Even though safety features in cars have evolved over the last several decades and car seat manufacturers have improved the quality and safety of their products, motor vehicle crashes continue to be the leading cause of death in children 4 years and older. Last week, the American Academy of Pediatrics Council on Injury, Violence, and Poison Prevention revised their policy statement on child passenger safety. Rear-facing car seats are the most protective for infants and toddlers and should be maintained for as long as possible, up to the maximum height and weight limits for that seat:
When a child rides rear-facing, the head, neck, and spine are all supported by the hard shell of the car safety seat, allowing the car seat to absorb most of the crash forces, and protecting the most vulnerable parts of the body. When children ride forward-facing, their bodies are restrained by the harness straps, but their heads – which for toddlers are disproportionately large and heavy – are thrown forward, possibly resulting in spine and head injuries.
Parents often look forward to transitioning from one stage or milestone to the next. In car seats, this is one area where transitions are not “positive,” and where delaying transitions is best, according to the AAP. Each transition – from rear-facing to forward-facing, from forward-facing to booster seat, and from booster seat to seat belt alone – reduces the protection to the child.
Parents should check the instruction manual and the labels on a car safety seat to find the manufacturer’s weight and height limits. When a child is approaching one of those limits, it is time to think about transitioning to the next stage.
All parents, grandparents, and other caretakers should carefully read the AAP’s five evidence-based recommendations to optimize safety in passenger vehicles for all children, from birth through adolescence:
All infants and toddlers should ride in a rear-facing car safety seat (CSS) as long as possible, until they reach the highest weight or height allowed by their CSS’s manufacturer. Most convertible seats have limits that will permit children to ride rear-facing for 2 years or more.
All children who have outgrown the rear-facing weight or height limit for their CSS should use a forward-facing CSS with a harness for as long as possible, up to the highest weight or height allowed by their CSS’s manufacturer.
All children whose weight or height is above the forward-facing limit for their CSS should use a belt-positioning booster seat until the vehicle lap and shoulder seat belt fits properly, typically when they have reached 4 ft 9 inches in height and are between 8 and 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 optimal protection.
All children younger than 13 years should be restrained in the rear seats of vehicles for optimal protection.
You read the last one correctly. You must be a teenager to ride in the front seat.
The Pennsylvania Department of Transportation has updated their webpage to reflect the changed recommendations, reminding visitors that September 23-29 is Child Passenger Safety Week and urging parents to have their car seats inspected by trained professionals at a location close to them.
The AAP has also updated their comprehensive car seat information page at healthychildren.org here.