Several readers have written in to say that grandparents claim that keeping toddlers in rear-facing car seats until they are age two (and beyond) is cruel or can damage the child’s legs. We tapped an expert for answers. – The Scientific Parent Editorial Staff

Why is rear-facing safer?

Instead of having your head pull violently away from your chest, as happens when you are forward-facing in a frontal crash, the rear-facing child is cradled in their seat in much the same way as you catch a fastball in a mitt. This video shows two 12-month-old crash test dummies each secured in the same car seat but one is rear-facing and one is forward-facing – watch how much the forward-facing dummy’s head and neck move – and remember that this video is slowed down tremendously as crashes happen quicker than the blink of an eye. For more on the physics behind why rear-facing is safer, see here.

Current Research and Evidence:

What seats are big enough for 2-year-olds rear-facing?
Convertible seats are ones that start rear-facing and then convert to forward-facing for older kids; kids typically start using a convertible seat rear-facing after out-growing an infant seat. The weight limit for rear-facing is now typically 40 pounds for most convertible seats, with several even going to 50 pounds rear-facing. The height limit is typically the same for most rear-facing seats – the child’s head must be at least 1 inch below the top of the car seat.

Common Questions from Parents + Grandparents:

DSC_0146-300x198What about their legs?
As kids get older, their feet will touch the back of the vehicle seat; this is both comfortable and safe. Ever wonder why a 5-year-old can sleep comfortably with his chin on his chest and never wake up complaining of a stiff neck? It’s because kids’ joints aren’t fully formed, which lets them sit comfortably in positions that would be painful for even a yoga master. For this reason, a 3-year-old can sit comfortably rear-facing with her legs crossed or in the “frog leg” position.

Other parents worry about leg injuries; studies show that forward-facing kids suffer many more leg injuries than rear-facing kids. The leg injuries to forward-facing children occur when the child’s legs fly up and hit the back of the front seat and the front seat moves backwards, compressing the child’s legs. Rear-facing kids will often go into a “cannonball” position during a frontal crash… meaning that however scrunched they might look, they end up super scrunched in the instant of a crash and we know that this does not cause injury.

My toddler wants to see out!
Rear-facing does not have to be boring! Older kids can ride quite upright so they can see out the side and rear windows. If there’s a head rest blocking your child’s view out the back window, you can usually remove it. By 9-12 months your baby knows you’re there when you talk to them from the front – even though they can’t see you. You can calm and entertain your child with songs and stories – and for older children games of “I spy” – all while they are rear-facing.

My toddler gets motion sick!
Volvo looked at several thousand pre-schoolers and found the same rates of motion sickness in those riding rear-facing as those riding forward-facing. Regardless of the direction your child rides, placing them in the center seat with an unobstructed view out the front/back window (and limited visibility out the side windows) will help keep the nausea away. See here for more info about how to help a child who gets motion sick.

My toddler gets bored!
Here are some toys and games for kids of different ages that are travel friendly.

The Car Seat Lady’s Recommendations

It’s not coincidence that flight attendants sit rear-facing. Rear-facing is the safest way for everyone to travel, not just babies. Therefore, it is our recommendation that children ride rear-facing until at least age 2 – and ideally longer, until reaching the maximum height or weight for rear-facing in their convertible car seat, which for most kids is around 2-4 years old.

Note that it is now law in a few states that children ride rear-facing until at least age 2.

A version of this post originally appeared on The Car Seat Lady website and can be found here.

Resources:

American Academy of Pediatrics, Committee on Injury, Violence & Poison Prevention. Child Passenger Safety. Pediatrics. 2011; 127: 788-793.
Henary B, et al. Car Safety Seats for Children: Rear Facing for Best Protection. Injury Prevention. 2007; 13 (6): 398-402.
Bull M, Durbin D. Rear-Facing Car Safety Seats: Getting the Message Right. Pediatrics. 2008; 121 (3): 619-20.
Watson E, Monteiro M. Advise Use of Rear Facing Child Car Seats for Children Under 4 Years Old. BMJ. 2009; 338: b1994.
Arbogast KB, et al. Injuries to Children in Forward Facing Child Restraints. Annu Proc Assoc Adv Automot Med. 2002; 46: 213-30.

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Categories: Accidents, Injuries, + Abuse, Ages + Stages, Newborns + Infants, Policy, Politics, + Pop Health, Toddlers + Preschoolers