Car Seat Turnabout

When is it safe to switch a baby from a rear-facing car seat to a seat that faces forward? The official answer has changed recently, creating problems for parents and car seat manufacturers.

“People are so anxious to turn them to face forward,” said Kathleen Weber, director of the Child Passenger Protection Research Program at the University of Michigan Medical School in Ann Arbor. “It’s almost like it’s a milestone like walking.” She said some parents even think that they must turn the seat around to keep their children safe.

For years, the consensus in this country was that a baby could face forward when he or she had reached 20 pounds, which correlated roughly with one year of age. But babies are changing; more of them are hitting 20 pounds long before they reach 12 months. “There are kids that are 9 months and kind of chubby; they weigh 25 pounds,” said Dr. Phyllis F. Agran, a researcher with the Pediatric Injury Prevention Research Group, part of the University of California, Irvine.

So in May 1996, the American Academy of Pediatrics changed its advice because the strength of a baby’s bones, the important factor in the body’s ability to withstand sudden force, is determined mostly by age, not by weight.

Babies are built differently

The problem for babies is that their heads are bigger in proportion to their bodies than adults’ heads. And babies have weak necks, so their heads move more in an accident. That puts a big strain on the backbone. “If you are facing forward, your head pulls on the vertebrae, and the vertebrae of babies is still soft,” Weber said. “They don’t keep locked together the ways yours and mine do.” In the mid-1990s, researchers found several cases of spinal cord injury from children facing forward, and concluded that these could have been avoided if the baby had been facing the back, its head cushioned by the back of the baby seat.

But the baby seats were mostly designed around two officially certified dummies, a “9-month-old” that weighs 20 pounds and a “1-year-old” that weighs 22. To certify a baby seat with anything bigger, a manufacturer had to switch to a “3-year-old” dummy that weighs 33 pounds. The National Highway Traffic Safety Administration does not allow the use of anything in between for certification.

The manufacturers are now producing rear-facing seats that are strong enough for the 33-pound dummy, which means a substantial redesign of the chairs. (Leaving a child in a rear-facing seat until age 3 is not a bad idea if the seat is big enough, experts say; that is the norm in Scandinavia, Weber said.)

Beware of used child seats

But the change means that parents should be wary of hand-me-down seats from older siblings or cousins. Some experts suggest that even if the baby’s weight exceeds the limit stated on the seat, the seat will be secure if it is wedged into the back seat, up against the rear of the front seat, but no one was willing to be publicly identified as saying so.

A study of 1994 data found that 673 children younger than 5 died while riding in vehicles, but the biggest problem was not the wrong kind of car seat; it was no car seat at all. Just over half were unrestrained, despite the fact that state laws on baby seats are stronger than laws on seat-belt use by adults. All 50 states require restraints for children.

The risk of death for an unrestrained child is double that for a child in a car seat.

But some parents will find the new advice hard to take, because it comes amid a drive to get baby seats in the back seat, away from passenger-side air bags. If the baby is in a rear-facing seat in the back, a driver may not be able to see the baby even with the rear-view mirror. And as babies enter the second half of the first year, they become far more interactive; they want to see and be seen.

Don’t be tempted, Agran said.

“A parent doesn’t need to interact with a kid when he or she is driving,” she said. “The parent needs to interact with the environment.”