The big milestones for your child when that first birthday arrives…walking, drinking whole milk, moving to a forward facing car seat. Whoa…not so fast on that last item! While the recommendation for changing to a forward facing car seat used to be 20 pounds and a year of age, new research and extensive crash testing has indicated that the longer we wait for this transition, the better. The American Academy of Pediatrics along with every transportation safety group recommends that children remain rear-facing until at least 2 years of age. In actuality, children can remain rear-facing until they outgrow the height and weight limits for the specific car seat in the rear-facing position. These parameters will be different for every car seat, so make sure and check your specific seat for these details.
“For newborns and infants, the head makes up about 25% of the body weight compared to only 6% in adults. That sure is a lot of weight to be violently thrown forward while only tethered by your spine!”
Here is the science (in a very brief form) about why it is important to leave a child rear-facing as long as possible. The laws of physics - inertia really - tell us that an object will move towards the point of impact. This means that in a head on collision, the first movement of the head and neck will be in the forward direction. For newborns and infants, the head makes up about 25% of the body weight compared to only 6% in adults. That sure is a lot of weight to be violently thrown forward while only tethered by your spine! An infant or toddler’s spinal canal is made of bone and cartilage, which is the flexible stuff that we have on our ears and in our nose. This cartilage allows for more “stretch” of the spinal canal (which is why newborns and young children can contort themselves into all kinds of crazy positions and still seem to be happy as a clam). As children grow, this cartilage converts into ossified bone, but this “conversion” is not fully completed until late childhood. While extra stretch might be good for posing newborns for those cute pictures, in a head on collision, the spinal canal might be able to stretch up to 2 inches, but the spinal cord is not as flexible, and in severe cases, sudden sheering forces can cause internal severing of the spinal cord which can cause paralysis or even death.
“When secured in a rear-facing car seat, there is no “whiplash” effect of the head violently going forward which reduces the risk of extreme stretching of the spinal canal.”
So now let’s think about that head on collision with a child in the rear-facing position. The infant or child will move towards the front of the car, which means the force of impact is absorbed over the entire head and back that is cradled by the car seat. When secured in a rear-facing car seat, there is no “whiplash” effect of the head violently going forward which reduces the risk of extreme stretching of the spinal canal.
Check out the short video below that shows what occurs to a child in a head on collision in both the forward and rear-facing positions.
Here are some of the most common questions and statements I get about leaving a child rear-facing (along with my general responses):
“My child’s legs are bent/folded/hanging over the seat. Doesn’t that put them at risk for leg injury in a crash?”
The likelihood of significant leg injury in a front impact crash is very low compared to the risk of injury to the head, neck or spinal cord in the same crash when forward facing. Children can have their legs bent at the knees, folded against the seat, or even hanging over the side of the seat and this risk of injury is still very minimal.
“I think my kiddos are bored/lonely back there. I can better engage and entertain them if they are forward facing.”
Your child knows your voice and knows you are there in the car even without seeing you by the time they are 9-12 months of age. You can sing with your child or tell stories very easily from the front seat. As kids get older, playing “I Spy” is a great way to engage with children while driving. There are also some great mirrors you can buy and mount on the headrest of the rear seat that allow you and your child to see each other through your rearview mirror.
“My child gets motion sick, and I think it is because they are rear facing.”
This one is a little tougher. Motion sickness is certainly a real issue even in children. There are limited studies showing that the rates of motion sickness are no different in rear vs forward facing children. If your child does seem to have some motion sickness, try to place their car seat in the middle position so they can see out the back window. The movement through the side windows might actually make motion sickness worse, so using a cling-on window shade to reduce how much movement they see through those side windows may help.
So even with the arrival of that first birthday celebration, hold off on making any changes to the configuration of your car just yet. Remember, the longer a child can ride rear-facing, the safer it is for them. Again, make sure that your child meets the height and weight limitations for their car seat to be rear-facing. If you are in doubt with regards to the position of your child’s car seat, talk to their pediatrician or contact the Safe Kids Coalition in your area to find out about the next car-seat checkup event in your area. These folks can provide great input on your specific car seat and how the seat fits your car and your kids, and they’ll even go hands on to ensure that your car seat is installed correctly in your vehicle. Click here to find out more.