How long to keep child in rear facing car seat

Car Seats: Information for Families

​One of the most important jobs you have as a parent is keeping your child safe when your child is riding in a vehicle.

Each year, thousands of young children are killed or injured in car crashes. Proper use of car safety seats helps keep children safe. But, because so many different seats are on the market, many parents find this overwhelming. If you are expectant parents, consider working with a certified passenger safety technician (CPST or CPS technician), before your baby is born, to ensure a safe ride home from the hospital.

The type of seat your child needs depends on several things, including your child's age, size, and developmental needs. Here is more information from the American Academy of Pediatrics (AAP) about choosing the most appropriate car safety seat for your child.

Visit here for a listing of car seats & car seat manufacturers.

Types of car seats at a glance:

This chart is a quick guide on where to start your search. It's important to continue your research to learn about each seat you use.

Car safety seats may be installed with either the vehicle's seat belt or its LATCH (lower anchors and tethers for children) system. LATCH is an attachment system for car safety seats. Lower anchors can be used instead of the seat belt to install the seat, and many parents find them easier to use in some cars. The top tether should always be used with a forward-facing seat, whether you use the seat belt or lower anchors to secure it. The seat belt and LATCH systems are equally safe, so caregivers should use one or the other, whichever works best for them, for their car safety seat, and their vehicle. In general, caregivers should only use 1 of the 2 options unless the car safety seat and vehicle manufacturers say it is OK to use 2 systems at the same time.

Vehicles with the LATCH system have lower anchors located in the back seat, where the seat cushions meet. Tether anchors are located behind the seat, either on the panel behind the seat (in sedans) or on the back of the seat, ceiling, or floor (in most minivans, SUVs, hatchbacks, and pickup trucks). All forward-facing car safety seats have tethers or tether connectors that fasten to these anchors. Nearly all passenger vehicles and all car safety seats made on or after September 1, 2002, are equipped to use LATCH. See vehicle owner's manual for highest weight of child allowed to use top tether.

All lower anchors are rated for a maximum weight of 65 pounds (total weight includes car safety seat and child). Parents should check the car safety seat manufacturer's recommendations for maximum weight a child can be to use lower anchors. New car safety seats have the maximum weight printed on their label.

NOTE: Seat belts—If you install a car safety seat by using your vehicle's seat belt, you must make sure the seat belt locks to hold the seat tightly. In most newer cars, you can lock the seat belt by pulling it all the way out and then allowing it to retract to keep the seat belt tight around the car safety seat. In addition, many car safety seats have built-in lock-offs so you can lock the belt without having to lock the seat belt separately as well. Refer to the vehicle owner's manual for details about how your seat belt locks.

Middle of the back seat—The safest place to ride for all children younger than 13 years is the back seat. If possible, it may be best for the child to ride in the middle of the back seat. However, it is sometimes difficult to install a car safety seat tightly in the middle if the vehicle seat is narrow or uneven. Also, many vehicles do not have lower anchors for the middle seating position. It is safest to put the car safety seat in a position where you can install it tightly with either the lower anchor system or the seat belt; in some cases, this position may be on either side of the back seat rather than in the middle. A child passenger safety technician (CPST or CPS technician) can help you decide which place is best to install your child's car safety seat in your vehicle.

The AAP recommends that all infants ride rear facing starting with their first ride home from the hospital. All infants and toddlers should ride in a rear-facing seat as long as possible until they reach the highest weight or height allowed by their car safety seat manufacturer. Most convertible seats have limits that will allow children to ride rear facing for 2 years or more. When infants outgrow their rear-facing–only seat, a convertible seat installed rear facing is needed. All parents can benefit from getting installation help from a CPST to ensure that their child's seat is properly installed.

Types of rear-facing seats

Three types of rear-facing seats are available: rear-facing–only, convertible, and all-in-one. When children reach the highest weight or length allowed by the manufacturer of their rear-facing–only seat, they should continue to ride rear facing in a convertible or all-in-one seat.

Rear-facing–only seats

• Are used for infants up to 22 to 35 pounds and 26 to 35 inches, depending on the model.

• Are small and have carrying handles.

• Usually come with a base that can be left in the car. The seat clicks into and out of the base so you don't have to install the seat each time you use it. Parents can buy more than one base for additional vehicles.

• Should be used only for a child's travel (not sleeping, feeding, or any other use outside the vehicle).

Convertible seats (used rear facing)

• Can be used rear facing and, later, "converted" to forward facing for older children when they outgrow either the weight limit or the length limit for rear facing. This means the seat can be used longer by your child. Convertible seats are bulkier than infant seats, however, and they do not come with carrying handles or separate bases and are designed to stay in the car.

• Many have higher limits in rear-facing weight (up to 40–50 pounds) and height than those of rear-facing– only seats, a feature that makes convertible seats ideal for bigger babies and toddlers.

• Have a 5-point harness that attaches at the shoulders, at the hips, and between the legs.

• Should be used only for a child's travel (not sleeping, feeding, or any other use outside the vehicle).

All-in-one seats (used rear facing)

• Can be used rear facing, forward facing, or as a belt- positioning booster. This means the seat may be used longer by your child as your child grows.

• Are often bigger in size, so it is important to check that they fit in the vehicle while they are rear facing.

• Do not have the convenience of a carrying handle or separate base; however, they may have higher limits in rear-facing weight (up to 40–50 pounds) and height than those of rear-facing–only seats, a feature that makes all-in-one seats ideal for bigger babies and toddlers.

Installation tips for rear-facing seats

Always read the vehicle owner's manual and the car safety seat manual before installing the seat.

When using a rear-facing seat, keep the following tips in mind:

• Place the harnesses in your rear-facing seat in slots that are at or below your child's shoulders.

• Ensure that the harness is snug (you cannot pinch any slack between your fingers when testing the harness straps over the child's shoulders) and that the chest clip is placed at the center of the chest, even with your child's armpits.

• Make sure the car safety seat is installed tightly in the vehicle with either lower anchors or a locked seat belt. Many car safety seats have an integrated lock-off system to keep the seat belt locked. If your seat has one, follow the manufacturer's recommendations on how to use it. If you can move the seat at the belt path more than an inch side to side or front to back, it's not tight enough.

• Never place a rear-facing seat in the front seat of a vehicle that has an active front passenger airbag. If the airbag inflates, it will hit the back of the car safety seat, right against your child's head, and could cause serious injury or death.

• If you are using a convertible or all-in-one seat in the rear-facing position, make sure the seat belt or lower anchor webbing is routed through the correct belt path. Check the instructions that came with the car safety seat to be sure.

• Make sure the seat is at the correct angle so your child's head does not flop forward. Check the instructions to find out the correct angle for your seat and how to adjust the angle if needed. All rear-facing seats have built-in recline indicators.

• Check the car safety seat instructions and vehicle owner's manual about whether the car safety seat may contact the back of the vehicle seat in front of it.

• Still having trouble? Check with a certified CPST in your area who can help.
  

Common questions

What if my child's feet touch the back of the vehicle seat?

What do I do if my child slouches down or to the side in the car seat?

• You can try placing a tightly rolled receiving blanket on both sides of your child. Many manufacturers allow the use of a tightly rolled small diaper or cloth between the crotch strap and your child, if necessary, to prevent slouching. Do not place padding under or behind your child or use any sort of car safety seat insert unless it came with the seat or was made by the manufacturer for use with that specific seat.
  

Why should I dress my child in thinner layers of clothing before strapping them into a car safety seat?

• Bulky clothing, including winter coats and snowsuits, can compress in a crash and leave the straps too loose to restrain your child, leading to increased risk of injury. Ideally, dress your baby in thinner layers and wrap a coat or blanket around your baby over the buckled harness straps if needed. See Winter Car Seat Safety Tips from the AAP.

Do preemies need a special car seat?

A car safety seat should be approved for a baby's weight. Very small babies who can sit safely in a semi-reclined position usually fit better in rear-facing–only seats. Babies born preterm should be screened while still in the hospital to make sure they can sit safely in a semi-reclined position. Babies who need to lie flat during travel may be able to ride in a car bed that meets Federal Motor Vehicle Safety Standard 213. They should be screened again while in the hospital to make sure they can lie safely in the car bed.

Always read the vehicle owner's manual and the car safety seat manual before installing the seat.

Any child who has outgrown the rear-facing weight or height limit for her convertible seat should use a forward- facing seat with a harness for as long as possible, up to the highest weight or height allowed by her car safety seat manufacturer. It is best for children to ride in a seat with a harness as long as possible, at least to 4 years of age. If your child outgrows a seat before reaching 4 years of age, consider using a seat with a harness approved for higher weights and heights.

Types of Forward-Facing Car Seat Restraints

Four types of car safety restraints can be used forward facing:

• Convertible seats: Seats can "convert" from rear facing to forward facing. These include all-in-one seats.

• Combination seats with harness: Seats can be used forward facing with a harness for children who weigh up to 40 to 65 pounds (depending on the model) or without the harness as a booster (up to 100–120 pounds, depending on the model).

• Integrated seats: Some vehicles come with built-in forward-facing seats. Weight and height limits vary. Do not use a built-in seat until your child has reached the highest weight or height allowed for your rear-facing convertible car safety seat. Read your vehicle owner's manual for details about how to use these seats.

• Travel vests: Vests can be worn by children 22 to 168 pounds and can be an option to traditional forward- facing seats. They are useful for when a vehicle has lap-only seat belts in the rear, for children with certain special needs, or for children whose weight has exceeded that allowed by car safety seats. These vests usually require use of a top tether.

Installation tips for forward-facing seats

Always read the vehicle owner's manual and the car safety seat manual before installing the seat.

It is important that the car safety seat is installed tightly in the vehicle and that the harness fits your child snugly.

To switch a convertible or all-in-one seat from rear-facing to forward-facing:

• Move the harness shoulder straps to the slots or position that is at or just above your child's shoulders. Check the instructions that came with the seat to be sure you are positioning the shoulder straps correctly.

• You may have to adjust the recline angle of the seat so that it sits more upright in your vehicle. Check the instructions to be sure.

• If using a seat belt, make sure it runs through the forward-facing belt path (be sure to follow car safety seat instructions) and that the seat belt is locked and tightened. Many car safety seats have an integrated lock-off to keep the seat belt locked. If your seat has one, follow the manufacturer's recommendations on how to use it.
  

• If using the lower anchors, make sure that the weight of your child plus the weight of the seat does not exceed 65 pounds. Most seats now state in the manual and on the stickers on the side the maximum child weight to use the anchors. If the child weighs too much, caregivers must use the seat belt to install.

• Always use the tether when you can. A tether is a strap that is attached to the top part of a car safety seat and holds the seat tightly by connecting to an anchor point in your vehicle (often on the seat back or rear shelf; see your vehicle owner's manual to find where tether anchors are in your vehicle). Tethers give important extra protection by keeping the car safety seat and your child's head from moving too far forward in a crash or sudden stop. All new cars, minivans, and light trucks are required to have tether anchors as of September 2000. Forward-facing seats come with tether straps. A tether should always be used as long as your child has not reached the top weight limit for the tether anchor. Check the car safety seat instructions and vehicle owner's manual for information about the top weight limit and locations of tether anchors.

• Watch the Video: How to Install a Forward-Facing Car Seat

Common question

What if I drive more children than those who can be buckled safely in the back seat?

• It's best to avoid this, especially if your vehicle has airbags in the front seat. All children younger than 13 years should ride in the back seat. If absolutely necessary, a child in a forward-facing seat with a harness may be the best choice to ride in front. Just be sure the vehicle seat is moved as far back away from the dashboard (and airbag) as possible.
  

Booster seats are for older children who have outgrown their forward-facing seats. All children whose weight or height exceeds the forward-facing limit for their car safety seat should use a belt-positioning booster seat until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches in height and are 8 to 12 years of age. Most children will not fit in most vehicle seat belts without a booster until 10 to 12 years of age. All children younger than 13 years should ride in the back seat. Instructions that come with your car safety seat will tell you the height and weight limits for the seat. As a general guideline, a child has outgrown a forward-facing seat when any of the following situations is true:

• They reach the top weight or height allowed for his seat with a harness. (These limits are listed on the seat and in the instruction manual.)

• Their shoulders are above the top harness slots.

• The tops of their ears have reached the top of the seat.

Types of booster seats

High-back and backless are 2 standard types of booster seats. They do not come with a harness but are used with lap and shoulder seat belts in your vehicle, the same way an adult rides. They are designed to raise a child up so that lap and shoulder seat belts fit properly over the strongest parts of the child's body.

Most booster seats are not secured to the vehicle seat with the seat belt or lower anchors and tether but simply rest on the vehicle seat and are held in place once the seat belt is fastened over a child. However, some models of booster seats can be secured to the vehicle seat and kept in place by using the lower anchors and tether along with lap and shoulder belts. (Currently, only a few vehicle manufacturers offer integrated booster seats.)

Installation tips for booster seats

When using a booster seat, always read the vehicle owner's manual and the car safety seat manual before installing the seat. Booster seats often have a plastic clip or guide to correctly position vehicle lap and shoulder belts. See the booster seat instruction manual for directions on how to use the clip or guide. Booster seats must be used with lap and shoulder belts. When using a booster seat, make sure:

• The lap belt lies low and snug across your child's upper thighs.

• The shoulder belt crosses the middle of your child's chest and shoulder and is off the neck.

• Watch the video: How to Use a Booster Seat

If your booster seat has lower anchors or tether attachments, check its manual for installation instructions.

Common questions about booster seats

What if my car has only lap belts in the back seat?

Lap belts work fine with rear-facing–only, convertible, and forward-facing seats that h av e a harness but can never be used with a booster seat. If your car has only lap belts, use a forward-facing seat that has a harness and higher weight limits. You could also

• Check to see if shoulder belts can be installed in your vehicle.

• Use a travel vest (check the manufacturer's instructions about the use of lap belts only and about the use of lap and shoulder belts).

• Consider buying another car with lap and shoulder belts in the back seat.

What is the difference between high-back boosters and backless boosters?

• Both types of boosters are designed to raise your child so seat belts fit properly, and both will reduce your child's risk of injury in a crash. High-back boosters should be used in vehicles without headrests or with low seat backs. Many seats that look like high-back boosters are actually combination seats. They come with harnesses that can be used for smaller children and, later, removed for older children. Backless boosters are usually less expensive and are easier to move from one vehicle to another. Backless boosters can be used safely in vehicles with headrests and high seat backs.
  

Seat belts are made for adults. Children should stay in a booster seat until adult seat belts fit correctly, typically when children reach about 4 feet 9 inches in height and are 8 to 12 years of age. Most children will not fit in a seat belt alone until 10 to 12 years of age. When children are old enough and large enough to use the vehicle seat belt alone, they should always use lap and shoulder seat belts for the best protection. All children younger than 13 years should ride in the back seat.

Using a seat belt:

An adult seat belt fits correctly when:

• The shoulder belt lies across the middle of the chest and shoulder, not the neck or throat.

• The lap belt is low and snug across the upper thighs, not the belly.

• Your child is tall enough to sit against the vehicle seat back with her knees bent over the edge of the seat without slouching and can comfortably stay in this position throughout the trip.

Other points to keep in mind when using seat belts include:

• Make sure your child does not tuck the shoulder belt under her arm or behind her back. This leaves the upper body unprotected and adds extra slack to the seat belt system, putting your child at risk of severe injury in a crash or with sudden braking.

• Never allow anyone to "share" seat belts. All passengers must have their own car safety seats or seat belts.

Common question

I've seen products that say they can help make the seat belt fit better. Should we get one of these?

• No, these products are unapproved and should not be used. They may actually interfere with proper seat belt fit by causing the lap belt to ride too high on the stomach or making the shoulder belt too loose. They can even damage the seat belt. This rule applies to car safety seats too; do not use extra products unless they came with the seat or are specifically approved by the seat manufacturer. These products are not covered by any federal safety standards, and the AAP does not recommend they be used. As long as children are riding in the correct restraint for their size, they should not need to use additional devices.
  

When shopping for a car seat, keep the following tips in mind:

• No one seat is the "best" or "safest. " The best seat is the one that fits your child's size, is correctly installed, fits well in your vehicle, and is used properly every time you drive.

• Don't decide by price alone. A higher price does not mean the seat is safer or easier to use.

• Avoid used seats if you don't know the seat's history.

• Watch the Video: What to Look For When Purchasing a Car Seat

Never use a car seat that:

• Is too old. Look on the label for the date the seat was made. Check with the manufacturer to find out how long it recommends using the seat.

• Has any visible cracks on it.
  

• Does not have a label with the date of manufacture and model number. Without these, you cannot check to see if the seat has been recalled.

• Does not come with instructions. You need them to know how to use the seat. Instructions can be found on manufacturer websites or by contacting the manufacturer.

• Is missing parts. Used car safety seats often come without important parts. Check with the manufacturer to make sure you can get the right parts.

• Was recalled. You can find out by calling the manufacturer or contacting the National Highway Traffic Safety Administration (NHTSA) Vehicle Safety Hotline at 888/327-4236. You can also visit the NHTSA Website.

• Do not use seats that have been in a moderate or severe crash. Seats that were in a minor crash may still be safe to use, but some car safety seat manufacturers recommend replacing the seat after any crash, even a minor one. The NHTSA considers a crash minor if all the following situations are true:

• The vehicle could be driven away from the crash.

• The vehicle door closest to the car safety seat was not damaged.

• No one in the vehicle was injured.

• The airbags did not go off.

• You can't see any damage to the car safety seat.

• If you have specific questions about the car seat, contact the manufacturer.

Front airbags are installed in all new cars. When used with seat belts, airbags work well to protect teenagers and adults; however, airbags can be very dangerous to children, particularly to those riding in rear-facing seats and to preschoolers and young school-aged children who are not properly restrained. If your vehicle has a front passenger airbag, infants in rear-facing seats must ride in the back seat. Even in a relatively low-speed crash, the airbag can inflate, strike the car safety seat, and cause serious brain injury and death.

Vehicles with no back seat or a back seat that is not made for passengers are not the best choice for traveling with small children; however, the airbag can be turned off in some of these vehicles if the front seat is needed for a child passenger. See your vehicle owner's manual for more information.

Side airbags are available in most new cars. Side airbags improve safety for adults in side-impact crashes. Read your vehicle owner's manual for more information about the airbags in your vehicle. Read your car safety seat instructions and the vehicle owner's manual for guidance on placing the seat next to a side airbag.

About carpooling

If your child is being driven by someone else, make sure:

• The car safety seat your child will be using fits properly in the vehicle used for transport.

• The car safety seat being used is appropriate for the age and size of your child.

• The person in charge of transporting your child knows how to install and use the car safety seat correctly.

Child care programs and schools should have written guidelines for transporting children, including

• All drivers must have a valid driver's license. In some states, school bus drivers need to have a special type of license.

• Staff to child ratios for transport should meet or exceed those required for the classroom.

• Every child should be supervised during transport, either by school staff or a parent volunteer, so the driver can focus on driving.

• School staff, teachers, and drivers should know what to do in an emergency, know how to properly use car safety seats and seat belts, and be aware of other safety requirements.

About car safety seats on airplanes

The Federal Aviation Administration (FAA) and the AAP recommend that children less than 40 pounds be securely fastened in certified child restraints when flying. This will help keep them safe during takeoff and landing or in case of turbulence. Most rear-facing, convertible, and forward-facing seats can be used on airplanes , but booster seats and travel vests cannot.

Read your seat's instruction manual and look for a label on the car safety seat that says, "This restraint is certified for use in motor vehicles and aircraft. " You can also consider using a restraint made only for use on airplanes and approved by the FAA. Larger children may use the airplane seat belt or continue to use their car safety seat on the airplane as long as it is labeled for use on aircraft and the child has not exceeded the seat's weight or height limit. Remember that your child will need an appropriate car safety seat to use at your destination. For more information, visit the FAA Website or the CARES (Airplane Safety Harness for Children) Website.

If you need installation help

If you have questions or need help with installing your car safety seat, find a certified child passenger safety technician (CPST or CPS technician). Lists of certified CPSTs and child seat–fitting stations are available on the following websites:

• National Child Passenger Safety Certification (Click on "Find a Tech" or call 877-366-8154.) – Includes list of CPSTs fluent in Spanish and other languages or with extra training in transportation of children with special needs.

• NHTSA Parents & Caregivers

Important reminders

Be a good role model. Make sure you always wear your seat belt. This will help your child form a lifelong habit of buckling up.

Make sure that everyone who transports your child uses the correct car safety seat or seat belt on every trip, every time. Being consistent with car safety seat use is good parenting, reduces fussing and complaints, and is safest for your child.

Never leave your child alone in or around cars, and lock your vehicle when it is not in use. Any of the following situations can happen when a child is left alone in or around a vehicle. A child can

• Die of heatstroke because temperatures can reach deadly levels in minutes.

• Be strangled by power windows, retracting seat belts, sunroofs, or accessories.

• Knock the vehicle into gear, setting it into motion.

• Be backed over when the vehicle backs up.

• Become trapped in the trunk of the vehicle.

Always read and follow the manufacturer's instructions for your car safety seat. If you do not have those, write or call the company's customer service department. Staff will ask you for the model number, name of seat, and date of manufacture. The manufacturer's address and phone number are on a label on the seat. Also, be sure to follow the instructions in your vehicle owner's manual about using car safety seats. Some manufacturers' instructions may be available on their websites.

Remember to fill out and mail in the registration card that comes with the car safety seat. You can also register your seat on the manufacturer's website. It will be important in case the seat is recalled.

Follow manufacturer directions for cleaning car seats. Cleaning but not disinfecting is usually permitted. That's because disinfectant products may decrease the protection provided by the seat and harness.

More information

• Ask the Pediatrician: Is it safe for my baby to travel in a car seat a few hours at a time?
  
• Car Seats: Product Listing
• Car Seat Checkup
• Car Seats and Obese Children: Suggestions for Parents
• Prevent Child Deaths in Hot Cars
• Travel Safety During COVID-1 9

_{Although the AAP is not a testing or standard-setting organization, this article sets forth the AAP recommendations based on the peer-reviewed literature available at the time of its publication and sets forth some of the factors that parents should consider before selecting and using a car seat.}

_{Figure 1 adapted from US Department of Transportation, National Highway Traffic Safety Administration (NHTSA). LATCH Makes Child Safety Seat Installation as Easy as 1-2-3. Washington, DC: NHTSA; 2011. DOT HS publication 809 489.}

_{Figure 4 from Bull MJ, Engle WA; American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention and Committee on Fetus and Newborn. Safe transportation of preterm and low birth weight infants at hospital discharge. Pediatrics. 2009;123(5):1424–1429.}

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

How long should my child ride rear-facing?

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Benjamin Hoffman, MD, FAAP

Answer

​Rear facing is not just for babies! The American Academy of Pediatrics (AAP) has long recommended that―infants ride in rear-facing car seats, and in 2018 the AAP updated that recommendation to encourage rear facing for as long as possible, until a child reaches the highest weight or height allowed by the manufacturer. Most convertible car safety seats have limits that will permit children to ride rear-facing past the second birthday.

Why the Change?

This recommendation was based not only on motor vehicle crashes in which children died or were injured, but also from what we know about the anatomy of young children. Young children have large heads compared to their body size, and a high center of gravity. The vertebrae in their spine are more shallow, and their ligaments are looser. All of these factors increase the risk of a spine injury in a crash. In a sudden, violent stop, a rear-facing seat will cradle a child's entire back and spread out the force of the crash, reducing the risk of serious injuries to the neck and spine.

More Evidence:

Children in other countries routinely ride rear-facing until age 4. Deaths and serious injuries to these children are extremely rare. While differences in car seats, vehicles, and driving conditions make it tricky to compare, data from those countries suggest that children in the U. S. are also best protected by riding rear-facing for as long as they can.

The Good News:

Over the years, car seat manufacturers have increased the weight and height limits on their rear-facing seats. This means that more children can ride rear-facing as they grow well into the toddler and preschool years.

No matter which direction your child faces in the car, though, it is important to read and follow the instructions from your car seat manufacturer. A certified child passenger safety technician can help you figure out what is best for your child and your vehicle. Find one online from the National Highway Traffic Safety Administration or Safe Kids Worldwide.

Additional Information from HealthyChildren.org:

• Rear-Facing Car Seats for Infants & Toddlers

• Car Seats: Product Listing

• Shopping for Car Seats: Tips for Parents

Benjamin Hoffman, MD, FAAP

​Benjamin Hoffman, MD, FAAP is a Professor of Pediatrics and the Director of the Tom Sargent Safety Center at Doernbecher Children's Hospital at Oregon Health and Science University in Portland, Oregon. In addition, he serves as Director of the Oregon Center for Children and Youth with Special Healthcare Needs. After graduating from Harvard Medical School and completing his pediatric training at Seattle Children's Hospital, Dr. Hoffman directed the pediatric residency program and served as assistant dean for graduate medical education at the University of New Mexico before moving to Oregon. He is a nationally recognized educator and expert in child passenger safety, and leader in the field of community health and advocacy training for pediatric residents. Within the American Academy of Pediatrics, Dr. Hoffman is a member of the Council on Injury, Violence, and Poison Prevention, as well as Associate Director of the Community Pediatrics Training Initiative. Follow him on Twitter @DrBenHoffman. ​

Last Updated

3/6/2020

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Child car seats, forward facing or rear facing? A small educational program. / Copyright / Blog on Avtokresel.net

November 30, 2013

THIS IS AN IMPORTANT TOPIC! HIGHLY RECOMMEND READING. ESPECIALLY to the sellers of regional stores, which are still...

THIS IS AN IMPORTANT TOPIC! HIGHLY RECOMMEND READING. ESPECIALLY sellers of regional stores, which so far on my blog, according to indirect data, are more than ordinary people. Little announcement - in this article I will analyze not only the standard postulates for installing cradles for newborns, but also much less unambiguous moments in the development of a child, namely, how should one ride, say, at 7 months? Or at 9? Or at 11?

Group 0+ - driving in a child car seat from birth:

A small child must ride in a rear facing child car seat. This common truth, it seems, has already been learned by everyone. Or almost everything. Or rather, not all. It is difficult to say how many times I have seen a child in a group 0+ seat, which they managed to install in the direction of the car! Yet these are the vast minority.
And the arguments of such "responsible" parents, as a rule, are "it's more convenient for the child", "the child sees better this way", "this is how he looks at his mother", etc.

So, a child car seat is a safety feature, not a decoration in a car. And it is babies who are most vulnerable in the car. That is why, according to the World Health Association, the use of child seats in infancy reduces mortality by 71%!!!! But we are talking about correctly installed child car seats!

At this age, the cervical spine is very poorly formed, and the mass of the head in relation to body weight is very large. Therefore, it is IMPOSSIBLE to place a child of group 0+ in the direction of travel in a car IN NO EVENT! This is fraught with injury even with sudden braking, not to mention a serious accident. And it’s just that the load in this position is distributed evenly over the child’s body, minimizing the load on the still very weak spine.

And the same applies to 7-8 month old babies, even if they weigh more than 9kg, which formally marked the beginning of group 1. And the fact that they already know how to sit themselves does not matter. If it does not fit into the cradle, we take the group 0+/1.

CONCLUSION: from birth and MINIMUM 9 MONTHS AND MINIMUM 9 kg of weight - ONLY AGAINST AUTO MOTION.

Group 1 car seats. Formally from 9 months, 9 kg to 18 kg (up to about 3 - 3.5 years).

And here is another slippery moment. FORMALLY a 9 month old baby who has reached a weight of 9kg can be put in a car seat of group 1. Those. along the way.
Now let's look at some facts.

- FACT 1. According to the same WHO:

Benefits of using child car seats - reducing the risk of injury in different installation directions (the higher the value, the more likely the child is to avoid injury):

- FACT 2. In Europe, amendments to the ECE R44 / 04 rule are being actively implemented, as well as the new I-Size standard, which will also become mandatory for car manufacturers. They will come into full force in 2018. An important innovation is, among other things, that rear facing car seats will be mandatory until the age of 15 months!!! Not 9, not 10, and not even 12, as the most advanced sellers recommend, but up to 15. Naturally, society still needs to get used to this, but from 2018 in the EU this will be enshrined in law.

- FACT 3. Below is a table comparing child deaths in traffic accidents in Germany and Sweden, broken down by age of children.

So, the graph compares 2 countries with a very high level of equipping cars with child car seats.

The only difference is that in Germany a child from 9 months 9 kg can already be seated in the direction of travel, and in Sweden (as in all Scandinavian countries), a child must ride against the direction of travel until 2 years old.

Pay attention to the age of 1 year (or so). That is the FORMAL beginning of group 1. We can see that in Germany at this age there is the largest peak of child mortality, more than 2 times higher than the maximum rates at other ages.

And in Sweden? NOT A SINGLE dead child at this age for 6 years.

OUTPUT:

It is necessary to drive against the course as long as possible. Ideally - up to one and a half to two years. Well, at least up to a year. We get used to it, a few years and everyone will do it, they won’t go anywhere. Fortunately, seats of group 0+/1 , which are not inferior in safety to good chairs of both declared groups, are not so few.

Well, this is especially true for reflection for those who are at 9-10 months wants to buy not only a chair of the 1st group, but a one-piece transformer 1-2-3.

P.S. For those who read to the end, which means they considered the article at least interesting. Do you have a website? Blog? Social media account? Recommend this article, it answers one of the most common questions and misconceptions of parents when choosing a child car seat. And they get very different answers. Maybe we can save a few children's lives in this way by joint efforts.

Comments

Carrying a child face or back?

Many parents ask the question "... at what age should a child be carried forward facing?" « , « ... our baby no longer wants to ride with his back, pick up a chair so that he can look out the window while sitting facing forward ", etc.

Let's figure out which car seat and how to transport a child, face or back?

Children aged up to 2-3 years , are the most vulnerable group . The child already runs well, jumps, but the muscles, bones and cartilaginous joints of the child are still fragile, not like those of a teenager or an adult, and in fact, situations sometimes occur on the road in which the load on the child's body can exceed the permissible limits.

In the event of an accident, the risk of death or serious injury in children under the age of 2-3 years REDUCED by 5!!! times (accident statistics involving children), IF he is in a car seat backwards (of course, if the car seat allows the child to be transported backwards).
Statistical analysis showed that forward-facing children were significantly more likely to be seriously injured.

So why is it safer to carry a child

So why is “backwards” safer and Sweden, which is famous for its safe cars, allows transportation of children up to 3 years old, backwards.

The first - according to the figures of the same statistics, in car accidents there are most frontal (frontal) collisions. They are very difficult for passengers (especially for small passengers), because the resulting speeds (with them and overload ) in this case - are maximum .

Second - children (especially those under 3 years old) are much more fragile than an adult (which we wrote about a little earlier). And the head of a child relative to the body is much heavier than that of an adult, and therefore it is almost impossible to hold the head with weak muscles!

The picture shows two options:

A - a child in a car seat facing in the direction of travel,

B - with his back in the direction of travel.

When the baby is in a forward-facing child car seat, there is no head restraint ( A ) .

In a head-on collision , the head jerks forward sharply and strongly due to inertia (if the blow is strong, the head may hit the child's chest, knees) and throws it back with force.

In this case, the main load will be on the child's neck and spine. At a resulting speed of 75-80 km/h, a force equivalent to 300-320 kg acts on the child's cervical region!!! Due to the fact that the vertebrae, muscles, cartilaginous joints are not so well developed, they are not able to withstand such a load, and the main destructive force affects the spinal cord, which remains unprotected.

Carried out crash tests have clearly shown that the neck of child dummies is extended by more than 5 cm ! The spinal cord can withstand no more than 5 mm . It is probably not necessary to explain the conclusions in real life ...

Quote from a medical source: “At autopsy, samples of the vertebrae and ligaments of infants withstand stretching up to 5 cm, but the brain tissue itself is torn if it is stretched a little more than 0, 5 cm.

In addition, a force equivalent to 90-96 kg. The soft sternum and ribs cannot protect vital organs such as the heart and spleen from damage.

When the child is seated backwards in the child car seat (B)

during a frontal collision, by inertia continues to move in the direction, forward and strongly pressed into the back of the car seat. With this position of the child in the car seat, the load is distributed proportionally over the back of the head, neck and back. In this case, the risk of serious injury is minimized.

For clarity, view this video:

So, in 2015, a new standard of security of children's car seats R129 ( I-SIZE ), this standard is complemented by several paragraphs, except for several paragraphs, except for several points something that should allow you to transport a child up to 105 cm backwards (more about the R129 standard ( I-SIZE )>>)

Until what age should a child ride backwards?

Minimum age, according to the recommendations of pediatricians - 11 - 12 months . This is the lower level , below which, irreversible consequences can occur ( even if you drive very slowly and carefully, it can happen - emergency braking, light accident, collision, reckless driver flying into the oncoming lane ). Indeed, for sure, many parents know that up to 1 year old, the child’s head is heavy, and he holds it on a very fragile neck.

More precisely, you need to navigate by the weight of the child so that it does not exceed the maximum allowed for the previous chair, and height - so that the top of the head is not higher than the back of the previous chair.

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At least up to a year old, the child must be carried backwards in the direction of travel (backward), remember this and do not make any exceptions! This is your child's life!

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Very often and very many people ask this kind of question: « How to carry him backwards until he is 2. 5-3 years old, where will he put his legs? "Parents forget that such a position - with bent legs apart ("toad") - is natural for the baby, and does not cause discomfort (we think with our head, in our body and imagine ourselves in the place of a child - we, of course, are not quite I would love to go). The child will perceive it in a completely different way, this is physiology.

Many parents rush to transfer their child to face forward, saying that he does not like to sit backwards, that he is interested in watching the road, that it is more convenient for them to follow the child. Perhaps these reasons seem important to them. But they are incomparable with another reason for placing a child car seat backwards - this position will save the life and health of YOUR child, and this is much more important than all other reasons!

TOTAL: Carrying a child backwards up to the age of 3 years is the safest!

With this article, we are trying to convey to parents that important piece of information that many neglect when choosing car seats.

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