Think You Know About Car Seat Safety? New Recommendations Issued by American Academy of Pediatrics

One of my most important jobs as a pediatrician is to talk to my patients and their parents about safety. One commonly discussed topic is car seats and car seat safety. In the past year, the American Academy of Pediatrics has issued new recommendations regarding having children rear-facing in their car seats until the age of 2. Though this has parents wanting to tear their hair out, it really is the best way to protect your children. I encourage you to check out the American Academy of Pediatrics website, but here’s a quick summary of their recommendations.

• All infants need to be in a rear facing car seat in the back seat of a car, regardless of weight, until age 2. Period. Part of the change stemmed from safety data in European countries, which showed better mortality and morbidity rates as compared to the United States. Any infant who outgrows his car seat needs to be in a convertible car seat. I've had many parents ask about their children's legs not fitting well in their rear-facing car seats. The rear-facing position, though, decreases the rates of head injury. Isn’t having a broken leg preferable to having a fractured skull?

• Children between the ages of 2-4 years may be in front-facing car seats, but must remain in the back seat. There are hybrid convertible seat/booster seats that are available to stretch out the cost over the years.

• For children age 4 and up, it gets trickier. Between the ages of 4-12 years children need a booster seat until they are 4 feet 9 inches or greater in height. There is a common misconception that once a child turns 8 they can stop using a booster seat. The height of your child is what’s most important. Until your child reaches that height, the seat belt will not lay properly across his/her chest. There are seat belt adjusters out there, but I recommend booster seats.

• Children should not sit in the front seat of a car until they are 13 years old minimum, and the size of a small adult. If you have a tiny 13 year old, you are much better off from a safety standpoint having him sit in the back seat. Please don't rationalize allowing your child to sit in the front seat by saying it's a short car ride; most accidents occur on short car rides, not the highway. Also, disabling the front air bag will not make your child much safer; just leave him in the back seat.

Final thoughts: Never reuse a car seat that's been involved in an auto accident or one that is older than five years. Even though your best friend may mean well and want to save you some extra cash, this could mean life or death for your child. And please, please, please do not place a child less than 13 years of age in the front seat of the car.