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Children to be kept in rear-facing car seats till 2 years

Pediatrics,
March 2011
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Children to be kept in rear-facing car seats till 2 years

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Children are best kept in rear-facing car seats until age two or until they have reached the height and weight maximums set by the car seat manufacturer.

This is a significant change from the prior recommendations by the American Academy of Pediatrics, which called for babies to stay in rear-facing seats until they were at least one year old and 9 kg. Rear-facing seats offer more support to the head, neck and spin of infants and toddlers in a crash. Though the recommendations were meant to encourage parents to keep children in the seats longer, many parents interpreted that wording to mean they should put their children in a forward facing seat at their first birthday - way too soon.

There's been a perception that it's a good idea to move from rear-facing to forward-facing. But if parents want to afford their child the best possible protection from the leading cause of death for children, they should delay that step as long as they can. Most rear-facing child safety seats today can accommodate children to fit the new guidelines.

The rate of deaths due to motor vehicle crashes in children under age 16 fell 45 percent between 1997 and 2009. Yet motor vehicle accidents are still the leading cause of death for children aged 4 years and older. Each year, more than 1,500 children under 16 years are killed annually in motor vehicle accidents. And for every death, some 18 children are hospitalised and 400 are hurt seriously enough to require medical attention.

A previous study has found that children under 2 years are 75 percent less likely to die or be severely injured in a crash if they're in a rear-facing car seat. And even age two shouldn't be read as a deadline. If a child is small for his or her age, you may want to delay turning around the seat even longer, while bigger, taller children may need to be turned sooner than age two. The recommendations also say that a forward-facing car seat with a harness offers more protection than a booster seat, while a booster seat is better than a seat belt alone.

Children should be kept in a forward-facing car seat as long as possible, even through 8 years of age if their weight or height is under the limit allowed by their child safety seats. Studies show that the car seats reduce the risk of child injury up to 82 percent and the risk of death by 28 percent, compared to wearing seat belts. Car seats have more structure - particularly side structure - to them than most booster seats. This added structure may offer additional protection, particularly in side impact crashes. In addition, most car seats sold today use 5-point harness systems which do a better job of restraining a child in the event of a crash than the 3-point vehicle seat belt, even when positioned properly with a booster seat. Parents are also advised to keep older children in a booster seat, which properly positions the seat belt, until they're 4 feet 9 inches tall and are between the ages of 8 and 12. The average child reaches that stature sometime after 10 years of age. Booster position the seat belt so that the shoulder belt lies across the middle of the chest and shoulder and keeps it off the neck or face, while the lap belt fits low and snug on the hips and upper thighs, not across the soft tissue of the belly.

The paediatricians’ group also recommended that child safety seats not be used outside the car - as they often are - since they can tip and fall off tables, countertops and other surfaces. More than 8,000 infants a year are injured in each year when child safety seats are used improperly or for unintended purposes, a supplemental report warned.

Following the above guidelines will give parents peace of mind that they are doing the best job they can of protecting their children from injury in the event of a car crash.

Wednesday, 06 April 2011


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