Most parents know that infants should ride in a rear facing car seat until age one. Actually, the American Academy of Pediatrics recommends keeping toddlers in car seats until age two. Children are five times safer in a rear-facing car seat than in a forward-facing car seat until the age of two.
Previously, it was believed that when the legs of children were long enough to reach the seatback of the seat the car seat is buckled into, there was a higher risk of injuries to the legs. Hence the previous recommendation of changing to a front-facing car seat after age one year. Now studies confirm that fractures of the legs are rare with rear-facing seats.
In a car accident, rear-facing car seats protect the neck, head, spine and pelvis better than front-facing car seats. Toddler’s heads are disproportionately large for their relatively weak necks, so the risk of paralysis and other serious spinal cord injury is much higher in forward-facing car seats.
If an infant car seat is used, the infant should be changed to a rear-facing convertible car seat when the infant’s head is within one inch of the top of the car seat and the maximum weight limit (usually between 22 and 32 pounds) has been reached. Toddlers over the age of 12 months old and under 4 years old should ride in a harnessed car seat, preferably one with five points.
Since car accidents are the number one cause of death in children,it is extremely important to continue to have toddlers ride in rear-facing car seats until age two.
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Last updated May 9, 2009 by Dr. Vee