agurlsride
New member
My friend watches a little boy with Downs Syndrome, he currently is riding in a combination seat. he is 4 years old and 24lbs. Should she buy him a new seat and turn him rear-facing or is he ok the way he is?
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Has he had x-rays and other screenings to determine whether he has occipital-cervical spinal junction abonormalities or cervical instability? If he has it, or if he has not been screened, yes, I would turn him rear-facing. Likewise, if he has any difficulty holding his head up or discomfort I would turn him. However, if it has been determined he has no cervical spinal problems, at 4, it depends on what works best for him, her, and his family. At 4 the margin of safety for rear-facing vs. forward-facing is pretty small IF he has no additional risk factors. It's safer for everyone but it's not a "must" at 4 years old, even for a small child, like it is at 1 or 2.
He's not near needing it by weight, and probably not by height yet, but just so you know, cervical spinal instability is very serious, and is one of the few conditions that NHTSA grants waivers for so kids can use higher-weight rear-facing seats from Sweden legally, if he needs it later.
The dilemma with children with Down Syndrome and testing for OC abnormalities is that the test is not accurate until the spinal column is fused and complete at around 6 years old. It is normal for there to be a extra space in the c-spine on all young children. Sometimes the spacing a way more than normal and you can get a positive diagnosis fairly early, but you cannot get a true negative until 5-6 years old.
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