AAP recs?

zactayaus · Jan 28, 2013

Doesn't the AAP recommend kids RF to at least age 2 or the limits of their seat but still highly recommending kids stay RF for as long as possible? I'm in an arguement with someone on a car seat group. She says I'm wrong and that the AAP says 2 or limits of the seat which ever comes first.

monstah · Jan 28, 2013

zactayaus said:
Doesn't the AAP recommend kids RF to at least age 2 or the limits of their seat but still highly recommending kids stay RF for as long as possible? I'm in an arguement with someone on a car seat group. She says I'm wrong and that the AAP says 2 or limits of the seat which ever comes first.

I think they say both, depending on where you get your quote from. Let me see what I can find...

Stelvis · Jan 28, 2013

No, the AAP recs very clearly state that all children must be turned FF at age 2 unless they outgrow the RF limits of their convertible earlier than 2.

I know that we don't agree with that, but that's what it says. It's not vague at all.

NHTSA on the other hand says to RF as long as possible up to age 4.

Brianna · Jan 28, 2013

Stelvis said:
No, the AAP recs very clearly state that all children must be turned FF at age 2 unless they outgrow the RF limits of their convertible earlier than 2.

I know that we don't agree with that, but that's what it says. It's not vague at all.

NHTSA on the other hand says to RF as long as possible up to age 4.

Depending on where you read it. I found this, which makes it seem that the recommendation is to rear face to a minimum of 2.

Toddlers should remain rear-facing in a convertible car seat until they have reached the maximum height and weight recommended for the model, or at least the age of 2.

http://aapnews.aappublications.org/content/30/4/12.2.full

creideamh · Jan 28, 2013

When you type age 2 into their new app (well, healthychildren.org's app, but same thing), it clearly says "All children 2 years or older, or those younger than 2 years who have outgrown the rear-facing weight or height limit for their car seat, should use a Forward-Facing Car Seat with a harness..."

Stelvis · Jan 28, 2013

creideamh said:
When you type age 2 into their new app (well, healthychildren.org's app, but same thing), it clearly says "All children 2 years or older, or those younger than 2 years who have outgrown the rear-facing weight or height limit for their car seat, should use a Forward-Facing Car Seat with a harness..."

This is the language I was referring to.

http://www.healthychildren.org/Engl...ar-Safety-Seats-Information-for-Families.aspx

mom of six · Jan 28, 2013

Here is a quote from the journal article where the statement was initially published. First, the link to the whole article: http://pediatrics.aappublications.org/content/127/4/788.full

The American Academy of Pediatrics (AAP) strongly supports optimal safety for children and adolescents of all ages during all forms of travel. This policy statement provides 5 evidence-based recommendations for best practices to optimize safety in passenger vehicles for all children, from birth through adolescence (a summary of recommendations is listed in Table 1):

All infants and toddlers should ride in a rear-facing car safety seat (CSS) until they are 2 years of age or until they reach the highest weight or height allowed by the manufacturer of their CSS.

All children 2 years or older, or those younger than 2 years who have outgrown the rear-facing weight or height limit for their CSS, should use a forward-facing CSS with a harness for as long as possible, up to the highest weight or height allowed by the manufacturer of their CSS.

All children whose weight or height is above the forward-facing limit for their CSS should use a belt-positioning booster seat until the vehicle lap-and-shoulder seat belt fits properly, typically when they have reached 4 feet 9 inches in height and are between 8 and 12 years of age.

When children are old enough and large enough to use the vehicle seat belt alone, they should always use lap-and-shoulder seat belts for optimal protection.

All children younger than 13 years should be restrained in the rear seats of vehicles for optimal protection.

Most of us are aimed at getting a RF car seats with higher weight and height limits so that we can rear-face until 3 or 4 or 5. Although most car seats have pretty good rear facing weight limit these days (aren't most at 40 lbs?) most of the population is buying the cheaper big-box-retailer car seats with the lower height limits so when it comes to "the limits of the seat" it may be reached before 2 and since the statement allows for either 2 or the limits of the seat they think they are have met the recommendation.

I think it is a matter of looking at it on the side of the minimums or maximums. Most of us choose maximums.

wendytthomas · Jan 28, 2013

In a new policy published in the April 2011 issue of Pediatrics (published online March 21), the AAP advises parents to keep their toddlers in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat. It also advises that most children will need to ride in a belt-positioning booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years of age.

Clearly, NOT clear. That's from http://www.aap.org/advocacy/releases/carseat2011.htm

However, since their 2002 recommendation says:

Children should face the rear of the vehicle until they are at least 1 year of age and weigh at least 20 lb to decrease the risk of cervical spine injury in the event of a crash. Infants who weigh 20 lb before 1 year of age should ride rear facing in a convertible seat or infant seat approved for higher weights until at least 1 year of age.3,4 If a car safety seat accommodates children rear facing to higher weights, for optimal protection, the child should remain rear facing until reaching the maximum weight for the car safety seat, as long as the top of the head is below the top of the seat back.3

(from http://pediatrics.aappublications.org/content/109/3/550.full)

Which to me means their updated recommendation is a continuation of this. Two years or longer for optimal safety. I do wish they'd combine them, though, so the wording is less vague.

Wendy

zactayaus · Jan 28, 2013

Wendy if you want to weigh in on the conversation at Car seats for the Littles that'd be cool. The original thread was by Susan Castle about a Nauti.

Stelvis · Jan 28, 2013

Then why would it say that ALL children AGE 2 AND OVER must ride in forward facing seats?

You can't fault a pediatrician who reads that and says you must turn forward facing at age 2.

Again, I don't agree with it, but it's pretty clear.

wendytthomas · Jan 28, 2013

Because that's what who wrote it thought it said, just like whoever wrote the other two pages thought something different. Obviously they're not clear on it over there.

No, I wouldn't fault a ped for saying that after reading the statement. I would, however, gently correct him or ask for his info beyond that, and then leave it. If he told me my child had to be forward facing after that I'd simple and nod and go about rear facing my child.

Wendy

Stelvis · Jan 28, 2013

You really think this is just a copy editing mistake? If so then why has it stood for going on 2 years without being corrected?

I think they wrote it that way intentionally.

wendytthomas · Jan 28, 2013

I suspect that there was an internal memo sent out. The person at Healthy Child wrote it one way. The person writing the AAP.org stuff wrote it another. THEY probably know what they meant, but unfortunately didn't pass that on clearly to us. Because there are multiple interpretations.

I don't think they meant it to be this way. But it's annoying.

Wendy

Stelvis · Jan 28, 2013

See, I picture more of a scenario where a committee drafted the language and they had to compromise between those who wanted to promote ERF up to 4 like NHTSA, and those who thought that was insane and likely to result in 3 year olds sitting RF in infant buckets. So they compromised with turning them at age 2 since the actual research only included children up to age 24 months.

Healthychildren IS the AAP.

wendytthomas · Jan 28, 2013

I know Healthy Children is the AAP. But I bet they have their own PR department.

Wendy

Stelvis · Jan 28, 2013

wendytthomas said:
I know Healthy Children is the AAP. But I bet they have their own PR department.

Wendy

The same exact language can be found on the AAP site/AAP publications:

http://aapnews.aappublications.org/content/32/4/1.2.full.pdf

hope41more · Jan 28, 2013

Stelvis said:
No, the AAP recs very clearly state that all children must be turned FF at age 2 unless they outgrow the RF limits of their convertible earlier than 2.

I know that we don't agree with that, but that's what it says. It's not vague at all.

NHTSA on the other hand says to RF as long as possible up to age 4.

Why the words "up to age 4?" What if my carseat lasts to rf at age 5?

zactayaus · Jan 28, 2013

Stelvis said:
The same exact language can be found on the AAP site/AAP publications:

http://aapnews.aappublications.org/content/32/4/1.2.full.pdf

Quote from the article you just posted: "All children should be restrained in
a rear-facing position in the back seat of the vehicle until they reach age
2 or the highest weight or height allowed by the car safety seat (CSS)
manufacturer."

My interpretation of this: Child should remain rear facing until age two but can continue to rear face to the limits of their seat. I honestly don't see how it reads any other way.:shrug-shoulders:

Stelvis · Jan 28, 2013

zactayaus said:
Quote from the article you just posted: "All children should be restrained in
a rear-facing position in the back seat of the vehicle until they reach age
2 or the highest weight or height allowed by the car safety seat (CSS)
manufacturer."

My interpretation of this: Child should remain rear facing until age two but can continue to rear face to the limits of their seat. I honestly don't see how it reads any other way.:shrug-shoulders:

Right, what they mean is, up to age 2 unless the restraint is outgrown earlier.

(Edited)

Stelvis · Jan 28, 2013

hope41more said:
Why the words "up to age 4?" What if my carseat lasts to rf at age 5?

NHTSA recommends RF through age 3. I don't think they mean to exclude 5 year olds, except that "in the wild" it's pretty rare to have a seat that would accommodate that or a parent who would actually do it. http://www.nhtsa.gov/DOT/NHTSA/Traffic Injury Control/Articles/Associated Files/4StepsFlyer.pdf

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