Recently the American Academy of Pediatrics changed its position on car seats by increasing the age to two years old that we should keep our children in rear facing seats. Here is part of their statement on the subject:
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. “For larger children, a forward-facing seat with a harness is safer than a booster, and a belt-positioning booster seat provides better protection than a seat belt alone until the seat belt fits correctly.”
While I am happy to see an organization in the USA make this recommendation they could have gone further. After reviewing the literature I firmly believe that we should keep our children in rear facing seats as long as possible. In a number of European countries it is commonplace to keep children in rear facing seats until they are 5 years old or up to 55lbs. Their standards are based on protecting the fragile neck and spine of children that are in greater risk in a forward facing seat than a rear facing one. In high speed collisions a child is more likely to suffer spinal injuries or even death in a forward facing seat than in a rear facing seat. Rear end collisions are not as big of a concern because in high speed rear end crashes the car should absorb most of the impact force and protect its occupants. Here is a video with animation that shows the difference between the two car seats.
You can say that this is just an animation and might not depict what would actually happen, but this animation is directly from impact tests done in Europe. Did you know that in the US side impact testing is not required of child safety seats? That fact alone shows that the US regulation of car seat safety is lacking far behind its European counterparts.
Most people who have reservations about this usually mention two things; first is that it can not be comfortable for a child to sit cross legged or with their knees in their chest, the second is the child might injure their legs or break a leg in a crash. This first concern might be true for an adult, but a child does not share our in flexibility in the hips so they should be comfortable facing rear especially if that is all they know. You might have a problem transitioning them to a rear facing seat after a year or more of forward facing. As for injuring or breaking a leg, there is little to no evidence of this occurring in a rear facing seat, but there is numerous evidence for severe neck and spinal injuries in forward facing seats. Even if your child might break a leg in a crash, wouldn't that be better than breaking their neck?
I bring this up on memorial day weekend, not to scare parents but to help them make informed decisions about their family's health. European safety standards are far better than ours and it is not a wonder why. In the US there are too many too powerful special interest groups that have control over regulation. It was a bold move for the AAP to change their recommendations but it has come long after parts of Europe and does not go far enough. If anything I hope that this article starts a little fire to get better informed on your child's safety as they travel in your cars. To be honest I wish I could say we kept our kids in rear facing until they were 5 years old but we did not, we did make it to about two years old though with each of them. Today we have them in booster seats that have backs to them, backless boosters are not safe but that is a topic for another day.
Here are a few other Internet sources to read to help you decide the best actions for your family.
American Academy Of Pediatrics 2011 Car seat release
This a a car safety website that has extensive info on rear facing car seats.
This link, and this other one are some blogs that have not been updated in a while but still have good personal information from people who keep their children in rear facing seats.
