Does My Child Really Need to Ride Rear-Facing Until Age 2?

10 baby ride rear facing

The short answer is, yes, absolutely keep your baby in a rear-facing child safety seat until at least 2 years old.

And here’s why:

Up until a few years ago we’d get calls every day that a child was turning 1 year old and the parent wanted an appointment with a  child passenger safety technician for help turning their car seat around from rear-facing to forward-facing. It became kind of a rite of passage for little ones on their 1st birthday to now be able to turn around and see out the front windshield and the parents loved being able to finally see their child in the car seat.

However, in recent years we’ve learned that forward-facing isn’t the safest way for a one-year-old to ride.

The American Academy of Pediatrics issued a statement about three years ago that stated a child would be safer riding in the vehicle rear-facing up to 2 years of age, or the upper rear-facing weight limit of their car seat.

The study that informed this statement from the AAP found that the likelihood for head and neck injuries in crashes of all directions was significantly lower if the child was riding rear-facing as compared to forward-facing.

A child’s head and neck structures aren’t fully developed until around the age of 2. When a child rides rear-facing in the car, their head and neck are better supported within the upper shell of the car seat and they are able to better sustain crash forces in a vehicle.

The AAP statement was an important step in child passenger safety and it is a recommendation that we fully support here at Cincinnati Children’s. Many car seat manufacturers are now making seats with higher rear-facing weight limits to help with this recommendation to keep children rear-facing longer.

But, despite the science that tells us how much safer one-year-olds are rear-facing, we still run into plenty of opposition from parents.

I hear concerns about “leg-scrunch” and whether the child is more likely to sustain a leg or foot injury in a crash. I always assure parents that I know what they’re talking about (I’ve seen lots of “leg scrunch”) but I assure them that it’s actually nothing to worry about. Kids are flexible and are able to cross their legs or put their feet up the back of the seat. A child seated forward-facing actually has a higher likelihood of sustaining a foot or leg injury if in a crash.

I’ve also heard concerns that children look uncomfortable riding rear-facing and/or that the child would prefer to ride forward-facing. My response to this is that a one-year-old has only ever experienced the car from a rear-facing perspective and therefore doesn’t know anything different. Rear-facing really is the most protected way to ride in a vehicle – it is up to parents to be responsible regardless of the perceived discomfort of the child or of the parent themselves.

Editor’s Note: If you have questions about child safety seats or would like to schedule an appointment for a free seat check with one of our certified child safety technicians, please call the Comprehensive Children’s Injury Center at Cincinnati Children’s at 513-636-7865.

 

Emily Lee

About the Author: Emily Lee

Emily Lee is an Injury Prevention Coordinator with the Cincinnati Children’s Comprehensive Injury Center. She is also a certified Child Passenger Safety Technician and Instructor. A lifelong Cincinnatian, Emily and her husband love exploring the city and spending time with their new dog, Bella.

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Comments

  1. Nicole February 24, 19:58
    Any opinion on the move to a booster? My son is nearly 5 and about 34 pounds. Should I switch him or keep him in his 5 point harness?
  2. Pat Goller February 24, 21:33
    My grandson is 3 1/2 yrs old. He weighs about 36 lbs. When is i time to switch to a booster seat. Thanks.
    • Emily Lee
      Emily Lee Author February 25, 10:40
      Nicole- Great question! In the state of Ohio, a child must be BOTH 4 years and 40 pounds to begin using a booster seat. I would recommend you keep your child in a 5-point harness until the upper-weight limit of the harness. A 5-point harness is safer than a seat-belt, especially for a child of his weight. Pat- As I told Nicole, above, a child should be a minimum of 4 years AND 40 pounds before they are moved into a booster seat. As long as your grandson hasn't outgrown the weight limit of the car seat's harness, he is safe to stay in his current seat.
  3. erin February 25, 23:10
    I have always been an advocate of rear facing until 2. My 22 month old is a big dude. He is just over 36 inches and 34 lbs. His car seat says it is approved rear facing up to 48 inches and 40 lbs. As long as he doesn't exceed the seat requirements, I can leave him rear facing, correct?
  4. patricia February 26, 08:02
    IF THE CHILDS LEGS ARE TO LONG. STILL REAR FACING. WHERE DO THEY PUT THE LEGS ON THE BACK SEAT? IF SO , THE CAR IS IN A WRECK AND THE INPACT JAMMED THE LEGS AND HAVE SPINAL PROBLEMS
    • amanda November 09, 13:02
      In my opinion, i would rather my baby have broken legs than a crushed skull... check the facts. it is better to rear face for as long as possible regardless of their legs.
  5. Chris February 26, 11:11
    What happens if you get rear-ended? Is it any different than the child being front facing with a head-on collision?
    • Emily Lee
      Emily Lee Author February 26, 16:05
      Patricia- When a child rides in the car rear-facing, sometimes their legs will hit the back of the vehicle seat. This is okay and actually safer than the child riding forward-facing. Research shows that children riding forward-facing sustain more foot, leg and spinal cord injuries than children riding rear-facing. When a child rides rear-facing and is in an accident, the child's seat will actually "ride-down" the crash and lean backwards before coming back towards the vehicle seat. The car seat helps to cocoon the child and protect them during the crash. Chris- The likelihood of being in a rear-facing crash is only about 4%, compared to frontal or side-impact crashes. When involved in a crash, the child or other passengers will move in the direction of the crash. In a rear-facing crash, the child will actually have more time to "ride-down" the crash forces (as mentioned in the previous reply). However, it is always safer for the child to be rear-facing in any crash to help them better sustain the crash forces.
      • Emily Lee
        Emily Lee Author February 26, 16:10
        Erin- Thanks for being an advocate for child passenger safety! Best practice would be to follow the manufacturer's instructions and keep your big guy rear-facing up to both the height and weight upper limits.
  6. Bobby Daugherty August 27, 00:35
    The recommendations and laws regarding child passenger safety seem to be constantly changing and/or revised. Can you tell us what the current recommendations are, or a reliable site to go to in order to be safe and current?
    • Kate Setter
      Kate Setter August 28, 17:13
      Hi Bobby - Emily provided this response to your question: Much of the confusion is that there are differences between the recommendations of organizations like the American Academy of Pediatrics (AAP) and laws that are established by individual states. The recommendations are made in the best interest of the child to keep them safe while in the car and are usually more strict than the law itself. Here is information from the AAP: http://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families.aspx And this is a state-by-state look at the laws: http://www.ghsa.org/html/stateinfo/laws/childsafety_laws.html The AAP is always a good resource for the most up-to-date recommendations that are informed by the latest research. Hope that helps!
  7. Amber September 28, 21:17
    My 24 month old is 36" and 39lbs. His Diono recommends rf 45 lbs. But he is so large it's like squishing him in the car seat. I'm seriously considering ff. I should probably wait?
    • Emily Lee
      Emily Lee Author March 24, 09:41
      Amber- I always recommend keeping a child rear-facing to the upper height and weight limits of their car seat, however, as the parent you can always make the decision to turn your child forward-facing when you see fit. Great job keeping him rear-facing this long!
  8. Shannon October 12, 18:26
    My child is still rear facing. She is 4 years old and weighs 38 lbs. She has a Britax car seat and the maximum weight for rear facing is 40 lbs. I am extremely nervous about turning her forward facing. Should I buy a new seat to keep her rear facing? I looked into the diono which goes up to 50 lbs rear facing.
    • Emily Lee
      Emily Lee Author October 13, 14:45
      Shannon, Great job keeping your child rear-facing so long! You definitely are providing your daughter a safer way to ride by keeping her rear-facing. However, now that she is reaching the upper weight limit of her rear-facing seat, it is ok to turn her forward. When I talk with parents about keeping their child rear-facing, I always say “two years or the upper height and weight limit of the seat”, therefore, you’ve already exceeded the 2 year mark and almost the weight limit. The reason pediatricians and the American Academy of Pediatricians recommended 2 years is because that is when they say a child’s head and next structures are fully developed, lessening their chance of a neck or spinal cord injury in the event of a crash. By all means, you are the parent and you will ultimately make the decision for your child, however, you’ve kept her rear-facing longer than most (which I applaud you for), so I would go ahead and continue to use your current Britax seat, forward-facing until that upper weight limit and then transition into a booster seat. If you have any further questions, please feel free to reach out to our department, the Comprehensive Children’s Injury Center, at 513-636-7865, Option 1 and speak with one of our certified passenger safety technicians.
      • Shannon October 14, 22:50
        Thank you for the response. :-) We are going to turn her around this week :-)
  9. jessicak November 07, 13:36
    I've had a massive amount of grief from the grandparents on both sides about my 19 month old STILL rear facing. Britax Boulevard has a max rear facing weight of 40lbs and our eleanor is less than 22 lbs. I know I'm not crazy or overprotective, just changing with times and up to date knowledge. With our baby girl being so very petite, I know when she turns two, I will still want her rear facing with good reasons I'm a huge advocate for child car safety. Keep informing and stick to your guns mama's.
  10. marisa February 02, 18:23
    My son is 6 months and 27 pounds! Does anyone have any recommendations for a convertible car seat?
    • Emily Lee
      Emily Lee Author February 03, 08:46
      Marisa- Thank you for your question. You are correct that the next stage of car seat your son needs is what we call a convertible car seat because they start out riding rear-facing and then are able to convert to a forward-facing car seat. With the latest AAP recommendation to keep children rear-facing until 2 years, many car seat manufacturers are helping parents do this by making car seats that have higher rear-facing weight limits. My advice to you is to take your little guy to the store with you and place him in a variety of convertible seats and test them out--check to see how the harnesses adjusts, how easy is it to secure him in the seat and get the harnesses tight. Also, check the upper height and weight limits of the seat for both rear and forward-facing. Lastly, check to see if the seat itself will fit in your vehicle. Some of the convertible car seats are quite large and depending on their rear-facing recline, some may take up more room than others. If you have any additional questions, please check out our website at www.cincinnatichildrens.org/ccic or call us at 513-636-7865, Option 1 for further assistance!
  11. ym February 23, 01:11
    Hi, I want to know if I can put my 8 month old in a different car seat that is convertible car seat that can be use for rear facing cause I'm having another one on the way and don't want to purchase another infant car seat than have to move my 8 month baby than have to buy a new car seat for her when she get bigger cuz I can't afford it. I want to know if I can put her in a different car seat like the convertible car seat that can be rear facing also? Please let me know. Thanks.
    • Emily Lee
      Emily Lee Author February 23, 08:41
      ym- Thanks for your question and congratulations, as well! Yes, you can move your 8-month old daughter to a convertible seat, as long as you use the seat rear-facing. We recommended and highly suggest that you use a convertible seat to the upper height and weight limit rear-facing before changing the direction to forward-facing. If you have any questions or need further assistance, please feel free to contact our department at 513-636-7865, Option 1. Thanks, Emily
  12. Gina March 19, 15:13
    Hi! My 10 month old boy is a big dude. He is 38 lbs and 37". We have already bought two new car seats for him because he is growing so quickly. Can you please advise us on front facing? Thank you
    • Emily Lee
      Emily Lee Author March 19, 15:35
      Gina- Thanks for your question! Many car seat manufacturers are increasing the rear-facing weight limit of their car seats, to accommodate larger kids and to help parents keep their kiddos rear-facing longer, however I am not aware of a car seat that allows rear-facing beyond 40 pounds. Unfortunately, you may need to turn your child forward-facing earlier than the law and I would recommend in order for him to meet the car seat manufacturer's recommendations for weight. If you have any additional questions, please don't hesitate to call the Comprehensive Children's Injury Center at 513-636-7865, Option 1 or visit our website at www.cincinnatichildrens.org/ccic.
  13. Sarah w March 24, 04:15
    My son is almost 4 months old and about 23lbs and 28". Our current car seat is good until 35lbs or 32". I am wanting to only have to buy one more car seat like a transition between infant and booster or if I can just buy one more and be done. Do you have any suggestions to which type? Or a specific mode you prefer. We also want to try to keep him RF as long as possible, but our boy is growing so fast so I'm trying to find something that will allow him to grow the longest.
    • Emily Lee
      Emily Lee Author March 24, 09:38
      Sarah- Thanks for your question! I would first recommend to continue using your current car seat until the upper height and/or weight requirements but definitely start looking for the next car seat. Lucky for you, there are many car seats now available that can be considered "the last car seat you'll ever have to buy." I cannot recommend any specific brand or make because what I may recommend for one family may not work for your child or your vehicle size. Therefore, I recommend you take your child to the nearest baby supply store and start browsing the market to see what is out there. Place your child in a variety of seats and test how easy it is to put him in the seat, harness him appropriately, and how easy the seat will be to install in your vehicle. Also, will the seat fit in your vehicle? All of these things should be considered when purchasing any seat. For your child, it may also be beneficial to see what the maximum height and weight requirements are and how many "stages" the seat can be used in. If you have any additional questions, please don't hesitate to reach out to the Comprehensive Children's Injury Center at 513-636-7865, Option 1 for further assistance. Happy shopping!
  14. Sara July 06, 22:22
    Hi! Had our 2 year well check today, and my pediatrician acted like I was crazy suggesting that extended rear facing is a better way to go...my mom came with us, and is anxious to forward face my son. She feels like the pediatrician gave the go ahead. The doc stated that extended rear facing was from 12-24 months. I didn't feel like arguing with her and now I'm just kind of confused. My son is almost 36" and 30 pounds. I believe the RF limits on his seat are up to 40lbs and I need to double check the height limit, but I don't think he's close to the limit. Thanks for your input and help.
    • Emily Lee
      Emily Lee Author July 07, 11:08
      Sara- Great job keeping your son rear-facing this long! You're pediatrician is correct that it's recommended that children remain rear-facing up to 2 years or the upper height and/or weight limit of the child's car seat. Therefore, you can keep your child rear-facing as long as he hasn't reached the upper height or weight limit of his current seat. If he has reached either limit, it's best to turn him around forward facing. -Emily
  15. Courtney September 03, 08:25
    I don't agree with the age restriction I feel it should be based off height and weight due to my daughter at a year old was tall enough to fit into 2t pants if she stayed rear facing at that point we had to fully cross her legs Indian style and then she still was uncomfortable. What would you do in this case cause now she is three and size wise she is about to fit into 6t pants?
    • Emily Lee
      Emily Lee Author September 03, 08:40
      Courtney- I agree! I always tell parents that it's best for their child to remain rear-facing until the age of 2, unless the child reaches the height and/or weight limits of the car seat (in the rear-facing mode) first. It is never best practice to keep a child rear-facing longer than the car seat manufacturer intended. That is going against their recommendations and how they designed and crash-tested the seat. Every child is unique and therefore may not be able to remain rear-facing as long as another child who may be smaller for their age. Also, just to reiterate, it's okay for a child's legs to be crossed or scrunched up into their rear-facing seat. It may appear uncomfortable to us (because we wouldn't want to sit that way) but we actually see more foot and leg injuries forward-facing than rear-facing. However, never keep your child rear-facing longer than the height and weight requirements allow.
  16. MomToOne April 30, 16:36
    Hi Emily, great article on child safety! My son is almost 21 months old and weighs 40lbs. We have him rear facing. We have graco all-in-one car seat with rear facing limit of 40lbs. Is it mandatory to switch him around? I would prefer he stays rear facing till he is 2years old. Thanks.
    • Emily Lee
      Emily Lee Author May 06, 09:52
      MomToOne- Thanks for your question! That's great that you were able to keep your son rear-facing for such a long time, however it's now time to turn him forward-facing due to the 40 pound weight limit of his car seat, rear-facing. It's always recommended to use a car seat according to the manufacturer's instructions and if they list the rear-facing upper weight limit as 40 pounds, it is best to follow that recommendation. If you'd prefer to keep your son rear-facing even longer, there are a few seats on the market that have a higher rear-facing weight limit, but that would require you to purchase a new car seat. It's your choice, but I definitely would recommend you following the manufacturer's instructions and not to exceed the rear-facing weight limit of your current car seat. I hope that helps! Emily