Recently, the American Academy of Pediatrics changed its guidelines on car seats in one pretty significant way.
Instead of children being in rear-facing seats until they turn 2, the American Academy of Pediatrics is now recommending that children stay in rear-facing seats as long as possible until they meet the upper number for that seat’s height or weight limits. That means that most children will outgrow that rear-facing seat anywhere from age 2 to age 5, but there could be some kids who are older than age 5 who are still in rear-facing seats because of their size.
Why make the change?
It’s all based on analysis of trauma data from car crashes, which is the No. 1 cause of death for children age 4 and older.
Children who were in rear-facing car seats had fewer injuries and a decreased chance of death than kids in forward-facing car seats.
Why is that? Kristen Hullum, a nurse and trauma injury prevention coordinator at St. David’s Round Rock Medical Center, says that it’s all about avoiding head, neck and spine injuries. Young children have immature spines and necks and are also head-heavy, she says. The rear-facing seats prevent more movement of the head, neck and spine than forward-facing ones.
“My 5-year-old is petite,” Hullum says. “I still have her rear-facing. That might have seemed pretty conservative to many people, but this justifies it,” she says of the new recommendations.
Here is the progression of where and in what your child should sit in the car:
1. Rear-facing infant carrier in the back seat (or convertible rear-facing car seat if its weight range is low enough for an infant) until the child outgrows the height or weight limit for that carrier, which is typically anywhere from 22 pounds to 35 pounds. For infant carriers, that usually happens around age 1, but it could be later.
2. Rear-facing car seat in the back seat until the child outgrows the height or weight limit for that seat. That could happen any time from age 2 to 5 or even later depending on the upper limits for that seat, which can be 40 to 50 pounds or even more.
3. Forward-facing car seat with a harness in the back seat until the child outgrows the upper height and weight limit, which could be anywhere from 65 to 90 pounds. The forward-facing seat should be tethered to the car.
4. A booster seat in the back seat that raises the child up so that the car’s seat belt fits the child properly until the child is 4 foot 9 inches tall and outgrows the upper limits for that booster, usually around 100 pounds. That could happen anytime between age 8 and age 12.
5. In the back seat using the car’s seat belt once they have reached the upper limit of the booster seat’s height and weight limits until age 13.
6. In the front seat, only after age 13, but also tall enough and heavy enough to not be injured by the air bag. That’s at least 4 foot 9 inches and 100 pounds. Even though it’s hard for preteens to want to be in the back seat, it’s about safety. Airbags inflate at 200 miles an hour, Hullum says. “If that air bag hits them in their face, there’s a significant brain injury,” she says. “The air bag should be at somebody’s chest.”
There are other recommendations and guidelines that parents should know.
Get your child seat professionally installed each time you get a new one. Hospitals and county Emergency Medical Services offer car seat checks that you can sign up to attend.
When picking a car seat, the most expensive one is not necessarily the best one. They all have to pass the same federal guidelines. It’s more of a question of which one has the fanciest cup holders.
If you can’t afford a car seat, your pediatrician or any car seat check location should be able tell you how to get a free one.
Car seats do have expiration dates that are usually between six and 10 years. They wear out with use.
Once a car seat has been in an accident, it is no longer safe to use. Car insurance companies will reimburse you for the cost of the new one.
Unless you know the complete history of that car seat, do not buy or receive a used one.
If you have a truck that only has a front seat, you can install a car seat in the passenger seat, but you have to make sure the air bag is turned off.
Rear-facing car seats could be a problem for toddlers and preschoolers who get motion sickness. If that’s the case, talk to your pediatrician about what medications or techniques they recommend.
For parents who might be thinking that their 5-year-old is never going to see the world around her if she’s still in a rear-facing seat, Hullum says, not to worry. Her 5-year-old can easily remind her if she’s passed a Chick-Fil-A.
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