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New Advice: Use Rear-Facing Seats Until Age 2, Booster Until Age 8-12

Children should ride in the back seat until age 13.

 New advice from the American Academy of Pediatrics (AAP) is changing the way parents buckle up their children for a drive.

Parents now are being advised to keep toddlers in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat, according to a new policy published in the medical journal "Pediatrics."

Additionally, children should ride in belt-positioning booster seats until they have reached 4 feet 9 inches tall and are between 8 and 12 years of age.

Why the Change?

According to the AAA, studies of U.S. crash data show 1-year-olds are five times less likely to be injured in a crash if they are in a rear-facing car seat than a forward-facing seat. Spinal cord injuries are a possible risk for toddlers who are in a crash in a forward-facing car seat because of their relatively large heads and fragile spines.

Keeping a toddler rear facing keeps the child’s head, neck and spine better supported as a rear-facing seat cradles the child while distributing the crash forces along the shell of the seat. This change should lead to more parents keeping children rear-facing longer, which should reduce injuries.

The change in the booster seat recommendation is based on evidence from crashes where poorly fitting seat belts caused abdominal and spinal injuries in this age group, says the AAA. The change should reduce injuries by leading to fewer children prematurely moving out of booster seats before they’re ready.

The previous AAP policy, from 2002, instructed that it was safest for infants and toddlers to ride rear-facing up to the limits of the car seat, but it also cited age 12 months and 20 pounds as a minimum. As a result, many parents turned the seat to face the front of the car when their child celebrated his or her first birthday.

"Parents often look forward to transitioning from one stage to the next, but when it comes to car seats, these transitions should be delayed until the child fully outgrows the seat," said pediatrician Dennis Durbin, MD, FAAP, lead author of the policy statement and accompanying technical report.

"A rear-facing child safety seat does a better job of supporting the head, neck and spine of infants and toddlers in a crash, because it distributes the force of the collision over the entire body," Dr. Durbin said.

While the rate of deaths in motor vehicle crashes in children under age 16 has decreased substantially — dropping 45 percent between 1997 and 2009 — it is still the leading cause of death for children ages 4 and older. Counting children and teens up to age 21, there are more than 5,000 deaths each year.

Children should transition from a rear-facing seat to a forward-facing seat with a harness, and stay in that seat until they reach the maximum weight or height for it. There are three types of rear-facing car safety seats: infant-only seats, convertible seats, and 3-in-1 seats. When children reach the highest weight or length allowed by the manufacturer of their infant-only seat, they should continue to ride rear-facing in a convertible seat or 3-in-1 seat.

After that, a booster seat should be used to make sure the vehicle's lap-and-shoulder belt fits properly. The shoulder belt should lie across the middle of the chest and shoulder, not near the neck or face. The lap belt should fit low and snug on the hips and upper thighs, not across the belly. Most children will need a booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years old.

All children should ride in the rear of a vehicle until they are 13 years old.

For more information, visit the Car Safety Seat page at healthychildren.org.

State Point Media

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