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Child safety expert Kimberlee Mitchell, right, installs a car seat for Kennedy Word, 8 months, as father Kendall Word, looks on during a car seat check hosted by Dorel Juvenile Group, AAA, and the New York City Department of Transportation in New York, Friday, July 16, 2010. (David Goldman / AP Images for Dorel Juvenile Group) Sharon Waldrop helps her son Jack in his car seat in Royal Oak, Mich., Tuesday, July 7, 2009.  (AP Photo/Carlos Osorio) In this Dec. 18, 2009 photo, Anne Epperson unbuckles her daughter Madeline, age 3, from her car seat at their home. (AP / Charlie Riedel) Experts say properly installing your car seat could mean the difference between life and death.

Kids should ride rear-facing longer, U.S. doctors say

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CTV News Video

CTV News: Avis Favaro on the recommendation
Parents of toddlers are now being encouraged to keep them in rear-facing child seats until age two, as studies show children are less likely to die or be severely injured in a crash if they are rear-facing.
CTV News Channel: Ben Hoffman, doctor
A member of the American Academy of Pediatrics says parents need to keep kids in rear-facing seats until the age of two. It ultimately comes down to protecting children in the best way possible due to the leading cause of death.
CTV News Channel: Kristen Gane, Safe Kids
A spokesperson for the child passenger safety program says new U.S. guidelines will be helpful in advancing child passenger safety, and the organization is pleased with the recommendations. Gane says age does not matter with car seats; height and weight are most important.
CTV News Channel: Brian Patterson, OSL
A representative from the Ontario Safety League says says while it may be difficult to enforce the regulations due to a childs size, parents should ensure the best safety devices are available for their children.

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Child safety expert Kimberlee Mitchell, right, installs a car seat for Kennedy Word, 8 months, as father Kendall Word, looks on during a car seat check hosted by Dorel Juvenile Group, AAA, and the New York City Department of Transportation in New York, Friday, July 16, 2010. (David Goldman / AP Images for Dorel Juvenile Group) Sharon Waldrop helps her son Jack in his car seat in Royal Oak, Mich., Tuesday, July 7, 2009.  (AP Photo/Carlos Osorio) In this Dec. 18, 2009 photo, Anne Epperson unbuckles her daughter Madeline, age 3, from her car seat at their home. (AP / Charlie Riedel) Experts say properly installing your car seat could mean the difference between life and death.

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Child safety expert Kimberlee Mitchell, right, installs a car seat for Kennedy Word, 8 months, as father Kendall Word, looks on during a car seat check hosted by Dorel Juvenile Group, AAA, and the New York City Department of Transportation in New York, Friday, July 16, 2010. (David Goldman / AP Images for Dorel Juvenile Group)

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Date: Mon. Mar. 21 2011 2:26 PM ET

Kids should sit in rear-facing car seats until they are 2 years old instead of 1, says new advice from a group of American pediatricians and U.S. traffic safety officials.

Older kids too should ride in booster seats longer too, up to the age of 12, depending on their height, the new recommendations advise.

Parents have long been told to follow the weight and body length limits listed on their car seat. But many have used the general guideline of one year of age or 20 to 22 pounds (9.0 to 9.9 kg) as a guideline for when to move them into a front-facing car seat or when to turn their baby's convertible car seat around.

The American Academy of Pediatrics is worried that some parents have been turning their babies around too early, putting the children at risk of serious injury or death in the event of a crash.

So after carefully reviewing the latest data that shows that children in rear-facing car seats are more likely to surivive a crash, the AAP has issued a new policy statement. The statement says toddlers should sit in rear-facing car seats until age two, or for as long as they are within the weight and height limits listed by the car seat's manufacturer.

If a child under the age of two outgrows the weight limits for their infant car seat, they should be moved to a rear-facing convertible car seat and kept in that position until age two, the AAP now says. Only after the age of two should the car seat be turned forward-facing.

The U.S. National Highway Traffic Safety Administration issued separate but similar recommendations, stressing that there is no need to hurry to transition a child to the next restraint type.

"The best possible thing you can do is keep your child rear-facing as long as possible," the AAP's Dr. Benjamin Hoffman, who helped write the new policy, told Reuters. "We hope we will be able to convince parents to keep their children rear-facing longer."

Dr. Claude Cyr, a member of the Canadian Paediatric Society's Injury Prevention Committee, says the U.S. and Canadian recommendations are similar. But he tells CTV News that the re-wording of the AAP guidelines could compel a review of the Canadian guidelines to see if they could be made clearer.

The CPS guidelines state that only when a car seat's weight or height limits have been exceeded, should parents move their children into the next phase of car seat.

"Parents should be encouraged to continue to use a rear-facing seat as long as the height and weight limitations allow," the CPS guidelines read.

After kids have been moved into a front-facing car seat with five-point harnesses, they should stay in that seat until they reach the top height or weight limit allowed by the car seat's manufacturer. The AAP says the lowest maximum weight limit for forward-facing car seats is 40 lb (18 kg), while some models of can accommodate children up to 65 lb (30 kg).

Kids who exceed those weight limits should then move to a booster seat used with the car's seatbelt, until they are tall enough to fit correctly with just the seat belt. That's usually when kids are between eight and 12 years old, or when they've reached 4 feet 9 inches (145 centimetres).

For a seat belt to fit properly, the lap belt must lie snugly across the upper thighs or lap, not the stomach. The shoulder belt should lie snug across the shoulder and chest and not cross the neck. A poorly fitting seat belt can cause abdominal and spinal injuries in a crash.

And no child younger than 13 should ride in the front seat, both groups remind.

According to the new AAP statement, published in the journal Pediatrics, 1,500 kids under 16 die every year in car crashes in the U.S.

Child safety seats have been shown to cut the risk of death by 28 per cent compared with seatbelts; they also reduce non-fatal injuries.

Car seats with five-point harnesses are able to distribute the energy of a crash over a bigger area of the body, instead of concentrating it on the points where a seatbelt touches the body: the shoulders, belly and hips.

Booster seats too have also been found to reduce the risk of non-fatal injury among 4- to 8-year-olds by 45 per cent compared with seat belts alone, the AAP says.

Comments are now closed for this story

Parent of 3 and a Carseat Tech, Manitoba
said
0 0

I'm a little disturbed by the number of comments by people who seem genuinely offended and/or angry at this article. There is legitimate research which has PROVEN that rear-facing is safer, and that children should remain in boosters until the seatbelt fits them PROPERLY.

Why would anyone argue this?
Why would someone choose to put their child into a potentially dangerous situation?
Why would you willingly make your child LESS SAFE in a vehicle, when the information is available to educate yourself, and the carseats & booster seats available now are designed to protect your children?

Children are more comfortable cross-legged or having their knees bent than they are with their legs dangling over the edge of a seat. An improperly-fitting seatbelt simply will not protect your child, so have them use a booster! When my children are old enough to complain about using a booster even if "none of my friends are, mom!" I will simply explain that I am keeping them safer. Period.
To those who proclaim "back in the day we never used carseats, and we turned out just fine", I'd like to congratulate you, but remind you that the ones who didn't turn out just fine aren't around to talk about it.

Really, people. These are our kids we're talking about. You have the information, and you have the means. Keep them safe. It's your job.


Buckshot
said
0 0

At the age of 10 months we were in a car accident with our son. He being far too long at that stage had been turned around and secured very carefully into the forward facing position. While the dogs in the car flew and a 30 foot trailer smacked around and into us...our son was smiling, safe and sound in his 5point harnessed seat. My son is 6 now. He and his brother are VERY tall for their age. His feet touch the floor in the car without a booster (he still uses his) the main problem is the seat belt does not come down enough on his shoulders. Yet his 8 year old cousin doesn't have to use a booster even though she is an inch shorter than he is? Does this make sense? No. I do believe manufacturers need to be more diligent in accomodating people of all shapes and sizes. Should a 4 foot 10 woman be using a booster while she drives or should they have to make the seat more adjustable? Maybe people should consider that not every vehicle is made for them I don't see to many 6'4 dudes driving a piddly little smart car afterall! What ever happened to common sense and choice? I don't need an 'expert' telling me what is safe for my children. That is my job and i'm serious about it.


parentof1
said
0 0

Do people not understand not all children are the same ? At the age of 5 months I had to get my son who was born at 10 lbs a convertable carseat he had already reached the weight and height by 6 months to be front facing. He's now about to be 12 months in a few weeks and still rear facing but his legs are majorly cramped and car rides that are neccisarry even quick ones are torture because the kid is so uncomfortable. You people saying the children can cross their legs and that no toddler sits with their legs straight down well yeah mine does and how do you expect me to keep a 1 year olds legs crossed the whole car ride especially when I'm driving and even if I wasn't I hope you try and go get a 1 year old boy to sit and do exactly what you want him to. I was 95 lbs. Untill about 10th grade so this law is a bit ridiculous I understand they law trying to make things safer but how the hell about making a law like people actually are required to think when they are driving before they act like total morons you know a law that actually shouldn't be that hard to achieve.


Robt.D.Miles
said
0 0

Vehicle Manufacturer's , need to Design safe Seat's for all age's. A simple ( Seat Imprint ) on a Dail , manual or Electronic , can be designed with Sensor's , then the required seat setting are in place. One step farther , hook the Seat ( Sensor's ) with the Ignition , so that No Vehicle will start unless every Rule is followed. Problem, I went with an 18 year old Girl in High School , only 4'7" , so should I have buckled her in the Back Seat, he , he ...


Amanda
said
0 0

Yes, I've tried the rear-facing with both of my kids. Beyond a year is ridiculous, and I'm talking from experience. I'm not talking about long road trips, but only the necessary ones to the grocery store that's too far to walk to. No amount of time on the road with your children SCREAMING in the back seat is safe. Think of what it does to your brain chemistry as a driver, with the increased levels of cortisol racing through your system. Now think of your child, screaming inconsolably in the back seat, choking on their own mucous while you're on the road with no safe place to pull over. Now the difference in them being forward facing, where they can see you better and stretch their legs stops the screaming. The driver is calmer as a result, and therefore more focused on the road and AVOIDING accidents. Yes, they should put their energies towards safer forward-facing car seats.


Redfern
said
0 0

I have never understood why car manufacturers were allowed to design their seats and seatbelts assuming that everyone was a 6 foot 200 lb male (never got pregnant!). People come in all shapes and sizes. By these standards one of my children would have been in a booster seat until the age of 18! As it is, we used wedge cushions for our two youngest children so that their seatbelts would be safe (raised their pelvis so the seatbelt wouldn't cut across their waists), and used locking clips on the shoulder belts to set them at the right height. There should be more pressure on the auto industry to create FULLY ADJUSTABLE seatbelts so that children 8 to 10 years old, and shorter, smaller adults, can ride safely in a car using a standard seatbelt. There are enough engineers and designers in this world...surely this is possible! Come on Ford, GM, Toyota, Honda....would someone please take up the challenge?


LisaG
said
0 0

@Giveitarest - awesome, so my nephew who weighed 20lbs at 5 months should be able to be moved forward facing because he fits the limits of the seat?You do realize that infants and toddlers have a head that is 25% of their body size, and as such is very heavy. Being forward facing in a crash they are extremely susceptible to internal decapitation and other spinal injuries. Why in the world would you want to risk that?!?Look up Kyle Miller for information on what happens if you are in a booster instead of a 5-point harness.Look up Joel's Journey if you want to know the importance of rear-facing seats.Both are sobering stories and should be used to inform the public about car seat safety.


LisaG
said
0 0

@Leslie - here is a direct quote from a Swedish webiste:"From 1992 through June 1997, only 9 children properly restrained rear-facing died in motor vehicle crashes in Sweden, and all of these involved catastrophic crashes with severe intrusion and few other survivors."also:"Looking at statistics in Sweden, where the recommendation is for children to sit rear facing until age 4, it’s obvious to see what a huge difference the simple concept of rear facing really make.""Over a million rearward-facing seats are in use in Sweden, and we do not know of any cases where a child in a rearward-facing car seat has been seriously injured in a frontal collision"however"A number of cases are known in which children have been totally paralyzed as a result of neck injuries while using forward-facing seats."As for numb legs on long trips, try having your legs dangle for hours at a time and see what happens to your feet. My children *choose* to cross their legs forward facing, so why would they do any differently rear facing?


Shayne
said
0 0

Oh Dear. They are saying that when I was in the eighth grade I should have been in a car seat because I was under the required weight? These people have no legitimacy. So kids are going to go from not being able to sit in the front seat to being able to drive within a year or two? Why would anybody listen to such obvious stupidity.


missmae
said
0 0

Every child is different, every car seat is different, every parent thinks differently and car seat safety standards for the most part, are only guidelines. I have an 8 year old who is 4'10...therefore big enough for an adult seat, but I have friends who's 8 year olds are still in them. That's why I have 2 extra booster seats in my house and when I am driving people around I take them with me. I also have friends who don't use boosters and they have younger kids, shorter kids, and I also have friends that use boosters and their kids are over 12. So there ya go! It's more of an each to their own type of deal because there are too many different rules in different provinces. Height, weight and age are all factors, but the final decisions are with the parents and they have to live with that decision if an accident were to happen.


Bryan from Lethbridge
said
0 0

Do these Doctors even HAVE Children? Car seats as is... already do not fit in most vehicles now avaiable for market. if you have 2 children in carseats then you are instantly promoted to "minivan" or "Large SUV" as that is the ONLY way you are getting two of the monsters installed correnctly. As for the size. all of my children hit the size and weight restriction by 8 months, it was difficult to keep them safely in the rear configuration for the full year... there is NO way they would fit until age 2. (my 2 yr old at 38lb is the smallest of my 4) the reason parents are moving thier childeren to the next level early is that kids are getting bigger sooner an no longer fit the "average size and weight" charts that haven't been updated since the 40's.


Diana
said
0 0

I guess I need a booster seat because I don't even fit into a seatbelt properly according to this! I would like to know how many of these Dr.'s go on long drives with their children by them selves. Almost impossible to keep a kid happy rear facing!


Mervin
said
0 0

We drove from Manitoba to BC, in a 1974 Volkswagen Bug, with SIX of us crammed in. One of the passengers was a BABA, and three were kids under 10. Not a seatbelt to be found. If we were to crash and roll, we would have blended really nicely. I wonder how we survived, without brain damage.....


Heather
said
0 0

I can't believe how many naysayers there are on here. Have you even tried it? Granted, my daughter is only average height at 21 months old, but she isn't even close to the point of having to cross her legs yet. I'm guessing that in 3 months she'll still be perfectly comfortable in her seat. Honestly, how many road trips are you people going on? We probably go on five major trips a year and I don't know about the rest of you, but taking a toddler on these things pretty much means you are stopping enough to stretch your legs. I would suspect that like most of us, you all drive for less than an hour the vast majority of the time.
Yes, we all survived the days of no car seats or inferior car seat laws. That's great for us. Some babies and toddlers didn't. We have better info now so times are changing. My crib looks very different from the one my parents would have slept in. My daughter's formula is far superior to that my mother had. I don't see how this is any different.


Liz
said
0 0

Why don't they simply design a safer front -facing car seat, perhaps with something which comfortably cradles and supports the baby's neck and head? Both my daughters were very tall for their ages and outgrew their rear-facing seats before 10 months of age. Just imagine cleaning all the mud and salt stains off the backs of your seats when a rear facing older child has a meltdown because his knees are stuck up at his chin!


Dale
said
0 0

It's great to protect children ....... butlike so many other things, not enough focus on preventing acidents in the first place. What about height requirements for drivers (not just age). The ability to see over the steering wheel must be important to safely operate a motor vehicle?


missmae
said
0 0

@frustrated... you need to contact your local safety council and they can advise you of your options. you might need to get a new car seat. they are all made differently and you just may need a more high end one with better safety features or one specially made for taller children. i was under the impression that the back holes were to be just below the shoulders, but i'm not completely sure of that.


Momof3boys
said
0 0

Hmm...valuing the opinion of a random 12-year-old over the safety (and perhaps life)of my child in a booster? Well, I know preteens are influential... but really.

Friends of ours were in a fatal crash after Christmas. 4 awesome kids now have to grow up without a dad. And those kids are fighting hard to recover from their injuries. If I have to keep my kids in boosters & carseats for years longer to avoid what they've gone through, I will. And I do.


LisaG
said
0 0

@Leslie - I can control how fast and safely I drive, however I cannot account for all the other drivers on the road.As a staunch car seat safety advocate, I am shocked at some of the lax parents I see. 6 yr olds in the front seat, 3 yr olds in boosters, infants forward facing. We need to educate parents, this is one of the biggest cause of death in children under 2.


Mother of 6 yr old
said
0 0

This comment is to LisaG & WendyS, sure they can cross their legs or fold them, but dont you think their legs would get tired or numb? Im sure yours do after awhile. How would you like doing a 3 hr car ride with your legs like that? I sure wouldnt enjoy that!! Yes children are more flexible but after awhile it does get uncomfortable. Keep in mind, my daughter was 3 feet tall at 2, that wouldnt Not have been very comfortable for her. Thanks. :)


Mother of tall 6 yr old
said
0 0

First id just like to say that I do agree that children should stay in booster seats longer than they are. However, I certainly dont think a pre-teen child at the age of 12 would enjoy sitting in a booster. I deff wouldnt make that a requirement. Like the article says depending on height when it comes to rear-facing car seats. My daughter was 3 feet tall at the age of 2, by the age of 6 months while in her rear-facing car seat, she was sitting very uncomfortably because her legs would be bent right back since she was so tall. There are always pros and cons to rear-facing & when to stop putting your child in a booster seat. But I certainly cannot see 12 year olds willingly sitting in a booster especially when they arent allowed to be in the front seat. Have a nice day! :)


c-drive
said
0 0

Child seats are such flawed products to begin with. If a 110 pound post-partum woman can't install it, then it's not designed properly.

The government need to crack down with better regulations requiring car manufacturers to do more than just the LATCH system.

If they were easier to use then parents would be able to focus on using them properly.

@Necessary Reaction Don't bother trying to say that old cars were safer than today's. That argument doesn't hold water.


Frustrated
said
0 0

I drive a SUV. I'm a tall guy and have the seat back as far as it will go (wish it could go even further). However, I also have two children (7 and 3). I had to move the rear facing around to front facing when the 3 year old was slightly older than a year old because there was absolutely no where for his legs to go. Now I've had to move him behind the passenger seat because the way the car seat is made, he can't sit behind me because the seat of the car seat makes his legs stick out straight as the seat ends in the middle of his calves and not his knees. Additionally, the 5 point harness at the top most slot in the seat is now about 2 inches below the level of his shoulders - which it seems to me I remember reading that it should be above the shoulders.So with all these rules and regulations, how am I supposed to "safely" put my kid in the car?I also tried to find out via gov websites, what the legal rules are regarding car seats and the ages and so on. But I couldn't find anything. And just like in this news story, it "suggests"... Doesn't mean it's law... or is it?


Necessary Reaction
said
0 0

This is in response to the degredation of the materials vehicles are made out of. When we rode around as kids on the back window ledge, the vehicles were strong enough to facilitate that.

Nowadays, do you want to test your luck bouncing around in a plastic or aluminum car... or a Smart Car?




Jason
said
0 0

I can remember lying on the rear dash of dads Chrysler watching cars following us( must have been rear facing back then). Rear facing seat or forward shouldn't matter, forward is still safer than the good old days.


Vee
said
0 0

I am trying to imagine a 12 year old (a pre-teen no less) who is slightly shorter statured than his or her peers, being driven around with mom and dad, and actually letting their friends see them in a booster seat. Whatever the recommendations are, guaranteed you won't get that age category to follow them. Can't car companies design seatbelts than can be adjusted for young and old alike?


Leslie
said
0 0

LisaG - Are you aware of how tall a 4 year old child is? I suspect you might be a little off on your info. I think if parents travelling with young children stick to the speed limit this would reduce more injuries than facing car seats to the rear for extended periods. My 2 cents.


John C
said
0 0

I am a firm believer in the fact that if a person fits inside of the physical parameters then the use of a saftey seat should be mandatory with out exception. Age should not be a release from the requirement. When I lived in Europe 1957 to 1960 I found it very frustrating when I went to a fair or amusement Park. They had a gate with a bar over it if you could physically fit under the bar flat footed then you were restricted to the kiddy rides. My Friend Jean and I hated this for at the age of 14 we were still the size of 6 year olds and had to ride on the baby rides as they were called by our peers and were the subject of an inordinate amount of teasing because of this. I realized even at the time it was dangerous for us to ride on the adult rides as none of the saftey restraints would work. Not fun by safe. As a saftey officer in later years I realize the necessity of this and to this day believe strongly that physical size should be the mandate not age.


RK
said
0 0

Ridiculous. 12 years old on a booster seat? I thought 8 was crazy enough. What next, all people under 16 have to be wrapped in bubble wrap and wear a hockey helmet? How is it that people can go 100 km/hr on a motorcycle down the 401 with no safety equipment, but kids have to be treated like eggs in a giant steel cage? Our society of political correctness and over board safety requirements makes no sense. I clearly remember travelling on a milk carton in the back of my dad’s full sized van all the way from Ontario to BC, and I’ve survived for almost 4 decades now. How times change.


Give it a rest !
said
0 0

Do you remember the old days when you could get into a car with your parents and sit in the back set with just a lap belt or when you could stand on the back seat and watch your parents drive. the days when there wasn't anything called an Airbag, crumple zones, and the only 5 point harnesses were in race cars......

with all the new technology there is today there really should be no need to have your kids in a rear-facing car seat past the age of 1 just as long as they are the correct weight (20lbs) I know in my current vehicle when the car seat is turned backwards, my wife had to sit in the back seat as the front seat needed to be pushed so far forward. Maybe the car companies could invent another air bag that in the event of a car crash a bag filled with air surrounds you and everyone in your vehicle, or better yet why don't we all walk around, wrapped in bubble wrap and wear helmets.

Come on people do you really think people are going to want to keep their children strapped in a seat until they are 12. Maybe you should try riding in a seat that you can't get out of for along car ride and see how you feel.


JJ
said
0 0

Both of my kids sat rear facing until they were 2 with no problems, even on long trips. They just crossed their legs. Don’t forget kids are way more flexible than the average adult, so they are not uncomfortable like we would be.


CMK
said
0 0

You can also purchase larger car seats than the infant car seats that can be rear facing for quite some time and they give the child more room. Not sure what I think about this new recommendation yet but there are options out there.


Mark from Brampton
said
0 0

Do you realize how many times doctors & experts have changed their minds about the way car seats should go and how your babies should sleep to avoid SIDS? I have 6 kids, and I think every one of them had to do things differently at different ages.Just use common sense.


mikel
said
0 0

Ridiculous, overblown reaction to a perceived problem that may occur in some obscure testing lab. Why not just ban kids from vehicles and solve the problem all together....


Wendy S
said
0 0

I think this is fantastic!! As for the comment about legs...the child would need to sit cross legged.


ERFing
said
0 0

As for the length question.

Broken leg = cast it
Broken neck = casket

The car is not suppose to be a lounger. It is transportation and I am willing to bet your two year old sits with his legs pulled up or bent normally. I do not know of a child that sits with his legs straight. If your on long trips, the standard bathroom breaks and diaper changes are sufficient stretching moments.


Babalou
said
0 0

I have a ten month old baby girl and her rear facing seat looks already to be small, as she's a little bit tall. I'm wondering by the time she's 2 years old, she would look like a preztel.


LisaG
said
0 0

They can fold their legs, sit cross legged. It's much easier to fix a broken leg than a broken neck in the event of a crash. In Sweden it's law to rear-face until (I believe) age 4, and they have the lowest incidence of death of children in automobile accidents in the world.


Concerned Parent
said
0 0

So my question would be: Where do you suppose children put their legs??? Rear-facing for my 2-year-old would mean an awful car trip as she would have NO way to stretch her legs.... As far as I know there is no way you can make them extra room to accomodate their length when they are rear-facing. Just curious if they thought of how to accomodate a child's length in this and not just weight.


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