Kids safest in rear-facing car seats until age 2

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Updated: 3/21/2011 6:36 pm
CHICAGO (AP/WSYR-TV) - Children should ride in rear-facing car seats longer, until they are 2 years old instead of 1, according to updated advice from a medical group and a federal agency.

The American Academy of Pediatrics and the National Highway Traffic Safety Administration issued separate but consistent new recommendations Monday.

Both organizations say older children who've outgrown front-facing car seats should ride in booster seats until the lap-shoulder belt fits them. Booster seats help position adult seat belts properly on children's smaller frames. Children usually can graduate from a booster seat when their height reaches 4 feet 9 inches.

Children younger than 13 should ride in the back seat, the guidelines from both groups say.
 
The advice may seem extreme to some parents, who may imagine trouble convincing older elementary school kids - as old as 12 - to use booster seats.

But it's based on evidence from crashes. For older children, poorly fitting seat belts can cause abdominal and spine injuries in a crash.

One-year-olds are five times less likely to be injured in a crash if they are in a rear-facing car seat than a forward-facing seat, according to a 2007 analysis of five years of U.S. crash data.

Put another way, an estimated 1,000 children injured in forward-facing seats over 15 years might not have been hurt if they had been in a car seat facing the back, said Dr. Dennis Durbin, lead author of the recommendations and a pediatric emergency physician at Children's Hospital of Philadelphia.

Toddlers have relatively large heads and small necks. In a front-facing car seat, the force of a crash can jerk the child's head causing spinal cord injuries.

Car seats have recommended weights printed on them. If a 1-year-old outweighs the recommendation of an infant seat, parents should switch to a different rear-facing car seat that accommodates the heavier weight until they turn 2, the pediatricians group says.

Luckily for parents, most car seat makers have increased the amount of weight the seats can hold. This year, about half of infant rear-facing seats accommodate up to 30 pounds, Durbin said. Ten years ago, rear-facing car seats topped out at children weighing 22 pounds.
 
"The good news is it's likely parents currently have a car seat that will accommodate the change," Durbin said.

The American Academy of Pediatrics recommendations appear Monday in the journal Pediatrics.

Rose Walsh of Child Care Solutions stressed that the child's size is the key factor in determining whether or not they can be taken out of the booster seat.

“What we want to make parents are aware of is that the child needs to actually properly fit in the seat before you take them out of the car seat,” said Walsh.

An adult seat belt needs to sit low on the hips and hit the collar bone.

Evidence shows that, for older children, poorly fitting seatbelts may cause abdominal spine injuries during crashes.

New York State law requires that kids under the age of 8 have the proper restrains for their height and weight.

Anyone who wishes to learn about he Car Seat Program at Child Care Solutions can call (315) 446-1220, extension 302 or visit the agency’s website.

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