New recommendations from the American Academy of Pediatrics and the National Highway Traffic Safety Administration state that children should ride rear facing until age 2. Many parents and care givers have questions. “Why so long rear facing? Won’t his legs get hurt? What’s he do with his legs? Won’t she be squished? It was good enough for my kids 20 years ago, why isn’t it good enough anymore?”
The answers to these are both simple and complex. The simple answer is that with better science, we can make better recommendations, and until about 4 years ago, we just didn’t have the science. Now that we do, we can say definitively that we know children who rear face, between ages one and two are 5 times safer than their forward facing peers. 5 times - that’s a HUGE difference – 500% safer! When you know better, you can do better. This is why our recommendations have changed.
Here is a video of rear facing verses forward facing
In the video, did you see how the rear facing seat back absorbed almost all of the crash forces? The child dummy rode up and down, then back towards the vehicle seat. The force was nearly all absorbed by the shell of the seat. In comparison, the forward facing dummy had all the force placed on his neck and extremities. This can lead to very serious injuries in young children, mainly to the head and spinal cord. We can fix a leg. We can’t fix a spine. Spinal cord injuries are one of the big things we’re trying to prevent injury to. In babies and young children, the spinal cord comes in a number of pieces. During the growth process, it hardens or ossifies, creating more and more linkages to itself so that by the time a child reaches puberty, it is one piece.
Cervical vertebrae for a one-year old (left), and beside it a cervical vertebrae for a 6 year old (right)
Thoracic vertebrae for a 1 yr old (left) and for a 6 yr old (right).
Lumbar vertebrae for a 1 yr old (left) and for a 6 yr old (right).
Pictures Courtesy of: Human Osteology, T. White, 2000
Note that in all pictures, the 1-yr olds' vertebrae is still in pieces.
The vertebrae do not begin to fuse until age 3-6 years old. This is why rear-facing is the safest as it gives more support and protection to the incomplete vertebrae and therefore the spinal cord. With vertebrae in pieces, a forward facing child has a greater chance of damage to the spinal cord when their head and neck whip forward and back in a crash.
This, however, brings us back to why we want to rear face children for as long as they fit into a rear facing seat. Between the new science that we’ve got and the knowledge about the spine, we’re finding that rear facing is extraordinarily protective.
With this in mind, we’ll go to the questions:
Why so long? Because the spine is in pieces and we want to prevent injury to it in kids under 3.
Won’t his legs get hurt rear facing? No. Nationally, in rear facing children, there have been no reported cases of injury to the extremities. On the other hand, in forward facing children, we’ve found that there are a great number of extremity injuries – it’s the second most likely thing to get hurt, after the head and neck.
What’s he do with his legs? Well, many kids put them over the sides of the car seat, up on the back of the vehicle seat or sit “criss-cross-applesauce”. It’s easy for them, they are very flexible.
Won’t she be squished? This child has just spent 9 months curled up in her mother’s womb. We recommend swaddling. This is no different. Children are very flexible and they can do many things that we as adults would be uncomfortable doing. Adult perceptions should be put aside when looking at comfort for a child. If your child outgrows their infant seat, there are now many convertible seats that rear face to 35, 40 and even 45 lbs.
When is my rear facing seat outgrown?
The child has outgrown the rear facing weight limit of his or her car seat (if the child is younger than one, he or she needs a car seat with a higher rear facing weight limit.)
The child is at LEAST one year old, preferably two years old – rear facing longer is safer
The child’s head comes to within one inch of the shell of the rear facing car seat
Want to rear face your older child? Have questions? Unsure if your seat is installed correctly? Get your seat checked! www.beseatsmart.org or 888-VMT-SEAT for fitting station locations