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New Guidelines for Children's Car Seats

American Academy of Pediatrics Wants Kids to Stay in Rear-Facing Seat Until Age 2

By Jennifer Warner
WebMD Health News

Reviewed By Laura J. Martin, MD

March 21, 2011 -- Toddlers and even older children may have to get used to some new seating arrangements in the car, according to new child passenger safety recommendations from the American Academy of Pediatrics (AAP).

The group is revising its advice and recommending that parents keep infants and toddlers in rear-facing car safety seats until age 2 or when they physically outgrow the limits for the seat.

In addition, they recommend that when children 2 or older reach the maximum weight or height for a forward-facing seat with a harness they transition to sitting in belt-positioning booster seats until they have reached 4 feet 9 inches tall and are between 8 and 12 years old.

Once they've outgrown the booster seat, the guidelines say all children under 13 should still ride in the back seats of the car.

"Parents often look forward to transitioning from one stage to the next, but these transitions should generally be delayed until they're necessary, when the child fully outgrows the limits for his or her current stage," says researcher Dennis Durbin, MD, of the American Academy of Pediatrics' committee on injury, violence and poison prevention, in a news release.

Rear-Facing Seats Are Safer

The previous AAP policy, issued in 2002, advised that infants and toddlers remain in rear-facing safety seats until they reached the limits of the car seat, but cited 12 months and 20 pounds as a minimum.

Researchers say that as a result, many parents turned the car seat around on the child's first birthday.

But new research has shown that children under age 2 are safer in rear-facing car seats. A 2007 study showed children under age 2 are 75% less likely to die or be severely injured in a crash if they are in a rear-facing car seat.

"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," says Durbin.

"The 'age 2' recommendation is not a deadline, but rather a guideline to help parents decide when to make the transition," says Durbin. "Smaller children will benefit from remaining rear-facing longer, while other children may reach the maximum height or weight before 2 years of age."

Researchers say a booster seat should make the vehicle's lap-and-shoulder belts fit properly. The shoulder belt should lie across the middle of the chest and shoulder, not near the face or neck.

The lap belt should fit low and snug on the hips and upper thighs, not across the belly.

SOURCES: Durbin, D. Pediatrics, April 2011; vol 127: pp e1050-1066, pp 788-793.News release, American Academy of Pediatrics.

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