allaboutbabysworld: Keeping Your Baby in a Rear Facing Car Seat

Everyone knows infants are supposed to be in rear facing car seats until they are a year old and 20 pounds, as required by law and recommended by the American Academy of Pediatrics (AAP). But did you know in 2011 the AAP revised its policy, due to a new study that found children younger than 2 are 75 percent less likely to be killed or injured in a car crash if they're in a rear-facing car seat. Currently the AAP and the National Highway Traffic Safety Administration recommend that children stay in rear facing car seats until they outgrow the weight and height limit on their car seat. This means most children should remain in a rear facing car seat until they are at least 2 or 3 years old. Depending on your car seats weight and height limit, your child could be as old as 4 or 5 before they need to turn their car seat around. Rear facing car seats used to have a weight and height limit that was typically met around a child's first birthday. Now, car seat manufacturers have raised the weight and height limit on their car seats, allowing your child to stay rear facing longer. The highest rear facing height and weight limit is currently is 45 lbs and 44", or when the child's head is 1.5" from the top of the car seat shell. This is means most
3 and 4 year olds can still be rear facing!

Bunny is currently rear facing at 15 months old, and about 20 pounds. Bunny will continue to be rear facing until she outgrows the weight and height limit of her car seat.

Why is rear facing better than forward facing? Young children are at a higher risk for head and spinal cord injuries because their ligaments and bones are still developing. A child's head is proportionally larger than their necks, making the structural support system unsteady. Rear facing seats give your child's head, neck and spine the best support from a car seat, and prevents your child's head from being thrown away from their body in a crash.

The most common concerns about rear facing car seats for toddlers and children are easily addressed.

Will my child be comfortable rear facing? Won't they get car sick?
No, your child will be just fine! Most toddlers and children are more comfortable rear facing because the car seat is reclined and it is MUCH more comfortable to sleep reclined vs upright. (Hopefully your child falls asleep in the car, Bunny does NOT!) Also, they can rest their feet on the seat instead of having their feet dangle over their car seat unsupported. As for getting car sick, the direction the seat faces rarely has an impact on motion sickness. Rear facing is what your child has been used to from the beginning. Why turn them around now?

Will my child's feet or legs be injured while rear facing because they are bent, crossed, or touching the back of the seat?
This is a VERY big misconception among parents. During the most common type of crash (frontal), the child's legs will fly up and away from the back of the seat. It is much more important to protect your child's head, neck and spine in a crash, which is what rear facing car seats do best. Not convinced? Take a look at this study done by Children's Hospital of Philadelphia that looks at children's injuries ages 1-4 resulting from a crash. Leg injuries were rare for children in rear facing car seats, but injuries to the lower extremity region were the second most common type of injury for children who were in forward facing car seats. Why? Because the legs of a child in a forward facing car seat are thrown forward in a crash and can hit the console or the back of the front seat. The study states, “Injuries below the knee were the most common, particularly to the tibia/fibula, and they most often occurred due to interaction with the vehicle seatback in front of the child’s seating position.” Most children find a comfortable position for their legs. Bunny either rests her legs against the seat or hangs them over the edge of her car seat.
"In a forward-facing car seat during an accident, your child's arms and legs fly forward and are more likely to be injured. In a rear-facing car seat, the chance of injuries to the arms and legs in a crash is less than 1 in 10,000," says Ben Hoffman, a nationally recognized injury prevention specialist and pediatrician at the Doernbecher Children's Hospital, Oregon Health & Science University.

My child fights me when I put him/her in the car seat, wouldn't it be easier if the car seat was forward facing?
Most likely, no. Most children go through a phase of disliking the car seat and/or the car. Bunny certainly did. She hated the car from the day she was born until recently. FINALLY at 15 months she doesn't mind being in the car. Most children fight about a lot of things, eating their vegetables, going to bed, being nice to siblings.

I can't see my child when they are rear facing. What if they choke or have an emergency? How can I interact with my child when they are rear facing?
This is where a mirror comes in handy. Bunny has a cute car seat mirror that is strapped to the headrest of her seat. I can see her, she can see me. We often wave to each other. I can see if she's sleeping, if she is happy, if she is breathing. If you are afraid your child will choke while eating food, don't feed them in the car. (See my review of a car seat mirror here.)

What if I am rear ended? Won't my child be less safe if s/he is rear facing?
The majority of rear end crashes happen when both cars are traveling in the same direction. One car is typically stopped or in the process of stopping, with the other car being in front or behind them. Crash forces are lessened in a rear end crash, which means a lower chance of injury. Severe rear end collisions are rare. Frontal and side impacts account for the majority of sever crashes involving a fatality, while rear end crashes account for less than 11.8%. "In short, if your child is rear-facing, he has optimal protection in the types of crashes you are most likely to be in. If he is forward-facing, he may have optimal protection in a rear-end crash, but statistically, that is the least likely to happen and he is 60% more likely to be injured or killed in the types of crashes (frontal, side impact) you are most likely to be in." CPSafety

My child is already forward facing! There is NO WAY s/he will be okay if I switch her/him to rear facing!
You don't know how your child will react until you try it! It is mainly the parents who are hesitant about the switch, not the child. Try to make it a positive experience! Or no experience at all. Turn the car seat around and go about your routine as usual. Many parents have turned their children back to rear facing after learning about the safety benefits rear facing provides. The majority of parents have little to no resistance from their child. Give it a try, you might be surprised at how well it is received!

Need some cold hard facts?
The AAP has recommended since 2002 that kids stay rear facing as long as possible! The previous MINIMUM guidance was age 1 or 20 pounds. The AAP recommends "Children should stay in rear-facing car seats until age 2 or until they grow too big for seat specifications"

CPSaftey states, "Children should not be turned forward-facing until they reach the maximum rear-facing limits of a convertible seat (that allows rear-facing to at least 30 lbs). These limits are either the maximum rear-facing weight limit or when the top of their head is within one inch of the top of the seat shell, whichever comes first. While most parents are aware that they must keep their children rear-facing "until they are AT LEAST 1 year old AND 20 lbs", very few are told that there are significant safety benefits when a child remains rear-facing as long as the seat allows. For most children, rear-facing can and should continue well into the second year of life."

"New research indicates that toddlers are more than five times safer riding rear-facing in a car safety seat up to their second birthday. " AAP

"Now we are challenged by greater evidence to imple- ment what we know to be best practice: Children should ride in a rear-facing seat to the highest weight or height allowed for use rear-facing by the manufacturer of the seat. " Rear Facing Car Seat Safety

Your child is five times safer in a car crash while riding rear-facing when between 12-24 months than if they were forward facing. 2's the new 1

Forward-facing children under the age of 2 are 75% more likely to be injured.

"To prevent severe spinal injury, children should remain rear-facing until they are at least one year old and weigh 20 lb, but safety experts recommend 18-24 months and up to 35 lb, depending on the restraint used." Carseat.org

"Rear-facing is safest for both adults and children, but especially for babies, who would face a greater risk of spinal cord injury in a front-facing carseat during a frontal crash." car-safety.org/

Here are some videos showing why children should be rear facing.