The American Academy of Pediatrics (AAP) has released new recommendations regarding child safety seats. According to the new guidelines, children should be kept in rear-facing car seats until age 2, or until they have reached the height and weight maximums set by the car seat manufacturer. This is a significant departure from the current recommendation for children to be kept in rear-facing seats until at least one year of age and at least 20 pounds in weight. The new guidelines are published in the April 2011 issue of the journal Pediatrics.
“We are excited that the AAP is endorsing rear-facing child safety seats until age 2. We have been educating parents to keep their child rear-facing longer, and to have pediatricians also relaying this message to parents will be helpful,” said Maureen Donnelly, RN, MSN, NPC, Coordinator, Safe Kids Southern New Jersey, led by the Children’s Regional Hospital at Cooper.
Rear-facing seats
Rear-facing seats are reported to be safer because they offer more support to the head, neck and spine of infants and toddlers in a crash. A 2007 study in the journal Injury Prevention found that children under the age of 2 are 75 percent less likely to die or be severely injured in a crash if they are placed in a rear-facing seat.
Most rear-facing child safety seats today can accommodate children to fit the new guidelines, the AAP reported.
Forward-facing seats
Kids should be kept in a forward-facing car seat as long as possible, even through age 8 if their weight or height is under the limit allowed by their child safety seat manufacturer, according to the new guidelines. Studies show that the car seats reduce the risk of child injury up to 82 percent and the risk of death by 28 percent, compared to wearing seat belts.
The typical forward-facing car seat fits children up to about 40 pounds, though there are more than 40 models that can accommodate kids up to 60, 65 or even 85 pounds.
The recommendations also say that a forward-facing car seat with a harness offers more protection than a booster seat, while a booster seat is better than a seat belt alone.
Booster seats
Parents also are advised to keep older children in a booster seat, which properly positions the car’s seat belts across the child’s chest and hips, until they’re 4 feet 9 inches tall and are between the ages of 8 and 12. Children often don’t reach this stature until around 10 years of age, Donnelly noted.
“Many children aren’t ready to move out of booster seats until they’re about 10, sometimes even 12 years old, which usually is when they are tall enough – around 4 feet 9 inches tall – to have the car’s lap and shoulder belts fit in the correct positions,” Donnelly said.
Donnelly noted that, while New Jersey’s child passenger safety law requires only those up to age 8 or 80 pounds to ride in a booster seat, the American Academy of Pediatrics now recommends a booster seat for all children up to 4 feet 9 inches tall, or when the seat belt fits properly. “We educate parents that staying in a booster seat until the seat belt fits your child is the safest practice,” Donnelly said.
Also, booster seats must be used with the car’s lap and shoulder belts. “They should never be used with just a lap belt because a child is not fully protected,” Donnelly said.
Seat belts
Seat belts, whether used with or without a booster seat, should fit so that the shoulder belt lies across the middle of the chest and shoulder, and is kept off the neck or face, while the lap belt fits low and snug on the hips and upper thighs, not across the soft tissue of the belly.
Children should ride in the backseat until they are 13 years old, since studies have shown this reduces the risk of injury by 40 percent to 70 percent, the AAP reported.
Also, adults should set a good example for children by buckling up for every ride, whether sitting in the front or rear seats.
Questions about car seat safety?
If you have any questions or would like more information about the safe transportation of infants, toddlers and children, you can contact Maureen Donnelly directly, at 856-968-TOTS (8687).