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Spokane, Washington  Est. May 19, 1883

Car seats should face rear longer, groups say

Separate reports also advise booster seats up to age 12

Carla K. Johnson Associated Press

CHICAGO – Children should ride in rear-facing car seats until they are 2 years old, not 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 today.

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 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.

A 1-year-old is five times less likely to be injured in a crash if the child is 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.

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 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 American Academy of Pediatrics recommendations appear today in the journal Pediatrics.