Rear Face as Long as Possible
The American Academy of Pediatrics has just issued a new guideline: keep your infant facing backwards until age 2, unless they outgrow their rear-facing car seat.
As doctors, we spend a lot of time and energy thinking and responding to illnesses, but for Americans ages 1-50 years old, injuries are the #1 cause of death, far more likely to cause harm and fatality than any illness or condition. That makes injuries the very #1 cause of death and harm in childhood, after one year of age!
One of the main causes of death and harm from injury is the car. We are used to cars, nearly everyone has been in one, so we tend to forget just how dangerous they really are. Cars are far more safe now than many years ago, but still remain the most dangerous part of our lives.
Perhaps the greatest step forward in reducing the chance of death or injury has been the invention of the seat and shoulder belt. Wearing it saves lives, lots of them. Cars, however, are sold to adults, not kids, so their safety belts only fit people who are taller than 4 foot 9 inches. If you are shorter than that, at any age, you need some sort of adapter to have the seat and shoulder belts actually fit, that is, actually work.
Until this month, the recommendation for children from birth to 1st birthday was to be in an infant car seat, facing backwards, until both 1 year old AND 20 pounds.
A study from 2007 recently showed that the benefit of facing backwards should be extended another year.
This study found that for children ages 1-2, the risk of serious injury was indeed reduced if they were facing backwards. I have reviewed this study and find that the evidence is compelling.
Therefore, we at Advanced Pediatrics support the AAP recommendation and urge all families to have their children, when in a car, be in a rear-facing car seat to age 2, unless they cannot obtain a car seat that can fit their child up to that age. In which, case the child should advance to the larger seat prior to age 2.
Dr. Arthur Lavin
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