Rear-facing until 2 years old

I have had several questions lately about the rear-facing guidelines and whether they were ‘necessary’, so I thought it best to clarify the issue for myself and the families I work with.  Right now, it is not the law but a recomendation to keep your infant rear-facing until 2 years old.  Here is a more specific guideline that I would encourage everyone with infants or toddlers to consider and incorporate:

  • All infants should ride rear-facing in either an infant car seat or convertible seat.
  • If an infant car seat is used, the infant should be switched to a rear-facing convertible car seat once the maximum height (when the infant’s head is within 1 inch ofthe top of the seat) and weight (usually 22 pounds to 32 pounds) have been reached for that infant seat as suggested by the car seat manufacturer.
  • Toddlers should remain rear-facing in a convertible car seat until they have reached the maximum height and weight recommended for the model, or at least the age of 2 if they have not met these maximums.

I think that these last few statements offer more flexibility than many folks think.  If your child is long enough and/or heavy enough to be hanging off the convertible seat with his or her legs up the back, then chances are he or she has ‘graduated’ to front-facing anyway.  However, this may also be an issue of having the right car seat, so it is important to make sure that you are using the correct one (see links below for checking your car seat). 

And what is the risk of front-facing too early?  Technically the risk is of spinal cord injury to infants and ‘internal decapitation’.  It is not as if this happens often to children who are in car seats, booster seats, or belted in.  However the risk is higher in infants and toddlers because their spines are still so vulnerable and flexible.  Truly, our spinal column continues to change and develop into adulthood!  Here are some reasons for rear-facing to consider:

  • 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.
  • Rear-facing car seats spread frontal crash forces over the whole area of a child’s back, head and neck; they also prevent the head from snapping relative to the body in a frontal crash.
  • Rear-facing carseats may not be quite as effective in a rear end crash, but severe frontal and frontal offset crashes are far more frequent and far more severe than severe rear end crashes.
  • Rear-facing carseats are NOT a safety risk just because a child’s legs are bent at the knees or because they can touch/kick the vehicle seat.
  • Rear-facing as long as possible is the recommendation of the American Academy of Pediatricians, and can reduce injuries and deaths.   Motor vehicle crashes are the #1 overall cause of death for children 14 and under.

Here are some links to do reading on your own and familiarize yourself with the recommendations: (American Academy of Pediatrics) (Swedish Accident Data)

And this is another way to view weight and car safety…

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