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.