Stages of Seat Safety - Stage 1


Rear Facing Seat

New recommendations from the American Academy of Pediatrics and the National Highway Traffic Administration state that children should ride rear facing longer. Many parents and care givers have questions. “Why so long rear facing? Won’t his legs get hurt? What’s he do with his legs? Won’t she be squished? It was good enough for my kids 20 years ago, why isn’t it good enough anymore?”

The answers to these are both simple and complex. The simple answer is that with better science, we can make better recommendations, and until about 4 years ago, we just didn’t have the science. Now that we do, we can say definitively that we know children who rear face until they reach the maximum height or weight of their convertible car seat are the safest.

Here is a video of rear facing verses forward facing

In the video, did you see how the rear facing seat back absorbed almost all of the crash forces?

The child dummy rode up and down, then back towards the vehicle seat. The force was nearly all absorbed by the shell of the seat. In comparison, the forward facing dummy had all the force placed on his neck and extremities. This can lead to very serious injuries in young children, mainly to the head and spinal cord. We can fix a leg. We can’t fix a spine. Spinal cord injuries are one of the big things we’re trying to prevent injury to. In babies and young children, the spinal cord comes in a number of pieces. During the growth process, it hardens or ossifies, creating more and more linkages to itself so that by the time a child reaches puberty, it is one piece.

Picture #1

Cervical vertebrae for a one-year old (left), and beside it a cervical vertebrae for a 6 year old (right)

Cervical vertebrae for a one-year old

Picture #2

Thoracic vertebrae for a 1 yr old (left) and for a 6 yr old (right).

Thoracic vertebrae for a 1 yr old

Picture #3

Lumbar vertebrae for a 1 yr old (left) and for a 6 yr old (right).



Pictures Courtesy of: Human Osteology, T. White, 2000
Lumbar vertebrae for a 1 yr old

Note that in all pictures, the 1-yr olds' vertebrae is still in pieces.

The vertebrae do not begin to fuse until age 3-6 years old. This is why rear-facing is the safest as it gives more support and protection to the incomplete vertebrae and therefore the spinal cord. With vertebrae in pieces, a forward facing child has a greater chance of damage to the spinal cord when their head and neck whip forward and back in a crash. This, however, brings us back to why we want to rear face children for as long as they fit into a rear facing seat. Between the new science that we’ve got and the knowledge about the spine, we’re finding that rear facing is extraordinarily protective.

With this in mind, we’ll go to the questions:

Why so long? Because the spine is in pieces and we want to prevent injury to it in kids under 3.

Won’t his legs get hurt rear facing? No. Nationally, in rear facing children, there have been no reported cases of injury to the extremities. On the other hand, in forward facing children, we’ve found that there are a great number of extremity injuries – it’s the second most likely thing to get hurt, after the head and neck.

What’s he do with his legs? Well, many kids put them over the sides of the car seat, up on the back of the vehicle seat or sit “criss-cross-applesauce”. It’s easy for them, they are very flexible.

stage-1-chloe-weinstein

Won’t she be squished?

This child has just spent 9 months curled up in her mother’s womb. We recommend swaddling. This is no different. Children are very flexible and they can do many things that we as adults would be uncomfortable doing. Adult perceptions should be put aside when looking at comfort for a child. If your child outgrows their infant seat (the ones with a carrying handle) there are now many convertible and all-in-one seats that rear face from 40-50 lbs.

When is my rear facing seat outgrown?

A child has outgrown the rear facing limit of their car seat when they exceed the manufacturer’s height or weight limit for that car seat.
Parents using an infant seat (the ones with a carrying handle) should transition to a rear facing convertible or all-in-one car seat to extend rear facing to the maximum height or weight of the car seat. Maximum child’s weight using a convertible or all-in-one is usually 40 to 50 lbs.
Rear facing beyond age 2 to the maximum height or weight of the car seat is a recommendation of the American Academy of Pediatrics.

Want to rear face your older child? Have questions? Unsure if your seat is installed correctly? Get your seat checked at one of our Car Seat Assistance Stations!


Other links on why rear facing is safest:

Joel’s Journey
install this seat
front-facing-seat
install a different seat

vt department of health child passenger safety program