When my kids were little, I faithfully followed every rule and regulation. They sat in car seats. The rungs in their cribs were the correct distance apart. We even made our own baby food and froze it in ice cube trays.
The grandparents rolled their eyes at us and said, "you kids survived even though you knocked around the backseat of the car. We fed you solids right away. You got formula." My aunt loves to recall the time that she breastfed her son, while driving a car.
Whatevah, mom! Eye roll. We didn't want to risk anything, when our kids' lives were at stake. So, we refused the antique crib and paid top dollar for the safest car seat at Babies R Us.
Even back then, I realized that car seats were a major pain in the ass. You can only fit two kids in the backseat of a regular car, so more people buy SUVs and pollute the air. It makes it harder to car pool and share parenting responsibilities. They are heavy. Babies have to face backwards, which makes them cry all the harder. We just retired Ian's stained and stinky booster seat, and everyone was a lot happier.
Yesterday, I broke the news to Jonah that not only was Ian supposed to go back in a booster seat, but he was, too. The American Academy of Pediatrics says that kids should face the rear of the car until, they are two, and that kids as old as 12 should remain in their booster seat.
We're choosing to ignore this new recommendation by the AAP. You have to balance safety with commonsense. Besides, Jonah would probably die of embarrassment. But if my kids were still little, I might take their recommendation about keeping babies in the rear facing car seat more seriously.
Question of the Day: What do you think about these new recommendations?
Apt. 11d 
Around every 30 months, the AAP makes some pronouncement that convinces me that they hate parents (and probably children and doctors too). I guess it’s been about that long since the “some morons don’t measure their medicine, so all toddlers must now cough and sniffle all night long” guideline.
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We even made our own baby food and froze it in ice cube trays.
We did that also. It was still less of a pain in the ass than the rear-facing car seat was to install in the old car. Sometimes I think “safety” is a deliberate attempt to limit family size by making children harder to raise.
From the article: Sweden, for instance, where children face the rear until age 4
I wonder if that doesn’t say more about the Swedish national character than Swedish safety engineering.
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Oh, my goodness.
By the way, notice that while the article gives a pretty good case for rear-facing baby and toddler seats, it doesn’t do the same thing for booster seats for older children. That’s an interesting omission, given that the Freakonomics guys say that there’s little safety advantage to booster seats for bigger kids. That study that you hear about is comparing accidents with children in booster seats to accidents with children riding with no restraint whatsoever.
http://abcnews.go.com/GMA/Parenting/child-safety-car-seats/story?id=8867880&page=1
I was planning to move our oldest out of her booster seat at 8, which was the previous cut-off (the Canadian cut-off is at 9). However, she’d gotten used to the better view, so we put it off until the day (she was about 8.5) when I was cleaning the car and discovered that the foam padding of her booster seat was falling apart.
The car seats and booster seats are an incredible nuisance when flying (both to carry and to install in strange cars), especially if you decide to be a good citizen and strap your child in on the plane. Also, living as a carless city family in DC, car seats were a major limitation. Living in NW DC, I never took both kids more than a 45-minute one-way walk away from home by myself, because I’d have no way of getting back home in case of emergency (without violating car seat regulations, we couldn’t even take a taxi home). I was pretty much tethered to a small circle for a couple of years. For the older child, I eventually decided to just put a taxi lap belt on her from about 3 and call it a day. I’ve heard that NYC families deal with these issues by just piling everybody willy nilly into taxis. Laura?
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At some point, I bought some little gadget that was supposed to be a sort of mini car seat for travel (just a back with straps), but I eventually decided that it was probably pretty unsafe.
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I’ve seen some family-type vehicles that have built-in car seats or boosters, which is nice. Here’s Volvo’s take on it:
http://blogs.edmunds.com/strategies/2007/02/2008-volvo-v70-wagon-built-in-booster-seats-with-height-adjustment.html
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and strap your child in on the plane
I’ve never tried to use anything but the regular seatbelt on the plane. Except for very young infants, I don’t think I’ve seen anybody do it.
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Yup, in NYC you pile into the taxi. No one carries around car seats for the 20 block ride uptown.
I seriously question whether the benefits of rear-facing outweigh the costs. And, what I mean by this is the following: ok, short 20 min trips rear-facing fine, but a 5 hour trip? Where do tall, big toddlers put their legs? I don’t understand this.
While I recognize the importance of technology, safety and new research, I’m still alive and I too drank formula and rolled around in the backseat of the car.
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Plus, my dad smoked the whole time we were in the car.
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We have ignored the rear-facing recommendation for both our children after age 9 months. As they do in my home country (small, nondescript Central European nation made up of fairly risk-averse people). I get what the studies say. But I had to balance the relative “safety” of driving while listening to uninterrupted screaming in the back seat that makes my stomach tie itself into knots and distracts me from the traffic at hand with the extra bit of risk of head injury. So sue me.
And yeah… NYC cabs: you just pile right in. We seem to survive fine (we currently live in Manhattan).
As for the AAP: this is the group that makes you feel bad about giving your babies formula but whose members are, in shocking numbers, unaware that there is a growth chart out there OTHER than the one distributed to them by formula companies. Which only becomes an issue if you listened to them in the first place and nursed your baby and then your baby looks too skinny to them on the formula-advert chart. (I’m still bitter about that experience. Which we had with multiple doctors).
In other words, I’d take what they say with a grain of salt. And I’d wonder, just a little bit, about exactly where the motivation comes from that causes them recommend that parents buy more and more elaborate car seats for longer and longer periods of time.
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I guess I’m a bit surprised at the distain for the new rules. My son rode rear facing almost to two, and it was fine. Crossing his legs or pushing them against the seat was actually more comfortable for him than them dangling off the front seems to be now. (He’s 5.)
The booster does seem over the top though. Here I think it’s 8/80 lbs (Ontario). But the backless boosters are pretty unobtrusive so they don’t bother me. We’ve got one at the ready but my 5 yr old is still in a carseat because he’s such a lightweight (just shy of 40 lbs) and his height hasn’t put him over the top yet.
My husband is sensitive on this one because he lost family in two separate accidents growing up – a cousin his age, and 5/6 siblings in a different accident (the 6th was the only belted one, in the front). There’s a big generational hole there.
Of course no one wore seatbelts then, or not very many people. I myself was brought home from the hospital in a box shoved behind the gear shift in a two-seater Corvette. 🙂
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We have the airplane recommended seat fasteners. They were a HUGE PITA and would stress my husband and I out terribly when we traveled so we just stopped using them. The way you install them is around the seat which impedes the tray table behind you. Which was a difficult choice since they cost a freaking fortune. As does everything involved in safety!
My girls are SMALL. Twins, Asian, little small. At 4.5 they weigh 30lbs. They are in convertible seats but I will move them to a back booster at 5 because I don’t want them harassed at school. I also flipped them around at 14 months in their seats because really, keeping them quiet with a little baby Einstein was more important for my sanity.
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Realizing that YMMV, I”m a little surprised that the comments so far have tilted so much towards criticism of the new rules. (I’d have expected a little more diversity of views, is all.) My daughter is very, very small–at almost 9, she weighs just over 40 pounds and is maybe 43″ high. So she stayed in a rear-facing seat until she was 2 simply because she was so very small and hadn’t outgrown her car seat. She didn’t switch to a booster seat until she was 7.5, when a car accident totalled our car and led us to get a new booster seat. The seat belt fits her much more comfortably with the booster than without.
When my daughter was 4, tons of her friends switched to booster seats b/c that was the guideline in place at the time in our old state. Most of her friends were way bigger than she was, of course, but we just said “well, you need a seat that’s the right size for you” and that seemed to give her a script she could use. It is way easier to deal with driving other kids around now that we can just use the bottom part of a booster seat, so don’t get me wrong, I’m happy about that. But these guidelines seem to be encouraging us to use actual size and fit of restraint as a judgement, rather than age as a proxy for size, and that seems good.
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Well a friend mentioned this to me the other day and I can’t see it. I can see the point of a carseat and I can even see the point of a booster seat since most cars have adult height shoulder straps in the back.
But my children are a: very tall for their ages and b: all had a lot of trouble burping, which meant that laying on their backs in rear-facing seats was often REALLY uncomfortable/painful for them. All three got turned around at about ten months. It was saner for everyone.
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Jenny, my daughter sounds similar in size to your girls – she’s 4 (and three-quarters, as she reminds us every stinkin’ day)and about 35 lbs. Most of her pals – her age, and just slightly bigger – are already in backless boosters. So for Christmas “Santa” brought her a Britax Frontier, which splits the difference: It’s a booster, so it satisfies the “big girl” desire, but it comes with a 5-point harness, which we’re gonna be using for a looooooong time. (It then transitions to a regular booster and then a backless booster.)
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I turned around the car seat for my 18 month toddler before picking him up yesterday. That article was seriously scary. I do not want to increase dramatically the chance that in an accident he will experience internal decapitation. It makes perfect sense to me that backwards is safer, especially for a kid whose head is about the size of mine, with a neck the size of our cat. He didn’t like it much, but adjusted pretty quickly.
I simply can’t imagine the level of anguish and guilt I’d feel if he was seriously injured just because I didn’t want to deal with him being a bit more whiny. The cost-benefit on that just doesn’t compute.
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In defense of the rear facing until 2, the statistic I heard ( and yes, i know all statistics are not interpreted correctly and i can’t vouch for this one other than to say it was in the Chicago Tribune) was that rear facing would eliminate 75% of serious injuries sustained in car accidents by those between 1 and 2yrs old .That seems like a pretty big improvement in safety, not even knowing what exactly they are counting as serious injuries. If my kids were that age, I’d do it.
The booster seat issue seems less clear though as i haven’t read or heard any clear cut evidence on the injuries eliminated in a booster seat vs not, for , say , a 9 year old who is 55 inches tall and weighs 62 pounds as my son does. So , he won’t go back in the booster unless i read something more concrete.
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that rear facing would eliminate 75% of serious injuries sustained in car accidents by those between 1 and 2yrs old
Except that I’d like to know how many serious injuries there are for children under 2. I mean, as long as the kid wasn’t screaming, I was happy to face him backward. But, if I have to listen to a constant yelling, I’d like to know if the lower risk of injury is equal to the increased risk from being distracted by constant yelling.
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My children screamed every second of every car ride while they were rear-facing. I don’t mean “whined” or “cried” or “complained”– I mean they actually screamed so much, it took everything of my sleep-deprived brain to not veer off the rode or smash into the car in front of me.
We drove far, far more safely as a family when they switched forward.
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Obviously, I meant “road” not “rode.” (Someone is screaming at me right now.)
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michaela, my girls are actually 4 and 3 quarters also. And M is 31.5 pounds and C is 30.5 pounds. They are about 39-40 inches tall. They are small. We have lap Maxi Cosi Rodi boosters for my huband’s car because nothing else will fit and the girls fit in them perfectly. and then we are still using Marathons for my car. I am not decided which I will move up to but most likely the Frontier. I just don’t want to have to buy 6 more seats!!! So the frontier would at least bring that down to 4! (doubles of everything, plus I have bought 10 carseats already!).
If we waited til they met the requirements I am not sure if they would ever be out of a booster. (projected height/weight is 4’10 and 90lbs)
I think it is completely safer to ride rear facing until 2. My girls, like Anjali’s child, screamed, cried and were so sweaty from no AC they HAD to be turned around.
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The Marathon will hold a big kid. We have a 40 pound boy in ours. We’ve never had a problem, so we have not switched yet.
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Also, you can get a Marathon in a shade that is a very near match for Cheerio crumbs.
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Jenny,
Some adult women are around that size, I wonder if they should be in boosters. I heard somewhere that an airbag is set to protect a 200 lb, 6′ tall individual, and can seriously injure/decapitate a small woman or child. I don’t know if that’s something to needlessly worry about, but I heard a recommendation that they make two deployment speeds, one for large and one for smaller individuals, and you set it when you sit in the seat, which makes sense.
I was also very small (about 10th percentile in height for my age, not even on the weight charts) until around age 11, and I remember feeling the indignity of having to sit in a booster seat long past the age of everyone else. I think eventually my parents just chucked out the booster seat even though I wasn’t really at the weight requirements. This was quite awhile ago, so safety was also a bit more lax then.
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B.I. My girls are Vietnamese. The Drs think maybe they will hit 5 feet because of all the meat and hormones in our food (even though we try to do organic). But being twins gives them another disadvantage in the size arena. Most VN women we encountered, in VN were under 5’1.
I love our Marathons but the girls will eventually be too tall for the straps. Which you are suppose to have at least 2 fingers from the top of shoulder to the actually place the harness goes in. My girls are almost there…
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I am thrilled by the recommendations. Getting into a car is the most dangerous thing most of us do on a daily basis. My 3.5 year old is happily rear facing and will be until he outgrows his seat in about 3-4 months.
when I was 6 my next door neighbor was killed in a car accident. She was 8. I will never forget that day. Worth it 100% in my opinion to do everything we can to make car trips as safe as possible.
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I think that according to the new guidelines your mother and I should still be in a booster seat.
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@Kyndra – Once a kid is able to hold their head up you no longer have to have rear facing seats at a 45 degree angle like you do for a newborn so they would not be lying down. That angle is to prevent newborns from having their heads flop forward and cut off air supply, by the time a kid is 6 months old or so you can definitely install the seat more upright, up to 30 degrees I believe, which would address an issue like reflux.
And since my my average 3.5 year old comfortably fits rear facing, I have to say I don’t understand how people say their 1 year olds don’t fit. Even a freakishly tall 1 year old.
You did what you felt was right at the time with the information you had and I would never fault you for that, but I sincerely hope that most people do better when they know better so the after the fact justifications I’ve been hearing from parents all over the net and in real life on this one really confuse me.
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Jenny
Yeah, the Vietnamese tend to be tiny. I have two Vietnamese foster brothers, who as adults they brought over most of their family, including multiple sisters and their mother, and I’m not sure any of them were at the 4’10″/90 lb mark. I remember when one of my brothers was getting married, I had to wear an ao dai for various events, and I had to borrow it from the sisters. I was 14, not quite 5’4″ and about 98 lbs, and they finally found an XXL one in the back of the closet I could wear as long as I didn’t breath too hard. Of course, I had to wear the same one to both the engagement party and the wedding, which I was told shamefully highlighted my “fatness.” In terms of height, my brothers, who came to America at 15 and lived with my family for 3 years, are about 5’8″ or so, and by far the tallest in their family, which they claim is due to all the milk they drank in the US.
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From the article: Sweden, for instance, where children face the rear until age 4
I wonder if that doesn’t say more about the Swedish national character than Swedish safety engineering.
MH-
Being part Swedish, I have to say you might be on to something.
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Technical report on the AAP’s website: http://pediatrics.aappublications.org/cgi/reprint/peds.2011-0215v1
My children are just old enough to make this academic for us. My husband’s Volvo has the integrated booster seats, which I recommend. If you read the technical report, parents do secure their children in cars more than in the past, but for some recommendations, adherence is not high.
Life is dangerous. The American Academy of Pediatrics also promulgated the Shopping Cart advice:
THINK ABOUT SAFER IDEAS FOR CHILDREN WHILE YOU SHOP
Instead of putting your child in a cart while you shop, try one of these safer ideas:
â—Ź Get another adult to come with you to watch your child while you shop.
â—Ź Put your child in a stroller, wagon, or frontpack instead of in a shopping cart.
â—Ź Ask your older child to walk and praise him or her for behaving and staying near you.
â—Ź Leave your child at home with another adult while you shop. â—Ź Shop online if your store offers shopping on the Internet.
aappolicy.aappublications.org/cgi/reprint/pediatrics;118/2/e545.pdf
My tolerance for this sort of safety craziness is now limited. It is possible to shop with a toddler in a shopping cart.
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I’m with Cranberry. That makes me want to hit people.
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Gah. I’m all for being safe in the car. I think technically our younger daughter should be in a booster. She’s 11 and she’s tiny. I think she rode in a booster until she was 6 or 7. We might or might not have been following recommendations. We just got tired of moving the damn thing from car to car as we switched drop off and pick up responsibilities. She rides in the back seat most of the time. We are pretty darn safe drivers. I know that doesn’t prevent the other crazies out there from hurting us.
What I want to see is a ban on cell phone use while driving here. I see it all the time and it drives me nuts. We almost got into a really serious accident because someone talking on her cell phone was distracted and ran a light. Mr. Geeky heard her screech her tires and therefore didn’t go when the light turned. Had he moved forward when the light turned, it’s likely he would be gone and me and Geeky Girl would have been seriously injured. The woman didn’t stop until she was in the middle of the intersection. As our lights shined on her, she was looking at us, phone still held to her ear. She had to continue through the intersection despite the red light.
If you’re really interested in traffic safety, read Traffic. It’s a great read and gives some really interesting, scientifically valid information about our not so safe driving habits. Not to mention explaining where traffic comes from.
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Oh, and when I was a kid, my mom left me in the magazine section by myself while she shopped. Dare ya to do that nowadays.
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I am less angry about this than I was about the cold medicine thing, but I worry that we’re seeing the same kind of one-way ratchet effect that characterizes airport security, seat belts in school buses, and even copyright law. There’s no countervailing group with enough political clout to encourage the authorities to balance the real costs on one hand with the risk-weighted benefits on the other.
How many of these safety recommendations have ever been withdrawn? The only one I can think of was the co-sleeping recommendation, and then only grudgingly because it touched a nerve with the AP crowd.
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Worth it 100% in my opinion to do everything we can to make car trips as safe as possible.
We could make cars so they don’t drive more than 20mph, or even slower. We could make them heavier (but low to the ground) so they’d use much more fuel. We could put long delays between when one light turned red and the other turned green, and so on. These things would really help make car travel safer. But they’d also be crazy and stupid, so it’s clear that we don’t really want to do _everything_ that would make car travel safer.
One thing to remember is that, for any group of people, there will always be a leading cause of death for people in that group. Car travel is, possibly, one of the more dangerous things kids do, but it’s still really pretty safe. At a certain point it’s quite plausible to ask whether further safety requirements are justified. I don’t know whether the ones discussed her are justified or not, but if it were up to me, I’d make more of them voluntary and up to the parents to decide on.
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According to the nytimes article, EMTs call the rear-facing child seat the orphan seat.
The article is suggesting that this is one safety precaution that has significant beneficial effect, which is why it has been the law already in many countries for a long time. That may not be true, but do those of you who are against have evidence that it is not?
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We could make cars so they don’t drive more than 20mph, or even slower.
I’m thinking of starting a movement to get my neighborhood streets, excepting a few main routes, turned into golf cart paths. Most of the people are over 60 anyway, so it would be just like a retirement community.
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“According to the nytimes article, EMTs call the rear-facing child seat the orphan seat.”
Here’s one possible confounding issue. You’re supposed to put those car seats in the rear middle seat, and that’s already the safest position in the car, car seat or no car seat.
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@Matt – Oh give me a break. I’m rolling my eyes here.
It is voluntary. No one is forcing you to keep your toddler rear facing. I would be shocked if the law changed to reflect this research any time soon. It is a recommendation based on the research that is available. What are they supposed to do, get a compelling study that shows that kids are 75% less likely to be killed or seriously injured in an accident rear facing between the ages of 1 and 2 and not tell parents about it so they can make informed decisions. Just keep spouting the 1 and 20 rule that was based on no evidence because it makes people feel bad that they want to flip their kid sooner. Of course there are some situations where turning a kid early is the only choice. You may have a car that can’t fit 2 rear facing car seats and have two kids close together. You may have a kid that gets horribly car sick where clearly the benefit of flipping starts to outweigh the risk. That’s why the decision is still in parents hands. But many people don’t have a compelling reason, they just flip their kids at 1 and 20 because it was what the AAP previously appeared to recommend. You had to read the wording very carefully to parse that it actually just said that was the minimum allowed. This new recommendation clarifies it so people can make a decision with the most current scientific evidence available.
People are free to ignore it and the vast majority of them probably will. Many people ignore vaccine recommendations too and that’s their choice.
And my point in pointing out that it is the leading cause of death for kids is that I see parents flipping out over minuscule risks from everything to non organic foods to kidnapping , who then climb in to their car without a second thought. We have seriously skewed ideas of what dangers we actually face on a daily basis.
@Amy P – That is the seating location most people put forward facing seats to and the study was specifically comparing the two.
Take a look at some crash footage some time comparing rear facing and forward facing and I think it becomes really clear why it is safer for a baby.
I’m sorry if I’m ranting a little, I’m just floored by the responses I’ve been reading today. I’m truly baffled by the anger over it.
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Auburn, this article comes pretty close to explaining why I was annoyed by the recommendation.
The vaccine analogy is wrong. Vaccination is more than recommended, if you want to send your kid to daycare or school. Which is good because skipping a vaccine puts a real risk on other people. Most vaccines aren’t 100% effective and they work not just by strengthening an individual’s immunity, but by creating a herd immunity where the disease can’t spread.
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auburn,
Maybe it would be more effective if the front-facing guideline wasn’t bundled in our minds with the much more questionable booster-until-4’9″ guideline.
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@Amy P – I know much less about the booster question research because honestly, my kids are a baby and a preschooler. Maybe you’re right. The evidence on rear facing is extremely compelling and it happens to be what I’ve heard the most comments on, probably because that’s age most of my friends kids are.
@MH – I don’t disagree with a lot of that article. Well, except to point out that the screaming thing is something that most kids outgrow right around 12-15 months which happens to coincide with when many people turn them, but most of them outgrow it even if you don’t. It’s just an age thing. I’m sure there are plenty of exceptions, but that has been the case for most of the people I know who have kept kids rear facing.
That said, I agree with many of her points, yet stil the data is not at fault. I think the AAP wold be deeply irresponsible to not point people towards the best evidence based practice just because it might be more difficult and inconvenient. People are still free to make their own choices as they always have. But I’m glad to finally see myths about things like legs touching the back of the seat being dispelled.
That said, car seat safety advocates are the first to say that the the car and car seat manufacturers desperately need to catch up with making seats easier to install and easier to use correctly. But it is those advocates who push for those changes just like they pushed for updates in the official recommendations. It’s not the parents who are whining about it who are pushing for change I can guarantee you.
Car seat manuals are practically useless and are clearly written as much by lawyers as by engineers. Nothing proves that more than the fact that something like 80% of seats that come into car seat checks are installed improperly.
Hell, we had a Suburu Forester which looks like a soccer mom car, right? That’s what I thought when we bought it at least. Well without question has to be the worst car for car seats ever made. 3 of 4 seats we tried just would not install correctly, period, and even those that did meant pushing the front passenger seat up so far that with the seat installed properly, I had to ride in the back seat anyway. There probably aren’t many people as patient as I am to sit in the parking lot at babies r us wrangling 4 different seats into that f*&^%$ car while 8.5 months pregnant so most people probably just walk away with seats that fit badly.
The problems are endless. Many older cars do not have the proper tether locations installed so you have to get them retrofitted if you want to follow the installation instructions properly. Back seats on many sedans and small SUVs are too shallow for multiple rear facing seats so if you have kids close together, you’re screwed. Many of the booster seats on the market are insanely wide so fitting three across is close to impossible, and seats that are made to address that issue happen to be the most expensive on the market, meaning you’d need $600 worth of car seats to fit 3 across in many cars. There are a million and one obstacles, and yet it is still what is safest and I think that public health officials would be remiss to not recommend that people follow best practices whenever possible. People are still free to do what they need to do to make their own family situations work, but they should know that those choices have safety trade offs so they can make them in the most informed way possible. Hell I’ve made trade offs too. I can’t afford a newer car, so I drive an old car which has definite safety trade offs, with a top of the line car seats installed rear facing. I do what I can within the means of my family.
I live in a neighborhood filled with recent immigrants from Mexico and Central America and car seat use around here is sporadic at best. We have a long way to go. Forget extended rear facing and booster seats, I’d just be thrilled if I just went through one day without seeing someone holding a tiny baby in their arms in the front seat on the freeway.
Also – You can get exceptions for vaccination. Very easily in the vast marority of places. The number of people who ignore the recommendations is actually quite shocking.
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Yup. Got a kid going into high school who hasnt had a growth spurt yet. Probably should technically still be in a car seat (weighs less than 80 pounds). But implementing this rule would mean she could never ride the team bus to a ball game, go anywhere in a car pool, go home with friends after school (Wait a sec. Just need to go grab my CAR SEAT . . ) Do these docs have kids?
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How many adults here ride in the backseat if there is somebody else driving and a free seat in the back? I’m not going to go look-up the numbers, but that might save more lives than booster seats for kids.
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“How many adults here ride in the backseat if there is somebody else driving and a free seat in the back? I’m not going to go look-up the numbers, but that might save more lives than booster seats for kids.”
My husband wants to know why all automobile seats (except the driver’s) don’t face backwards. It would be much safer for everybody. He also really liked the idea of crash helmets in the car for the kids.
http://www.bikebiz.com/news/read/us-attorney-patents-car-helmet-for-kids
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@MH – It absolutely would be safer for adults to ride in back. I don’t know about you, but I think many of us follow safety standars for our kids that we don’t for ourselves. As much as I value my own life, I personally value my son’s lives even more. I’m sure I’m not the only parent who feels that way. Adults are perfectly capable of deciding risk benefit for themselves on this issue and to choose to ride in the back if they choose.
@Amy P – You are not the first person to ask that for sure. It would certainly be safer for everyone but the driver to ride rear facing. It’s a bit easier to just keep a rear facing seat installed as it already is when a kid turns one, than to redesign an entire fleet of vehicles though don’t you think?
@Sara – a high schooler would not be included in the new recommendations, unless your high schooler is a genius who skipped a few grades. Nor would a 4’9″ adult for that matter since I’ve been hearing that one a lot today too. Although as a short adult I can attest that it can be challenging to get a good seatbelt fit in some cars.
The recommendation states: ” Belt-Positioning Booster Seat until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches in height and are between 8 and 12 years of age.”
The way to tell if the belt fits properly is to do the 5 step test, which most kids will pass between 8-12 years old. The 5 step test is:
1. Does the child sit all the way back against the auto seat?
2. Do the child’s knees bend comfortably at the edge of the auto seat?
3. Does the belt cross the shoulder between the neck and arm?
4. Is the lap belt as low as possible, touching the thighs?
5. Can the child stay seated like this for the whole trip?
If the answer to those questions is yes, then the child no longer needs a booster. The age that happens will depend on several factors, but will typically be between 8-12 depending on height and maturity. But I think you’d be hard pressed to find many high schoolers without special needs that don’t pass it easily.
Here’s one that has an illustration:
http://www.carseat.org/Boosters/630.htm
If we are going to criticize the recommendations, lets at least be clear about what they say, right?
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@Amp P – Also, on the rear facing thing, I forgot to mention too that the reason that young kids are so much safer rear facing is that their bodies are not yet fully formed.
“Very young children have immature vertebrae that are still partly made of cartilage. These are soft and will deform and/or separate under tension, leaving just the spinal cord as the last link between the head and the torso. According to documented research, autopsy specimens of infant spines and ligaments allow for spinal column elongation of up to two inches, but the spinal cord ruptures if stretched more than 1/4 inch. Real-world experience has shown that a young child’s skull can be literally ripped from her spine by the force of a crash.”
http://www.carseatsite.com/rear-face_article.htm
Look at that footage I posted with that in mind. That is what is referred to as internal decapitation. Adults are not at risk for it so while we would also be safer rear facing, as would older kids, the benefit would not be nearly as great. Somewhere around 4 years old the bones begin to harden and it is believed that kids are at less risk for that injury from that point forward. The research isn’t there yet for kids 2-4 but the theory is that the benefit will hold for that age range as well and it’s being studied now.
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“Oh, and when I was a kid, my mom left me in the magazine section by myself while she shopped.”
Comics and science-fiction paperbacks, ftw.
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It’s a bit easier to just keep a rear facing seat installed as it already is when a kid turns one, than to redesign an entire fleet of vehicles though don’t you think?
Of course. But again, what this shows is that you don’t really mean what you said about doing everything we can to make car rides safer. Once we accept that, then it’s all just cost-benefit analysis, which was my point.
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It seems like from what auburn says about the poor fit between car seats and cars that we probably need a major redesign no matter what (or maybe just a very accurate directory of which car seats fit correctly with which vehicles):
“The problems are endless. Many older cars do not have the proper tether locations installed so you have to get them retrofitted if you want to follow the installation instructions properly. Back seats on many sedans and small SUVs are too shallow for multiple rear facing seats so if you have kids close together, you’re screwed. Many of the booster seats on the market are insanely wide so fitting three across is close to impossible, and seats that are made to address that issue happen to be the most expensive on the market, meaning you’d need $600 worth of car seats to fit 3 across in many cars.”
As I recall, in the good old days, there’d be a rear-facing seat at the back of one of those land-yacht station wagons (not that that was a particularly safe design in case of rear-end collision).
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I plan on looking at the data about rear-facing car seats, but the Durban group paper rebutting the Leavitt data is very bad science. The paper has misleading cites, purposeful obfuscation, a non-significant result that is treated positively because they “know” that boosters must be good regardless of the data, and a self-serving plea for more research after negative findings.
The Durban cites about 9-12 year olds in booster seats do not show, or in one case even address, that boosters are safer for that age group. instead they confound age and car location and seat belt use (9-12 year olds are safer belted in the back 2-12 year olds are safer in boosters.)
Durban lead the team wrote AAP regulations. I am deeply troubled by the quality of the science in the papers I’ve read so far. Now on the other hand, I think it unlikely that the having your kid in a booster will be more dangerous for your child physically, so I’m comfortable making my own decision based on the what I read of the science.
(PS: Many of these papers are publicly accessible, and cited in the guidelines — though misleadingly in some instances.)
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The paper has misleading cites, purposeful obfuscation, a non-significant result
Holy crap. That’s not even trying.
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“The paper has misleading cites, purposeful obfuscation, a non-significant result that is treated positively because they “know” that boosters must be good regardless of the data, and a self-serving plea for more research after negative findings.”
bj, that was beautiful.
“Now on the other hand, I think it unlikely that the having your kid in a booster will be more dangerous for your child physically, so I’m comfortable making my own decision based on the what I read of the science.”
There could potentially be poorer neck support for bigger children if the booster seat pushes them up too high.
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@amy p – backless boosters are only to be used in seats with head rests, which all new cars do in all seating positions. If the seat has no headrests, you have to use a high back booster which has head and neck support built in, so that shouldn’t be an issue. So basically if people are using the products as intended, that shouldn’t be an issue. Funny enough the engineers do think about this stuff too. Just about anything can be dangerous if you use it wrong.
@MH – I’m very serious about what I said and would be thrilled if major changes were made in car design to make them safer. Unfortunately I’m not a billionaire and don’t own a car company so it doesn’t matter what I think.
But here it’s not just a cost benefit analysis, although of course that comes into play with with just about every decision we make weather it is a large scale policy change or a simple decision for our families. That’s basic economics isn’t it?
But please read what I wrote about the anatomy differences between young children under 4 and older children and adults to see why rear facing for kids under 4 is so much more valuable than it is for adults and older kids. There would be a benefit to adults riding rear facing, yes, but it’s not nearly as significant as it is for young kids where it prevents a very specific highly deadly and disabling injury.
I don’t know much about the booster studies so I really can’t comment on those at all, but the rear facing study, which I have read, seems quite significant to me. I’m not a scientist or doctor and can’t claim expertise, but did work in public health for 4 years so I’m not a stranger to reading a study. I sincerely hope that the good information on extended rear facing is not thrown out because the booster information may be less sound. That would be very unfortunate.
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Did you mean “kids under 2” instead of “kids under 4?” I’ve never heard of a rear facing seat for a 4 year old and I don’t think it would be possible.
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“It seems like from what auburn says about the poor fit between car seats and cars that we probably need a major redesign no matter what (or maybe just a very accurate directory of which car seats fit correctly with which vehicles)”
I don’t know about a major redesign, some tweaks yes, that would be helpful. Newer cars address some of the biggest problems by adding latch in most rear seating positions and tether anchors that come standard. All car seats have to meet crash test standards installed with just a seatbelt and no anchors which is what is available in non retrofitted older cars so you can use them in those cars, but it would be somewhat safer to have anchors retrofitted to improve forward facing installation. No anchors are needed for rear facing. Actually installation in the center seat of my old 1995 Accord, which had just a lap belt, was a breeze. Way easier than my brand new Hyundai actually.
I think mostly what is needed is more cooperation between car manufactures and car seat manufacturers. I’d also like to see some more options for narrow extended rear facing seats in a more affordable price range. Right now the best seat for three across in sedan’s and small SUVs is over $200. Car seat manufactures are catching on to that need though and more options are becoming available all the time. The extended rear facing options have expanded from 1 or 2 seats a few years ago to 7 or 8 on the market now, including one that is under $60 and will easily get most kids past 2 rear facing.
And there is information available out there about which car seats fit which cars, you just unfortunately have to dig a little for it. There are several websites where Certified Passenger Safety Technicians report back on installs for specific seats for specific cars. Car-seat.org is a great resources. There are threads about things like, which 3 across arrangements work in which cars, and specific compatibility problems between certain brand seats and cars. Some seats have a reputation for being easier to install well than others and there are always car seat clinics, often held for free through local fire stations, that help people learn the proper way to install seats. Many fire fighters are CPSTs and can help you install a seat properly if you are having issues. And it’s almost always free.
I’d love to see that information more widely available and especially would love to see car seat manufactures publish a list of known compatibility problems with car makes and models so people wouldn’t have to stand out in the freezing cold at a babies r us parking lot to figure that out. I don’t see that happening any time soon because of liability concerns however. I think it is going to have to come primarily from less official sources unfortunately.
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@MH, no there are definitely seats that fit rear facing 3-4 year olds. My very average size 50th percentile on height son is still happily and comfortably rear facing and he’s 3 years 3 months. Most proponants of rear facing will flip them somewhere between their 3-4 birthdays. He’ll probably outgrow the seat a few months before his 4th birthday and I’ll turn him then. He actually complains when we ride forward facing in friends cars because there is no where to put his feat. He fits just fine.
The recommendation is for kids to rear face as long as possible, until at least 2, or when they outgrow the seat rear facing. The age at which that happens will depend on the kid, and the seat. There are several seats on the market that will get an average kid to 3-4.
4 seems to be the age where most experts seem to thing there would be a steep drop off in safety returns because of the anatomy changes taking place around that age. Kids in Sweden pretty much all ride rear facing until 4. They have seats which are specifically designed for extended rear facing.
You can see rear facing kids up to age 4 here: http://www.cpsafety.com/articles/rfalbum.aspx
And just to pre-empt it, no they really don’t mind having their legs like that. I’ve asked my kid. Believe me, he would tell me! We project a lot of our perceptions about comfort on them I think. We had an older seat that he did get uncomfortable in and he told me, so I upgraded his and passed the other one on to the baby.
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I know they don’t mind having their little legs smushed. Why is it that legs being cramped is the only thing addressed as a negative point to facing backward? Three year olds wants to see everything happening. At least mine was greatly upset when he could’t.
In fact, to punish him, we send him into a spot where he can still hear us but cannot see us. This is, I understand, not an uncommon punishment and it is very effective because he really, really hates to be facing away from the action.
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You asked me if it was possible and I’m telling you that it is. I mentioned it because that’s the question I get most often when people see my seat installed rear facing. I’d be happy to address other questions if you have them.
I can still talk and interact with my 3 year old while rear facing. I do have a small car though so it might be harder in a big suv for instance I guess, I don’t know because I’ve never driven one. My son can see very well out the back and sides. He has never complained, even after riding in other cars forward facing for short periods. Like I said, he likes having someplace to put his feet and he naps much better rear facing which makes mama happy. 🙂
To me the safety benefits at this stage sill outweigh him being able to see the view. Maybe if he was truly miserable I would make another choice. It hasn’t happened yet though so I can’t say for sure. I can understand why someone else might make a different decision though and I certainly won’t criticize them for it as long as it’s an informed one.
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We may be using different definitions of “possible.” I’m sure some families can do it easily and I’m sure any family can do it if they keep trying for long enough. The same could be said about lots of actions, actions that may or may not produce a bigger improvement in safety for kids.
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One of these days, the AAP is going to have carseat safety regulations that specifically state which car should have which brand car seat. Can you imagine? If you drive a Honda Accord, buy your 1-12 month old the Britax Whatsit. If you drive a Toyota Camry, put your 2 year old, 25 pound toddler in a Graco Thingamagig.
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auburn — could you give me a cite to the rear facing stud you’re talking about. I’d like to read that one, too. My kids are older, and so those data are not relevant to my personal decision making, so I haven’t hunted them all down.
But, my bigger interest in the question stems from how one should make policy recommendations. I’m not necessarily upset at the policy recommendation made by the AAP I do think the empirical evidence is generally pretty straightforward that there’s no significant risk to the use of a booster, though it is theoretically possible. Therefore, the AAP admonishments are unlikely to cause harm, though they may annoy some. Then, we have the same issue we’ve encountered in other controversial guidelines, that the AAP often takes more conservative and demanding positions than is justified by the scientific data. I think there’s a reason why they do this (on BF’ing, potentially on cold medicine, or shopping carts): I think they set the threshold high, with the assumption that people will be sloppy and incomplete in how they follow the rules. People on average, that is. As public heath recommendations (though not coercive laws) that might be a reasonable position.
I still feel free to evaluate the data for myself and make my personal decisions based on my evaluation, rather than theirs. And, if someone else wants to be more conservative than me on following the recs, I feel no reason to try to convince them otherwise.
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I haven’t tried to do a head to head comparison, but my suspicion is that the car recommendation is actually pretty big. Odds are (and I think the data supports this assertion, though I think that I should have a cite if I really want to say that) that one’s child would be safer in a big SUV than in a small car given almost any restraint system (though I’m not sure where the unbelted in SUV v in a rear facing appropriately installed car seat in a Honda, or whatever the current small car is).
All our cars are big, and I suspect this also guides our decisions about seats and seating locations.
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that one’s child would be safer in a big SUV than in a small car given almost any restraint system
That’s certain what my in-laws kept saying. One day, they showed-up with a giant Jeep and the information that we were going to test drive it. It’s been a good vehicle, but parking is a pain.
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one’s child would be safer in a big SUV than in a small car
And most of the danger caused by this sort of choice being made by lots and lots of people will be born by children whose families are too poor to buy a car at all, so can be easily ignored by those making the decisions here, too. (This might be a slight exaggeration. Some of the extra danger is put on people, including children, in smaller cars, too, when they are hit by big SUVs.)
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bj – There are several studies that have shown benefit to rear facing, but the big recent one that was from a few years ago and has been sited in the new recommendations is here:
http://injuryprevention.bmj.com/content/13/6/398.abstract
The paper I’ve seen referenced most with the information on neck injuries and forward facing kids is this one. It’s a paper on data from Sweden:
Click to access 05-0330-O.pdf
I would imagine the risk with the specific type of head and neck injury that was seen in young kids in forward facing seats would hold across car types. Although I would imagine that newer cars would pretty much always fare better because of the improved technology with crumple zones which do a better job of absorbing some of the forces of the impact.
Passengers are safer from intrusion in a newer, larger cars I believe. Accidents with heavy intrusion are some of the hardest to protect against overall. And I believe bigger cars do better in side impact collisions which is one of the deadliest types of accidents, and one of the ones that rear facing seats offer the greatest additional protection. Side impact crashes make up only 7 percent of accidents overall, but account for 30% of fatalities IIRC. The fact that rear facing was protective in those crashes was not an expected result I don’t believe. I think most people were expecting to see the greatest result in forward facing crashes, and while there was a definite benefit in those crashes, it was not as large as expected.
I would probably feel safer turning my son forward in our new Hyundai Tuscon than I would in my 15 year old honda accord, because it is a safer car overall and has good side impact protection. But since there is no down side to keeping him rear facing, and may be a significant benefit, I figure we might as well just stick with it. Luckily my crappy little honda is just a commuting car so the kids aren’t in it often.
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And most of the danger caused by this sort of choice being made by lots and lots of people will be born by children whose families are too poor to buy a car at all, so can be easily ignored by those making the decisions here, too.
Plus, Medicaid rates being what they are, the pediatricians don’t need to worry so much about lost business.
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“This might be a slight exaggeration. Some of the extra danger is put on people, including children, in smaller cars, too, when they are hit by big SUVs.”
Our Ford Taurus (which is a pretty big car, as cars go) almost got turned into the filling for an SUV sandwich a couple years ago. We had an SUV on our left, and then an SUV on our right that was turning into our lane without noticing that we were there. Time seemed to go very slowly, because we could see exactly what was going to happen. My husband was driving and had only had his driver’s license for about two years at that point, so we were at a loss for what to do. Fortunately, the other SUV saw what was going on and skooched over enough to give us room to escape the other SUV. I’m not sure if there was another evasive maneuver that would have done the job. The situation didn’t come up in our driving courses.
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Sometime later, I remembered that that model of Taurus is not so great for side impact.
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We did buy an extra seat for our infants, and schlep a car seat along, before it was required. We also kept our older children in a booster seat longer than the contemporary legal requirements.
There is a point of diminishing returns, though. Increasing safety guidelines may give some a warm and fuzzy feeling, particularly if the cost of adhering to the guidelines is borne by someone else. If it takes used child safety equipment off the market, and pushes parents to buy new equipment, that’s a benefit to manufacturers.
There’s also the Britney Spears approach to child automobile safety. Pushing for more restrictive safety standards in child raising won’t alter the behavior of those who never use seat belts.
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“There’s also the Britney Spears approach to child automobile safety. Pushing for more restrictive safety standards in child raising won’t alter the behavior of those who never use seat belts.”
Indeed. As we discussed earlier, compliance with the current car seat regimen is really tough when traveling or if you don’t have a permanent car of your own to install a seat for the next year or two. To install and remove car seats properly in each vehicle that you and your kids ride in is just not a reasonable expectation, which is why the NYCers don’t do it. There’s got to be some easier way to do this.
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