Subscribe today for more stories, tips, and updates.

Cincinnati Children's Blog
  • Subscribe
  • CincinnatiChildrens.org
  • Contact Us
  • Blog
  • Healthy Living
  • Rare and Complex Conditions
  • Safety and Prevention
  • Heart Conditions
  • Learning and Growing
  • Research and Discoveries
  • ?
  • Blog
  • Healthy Living
  • Rare and Complex Conditions
  • Safety and Prevention
  • Heart Conditions
  • Learning and Growing
  • Research and Discoveries
  • ?
  • Subscribe
  • CincinnatiChildrens.org
  • Contact Us
HOME/Safety and Prevention/How Long Should My Child Ride Rear-Facing?

How Long Should My Child Ride Rear-Facing?

How Long Should My Child Ride Rear-Facing?
August 15, 2019
38 Comments
By: Emily Lee

The short answer to this question is, as long as possible.

Previously, the American Academy of Pediatrics (AAP) stated that children are safer riding rear-facing up to age 2. The AAP recently removed the specific age milestone. Now, the latest research shows that keeping children in a rear-facing car safety seat for as long as possible—until they reach the highest weight or height allowed by their car seat—is the best way to keep them safe.

WHY SO LONG?

Studies show that the likelihood for head and neck injuries in crashes of all directions is significantly lower if a child is riding rear-facing as compared to forward-facing. When children ride rear-facing in the car, their head, neck and spine are better supported within the upper shell of the car seat. In this position, the car seat absorbs most of the crash forces and does a better job of protecting these areas of the body.

Children who ride forward-facing are restrained by the harness straps. But in an accident, their heads can be thrown forward, which can result in serious spine and head injuries. Riding rear-facing lowers the risk of these injuries.

BUT MY CHILD’S LEGS ARE SCRUNCHED

Some parents ask me about their child’s legs being scrunched while riding rear-facing, and whether the child is more likely to sustain a leg or foot injury in a crash. I understand their concern, but 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. Believe it or not, 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. I always emphasize safety first. 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.

USE THE RIGHT SEAT

Above all, make sure you are using the right car safety seat for your child. The risk of death or serious injury is lowered by more than 70 percent when you use the right car or booster seat.

The updated AAP statement is 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 rear-facing weight limits of 40 pounds or more to help with this recommendation to keep children rear-facing longer. The direction in which your child rides is incredibly important to how protected your child will be in the unfortunate event your family is in a crash. Choose best practice to keep you and your children safe while you ride in the car.

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.

Subscribe today for more stories, tips, and updates.

Related Articles

10 Toy Safety Tips for the Holidays
10 Toy Safety Tips for the Holidays
Parents, Know the Dangers of Water Beads
Parents, Know the Dangers of Water Beads
10 Questions to Answer Before Using Your Fireplace This Winter
10 Questions to Answer Before Using Your Fireplace This Winter
How to Avoid Purchasing a Counterfeit Car Seat
How to Avoid Purchasing a Counterfeit Car Seat
TAGS:
  • car seat safety
  • injury prevention
Avatar photo

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.

Write A Comment

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Comments

Nicole February 24, 2014 at 7:58 pm

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?

    Michelle Price April 29, 2020 at 9:15 am

    Hi Nicole. I’m Michelle Price, and one of the other Certified Child Passenger Safety Technicians (CPSTs) at Cincinnati Children’s. Thanks so much for your question. At a minimum (in the state of Ohio), a child should be 4 years old AND 40 lbs before they move to a booster. With that said, double check the height and weight limit for your 5-point harness car seat. As long as your son still fits, I would recommend keeping him in the 5-point harness until he outgrows it at which point he would transitions to a booster.

Pat Goller February 24, 2014 at 9:33 pm

My grandson is 3 1/2 yrs old. He weighs about 36 lbs. When is i time to switch to a booster seat. Thanks.

    Avatar photo
    Emily Lee February 25, 2014 at 10:40 am

    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.

erin February 25, 2014 at 11:10 pm

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?

patricia February 26, 2014 at 8:02 am

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 9, 2015 at 1:02 pm

    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.

Chris February 26, 2014 at 11:11 am

What happens if you get rear-ended? Is it any different than the child being front facing with a head-on collision?

    Avatar photo
    Emily Lee February 26, 2014 at 4:05 pm

    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.

      Avatar photo
      Emily Lee February 26, 2014 at 4:10 pm

      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.

Bobby Daugherty August 27, 2014 at 12:35 am

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?

    Avatar photo
    Kate Setter August 28, 2014 at 5:13 pm

    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: https://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: https://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!

Amber September 28, 2014 at 9:17 pm

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?

    Avatar photo
    Emily Lee March 24, 2015 at 9:41 am

    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!

Shannon October 12, 2014 at 6:26 pm

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.

    Avatar photo
    Emily Lee October 13, 2014 at 2:45 pm

    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, 2014 at 10:50 pm

      Thank you for the response. 🙂 We are going to turn her around this week 🙂

jessicak November 7, 2014 at 1:36 pm

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.

marisa February 2, 2015 at 6:23 pm

My son is 6 months and 27 pounds! Does anyone have any recommendations for a convertible car seat?

    Avatar photo
    Emily Lee February 3, 2015 at 8:46 am

    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 http://www.cincinnatichildrens.org/ccic or call us at 513-636-7865, Option 1 for further assistance!

ym February 23, 2015 at 1:11 am

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.

    Avatar photo
    Emily Lee February 23, 2015 at 8:41 am

    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

Gina March 19, 2015 at 3:13 pm

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

    Avatar photo
    Emily Lee March 19, 2015 at 3:35 pm

    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 http://www.cincinnatichildrens.org/ccic.

Sarah w March 24, 2015 at 4:15 am

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.

    Avatar photo
    Emily Lee March 24, 2015 at 9:38 am

    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!

Sara July 6, 2015 at 10:22 pm

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.

    Avatar photo
    Emily Lee July 7, 2015 at 11:08 am

    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

Courtney September 3, 2015 at 8:25 am

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?

    Avatar photo
    Emily Lee September 3, 2015 at 8:40 am

    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.

MomToOne April 30, 2016 at 4:36 pm

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.

    Avatar photo
    Emily Lee May 6, 2016 at 9:52 am

    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

KT September 14, 2016 at 10:15 pm

My son is 2 yrs 9 mo. (33 months) old and is 37″ tall and 34 lbs.
He just reached the maximum height allowance for rear facing in his convertible car seat.
Should I buy him a new seat with a greater rear facing height allowance, or is it safe to turn him forward facing?

    Avatar photo
    Emily Lee September 15, 2016 at 8:22 am

    Great question! It is recommended that a child remain rear-facing until they reach 2 years of age or the upper height or weight limit of their current car seat. Therefore, since your child is over 2 years and has reached the height limit on his current car seat you can turn him forward facing. However, if you would want to keep him rear-facing longer, that is your choice as a parent and you may be able to find a seat with a higher rear-facing height limit.

When should baby be moved to a convertible car seat? • Parentifact June 13, 2017 at 2:04 pm

[…] Cincinnati Children’s Hospital’s blog also has information on car seat safety and recommendations. […]

Kevin March 6, 2019 at 5:32 pm

I fully support rear facing as long as… Ideally I would like to see the phrase “as long as reasonable” instead of “as long as possible”. Both of our kids began getting car-sick at about 18 months. With the first, we suffered through the consequences of leaving her rear facing for months before a friend suggested that it was because she was riding rear-facing. The vomiting stopped almost altogether when we turned her forward facing. We didn’t wait so long with our second daughter. Is it possible for her to ride rear-facing? Yes. Does it increase her chances of choking? Probably? Does it have a significant negative effect on the quality of life for child, mom, dad, grandparents, etc? Definitely! Please keep your kids rear-facing as long as reasonable.

    Avatar photo
    Emily Lee March 7, 2019 at 9:11 am

    Kevin-
    Thank you for your comment. I appreciate you sharing the stories of your two daughters and the decisions you made regarding their transportation. Yes, we advise families to keep their child in a rear-facing position for as long as possible (usually dependent on the height and weight parameters set by the manufacturer), but we understand that it may not always be possible to adhere to these due to other circumstances (as you described). The role of a technician is to educate and inform parents and caregivers so that they can choose what they feel is best. Ultimately, each caregiver makes the final decision about the child’s transportation and I’m glad to hear you did what you felt was best for your daughters.

Casey jones June 17, 2020 at 3:28 am

Thanks for the great info regarding baby car seats, it was really helpful!

Topics

  • Cancer and Blood Diseases
  • Child Development and Behavior
  • Childhood Obesity
  • Chronic Care Networks
  • Cincinnati Walks for Kids
  • Featured Faces
  • Fetal Conditions
  • Fitness and Nutrition
  • Food Allergies
  • Ghana 2012
  • Health Care Public Policy
  • Health Care Quality
  • Health Care Reform
  • Healthy Living
  • Heart Conditions
  • Hospital Operations
  • How We Do It
  • Learning and Growing
  • Meet The Team
  • Nurses Week 2012
  • Patient Family Experience
  • Patient Flow
  • Patient Safety
  • Patient Stories
  • Pin of the Week
  • Radiology
  • Rare and Complex Conditions
  • Research
  • Research and Discoveries
  • Safety and Prevention
  • Share Your Story
  • Technology
  • Uncategorized
  • Vaccines
  • Volunteerism
  • What Makes Us Different
  • What's New
See All Topics
See Less Topics

Subscribe

Never miss a post! Sign up to get new blog updates delivered to your email.

Popular Posts

  • 6 Questions to Ask When Your Child Complains of Chest Pain 2.2k views
  • Caring for the Caregivers of Children with Congenital Heart Disease  1.4k views
  • Stuttering In Young Kids: When To Be Concerned 0.9k views
  • Laryngomalacia: Is My Child’s Noisy Breathing Serious? 707 views
  • 4 Questions to Ask When Your Child Has Recurrent Croup 617 views
  • What’s the difference between a CAT-Scan and a CT-Scan? 546 views
About

The Cincinnati Children’s blog features thoughts and perspectives from our experts on all things pediatric health. This blog does not provide medical advice, diagnosis, or treatment. Learn More »

Contact Us
  • 3333 Burnet Avenue, Cincinnati, Ohio 45229-3026
  • 1-513-636-4200 | 1-800-344-2462
  • TTY: 1-513-636-4900
  • socialmedia@cchmc.org
Connect With Us
  • Subscribe
  • CincinnatiChildrens.org
  • Contact Us

© 2009-2022 Cincinnati Children’s Hospital Medical Center