News Article: Car seat guidelines may be revised

jess71903

Ambassador
This was posted on another board. I thought it was a pretty good article.
BY HEATHER HOLLINGSWORTH
Associated Press

FAIRWAY, Kan. —Anne Epperson thought little of it when she flipped her daughter's convertible car seat around so she could face forward after her first birthday.

But if car seat advocates get their way, parents like Epperson will be delaying the switch, possibly for years.

The American Academy of Pediatrics is revising recommendations that they hope will clear up confusion over how long children should spend riding rear facing in car seats and make them safer in the process.

Some experts, citing a much-touted 2007 study, say tots are being put at risk switching to the forward-facing position at 1 year of age and 20 pounds, currently the minimum guideline from the pediatrics group and the National Transportation Highway Safety Administration.

That's because the extreme forces in some frontal crashes can jerk the heads of forward-facing children away from their immature bodies, creating a risk of spinal cord injuries. Rear-facing children are safer because their entire backs absorb the force of the crash.

The issue becomes confusing because both groups also advise that children are safer if they remain rear facing until the upper height and weight limit of their car seats. Many seats top out at 35 pounds in the rear-facing position, a weight many children don't reach until somewhere between their third and fourth birthdays.

It's rare in the U.S. for children to remain rear facing that long, although several countries require their youngest passengers to ride rear facing until they are 4 or 5 years old and 55 pounds.

The issue has attracted growing attention since a 2007 article in the journal Injury Prevention showed that U.S. children are five times less likely to be injured in a crash between their first and second birthdays if they are rear facing.

"We rarely if ever see spine injuries in children in rear-facing car seats," said Marilyn Bull, the contributing pediatric researcher in the study. "We will see head injuries or we will see a few other injuries, but the vast majority of serious injuries occur when children are forward facing."

The AAP is still discussing how it is going to revise the recommendations.

Dennis Durbin, who is leading the effort to update the group's policy on child passenger safety, said the emphasis will be more on remaining rear facing to the upper weight limit of the seat. The academy is hoping to introduce the new guidelines within the year.

Durbin said he is well aware of the research and said one of the goals with the revision is to reorder the policy and "really state what the ideal is."

That's good news to safety advocates.

"When it is written one year and 20 pounds, parents don't pay attention to the rest," said Pam Holt, the previous chairwoman of the National Child Passenger Safety Board and the trauma prevention coordinator at St. John's Hospital in Springfield, Mo.

Count Epperson among the confused parents. The 35-year-old said she doesn't recall getting advice to keep her 23-month-old daughter or 3-year-old daughter rear facing longer.

"I've read a lot of books, but I've never heard that," Epperson said as she picked her daughters up from a church day care in the Kansas City suburb of Fairway. "I had no idea."

Pediatricians get some of the blame, said Benjamin Hoffman, part of an American Academy of Pediatrics committee that helps educate parents and doctors about injury prevention. The Albuquerque pediatrician said some are still promoting old guidelines that say children must be turned forward at a year.

Hoffman, also a certified car seat technician, came across a mother recently whose pediatrician had given her that old advice, and she balked when he suggested she keep her 1-year-old son in the rear-facing position.

"I don't care what you think," she told Hoffman. "You aren't my pediatrician."

Stories like these make activists shake their heads. Motor vehicle crashes are the single leading cause of death for U.S. children, claiming an average of about four lives a day. Hoffman said it is tragic that "people are not operating on the best information they possibly could."

"The bottom line is that in a crash, a child who is rear facing is going to have all the crash forces spread over their entire back, from the tops of their head to the tips of their toes," Hoffman said. "And spreading all that force out over such a wide area significantly decreases the risk of injury."

Experts said part of the problem is that parents often have viewed switching their children to the forward-facing position as a rite of passage.

"It's like graduating from preschool into kindergarten," Hoffman said. "They view it as a good thing. What we need to do is work on changing people's attitudes so that they recognize that every step you make from rear facing to forward facing to booster, you lose some safety, and that people should switch only when absolutely necessary. It's not necessarily a negative step but neither is it a positive step.

"And the fact of the matter is the kids don't know any different. And if our first priority was to keep the kids as safe as possible, it would be a no-brainer."

Read more: http://www.kansas.com/news/story/1119133.html#ixzz0bhAKaNIi

http://www.kansas.com/news/story/1119133.html
 
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Maedze

New member
I want to find the author of that article and keep her in my pocket and pet her and make kissy faces at her and give her cheese doodles on the sly.
 

Marionetteworks

New member
I'm not sure that asking to keep kids in those seats much longer than 1 year is realistic. I have two mid-size cars and my graco infant seat barely fits behind the front seats. At 1 year both my kids outgrew this seat and there's no way a bigger one would fit. I'm 5"8 so it's not that even that my seat is too far back, and the problem must be even bigger for taller people. I also recently helped a friend install an infant rear-facing seat in his compact car - it fit behind the passenger seat but the passenger is not going to be very comfortable there. And if he had a second older child like me he would be out of luck.
 

Andie

New member
I'm not sure that asking to keep kids in those seats much longer than 1 year is realistic. I have two mid-size cars and my graco infant seat barely fits behind the front seats. At 1 year both my kids outgrew this seat and there's no way a bigger one would fit. I'm 5"8 so it's not that even that my seat is too far back, and the problem must be even bigger for taller people. I also recently helped a friend install an infant rear-facing seat in his compact car - it fit behind the passenger seat but the passenger is not going to be very comfortable there. And if he had a second older child like me he would be out of luck.

Hello and welcome to car-seat.org!

Usually, a rear facing convertible will take up less room front to back than the infant seat, because it can be installed more upright for older babies and toddlers. The 45* angle is mainly for newborns with no head control. It keeps the airway open. For an older infant/toddler the seat can be upright as much as 30*.

Editing to add a pic of my Complete Air, installed at the angle my 2 year old likes it (I'm guessing it's about 40*) in my Mercury Sable. The front seat was pushed forward because I needed to get behind the seat to install, but my passenger can push the seat almost all the way back:
onenoodle.jpg
 
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Maedze

New member
I'm not sure that asking to keep kids in those seats much longer than 1 year is realistic. I have two mid-size cars and my graco infant seat barely fits behind the front seats. At 1 year both my kids outgrew this seat and there's no way a bigger one would fit. I'm 5"8 so it's not that even that my seat is too far back, and the problem must be even bigger for taller people. I also recently helped a friend install an infant rear-facing seat in his compact car - it fit behind the passenger seat but the passenger is not going to be very comfortable there. And if he had a second older child like me he would be out of luck.

Welcome to c-s.org!

We're very glad you found us :)

Not only is it COMPLETELY realistic to keep a child rear facing past one year old, it's the ONLY safe option.

It is extremely easy to keep a child safe in even a compact car, and that means keeping the child rear facing for the first 3 to 4 years of a child's life.

Infant seats take up more room front to back than a correctly installed convertible for a toddler or preschooler, which can be installed quite upright.

My oldest was turned foward facing at 2.5 when he reached the max limit of his seat. My second was turned forward facing at 4 yeas and 40 pounds, and my third is 2 and a half and still happily rear facing, which he will be for a bare minimum of another 18 months.

They are comfortable, cozy, and most importantly, SAFE. A one year old in a forward facing seat is at serious risk of debilitating, life-altering injury...or even worse...in a forward facing seat.
 

JerseyGirl'sMama

New member
I think it is a wonderful article. I wish it would have touched a little bit more on the severity of front-facing injuries. It says 'spinal cord injuries' but I think most parents need to hear 'internal decapitation' or 'paralyzation' to really get it.
 

Marionetteworks

New member
For an older infant/toddler the seat can be upright as much as 30*.

Ah, that helps somewhat. It probably depends what kind of car seat you have, with my Britax Marathon it was right against the back of the driver's seat, and my little 1-year-old didn't have much room for his legs. I'd probably have to buy a different seat to keep it rear-facing. I'm also skeptical about that being the "ONLY" safe option, it's safe-er due to better resistance to neck injuries, but the ONLY safe option? Come on...
 

BananaBoat

Well-known member
Ah, that helps somewhat. It probably depends what kind of car seat you have, with my Britax Marathon it was right against the back of the driver's seat, and my little 1-year-old didn't have much room for his legs. I'd probably have to buy a different seat to keep it rear-facing. I'm also skeptical about that being the "ONLY" safe option, it's safe-er due to better resistance to neck injuries, but the ONLY safe option? Come on...

Britax seats are notorious for their lack of rear-facing legroom, low harness slots & (now) fairly low rear-facing max weight. There are currently quite a few seats on the market that rear-face to 40-45lbs & provide ample legroom for older rear-facers. There are also a fair number of convertibles that take up less front-to-back room than the Marathon...like the True Fit or the Complete Air.

I'll let a tech go into the intricacies of spinal protection of rear versus front facing, but the general thought is that the neck bones of a baby don't harden until the age of 4ish. Until then, any significant force/load on the neck can severely injure/paralyze the child. This is far more likely to happen while front-facing than rear-facing. As far the legs...all that requires is a cast :shrug-shoulders:
 

Andie

New member
Britax seats are notorious for their lack of rear-facing legroom, low harness slots & (now) fairly low rear-facing max weight. There are currently quite a few seats on the market that rear-face to 40-45lbs & provide ample legroom for older rear-facers. There are also a fair number of convertibles that take up less front-to-back room than the Marathon...like the True Fit or the Complete Air.

:yeahthat:

Ah, that helps somewhat. It probably depends what kind of car seat you have, with my Britax Marathon it was right against the back of the driver's seat, and my little 1-year-old didn't have much room for his legs. I'd probably have to buy a different seat to keep it rear-facing. I'm also skeptical about that being the "ONLY" safe option, it's safe-er due to better resistance to neck injuries, but the ONLY safe option? Come on...

It is certainly the safest option. I'm not a tech, but let me see if I can explain it. A baby/toddler has a head that is much bigger in proportion to their body. The actual percentages escape me at the moment. Couple a heavy head with a immature, un-fused spine and you have a recipe for serious injury or even death. A child's spine doesn't begin to ossify (harden) until somewhere between 4-6 years of age. Until it is ossified, the spinal column can stretch quite a bit with the right forces (like a car crash). Now the spinal cord, which pretty much holds everything together can only stretch about 1/4" of an inch before it snaps - considerably less than the spinal column can. When this happens, it's called internal decapitation.

In a crash in a RF seat, the child is cradled in the seat and the forces are spread out over the back of the child restraint. In a FF seat, the child is thrown violently forward. Including that heavy, disproportionate head which puts tremendous strain on the spine & spinal cord. It's not simple whiplash that we are worried about.

Also, chances of a leg injury from rear facing are very low, there are actually more broken legs in FF children because they hit the vehicle seat in front of them. I know that it sounds horrible, but personally, I'd rather chance a broken leg that can be fixed than a broken neck.
 

Maedze

New member
Ah, that helps somewhat. It probably depends what kind of car seat you have, with my Britax Marathon it was right against the back of the driver's seat, and my little 1-year-old didn't have much room for his legs. I'd probably have to buy a different seat to keep it rear-facing. I'm also skeptical about that being the "ONLY" safe option, it's safe-er due to better resistance to neck injuries, but the ONLY safe option? Come on...

The safEST option is to not drive in a car at all and live in a below-ground bunker with canned goods (non-leaching cans), filtered water and pumped purified air.

The only safe choice for a one year old in a car is to ride rear facing. Your child is 500% more at risk for life altering injury or death in an accident.

While the Britax seats don't have much room for rear facing legs the way other convertibles do, 1 year olds are fine in them rear facing. Kids frog their legs, and they're perfectly happy like that. It's adults who develop the impression that they're uncomfortable, when they're not. It's perfectly safe for their legs to be frogged, draped over the side of the seat, propped up against the seat back, pressed into the bottom of the vehicle seat back, or bent up around their ears. It is not safe for them to be in a forward facing seat.
 

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