British Medical Journal Article on rear facing under 4 years old

http://www.bmj.com/cgi/content/full...FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT

The authors of the article advise healthcare professionals to tell parents that rear-facing is safer for kids up to 4 years old.

I think it's awesome that this study is out of Britain, where we know kids rarely even RF to a year.

I have a question. I posted the GMA link on my FB and one of my (more educated) friends posted this:

I just can't force myself to care about this issue. It sounds terrible, but I'm just not compelled. I know they are 5 times safer RFing, but 5 times a small number is still a small number

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I've never thought about the actual numbers I guess.

When it could be the difference between life and death, I don't think it is such a small number.

In my humble opinion, even if one were to discount the sample size of the 1 study conducted here in the United States, the data from Sweden is abundant and has been collected for years. (I want to say that Volvo performed the first crash-test of a rear-facing seat in something like 1967). There is so much information beyond that one study, in terms of both crash test data and real life crash outcomes.

I have to admit, though, I try to present the number from the US study as 500%, because 5 times something is the same as 500% more than something. Somehow, though, the 500% sounds more impressive.

I agree...here's another comment from the same person. I knew she would eventually go over my head:

"Its not 5xs the safety, which would be a big number, it is 5 times the risk of significant injury already assuming a crash (I read the original paper in the actual academic journal). Considering that you first have to get into an accident, which is a small probability event, and then you have to be in one in which significant injury occurs, we are talking about a very, very small number. According to the NHTSA, only 208,000 of the 61 million children in the US were injured in a car crash. That makes your likelihood of injury 0.03%. Making your kid 5xs safer would decrease the likelihood of injury to 0.006%. And its less than that, really, because those are for all children, and we are just talking about children until age 4 at the max."

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jess71903 said:

I agree...here's another comment from the same person. I knew she would eventually go over my head:

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She is extrapolating the statistics from this study incorrectly. The statistics from that study refer to children who HAVE been in a crash.

In her comparison, she is using children who were injured in a crash versus the entire childhood population of the United States, even those who obviously haven't been in a crash. The statistics refer to the risk of injury to a child in a car crash. One can't take those statistics and then compare children who have been injured in a crash versus children who haven't even been in a crash at all.

bree said:

She is extrapolating the statistics from this study incorrectly. The statistics from that study refer to children who HAVE been in a crash.

In her comparison, she is using children who were injured in a crash versus the entire childhood population of the United States, even those who obviously haven't been in a crash. The statistics refer to the risk of injury to a child in a car crash. One can't take those statistics and then compare children who have been injured in a crash versus children who haven't even been in a crash at all.

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Thank you. I am an educated woman and had to take a research class and a statistics class for my degree, but they are still Greek to me!

Then lets just throw all our kids into the back of the bed of a pickup truck. I mean, the liklihood of us getting into an accident really isn't that great anyway.

I know! Where do you draw that statistical line?

Here was my response...correct and add as you feel compelled. I ran out of room to add more, but I can always keep commenting .

If I'm reading your comment correctly, you are using the stats in the study to apply to ALL children when they just apply to those who have been in a crash. You take the probability of a crash out of it because we are only talking about children in crashes. So if you do get into a crash, you child is 5 times more likely to come out without death or serious injury if he is rear facing than if he is forward facing. Whether or not the accident is an injury accident may just depend on how your child is restrained. A 30mph crash with a FF 6 month old most certainly would involve serious injury. With a FF 50lb 5 year old- maybe not.
I really don't think we have to hash this out. I know how you feel about it and that's fine. Ultimately all of this is parental decision. For me, there is no additional benefit to turning Gage before he hits the weight limit, especially given his already-compromised neurological system.

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jess71903 said:

Thank you. I am an educated woman and had to take a research class and a statistics class for my degree, but they are still Greek to me!

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No problem! I can't remember half the stuff I learned in my research and statistics classes in college, and I used to conduct my own research! I used to be able to do statistics by hand, and I don't even think I could remember how to do them on the computer program I used to use anymore.

I think your comment looks good. I liked the part where you mentioned how there would be no additional benefit to turning your son forward-facing. I feel like that is an important point. Even if one doesn't find the argument for rear-facing compelling, there's still no benefit to being forward-facing.

jess71903 said:

I have a question. I posted the GMA link on my FB and one of my (more educated) friends posted this: I just can't force myself to care about this issue. It sounds terrible, but I'm just not compelled. I know they are 5 times safer RFing, but 5 times a small number is still a small number

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5 times is a HUGE number!! Your friend may be educated, but that doesn't mean she can multiply.

Simple math - if Mary makes $20,000 per year income, and her friend Jane makes 5 times as much, then Jane makes $100,000 per year.

I'd rather be Jane. That's a no brainer.

It's also important to note that each individual child's greatest risk of death is in a vehicle accident. That means if your shower is not quite as hot as you'd like it because of burn prevention, you are giving up a hot shower for a smaller likelyhood of death than due to a car wreck, and continuing to RF doesn't involve giving anything up!

My response (in my head anyway) is always the what if. Why would I want to put my child in a proven less safe position if they fit within the guidelines of rear facing? If we were to get into that rare accident, I want to give my child the best chance at surviving it with little to minimal injury. Rear facing does this. I could get into only 1 accident ever with my kids, but that 1 accident could be really bad, like a spin out at 50 mph on a highway into a tree, or side impacted by someone running a red light at 50. THese accidents can cause death, no matter how you are strapped in so why not give your kids the best chance at survival IF it were to happen.

Oh, and if I am even remembering correctly, the statistics were filtered down to only children restrained in actual 5 point harnesses, weren't they? So kids that died because they weren't in seats or buckled at all weren't part of the stats. Am I right in remembering this? It has been a while since I read it

jujumum said:

5 times is a HUGE number!! Your friend may be educated, but that doesn't mean she can multiply.

Simple math - if Mary makes $20,000 per year income, and her friend Jane makes 5 times as much, then Jane makes $100,000 per year.

I'd rather be Jane. That's a no brainer.

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Hmmm... yeah, but it's more like you have a .1% chance of being injured in a crash FF, and a .02% chance of being injured RF (I'm just guessing here, but that's probably not THAT far off). The numbers are just really, really small. And that's mostly in side impacts (the results weren't even statistically significant in frontal crashes, which are much more common, statistically). There's still no reason to FF before you absolutely have to, but the numbers in real life are just almost too small to comprehend.

joolsplus3 said:

Hmmm... yeah, but it's more like you have a .1% chance of being injured in a crash FF, and a .02% chance of being injured RF (I'm just guessing here, but that's probably not THAT far off). The numbers are just really, really small. And that's mostly in side impacts (the results weren't even statistically significant in frontal crashes, which are much more common, statistically). There's still no reason to FF before you absolutely have to, but the numbers in real life are just almost too small to comprehend.

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I'm confused now. I am trying to rf my kids as long as possible because every thing I have read hear says they are so much safer rf than ff. So, they are not 5x safer rf? Just a tiny bit safer, statistically, and the friend of the pp is right?

ETA: I mean 'children involved in car accidents' being 5x safer. Crash probability statistics vs. car seat safety statistics are unrelated in my opinion. The variabilities involved in equating crash probability are so varying (ie. type of vehicle, types of roadways traveled, experience of the driver, driving conditions, trip length, etc. of the vehicle involved vs. typical/national averages) are uncomputable from a data perspective on a case by case basis. All I care about is the performance of the seat in a crash, not the likelyhood of whether or not it will be in a crash. I need to assume the worst case scenario (ie. being involved in a crash) when making car seat decisions.

joolsplus3 said:

Hmmm... yeah, but it's more like you have a .1% chance of being injured in a crash FF, and a .02% chance of being injured RF (I'm just guessing here, but that's probably not THAT far off). The numbers are just really, really small. And that's mostly in side impacts (the results weren't even statistically significant in frontal crashes, which are much more common, statistically). There's still no reason to FF before you absolutely have to, but the numbers in real life are just almost too small to comprehend.

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jujumum said:

I'm confused now. I am trying to rf my kids as long as possible because every thing I have read hear says they are so much safer rf than ff. So, they are not 5x safer rf? Just a tiny bit safer, statistically, and the friend of the pp is right?

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Jools, I'm not quite sure what you mean, either.

Do you mean the odds of BEING in a severe crash are very low? If so, I agree with that. But once you ARE in a severe crash, RF vs FF can make a huge difference, especially for a little kid.

Sorry if I'm missing something really obvious--battling a cold and sleep deprivation.

Most parents can't really understand what "500% safer" means. Some people ask me if that means 5 times as many FF kids die compared to RF kids and that's of course not true. It seems like many are just looking at fatalities which I think is missing the big picture. It's 500% safer to RF compared to FF and that applies to injury rates. But having your son/daughter break a neck counts as an injury and isn't that much fun. Just ask Joel who is miraculously making a great recovery. Injuries while FF are nasty and concern neck and head area, something that really affect life quality.

When I make presentations and speak to parents or soon-to-be parents it's clear it's tough to understand the "500%". Statistically, out of 100 accidents, 92 RF kids will walk away fine and 8 will be seriously injured or die. Looking at FF kids, out of 100 accidents, 60 kids will walk away fine and 40 will be seriously injured or die. That's quite a big difference.

We live in a society where most parents freak out about the least dangerous things. I think traffic safety is important since lots of kids (and adults) die each year. It's the number one killer of kids in some countries which makes it more real.

I guess the risk of being in a crash isn't that huge but who has a choice of when or if to crash? I like keeping kids Rf since it's so easy. Keep your kid RF instead of FF to 4, or as long as you can, and it's extremely unlikely anything will ever happen. Over 1 million RF seats have been used so far in Sweden and so far not one single child has died in a correctly installed seat.

Kids enjoy RF as much as Ff so to me it's just such a simple solution of keeping kids safe in situations which are proven to be among the least safe.

This study might not convince everyone but there is plenty of real life data. Swedes have done Rf since 1965. The amount of data collected is incredible. Volvo, different insurance companies, crash test institutes, Swedish NHTSA, etc have followed progress very closely.

The publication in the British medical journal has gotten people talking all over the world which is a good start. I hope more get interested in RF past 12 months which has proven to be a real life saver.

Adventuredad said:

Statistically, out of 100 accidents, 92 RF kids will walk away fine and 8 will be seriously injured or die. Looking at FF kids, out of 100 accidents, 60 kids will walk away fine and 40 will be seriously injured or die. That's quite a big difference.

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That's a much easier to understand comparison, statistically. But, just being argumentative here, regarding the 40 out of 100 FF kids that are seriously injured or killed, how many are really closer to age 1 and how many closer to age 4.

And another statistic to argue would be the liklihood of actually being part of the 100 accidents. 100 out of how many vehicles on the road are we talking?

My point being, statistics are just numbers. You can make numbers say whatever you want them to say, really. You can use the same statistic and apply it in different ways to argue both sides of the same issue.

Statistics don't convince me. Visuals do... And watching the difference between the FF vs. the RF crash test is enough for me. I don't care what the numbers are.

Mama Jo said:

That's a much easier to understand comparison, statistically. But, just being argumentative here, regarding the 40 out of 100 FF kids that are seriously injured or killed, how many are really closer to age 1 and how many closer to age 4.

And another statistic to argue would be the liklihood of actually being part of the 100 accidents. 100 out of how many vehicles on the road are we talking?

My point being, statistics are just numbers. You can make numbers say whatever you want them to say, really. You can use the same statistic and apply it in different ways to argue both sides of the same issue.

Statistics don't convince me. Visuals do... And watching the difference between the FF vs. the RF crash test is enough for me. I don't care what the numbers are.

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^^Ditto!!!

The fact is, though -- visuals can lie too. Humans are visual people. we believe strongly what we see. But that doesn't mean that what we see is always true.

For example, the very popular Kyle video going around is VERY effective -- but doesn't say anything about whether he should have been FF or RF. If the car seat was installed by the seatbelt, and the seatbelt failed, FF or RF would have made NO difference.