The American Academy of Pediatrics is now recommending toddlers stay rear-facing in car seats until age 2, according to a report released today. (See below for full report).
The AAP reports:
Recent data shows why toddlers between ages 12 and 23 months who ride rear-facing in a car safety seat are more than five times safer than those riding forward-facing in a seat.
This replaces a previous recommendation that toddlers be rear-facing until age one. Other safety experts recommend rear-facing for "as long as possible"—this is the first report that specifies age 2.
The only hitch to this recommendation: some car seats won't be able to safely hold a two-year-old rear-facing. Why? According to CDC growth charts, the average weight of a 24 month old baby is 28 pounds (boys) and 26.5 pounds (girls). (FYI: We corrected these figures after a reader below pointed out our initial post overstated these numbers—we apologize for that).
While most convertible car seats work to 35 pounds rear-facing, a few models still only go to 30 or 33. Example: Combi's new Cocorro convertible seat only goes to 33 pounds. And the Combi Zeus is only 22 pounds rear facing. Most Britax seats, however, are 35 pounds rear-facing.
And remember that the 27-28 pound weight of a 2 year old is the MEDIAN figure—or 50th percentile weight. The biggest babies (100th percentile) would be close to 34 pounds by the time they hit their 2nd birthdays.
Bottom line: be sure you get a car seat that works rear-facing to at least 35 pounds.
—
Above, we posted a link to a summary of this report that is on the AAP web site. The actual article in the AAP news is on their subscription-only part of their web site (that is, not viewable by the public). Since we've received so many queries about this today, we are reprinting the entire report below:
New
advice: Rear-facing car seats safer for children until they are 2
by Lori
O’Keefe • Correspondent
Toddlers between the ages of 12 and 23 months who ride
rear-facing in a car safety seat are more than five times safer than toddlers
in that same age group who ride forward-facing in a car seat.
Overall, children under the age of 2 are 75% less likely to
die or experience a serious injury when they ride in a rear-facing car seat,
according to the first U.S. data to substantiate the benefits of toddlers riding
rear-facing until they are almost 2 years old (Henary B, et al. Inj Prev. 2007;13:398-402).
There is a common myth that rear-facing toddlers whose feet
reach the back of the vehicle seat are more likely to suffer injuries to the
lower extremities in a car accident, according to a commentary co-written by
Marilyn J. Bull, M.D., FAAP, AAP District V chair and one of the co-authors of
the study. However, lower extremity injuries are rare with rear-facing seats,
Dr. Bull wrote in the commentary (Bull MJ, Durbin DR. Pediatrics. 2008;121:619-620).
Rear-facing seats are more likely to support the back, neck,
head and pelvis because the force of a crash is distributed evenly over the
entire body. Forward-facing children are more likely to be injured because the
force of the crash is concentrated on seat belt contact points, and younger
children’s heads are disproportionately large for their small, weak necks,
according to the study.
“I teach my medical students that parents worry about leg
injuries but that it is far better to send children to orthopedic specialists
to have lower extremities treated than to send them to neurological specialists
to have cervical spine injuries treated,” said Dr. Bull. “I put it into the
context of rehabilitation potential: fracture vs. paralysis.”
In Sweden, children ride in rear-facing seats until the age
of 4, which has been proven to be 90% effective compared to children who ride
unrestrained. However, car seats are engineered differently in Sweden to allow
older toddlers to remain rear-facing longer.
“Since motor vehicle injuries are the leading cause of death
in children, the Academy must do whatever it can to educate our members and the
general public about the safest ways for children to ride in motor vehicles,”
said AAP President David T. Tayloe Jr., M.D., FAAP. “We should make sure all of
our members know to encourage parents to keep their children in rear-facing car
seats as long as they do not exceed the size limits of the car seats.”
Dr. Bull noted that it takes less than 30 seconds to tell
parents that children are five times safer riding rear-facing until their
second birthday — a statistic that is likely to stick with parents.
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Could you link to the actual report, please? Thanks.
Could you link to the actual report, please? Thanks.
Weight is one thing, but my son is tall, and there is no rear-facing seat option that would be even close to comfortable for his legs –even at 18 months, much less age 2.
Weight is one thing, but my son is tall, and there is no rear-facing seat option that would be even close to comfortable for his legs –even at 18 months, much less age 2.
ditto the height concerns. like infant seats, most kids grow out of the height/length limits before the weight limits.
ditto the height concerns. like infant seats, most kids grow out of the height/length limits before the weight limits.
Derick–a child has only outgrown a seat by height rear facing when the top of their head is within one inch of the top of the shell. There is no danger to the legs while rear facing like some thing. The danger of forward facing is the head excursion. A 2 year olds spine is not fused together completely, and the force on the head can cause internal decapitation. I’ll take uncomfortable legs any day!
Christina–visit car-safety.org and you will find what you’re looking for there.
Derick–a child has only outgrown a seat by height rear facing when the top of their head is within one inch of the top of the shell. There is no danger to the legs while rear facing like some thing. The danger of forward facing is the head excursion. A 2 year olds spine is not fused together completely, and the force on the head can cause internal decapitation. I’ll take uncomfortable legs any day!
Christina–visit car-safety.org and you will find what you’re looking for there.
I had my son rear-facing until 14 or 15 months because I knew that it was much safer. Now I wish I hadn’t turned him forward, since it would be VERY hard to turn him around again and actually get him to ride in there. I would also like a link to the article that this post came from. I looked around on car-safety.org and didn’t find anything.
I had my son rear-facing until 14 or 15 months because I knew that it was much safer. Now I wish I hadn’t turned him forward, since it would be VERY hard to turn him around again and actually get him to ride in there. I would also like a link to the article that this post came from. I looked around on car-safety.org and didn’t find anything.
Can you please post a link to the AAP article?
Thanks!
Can you please post a link to the AAP article?
Thanks!
If your child’s legs are long, teach them how to criss cross them. My daughter likes that she can push on the seat in front of her and rock her seat. The only reason to turn a 1 year around is if they are over the weight limit for rear facing for that carseat. For a Britax Marathon, that is either 33 or 35lbs.
If your child’s legs are long, teach them how to criss cross them. My daughter likes that she can push on the seat in front of her and rock her seat. The only reason to turn a 1 year around is if they are over the weight limit for rear facing for that carseat. For a Britax Marathon, that is either 33 or 35lbs.
I believe Christina meant car-seat.org.
This article didn’t come from car-seat.org, but the folks at car-seat.org are wonderful and can help you find a seat that will fit your child comfortably until 2 years old.
I believe Christina meant car-seat.org.
This article didn’t come from car-seat.org, but the folks at car-seat.org are wonderful and can help you find a seat that will fit your child comfortably until 2 years old.
Do you have a link to the entire AAP report? This release isn’t showing on their site. Thanks!
Do you have a link to the entire AAP report? This release isn’t showing on their site. Thanks!
Same for height issues. My daughter is just going to be turning two and is nearly somewhere around 37-38 inches tall. There is no comfortably way her legs would fit rear facing, even crossed, in our very nice Britax. Weight wise she only weights around 30 pounds, but she just keeps getting taller.
Same for height issues. My daughter is just going to be turning two and is nearly somewhere around 37-38 inches tall. There is no comfortably way her legs would fit rear facing, even crossed, in our very nice Britax. Weight wise she only weights around 30 pounds, but she just keeps getting taller.
Re: Link to the AAP article.
We just updated the post to address this—the article was supposed to be posted online today, April 1. But the AAP hasn’t updated their site just yet. We will post a link when we see it go live!
Re: Link to the AAP article.
We just updated the post to address this—the article was supposed to be posted online today, April 1. But the AAP hasn’t updated their site just yet. We will post a link when we see it go live!
Great news! I’d like to point out that the CDC numbers mentioned above are not correct, though. The average height and weight for a three (3) year old boy is about 32 pounds, average height is about 38 inches, according to this chart… http://www.cdc.gov/nchs/data/nhanes/growthcharts/set1clinical/cj41l017.pdf That makes sense, given that the ‘three year old’ dummy used for crash testing is about 34 pounds and 37 inches tall. Any of the larger convertible seats with 35 pound rearfacing weight limits and 50 or 65 pound forward facing height limits will get most kids easily to age 2 and beyond. The Britax Roundabout, Graco Comfortsport, and Evenflo’s Titan and Tribute, along with the Zeus as noted above, will probably not last up to age 2. The car seat board is a fantastic place to come ask questions about all these seats and which would work best for your child, your budget, and your car. Come visit! https://windsorpeak.com/vbulletin/forumdisplay.php?f=12
Great news! I’d like to point out that the CDC numbers mentioned above are not correct, though. The average height and weight for a three (3) year old boy is about 32 pounds, average height is about 38 inches, according to this chart… http://www.cdc.gov/nchs/data/nhanes/growthcharts/set1clinical/cj41l017.pdf That makes sense, given that the ‘three year old’ dummy used for crash testing is about 34 pounds and 37 inches tall. Any of the larger convertible seats with 35 pound rearfacing weight limits and 50 or 65 pound forward facing height limits will get most kids easily to age 2 and beyond. The Britax Roundabout, Graco Comfortsport, and Evenflo’s Titan and Tribute, along with the Zeus as noted above, will probably not last up to age 2. The car seat board is a fantastic place to come ask questions about all these seats and which would work best for your child, your budget, and your car. Come visit! https://windsorpeak.com/vbulletin/forumdisplay.php?f=12
Great to hear that this message will be reaching more parents. My little ones are almost 4, but still under 30 pounds. They ride rear-facing with their legs folded, propped up on the seat back, or over the sides of the carseat.
Great to hear that this message will be reaching more parents. My little ones are almost 4, but still under 30 pounds. They ride rear-facing with their legs folded, propped up on the seat back, or over the sides of the carseat.
Oh My God. When will the infantilization of Americans end????!!!!!
Oh My God. When will the infantilization of Americans end????!!!!!
Michelle–not sure what you mean by that?
Amelia–the sunshine kids radian and the first years true fit have a lot more leg room. My 2 year old is 36 inches and RF in a britax marathon, and she doesn’t complain. She props her feet up on the back of the van seat.
Michelle–not sure what you mean by that?
Amelia–the sunshine kids radian and the first years true fit have a lot more leg room. My 2 year old is 36 inches and RF in a britax marathon, and she doesn’t complain. She props her feet up on the back of the van seat.
It really didn’t get very difficult to buckle my dd into her rearfacing seat in our old Toyota Echo until she was about 3. She was perfectly comfortable in there, but getting her into the seat was a pain by then (and a forward facing three year old in a harnessed and top tethered seat is a very safe option, so we went forward facing in the car, while continuing to rearface in the van till she was 33 pounds at age 4.5). 2 is a perfectly reasonable goal for rearfacing in all cars. And kids that age do not need a full 45 degree recline, they can sit more upright, so you won’t be eating the dashboard. Rearfacing is considerably more reclined and comfortable, and much better for longer trips in terms of neck and leg comfort 🙂
It really didn’t get very difficult to buckle my dd into her rearfacing seat in our old Toyota Echo until she was about 3. She was perfectly comfortable in there, but getting her into the seat was a pain by then (and a forward facing three year old in a harnessed and top tethered seat is a very safe option, so we went forward facing in the car, while continuing to rearface in the van till she was 33 pounds at age 4.5). 2 is a perfectly reasonable goal for rearfacing in all cars. And kids that age do not need a full 45 degree recline, they can sit more upright, so you won’t be eating the dashboard. Rearfacing is considerably more reclined and comfortable, and much better for longer trips in terms of neck and leg comfort 🙂
See, that would be the difference. I drive a car, a small one. Sure, there is plenty of room for large car seats in SUV’s and vans, but if you drive a smaller more efficient vehicle because of either cost, or being in the city, your options are so much more limited. Especially if you have to do any long trips.
See, that would be the difference. I drive a car, a small one. Sure, there is plenty of room for large car seats in SUV’s and vans, but if you drive a smaller more efficient vehicle because of either cost, or being in the city, your options are so much more limited. Especially if you have to do any long trips.
While the AAP (magazine) article contained no actual research (I am on the Biostatistics faculty at a research medical center), I was able to download and read the “new research” in the 2007 Henary et al paper. (It took over a year to get this message out? I guess such magazines are useful then…) As much as I expect my very tall 20-month-old son might hate getting turned back to rear-facing, I might give it a try, since the research does appear fairly compelling. If he hates it, though, I won’t lose sleep over keeping him front-facing at this point. I have little doubt that *everyone* would be somewhat safer rear-facing, including adults, but would you like a vehicle where only the driver’s seat faced forward?
While the AAP (magazine) article contained no actual research (I am on the Biostatistics faculty at a research medical center), I was able to download and read the “new research” in the 2007 Henary et al paper. (It took over a year to get this message out? I guess such magazines are useful then…) As much as I expect my very tall 20-month-old son might hate getting turned back to rear-facing, I might give it a try, since the research does appear fairly compelling. If he hates it, though, I won’t lose sleep over keeping him front-facing at this point. I have little doubt that *everyone* would be somewhat safer rear-facing, including adults, but would you like a vehicle where only the driver’s seat faced forward?
Michelle – in a world where our children are having sex at 12 and growing up much faster than they should, some infantilization is a refreshing change.
I don’t see how new data regarding safety of car seats is the infantilization of Americans, but to each her own.
I for one, will be looking at this and most likely putting my 13 month old back to rear facing until he is 30 lbs (the maximum weight for our car seat), which is not very far off….
Michelle – in a world where our children are having sex at 12 and growing up much faster than they should, some infantilization is a refreshing change.
I don’t see how new data regarding safety of car seats is the infantilization of Americans, but to each her own.
I for one, will be looking at this and most likely putting my 13 month old back to rear facing until he is 30 lbs (the maximum weight for our car seat), which is not very far off….
For all those worried about their kids legs if they keep a tall child RF, think of it this way…
There has never been a reported case of a child getting his/her legs injured due to RF, but even if there were:
RF may equal “cast it”
but FF could equal “casket”
For all those worried about their kids legs if they keep a tall child RF, think of it this way…
There has never been a reported case of a child getting his/her legs injured due to RF, but even if there were:
RF may equal “cast it”
but FF could equal “casket”
I take all of these precautions seriously. I’ve known quite a few people who have lost their babies in FF carseats. I would rather have a broken leg than a broken neck. My little baby is 5 months old and she is just a precious gem. I want to keep her as safe as possible. I wish I would have known this when my son was a baby. I was in such a hurry to have him facing forward….I’m just glad we didn’t have a wreck. Keep your kids safe! They are your blessings and miracles!
I take all of these precautions seriously. I’ve known quite a few people who have lost their babies in FF carseats. I would rather have a broken leg than a broken neck. My little baby is 5 months old and she is just a precious gem. I want to keep her as safe as possible. I wish I would have known this when my son was a baby. I was in such a hurry to have him facing forward….I’m just glad we didn’t have a wreck. Keep your kids safe! They are your blessings and miracles!
My son – now 2.5 years – is also very tall. We had an infant SafeSeat for him, and he outgrew it by height at his first birthday. His next seat was a Britax Marathon, which I discovered had the same rear-facing height limits as the SafeSeat, so he ended up forward-facing far earlier than I would have liked. Another commenter said that kids don’t outgrow by height until their heads are within an inch (if I remember correctly) of the top of the seat – why then does the user’s guide give a very different figure?
On another angle, we bought a Volvo last year, and I was surprised to find a passage in the owner’s manual which recommended rear-facing to four years of age. I did a little googling, and sure enough, in Sweden there are carseats available to fit up to the size of a four year old.
My son – now 2.5 years – is also very tall. We had an infant SafeSeat for him, and he outgrew it by height at his first birthday. His next seat was a Britax Marathon, which I discovered had the same rear-facing height limits as the SafeSeat, so he ended up forward-facing far earlier than I would have liked. Another commenter said that kids don’t outgrow by height until their heads are within an inch (if I remember correctly) of the top of the seat – why then does the user’s guide give a very different figure?
On another angle, we bought a Volvo last year, and I was surprised to find a passage in the owner’s manual which recommended rear-facing to four years of age. I did a little googling, and sure enough, in Sweden there are carseats available to fit up to the size of a four year old.
@Melanie – it is true that the seats aren’t outgrown in height until heads are within an inch of the top when RF – and FF it’s when the top of the ears reach the top of the seat I believe. They do say that in the manual somewhere, but they also give a max in inches which isn’t the primary thing to look at.
HTH
@Melanie – it is true that the seats aren’t outgrown in height until heads are within an inch of the top when RF – and FF it’s when the top of the ears reach the top of the seat I believe. They do say that in the manual somewhere, but they also give a max in inches which isn’t the primary thing to look at.
HTH
Great information about the rear facing car seats and toddler car seats it will very useful to kids who are around below 2years and it would be much comfortable for them to relax in driving. This information is very useful for many parents who want to know about car seats.
Great information about the rear facing car seats and toddler car seats it will very useful to kids who are around below 2years and it would be much comfortable for them to relax in driving. This information is very useful for many parents who want to know about car seats.
My 20 month old is almost 30 lbs. so I am leaving her FF but you can bet with our next baby, he/she will face the rear until at least age 2.
Just a side note…in the original article above, average and median were used interchangeably even though they are not the same. Median is the middle number when all data is lined up from least to greatest and mean is the statistical average.
(Sorry – I am a math teacher, so I cannot help it)
My 20 month old is almost 30 lbs. so I am leaving her FF but you can bet with our next baby, he/she will face the rear until at least age 2.
Just a side note…in the original article above, average and median were used interchangeably even though they are not the same. Median is the middle number when all data is lined up from least to greatest and mean is the statistical average.
(Sorry – I am a math teacher, so I cannot help it)
I have the Graco Quattro Tour Deluxe. I HIGHLY recommend it.The car seat is the Graco Safe Seat, Step 1. It has a higher weight capacity than most infant carrier car seats.The car seat can be used in the car, or you can remove it from the base and carry the baby in it. The car seat also attaches to the stroller, and the stroller can be used without the car seat as well.Many people have referred to teh stroller as teh “cadillac”. We spent A LOT of time at the ball field last year, and the stroller was like a miniature play pen. You can lay the seat flat, and there is a boot that velcros up to close off the foot opening and my daughter would sit backwards in it like that, and play with her toys.The basket on the stroller is large, there are snack/cup trays for parent and child as well as a couple of cubbies to put cell phone, keys, etc.
I have the Graco Quattro Tour Deluxe. I HIGHLY recommend it.The car seat is the Graco Safe Seat, Step 1. It has a higher weight capacity than most infant carrier car seats.The car seat can be used in the car, or you can remove it from the base and carry the baby in it. The car seat also attaches to the stroller, and the stroller can be used without the car seat as well.Many people have referred to teh stroller as teh “cadillac”. We spent A LOT of time at the ball field last year, and the stroller was like a miniature play pen. You can lay the seat flat, and there is a boot that velcros up to close off the foot opening and my daughter would sit backwards in it like that, and play with her toys.The basket on the stroller is large, there are snack/cup trays for parent and child as well as a couple of cubbies to put cell phone, keys, etc.