds. Most parents cannot wait to turn their child around so they can finally see what is going on in that back seat.  Parents often treat that one year mark as a graduation or an important milestone for their child to reach – like learning to sit up or saying those first words. Finally, their child has made it – turn that baby around.

As a new parent myself, I can relate to wanting to celebrate a milestone.  But, as a car seat technician and safety advocate, I truly believe in the importance of this new recommendation.

The AAP changed their recommendation to include rear-facing until two-years-old based on new evidence related to crash data for young children. The rear-facing position in the vehicle provides optimal support for the child’s head, neck and spine. Because an infant’s head is proportionally much larger than an older child or adult, they require additional protection in a crash situation. In fact, Swedish researchers have reported that rear-facing child restraints reduce the risk of significant injuries by 90% as compared to unrestrained children.  Data from crashes in the United States was also reviewed and researchers found that children in forward-facing child restraints were significantly more likely to be seriously injured, when compared to children in rear-facing child restraints.

The good news for parents is that many convertible car seats on the market today can help your family comply with this recommendation.  Convertible seats offer great flexibility for families – allowing children to use them rear-facing and then forward-facing. This will allow you to get many years’ worth of use out of just one seat. Most convertible seats allow children to be rear-facing until at least 35 pounds, but many more have upper weight limits of 40 pounds – some even go as high as 45 pounds! Most of these manufacturers have also increased the upper weight limits for the harness when using the seat in forward-facing mode too – which is great, because just as it is safer to remain rear-facing longer, it is safer to keep your child in a five point harness as long as possible.  We encourage every family to use their car seat to the upper weight limits for both rear and forward-facing children.

One of the most common questions we get is if the child is too long to keep rear-facing because their feet touch the vehicle seat.  This is okay!  Make sure you are following your child restraint manufacturer’s recommendations about height limits.  Each seat will have those limits clearly marked on the seat and in the instruction manual.  In many cases, a child’s feet may touch the vehicle seat back well before they actually outgrow the length of their car seat.  You may encourage your child to sit with their legs crossed (think “criss-cross-applesauce”) if that makes them more comfortable.  Convertible seats are typically deeper than traditional infant carriers – so may also help better fit the length of your child.

Remember, children should remain rear-facing to help prevent significant injury – head, neck or spinal trauma.  Injuries to the extremities, which may occur in any crash situation, are typically less severe.

I know it is difficult when you cannot just look in the rear view mirror to see what is going on with your baby.  Those major baby melt downs can be incredibly stressful when you are driving by yourself – I get it. But keeping that sweet baby safe in the car is critically important.  Motor vehicle crashes continue to be the leading cause of death for children in Tennessee and across the country.

Rear-facing is simply the safest option for young children.

This week we join car seat techs and safety advocates across the country celebrating National Child Passenger Safety Week.  This is a great time to make sure your car seat is properly installed by visiting one of the free car seat checks that Children’s Hospital is hosting on Saturday, September 22^nd. 

Click here to read more information about child passenger safety and the car seat services offered at Children’s Hospital.

Sarah Haverstick serves as Safe Children Program Manager for the Monroe Carell Jr. Children’s Hospital at Vanderbilt and mama to 5-month-old Charlotte.