The American Academy of Pediatrics published new recommendations Monday citing strong evidence that children are safer remaining in rear-facing car seats until age two, and in booster seats as late as age 12.
The research reference in the journal, Pediatrics, shows that children under two who ride in rear-facing child restraints are 75 percent less likely to die or be severely injured in a crash.
Along with keeping kids in rear-facing seats until age two, the academy also suggests children remain in a seat with a five-point safety harness until they reach the weight and height limit of that harness. For older kids, the academy says children should use boosters until they are 4 feet 9 inches tall, likely between the ages of 8 and 12 years old.
This is a significant change from the prior recommendations, which called for babies to stay in rear-facing seats until they were at least one years old and 20 pounds. Rear-facing seats offer more support to the head, neck and spin of infants and toddlers in a crash.
The rate of deaths due to motor vehicle crashes in children under age 16 fell 45 percent between 1997 and 2009, according to background information in the article.
Yet motor vehicle accidents are still the leading cause of death for children ages 4 and older. Each year, more than 1,500 children under age 16 are killed annually in motor vehicle accidents. And for every death, some 18 children are hospitalized and 400 are hurt seriously enough to require medical attention, according to the article.
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.
Kids should be kept in a forward-facing car seat as long as possible, even through age eight if their weight or height is under the limit allowed by their child safety seats, according to the new guidelines. 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.
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 age 10, Hoffman said.
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.
Prior research shows booster seats can reduce the risk of injury by 45 percent in 4- to 8-year olds compared to kids of that age in seat belts.
Children should ride in the backseat until they are 13 years old, since studies have shown this reduces the risk of injury by 40 to 70 percent, the AAP added.
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That’s great, but how do they suggest cars actually fit rear-facing seats until a child is two? It’s difficult enough until they’re one. Not to diminish the safety of the children, but this, unfortunately, is completely impractical.
You need a convertible car seat – not an infant bucket seat. Convertible car seats can be installed rear facing and turned around for front facing after the child turns two – they kast a really long time, some up to 70 lbs!
I like this article a lot; however it did not talk about the many misconceptions of rear facing past age 1. After kids outgrown their infant only seats, parents need to switch to a convertible car seat and use it rear facing until the child outgrows it by weight or height. And how it a car seat outgrown? Well, here is how you tell:
A rear facing car seat is outgrown when ONE of the following happens:
-the child has hit the maximum weight limit of the seat
-the child’s head is less than 1 inch away from the car seat’s shell as shown in the link below:
http://www.car-seat.org/showthread.php?t=30201
Studies have shown that rear facing kids are 5 times safer than front facing kids. Also, kids under the age of 2 may suffer from internal decapitation in a car crash.
Older rear facing kids can be much more upright. Car seats need to be only 45 degrees for a newborn without head and neck control; the 45 degrees is to keep a newborn’s airway open.
In other countries, kids ride rear facing until they are at least 4 years old; in these countries, they have car seats with weight limits up to 55 lbs! The highest weight limit car seat available in the United States goes up to 45 lbs (there are currently 2, soon 3 convertibles that have these high weight limits). There is absolutely no excuse to front face a child before age 2 (and before its really necessary- which is when they outgrow it).
Statistics show that more than 95% of child safety seats are used or installed incorrectly. I believe the statistics should be closer to 99.99999% of misuse- that is how much I see among family members and friends, even among the very best parents.
Car seats isn’t like choosing between formula and breastmilk; it is not like choosing whether or not your child can stay up late or not. I know many parents who think that using a car seat correctly is just another parenting choice. It is NOT a choice when you know how violent a crash is. If you were in a crash, an incorrectly used car seat can have very devastating consequences.
I know many states have laws that say kids need to stay in a booster seat until they are 8 years old or 4′ 9″ in height. Well, nothing magical happens at age 8; the law of physics do not stop applying to a child who turned 8 years old. The problem with this law is that many 8 year olds are not ready to use a seat belt alone in the car.
Seat belts begin fitting people who are 4′ 9″ tall. I haven’t seen an 8 year old capable to this day able to fit an adult seat belt properly.
The ONLY way to evaluate when a child can stop using a booster seat is when they past the 5 step test. This test is a series of questions you ask when you buckle a child in without their booster seat. You must answer ‘yes’ to ALL questions before your child can ride in a lap AND shoulder belt alone.
Here is the 5 step test:
1. Does the child sit all the way back on the vehicle seat?
2. Are knees bent comfortably at the edge of the vehicle seat? (without slouching)
3. Does seatbelt cross the shoulder properly? (it should be centered over the collar bone)
4. Is the lap portion of the seatbelt low – touching the thighs?
5. Can the child stay seated this way for the entire ride, every ride (awake and asleep)?
http://carseatblog.com/3966/the-5-step-test/
The above link is a very detailed article written by a child passenger safety technician on how to conduct the 5 step test.
And for parents who want their 8 year old to be a “big boy” or a “big girl” think again- watch the video below and you will understand why kids really do need to be using boosters until they past the 5 step test:
http://www.boosttil8.org/
The Above link is about Kyle Sorenson; he was 8 years old when he was in a car crash. The adult seat belt did not fit him; he is now paraylzed from the neck down because the adult seat belt did not fit. Something so simple as using a booster seat could have prevented this terrible injury.
Pingback: Is a booster seat the right carseat for a 3 year old?
Parents with heavy toddlers:
A child can safely transition to a booster seat when ALL of the following apply:
-the child is at least 4 years old (preferably 5-6 to get the hip bones more developed)
-the child is at least 40 lbs
-the child is capable of sitting still, without playing with the seat belt, leaning over to pick up a toy; the child needs to be in correct position at all times (which most 4 year olds cannot)
If you have a heavy 2 or 3 year old there are much bigger car seats with the internal 5 point harness your child can ride in. In order to choose a car seat that will last you your money’s worth, you need to understand how a forward facing car seat is outgrown.
A forward facing car seat is outgrown when ONE of the following happens:
-the child has hit the maximum weight limit of the seat
-the tips of the child’s ears are even with the car seat’s shell/ headrest
-the harness is at your child’s shoulders when used in the top harness slots*
When front facing the harness MUST be at or slightly above you child’s shoulders. This may seem insignificant, but in a crash, when the harness is below the shoulders and the child is front facing, the shoulders and spine will compress, causing severe injuries to the child’s spine. Also, because of the compression, a child’s head will fly forward farther.
Most kids outgrow their car seats by height- when the harness is at the child’s shoulders. This is why you want high top harness slots. The Graco Nautilus has a 65 lb weight limit with the internal harness and has 18″ top slots. The Graco Argos goes up to 70 lbs and has 18″ top slots. The Britax Frontier 85 will last your child the longest because of its 85 lb weight limit with the harness and its 20″ top slots for the harness. I’ve asked many parents with 2 year olds who were 40 lbs. They said that they do not regret the decision of buying a Britax Frontier 85 at all because they were able to keep their child in a harness much longer.
There is another car seat- the Evenflo Maestro; it has 18″ top slots, but has a weight limit with the internal harness. If you have a lightweight but a child with a long torso; this may be the car seat for you…
The point is that there are options.
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